ST JAMES HOSPITAL: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: ST JAMES HOSPITAL (EIN 16-0743310)
Tax period: 2020-07-01 to 2021-06-30
Filed: 2022-05-11
IRS object ID: 202241319349305399
Schema version: 2020v4.0
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-05-11T13:49:37-07:00	ReturnTs
Tax Period End	2021-06-30	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-07-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	160743310	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ST JAMES HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	STJA	BusinessNameControlTxt
Phone	6073248110	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7329 Seneca Road North	AddressLine1Txt
City	Hornell	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14843	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Jim Wright	PersonNm
Person Title	Interim CFO	PersonTitleTxt
Phone	5853701815	PhoneNum
Signature	2022-05-11	SignatureDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	1	TrustedCustomerCd
OOB Security Verification	11	OOBSecurityVerificationCd
Last Submission Rqr OOB	0	LastSubmissionRqrOOBCd
Authentication Assurance Level	AAL2	AuthenticationAssuranceLevelCd
Profile Password Change	Yes (X)	ProfilePasswordChangeInd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	James Wright	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7329 Seneca Road North	AddressLine1Txt
City	Hornell	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14807	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$52,945,961	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	https://www.urmc.rochester.edu/st-james	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1921	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	SEE SCHEDULE O.	ActivityOrMissionDesc
Voting Members Governing Body	13	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	449	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$6,023,372	PYContributionsGrantsAmt
CY Contributions Grants	$12,952,596	CYContributionsGrantsAmt
PY Program Service Revenue	$13,970,178	PYProgramServiceRevenueAmt
CY Program Service Revenue	$38,612,959	CYProgramServiceRevenueAmt
PY Investment Income	$11,743	PYInvestmentIncomeAmt
CY Investment Income	$190,799	CYInvestmentIncomeAmt
PY Other Revenue	$842,514	PYOtherRevenueAmt
CY Other Revenue	$1,189,607	CYOtherRevenueAmt
PY Total Revenue	$20,847,807	PYTotalRevenueAmt
CY Total Revenue	$52,945,961	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$9,221,344	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$19,334,124	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$11,347,388	PYOtherExpensesAmt
CY Other Expenses	$26,011,147	CYOtherExpensesAmt
PY Total Expenses	$20,568,732	PYTotalExpensesAmt
CY Total Expenses	$45,345,271	CYTotalExpensesAmt
PY Revenues Less Expenses	$279,075	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$7,600,690	CYRevenuesLessExpensesAmt
Total Assets BOY	$107,500,975	TotalAssetsBOYAmt
Total Assets EOY	$102,328,620	TotalAssetsEOYAmt
Total Liabilities BOY	$46,883,707	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$34,064,785	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$60,617,268	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$68,263,835	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	See Schedule O for Part I, Line 1	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$34,525,464	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$39,993,365	RevenueAmt
Desc	ST. JAMES HOSPITAL IS AN ACUTE HEALTHCARE FACILITY PROVIDING ROUTINE, AMBULATORY AND ANCILLARY SERVICES. MAJOR SERVICES INCLUDE MEDICAL, SURGICAL, RADIOLOGY, AND LABORATORY. TOTAL ACUTE DISCHARGES FOR THE HOSPITAL WERE 718. OUTPATIENT REGISTRATIONS FOR THE HOSPITAL WERE 185,490. ST. JAMES HOSPITAL OPERATES SEVERAL PHYSICIAN PRACTICES. TOTAL OFFICE VISITS WERE 32,517, INCLUDING URGENT CARE.	Desc
Total Other Prog Srvc Expense	$0	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$0	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$0	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$34,525,464	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (1)	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	Yes (1)	OperateHospitalInd
Audited Financial Stmt Att	Yes (1)	AuditedFinancialStmtAttInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	Yes (1)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (1)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	110	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	449	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	13	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	James Helms	PersonNm
Phone	6072472250	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7329 Seneca Road North	AddressLine1Txt
City	Hornell	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14843	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	OfficerOfficerInd
Steve Goldstein
Board Member	1	72.00	Yes (X)	$0	$1,352,695	$336,816
Michael Kamali MD
Board Member	1	55	Yes (X)	$0	$608,375	$48,427
John Robshaw
Physician	40	0		$451,490	$0	$33,556	Yes (X)
Ismail Mehr MD
Board Member	40	0	Yes (X)	$468,463	$0	$0
Aileen Shinaman
Board Member	1	55	Yes (X)	$0	$350,847	$96,961
Shane Varghese
Physician	40	0		$276,661	$0	$9,514	Yes (X)
Sachin Manthuruthil
Physician Assistant	40	0		$272,445	$0	$9,451	Yes (X)
Giacomo Floria
Chief Advanced Practice Provider	40	0		$215,258	$0	$23,554	Yes (X)
Curtis Wininger
Physician Assistant	36	0		$209,944	$0	$14,467	Yes (X)
Bryan O'Donovan
President/CEO	55	0		$200,387	$0	$11,087		Yes (X)
James Helms
CFP/ VP of Finance	30	30		$0	$183,798	$11,379		Yes (X)
Spencer Annabel MD
Board Member	1	0	Yes (X)	$0	$0	$0
Skip Sullivan
Board Member	1	0	Yes (X)	$0	$0	$0
Shawn Hogan
Chair	1	0	Yes (X)	$0	$0	$0
Greg Sammons
Board Member	1	0	Yes (X)	$0	$0	$0
Nick Kelley
Board Member	1	0	Yes (X)	$0	$0	$0
Susan Gray
Board Member	1	0	Yes (X)	$0	$0	$0
Brian Schu
Secretary	1	0	Yes (X)	$0	$0	$0
Pete Wall
Vice Chair	1	0	Yes (X)	$0	$0	$0
John Weyand DC
Treasurer	1	0	Yes (X)	$0	$0	$0

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,094,648	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,495,715	TotReportableCompRltdOrgAmt
Total Other Compensation	$595,212	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	10	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt	Address Line2ContractorAddress/USAddress/AddressLine2Txt
Abadan Medical PPLC
325 Cleveland Avenue	Hornell	NY	14843	Contract Physician	$468,463
Asif Ali Khan
47 Angels Path	Webster	NY	14580	Contract Physician	$326,885
Comphealth Medical Staffing
PO Box 972670	Dallas	TX	75397	Nursing Staffing	$241,329
Trusted Nurse Staffing LLC
Buffalo Station	Buffalo	NY	14240	Nurse Staffing	$225,516	1200 William Streetq
Medical Solutions LLC
PO Box 310737	DeMoines	IA	50331	Nurse Staffing	$176,497

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	11	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$0	RelatedOrganizationsAmt
Government Grants	$12,952,596	GovernmentGrantsAmt
All Other Contributions	$0	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$12,952,596	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	Net Patient Revenue	Desc
Business	621990	BusinessCd
Total Revenue Column	$38,612,959	TotalRevenueColumnAmt
Related Or Exempt Func Income	$38,612,959	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$38,612,959	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$190,799	TotalRevenueColumnAmt
Related Or Exempt Func Income	$190,799	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Field	Value	IRS element (for citing)
Contri Rpt Fundraising Event	$0	ContriRptFundraisingEventAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Lifeline Revenue	900099	$12,191	$12,191	$0	$0
URMC Revenue	900099	$677,727	$677,727	$0	$0

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$499,689	TotalRevenueColumnAmt
Related Or Exempt Func Income	$499,689	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,189,607	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$52,945,961	TotalRevenueColumnAmt
Related Or Exempt Func Income	$39,993,365	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$519,860	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$519,860	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$15,036,829	TotalAmt
Program Services	$11,228,187	ProgramServicesAmt
Management And General	$3,808,642	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$282,728	TotalAmt
Program Services	$202,534	ProgramServicesAmt
Management And General	$80,194	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,408,026	TotalAmt
Program Services	$1,725,005	ProgramServicesAmt
Management And General	$683,021	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,086,681	TotalAmt
Program Services	$778,451	ProgramServicesAmt
Management And General	$308,230	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$47,178	TotalAmt
Program Services	$2,041	ProgramServicesAmt
Management And General	$45,137	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$102,353	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$102,353	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$146,755	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$146,755	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$322,894	TotalAmt
Program Services	$63,327	ProgramServicesAmt
Management And General	$259,567	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$687,588	TotalAmt
Program Services	$294,564	ProgramServicesAmt
Management And General	$393,024	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$368,358	TotalAmt
Program Services	$171,397	ProgramServicesAmt
Management And General	$196,961	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$4,193,097	TotalAmt
Program Services	$1,951,047	ProgramServicesAmt
Management And General	$2,242,050	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$256,839	TotalAmt
Program Services	$119,507	ProgramServicesAmt
Management And General	$137,332	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Physician Fees	$7,295,252	$7,295,252	$0	$0
Medical Supplies	$4,975,229	$4,975,229	$0	$0
Purchased Services	$5,200,409	$4,092,476	$1,107,933	$0
Equipment Rental	$1,631,892	$1,415,482	$216,410	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$783,303	TotalAmt
Program Services	$210,965	ProgramServicesAmt
Management And General	$572,338	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$45,345,271	TotalAmt
Program Services	$34,525,464	ProgramServicesAmt
Management And General	$10,819,807	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$11,477,904	BOYAmt
EOY	$11,404,429	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$17,042	BOYAmt
EOY	$17,292	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$4,850,610	BOYAmt
EOY	$1,002,304	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,071,305	BOYAmt
EOY	$5,095,005	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$5,441,600	BOYAmt
EOY	$5,441,600	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$1,175,184	BOYAmt
EOY	$1,224,712	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$285,033	BOYAmt
EOY	$400,271	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$68,734,399	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$6,869,104	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$63,696,108	BOYAmt
EOY	$61,865,295	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$17,486,189	BOYAmt
EOY	$15,877,712	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$107,500,975	BOYAmt
EOY	$102,328,620	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$14,423,181	BOYAmt
EOY	$8,779,355	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$10,430,457	BOYAmt
EOY	$9,617,273	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$22,030,069	BOYAmt
EOY	$15,668,157	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$46,883,707	BOYAmt
EOY	$34,064,785	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$58,987,651	BOYAmt
EOY	$66,588,340	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,629,617	BOYAmt
EOY	$1,675,495	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$60,617,268	BOYAmt
EOY	$68,263,835	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$107,500,975	BOYAmt
EOY	$102,328,620	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$7,600,690	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$0	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Investment Expense	$0	InvestmentExpenseAmt
Prior Period Adjustments	$0	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$45,877	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$26,366	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$26,366	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$26,366	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$26,366	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$26,366	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$26,366	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$27,732	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	-$1,366	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$26,366	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$27,732	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$27,732	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	1	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$950,912	OtherCostOrOtherBasisAmt
Book Value	$950,912	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$53,222,896	OtherCostOrOtherBasisAmt
Depreciation	$3,008,912	DepreciationAmt
Book Value	$50,213,984	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$136,058	OtherCostOrOtherBasisAmt
Depreciation	$137,239	DepreciationAmt
Book Value	-$1,181	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$12,560,267	OtherCostOrOtherBasisAmt
Depreciation	$3,722,953	DepreciationAmt
Book Value	$8,837,314	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$1,864,266	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$1,864,266	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$61,865,295	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
Right to use Asset	$10,330,119
Due from Third Parties	$3,496,205
Other Misc Assets	$2,051,388

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$15,877,712	TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Due to Third Parties	$3,099,494
Legal/Insurance Liability	$318,878
Right to Use Liability	$11,140,376
Other Liabilities	$1,109,409

Field	Value	IRS element (for citing)
Total Liability	$15,668,157	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule D, Part V, Line 4

With the help of nearly 350 community members, business partners, employees, providers, and friends and donors like you, SJ Foundation raises charitable gifts to make possible a range of facilities improvements, capital equipment and program initiatives.

Schedule D, Part X, Line 2

Income Taxes - The hospital and the Foundation are non-for-profit corporations described in Section 501(c)(3) of the Internal Revenue Code (Code) and is exempt from federal, state and local income taxes on related income pursuant to Section 501(a) of the Code. The hospital and the Foundation have also been classified by the Internal Revenue Service as a corporation that is not a private foundation. HMV is considered a for-profit entity and subject to New York State and Federal income taxes. AS of June 30, 2021 the Hospital does not have a liability for unrecognized tax positions. The Hospital files informational tax returns in the U. S. federal jurisdiction and New York State.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (1)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (1)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (1)	ExpensesExceedBudgetInd
Unable To Provide Care	0	UnableToProvideCareInd
Annual Community Bnft Report	0	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$502,095	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$819,954	DirectOffsettingRevenueAmt
Net Community Benefit Expns	-$317,859	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$9,777,383	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,321,711	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,455,672	NetCommunityBenefitExpnsAmt
Total Expense	0.0762	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$10,279,478	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,141,665	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,137,813	NetCommunityBenefitExpnsAmt
Total Expense	0.0762	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$48,029	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$48,029	NetCommunityBenefitExpnsAmt
Total Expense	0.0011	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$41,028	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$41,028	NetCommunityBenefitExpnsAmt
Total Expense	0.0009	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$18,151	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$18,151	NetCommunityBenefitExpnsAmt
Total Expense	0.0004	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$107,208	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$107,208	NetCommunityBenefitExpnsAmt
Total Expense	0.0024	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$10,386,686	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,141,665	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,245,021	NetCommunityBenefitExpnsAmt
Total Expense	0.0786	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$666,339	BadDebtExpenseAmt
Bad Debt Expense Attributable	$204	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$6,450,953	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$7,396,073	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$945,120	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (1)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (1)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	St James Hospital	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	411 Canisteo Street	AddressLine1Txt
City	Hornell	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14843	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.urmc.rochester.edu/st-james	WebsiteAddressTxt
State License	5002001H	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	St James Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (1)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (1)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (1)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (1)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	See Supplemental Information	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	See Supplemental Information	OtherWebsiteURLTxt
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	See Supplemental Information	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
Organization Incur Excise Tax	0	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (1)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	See Supplemental Information	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	See Supplemental Information	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	See Supplemental Information	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr Prvt	Yes (X)	LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	0	GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5-St James Hospital	THE COMMUNITY NEEDS ASSESSMENT (CHNA) WAS CONDUCTED IN 2018 IN COLLABORATION WITH STEUBEN COUNTY PUBLIC HEALTH. THIS INCLUDED THE THREE HOSPITALS LOCATED WITHIN THE COUNTY. A VARIETY OF PARTNERS WERE ENGAGED THROUGHOUT THE PROCESS INCLUDING REPRESENTATIVES FROM LOCAL FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS). COMMUNITY BAESD ORGANIZATIONS (CBOS). THE COUNTY LEGISLATURE, COUNTY GOVERNMENT EMPLOYEES, SCHOOL DISTRICT REPRESENTATIVES, OFFICE FOR HTE AGIN, AND MORE. THE COMMUNITY AT LARGE WAS ENGAGED THROUGHOUT THE ASSESSMENT PERIOD VIA A REGIONAL HEALTH SURVEY IN 2018 (MY HEALTH STORY 2019) AND FOCUS GROUPS. A FULL LIST OF PARTICIPANTS CAN BE FOUND INT HE COMMUNITY SERVICE PLAN LOCATED ON THE ST JAMES HOSPITAL WEBSITE.
Schedule H, Part V, Section B, Line 6a-St James Hospital	ARNOT HEALTH- IRA DAVENPORT MEMORIAL HOSPITAL, GUTHRIE CORNING HOSPITAL, ST. JAMES HOSPITAL
Schedule H, Part V, Section B, Line 6b-St James Hospital	CENTER FOR COMMUNITY HEALTH AND PREVENTION, CENTER FOR TOBACCO FREE FINGER LAKES, FINGER LAKES COMMUNITY HEALTH, OAK OARCHARD HEALTH, PREGNANCY RESOURCE CENTER OF HTE VALLEY, PROACTION, SEUBEN COUNTY ALCOHOL AND SUBSTANCE ABUSE SERVICES/MENTAL HEALTH, STEUBEN COUNTY PUBLIC HEALTH STEUBEN RURLA HEALTH NETWORK, STTAC
Schedule H, Part V, Section B, Line 7a-St James Hospital	https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/st-james/images/Steuben-CHA-and-CHIP-2019-2021.pdf
Schedule H, Part V, Section B, Line 7b-St James Hospital	https://www.steubencountyny.gov/Files/Documents/publichealth/Steuben%20County%20CHIP%20Chart%20-%20120319.pdf
Schedule H, Part V, Section B, Line 10a-St James Hospital	https://www.urmc.rochester.edu/pay-bill/financial-assistance.aspx
Schedule H, Part V, Section B, Line 11-St James Hospital	PRIORITY: PREVENT CHRONIC DISEASES - FOCUS AREA - TOBACCO PREVENTION - INTERVENTION - ASSIST MEDICAL AND BEHAVIORAL, HEALTH CARE ORGANIZATIONS AND PROVIDER GROUPS IN ESTABLISHING POLICIES, PROCEDURES, AND WORKFLOWS TO FACILITATE THE DELIVERY OF TOBACCO DEPENDENCE TREATMENT, CONSISTENT WITH THE PUBLIC HEALTH SERVICE CLINICAL PRACTICE GUIDELINES, COMMUNITY HEALTH CENTERS AND BEHAVIORAL HEALTH PROVIDERS: ST JAMES HOSPITAL AND ST JAMES PRIMARY CARE ASSESS PATIENTS FOR TOBACCO USE AND PROVIDE TOBACCO CESSATION EDUCATION AND ALSO REFER PATIENTS TO NY QUITS IF PATIENTS AGREEABLE. TREATMENT OPTIONS ARE DISCUSSED AND OFFERED TO PATIENT, FOCUS AREAS - PREVENT MENTAL & SUBSTANCE USE DISORDERS - INTERVENTION - BUILD SUPPORT SYSTEMS TO CARE FOR OPIOD USERS OR AT RISK OF AN OVERDOSE. ST JAMES HOSPITAL IS LINKING ED PROVIDERS WITH I-STOP. SJH IS WORKING WITH CASA TRINITY TO IDENTIFY PATIENTS WITH SUBSTANCE ABUSE CONCERNS WHETHER NEW OR CHRONIC. SJH REACHES OUT TO CASA'S CASE WORKERS WHO COME DIRECTLY ON-SITE AT THE HOSPITAL TO GET THEM LINKED WITH THEIR PROGRAM, (EITHER INPATIENT OR OUTPATIENT). IF THE PATIENT IS IN WITHDRAWAL AT THE TIME OF ARRIVAL TO SJH, THEY ARE ADMITTED AND PROVIDED CARE TO SAFELY GET THROUGH THE ACTIVE DETOX/WITHDRWAWL PHASE. THEY ARE LINKED WITH CASA FROM THE TIME THEY ARRIVE. ALSO PROVIDE EDUCATION AND TRAINING TO ED PROVIDERS FOR OPIATE PRESCRIBING, INTERVENTION- PREVENT SUICIDES - IDENTIFY AND SUPPORT PEOPLE AT RISK: GATEKEEPER TRAINING, CRISIS INTERVENTION, TREATMENT FOR PEOPLE AT RISK OF SUICIDE, TREATMENT TO PREVENT RE-ATTEMPTS, POSTVENTION, SAFE REPORTING AND MESSAGING ABOUT SUICIDE. SJH'S PSYCHIATRIC ASSESSMENT OFFICES (pao) IS LOCATED IN THE EMERGENCY DEPARTMENT. THE PAO CONNECTS MENTAL HEALTH PATIENTS AND SUBSTANCE ABUSE PATIENTS WITH COMMUNITY RESOURCES. THE PAO WORKS WITH A TELEPHYCH - PSYCHIATRIST TO IDENTIFY THE NEED FOR INPATIENT TREATMENTS AS WELL. THIS HELPS TO KEEP PATIENTS WIHIN THEIR OWN COMMUNITY AND NOT TO TRAVEL OUTSIDE THE COMMUNITY UNLESS THE NEED FOR FURTHER SERVICES IS AVAILABLE.
Schedule H, Part V, Section B, Line 16a-St James Hospital	https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/st-james/images/SJMH-Charity-Care-Summary.pdf
Schedule H, Part V, Section B, Line 16b-St James Hospital	https://www.urmc.rochester.edu/MediaLibraries/URMCMedia/pay-bill/documents/affiliate-sliding-fee-application.pdf
Schedule H, Part V, Section B, Line 16c-St James Hospital	https://www.urmc.rochester.edu/pay-bill/financial-assistance/st-james-hospital-financial-assistance.aspx

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 7	The cost-to-charge ratio is used to find 7A and 7B, computed by taking total expenses divided by total gross patient revenue.
Schedule H, Part I, Line 7, Column f	Due to the adoption of new accounting pronouncement ASC606, current year implicit price concessions are treated as a contra-revenue item on the statement of revenues.
Schedule H, Part III, Section A, Line 2	The costing methodology used in determining the amounts reported on lines 2 and 3 are based on actual charges written off ( amounts that are deemed to be uncollectible and recorded as implicit price concessions under new accounting pronouncement ASC606). The test of the implicit price concessions (Bad Debt Expense ) footnote can be found on page 7 of the electronically attached audited financial statements.
Schedule H, Part III, Section A, Line 4	The costing methodology used in determining the amounts reported on lines 2 and 3 are based on actual charges written off ( amounts that are deemed to be uncollectible and recorded as implicit price concessions under new accounting pronouncement ASC 606). The test of the implicit price concessions (Bade Debt Expense ) footnote can be found on page 7 of the electronically attached audited financial statements.
Schedule H, Part III, Section B, Line 8	To determine Medicare allowable costs reportable in the Medicare cost report, the cost-to-charge ratio is applied to gross patient revenue associated with services performed for patients who are eligible for Medicare.
Schedule H, Part III, Section C, Line 9b	A bad debt results from a patient account balance from which payment was anticipated from the patient, credit extended and then account later deemed to be uncollectible. A bad debt does not meet the criteria for charity care, that is, bad debt patients are considered to have the financial capability and ability to pay, but are unwilling to pay. Collection activities are only pursued with respect to amounts that patients are able to pay as determined by that hospital's charity care policy. No collection actives take place with respect to amounts that patients are not expected to pay under this policy. A separate charity care policy is in place and would be exhausted before a patient balance would be deemed Self-pay. Under the charity care policy, charity care/financial assistance is provided to a patient with a demonstrated inability to pay. A patient is eligible for charity care/financial assistance consideration based upon meeting certain income eligibility criteria as established by the federal poverty income guideline sliding scale. Per NYS PHL 2807k, this considers patients whose household income is up to 300% of the most recent federal poverty guidelines. All uninsured, low-income patients within St. James Hospital's primary service area who can demonstrate an inability to pay charge may apply for charity care/financial assistance for adjustment to their balances for all medically necessary healthcare services, provided that a member, in good standing of St. James Hospital's medical staff determines the need for such medical care.
Schedule H, Part VI, Line 2	In conjunction with the community needs assessment that is done every three years in conjunction with Steuben County public Health, the organization uses the following to determine the health needs of the community: community town hall meetings, surveying participants at public health education programs, local case management meetings, and physician/medical office information shared. In addition, regional data and information from DSRIP projects is used to assess community need. St. James Hospital conducts a community needs assessment every three years in conjunction with Steuben County Public Health, Based on resident's feedback the county's healthcare priorities, strategies, and programs are determines. St. James Hospital crates an annual plan based on this assessment, and the progress of these initiatives is reported annually to the NYS Department of Health. Local Healthcare Priorities are also identified through surveying participants at public health education programs.
Schedule H, Part VI, Line 3	At the time of registration, all self-pay individuals receive an information sheet describing the type of Federal State and Local government programs available including St. James Hospital's charity care policy. The eligibility process is coordinated by a financial counselor, who contacts the patient family member by phone and/or letter. Patients who qualify for Medicaid are also directed to an in-house facilitated enroller, who coordinates the Medicaid application process on behalf of the patient.
Schedule H, Part VI, Line 4	The primary service area for St. James Hospital is the 15-mile radius extending from Hornell, NY (Steuben County) and includes the towns of Wayland to the northeast and Troupsburg to the southeast (just outside of the 15-mile radius). The secondary service area is the 30-mile radius extending from Hornell, per the 2010 census, the population for the primary service area (Steuben County) remained relatively flat, increasing 0.3% from 2000 to 2010, with a slight decrease of 3% estimated for 2020. The population aged 65 and over comprises 20% of the primary service area compared to 17% for NYS. The population is racially and ethnically homogenous with 95% white, 1.7% black, 1.7% Hispanic/Latino, 1.6% Asian. Median household income is $53,663 compared to $68,486 for the state. Approximately 23.6% of the county population have a bachelor's degree or higher compared to 36.6% of the state.
Schedule H, Part VI, Line 5	St. James Hospital is the lead agency for the cancer services program (CSP) of Steuben County. A community-based, grant-funded program of New York State Department of Health (NYSDOH), the CSP serves uninsured men and women with comprehensive, age appropriate, no-cost screenings for breast, cervical and colorectal cancer. In addition, St. James Hospital received the NYSDOH Breast and Prostate peer education program in 2016 and began implementation of a community education based program. St James Hospital participates in coordinating the annual healthy kids day at the Maple City Kids Quarter miler. This event is directed to parents and community youth and i includes a pediatric health fair a long standing community kids "fun run" to promote exercise and healthy lifestyles. The organization participates in local health fairs and works with local businesses to promote workplace wellness via SCP program mentioned above. In addition, St. James Hospital operates a cardiac rehab program and coumadin clinic that provide outpatient based services to the community. A collaboration with Noyes Memorial Hospital supports a diabetes education program available to the community. St. James Hospital staff members throughout the organization participate in community initiatives and hold seats on boards, including the Steuben Rural Health Network, YMCA United Way of the southern Tiers, Smart Steuben, Steuben prevention coalition and other non-profit organization whose primary mission is to assess and address community needs.
Schedule H, Part VI, Line 6	The University of Rochester Medical Center is an integrated academic health center that comprises the School of Medicine and Dentistry, including its Faculty Practice (University of Rochester Medical Faculty Group), Strong Memorial Hospital, Highland Hospital, Golisano Children's Hospital, James P Wilmont Cancer Center, Strong West, School of Nursing, Eastman Institute for Oral Health' Visiting Nurse Services, Highlands at Pittsford; the Highlands Living Center, Inc. Highlands at Brighton, FF Thompson Health System, Jones Memorial Hospital, Noyes Health, St James Hospital and Accountable Health Partners, LLC. UR Medical Center and the Affiliated Health Care entities have embraced a comprehensive approach to community health, which employs the multidisciplinary skills found in an academic medical center to both provide important community services and conduct community - based research. These activities help inform policy makers and the community about local health challenges, evaluate the effectiveness of interventions, and serve as foundation for evidence-based practices to improve health and overall quality of life.
Schedule H, Part VI, Line 7	New York State

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Steve Goldstein
Board Member	$0	$1,113,771	$0	$0	$0	$238,924	$0	$315,600	$0	$21,216	$0	$1,689,511	$0	$111,000
Michael Kamali MD
Board Member	$0	$586,945	$0	$18,752	$0	$2,678	$0	$19,100	$0	$29,327	$0	$656,802	$0	$0
Aileen Shinaman
Board Member	$0	$330,997	$0	$0	$0	$19,850	$0	$18,275	$0	$78,686	$0	$447,808	$0
Bryan O'Donovan
President/CEO	$200,387	$0	$0	$0	$0	$0	$0	$0	$11,087	$0	$211,474	$0
Giacomo Floria
Chief Advanced Practice Provider	$169,928	$0	$0	$0	$45,330	$0	$0	$0	$23,554	$0	$238,812	$0
Sachin Manthuruthil
Physician Assistant	$272,445	$0	$0	$0	$0	$0	$0	$0	$9,451	$0	$281,896	$0
Shane Varghese
Physician	$276,661	$0	$0	$0	$0	$0	$0	$0	$9,514	$0	$286,175	$0
Curtis Wininger
Physician Assistant	$209,944	$0	$0	$0	$0	$0	$0	$0	$14,467	$0	$224,411	$0
John Robshaw
Physician	$451,490	$0	$0	$0	$0	$0	$0	$0	$33,556	$0	$485,046	$0
James Helms
CFP/ VP of Finance	$0	$183,798	$0	$0	$0	$0	$0	$0	$0	$11,379	$0	$195,177

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule J, Part I, Line 4	FormAndLineReferenceDesc
Explanation	The following individuals participated in a supplemental nonqualified retirement plan and received employer paid amounts that are included in deferred compensation. Steven Goldstein SERP Plan $159,400 Steven Goldstein 457 (f) Plan $150,000 Michael Kamali, MD SERP Plan $12,900 The following individual participated in a supplemental non qualified retirement plan and received employer paid amounts that are included in other reportable compensation Steven Goldstein 457 (f) Plan $152,459 These amounts represent employee deferrals of compensation, plus investment earnings, over several years that vested and were paid pursuant to the requirements of the plan. The employee deferrals were reported as deferred compensation in Schedule J, Part II, Column C in prior years and are also reflected in Schedule J, Part II, Column (F)	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part I, Line 1	St James Hospital, governed by a self-perpetuating community based board, is a community of persons committed to being a transforming, healing presence within the rural communities we service, particularly addressing the needs of the poor, underserved and disadvantaged.
Form 990, Part III (Cont. 1)	See the mission description above for Part 1, Line 1
Form 990, Part VI, Section A, Line 6	The sole member of St. James Hospital is the University of Rochester (UR). As such, UR has the authority to elect the governing body of St. James Hospital and certain decisions of St. James Hospital are subject to the approval of UR. Such decisions include amendment of the certificate of incorporation and bylaws and approval of extraordinary corporate actions such as merger or dissolution.
Form 990, Part VI, Section A, Line 7a	Refer to Schedule O, Membership information Form 990 Part V, Line 6
Form 990, Part VI, Section A, Line 7b	Refer to Schedule O, Membership information Form 990 Part V, Line 6
Form 990, Part VI, Section B, Line 11b	A copy of the Form 990 was made available to each board member before it was files. St. James Hospital has designated the audit and compliance committee as the group to be educated and to review the return.
Form 990, Part VI, Section B, Line 12c	Board members, officers and key employees (determined by the President & CEO) complete conflict of interest forms annually to identify actual and potential conflicts of interest that may exist relative to their duties with the organization and the organization's COI policy. The CEO shall disclose tot eh Board or appropriate committee thereof any employee disclosure made relevant to the matter and the evaluation thereof. Copies are provided to the Corporate Compliance Officer and maintained by the executive assistant to the Board of Directors and the CEO. If a conflict is disclosed, that person shall leave the Board or Committee meeting while the determination of a conflict of interest is discussed and voted upon. the Chairperson of the Board of committee will determine if a conflict of interest exists. To help ensure compliance with the COI policy, among the provision s the person with an actual or potential conflict of interest will not be allowed to participate in any discussion or decision on any area of the conflict identified and leave the room during discussion and vote. The Corporate Responsibility and Compliance Committee review these procedures every two years to assess their effectiveness and recommend ( or make) appropriate changes as needed to ensure the conflict of interest policy is consistently and effectively enforced
Form 990, Part VI, Section B, Line 15	The board has an independent committee review and approve all elements of remuneration for all disqualified parties, as well as other key management. The board/committee has an established compensation philosophy which details the objectives of market positioning and pay elements. The committee reviews market data, comparative market compensation data, approves any salary adjustments for the executive population, considers both reasonableness and effectiveness of all remunerative programs and establishes the detailed performance expectations. All of these discussions and decisions are documented through the provision of meeting minutes.
Form 990, Part VI, Section C, Line 19	St. James Hospital's Form 1023 and Form 990 are available on request. St. James Hospital's governing documents, conflict of interest policy and audited financial statements are not routinely made available to the public.
Form 990, Part XI, Line 9	Donor Restricted Contributions $70779 Net Assets Released from Restrictions ($24902)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (34 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Address Line2USAddress/AddressLine2Txt
UNIVERSITY OF ROCHESTER
910 GENESEE STREET STE 200	ROCHESTER	NY	14611	160743209	SCHOOL	NY	501 C (3)	2	N/A	0
HIGHLAND HOSPITAL OF ROCHESTER
1000 SOUTH AVENUE	ROCHESTER	NY	14620	160743037	HOSPITAL	NY	501 C (3)	3		0	SPHS
THE HIGHLAND FOUNDATION INC
1000 SOUTH AVENUE	ROCHESTER	NY	14620	237310662	FUNDRAISING	NY	501 C (3)	12A 1		0	HIGHLD HOSP
HIGHLAND FACILITIES DEVELOPMENT CORP
1000 SOUTH AVENUE	ROCHESTER	NY	14620	223039077	MEDICAL BLDG	NY	501 C (3)	10		0	HIGHLD HOSP
HIGHLAND COMMUNITY DEVELOPMENT CORP
100 HAHNEMANN TRAIL	PITTSFORD	NY	14534	223154715	ELDER CARE	NY	501 C (3)	10		0	SPHS
THE HIGHLANDS LIVING CENTER INC
500 HAHNEMANN TRAIL	PITTSFORD	NY	14534	223240227	HEALTHCARE	NY	501 C (3)	10		0	SPHS
THE MEADOWS AT WESTFALL INC
5901 LAC DE VILLE BLVD	ROCHESTER	NY	14618	161502303	HEALTHCARE	NY	501 C (3)	10		0	SPHS
STRONG PARTNERS HEALTH SYSTEM INC
601 ELMWOOD AVENUE BOX 706	ROCHESTER	NY	14642	161499099	SUPPORT ORG	NY	501 C (3)	12A 1		0	UNIV OF ROCH
UR Medicine Home Care Inc
2180 EMPIRE BOULEVARD	WEBSTER	NY	14580	222577664	FUNDRAISING	NY	501 C (3)	7		0	UNIV OF ROCH
UR MEDICINE HOME CARE CERTIFIED SERVICES INC
2180 EMPIRE BOULEVARD	WEBSTER	NY	14580	160743215	HEALTHCARE	NY	501 C (3)	10		0	URMC
UR Medicine Home Care Licensed Service Inc
2180 EMPIRE BOULEVARD	WEBSTER	NY	14580	161561691	HEALTHCARE	NY	501 C (3)	10		0	URMC
EXCELL PARTNERS INC
343 STATE STREET KODAK TOWER	ROCHESTER	NY	14650	201862628	ECONOMIC DEV	NY	501 C (4)	N/A		0	UNIV OF ROCH	2nd Floor
ROCHESTER BIOVENTURE CENTER INC
601 ELMWOOD AVENUE BOX 706	ROCHESTER	NY	14642	202485999	BIOTECH INCUB	NY	501 C (3)	12A 1		0	UNIV OF ROCH
NEXTCORPS INC
260 EAST MAIN STREET SUITE 6000	ROCHESTER	NY	14604	161195028	BUSINESS INCU	NY	501 C (3)	7		0	UNIV OF ROCH
U OF R BROADCASTING CORPORATION
201 WILSON COMMONS	ROCHESTER	NY	14627	160743209	BROADCAST LIC	NY	501 C (4)	N/A		0	UNIV OF ROCH
UR REAL ESTATE CORPORATION
263 WALLIS HALL	ROCHESTER	NY	14627	271140014	SUPPORT ORG	NY	501 C (3)	12A 1		0	UNIV OF ROCH
MELIORA REAL ESTATE CORPORATION
263 WALLIS HALL	ROCHESTER	NY	14627	452464788	SUPPORT ORG	NY	501 C (3)	12A 1		0	UNIV OF ROCH
F F THOMPSON HEALTH SYSTEM INC
350 PARRISH STREET	CANANDAIGUA	NY	14424	222959987	SUPPORT ORG	NY	501 C (3)	12A 1		0	UNIV OF ROCH
THE FREDERICK FERRIS THOMPSON HOSPITAL
350 PARRISH STREET	CANANDAIGUA	NY	14424	160743024	HOSPITAL	NY	501 C (3)	3		0	THS
M M EWING CONTINUING CARE CENTER
350 PARRISH STREET	CANANDAIGUA	NY	14424	237046583	HEALTHCARE	NY	501 C (3)	3		0	THS
F F T SENIOR COMMUNITIES INC
1 FERRIS HILLS	CANANDAIGUA	NY	14424	161557494	ELDER CARE	NY	501 C (3)	10		0	THS
THE F F THOMPSON FOUNDATION INC
350 PARRISH STREET	CANANDAIGUA	NY	14424	222959984	FUNDRAISING	NY	501 C (3)	7		0	THS
FINGER LAKES HOME CARE INC
756 PRE EMPTION ROAD	GENEVA	NY	14456	161489133	HEALTHCARE	NY	501 C (3)	10		0	URM HOME CARE CERTIFIED SRVCS
FINGER LAKES VISITING NURSE SERVICE INC
756 PRE EMPTION ROAD	GENEVA	NY	14456	223067627	HEALTHCARE	NY	501 C (3)	10		0	URM HOME CARE
THE MEMORIAL HOSPITAL OF WILLIAM F AND GERTRUDE F JONES INC
191 NORTH MAIN STREET	WELLSVILLE	NY	14895	222807681	HOSPITAL	NY	501 C (3)	3		0	UNIV OF ROCH
LIVINGSTON HEALTH CARE SYSTEM INC
111 CLARA BARTON STREET	DANSVILLE	NY	14427	161455240	SUPPORT ORG	NY	501 C (3)	12A 1		0	UNIV OF ROCH
NICHOLAS H NOYES MEMORIAL HOSPITAL INC
111 CLARA BARTON STREET	DANSVILLE	NY	14427	160743979	HOSPITAL	NY	501 C (3)	3		0	LHCS
RED JACKET CENTER INC
111 CLARA BARTON STREET	DANSVILLE	NY	14427	161037658	MEDICAL BLDG	NY	501 C (3)	12A 1		0	LHCS
THE FOUNDATION FOR NOYES MEMORIAL HEALTH SYSTEM INC
111 CLARA BARTON STREET	DANSVILLE	NY	14427	161584778	FUNDRAISING	NY	501 C (3)	7		0	LHCS
JONES MEMORIAL HOSPITAL FOUNDATION
191 NORTH MAIN STREET	WELLSVILLE	NY	14895	473763374	SUPPORT ORG	NY	501 C (3)	7		0	JONES HOSP
JONES MEDICAL SERVICES PC
191 NORTH MAIN STREET	WELLSVILLE	NY	14895	465210222	MEDICAL CLINIC	NY	501 C (3)	3		0	JONES HOSP
ST JAMES FOUNDATION INC
411 CANISTEO STREET	HORNELL	NY	14843	161486437	FUNDRAISING	NY	501 C (3)	7		0	STJAMES HOSP
UR MEDICINE HOME CARE COMMUNITY SERVICES INC
2180 EMPIRE BOULEVARD	WEBSTER	NY	14580	825091873	HEALTHCARE	NY	501 C (3)	10		0	URMC
UR MEDICINE HOME CARE FOUNDATION INC
2180 EMPIRE BOULEVARD	WEBSTER	NY	14580	831912967	SUPPORT ORG	NY	501 C (3)	12A 1		0	URMC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1Txt	Address Line2USAddress/AddressLine2Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Excell Innovate NY Fund LP
343 State St	Kodak Tower 2nd Fl	Rochester	NY	14650	462405519	Investment Fund	NY	ETV Inc
Excell Minority and Women Owned Investment Fund LP
343 State St	Kodak Tower 2nd Fl	Rochester	NY	14650	810723223	Investment Fund	NY	ETV Inc
Excell Partners Innovative TC Fund LP
343 State St	Kodak Tower 2nd Fl	Rochester	NY	14650	810711015	Investment Fund	NY	ETV Inc
FINGER LAKES VENTURE FUND LP
343 STATE STREET	KODAK TOWER 2ND FLOOR	ROCHESTER	NY	14650	833941257	INVESTMENT FUND	NY	ETV INC

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line2USAddress/AddressLine2Txt	OwnershipOwnershipPct
MEDICAL ADMINISTRATIVE ASSOCIATES INC
777 SOUTH CLINTON AVENUE	ROCHESTER	NY	14620	161354319	RETAIL PHARMACY	NY	HIGHLD HOSP	C	0
UR EQUITY HOLDINGS INC
110 OFFICE PARK WAY	PITTSFORD	NY	14534	273040889	HOLDING CO	DE	UNIV OF ROCH	C	0
F F T H PROPERTIES AND SERVICES INC
350 PARRISH STREET	CANANDAIGUA	NY	14424	161286518	HOLDING CO	NY	THS	C	0
FINGER LAKES COMMUNITY CARE NETWORK INC
350 PARRISH STREET	CANANDAIGUA	NY	14424	161423442	INACTIVE	NY	THS	C	0
EXCELL TECHNOLOGY VENTURES INC
343 STATE STREET KODAK TOWER	ROCHESTER	NY	14650	800909149	BIOTECH INCUBATOR	NY	ROCH BIOVENTURE	C	0	2ND Floor
ACCOUNTABLE HEALTH PARTNERS LLC
135 CORPORATE WOODS STE 320	ROCHESTER	NY	14623	300787967	ACCT CARE NETWORK	NY	UNIV OF ROCH	C	0
ACCOUNTABLE HEALTH PARTNERS IPA LLC
135 CORPORATE WOODS STE 320	ROCHESTER	NY	14623	371746016	INDEP PRACTICE ASSOC	NY	AHP LLC	C	0
AHP INSURANCE COMPANY
76 ST PAUL STREET SUITE 500	BURLINGTON	VT	05401	814644839	CAPTIVE INSURANCE CO	VT	AHP LLC	C	0
LUMINATE VENTURE CHALLENGE CORP
260 EAST MAIN STREET SUITE 6000	ROCHESTER	NY	14604	823954131	BUSINESS INCU	NY	NEXTCORPS INC	C	0
HORNELL MEDICAL VILLAGE LLC
7100 ROUTE 70A	HORNELL	NY	14843	611886763	HOLD REAL ESTATE	NY	ST JAMES HOSP	C	0		1

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	0	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	0	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	0	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (1)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (1)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (1)	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (1)	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	HORNELL MEDICAL VILLAGE LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	j	TransactionTypeTxt
Involved	$833,112	InvolvedAmt
Method Of Amount Determination	Rental of Building & Equipment	MethodOfAmountDeterminationTxt