2019-11-13T12:38:39-06:00 2018-12-31 KPMG LLP 515 Broadway 4th Floor Albany NY 122072974 990 2018-01-01 141338413 Glens Falls Hospital % WILLIAM WALBRIDGECONTROLLER GLEN 5189265005 100 Park Street Glens Falls NY 12801 DIANNE SHUGRUE PRESIDENT/ CEO 5189265005 2019-11-13 true Todd P Teresco P00247720 5184274600 2019-11-12 167.68.102.5 14012520193175000000 2019-11-13 P 61534EC9BCA1C3D89F6EB9A5054E4B493C585575 7B5190DACD7950FB62E11B317DAE60956DD6A6E7 2018 2020-03-31 21:24:44Z DIANNE SHUGRUE 100 Park Street Glens Falls NY 12801 399578488 false X glensfallshospital.org X 1897 NY SEE SCHEDULE O 15 14 3157 269 2423168 0 9454267 11033487 299073123 311160004 2713069 7941835 4244274 38107987 315484733 368243313 12900 12000 0 0 182143932 183382186 0 0 459039 167515549 173171915 349672381 356566101 -34187648 11677212 301638017 271762967 195951954 167848197 105686063 103914770 X SEE SCHEDULE O false false 269097073 12000 347320662 Glens Falls Hospital provides a comprehensive health care system that stretches across 3,000 square miles in upstate NY. We provide high quality care to people, regardless of their ability to pay. We are a 406 bed facility with more than 225 certified physicians in over 25 specialties. Our services include, but are not limited to, emergency care, surgical services, mental health, cancer care, primary care and preventative health education. In 2018, we had 58,360 patient days and 13,303 discharges. The Emergency Care Center provided care to 47,919 patients. Our Mental Health department provided 56,625 outpatient treatments and 4,905 inpatient days. Our Surgery Center performed 10,492 procedures. 269097073 true true false true false false false false false true true false false false true true false true false false false false false false false false true true false true true true false false false false false false false true false false false false false false false true false false false true 238 0 true 3157 true true true false false false false false false false false false false false X 15 14 false false false false false false false true true true false false true true true true true true true true true NY X WILLIAM WALBRIDGECONTROLLER 5189265005 100 PARK STREET GLENS FALLS NY 12801 GLENDA KELMAN RN CHAIRMAN 1.0 0.0 X X 0 0 0 JOSEPH F RACCUIA DIRECTOR (THRU 05/18/18) 1.0 0.0 X 0 0 0 MARK BEHAN VICE CHAIRMAN 1.0 0.0 X X 0 0 0 JOHN C BIENIEK DIRECTOR 1.0 0.0 X 0 0 0 TENEE' CASACCIO DIRECTOR 1.0 0.0 X 0 0 0 JAMES E CULLUM DIRECTOR 1.0 0.0 X 0 0 0 KATHIE L DUNCAN DIRECTOR 1.0 0.0 X 0 0 0 GEORGE FERONE DIRECTOR 1.0 0.0 X 0 0 0 KEVIN J HERLIHY MD DIRECTOR 1.0 0.0 X 0 0 0 GARY R HICKS DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM H REYNOLDS MD DIRECTOR 1.0 0.0 X 0 0 0 DAVID WESTFALL MD DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM HART DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM POWERS SECRETARY 1.0 0.0 X X 0 0 0 CARL CEDRONE DIRECTOR 1.0 0.0 X 0 0 0 GREGORY CHAMPION DIRECTOR 1.0 0.0 X 0 0 0 DIANNE SHUGRUE PRESIDENT/CEO 40.0 0.0 X 670846 0 11988 MITCH AMADO CFO 40.0 0.0 X 391137 0 19440 PAUL SCIMECA SR VP OPERATIONS 40.0 0.0 X 408463 0 19515 DONNA KIRKER VP PATIENT SERVICES 40.0 0.0 X 283567 0 11844 PATTI HAMMOND VP PHYSICIAN PRACTICE MGT 40.0 0.0 X 293646 0 17293 JOHN P STOUTENBURG MD ONCOLOGY PHYSICIAN 40.0 0.0 X 708131 0 22244 IQBAL BASHIR MD CARDIAC PHYSICIAN 40.0 0.0 X 657956 0 22244 AQUEEL A GILLANI MD ONCOLOGY PHYSICIAN 40.0 0.0 X 706647 0 19260 CHARLES YUN MD ONCOLOGY PHYSICIAN 40.0 0.0 X 713337 0 12832 MICHAEL LAYDEN MD CARDIAC PHYSICIAN 40.0 0.0 X 632070 0 22244 5465800 0 178904 204 false true false HUDSON HEADWATERS HEALTH NETWORK 9 CAREY RD QUEENSBURY NY 12804 MEDICAL SERVICES 4533479 GRANT THORNTON LLP 33562 TREASURY CENTER CHICAGO IL 60694 CONSULTANTS 2252556 REVMD PARTNERS 1111 PASQINELLI DR SUITE 400 WESTMONT IL 60559 COLLECTION SERVICES 2100454 BERKELEY RESEARCH GROUP LLC 200 Powell St Suite 1200 EMERYVILLE CA 94608 CONSULTANTS 1030168 COMPHEALTH PO BOX 972651 DALLAS TX 75397 TEMP EMPLOYEES 890792 42 1793284 9086815 153388 11033487 PATIENT SERVICE REVENUE 622110 301811830 301811830 HOSPITAL LAB SERVICES 621500 2177754 2177754 CENTER FOR OCCUPATIONAL HEALTH 621340 831930 831930 OUTPATIENT PHARMACY 446110 3005519 3005519 MEDICAL HOME PROJECT 621110 881610 881610 2451361 2442508 8853 311160004 1535705 1535705 0 0 0 0 0 34586904 3154401 29813426 1521749 4773478 1632652 6406130 6406130 0 0 0 0 0 0 0 0 0 SALE OF RENAL SERVICE LINE 900099 24939300 24939300 PROCEEDS FROM LEGAL SETTLEMENT 900099 8804752 8804752 INVESTMENT IN YANKEE ALLIANCE 900099 2135095 1774336 360759 2228840 642270 -124198 1710768 38107987 368243313 345134055 2423168 9652603 0 12000 12000 0 0 2127739 2127739 25508 25508 156007437 126774044 29017358 216035 4973028 3991051 975177 6800 9648890 7478279 2157870 12741 10599584 8506584 2078507 14493 7705607 1720909 5933961 50737 766619 766619 209281 197025 12256 34959 34959 0 0 33533992 13013964 20450815 69213 727765 250 727515 93383726 87188931 6177983 16812 7362449 189881 7172568 0 3848965 1017950 2831015 273251 195732 76492 1027 0 346516 252434 91688 2394 2930354 2355731 574623 0 17278721 13890481 3388240 2213704 1785683 428021 NYS ASSESSMENT 1240868 1240868 RECRUITMENT FEES 191980 1493 190487 DONATED FUNDS EXPENSE 284391 173477 55002 55912 LICENSE AND TAXES 292011 278123 13888 546756 244568 301569 619 356566101 269097073 87009989 459039 4729854 7405413 2514883 13896664 0 0 57794987 37759695 0 0 0 0 98083 161820 5535870 5235014 3388298 3369304 362401858 236448808 122348158 125953050 93185775 70760064 0 0 0 0 0 0 12042109 7221943 301638017 271762967 87954626 54723899 0 0 0 0 56041699 52751418 0 0 0 0 26335859 15973012 0 0 25619770 44399868 195951954 167848197 X 98880485 97266671 5298906 5141427 1506672 1506672 105686063 103914770 301638017 271762967 X 11677212 -9225502 -4223003 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 34959 34959 false Part IIB, Line 1I IN 2018, GLENS FALLS HOSPITAL PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION, THE HOSPITAL ASSOCIATION OF NEW YORK, AND IROQUOIS HEALTHCARE ALLIANCE, A PORTION OF WHICH WENT TOWARDS LOBBYING EXPENSES AS DETERMINED BY THE ASSOCIATIONS AND THE ALLIANCE. 1506672 218087 12000 206087 1506672 1506672 154101 12900 141201 1506672 1506672 393967 15300 378667 1506672 1506672 602863 16200 586663 1506672 1506672 0 355034 16000 53115 285919 1506672 1.00000 false false 9917434 9917434 185980563 117300886 68679677 166503861 119147922 47355939 125953050 0 DEFERRED COMP PAYABLE 7776838 SELF INSURED LIABILITY RESERVE 8789466 ASSET RETIREMENT OBLIGATION 424085 LONG TERM PAYABLE 27409479 44399868 X 354782808 -9225502 -4219976 -13445478 368228286 15027 15027 368243313 356554101 -12000 -12000 356566101 356566101 Part V, Line 4 Permanently restricted net assets are investments to be held in perpetuity, the income from which is expendable to support the following: Dental Care 1,053,285 Indigent Care 148,927 Gen. Operating Expenses 169,975 Health Education 134,485 Total 1,506,672 Part X, Line 2 The Hospital recognizes the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than fifty percent likely of being realized upon settlement. Changes in recognition in measurement are reflected in the period in which the change in judgment occurs. The Hospital did not recognize the effect of any uncertain tax positions in either 2018 or 2017. PART XI, LINE 2D Change in interest in net assets of GFH Foundation 86,914 Cumulative effect of Change in Accounting Principle (4,306,890) ---------------- Total (4,219,976) PART XI, LINE 4B OTHER GRANTS PAID 12,000 RECEIPTS OF FOUNDATION FUNDS TO BALANCE SHEET ACCOUNTS 3,027 ---------------- Total 15,027 PART XII, LINE 4B OTHER GRANTS PAID (12,000) true true true X 130. true X 330. true true true false true true 3634633 3195972 438661 0.00120 54688391 34676486 20011905 0.05610 58323024 37872458 20450566 0.05730 2056988 1493512 563476 0.00160 717692 0 717692 0.00200 128531084 121606636 6924448 0.01940 140224 29247 110977 0.00030 42338 0 42338 0.00010 131488326 123129395 8358931 0.02340 189811350 161001853 28809497 0.08070 132598 43000 89598 0.00030 171928 0 171928 0.00050 304526 43000 261526 0.00080 true 72293384 104594031 -32300647 X true false Imaging Svc of NENY Diagnostic Radiology 0.5 0.5 0.5 N Country Eye Ctr Eye center 0.3 0.3 0.3 1 1 Glens Falls Hospital 100 Park Street Glens Falls NY 12801 glensfallshospital.org Lic#5601000H X X X Glens Falls Hospital 1 false false true X X X X X X X X X 16 true false false true X See Section C X true 16 true See Section C false true X 130. 330. X X X true true X X X true X See Section C X See Section C X X X X true X false X X X true X false false Part V Line 5 In conducting the CHNA, non-profit hospitals are required to take into account input from persons who represent the broad interests of the community served, including those with special knowledge of or expertise in public health. In addition, members, leaders or representatives of medically underserved, low-income, minority populations should be consulted. Glens Falls Hospital met this requirement through participation in regional health assessment and planning efforts facilitated by the Adirondack Rural Health Network (ARHN). GFH coordinated with Fulton, Essex, Hamilton, Franklin, Clinton, Warren and Washington County Public Health, in addition to Adirondack Health, Inter-Lakes Health and Moses Ludington Hosptial, Nathan Littauer Hospital & Nursing Home, UVM Health Network-Alice Hyde Medical Center, UVM Health Network-Champlain Valley Physicians Hospital and UVM Health Network-Elizabethtown Community Hospital, to conduct a survey of selected stakeholders representing health care and service-providing agencies within the region. Respondents to the survey indicated they represent a wide array of sectors including: day program services, education, employment, training, health care service prevention/wellness, healthy environment, housing/residential and social services. The results of the survey were incorporated into the CHNA as they are intended to provide an overview of regional needs and priorities, to inform future planning and the development of a regional health care agenda. The survey results were presented at both the county and regional levels. Part V Line 7a and 10a The Hospital's CHNA and Implementation Strategy is posted on its website: www.glensfallshospital.org/services/community-services/health-promotion-ce nter/ PART V LINE 11 ALL OF THE COMMUNITY HEALTH ASSESSMENT NEEDS ARE LONG-TERM GOALS AND ARE ACTIVELY BEING WORKED ON IN SOME RESPECT. A THREE-YEAR ACTION PLAN WAS DEVELOPED AND INCLUDES INITIATIVES LED BY GFH TO ADDRESS THE PRIORITIZED COMMUNITY HEALTH NEEDS. IT INCLUDES INITIATIVES TO ADDRESS THE FOCUS AREAS UNDER THE PREVENT CHRONIC DISEASE PRIORITY AREA OF THE NYS PREVENTION AGENDA. MANY OF THE INITIATIVES IMPACT MORE THAN ONE FOCUS AREA AND SOME INFLUENCE ALL THREE FOCUS AREAS. EACH INITIATIVE INCLUDES A BRIEF DESCRIPTION, HEALTH DISPARITIES ADDRESSED, GOAL, SMART OBJECTIVE(S) AND CORRESPONDING PERFORMANCE MEASURE(S), AND KEY ACTIVITIES FOR THE IMPROVEMENT STRATEGY. GFH CONTINUES TO BE ACTIVELY INVOLVED IN THE COUNTIESOTHER PARTNER-LED INITIATIVES. ADDITIONAL ANALYSIS REVEALED AN INCREASING DEMAND AND NEED FOR MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES THROUGHOUT THE THREE COUNTY REGION. Glens Falls Hospital recognizes this trend and the need for quality services and programs, however, has not historically formalized strategies into the plan due to lack of resources and capacity. Currently, Glens Falls Hospital is the contracted behavioral health provider for Warren and Washington counties. The need will only increase, and we are working to proactively ensure patients have access to the care they need. Most recently, Glens Falls Hospital is working with Warren and Washington Counties to conduct a thoughtful and deliberate partnership exploration process for outpatient behavioral and substance use services. We are working with the Counties to identify potential partners who can help us better serve patients, with a goal to expand access to much-needed specialized behavioral health services in our community. Simultaneously, GFH will continue to work through initiatives such as Health Home and DSRIP to work with all providers on integrated care models and population health strategies. Part V Line 16a and 16b The Hospital's financial assistance policy and application form is posted on its website: www.glensfallshospital.org/patients-and-visitors/patients/patient-financia l-assistance/ Part V, Line 20d In 2018, the Hospital did not have a presumptive eligibility tool, but is actively researching and pursuing a software tool to be able to put one in place in the near future. 20 Adirondack Cardiology 6 Hearts Way Queensbury NY 12804 Hosp. Extension Clinic - Cardiology and Cardiac Rehabilitation Behavioral Health ServicesRidge Commons 1 Lawrence Street Glens Falls NY 12801 Hosp. Extension Clinic - O/P Mental Health Services The Rehab Center & Hearing Center 2 Country Club Road Queensbury NY 12804 Hosp. Extension Clinic - O/P PT, OT, Speech, Audiology Cambridge Medical Center and Urgent Care 35 Gilbert St Cambridge NY 12816 Hosp. Extension Clinic - Primary Medical Care, PT, O/P Radiology, Mental Heath Svcs Granville Medical Center 79 North St Granville NY 12832 Hosp. Extension Clinic - Primary Medical Care, O/P Radiology, Lab, Rehab Greenwich Medical Center 1134 County Rt 29 Greenwich NY 12834 HOsp. Extension Clinic - Primary Medical Care, O/P Radiology, PT Center for Recovery 101 Ridge St Glens Falls NY 12801 Hosp. Extension Clinic - Chemical Dependence, O/P Rehab Physical Therapy at Irongate 4 Irongate Ctr Glens Falls NY 12804 Hosp. Extension Clinic - O/P PT, OT, Speech, Audiology Wilton Medical Center 135 North Rd Gansevoort NY 12831 Hosp. Extension Clinic - Primary Medical Care, O/P Radiology, PT The Center for Recovery 340 Main St Hudson Falls NY 12839 Hosp. Extension Clinic - Chemical dependence, O/P Rehab Physical Therapy at Main Street 17 Main St Glens Falls NY 12801 Hosp. Extension Clinic - Physical Therapy O/P Whitehall Medical Center 65 Poultney St Whitehall NY 12887 Hosp. Extension Clinic - Primary Medical Care, O/P Radiology, Rehab Glens Falls Broad St Medical Center 2 Broad St Glens Falls NY 12801 Hosp. extension clinic - Primary medical care, ENT Services Evergreen Medical Center Evergreen Plaza 13 Palmer Ave Corinth NY 12822 Hosp. Extension Clinic - Primary Medical Care, PT, O/P Radiology, Mental Health Svcs Fort Edward Medical Center 327 Broadway Fort Edward NY 12828 Hosp. Extension Clinic - Primary Medical Care, O/P Advanced Imaging at Baybrook 22 Willowbrook Rd Queensbury NY 12804 Hosp. Extension Clinic - diagnostic op radiology, CT Scanner Salem Medical Center 213 Main St Salem NY 12865 Hosp. Extension Clinic - Primary Medical Care, O/P PT Hudson Falls Medical Center 325 Main St Hudson Falls NY 12839 Hosp. Extension Clinic - Primary Medical Care GFH Sleep Lab 92 Broad St GLENS FALLS NY 12801 HOSP. EXTENSION CLINIC - Sleep Studies Stuart M Townsend Middle School 27 Hyland Drive Lake Luzerne NY 12846 School-based hosp. ext. clinic Health education, immunology, screenings Part 1, Line 6a Glens Falls Hospital develops and produces the Community Health Needs Assessment (CHNA) and Implementation Strategy (IS) per IRS guidelines, and publishes the report on the website. In addition, a Community Service Plan is produced per NYS Department of Health guidelines, and also made available on the website. These reports also include the American College of Surgeons Commission on Cancer requirements for the C.R. Wood Cancer Center. Paper copies are available for pick up in person or by mail by request. In addition, Glens Falls Hospital produces an Annual Report, which is mailed to approximately 60,000 households, and available at multiple locations throughout the hospital. A Community Newsletter is also distributed multiples times per year. Part 1, Line 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS A COST-TO-CHARGE RATIO AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TOCHARGES. Part II, Community Building Activities Glens Falls Hospital regularly assesses the makeup of the region's physician population, paying particular attention to physicians who may be approaching retirement age and specialties that may have a physician shortage due to retirement or relocation. The hospital employs a full-time physician recruiter who focuses on the recruitment and retention of high quality providers. The position actively recruits for vacancies and shortages among hospital employed physicians, and partners with independent practices to help them keep a full complement of physicians across specialties. The Hospital also monitors and actively engages in preventing the spread of infectious disease through school based health and the Hospital's infection control program. This includes vaccinations for children, and access to flu vaccines for the residents of our service area, (free or at a significantly reduced cost), including an annual HPODS drill. The Hospital meets regularly with community groups in planning for emergency preparedness. Coordinating with police departments, fire departments, EMS and county officials. Emergency drills are carried out for such things as natural disasters, terrorism, accidents with mass casualties and bio hazards. Community members play an active roll in these drills. Part III, Section A, Line 2 Bad Debt Expense DUE TO THE ADOPTION OF ASU NO. 2014-09 REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) BAD DEBT EXPENSE IS NO LONGER REPORTED ON THE AUDITED FINANCIAL STATEMENT. RATHER IT IS TREATED AS A PRICE CONCESSION. PLEASE SEE THE FOLLOWING AUDITED FINANCIAL STATEMENT FOOTNOTE WHICH DESCRIBES THIS PROUNONCEMENT. Recent Accounting Pronouncements - footnote 1(n) (i) from the Audited Financial Statements (ii) Revenue from Contracts with Customers Adoption of ASU No. 2014-09 Revenue from Contracts with Customers (Topic 606). Upon adoption, the majority of what is currently classified as provision for uncollectible accounts and presented as a reduction to net patient service revenue on the consolidated statements of operations and changes in net assets is treated as a price concession that reduces the transaction price, which is reported as net patient service revenue. During 2018 and 2017, the Hospital incurred approximately $1,895,743 million and $8,453,828 million in provisions for uncollectable accounts, respectively. Part III, Section A, Line 4 Charity Care Footnote 1(g) from the Audited Financial Statements Consistent with the Hospitals mission, care is provided to patients regardless of their ability to pay and who qualify for charity care under its Patient Financial Assistance Program. Charity care is defined as services for which patients have the obligation and willingness to pay but do not have the ability to do so. The System does not report charity care as net patient service revenue. The cost of charity care was approximately $8,125,000 and $7,900,000 for 2018 and 2017, respectively, as determined based on the application of a ratio of overall Hospital costs to patient charges. Included in patient service revenues for 2018 and 2017 is approximately $2,290,000 and $2,981,000, respectively, from uncompensated care pools and income from restricted endowments. The Hospital annually conducts a comprehensive assessment of the community and charitable benefits it provides. The most recent assessment was completed in fall 2018 and culminated with the issuance of the Glens Falls Hospital Community Service Plan, a copy of which is available from management upon request. Part III, Section B, Lines 5,6,7 In addition to the amount included in the Medicare Cost Report and reported on lines 5,6 & 7, the hospital incurred losses on services provided to Medicare patients and paid for under the Part B fee schedule and not reportable on the Medicare Cost Report. A complete reconciliation of amounts reportable in Section B. Total revenues included on the Medicare Cost Report, reported on line 5 $72,293,384 Total revenues from Medicare Part B services, Not reported on line 5 $1,502,518 ------------- Total revenues for Medicare services $73,795,902 Total costs included on the Medicare Cost report, reported on line 6 $ 104,594,031 Total costs from Medicare Part B services, not reported on line 6 $ 1,924,789 ------------- Total costs for Medicare services $ 106,518,820 Total (shortfall) included on the Medicare Cost Report, reported on line 7 $(32,300,647) Total (shortfall) from Medicare Part B services, not reported on line 7 $(422,271) -------------- Total (Shortfall) for Medicare services $(32,722,918) Part III, Line 8 The costing methodology used to determine the Medicare allowable costs reported in the organization's Medicare Cost Report, as reflected on line 6, is the methodology prescribed by Medicare in the completion of Form CMS-2552-96 and conforms to the requirements and principals set forth in 42 CFR, Part 412, 42 CFR, Part 413 and in the Provider Reimbursement manual, Part 1. GLENS FALLS HOSPITAL CONSIDERS 100% OF THE AMOUNT REPORTED IN PART III, LINE 7 A COMMUNITY BENEFIT. GLENS FALLS HOSPITAL IS THE ONLY COMPREHENSIVE ACUTE-CARE HOSPITAL SERVING A PREDOMINATELY RURAL, 3,000 SQUARE MILE AREA OF UPSTATE NEW YORK THAT ENCOMPASSES WARREN, WASHINGTON, HAMILTON, ESSEX AND NORTHERN SARATOGA COUNTIES. IN A VERY REAL SENSE, IT IS THE SAFETY NET HOSPITAL FOR THE MEDICARE PATIENTS IN THESE COMMUNITIES. DESPITE THE FACT THAT THE PAYMENTS RECEIVED FROM MEDICARE FOR THE SERVICES PROVIDED ARE GENERALLY BELOW THE RATES THAT THE HOSPITAL RECEIVES FROM MANAGED CARE PAYERS AND PRIVATE INSURERS THE HOSPITAL REMAINS COMMITTED TO SERVING ELDERLY PATIENTS AND IMPROVING THE HEALTH STATUS OF THE ELDERLY. Part III, Section C, Line 9b It is Glens Falls Hospital policy to delay final collections efforts while a patient financial assistance application is in process. A final determination is required before outside collection efforts are initiated. Part VI, Line 2 Needs Assessment In addition to completing a CHNA, hospitals in NYS are required to work together with county public health departments to complete a Community Service Plan (CSP) that mirrors the CHNA and Implementation Strategy (IS) per the ACA. Furthermore, all American College of Surgeons (ACoS) Commission on Cancer (CoC) cancer programs are required to complete a community needs assessment as well. To ensure the most efficient use of hospital resources and support a comprehensive approach to community health and population health management in the region, GFH chose to align and combine the requirements of the three entities. Working within the framework provided by the NYS Prevention Agenda, GFH and Warren, Washington and Saratoga County Public Health collaborated in the development of the CHNA in a way that can meet the requirements of all three entities. Additionally, GFH coordinated with Fulton, Essex, Hamilton, Franklin and Clinton County Public Health, in addition to several other hospitals in the region, through regional health assessment and planning efforts coordinated by ARHN. Part VI, Line 3 Patient education of eligibility for assistance Brochures are given at the point of service. All patient's statements advertise charity care programs. Customer Service representatives are trained to outline and encourage participation in the program. Vendor Medicaid eligibility process includes a charity care screening step for all inpatient and outpatient. Website contains information on charity care programs and the web portal has an application form online that can be printed and filled out. Part VI, Line 4 Community Information The Glens Falls Hospital healthcare system serves a large area of upstate New York that includes all or portions of the following counties: Warren, Washington, Hamilton, Essex and Northern Saratoga. The service area covers approximately 400,000 people. The population is largely white, non-Hispanic (93.7%). People over the age of 65 constitute 16.4% of the population; children under the age of 17 make up 19.6% of the population. The average household income is $69,553, lower than the NYS average of $85,736. Just over 1/4 of the population has obtained a Bachelor's degree or higher level of education (28.3%). Two age groups that will see the greatest growth are people aged 65 to 74 years and those over 75 years of age. Part VI, Line 5 Promotion of Community Health The governance of GFH is vested in the Board of Governors (the Board), which is compromised of duly elected community members and physicians. The Board consists of not less than twelve and not more than eighteen members. Any and all physicians living in the service area who are qualified, and who meet requirements as documented in the medical staff bylaws, are extended privileges. Funds in excess of expenses are allocated for capital projects, medical research and clinical trials, patient care improvements and system improvements. Capital projects are prioritized by an interdisciplinary commitee, consisting of physicians from different specialties as well as hospital management. Part VI, Line 7 STATE FILING OF COMMUNITY BENEFIT REPORT GLENS FALLS HOSPITAL FILES A COMMUNITY BENEFIT REPORT IN NEW YORK STATE. true NURSING SCHOLARSHIPS 3 12000 SCHEDULE I, PART I, LINE 2 BASED ON DATA COLLECTED THROUGH THE APPLICATION PROCESS, GRANTS ARE MADE ONLY TO APPLICANTS MEETING CERTAIN SELECTION CRITERIA. X true X X X X X X false false false false false false false true false DIANNE SHUGRUE PRESIDENT/CEO 621772 46236 2838 11000 988 682834 0 MITCH AMADO CFO 348560 39739 2838 10926 8514 410577 0 PAUL SCIMECA SR VP OPERATIONS 354494 51131 2838 11000 8515 427978 0 DONNA KIRKER VP PATIENT SERVICES 251169 31167 1231 11000 844 295411 0 JOHN P STOUTENBURG MD ONCOLOGY PHYSICIAN 650257 57454 420 11000 11244 730375 0 IQBAL BASHIR MD CARDIAC PHYSICIAN 437972 176084 43900 11000 11244 680200 0 PATTI HAMMOND VP PHYSICIAN PRACTICE MGT 272666 17511 3469 11000 6293 310939 0 AQUEEL A GILLANI MD ONCOLOGY PHYSICIAN 613055 92962 630 11000 8260 725907 0 CHARLES YUN MD ONCOLOGY PHYSICIAN 530622 182295 420 6922 5910 726169 0 MICHAEL LAYDEN MD CARDIAC PHYSICIAN 438400 171069 22601 11000 11244 654314 0 Part I, Line 41 PATTI HAMMOND RECEIVED A HOUSING ALLOWANCE OF $1,250, WHICH IS INCLUDED IN THE AMOUNT REPORTED IN PART II, COLUMN B(iii) AS OTHER REPORTABLE COMPENSATION. Part 1, Line 7 PHYSICIANS ARE ELIGIBLE AND DID RECEIVE ADDITIONAL COMPENSATION THROUGH PARTICIPATION IN AN INCENTIVE PROGRAM THAT ADDRESSED QUALITY, PATIENT SATISFACTION AND THEIR PERSONAL PRODUCTIVITY. A Glens Falls Civic Development Corp Series 2015 451673501 2015-09-21 67000000 Refund '03 bonds, capital projects false false false A 13400000 0 67000000 0 0 0 360205 0 0 17520856 49118939 0 2015 true false true true A false true true true false 0.01400 0.01400 false false false true A false true false false false false 0 false false false 0 false true A true David Westfall MD Director 22500 Joint Venture false Joanne Detore Relative of Director 25508 Compensation false FORM 990, SCHEDULE L, PART V DR. WESTFALL IS A DIRECTOR OF THE GLENS FALLS HOSPITAL BOARD, AND IS ALSO A MEMBER IN AN ENTITY INVOLVED IN A JOINT VENTURE WITH GLENS FALLS HOSPITAL. GLENS FALLS HOSPITALS INVESTMENT IN THIS JOINT VENTURE (NEW YORK EYE SURGERY CENTER, LLC) EXCEEDS $10,000. DR. WESTFALL IS A DIRECTOR OF THE GLENS FALLS HOSPITAL BOARD AND HAS A FAMILY MEMBER WHO IS AN EMPLOYEE OF GLENS FALLS HOSPITAL AND WAS PAID MORE THAN $10,000 IN 2018. All of Glens Falls Hospital Board members are required to sign a conflict of interest policy, to ensure that the Hospital operates in a manner consistent with its charitable purposes. Activities, arrangements and services are the result of arms length bargaining reflecting reasonable payments for goods and services. Board bylaws stipulate that board members recuse themselves regarding any subject that pertains to a potential conflict of interest. Part I, Line 1 & Part III, Line 1 Glens Falls Hospital is an acute care facility and is the largest hospital between Albany and Montreal. It serves 6 counties and operates 20 regional care facilities. We have more than 225 affiliated, board certified physicians, ranging from primary care to surgical specialties. Glens Falls Hospital provides access to primary care and preventative health education and outreach activities, services offered to the community for free or reduced costs including patient financial assistance and charity care. The mission of Glens Falls Hospital is to improve the health of the people in our region by providing access to exceptional, affordable, and patient-centered care every day and in every setting. Our fundamental values are C.A.R.E.S. Collaboration, Accountability, Respect, Excellence and Safety. PART VI, SECTION A, LINE 9 JOSEPH RACCUIA - 64 HEARTHSTONE DRIVE, WILTON NY 12831 Part VI, Section A, Line 11 An overview of the changes to the Form 990 was reviewed with the Audit and Compliance Committee in October, 2019. The Form 990 was reviewed by the CFO, Controller, Director of Finance, VP of Planning, and our Independent accountant, KPMG, to make sure it was filled out completely and accurately. A completed copy will be sent to the Audit and Compliance Committee along with the Board of Governors once it is filed. Part VI, Section B, Line 12b Each director, principal officer and member of a committee with board delegated powers shall annually sign a statement which affirms that such person, a) has received a copy of the conflicts of interest policy, b) has read and understands the policy, c) has agreed to comply with the policy and d) understands that the corporation is a charitable organization and that in order to maintain its Federal exemption it must engage primarily in activities which accomplish one or more of its tax exempt purposes. To ensure that the corporation operates in a manner consistent with its charitable purposes and that it does not engage in activities that could jeopardize its status as an organization exempt from federal income tax, periodic reviews shall be conducted. Reviews shall include the following subjects: A) whether compensation arrangements and benefits are reasonable and are the result of arm's length bargaining. B) whether acquisitions of physician practices and other provider services result in inurement or impermissible private benefit. C) whether partnership and joint venture arrangements and arrangements with management service organizations and physician hospital organizations conform to written policies, are properly recorded, reflect reasonable payments for goods and services, further the corporation's charitable purposes and do not result in inurement or impermissible private benefit. In conducting reviews, the corporation may use outside advisors. Part VI, Section B, Line 15a & 15b Glens Falls Hospital is committed to developing and maintaining a total compensation program that is competitive with programs offered by other health care organizations that are comparable to GFH in revenue, structure, mission and scope of services. The compensation philosophy includes: base salary ranges positioned in the 50th percentile of a national and regional peer group, annual incentive opportunities tied to performance goals established by the Board, benefits delivered in the 50th percentile of a national peer group and total compensation positioned at approximately the 50th percentile for expected performance, and somewhat above that for exceptional performance. Executive pay is reviewed annually by a third party consultant. This review includes comparison of GFH executive pay practices with national and regional benchmark studies as appropriate. The consultant is engaged directly by the GFH Board of Governors and reports their findings to the Board Personnel Committee for review and action. Part IV, Section C, Line 19 The organization makes its governing documents, conflicts of interest policy and financial statements available TO THE PUBLIC upon request. Part XI, Line 9 Change in interest in net assets of GFH Foundation 86,914 Cumulative effect of Change in Accounting Principle (4,306,890) Foundation transfers to BS Accounts (3,027) ---------------- Total (4,223,003) Part I, Line 7a and 7b - Unrelated Business Income Part 1, Line 7a includes only revenues reported on Part VIII, column C as unrelated business revenue. Glens Falls Hospital's unrelated taxable income for tax year 2018 included $82,324 in expenses incurred to maintain employee parking spaces. Under Internal Revenue Code Section 512(a)(7), such expenses are included in unrelated business taxable income as amounts paid for disallowed fringes and are therefore reflected in Part I, Line 7b. Glens Falls Hopital Foundation 100 Park Street Glens Falls NY 12801 141790805 Support Org NY 501(c)(3) 12,Type III NA false Adirondack Health Services Inc 100 Park Street Glens Falls NY 12801 141667492 PARENT ORG NY 501(c)(3) 12, Type I NA false Glens Falls Medical PLLC 100 Park Street Glens Falls NY 12801 823943636 Physician Off NY 501(C)(3) 12, Type I NA true Imag Svc of NENY 100 Park Street Glens Falls NY 12801 141820955 Diag. radiolo NY NA RELATED 449232 85432 false 0 false 0.50000 No Country Eye Ctr 465B Maple Ave Saratoga NY 128665531 453715451 Eye Center NY NA RELATED 234710 143997 false 0 false 0.30000 false false false false false false false false false true false false false false false false true false false Glens Falls Medical PLLC j 3450091 cash basis Glens Falls Medical PLLC q 900000 cash basis Part V, Lines 1j & 1k Glens Falls Hospital provided leased services to Glens Falls Medical PLLC in 2018 for $3,450,091. Glens Falls Medical PLLC reimbursed Glens Falls Hospital $900,000 for the leased expenses incurred.