MARGARETVILLE MEMORIAL HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: MARGARETVILLE MEMORIAL HOSPITAL (EIN 15-0552726)
Tax period: 2019-01-01 to 2019-12-31
Filed: 2020-11-05
IRS object ID: 202003109349303110
Schema version: 2019v5.1
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-11-05T19:29:42-06:00	ReturnTs
Tax Period End	2019-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1101 NEW YORK AVENUE NW	AddressLine1Txt
City	WASHINGTON	CityNm
State Abbreviation	DC	StateAbbreviationCd
ZIP	20005	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	150552726	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MARGARETVILLE MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% ERIN NAGY	InCareOfNm
Business Name Control	MARG	BusinessNameControlTxt
Phone	8459436084	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	42084 STATE ROUTE 28	AddressLine1Txt
City	MARGARETVILLE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12445	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DR MICHAEL DOYLE	PersonNm
Person Title	EXEC. DIRECTOR/CMO	PersonTitleTxt
Phone	8459436024	PhoneNum
Signature	2020-11-03	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JUSTIN LOWE	PreparerPersonNm
PTIN	P01866796	PTIN
Phone	2023276000	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	173.68.23.158	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	26308520203105000027	FederalOriginalSubmissionId
Federal Original Submission Id	2020-11-05	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	8C0075DE128CBD006CA99682002307B42C2396E3	AtSubmissionCreationDeviceId
At Submission Filing Device Id	047C777BBD395ADD529156C75D94AFF56594489C	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	DR MICHAEL DOYLE	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	396 BROADWAY	AddressLine1Txt
City	KINGSTON	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12401	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$13,959,484	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	https://www.margaretvillehosp.org/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1930	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	To operate a critical access hospital for quality medical care and diagnostic services to medically undeserved communities in the area.	ActivityOrMissionDesc
Voting Members Governing Body	19	VotingMembersGoverningBodyCnt
Voting Members Independent	15	VotingMembersIndependentCnt
Total Employee	148	TotalEmployeeCnt
Total Volunteers	15	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$1,731,638	PYContributionsGrantsAmt
CY Contributions Grants	$1,645,847	CYContributionsGrantsAmt
PY Program Service Revenue	$10,522,404	PYProgramServiceRevenueAmt
CY Program Service Revenue	$10,396,672	CYProgramServiceRevenueAmt
PY Investment Income	$2,395	PYInvestmentIncomeAmt
CY Investment Income	$2,981	CYInvestmentIncomeAmt
PY Other Revenue	$2,049,061	PYOtherRevenueAmt
CY Other Revenue	$1,889,774	CYOtherRevenueAmt
PY Total Revenue	$14,305,498	PYTotalRevenueAmt
CY Total Revenue	$13,935,274	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	$8,570,991	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$8,616,374	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$6,186,385	PYOtherExpensesAmt
CY Other Expenses	$6,864,586	CYOtherExpensesAmt
PY Total Expenses	$14,757,376	PYTotalExpensesAmt
CY Total Expenses	$15,480,960	CYTotalExpensesAmt
PY Revenues Less Expenses	-$451,878	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,545,686	CYRevenuesLessExpensesAmt
Total Assets BOY	$5,391,412	TotalAssetsBOYAmt
Total Assets EOY	$4,988,619	TotalAssetsEOYAmt
Total Liabilities BOY	$4,174,327	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$5,617,160	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$1,217,085	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	-$628,541	NetAssetsOrFundBalancesEOYAmt
Mission	To operate a critical access hospital for quality medical care and diagnostic services to medically underserved communities in the area.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$12,146,813	ExpenseAmt
Revenue	$10,471,597	RevenueAmt
Desc	Margaretville Memorial Hospital is a critical access hospital that provides acute health care services to residents and visitors to the communities served. Margaretville Memorial Hospital recorded 1,048 patient days, 3,543 emergency room visits, 141 outpatient surgeries, 230 discharges and 199 infusion therapies in 2019.	Desc
Total Program Service Expenses	$12,146,813	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	30	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	148	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	19	GoverningBodyVotingMembersCnt
Independent Voting Member	15	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	ERIN NAGY	PersonNm
Phone	8459436084	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	741 GRANT AVENUE	AddressLine1Txt
City	LAKE KATRINE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12449	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Key EmployeeKeyEmployeeInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd	OfficerOfficerInd
Robert Ross
EXEC. VP (resigned 12/31/19)	1.0	39.0	Yes (X)	$0	$746,325	$78,632
David Scarpino
FORMER CEO (RESIGNED 12/31/18)	0.0	0.0		$0	$520,041	$28,911	Yes (X)
Catherine Allen MD
TRUSTEE (EFF. 5/1/19)	1.0	39.0		$385,427	$0	$12,461		Yes (X)
Joseph Marsicovete
Chief Operating Officer	2.0	38.0		$0	$321,847	$20,272			Yes (X)
Paul Llobet MD
TRUSTEE (RESIGNED 9/2/2019)	1.0	39.0		$0	$273,652	$5,826		Yes (X)
Thomas Brunelle
TRUSTEE (RESIGNED 9/28/19)	2.0	38.0		$0	$254,482	$15,091				Yes (X)
MARK POHAR
EXEC DIR/ex-officio trustee	20.0	20.0		$0	$233,640	$31,736				Yes (X)
Eileen King
CLINICAL COORDINATOR	40.0	0.0		$236,826	$0	$27,059			Yes (X)
Brian Callahan
Nurse Practitioner	40.0	0.0		$227,329	$0	$27,782			Yes (X)
NANETTE TREADWELL
PHYSICIAN ASSISTANT	40.0	0.0		$207,782	$0	$21,254			Yes (X)
Michael Doyle MD
EXEC DIR/CMO (eff. 9/28/19)	2.0	38.0		$0	$222,821	$239				Yes (X)
JANE ULRICH
SR. VP OF NURSING	2.0	38.0		$0	$193,388	$24,654			Yes (X)
CHRISTOPHER ESOLA
trustee	1.0	39.0		$0	$115,441	$6,351		Yes (X)
Carey Wagner
CHAIR	1.0	4.0		$0	$0	$0		Yes (X)
JANE Piasek
Trustee	1.0	1.0		$0	$0	$0		Yes (X)
Fred Marguiles
Secretary	1.0	1.0		$0	$0	$0		Yes (X)
Arthur Martello
Trustee	1.0	1.0		$0	$0	$0		Yes (X)
Jenny Morrill-Liddle
Vice Chair	1.0	1.0		$0	$0	$0		Yes (X)
Thomas O'Brien
TRUSTEE (RESIGNED 3/10/19)	1.0	1.0		$0	$0	$0		Yes (X)
David Riordan
Trustee	1.0	1.0		$0	$0	$0		Yes (X)
Nancy Slauson
Trustee	1.0	1.0		$0	$0	$0		Yes (X)
Kent Garrett
Trustee	1.0	1.0		$0	$0	$0		Yes (X)
Thomas Collins
TRUSTEE	1.0	4.25		$0	$0	$0		Yes (X)
James Howie
Trustee	1.0	1.0		$0	$0	$0		Yes (X)
KRISTIN FLACHS
TRUSTEE	1.0	1.0		$0	$0	$0		Yes (X)
KAREN KOLAR
TRUSTEE	1.0	2.0		$0	$0	$0		Yes (X)
ARNIE SCHWARTZ
TRUSTEE	1.0	1.0		$0	$0	$0		Yes (X)
Josefina Rubio
TRUSTEE (EFF. 3/1/19)	1.0	1.0		$0	$0	$0		Yes (X)
Marta Weisz-Margiotta
TRUSTEE (EFF. 3/1/19)	1.0	1.0		$0	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,057,364	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,881,637	TotReportableCompRltdOrgAmt
Total Other Compensation	$300,268	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	12	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Laboratory Corp of America
PO Box 12140	BURLINGTON	NC	27216	Laboratory Services	$594,101
Seco Physical Occupational Therap
Eaton Center 26 Conkey Ave Suite	NORWICH	NY	13815	CONSULTING	$231,148
CROSS COUNTRY STAFFING INC
PO BOX 404674	ATLANTA	GA	30384	STAFFING AGENCY	$106,611

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	3	CntrctRcvdGreaterThan100KCnt
Government Grants	$1,616,453	GovernmentGrantsAmt
All Other Contributions	$29,394	AllOtherContributionsAmt
Total Contributions	$1,645,847	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	NET PATIENT SERVICE REVENUE	Desc
Business	621300	BusinessCd
Total Revenue Column	$10,396,672	TotalRevenueColumnAmt
Related Or Exempt Func Income	$10,396,672	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$10,396,672	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,981	TotalRevenueColumnAmt
Exclusion	$2,981	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$76,075	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$10,438	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$65,637	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$65,637	TotalRevenueColumnAmt
Exclusion	$65,637	ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$35,886	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$13,772	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$22,114	TotalRevenueColumnAmt
Exclusion	$22,114	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	ExclusionExclusionAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PHARMACY REVENUE	446110	$1,545,812	$1,545,812
AMBULANCE REVENUE	621300	$74,925		$74,925
AUXILIARY REVENUE	900099	$103,803	$103,803

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$77,483	TotalRevenueColumnAmt
Exclusion	$77,483	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,802,023	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,935,274	TotalRevenueColumnAmt
Related Or Exempt Func Income	$10,471,597	RelatedOrExemptFuncIncomeAmt
Exclusion	$1,817,830	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

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

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

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

Foreign Grants ForeignGrantsGrp

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

Benefits To Members BenefitsToMembersGrp

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

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$397,888	TotalAmt
Program Services	$397,888	ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

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

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$6,310,374	TotalAmt
Program Services	$4,901,024	ProgramServicesAmt
Management And General	$1,409,350	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$14,857	TotalAmt
Program Services	$11,143	ProgramServicesAmt
Management And General	$3,714	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,443,376	TotalAmt
Program Services	$1,082,532	ProgramServicesAmt
Management And General	$360,844	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$449,879	TotalAmt
Program Services	$337,409	ProgramServicesAmt
Management And General	$112,470	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

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

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$162	TotalAmt
Management And General	$162	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$81,300	TotalAmt
Management And General	$81,300	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$2,078	TotalAmt
Management And General	$2,078	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

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

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

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

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,294,588	TotalAmt
Program Services	$1,981,512	ProgramServicesAmt
Management And General	$313,076	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$6,984	TotalAmt
Management And General	$6,984	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$494,027	TotalAmt
Program Services	$278,439	ProgramServicesAmt
Management And General	$215,588	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

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

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$202,631	TotalAmt
Program Services	$7,313	ProgramServicesAmt
Management And General	$195,318	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$39,036	TotalAmt
Management And General	$39,036	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$68,830	TotalAmt
Program Services	$65,265	ProgramServicesAmt
Management And General	$3,565	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$27,949	TotalAmt
Management And General	$27,949	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$408,436	TotalAmt
Program Services	$408,436	ProgramServicesAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$132,107	TotalAmt
Management And General	$132,107	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$1,572,940	$1,570,608	$2,332
EQUIPMENT SVC CONTRACTS	$1,020,108	$992,991	$27,117
CONTRACTED SERVICES	$326,338		$326,338
INPATIENT ALLOWANCES	$91,265	$91,265

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$95,807	TotalAmt
Program Services	$20,988	ProgramServicesAmt
Management And General	$74,819	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$15,480,960	TotalAmt
Program Services	$12,146,813	ProgramServicesAmt
Management And General	$3,334,147	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$250,785	BOYAmt
EOY	$340,409	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$613,541	BOYAmt
EOY	$835,350	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,277,479	BOYAmt
EOY	$1,173,414	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	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$332,443	BOYAmt
EOY	$331,568	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$74,915	BOYAmt
EOY	$148,937	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$22,568,435	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$20,933,887	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$1,713,163	BOYAmt
EOY	$1,634,548	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	$1,129,086	BOYAmt
EOY	$524,393	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$5,391,412	BOYAmt
EOY	$4,988,619	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,589,907	BOYAmt
EOY	$3,564,592	EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$141,188	BOYAmt
EOY	$243,021	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,443,232	BOYAmt
EOY	$1,809,547	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,174,327	BOYAmt
EOY	$5,617,160	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	$1,217,085	BOYAmt
EOY	-$628,541	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$1,217,085	BOYAmt
EOY	-$628,541	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$5,391,412	BOYAmt
EOY	$4,988,619	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$1,545,686	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	-$299,940	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	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 (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

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 C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$2,078	OtherActivitiesAmt
Total Lobbying Expenditures	$2,078	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	MARGARETVILLE MEMORIAL HOSPITAL PAYS DUES TO THE IROQUOIS HEALTHCARE ALLIANCE OF NEW YORK STATE (IHA). IN ACCORDANCE WITH SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY IHA, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2019 IHA ANNUAL DUES WERE $2,078.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$23,128	OtherCostOrOtherBasisAmt
Book Value	$23,128	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,042,550	OtherCostOrOtherBasisAmt
Depreciation	$3,997,471	DepreciationAmt
Book Value	$1,045,079	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$16,942,649	OtherCostOrOtherBasisAmt
Depreciation	$16,507,555	DepreciationAmt
Book Value	$435,094	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$560,108	OtherCostOrOtherBasisAmt
Depreciation	$428,861	DepreciationAmt
Book Value	$131,247	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$1,634,548	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDesc	Book ValueBookValueAmt
OTHER RECEIVABLE	$520,035
ASSETS LIMITED AS TO USE	$4,358

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$524,393	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
OTHER NON-CURRENT LIABILITIES	$518,004
DUE TO RELATED PARTIES	$1,291,543

Field	Value	IRS element (for citing)
Total Liability	$1,809,547	TotalLiabilityAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	HARVEST MOON	Event1Nm
Gross Receipts Event1	$33,071	GrossReceiptsEvent1Amt
Gross Revenue Event1	$33,071	GrossRevenueEvent1Amt
Food And Beverage Event1	$5,280	FoodAndBeverageEvent1Amt
Entertainment Event1	$750	EntertainmentEvent1Amt
Other Direct Expenses Event1	$4,927	OtherDirectExpensesEvent1Amt
Event2	FLEA MARKET	Event2Nm
Gross Receipts Event2	$2,815	GrossReceiptsEvent2Amt
Gross Revenue Event2	$2,815	GrossRevenueEvent2Amt
Food And Beverage Event2	$0	FoodAndBeverageEvent2Amt
Entertainment Event2	$0	EntertainmentEvent2Amt
Other Direct Expenses Event2	$2,815	OtherDirectExpensesEvent2Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Total	$35,886	GrossReceiptsTotalAmt
Gross Revenue Total Events	$35,886	GrossRevenueTotalEventsAmt
Food And Beverage Total Events	$5,280	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$750	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$7,742	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$13,772	DirectExpenseSummaryEventsAmt
Net Income Summary	$22,114	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent150	Yes (X)	Percent150Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$111,530	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$22,354	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$89,176	NetCommunityBenefitExpnsAmt
Total Expense	0.00580	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,151,734	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,851,202	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$300,532	NetCommunityBenefitExpnsAmt
Total Expense	0.01940	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,263,264	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,873,556	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$389,708	NetCommunityBenefitExpnsAmt
Total Expense	0.02520	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,543	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$50	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,493	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,350,306	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,370,658	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,979,648	NetCommunityBenefitExpnsAmt
Total Expense	0.12790	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,357,849	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,370,708	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,987,141	NetCommunityBenefitExpnsAmt
Total Expense	0.12840	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$7,621,113	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$5,244,264	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,376,849	NetCommunityBenefitExpnsAmt
Total Expense	0.15360	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$615,078	BadDebtExpenseAmt
Reimbursed By Medicare	$4,431,656	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$3,369,164	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$1,062,492	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 (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	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	MARGARETVILLE MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	42084 STATE ROUTE 28	AddressLine1Txt
City	MARGARETVILLE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12455	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.HAHV.ORG	WebsiteAddressTxt
State License	1226701C	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MARGARETVILLE MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	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 (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	150.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE SECTION C	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 (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B, LINE 3E:	Through the collaboration and partnership with Delaware County Public Health Department, Margaretville Hospital, in accordance with New York State Prevention Agenda mandate, has chosen to align with our community partners in focusing on two priority areas: a. Prevent Chronic Diseases b. Promote Healthy Women, Infants, and Children Margaretville Hospital involved key members of the Hospital Team in the assessment and selection of its health priorities. After identification of the criteria for priority selection, a work group was convened by the Delaware County Public Health Department which included Margaretville Hospital affiliated with Health Alliance of the Hudson Valley and Westchester Medical Center Health, Delaware Valley Hospital affiliated with United Health Services, Bassett Healthcare Network O'Connor Hospital, as well as the Southern Tier PHIP. Through this work group, the data from the community engagement sessions, as well as the hospital and county health department community health assessments, were aligned with the priorities outlined by the NYS 2019-2024 Prevention Agenda. Additionally, the rationale for choice of priorities was based on available resources and capacity to address the priority. Opportunity for development of collaborative interventions by Margaretville Hospital, the Delaware County Public Health Department and other community partners, was also considered. Through the collaboration described above with county public health and community-based organizations, Margaretville Hospital aligned together to select two Prevention Agenda Priorities: a. Prevent Chronic Diseases b. Promote Well-Being and Prevent Mental and Substance Use Disorders Both of the Community Health Needs Assessment (CHNA) 2019 priorities are from the NYS Prevention Agenda 2019-2024. Margaretville Hospital participated in a workgroup consisting of the three local health systems and the county Public Health department to identify focus areas, and objectives for each of the Agenda Priorities jointly identified by the hospital and collaborators: The New York State Prevention Agenda outlines three other priority areas that were not selected as priorities for the Margaretville hospital 2019-2021 Community Service Plan: Promote a Healthy and Safe Environment, Promote Healthy Women, Infants and Children, and Prevent Communicable Diseases. Although all of these merit focus for improving population health, they were not selected due to the limited amount of resources available to address these issues and the relative severity of need demonstrated for the priority areas that were chosen. Part V, Section B, Line 5: Margaretville Memorial Hospital (Margaretville Hospital), an affiliate of HealthAlliance of the Hudson Valley, a member of the Westchester Medical Center Health Network (WMCHealth) was an active member of a comprehensive Delaware County Community Health Needs Assessment which includes 3 hospitals and the Delaware County Public Health Department. Margaretville Hospital staff was heavily involved in the collaborative and contributed immensely towards the creation of the assessment. The primary proactive means for receiving community input was through the Regional Assessment conducted by the Southern Tier Population Health Improvement Program (PHIP). In the Southern Tier, PHIP covers five counties including Delaware County. In order to inform the direction of the Southern Tier PHIP, also known as Health Action Priorities Network (HAPN), the team conducted a regional health assessment utilizing stakeholder interviews and consumer focus groups. The information/data from the Delaware County assessment was utilized to direct the selection of the public health priorities for Margaretville Hospital. From June 2018 through January 2019, structured interviews in Delaware County were conducted with professionals working in diverse fields such as health care, education, transportation, economic development, mental health, law enforcement and elected officials, among others. The interview focused on 10 key questions and five secondary questions centered on health disparities, key barriers to addressing them, and gaps in service provision. Consumers' input was sought through focus groups which were conducted from January through March of 2019. Population Health Coordinators met with pre-existing groups including support groups, service clubs, parent groups and senior meals. HAPN/PHIP Southern Tier conducted focus groups in Delaware County. The group attendants were asked about their experiences with health and health care delivery. Responses from the focus groups were collected by note-takers and summarized qualitatively by the Population Health Coordinators. In addition, Margaretville Hospital is an active participant in Delaware County's Community Health Improvement Plan process. This process included input and suggestions from Delaware County Public Health, Delaware Valley Hospital, Margaretville Hospital, O'Connor Hospital, and the Southern Tier PHIP. In May of 2019, the PHIP Population Health Coordinators worked with the Delaware County committee to hold a community roundtable event at SUNY Delhi, located in Delhi NY, Delaware County. All Health and Human Services providers that received the survey were invited, as well as the community residents who provided their names and contact information electronically via the survey. The event was also promoted via email and social media communications. Hospital and Public Health representatives shared the invitation with their Boards of Directors. The roundtable event was attended by 40 people, and included a presentation on the survey data by the PHIP Coordinators. In addition, Delaware County's Director of Public Health and the Director of Operational Support from O'Connor Hospital (located in Delhi and affiliated with the Bassett Healthcare system) presented on the NY State and Federal requirements for completion of the Community Health Assessment, Community Health Improvement Plan, and the hospitals' Community Service Plans.
PART V, SECTION B, LINE 6A:	The CHNA was conducted with Delaware Valley Hospital (DVH), an affiliate of United Health Services (UHS) system; Margaretville Hospital (MH), which is a part of the Health Alliance of the Hudson Valley and a member of the Westchester Medical Center Health Network; and O'Connor Hospital (OCH), of the Bassett Healthcare Network.
PART V, SECTION B, LINE 6B:	Margaretville Hospital worked very closely with Delaware County Public Health.
PART V, SECTION B, LINE 7:	The CHNA has been widely available to the public through the website at HTTPS://WWW.HAHV.ORG/UPLOADS/PUBLIC/DOCUMENTS/HEALTHALLIANCE%20PDFS/COMMUN ITY%20HEALTH/MH%20CSP_CHNA%202019_2021.PDF
PART V, SECTION B, LINE 10:	Margaretville Hospital has adopted an implementation strategy that will address the significant community health needs outlined in the hospital's CHNA which can be found on our website at HTTPS://WWW.HAHV.ORG/UPLOADS/PUBLIC/DOCUMENTS/HEALTHALLIANCE%20PDFS/COMMUN ITY%20HEALTH/MH%20CSP_CHNA%202019_2021.PDF
PART V, SECTION B, LINE 11:	Through the collaboration and partnership with Delaware County Public Health Department, Margaretville Hospital, in accordance with New York State Prevention Agenda mandate, has chosen to align with our community partners in focusing on two priority areas: a. Prevent Chronic Diseases b. Promote Healthy Women, Infants, and Children Margaretville Hospital involved key members of the Hospital Team in the assessment and selection of its health priorities. After identification of the criteria for priority selection, a work group was convened by the Delaware County Public Health Department which included Margaretville Hospital affiliated with Health Alliance of the Hudson Valley and Westchester Medical Center Health, Delaware Valley Hospital affiliated with United Health Services, Bassett Healthcare Network O'Connor Hospital, as well as the Southern Tier PHIP. Through this work group, the data from the community engagement sessions, as well as the hospital and county health department community health assessments, were aligned with the priorities outlined by the NYS 2019-2024 Prevention Agenda. Additionally, the rationale for choice of priorities was based on available resources and capacity to address the priority. Opportunity for development of collaborative interventions by Margaretville Hospital, the Delaware County Public Health Department and other community partners, was also considered. Through the collaboration described above with county public health and community-based organizations, Margaretville Hospital aligned together to select two Prevention Agenda Priorities: a. Prevent Chronic Diseases b. Promote Well-Being and Prevent Mental and Substance Use Disorders Both of the Community Health Needs Assessment (CHNA) 2019 priorities are from the NYS Prevention Agenda 2019-2024. Margaretville Hospital participated in a workgroup consisting of the three local health systems and the county Public Health department to identify focus areas, and objectives for each of the Agenda Priorities jointly identified by the hospital and collaborators: The New York State Prevention Agenda outlines three other priority areas that were not selected as priorities for the Margaretville hospital 2019-2021 Community Service Plan: Promote a Healthy and Safe Environment, Promote Healthy Women, Infants and Children, and Prevent Communicable Diseases. Although all of these merit focus for improving population health, they were not selected due to the limited amount of resources available to address these issues and the relative severity of need demonstrated for the priority areas that were chosen. AREAS OF FOCUS: Margaretville decided to address the county's health needs through the following implementation plan in guidance of NYS Prevention Agenda. Priority 1: Prevent Chronic Disease Focus Area 1: Healthy eating and food security Goal 1.3: Increase food security Objective 1.13: Increase the % of adults with perceived food security. Community Based Strategy and Commitment of Resources: The dietary department at Margaretville Hospital/MRCC will design and implement a food program designed to address food insecurity for inpatients (acute, observation and swing bed). The goal is for the dietitians, upon interview and screening, to identify patients with limited food access or possible food insecurity. They will establish a patient referral process to public health nutrition program such as WIC, SNAP or local food emergency services or food pantry prior to patients discharge. Focus Area 3: Tobacco Prevention Goal 3.2: Promote tobacco use cessation Objective: 3.2.2 Use health communications and media opportunities to promote the treatment of tobacco dependence by targeting smokers with emotional evocative and graphic messaging to encourage evidence-based quit attempts and increase awareness of available cessation benefits. Community Based Strategy and Commitment of Resources: Margaretville Hospital will partner with the HealthAlliance Marketing Department and Tobacco-Free Action Coalition to develop annual campaigns targeting current tobacco users in the community and our own facilities on the harm of smoking. In addition, we provide information through various messaging channels to include email, social media, earned media, and message boards. Focus Area 4: Preventive Care and management. Goal 4.4: In the community setting, improve self-management skills for individuals with chronic diseases, including asthma, arthritis, cardiovascular disease, diabetes and pre-diabetes and obesity. Objective 4.4.1: Increase the % of adults with chronic conditions who have taken a course or class to learn how to manage their condition. Community Based Strategy and Commitment of Resources: Margaretville Hospital will provide COPD education classes including a focus on self-management. Margaretville Hospital will also promote and support the Chronic Disease Self-Management Program (CDSMP) classes taking place in Delaware County. Priority 2: Promote Well-Being and Prevent Mental Health and Substance Use Disorders Focus Area 2: Mental and Substance Use Disorders Prevention Goal 2.2: Prevent opioid and other substance misuse and deaths. Objective 2.2.4: Reduce all E.D. visits (including outpatient and admitted patients) involving one opioid overdose. Community Based Strategy and Commitment of Resources: Margaretville Hospital will actively participate in the Catskills Addiction Coalition as the fiduciary member and recipient of the Rural Communities Opioid Response Planning grant for 2019 to 2020. In addition, the hospital will participate in the Delaware County Opioid Task Force and openly share OCH data with the Delaware County Public Health Department on number of patients reporting to E.D. with substance abuse issues for collaboration and appropriate access to services among community partners. Additionally, work towards receiving a three-year HRSA implementation grant to implement programs of the Catskills Addiction Coalition. Devote resources and attention of staff and leadership to collaborating with other community organizations on creative solutions. Focus Area 2: Mental and Substance Use Disorders Prevention Goal 2.3: Prevent and address adverse childhood experiences (ACES) Objective 2.3.3: Increase communities reached by opportunities to build resilience by at least 10 percent Community Based Strategy and Commitment of Resources: Margaretville Hospital will partner with HealthAlliance's Youth Mental Health First Aid Program to deliver the training to a variety of organizations and overall public through a variety of outreach and network building. In addition, the ultimate goal is to help drive referrals of youth needing additional support from clinicians. Focus Area 2: Promote Well-Being and Prevent Substance Use Disorders Goal 2.5: Prevent Suicides Objective 2.5.4: Build support systems to care for opioid users or at risk of an overdose Community Based strategy and Commitment of Resources: Margaretville Hospital will host QPR training at least once annually for Margaretville Hospital staff and four times annually throughout Delaware County in conjunction with the Delaware County Suicide Prevention. We will assess and identify the appropriate community organizations and internal staff for preventative steps to be taken.
PART V, SECTION B, LINE 16A, B AND C:	The hospital's financial assistance policy and application are available at the following link: https://www.hahv.org/financial-assistance

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 7:	Margaretville Memorial Hospital's costing methodology was based upon worksheet S-10 of the Medicare cost report. The cost-to-charge ratio was used for the various sub-line items of line # 7. PART I, LINE 7G: The costs on line 7g do not include any costs attributable to physician clinics.
Part III, Line 2: Methodology Used to Estimate Amount of Bad Debt Expense	The amount reported on line 2 is equal to the provision for bad debt expense per the audited financial statements. The explanation of the methodology used to estimate this amount can be found in footnote #2 on pages 16-17 of the attached audited financial statements.
Part III, Line 4: Description of Bad Debt Expense	The text of the footnote that describes bad debt expense can be found on pages 16-17 of the attached audited financial statements.
Part III, Line 8: Costing Methodology	Since Margaretville Memorial Hospital is a critical access hospital, the hospital receives 101% of its cost for most of its services; therefore Margaretville should always have a surplus from Medicare. The amount reported on Line 6 was derived by using the Medicare allowable costs as reported on the Medicare cost report and the applicable adjustments from Worksheet A. For 2019, Margaretville Memorial Hospital does not have a loss from Medicare therefore it is not considered a community benefit.
PART III LINE 9B: Collection Practices	The credit and collection policy for self-pay balances provides that, in some cases, non-insured patients that do not qualify for medicaid qualify for charity care. In those instances, the credit and collection department will follow the guidelines as set forth in the charity care policy. The charity care policy provides that the financial counselor evaluates the information provided in patients' charity care applications in conjunction with federal income poverty guidelines to determine the write-off percentage. If the patient/guarantor qualifies for charity care based on the sliding scale, the patient will be required to pay the outstanding amount. A payment plan is established not to exceed 10% of the guarantor's gross monthly income.
PART VI, LINE 2: NEEDS ASSESSMENT	For the community based strategies, Margaretville hospital will continue to actively participate in a work group consisting of the public health department and three other local hospitals for the purposes of maintaining engagement with local partners over the next three year period. Initially, meetings will be held on a quarterly basis; however frequency will be revisited throughout the timeframe to ensure that the meetings are meeting the needs of all partners. Progress will be tracked by the work group Margaretville hospital is actively participating in. Annually hospital leadership presents an update to the hospital's board of trustees noting specific achievements and barriers to implementation. Anecdotal feedback will be in work group meetings, meetings involving health and wellness groups such as the suicide prevention network of Delaware County, and from patients and individuals participating in interventions, allowing continual review of the community service plan tasks and mid-course corrections when required. Periodic public notices will be posted on the hospital website. Finally, as available, local, state and national health status indicators will be reviewed.
PART VI, LINE 3:	The hospital informs the patient of the availability of charity care several ways: 1. notice is on every patient bill with an application on the back of the bill 2. on the hospital website 3. all members of the patient accounting department are trained to screen patients for charity care when discussing bills and concerns regarding inability to pay 4. fliers are posted in registration areas of the hospital 5. registration clerks will identify patients without a pay source and refer the patient to a financial counselor and hand the patient a financial assistance form 6. financial counselors assist patients in securing Medicaid and screen for charity care 7. the collection agencies that HAHV engages with are aware of the charity care policy and assist patients in applying up to 180 days post-placement with them HealthAlliance is committed to: - Providing access to quality healthcare services with compassion, dignity and respect for those we serve, particularly the poor and the underserved in our communities. - Caring for all persons, regardless of their ability to pay for services. - Assisting patients who cannot pay for part or all of the care they receive. - Balancing needed financial assistance for some patients with broader fiscal responsibilities in order to sustain viability and provide the quality and quantity of services for all who may need care in a community. In accordance with AHA recommendations, HealthAlliance adopted the following guiding principles when handling the billing, collection and financial support functions for our patients: - provide effective communications with patients regarding hospital bills - make affirmative efforts to help patients apply for public and private financial support programs - offer financial support to patients with limited means - implement policies for assisting low-income patients in a consistent manner - implement fair and consistent billing and collection practices for all patients with patient payment obligations HealthAlliance effectively communicates with patients regarding patient payment obligations. Financial counseling is provided to patients about their payment obligation and hospital bills. Information on hospital-based financial support policies and external programs that provide coverage for services are made available to patients during the pre-registration and registration processes and in response to patients seeking financial assistance. Information regarding the financial assistance is also provided by the onsite financial counseling staff in both inpatient and outpatient areas. Patient accounting also supports the financial counseling program by providing patients with information and applications while handling customer service calls. Financial counselors and county Medicaid workers also provide guidance regarding the financial assistance program when necessary. Financial assistance is available on the back of every hospital bill as well as the hospital website at www.hahv.org. Financial counselors make affirmative efforts to help patients apply for public and private programs for which they may qualify and that may help them obtain and pay for healthcare services. The patient does not need to have an account with the hospital; they just have to be in a situation where they are in need of insurance coverage. Every effort is made to determine a patient's eligibility prior to or at the time of admission or service. However, determination for financial support can be made during any stage of the patient's stay after stabilization or collection cycle. HealthAlliance offers financial support to patients with limited means. This support is available to uninsured and underinsured patients who do not qualify for public programs or other assistance. Notification about financial assistance, including contact information, is available through the hospital website, hospital posters and flyers, financial assistance applications and hospital statements. The financial assistance policy (FAP) and application are available on our website at https://www.hahv.org/financial-assistance and are supplied in both English and Spanish as well as plain language summary format. If additional assistance is needed, HealthAlliance offers translation services for patients. HealthAlliance has an established written policy for the billing, collection and support for patients with payment obligations. The organization makes every effort to adhere to the policy and is committed to implementing and applying the policy for assisting patients with limited means in a professional, consistent manner. Educated staff members work closely with patients (including those working in patient registration and admitting, financial assistance, customer service, billing and collections) about these policies with an emphasis on treating all patients with dignity and respect regardless of their insurance status or their ability to pay for services. All patient registration staff receive in-service training regarding the financial assistance program. Patient accounting also receives information about the program and how to handle patients seeking financial assistance. Financial counselors receive in depth training to handle financial assistance requests, process applications, and manage outcomes. HealthAlliance provides several options for patients who either do not have insurance coverage or who have inadequate insurance coverage. Our many programs have been very successful and many have taken advantage of our offerings. Financial counseling offers a patient the opportunity to speak to a financial counselor to determine what assistance can be accessible based on family income. Patients often shop around for the most economical healthcare and we offer price quotes. This allows the patient to know their financial obligation up front and understand the competitive pricing being offered. Despite millions of dollars of charity care distributed to needy patients every year, a consistent challenge is patients not utilizing the programs we offer. Often they don't want to provide the necessary financial information to initiate the financial aid process. Continual outreach and education is occurring to minimize confusion and improve utilization. HealthAlliance is committed to providing the best possible healthcare and is very sensitive to low income patients' ability to pay. The call center offers the convenience of calling one telephone number for all billing inquiries regardless of which hospital the patient is calling about.
PART VI, LINE 4: Community Description	Margaretville Memorial Hospital (Margaretville Hospital), a member of HealthAlliance of the Hudson Valley and the Westchester Medical Center Health Network (WMCHealth) is a rural Critical Access Hospital whose mission is to provide immediate access to high quality medical care and diagnostic testing services to medically underserved areas in the Catskill Mountains. Margaretville Hospital provides linkages to high tech and specialty medical care through an active relationship with HealthAlliance and WMCHealth. Margaretville Hospital is the Delaware County affiliate of HealthAlliance of the Hudson Valley (HealthAlliance), a multi-campus health care system consisting of HealthAlliance Hospital's Mary's Ave. and Broadway campuses in Kingston, NY, and Margaretville Hospital, which is co-located on a single campus in Margaretville, NY (Delaware County), with the Mountainside Residential Care Center, a skilled nursing facility. HealthAlliance defines its primary service area by a federal definition that consists of the top 75% of hospital discharges from the lowest number of contiguous zip codes. Margaretville hospital serves the communities of Margaretville, Arkville, Andes, Fleischmanns, Roxbury, Halcott Center, Halcottsville, and New Kingston. Due to the geographical location of acute care hospitals affiliated with HealthAlliance, there are two distinct primary services areas within Ulster and Delaware Counties, though not encompassing all of each county. For operational and community needs development, HealthAlliance regards these two service areas as a single primary service area with the predominant population in Ulster County. However, for the purposes of this document, which will align with the Delaware County Community Health Assessment and the Community Health Improvement Plan, we will present the information pertaining to the Margaretville Hospital service area, located in Delaware County and described in the beginning of this section. Other community health services and resources available in Delaware County include 23 ambulance services, mostly consisting of volunteer membership. In addition to Margaretville Hospital, there are three other hospitals, operated by two other healthcare systems: Delaware Valley Hospital affiliated with United Health Services, as well as O'Connor Hospital affiliated with the Bassett Healthcare Network. Additionally, there are three nursing homes in the county, 15 primary care offices including health centers and private physician offices, 15 locations and 9 full-time equivalent dentists, and two mental health clinics with multiple locations within the county. Delaware County covers 1,442 square miles in upstate New York, belonging to both the Southern Tier region and the Catskill Mountain range. Delaware County is the fourth largest county in New York by area and is the sixth most rural with a population density of 33 persons per square mile. The county includes the Catskill/Delaware Watershed, which is the largest unfiltered drinking water supply in the United States. The watershed region encompasses the central and eastern sections of Delaware County and includes roughly 65% of the county's land area and 11 of its 19 townships. Approximately 55% of Delaware County's population lies within the Watershed. Based on the 2010 Census, the population of Delaware County is 47,840, 50.2% male and 49.8% female. In 2013, the population decreased to 46,772, representing a 2.3% reduction in population (Table 1). At the time of the 2010 Census, 9,405 people were less than 18 (19.6%), 38,575 were 18 and over (80.4%) and 9,331, were 65 and over (19.4%). It is estimated that 46.5% of the total population is 45 years of age or older.
PART VI, LINE 5: Promotion of Community Health	Please see narrative for Schedule H, Part V, Section B, line 11 for a complete description of how the organization's hospital facilities furthers its exempt purposes by promoting the health of the community.
PART VI, LINE 6: Affiliated Health Care System	Health Alliance is the parent company to affiliate members HA Mary's Avenue campus, Broadway campus, Margaretville Memorial Hospital, a rural critical access hospital; Mountainside Residential Care Center, a skilled nursing facility. This integrated healthcare system is committed to providing quality and compassionate medical care for our patients, their families and our community. In addition to service consolidation between the two Kingston hospitals, HAHV also committed to streamlining operations and improving care at the other affiliate locations.
PART VI, LINE 7: STATE FILING OF COMMUNITY BENEFIT REPORT	NEW YORK

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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
Eileen King
CLINICAL COORDINATOR	$236,034	$0	$0	$0	$792	$0	$240	$0	$26,819	$0	$263,885	$0	$0	$0
Joseph Marsicovete
Chief Operating Officer	$0	$314,013	$0	$0	$0	$7,834	$0	$6,750	$0	$13,522	$0	$342,119	$0	$0
Paul Llobet MD
TRUSTEE (RESIGNED 9/2/2019)	$0	$215,705	$0	$0	$0	$57,947	$0	$5,826	$0	$0	$0	$279,478	$0	$0
MARK POHAR
EXEC DIR/ex-officio trustee	$0	$213,746	$0	$0	$0	$19,894	$0	$5,475	$0	$26,261	$0	$265,376	$0	$0
NANETTE TREADWELL
PHYSICIAN ASSISTANT	$206,990	$0	$0	$0	$792	$0	$240	$0	$21,014	$0	$229,036	$0	$0	$0
JANE ULRICH
SR. VP OF NURSING	$0	$188,242	$0	$0	$0	$5,146	$0	$3,802	$0	$20,852	$0	$218,042	$0	$0
Robert Ross
EXEC. VP (resigned 12/31/19)	$0	$619,700	$0	$107,625	$0	$19,000	$0	$39,200	$0	$39,432	$0	$824,957	$0	$0
Catherine Allen MD
TRUSTEE (EFF. 5/1/19)	$384,995	$0	$0	$0	$432	$0	$0	$0	$12,461	$0	$397,888	$0	$0	$0
Thomas Brunelle
TRUSTEE (RESIGNED 9/28/19)	$0	$235,297	$0	$0	$0	$19,185	$0	$0	$0	$15,091	$0	$269,573	$0	$0
Michael Doyle MD
EXEC DIR/CMO (eff. 9/28/19)	$0	$222,694	$0	$0	$0	$127	$0	$0	$0	$239	$0	$223,060	$0	$0
Brian Callahan
Nurse Practitioner	$226,813	$0	$0	$0	$516	$0	$0	$0	$27,782	$0	$255,111	$0	$0	$0
David Scarpino
FORMER CEO (RESIGNED 12/31/18)	$0	$0	$0	$0	$0	$520,041	$0	$0	$0	$28,911	$0	$548,952	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule J, Part I, line 3	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL (CEO) RETIRED EFFECTIVE 12/31/18 AND WAS PAID SEVERANCE IN 2019 FROM A RELATED ORGANIZATION. THE ORGANIZATION'S EXECUTIVE DIRECTOR RECEIVES COMPENSATION FROM A RELATED ORGANIZATION. IN ORDER TO ESTABLISH COMPENSATION PAYMENTS, THE ORGANIZATION TYPICALLY COMPLETES A COMPENSATION STUDY OR ENGAGES AN INDEPENDENT CONSULTANT. THE RESULTS OF SAID STUDY OF CONSULTANT'S FINDINGS ARE IMPLEMENTED INTO A WRITTEN EMPLOYMENT CONTRACT. ALL ACTIONS ABOVE ARE APPROVED BY THE BOARD OF DIRECTORS/COMPENSATION COMMITTEE PRIOR TO FINALIZATION. SCHEDULE J, PART I, LINE 4A DAVID SCARPINO RECEIVED SEVERANCE PAYMENTS OF $520,041 IN 2019 FROM A RELATED ORGANIZATION. PAUL LLOBET, MD RECEIVED SEVERANCE PAYMENTS OF $36,723 IN 2019 FROM A RELATED ORGANIZATION.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, LINE 6	healthalliance, inc. is the sole corporate member of Margaretville memorial hospital. FORM 990, PART VI, LINE 7A HEALTHALLIANCE, INC., THE SOLE CORPORATE MEMBER OF MARGARETVILLE MEMORIAL HOSPITAL, HAS THE POWER TO ELECT ONE OR MORE MEMBERS OF THE LOCAL GOVERNING BODY OF THE HOSPITAL.
FORM 990, PART VI, LINE 7B	ALL DECISIONS MADE AT THE LOCAL BOARD LEVEL OF MARGARETVILLE MEMORIAL HOSPITAL, OTHER THAN THOSE RELATED TO QUALITY ASSURANCE AND BUILDING AND GROUNDS, ARE SUBJECT TO APPROVAL BY MEMBERS OF HEALTHALLIANCE, INC. BOARD OF TRUSTEES. THESE DECISIONS INCLUDE ELECTION AND REMOVAL OF MEMBERS OF THE LOCAL LEVEL GOVERNING BODY, APPOINTMENT/REMOVAL OF CORPORATE OFFICERS, APPROVAL OF BYLAW AMENDMENTS, REVIEW OF ANNUAL CAPITAL AND OPERATING BUDGETS, REVIEW AND/OR MODIFICATIONS OF ANY CERTIFICATE OF NEED APPLICATIONS, REVIEW INCURRENCE OF DEBT AND DEVELOP AND IMPLEMENT JOINT MEDICAL STAFF APPOINTMENTS.
FORM 990, PART VI, LINE 11B	THE FORM 990 WAS PREPARED BY THE ORGANIZATIONS TAX ADVISORS WITH ASSISTANCE FROM THE ORGANIZATIONS FINANCE DEPARTMENT AND OTHER DEPARTMENTS THROUGHOUT THE ORGANIZATION. THE FORM 990 WAS REVIEWED BY SENIOR MANAGEMENT. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PROVIDED TO THE BOARD OF THE ORGANIZATION FOR APPROVAL PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, LINE 12C	THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY MEANS OF A SURVEY DEVELOPED AND APPROVED BY THE CHIEF COMPLIANCE OFFICER. THE SURVEY IS SENT TO ALL TRUSTEES, OFFICERS, AND KEY EXECUTIVES FOR COMPLETION. ALL SURVEY RESPONSES ARE REVIEWED BY THE CHIEF COMPLIANCE OFFICER. ANY POTENTIAL CONFLICTS IDENTIFIED IN THE RESPONSES ARE DISCUSSED WITH SENIOR MANAGEMENT AND/OR REFERRED TO THE WMCHEALTH CONFLICTS OF INTEREST COMMITTEE FOR DISCUSSION. POTENTIAL ACTIONS TO BE TAKEN IN RESPONSE TO A CONFLICT CAN BE ONE OR MORE OF THE FOLLOWING: 1) DISCLOSURE OF THE CONFLICT, 2) INDIVIDUAL RECUSAL FROM DECISIONS FOR TRANSACTIONS WHERE THAT INDIVIDUAL MAY HAVE A CONFLICT, 3) REQUEST IN WRITING THE INDIVIDUAL ALLEVIATES THE CONFLICT, OR 4) REMOVAL OF THE INDIVIDUAL FROM EMPLOYMENT.
FORM 990, PART VI, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9	TRANSFER TO RELATED PARTIES (299,940)
FORM 990 PART IX LINE 11G	DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:1244132
FORM 990 PART IX LINE 11G	DESCRIPTION:OTHER MANPOWER TOTAL FEES:131096
FORM 990 PART IX LINE 11G	DESCRIPTION:BIOMEDICAL SERVICES TOTAL FEES:110189
FORM 990 PART IX LINE 11G	DESCRIPTION:COLLECTION FEES TOTAL FEES:22163
FORM 990 PART IX LINE 11G	DESCRIPTION:WASTE DISPOSAL TOTAL FEES:19511
FORM 990 PART IX LINE 11G	DESCRIPTION:CONSULTING & MGT TOTAL FEES:26548
FORM 990 PART IX LINE 11G	DESCRIPTION:PHYSICIAN FEES TOTAL FEES:740949

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
WMC HEALTH NETWORK - ROCKLAND INC
100 WOODS ROAD	VALHALLA	NY	10595	320467873	SUPPORTING	NY	501(C)(3)	12A	NA	false
WMC HEALTH NETWORK - ULSTER INC
100 WOODS ROAD	VALHALLA	NY	10595	320477183	SUPPORTING	NY	501(C)(3)	12A	WCHCC	false
WESTCHESTER COUNTY HEALTH CARE CORP
100 WOODS ROAD	VALHALLA	NY	10595	133964321	HEALTHCARE	NY	115	N/A	NA	false
WMC NEW YORK INC
100 WOODS ROAD	VALHALLA	NY	10595	134107894	FUNDRAISING	NY	501(C)(3)	12A	WCHCC	false
NORTH ROAD LHCSA INC
100 WOODS ROAD	VALHALLA	NY	10595	465293268	HOMECARE SVCS	NY	501(C)(3)	10	WCHCC	false
MID-HUDSON VALLEY EARLY EDUCATION CENTER
100 WOODS ROAD	VALHALLA	NY	10595	465534882	PRESCHOOL	NY	501(C)(3)	7	WCHCC	false
WESTCHESTER MEDICAL CENTER FOUNDATION
100 WOODS ROAD	VALHALLA	NY	10595	134095845	FUNDRAISING	NY	501(C)(3)	7	WCHCC	false
HEALTHALLIANCE INC
741 GRANT AVENUE	LAKE KATRINE	NY	12449	261850453	SUPPORTING	NY	501(C)(3)	12A	WCHCC	false
HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS
396 BROADWAY	KINGSTON	NY	12401	141349558	EXEMPT HOSP	NY	501(C)(3)	3	HA INC	false
HEALTHALLIANCE HOSP MARY'S AVE CAMPUS
105 MARYS AVENUE	KINGSTON	NY	12401	141338470	EXEMPT HOSP	NY	501(C)(3)	3	HA INC	false
MARGARETVILLE NURSING HOME INC
42158 STATE HIGHWAY 28	MARGARETVILLE	NY	12455	223143565	NURSING HOME	NY	501(C)(3)	10	MMH	Yes (true)
MARGARETVILLE HEALTH FOUNDATION
42084 STATE HIGHWAY 28	MARGARETVILLE	NY	12455	261998454	SUPPORT FDN	NY	501(C)(3)	12A	MMH	Yes (true)
FASC FOUNDATION
741 GRANT AVENUE	LAKE KATRINE	NY	12449	264201295	SUPPORT FDN	NY	501(C)(3)	7	HAH BWAY	false
GOOD SAMARITAN FDN FOR BETTER HEALTH
255 LAFAYETTE AVE	SUFFERN	NY	10901	133400353	SUPPORT FDN	NY	501(C)(3)	7	BSCHSI	false
BON SECOURS COMMUNITY HOSPITAL FDN
255 LAFAYETTE AVE	SUFFERN	NY	10901	810667395	SUPPORT FDN	NY	501(C)(3)	7	BSCHSI	false
BON SECOURS WARWICK HEALTH FOUNDATION
255 LAFAYETTE AVE	SUFFERN	NY	10901	141972807	SUPPORT FDN	NY	501(C)(3)	7	BSCHSI	false
BON SECOURS CHARITY HEALTH SYSTEM INC
255 LAFAYETTE AVE	SUFFERN	NY	10901	912135195	SUPPORTING	NY	501(C)(3)	12C, III-FI	WCHCC	false
HealthAlliance Foundation Inc
741 GRANT AVENUE	LAKE KATRINE	NY	12449	222511450	FUNDRAISING	NY	501(C)(3)	7	HA INC	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Legal Domicile StateLegalDomicileStateCd
HUDSON RIVER WEST INSURANCE (BARBADOS)
38 PINE ROAD	BELLEVILLE ST MICHAEL	BB	CAP INSURANCE	BB	BSCHSI	C CORP	false
KINGSTON INSURANCE (BARBADOS) LIMITED
38 PINE ROAD	BELLEVILLE ST MICHAEL	BB	CAP INSURANCE	BB	HEALTHALLIANCE	C CORP	false
NORTHEAST PROVIDER SOLUTIONS INC
			MSO & HEARING		NA	c corp	false	100 WOODS ROAD	VALHALLA	NY	10595	133991673	NY
WMC ADVANCED PHYSICIAN SERVICES PC
			PHYSICIAN OFF		NA	c corp	false	19 BRADHURST AVENUE	HAWTHORNE	NY	10595	264709927	NY
WESTCHESTER MEDICAL REGIONAL PHYS SVCS
			PHYSICIAN OFF		NA	c corp	false	241 NORTH ROAD	POUGHKEEPSIE	NY	10532	465522536	NY
WCHCC (BERMUDA) LIMITED
VICTORIA HALL 11 VICTORIA STREET	HAMILTON	BD	CAP INSURANCE	BD	NA	c corp	false
KINGSTON REGIONAL HEALTH CARE ENTERPRISE
			INVESTMENT		HAH BWAY	c corp	false	396 BROADWAY	KINGSTON	NY	12401	161514994	NY
MID HUDSON PHYSICIANS PC
			MEDICAL SVCS		na	c corp	false	396 BROADWAY	KINGSTON	NY	12401	203564769	NY
bschs medical group pc
			physician off		bschs	c corp	false	10 franklin turnpike	mahwah	NJ	07430	821632215	NJ

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

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	MARGARETVILLE NURSING HOME INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	o	TransactionTypeTxt
Involved	$806,939	InvolvedAmt
Method Of Amount Determination	COST	MethodOfAmountDeterminationTxt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE R, PART II, Bon Secours Charity Health System, Inc. (BSCHS)	FormAndLineReferenceDesc
Explanation	Margaretville Memorial Hospital has a brother-sister relationship with BSCHS's six subordinates in a group exemption within BSCHS.	ExplanationTxt