UPSTATE COMMUNITY MEDICAL P C: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
UPSTATE COMMUNITY MEDICAL P C (EIN 20-3889761)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-15
IRS object ID
201841359349307199
Schema version
2016v3.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-05-15T13:46:12-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161226221PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15784 WIDEWATERS PARKWAYAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13214ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN203889761EIN

Business Name BusinessName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line14900 BROAD ROAD NO 1507AddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13215ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBONNIE D GROSSMAN MDPersonNm
Person TitleDIRECTORPersonTitleTxt
Phone3154925140PhoneNum
Signature2018-05-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANGELA M FRANCOPreparerPersonNm
PTINP00589741PTIN
Phone3154463600PhoneNum
Preparation2018-05-15PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address24.39.85.114IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-05-15IPDt
IP Tm08:14:37IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDBC66B94D4E8BBC2CD5667BCBB29FBD4485B0A11AtSubmissionCreationDeviceId
At Submission Filing Device IdFE5DB79484C1E450CD574647AD99A64FA1CFF6DBAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMATTHEW GLIDDEN MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1750 EAST ADAMS STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13215ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$17,040,908GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.UPSTATE.EDU/COMMUNITY/UCM/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2005FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTHE ROLE OF UPSTATE COMMUNITY MEDICAL, P.C. (UCM) IS TO PROVIDE A COMPREHENSIVE SOURCE FOR ACUTE MEDICAL CARE AND RELATED SERVICES TO ADVANCE THE MISSION OF UPSTATE MEDICAL UNIVERSITY OF NEW YORK. UCM WAS FORMED FOR THE CHARITABLE PURPOSE OF SERVING THE HEALTH CARE NEEDS OF THE COMMUNITY SERVICED BY THE HOSPITAL AND ADVANCING THE CHARITABLE PURPOSE OF THE UNIVERSITY.ActivityOrMissionDesc
Voting Members Governing Body1VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee82TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$13,271,243PYProgramServiceRevenueAmt
CY Program Service Revenue$17,004,406CYProgramServiceRevenueAmt
PY Investment Income$3,090PYInvestmentIncomeAmt
CY Investment Income$2,967CYInvestmentIncomeAmt
PY Other Revenue$112,394PYOtherRevenueAmt
CY Other Revenue$33,535CYOtherRevenueAmt
PY Total Revenue$13,386,727PYTotalRevenueAmt
CY Total Revenue$17,040,908CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,086,440PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,961,378CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$7,906,025PYOtherExpensesAmt
CY Other Expenses$9,296,281CYOtherExpensesAmt
PY Total Expenses$14,992,465PYTotalExpensesAmt
CY Total Expenses$17,257,659CYTotalExpensesAmt
PY Revenues Less Expenses-$1,605,738PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$216,751CYRevenuesLessExpensesAmt
Total Assets BOY$4,238,322TotalAssetsBOYAmt
Total Assets EOY$5,959,673TotalAssetsEOYAmt
Total Liabilities BOY$7,030,436TotalLiabilitiesBOYAmt
Total Liabilities EOY$7,536,043TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$2,792,114NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$1,576,370NetAssetsOrFundBalancesEOYAmt
MissionTHE ROLE OF UPSTATE COMMUNITY MEDICAL, P.C. IS TO PROVIDE A COMPREHENSIVE SOURCE FOR ACUTE MEDICAL CARE AND RELATED SERVICES TO UNINSURED AND UNDERINSURED INDIVIDUALS IN THE COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$3,929,753ExpenseAmt
Revenue$3,924,978RevenueAmt
DescHOSPITALIST SERVICE - PROVIDED ACUTE MEDICAL CARE FOR THE PATIENTS OF UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,631,816ExpenseAmt
Revenue$1,663,673RevenueAmt
DescSURGICAL PHYSICIANS' ASSISTANT SERVICE - PROVIDED SKILLED MEDICAL SERVICES FOR PHYSICIANS PERFORMING SURGICAL PROCEDURES AT THE UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUS.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$221,519ExpenseAmt
Revenue$2,196,533RevenueAmt
DescOBGYN HOSPITALIST SERVICE - PROVIDED OB/GYN HEALTHCARE SERVICES TO THE UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUS.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$10,599,288ExpenseAmt
Revenue$9,252,757RevenueAmt
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$10,599,288TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$9,252,757TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$16,382,376TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document11IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee82EmployeeCnt
Employment Tax Returns Filed0EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members1GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line11001 W FAYETTE STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13204ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
MATTHEW GLIDDEN
OFFICER40.00Yes (X)Yes (X)$0$0$0
MARY ELLEN GRECO MD
PHYSICIAN40.00$267,077$0$10,600Yes (X)
KRISTINE M KEENEY MD
PHYSICIAN40.00$267,077$0$10,600Yes (X)
ALFREDO LOPEZ MD
PHYSICIAN40.00$232,600$0$9,304Yes (X)
ADAM A THABET
PHYSICIANS ASSISTANT40.00$225,460$0$8,772Yes (X)
MARY E VEEDER-CIVITELLO MD
PHYSICIAN40.00$217,454$0$8,698Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,209,668TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$47,974TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CHAG ANESTHESIA GROUP
5000 BRITTONFIELD PARKWAYEAST SYRACUSENY13057PROFESSIONAL MEDICAL SERVICES$2,879,001
DEPARTMENT OF MEDICINE MEDICAL SERVICE
550 E GENESEE ST SUITE 201SYRACUSENY13202PROFESSIONAL MEDICAL SERVICES$1,188,243
SYRACUSE ORTHOPEDIC SPECIALIST
5824 WIDEWATERS PARKWAYEAST SYRACUSENY13057PROFESSIONAL MEDICAL SERVICES$598,400
PRACTICE RESOURCES LLC
1001 W FAYETTE STSYRACUSENY13204ADMINISTRATIVE AND BILLING SERVICES$416,967
HOWARD WEINSTEIN MD PC
4900 BROAD ROADSYRACUSENY13215PROFESSIONAL MEDICAL SERVICES$221,543
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PROFESSIONAL SERVICE AGREEMENT -621110$12,597,390$12,597,390
PROFESSIONAL SERVICES621110$4,407,016$4,407,016
FieldValueIRS element (for citing)
Total Program Service Revenue$17,004,406TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,967TotalRevenueColumnAmt
Exclusion$2,967ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescPROVIDER BASED REVENUEDesc
Business621110BusinessCd
Total Revenue Column$14,146TotalRevenueColumnAmt
Related Or Exempt Func Income$14,146RelatedOrExemptFuncIncomeAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,389TotalRevenueColumnAmt
Related Or Exempt Func Income$19,389RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$33,535OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,040,908TotalRevenueColumnAmt
Related Or Exempt Func Income$17,037,941RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,967ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,825,544TotalAmt
Program Services$6,484,267ProgramServicesAmt
Management And General$341,277ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$202,557TotalAmt
Program Services$192,429ProgramServicesAmt
Management And General$10,128ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$469,526TotalAmt
Program Services$446,050ProgramServicesAmt
Management And General$23,476ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$463,751TotalAmt
Program Services$440,563ProgramServicesAmt
Management And General$23,188ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$78,000TotalAmt
Management And General$78,000ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$15,326TotalAmt
Program Services$15,326ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$9,532TotalAmt
Program Services$9,532ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$401,220TotalAmt
Program Services$401,220ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$107,037TotalAmt
Program Services$107,037ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$184,200TotalAmt
Program Services$174,990ProgramServicesAmt
Management And General$9,210ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$194,534TotalAmt
Program Services$184,807ProgramServicesAmt
Management And General$9,727ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,761TotalAmt
Program Services$2,761ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$72,706TotalAmt
Program Services$69,071ProgramServicesAmt
Management And General$3,635ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,484TotalAmt
Program Services$3,484ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$415,406TotalAmt
Program Services$394,636ProgramServicesAmt
Management And General$20,770ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PURCHASED SERVICES$7,277,448$7,277,448
BILLING FEES$355,872$355,872
BAD DEBT EXPENSE$136,517$136,517
PERMITS, LICENSES, DUES$34,409$34,409

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$7,829TotalAmt
Program Services$7,829ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,257,659TotalAmt
Program Services$16,382,376ProgramServicesAmt
Management And General$875,283ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$91,772BOYAmt
EOY$2,360,935EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,793,176BOYAmt
EOY$409,726EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$294,730BOYAmt
EOY$60,318EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$32,553BOYAmt
EOY$38,291EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$94,395LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$56,066LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$26,091BOYAmt
EOY$38,329EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$3,052,074EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,238,322BOYAmt
EOY$5,959,673EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,008,953BOYAmt
EOY$4,806,301EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,021,483BOYAmt
EOY$2,729,742EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,030,436BOYAmt
EOY$7,536,043EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow SFAS117Yes (X)OrgDoesNotFollowSFAS117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$100BOYAmt
EOY$100EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

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

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY-$2,792,214BOYAmt
EOY-$1,576,470EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$2,792,114BOYAmt
EOY-$1,576,370EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,238,322BOYAmt
EOY$5,959,673EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$216,751ReconcilationRevenueExpnssAmt
Prior Period Adjustments$1,432,495PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

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

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$5,881,986CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,271,243CurrentTaxYearMinus1YearAmt
Current Tax Year$17,004,406CurrentTaxYearAmt
Total$36,157,635TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$5,881,986CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,271,243CurrentTaxYearMinus1YearAmt
Current Tax Year$17,004,406CurrentTaxYearAmt
Total$36,157,635TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$36,157,635PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$1,454CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,090CurrentTaxYearMinus1YearAmt
Current Tax Year$2,967CurrentTaxYearAmt
Total$7,511TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$1,454CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,090CurrentTaxYearMinus1YearAmt
Current Tax Year$2,967CurrentTaxYearAmt
Total$7,511TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$112,394CurrentTaxYearMinus1YearAmt
Current Tax Year$33,535CurrentTaxYearAmt
Total$145,929TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$5,883,440CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,386,727CurrentTaxYearMinus1YearAmt
Current Tax Year$17,040,908CurrentTaxYearAmt
Total$36,311,075TotalAmt
FieldValueIRS element (for citing)
First5 Years509Yes (X)First5Years509Ind

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$94,395OtherCostOrOtherBasisAmt
Depreciation$56,066DepreciationAmt
Book Value$38,329BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$38,329TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM UNIVERSITY HOSPITALDesc
Book Value$3,052,074BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,052,074TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLT DEBTDesc
Amt$2,729,742Amt
FieldValueIRS element (for citing)
Total Liability$2,729,742TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$17,040,908TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$17,040,908RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$17,040,908TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$17,257,659TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$17,257,659ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$17,257,659TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS. THESE STANDARDS DID NOT HAVE AN IMPACT ON THE ORGANIZATION'S FINANCIAL STATEMENTS. AS OF JUNE 30, 2017, THE ORGANIZATION DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2013 THROUGH 2016.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MARY ELLEN GRECO MD
PHYSICIAN$267,077$0$0$0$0$0$0$0$10,600$0$277,677$0$0$0
KRISTINE M KEENEY MD
PHYSICIAN$267,077$0$0$0$0$0$0$0$10,600$0$277,677$0$0$0
ALFREDO LOPEZ MD
PHYSICIAN$232,600$0$0$0$0$0$0$0$9,304$0$241,904$0$0$0
ADAM A THABET
PHYSICIANS ASSISTANT$225,460$0$0$0$0$0$0$0$8,772$0$234,232$0$0$0
MARY E VEEDER-CIVITELLO MD
PHYSICIAN$217,454$0$0$0$0$0$0$0$8,698$0$226,152$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BA COPY OF FORM 990 WAS DISTRIBUTED FOR REVIEW BEFORE IT WAS FILED.
FORM 990, PART VI, SECTION B, LINE 12CEACH DIRECTOR, OFFICER AND MEMBER OF A COMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A STATEMENT WHICH AFFIRMS SUCH PERSON HAS READ, UNDERSTANDS, AND HAS COMPLIED WITH THE POLICY.
FORM 990, PART VI, SECTION B, LINE 15BASE SALARY USING COMPARISON DATA AND BONUS OR INCENTIVE COMPENSATION IS BASED ON WRVU ESTABLISHED BY THE FEDERAL GOVERNMENT, TIME, SKILL, AND TRAINING. PERIODIC REVIEWS SHALL BE CONDUCTED REGARDING COMPENSATION AND BENEFIT ARRANGMENTS FOR REASONABLENESS AND CONFORMITY OF CONTRACTS FOR REASONABLE PAYMENT.
FORM 990, PART VI, SECTION C, LINE 19AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 2C:THE FINANCE COMMITTE IS RESPONSIBLE FOR OVERSEEING THE SELECTION OF THE INDEPENDENT ACCOUNTANT.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line1750 E ADAMS STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13210ZIPCd
FieldValueIRS element (for citing)
EIN161469571EIN
Primary ActivitiesPATIENT CAREPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
SUNY UPSTATE UNIVERSITY HOSPITAL
L$13,704,193PROFESSIONAL SERVICES AGREEMENT
SUNY UPSTATE UNIVERSITY HOSPITAL
M$781,983ADMIN SERVICES AGREEMENT

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