UPSTATE COMMUNITY MEDICAL P C: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
UPSTATE COMMUNITY MEDICAL P C (EIN 20-3889761)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-15
IRS object ID
202301359349318065
Schema version
2021v4.2
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)
Return2023-05-15T17:40:37-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161226221PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FUST CHARLES CHAMBERS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15784 WIDEWATERS PARKWAYAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13214ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN203889761EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UPSTATE COMMUNITY MEDICAL PCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlUPSTBusinessNameControlTxt
Phone3156349272PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14900 BROAD ROAD 1507AddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13215ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAMY TUCKERPersonNm
Person TitleDIRECTORPersonTitleTxt
Phone3154925140PhoneNum
Signature2023-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstAMYPersonFirstNm
Person LastTUCKERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHOMAS J GIUFREPreparerPersonNm
PTINP00841958PTIN
Phone3154463600PhoneNum
Preparation2023-05-15PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerAMY TUCKERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1750 EAST ADAMS STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13215ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$28,116,999GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.UPSTATE.EDU/COMMUNITY/UCM/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2005FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTHE ROLE OF UPSTATE COMMUNITY MEDICAL, P.C. (UCM) IS TO PROVIDE A COMPREHENSIVE SOURCE FOR ACUTE MEDICAL CARE AND RELATED SERVICES TO ADVANCE THE MISSION OF UPSTATE MEDICAL UNIVERSITY OF NEW YORK. UCM WAS FORMED FOR THE CHARITABLE PURPOSE OF SERVING THE HEALTH CARE NEEDS OF THE COMMUNITY SERVICED BY THE HOSPITAL AND ADVANCING THE CHARITABLE PURPOSE OF THE UNIVERSITY.ActivityOrMissionDesc
Voting Members Governing Body1VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee155TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$26,003,580PYProgramServiceRevenueAmt
CY Program Service Revenue$27,538,353CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$676,758PYOtherRevenueAmt
CY Other Revenue$578,646CYOtherRevenueAmt
PY Total Revenue$26,680,338PYTotalRevenueAmt
CY Total Revenue$28,116,999CYTotalRevenueAmt
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$13,330,824PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,788,927CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$13,766,984PYOtherExpensesAmt
CY Other Expenses$14,721,547CYOtherExpensesAmt
PY Total Expenses$27,097,808PYTotalExpensesAmt
CY Total Expenses$28,510,474CYTotalExpensesAmt
PY Revenues Less Expenses-$417,470PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$393,475CYRevenuesLessExpensesAmt
Total Assets BOY$6,542,142TotalAssetsBOYAmt
Total Assets EOY$6,847,097TotalAssetsEOYAmt
Total Liabilities BOY$9,749,228TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,447,658TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$3,207,086NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$3,600,561NetAssetsOrFundBalancesEOYAmt
MissionTHE ROLE OF UPSTATE COMMUNITY MEDICAL, P.C. IS TO PROVIDE A COMPREHENSIVE SOURCE FOR ACUTE MEDICAL CARE AND RELATED SERVICES TO UNINSURED AND UNDERINSURED INDIVIDUALS IN THE COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$6,691,110ExpenseAmt
Revenue$6,670,266RevenueAmt
DescHOSPITALIST SERVICE - PROVIDED ACUTE MEDICAL CARE FOR THE PATIENTS OF UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$4,437,235ExpenseAmt
Revenue$4,337,235RevenueAmt
DescANESTHESIA SERVICE - PROVIDED ANESTHESIA SERVICES FOR THE PATIENTS OF UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$2,977,369ExpenseAmt
Revenue$2,969,041RevenueAmt
DescINTENSIVE CARE UNIT SERVICE - PROVIDED OBGYN HEALTHCARE SERVICS FOR THE PATIENTS OF UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUSDesc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$12,978,463ExpenseAmt
Revenue$14,140,457RevenueAmt
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$12,978,463TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$14,140,457TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$27,084,177TotalProgramServiceExpensesAmt
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 StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
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 Document17IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee155EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
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 Members1GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
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 CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROBERT J CALNONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3154721488PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 W FAYETTE STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13204ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
AMY TUCKER MD
OFFICER2.0040.00Yes (X)Yes (X)$0$517,017$37,774
MARY ELLEN GRACO MD
PHYSICIAN40.00$345,239$0$17,029Yes (X)
ANTHONY M STIRPE
PHYSICIAN ASSISTANT40.00$309,880$0$17,029Yes (X)
KENNETH K RHEE
PHYSICIAN40.00$390,449$0$17,029Yes (X)
ALFREDO LOPEZ MD
PHYSICIAN40.00$320,280$0$17,029Yes (X)
MICHAEL L MCGRATTAN MD
PHYSICIAN40.00$300,815$0$14,322Yes (X)
MATTHEW GLIDDEN
FORMER OFFICER0.0040.00$0$401,980$47,270Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,666,663TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$918,997TotReportableCompRltdOrgAmt
Total Other Compensation$167,482TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K49IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DEPARTMENT OF MEDICINE MEDICAL SERVICE
550 E GENESEE ST SUITE 201SYRACUSENY13202PROFESSIONAL MEDICAL SERVICES$5,754,206
CHAG ANESTHESIA GROUP
5000 BRITTONFIELD PARKWAYEAST SYRACUSENY13057PROFESSIONAL MEDICAL SERVICES$4,167,038
PRACTICE RESOURCES LLC
1001 W FAYETTE STSYRACUSENY13204ADMINISTRATIVE AND BILLING SERVICES$785,584
FINGER LAKES PSYCHIATRIC ASSOCIATION
8401 BREA LEURE RDMANLIUSNY13104PROFESSIONAL MEDICAL SERVICES$408,277
UNIVERSITY OBGYN ASSOCIATES INC
736 IRVING AVE 3 WEST TOWERSYRACUSENY13210PROFESSIONAL MEDICAL SERVICES$343,505
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K10CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PROFESSIONAL SERVICE AGREEMENT -621110$20,041,567$20,041,567
PROFESSIONAL SERVICES621110$7,496,786$7,496,786
FieldValueIRS element (for citing)
Total Program Service Revenue$27,538,353TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$578,646TotalRevenueColumnAmt
Related Or Exempt Func Income$578,646RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$578,646OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,116,999TotalRevenueColumnAmt
Related Or Exempt Func Income$28,116,999RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,778,748TotalAmt
Program Services$11,272,335ProgramServicesAmt
Management And General$506,413ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$377,506TotalAmt
Program Services$305,087ProgramServicesAmt
Management And General$72,419ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$822,292TotalAmt
Program Services$822,292ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$810,381TotalAmt
Program Services$772,940ProgramServicesAmt
Management And General$37,441ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$162,600TotalAmt
Management And General$162,600ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$25,471TotalAmt
Management And General$25,471ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$44,464TotalAmt
Management And General$44,464ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$15,306TotalAmt
Program Services$498ProgramServicesAmt
Management And General$14,808ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$30,099TotalAmt
Management And General$30,099ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$393,664TotalAmt
Program Services$386,739ProgramServicesAmt
Management And General$6,925ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$302,934TotalAmt
Program Services$287,502ProgramServicesAmt
Management And General$15,432ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$161TotalAmt
Program Services$48ProgramServicesAmt
Management And General$113ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$54,087TotalAmt
Program Services$53,018ProgramServicesAmt
Management And General$1,069ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$709,230TotalAmt
Program Services$651,890ProgramServicesAmt
Management And General$57,340ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PURCHASED SERVICES$12,159,769$11,729,724$430,045
BILLING FEES$528,360$528,360
BAD DEBT EXPENSE$226,770$226,770
PERMITS, LICENSES, DUES$36,454$30,734$5,720

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$32,178TotalAmt
Program Services$16,240ProgramServicesAmt
Management And General$15,938ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$28,510,474TotalAmt
Program Services$27,084,177ProgramServicesAmt
Management And General$1,426,297ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$570,476BOYAmt
EOY$852,211EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$397,418BOYAmt
EOY$339,371EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$27,955BOYAmt
EOY$65,151EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$94,395LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$94,395LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$5,546,293BOYAmt
EOY$5,590,364EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,542,142BOYAmt
EOY$6,847,097EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,276,080BOYAmt
EOY$1,307,936EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,473,148BOYAmt
EOY$9,139,722EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,749,228BOYAmt
EOY$10,447,658EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$10BOYAmt
EOY$10EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$90BOYAmt
EOY$90EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY-$3,207,186BOYAmt
EOY-$3,600,661EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$3,207,086BOYAmt
EOY-$3,600,561EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,542,142BOYAmt
EOY$6,847,097EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$393,475ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$250,594CurrentTaxYearMinus2YearsAmt
Total$250,594TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,980,209CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$22,138,125CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$25,668,422CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,003,580CurrentTaxYearMinus1YearAmt
Current Tax Year$27,538,353CurrentTaxYearAmt
Total$120,328,689TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$18,980,209CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$22,138,125CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$25,919,016CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,003,580CurrentTaxYearMinus1YearAmt
Current Tax Year$27,538,353CurrentTaxYearAmt
Total$120,579,283TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$120,579,283PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,487CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$673CurrentTaxYearMinus3YearsAmt
Total$3,160TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,487CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$673CurrentTaxYearMinus3YearsAmt
Total$3,160TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$33,050CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$913,847CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$513,036CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$676,758CurrentTaxYearMinus1YearAmt
Current Tax Year$578,646CurrentTaxYearAmt
Total$2,715,337TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$19,015,746CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$23,052,645CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,432,052CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$26,680,338CurrentTaxYearMinus1YearAmt
Current Tax Year$28,116,999CurrentTaxYearAmt
Total$123,297,780TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.97800PublicSupportCY509Pct
Public Support PY5090.98060PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00010InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$94,395OtherCostOrOtherBasisAmt
Depreciation$94,395DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
DUE FROM UNIVERSITY HOSPITAL$4,791,304
OTHER RECEIVABLES$799,060
FieldValueIRS element (for citing)
Total Book Value Other Assets$5,590,364TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO RELATED PARTIESDesc
Amt$9,139,722Amt
FieldValueIRS element (for citing)
Total Liability$9,139,722TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$27,890,229TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$27,890,229RevenueSubtotalAmt
Other Revenues Not Included$226,770OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$226,770RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$28,116,999TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$28,283,704TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$28,283,704ExpensesSubtotalAmt
Other Expenses Not Included$226,770OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$226,770ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$28,510,474TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE FINANCIAL STATEMENTS DO NOT GIVE CONSIDERATION FOR FEDERAL AND STATE INCOME TAXES AS THE CORPORATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3). AS OF JUNE 30, 2022 AND 2021, THE CORPORATION DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2019 THROUGH 2022.
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 226,770.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 226,770.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Severance Payment0SeverancePaymentInd
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 (7 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
AMY TUCKER MD
OFFICER$0$517,017$0$0$0$0$0$13,524$0$24,250$0$554,791$0$0
MATTHEW GLIDDEN
FORMER OFFICER$0$401,980$0$0$0$0$0$23,020$0$24,250$0$449,250$0$0
KENNETH K RHEE
PHYSICIAN$387,281$0$0$0$3,168$0$11,600$0$5,429$0$407,478$0$0$0
MARY ELLEN GRACO MD
PHYSICIAN$344,127$0$0$0$1,112$0$11,600$0$5,429$0$362,268$0$0$0
ALFREDO LOPEZ MD
PHYSICIAN$318,508$0$0$0$1,772$0$11,600$0$5,429$0$337,309$0$0$0
ANTHONY M STIRPE
PHYSICIAN ASSISTANT$309,476$0$0$0$404$0$11,600$0$5,429$0$326,909$0$0$0
MICHAEL L MCGRATTAN MD
PHYSICIAN$300,500$0$0$0$315$0$11,600$0$2,722$0$315,137$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF FORM 990 WAS DISTRIBUTED FOR REVIEW BEFORE IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12CTHE COMPANY BYLAWS REFLECT THAT THE BOARD ENFORCES A POLICY THAT REQUIRES ALL DIRECTORS, OFFICERS, AND OTHER PERSONS IN A POSITION TO INFLUENCE CORPORATE DECISIONS TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AND THE PROCESS THAT SHALL BE FOLLOWED WHEN A DISCLOSURE IS MADE. ENHANCEMENTS TO THE POLICY CONTINUE TO BE MADE.
FORM 990, PART VI, SECTION B, LINE 15SALARY AND BONUS OR INCENTIVE COMPENSATION IS DETERMINED BASED ON A REVIEW OF RELEVANT MARKET DATA. PERIODIC REVIEWS ARE CONDUCTED AS APPROPRIATE FOR REASONABLENESS, VALUATION, PERFORMANCE, AND COMPLIANCE WITH CONTRACTUAL REQUIREMENTS.
FORM 990, PART VI, SECTION C, LINE 19AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C:THE FINANCE COMMITTEE IS RESPONSIBLE FOR OVERSEEING THE SELECTION OF THE INDEPENDENT ACCOUNTANT.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1SUNY UPSTATE UNIVERSITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1750 E ADAMS STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13210ZIPCd
FieldValueIRS element (for citing)
EIN161469571EIN
Primary ActivitiesPATIENT CAREPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Controlled Organization0ControlledOrganizationInd
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 OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
SUNY UPSTATE UNIVERSITY HOSPITAL
L$20,041,567PROFESSIONAL SERVICES AGREEMENT
SUNY UPSTATE UNIVERSITY HOSPITAL
M$430,045ADMIN SERVICES AGREEMENT

Comments

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