BRADFORD REGIONAL MEDICAL SERVICES: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
BRADFORD REGIONAL MEDICAL SERVICES (EIN 23-2875157)
Tax period
2023-01-01 to 2023-12-31
Filed
2024-11-15
IRS object ID
202443209349305699
Schema version
2023v5.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-11-15T09:30:42-06:00ReturnTs
Tax Period End2023-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN135565207PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1515 BROADWAY 4TH FLOORAddressLine1Txt
CityALBANYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP122072974ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN232875157EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BRADFORD REGIONAL MEDICAL SERVICESBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBRADBusinessNameControlTxt
Phone7163756190PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1515 MAIN STREETAddressLine1Txt
CityOLEANCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14760ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonHUGH CHISHOLMPersonNm
Person TitleCFOPersonTitleTxt
Phone7163756190PhoneNum
Signature2024-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSTEPHANIE LONCZAKPreparerPersonNm
PTINP01880207PTIN
Phone5184274600PhoneNum
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2024-10-15 13:58:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCHERYL KLASSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1515 MAIN STREETAddressLine1Txt
CityOLEANCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14670ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,481,833GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionMULTI-SPECIALTY PHYSICIAN GROUP PRACTICE ORGANIZED TO SERVE PATIENTS IN BRADFORD, PA, AND THE SURROUNDING AREA.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$3,651,352PYProgramServiceRevenueAmt
CY Program Service Revenue$3,464,054CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$77,006PYOtherRevenueAmt
CY Other Revenue$17,779CYOtherRevenueAmt
PY Total Revenue$3,728,358PYTotalRevenueAmt
CY Total Revenue$3,481,833CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,673,465PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,100,363CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,088,726PYOtherExpensesAmt
CY Other Expenses$949,798CYOtherExpensesAmt
PY Total Expenses$5,762,191PYTotalExpensesAmt
CY Total Expenses$6,050,161CYTotalExpensesAmt
PY Revenues Less Expenses-$2,033,833PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$2,568,328CYRevenuesLessExpensesAmt
Total Assets BOY$1,851,254TotalAssetsBOYAmt
Total Assets EOY$967,877TotalAssetsEOYAmt
Total Liabilities BOY$6,809,881TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,494,832TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$4,958,627NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$7,526,955NetAssetsOrFundBalancesEOYAmt
MissionMULTI-SPECIALTY PHYSICIAN GROUP PRACTICE ORGANIZED TO SERVE PATIENTS IN BRADFORD, PA, AND THE SURROUNDING AREA.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,856,102ExpenseAmt
Revenue$3,464,054RevenueAmt
DescMULTI-SPECIALTY PHYSICIAN GROUP PRACTICE ORGANIZED TO SERVE PATIENTS IN BRADFORD, PA, AND THE SURROUNDING AREA.Desc
Total Program Service Expenses$4,856,102TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document11IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TANNYAH M CHAPMANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7163757426PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1515 MAIN STREETAddressLine1Txt
CityOLEANCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14760ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
SHABIR BHAYANI MD
DIRECTOR40.005.50Yes (X)$0$0$0
MARC BOUTILLETTE
DIRECTOR1.005.50Yes (X)$0$0$0
DANIEL DEROSE
BOARD VICE CHAIRMAN1.005.50Yes (X)$0$0$0Yes (X)
LISELLE ESPOSITO
DIRECTOR1.005.50Yes (X)$0$0$0
DAVID FERGUSON
BOARD TREASURER1.005.50Yes (X)$0$0$0Yes (X)
LISA FIORENTINO PHDRN
BOARD SECRETARY1.005.50Yes (X)$0$0$0Yes (X)
MUHAMMED JAVED MD
BOARD CHAIRMAN1.005.50Yes (X)$0$136,667$0Yes (X)
JULIE MARASCO
DIRECTOR1.005.50Yes (X)$0$0$0
ZAFAR MIRZA MD
DIRECTOR AND PHYSICIAN1.0040.00Yes (X)$0$1,205,081$0
DOUGLAS PISANO PHD
DIRECTOR1.005.50Yes (X)$0$0$0
ANIL PRADHAN MD
DIRECTOR1.005.50Yes (X)$0$0$0
DAVID PRINCE
DIRECTOR1.005.50Yes (X)$0$0$0
GILBERT WITTE MD
DIRECTOR1.005.50Yes (X)$0$0$0
RICHARD ESCH
DIRECTOR (AS OF 06/2023)1.005.50Yes (X)$0$0$0
PAUL RIDLEY
DIRECTOR (UNTIL 06/2023)1.005.50Yes (X)$0$0$0
JEFF BELT
BOARD CHAIRMAN (UNTIL 04/2023)1.005.50Yes (X)$0$0$0
LUIS GONZALEZ MD
MEDICAL STAFF PRESIDENT40.005.50$0$661,166$4,049Yes (X)
JILL OWENS
PRESIDENT & CEO1.0040.00$0$420,884$25,210Yes (X)
SCOTT BONDEROFF
COO (AS OF 04/2023)1.0040.00$0$206,012$17,416Yes (X)
JENNIFER RUGGLES
CNO (AS OF 04/2023)1.0040.00$0$202,259$40,596Yes (X)
DAVID MONROE
CHIEF ADMIN OFFICER1.0040.00$0$151,796$35,564Yes (X)
P HENRI LAMOTHE
VP - MEDICAL AFFAIRS1.0040.00$0$303,562$21,608Yes (X)
LESLEY ZUREK
VP - HUMAN RES. (AS OF 01/2023)1.0040.00$0$139,798$2,643Yes (X)
LAURIE DUNN
CNO (UNTIL 04/2023)1.0040.00$0$85,680$3,377Yes (X)
RICHARD G BRAUN JR
FORMER COO0.000.00$0$111,538$60Yes (X)
JEFFREY S ZEWE
FORMER PRESIDENT & CEO0.000.00$0$214,696$84Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,839,139TotReportableCompRltdOrgAmt
Total Other Compensation$150,607TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHANGE HEALTHCARE LLCBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line15995 WINDWARD PKWYAddressLine1Txt
CityALPHARETTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30005ZIPCd
FieldValueIRS element (for citing)
ServicesBILLING SERVICESServicesDesc
Compensation$109,126CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUDesc
Business621990BusinessCd
Total Revenue Column$3,464,054TotalRevenueColumnAmt
Related Or Exempt Func Income$3,464,054RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$3,464,054TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$2,800RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$2,800RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,800TotalRevenueColumnAmt
Exclusion$2,800ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHERDesc
Business900099BusinessCd
Total Revenue Column$14,979TotalRevenueColumnAmt
Exclusion$14,979ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$14,979OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,481,833TotalRevenueColumnAmt
Related Or Exempt Func Income$3,464,054RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$17,779ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,583,181TotalAmt
Program Services$3,590,684ProgramServicesAmt
Management And General$992,497ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$376,463TotalAmt
Program Services$271,053ProgramServicesAmt
Management And General$105,410ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$140,719TotalAmt
Program Services$101,318ProgramServicesAmt
Management And General$39,401ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$6,339TotalAmt
Management And General$6,339ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$255,450TotalAmt
Program Services$242,185ProgramServicesAmt
Management And General$13,265ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$203,273TotalAmt
Program Services$203,273ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$9,734TotalAmt
Program Services$9,734ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$4,637TotalAmt
Program Services$4,637ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$61,267TotalAmt
Program Services$61,267ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$106,261TotalAmt
Program Services$106,261ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$270,751$265,690$5,061
OTHER$32,086$32,086

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,050,161TotalAmt
Program Services$4,856,102ProgramServicesAmt
Management And General$1,194,059ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$632,502BOYAmt
EOY$62,214EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$181,269BOYAmt
EOY-$34,333EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$83,333BOYAmt
EOY$16,667EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$41,564BOYAmt
EOY$69,705EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,016,819LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$398,195LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$677,586BOYAmt
EOY$618,624EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$235,000BOYAmt
EOY$235,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,851,254BOYAmt
EOY$967,877EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$591,250BOYAmt
EOY$714,592EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$147,491BOYAmt
EOY$37,751EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,071,140BOYAmt
EOY$7,742,489EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,809,881BOYAmt
EOY$8,494,832EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$4,958,627BOYAmt
EOY-$7,526,955EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$4,958,627BOYAmt
EOY-$7,526,955EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,851,254BOYAmt
EOY$967,877EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$2,568,328ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$850,000OtherCostOrOtherBasisAmt
Depreciation$285,633DepreciationAmt
Book Value$564,367BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$166,819OtherCostOrOtherBasisAmt
Depreciation$112,562DepreciationAmt
Book Value$54,257BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$618,624TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescGOODWILLDesc
Book Value$235,000BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$235,000TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATESDesc
Amt$7,742,489Amt
FieldValueIRS element (for citing)
Total Liability$7,742,489TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationFIN 48 FOOTNOTE FORM 990 KALEIDA AND SUBSTANTIALLY ALL OF ITS AFFILIATES HAVE BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE ORGANIZATIONS DESCRIBED IN INTERNAL REVENUE CODE (THE CODE) SECTION 501(C)(3) AND, THEREFORE, ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. KALEIDA RECOGNIZES INCOME TAX POSITIONS WHEN IT IS MORE-LIKELY THAN-NOT THAT THE POSITION WILL BE SUSTAINABLE BASED ON THE MERITS OF THE POSITION. MANAGEMENT HAS CONCLUDED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT NEED TO BE RECORDED.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ZAFAR MIRZA MD
DIRECTOR AND PHYSICIAN$0$1,205,081$0$0$0$0$0$0$0$0$0$1,205,081$0$0
LUIS GONZALEZ MD
MEDICAL STAFF PRESIDENT$0$661,166$0$0$0$0$0$0$0$4,049$0$665,215$0$0
JILL OWENS
PRESIDENT & CEO$0$395,386$0$0$0$25,498$0$8,699$0$16,511$0$446,094$0$0
P HENRI LAMOTHE
VP - MEDICAL AFFAIRS$0$303,562$0$0$0$0$0$462$0$21,146$0$325,170$0$0
JENNIFER RUGGLES
CNO (AS OF 04/2023)$0$162,782$0$39,477$0$0$0$7,986$0$32,610$0$242,855$0$0
SCOTT BONDEROFF
COO (AS OF 04/2023)$0$196,012$0$10,000$0$0$0$0$0$17,416$0$223,428$0$0
JEFFREY S ZEWE
FORMER PRESIDENT & CEO$0$0$0$0$0$214,696$0$0$0$84$0$214,780$0$0
DAVID MONROE
CHIEF ADMIN OFFICER$0$151,796$0$0$0$0$0$8,139$0$27,425$0$187,360$0$0
RICHARD G BRAUN JR
FORMER COO$0$0$0$0$0$111,538$0$0$0$60$0$111,598$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4AFormAndLineReferenceDesc
ExplanationTHE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAYMENTS. THESE AMOUNTS ARE REPORTED IN SCHEDULE J, PART II, COLUMN (III). - RICHARD G. BRAUN, JR. - $111,538 - JEFFREY ZEWE - $214,696ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6ARTICLE III OF THE BRADFORD REGIONAL MEDICAL SERVICES (BRMS) BYLAWS DISCUSSES THE ORGANIZATION'S BOARD OF DIRECTORS. OLEAN GENERAL HOSPITAL BECAME THE MEMBER OF BRMS WHEN BRMC, ITS FORMER SOLE MEMBER, WAS MERGED INTO OGH ON JANUARY 12, 2018.
FORM 990, PART VI, SECTION A, LINE 7ATHE BOARD SHALL CONSIST OF VOTING DIRECTORS APPOINTED BY OLEAN GENERAL HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7BALL POWERS OF THE CORPORATION SHALL BE EXERCISED BY AND UNDER THE AUTHORITY OF THE BOARD OF DIRECTORS, HEREINAFTER REFERRED TO AS THE "BOARD AND THE BUSINESS, PROPERTY AND AFFAIRS OF THE CORPORATION SHALL BE MANAGED UNDER THE BOARD'S DIRECTION. PROVIDED, HOWEVER, THAT THE BOARD SHALL OBTAIN THE APPROVAL OF OLEAN GENERAL HOSPITAL (OGH) BEFORE ACTION ON ANY OF THE FOLLOWING MATTERS BECOMES FINAL AND EFFECTIVE: 1, AMENDMENT OF THE ARTICLES OF INCORPORATION OF THIS CORPORATION OR THESE BYLAWS; 2. THE SALE, LEASE OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL THE PROPERTY OR ASSETS OF THIS CORPORATION; 3. MERGER OR CONSOLIDATION WITH ANY OTHER CORPORATION; 4. DISSOLUTION OF THIS CORPORATION; 5. APPROVAL OF AN ANNUAL BUDGET FOR THIS CORPORATION; 6. ANY TRANSFER OF FUNDS BY GRANT, GIFT, OR LOAN FROM THIS CORPORATION; 7. ANY OTHER MATTER THAT BY LAW WOULD REQUIRE THE APPROVAL OF BRMC.
FORM 990, PART VI, SECTION B, LINE 11BA DRAFT COPY OF THE FORM 990 IS REVIEWED FOR ACCURACY AND COMPLETENESS BY THE UAHS CHIEF FINANCIAL OFFICER AND OTHER SENIOR MANAGEMENT OF THE UPPER ALLEGHENY HEALTH SYSTEM. A DRAFT COPY OF THE FORM 990 IS THEN PROVIDED TO MEMBERS OF THE BOARD OF DIRECTORS TO REVIEW AND COMMENT PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY IS PERIODICALLY REVIEWED, AND EACH MEMBER OF THE BOARD COMPLETES A DISCLOSURE FORM.
FORM 990, PART VI, SECTION B, LINE 15FORM 990, PART VI, LINE 15A AND 15B ARE CHECKED NO BECAUSE THE ORGANIZATION DOES NOT COMPENSATE ITS PRESIDENT. THE SALARY FOR THE PRESIDENT AND OTHER OFFICERS IS DETERMINED AND PAID FOR BY RELATED ORGANIZATIONS. THE PROCESS FOR COMPENSATION SETTING BY THE RELATED ORGANIZATIONS IS AS FOLLOWS: ON A REGULAR BASIS, THE ORGANIZATION PROVIDES DOCUMENTATION TO THE COMPENSATION COMMITTEE OF THE BOARD WITH RESPECT TO THE COMPENSATION OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES FOR REVIEW AND APPROVAL. SUCH INFORMATION IS COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT AND INCLUDES COMPARABLE DATA FROM SIMILAR SIZE TAX-EXEMPT ORGANIZATIONS IN THE WESTERN NEW YORK COMMUNITY AS WELL AS COMPENSATION FOR THESE POSITIONS (AS DISCLOSED ON FORM 990) WITH OTHER ORGANIZATIONS IN THE HEALTH CARE INDUSTRY THAT ARE OF SIMILAR SIZE, DEMOGRAPHICS AND GEOGRAPHY. REVIEW AND APPROVAL OF THE COMPENSATION ARRANGEMENT BY THE COMPENSATION COMMITTEE IS DOCUMENTED.
FORM 990, PART VI, SECTION C, LINE 19BRADFORD REGIONAL MEDICAL SERVICES' FORM 990, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST, FOR A LEGITIMATE BUSINESS PURPOSE (AS DETERMINED BY TOP MANAGEMENT), DOCUMENTS MAY BE VIEWED AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
KALEIDA HEALTH
726 EXCHANGE STREET SUITE 200BUFFALONY14210161533232HOSPITALNY501(C)(3)3N/A0
MILLARD FILLMORE AMBULATORY SURG CENTER
726 EXCHANGE STREET SUITE 200BUFFALONY12410161307129SUPPORT ORGNY501(C)(3)12A0KH
VNA HOME CARE SERVICES
726 EXCHANGE STREET SUITE 200BUFFALONY14210161491203HOME HLTHCARENY501(C)(3)100KH
VNA OF WESTERN NEW YORK
726 EXCHANGE STREET SUITE 200BUFFALONY14210160743214HOME HLTHCARENY501(C)(3)100KH
VISK INC
726 EXCHANGE STREET SUITE 200BUFFALONY14210222738425SUPPORT ORGNY501(C)(3)100KH
THE CHILDREN'S HOSPITAL OF BUFFALO FOUNDATION
726 EXCHANGE STREET SUITE 200BUFFALONY14210161332044FUNDRAISINGNY501(C)(3)70KH
KALEIDA HEALTH FOUNDATION
726 EXCHANGE STREET SUITE 200BUFFALONY14210161579143FUNDRAISINGNY501(C)(3)70KH
UPPER ALLEGHENY HEALTH SYSTEM INC
515 MAIN STREETOLEANNY14760271255425SUPPORT ORGNY501(C)(3)12A0KH
OLEAN GENERAL HOSPITAL
515 MAIN STREETOLEANNY14760160743102HOSPITALNY501(C)(3)30UAHS
HEALTH SYSTEM PHYSICIAN PC
130 SOUTH UNION STOLEANNY14760232875157PHYS. GROUPNY501(C)(3)100OGH
CHILDREN'S HEALTH HOME OF WNY INC
726 EXCHANGE STREET SUITE 200BUFFALONY14210814086046PED HOME HEALTHNY501(C)(3)100KH

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
HARLEM ROAD LEASING LLC
3435 MAIN STREETBUFFALONY14214205588135EQUIPMENT LEASINGNYKALEIDA HEALTH00
AMTON IMAGING LLC
199 PARK CLUB LANE SUITE 300WILLIAMSVILLENY14221262925470HEALTH CARENYKALEIDA WNYI00
SITE E LLC
726 EXCHANGE STREET SUITE 200BUFFALONY14210272124795REAL ESTATE MGMTNYKPI00
SOUTHTOWNS IMAGING LLC
5959 BIG TREE ROAD SUITE 105ORCHARD PARKNY14127471123230EQUIPMENT LEASINGNYKALEIDA WNYI00
COLLABORATIVE CARE VENTURES L
726 EXCHANGE STREET SUITE 200BUFFALONY14210472365690HEALTH CARENYKALEIDA HEALTH00
GREAT LAKES MED BILLING SVCS
199 PARK CLUB LANEWILLIAMSVILLENY14221461668448MEDICAL BILLINGNYKALEIDA WNYI00
SOUTHTOWNS SURGERY CENTER LLC
726 EXCHANGE STREET SUITE 200BUFFALONY14210464742028HEALTH CARENYKALEIDA HEALTH00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
BRADFORD HEALTH ENTERPRISES
116-156 INTERSTATE PARKWAYBRADFORDPA16701251591420INVESTMENTSPAOLEAN GENERAL HOSPITALC0
KALEIDA PROPERTIES INC
726 EXCHANGE STREET SUITE 200BUFFALONY14210222738483PROP MGMT SERNYC0N/A
WESTLINK CORPORATION
726 EXCHANGE STREET SUITE 200BUFFALONY14210161354421MED & DIAG SVNYC0N/A
KHBC INC
726 EXCHANGE STREET SUITE 200BUFFALONY14210462164089HEALTH CARENYC0N/A
GREAT LAKES INTEGRATED NETWORK INC
726 EXCHANGE STREET SUITE 200BUFFALONY14210823184375HEALTH CARENYC0N/A
OLEAN MEDICAL PRACTICE PLLC
726 EXCHANGE STREET SUITE 515BUFFALONY14210881324896HEALTH CARENYC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.