GUTHRIE CORTLAND MEDICAL CENTER: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
GUTHRIE CORTLAND MEDICAL CENTER (EIN 15-0532079)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-07
IRS object ID
201703119349302525
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)
Return2017-11-07T14:35:39-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

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 Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN150532079EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CORTLAND REGIONAL MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCORTBusinessNameControlTxt
Phone6077563501PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1134 HOMER AVENUEAddressLine1Txt
CityCORTLANDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13045ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDENISE WRINNPersonNm
Person TitleVP OF FINANCE/CFOPersonTitleTxt
Phone6077563501PhoneNum
Signature2017-10-31SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonANGELA M FRANCOPreparerPersonNm
PTINP00589741PTIN
Phone3154463600PhoneNum
Preparation2017-10-31PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address24.39.85.114IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-10-31IPDt
IP Tm12:06:04IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id517AEBE328CBAAA90E396C2FD1060AA56161F780AtSubmissionCreationDeviceId
At Submission Filing Device Id02454C825BF74D5B05CA8C2679FAA2CC9611F4B4AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2018-03-14 21:41:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDENISE WRINNPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1134 HOMER AVENUEAddressLine1Txt
CityCORTLANDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13045ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$91,684,331GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CORTLANDREGIONAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1892FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionCORTLAND REGIONAL MEDICAL CENTER,INC., LOCATED IN CORTLAND, NY, IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL. THE HOSPITAL PROVIDES GENERAL INPATIENT, INPATIENT PSYCHIATRIC, OUTPATIENT, EMERGENCY, LONG-TERM HOME HEALTH CARE AND SKILLED NURSING SERVICES FOR RESIDENTS IN THE GREATER CORTLAND COUNTY AREA.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee1141TotalEmployeeCnt
Total Volunteers258TotalVolunteersCnt
Total Gross UBI$304,540TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$161,706NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,441,212PYContributionsGrantsAmt
CY Contributions Grants$2,382,573CYContributionsGrantsAmt
PY Program Service Revenue$80,207,019PYProgramServiceRevenueAmt
CY Program Service Revenue$76,722,538CYProgramServiceRevenueAmt
PY Investment Income$1,804,718PYInvestmentIncomeAmt
CY Investment Income$121,904CYInvestmentIncomeAmt
PY Other Revenue$5,630,307PYOtherRevenueAmt
CY Other Revenue$5,050,504CYOtherRevenueAmt
PY Total Revenue$89,083,256PYTotalRevenueAmt
CY Total Revenue$84,277,519CYTotalRevenueAmt
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$48,901,318PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$48,483,245CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$38,819,282PYOtherExpensesAmt
CY Other Expenses$39,369,837CYOtherExpensesAmt
PY Total Expenses$87,720,600PYTotalExpensesAmt
CY Total Expenses$87,853,082CYTotalExpensesAmt
PY Revenues Less Expenses$1,362,656PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$3,575,563CYRevenuesLessExpensesAmt
Total Assets BOY$112,423,569TotalAssetsBOYAmt
Total Assets EOY$72,395,386TotalAssetsEOYAmt
Total Liabilities BOY$49,156,386TotalLiabilitiesBOYAmt
Total Liabilities EOY$49,930,155TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$63,267,183NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$22,465,231NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCORTLAND REGIONAL MEDICAL CENTER PROVIDES QUALITY HEALTH CARE WITH SKILL AND COMPASSION, MEETING THE LIFE LONG HEALTH CARE NEEDS OF ALL CITIZENS OF CORTLAND AND THE SURROUNDING COMMUNITIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$71,405,949ExpenseAmt
Revenue$84,277,527RevenueAmt
DescCORTLAND REGIONAL MEDICAL CENTER IS DEDICATED TO SERVING THE LIFELONG HEALTH CARE NEEDS OF CORTLAND AND THE SURROUNDING AREA. AS A TEAM-ORIENTED COMMUNITY HEALTH AND MEDICAL ORGANIZATION, CORTLAND REGIONAL MEDICAL CENTER PROVIDES QUALITY CARE, SKILL AND COMPASSION TO ALL PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. OUR HOSPITAL IS COMMITTED TO: *IMPROVING THE WELLNESS OF THE COMMUNITY THROUGH LEADERSHIP IN HEALTH-RELATED ACTIVITIES AND EDUCATION. *SUPPORTING AND PRESERVING THE PERSONAL AND PROFESSIONAL GROWTH OF OUR QUALITY HEALTH-CARE TEAM, THEREBY PROVIDING STIMULATING ENVIRONMENT FOR ALL EMPLOYEES. *RECRUITING AND RETAINING QUALITY HEALTH-CARE PROFESSIONALS. *COOPERATING WITH OTHER HEALTH-CARE PROVIDERS,REGULATORY AGENCIES, AND INSURANCE COMPANIES TO ADVANCE OUR SERVICE TO EVERY MEMBER OF THE COMMUNITY. *MAINTAINING THE HOSPITALS FINANCIAL VIABILITY FOR THE WELL-BEING OF THE COMMUNITY. *ACQUIRING AND MAINTAINING EQUIPMENT REQUIRED TO PROVIDE QUALITY CARE. *ENCOURAGING THE ACTIVE PARTICIPATION OF COMMUNITY MEMBERS IN A VOLUNTEER CAPACITY IN ORDER TO AUGMENT OUR SERVICES. CORTLAND REGIONAL MEDICAL CENTER IS A VOLUNTARY, NOT-FOR-PROFIT CORPORATION. THE MEDICAL CENTER PROVIDES HEALTH CARE SERVICES OF PREVENTIVE, CURATIVE AND EDUCATIONAL NATURE. THE PRIMARY SERVICES PROVIDED ARE: ACUTE MEDICAL INPATIENT CARE (INCLUDING PEDS AND MATERNITY), PSYCHIATRIC INPATIENT CARE, RESIDENTIAL CARE (SKILLED NURSING FACILITY), EMERGENCY ROOM, AMBULATORY SURGERY, OUTPATIENT DIAGNOSTIC SERVICES, LONG TERM HOME HEALTH CARE PROGRAM, COMMUNITY HEALTH WELLNESS SCREENING, ADULT DAY CARE AND CLINIC. INPATIENT PATIENT DAYS WERE 42,729 AND OUTPATIENT SERVICE (ER, CLINIC, AMB SURG, REF AMB & LTHHC) VISITS WERE 106989. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE. THE CHARGES FOREGONE UNDER THIS POLICY AMOUNTED TO $1,239,647 IN 2016.Desc
Total Program Service Expenses$71,405,949TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
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 Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
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 Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document100IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1141EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
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 Members17GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
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 Line1DENISE WRINN - CORTLAND REGIONAL MEDBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6077563501PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1134 HOMER AVENUEAddressLine1Txt
CityCORTLANDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13045ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
MARK RAYMOND
BOARD MEMBER - SECRETARY1.00Yes (X)Yes (X)$0$0$0
STEVEN CINQUANTI
BOARD MEMBER1.00Yes (X)$0$0$0
WILLIAM POMEROY
BOARD MEMBER - CHAIRPERSON1.00Yes (X)Yes (X)$0$0$0
JOHANNA AMES
BOARD MEMBER - VICE CHAIRP1.00Yes (X)Yes (X)$0$0$0
JEFFREY SEIBERT
BOARD MEMBER - TREASURER1.00Yes (X)Yes (X)$0$0$0
NANCY RONGO
BOARD MEMBER1.00Yes (X)$0$0$0
PATRICK HAYES MD
BOARD MEMBER1.00Yes (X)$0$0$0
CATHERINE BERTINI
BOARD MEMBER1.00Yes (X)$0$0$0
GARRY VANGORDER
BOARD MEMBER1.00Yes (X)$0$0$0
REV DAVID JOHNSON
BOARD MEMBER1.00Yes (X)$0$0$0
ANNA MARIE GARCIA MD
BOARD MEMBER1.00Yes (X)$0$0$0
LEO MCGRATTAN
BOARD MEMBER1.00Yes (X)$0$0$0
MARK PRUS
BOARD MEMBER1.00Yes (X)$0$0$0
LEE SHURTLEFF
BOARD MEMBER1.00Yes (X)$0$0$0
DAVID MAYO
BOARD MEMBER1.00Yes (X)$0$0$0
GARY NELSON
BOARD MEMBER1.00Yes (X)$0$0$0
MARC SETTERINI MD
BOARD MEMBER1.00Yes (X)$0$0$0
DOUGLAS RAHNER MD
BD MBER EX OFFICIO TRUSTEE1.00Yes (X)$30,000$0$0
MARK WEBSTER
PRESIDENT/CEO40.00Yes (X)$426,307$0$66,870
TRACY GATES
VICE PRESIDENT - COO40.00Yes (X)$175,108$0$17,070
MARY WRIGHT
VICE PRESIDENT-NURSING SER40.00Yes (X)$188,927$0$27,984
DENISE WRINN
VICE PRESIDENT - CFO40.00Yes (X)$236,703$0$31,389
ROGER SCOTT MD
VICE PRESIDENT MEDICAL AFF40.00Yes (X)$338,746$50,192$36,159
JOE DALLAIRD
DIRECTOR - REVENUE CYCLE40.00$156,567$0$20,636Yes (X)
MATTHEW DENNISTON
DIRECTOR - PHARMACY40.00$124,663$0$13,790Yes (X)
ROBERT DUTHE
DIRECTOR - IT40.00$163,968$0$7,952Yes (X)
MICHELLE TUCKER
PHARMACIST40.00$122,647$0$27,888Yes (X)
ALAN JAMES
CONTROLLER40.00$117,533$0$24,102Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,081,169TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$50,192TotReportableCompRltdOrgAmt
Total Other Compensation$273,840TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K24IndivRcvdGreaterThan100KCnt
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
DCCS LLC
205 HACKNEY CIRCLEWILMINGTONDE19803CONSULTING SERVICES$942,780
EMERGENCY MEDICINE PHYSICIANS
4535 DRESSLER ROAD NWCANTONOH44718PHYSICIAN SERVICES$849,133
ISS SOLUTIONS
PO BOX 13700-1066PHILADELPHIAPA191911066MED EQUIP REPAIR SVCES$554,617
LABORATORY CORP OF AMERICA
PO BOX 12140BURLINGTONNC27216LABORATORY SERVICES$508,203
AMES LINEN
67 HUNTINGTON STREETCORTLANDNY13045LINEN SERVICES$397,776
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K21CntrctRcvdGreaterThan100KCnt
Related Organizations$154,652RelatedOrganizationsAmt
Government Grants$2,030,741GovernmentGrantsAmt
All Other Contributions$197,180AllOtherContributionsAmt
Total Contributions$2,382,573TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPROGRAM SERVICE REVENUEDesc
Business621990BusinessCd
Total Revenue Column$76,722,538TotalRevenueColumnAmt
Related Or Exempt Func Income$76,722,538RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$76,722,538TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$414,769TotalRevenueColumnAmt
Exclusion$414,769ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$7,113,947SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$7,406,812SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$292,865SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$292,865TotalRevenueColumnAmt
Exclusion-$292,865ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
CHILD DAYCARE REVENUE900099$370,744$66,204$304,540
CAFETERIA REVENUE900099$281,409$281,409
RELATED COMPANY REIMBURSEMENT900099$48,475$48,475

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,349,876TotalRevenueColumnAmt
Related Or Exempt Func Income$4,349,876RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$5,050,504OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$84,277,519TotalRevenueColumnAmt
Related Or Exempt Func Income$81,468,502RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$304,540UnrelatedBusinessRevenueAmt
Exclusion$121,904ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,575,263TotalAmt
Program Services$840,767ProgramServicesAmt
Management And General$734,496ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$35,302,814TotalAmt
Program Services$29,335,903ProgramServicesAmt
Management And General$5,966,911ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,683,609TotalAmt
Program Services$1,345,045ProgramServicesAmt
Management And General$338,564ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$7,318,316TotalAmt
Program Services$6,103,734ProgramServicesAmt
Management And General$1,214,582ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,603,243TotalAmt
Program Services$2,068,775ProgramServicesAmt
Management And General$534,468ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$217,545TotalAmt
Management And General$217,545ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$110,208TotalAmt
Management And General$110,208ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$88,092TotalAmt
Management And General$88,092ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,072,163TotalAmt
Program Services$3,792,617ProgramServicesAmt
Management And General$2,279,546ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$227,937TotalAmt
Program Services$158,817ProgramServicesAmt
Management And General$69,120ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$699,547TotalAmt
Program Services$229,244ProgramServicesAmt
Management And General$470,303ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,822,514TotalAmt
Program Services$1,155,067ProgramServicesAmt
Management And General$667,447ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,153,217TotalAmt
Program Services$1,554,532ProgramServicesAmt
Management And General$598,685ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$369,587TotalAmt
Program Services$238,648ProgramServicesAmt
Management And General$130,939ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$42,655TotalAmt
Program Services$15,961ProgramServicesAmt
Management And General$26,694ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,330,301TotalAmt
Program Services$4,501,258ProgramServicesAmt
Management And General$829,043ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$477,609TotalAmt
Program Services$352,303ProgramServicesAmt
Management And General$125,306ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SUPPLIES$11,504,963$10,979,596$525,367
PURCHASED SERVICES$5,360,765$4,221,491$1,139,274$0
BAD DEBT EXPENSE$2,914,122$2,914,122
EQUIPMENT RENTAL & MAIN$898,791$836,458$62,333

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,079,821TotalAmt
Program Services$761,611ProgramServicesAmt
Management And General$318,210ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$87,853,082TotalAmt
Program Services$71,405,949ProgramServicesAmt
Management And General$16,447,133ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$18,115BOYAmt
EOY$26,943EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$9,290,175BOYAmt
EOY$10,452,793EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$182,108BOYAmt
EOY$66,757EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,916,682BOYAmt
EOY$8,296,698EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$22,905,722BOYAmt
EOY$565,389EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$673,727BOYAmt
EOY$629,819EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$990,031BOYAmt
EOY$660,503EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$138,941,000LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$101,492,500LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$40,933,099BOYAmt
EOY$37,448,500EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$8,699,247BOYAmt
EOY$7,588,614EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$17,814,663BOYAmt
EOY$6,659,370EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$112,423,569BOYAmt
EOY$72,395,386EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$8,631,389BOYAmt
EOY$10,351,678EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,470,000BOYAmt
EOY$17,945,090EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$849,830BOYAmt
EOY$579,217EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$20,205,167BOYAmt
EOY$21,054,170EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$49,156,386BOYAmt
EOY$49,930,155EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$58,181,422BOYAmt
EOY$16,993,187EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,077,266BOYAmt
EOY$1,380,500EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,008,495BOYAmt
EOY$4,091,544EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$63,267,183BOYAmt
EOY$22,465,231EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$112,423,569BOYAmt
EOY$72,395,386EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$3,575,563ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,140,837NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$38,367,226OtherChangesInNetAssetsAmt
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)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$88,092DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$88,092TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationCORTLAND REGIONAL MEDICAL CENTERS LOBBYING ACTIVITY CONSISTED OF: COUNSEL, ADVOCACY AND REPRESENTATION OF CORTLAND REGIONAL MEDICAL CENTER WITH THE GOVERNORS OFFICE, THE LEGISLATURE AND STATE AGENCIES IN REGARD TO BUDGET OR REGULATORY ISSUES. PART OF WHAT WE PAY LAW OFFICES OF JACKSON LEWIS LLP AND A PORTION OF THE DUES PAID TO HEALTHCARE ASSOCIATION OF NEW YORK STATE (HANYS), IROQUOIS HEALTHCARE ASSOCIATION, HOME CARE ASSOCIATION OF NEW YORK (HCA), AMERICAN HOSPITAL ASSOCIATION (AHA) AND LEADING AGE IS DESIGNATED TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,085,760BeginningYearBalanceAmt
Contributions$196,550ContributionsAmt
Investment Earnings Or Losses-$49,528InvestmentEarningsOrLossesAmt
Other Expenditures$239,262OtherExpendituresAmt
End Year Balance$5,472,044EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,836,329BeginningYearBalanceAmt
Investment Earnings Or Losses-$68,552InvestmentEarningsOrLossesAmt
Other Expenditures$1,682,017OtherExpendituresAmt
End Year Balance$5,085,760EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,558,281BeginningYearBalanceAmt
Investment Earnings Or Losses$73,819InvestmentEarningsOrLossesAmt
Other Expenditures$795,766OtherExpendituresAmt
End Year Balance$6,836,329EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,188,155BeginningYearBalanceAmt
Contributions$1,273,892ContributionsAmt
Investment Earnings Or Losses$188,855InvestmentEarningsOrLossesAmt
Other Expenditures$8,092,623OtherExpendituresAmt
End Year Balance$7,558,281EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,676,900BeginningYearBalanceAmt
Contributions$9,189,148ContributionsAmt
Investment Earnings Or Losses$91,654InvestmentEarningsOrLossesAmt
Other Expenditures-$230,453OtherExpendituresAmt
End Year Balance$14,188,155EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.74770PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.25230TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,926,033OtherCostOrOtherBasisAmt
Book Value$2,926,033BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$73,003,023OtherCostOrOtherBasisAmt
Depreciation$47,302,467DepreciationAmt
Book Value$25,700,556BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$58,989,002OtherCostOrOtherBasisAmt
Depreciation$51,245,744DepreciationAmt
Book Value$7,743,258BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,022,942OtherCostOrOtherBasisAmt
Depreciation$2,944,289DepreciationAmt
Book Value$1,078,653BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$37,448,500TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
BENEFICIAL INTEREST IN NET ASSETS OF CORTLAND MEMORIAL FOUNDATION$4,785,857
OTHER RECEIVABLES$1,873,513
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,659,370TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
DUE TO THIRD PARTY PAYORS$3,044,902
ADDITIONAL MINIMUM PENSION LIABILITY$15,401,585
ADVANCES FROM THIRD PARTY PAYORS$920,240
LONG TERM INSURANCE LIABILITY$1,577,400
LONG TERM INTEREST RATE SWAP LIABILITY$110,043
FieldValueIRS element (for citing)
Total Liability$21,054,170TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE HOSPITAL'S ENDOWMENT CONSISTS OF FUNDS ESTABLISHED TO PURCHASE MEDICAL EQUIPMENT WHICH SUPPORTS VARIOUS DEPARTMENTS OF THE HOSPITAL.
PART X, LINE 2:INCOME TAXES: THE HOSPITAL QUALIFIES AS A TAX-EXEMPT, NOT-FOR-PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2016 AND 2015, THE HOSPITAL 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. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Persons Served1629PersonsServedCnt
Total Community Benefit Expns$419,115TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$419,115NetCommunityBenefitExpnsAmt
Total Expense0.00490TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Persons Served29657PersonsServedCnt
Total Community Benefit Expns$22,939,191TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,527,245DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,411,946NetCommunityBenefitExpnsAmt
Total Expense0.07550TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Persons Served31286PersonsServedCnt
Total Community Benefit Expns$23,358,306TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,527,245DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,831,061NetCommunityBenefitExpnsAmt
Total Expense0.08040TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,930,022TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,210,715DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,719,307NetCommunityBenefitExpnsAmt
Total Expense0.07910TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$17,930,022TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,210,715DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,719,307NetCommunityBenefitExpnsAmt
Total Expense0.07910TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Persons Served31286PersonsServedCnt
Total Community Benefit Expns$41,288,328TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$27,737,960DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,550,368NetCommunityBenefitExpnsAmt
Total Expense0.15950TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,914,122BadDebtExpenseAmt
Bad Debt Expense Attributable$412,393BadDebtExpenseAttributableAmt
Reimbursed By Medicare$24,037,186ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$34,453,126CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$10,415,940MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CORTLAND REGIONAL MEDICAL CENTER INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1134 HOMER AVENUEAddressLine1Txt
CityCORTLANDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13045ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.CORTLANDREGIONAL.ORGWebsiteAddressTxt
State License1101000HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CORTLAND REGIONALMEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.CORTLANDREGIONAL.ORG/ABOUT-CRMC/COMMUNITY-SERVICE-POwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLCCHD.CORTLAND-CO.ORG/INDEX.PHP/DATA-AND-REPORTSOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Rpt Available Thru Other MethodYes (X)RptAvailableThruOtherMethodInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.CORTLANDREGIONAL.ORGStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.CORTLANDREGIONAL.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.CORTLANDREGIONAL.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.CORTLANDREGIONAL.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back MedicareYes (X)LookBackMedicareInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
CORTLAND REGIONAL.MEDICAL CENTER, INC.PART V, SECTION B, LINE 5: IN ADDITION TO CORTLAND COUNTY DEPARTMENT OF HEALTH, PREVENTION AGENDA PARTNERS INCLUDE: SEVEN VALLEYS HEALTH COALITION, AREA SCHOOL DISTRICTS, CNY REGIONAL CENTER FOR TOBACCO HEALTH SYSTEMS AT ST. JOSEPH'S HOSPITAL HEALTH CENTER, CORTLAND COUNTY PLANNING DEPARTMENT, BUSINESS OWNERS, CORTLAND COUNTY COMMUNITY ACTION PROGRAM, INC (CAPCO), CHILD DEVELOPMENT COUNCIL, FAMILY HEALTH NETWORK (FHN), CORTLAND AREA COMMUNITIES THAT CARE COALITION (CACTC), CORTLAND COUNTY MENTAL HEALTH, CORTLAND PREVENTION RESOURCES, SUNY CORTLAND, SEVERAL DENTAL AND MEDICAL PRACTICES, AND THE COMMUNITY AT LARGE.
CORTLAND REGIONAL.MEDICAL CENTER, INC.PART V, SECTION B, LINE 7D: CORTLAND REGIONAL MEDICAL CENTER'S COMMUNITY HEALTH NEEDS ASSESSMENT IS PLACED IN THE COUNTY'S PUBLIC LIBRARIES, INCLUDING CINCINNATUS, CORTLAND, HOMER, MARATHON AND MCGRAW. THE COMMUNITY HEALTH NEEDS ASSESSMENT IS ALSO AVAILABLE ON THE MEDICAL CENTER'S WEBSITE AT WWW.CORTLANDREGIONAL.ORG AND ON THE SEVEN VALLEYS HEALTH COALITION WEBSITE AT WWW.SEVENVALLEYSHEALTH.ORG.
CORTLAND REGIONAL.MEDICAL CENTER, INC.PART V, SECTION B, LINE 11: ACCESS TO PRIMARY CARE PHYSICIANS, AS WELL AS, SPECIALTY PHYSICIANS IS A CURRENT NEED IN CORTLAND COUNTY. CORTLAND REGIONAL MEDICAL CENTER IS ACTIVELY RECRUITING FOR ORTHOPEDICS,FAMILY PRACTICE AND UROLOGY. CRMC HAS BEEN SUCCESSFUL RECRUITING OF INTERNAL MEDICINE, PSYCHIATRIST, PULMONOLOGIST, OPHTHALMOLOGIST, ENDOCRINOLOGIST, MIDWIVES AND GASTROENTEROLOGIST. IT IS IMPORTANT TO HAVE THESE PHYSICIAN SERVICES IN CORTLAND, CLOSE TO HOME FOR THE RESIDENTS OF CORTLAND COUNTY. THESE NEW SERVICES WILL GREATLY BENEFIT THE COMMUNITY HEALTH NEEDS FOR THE SURROUNDING CORTLAND AREA.
FieldValueIRS element (for citing)
Facility6FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - CRNURSING & REHABILITATION FACILITY
134 HOMER AVENUECORTLANDNY13045SKILLED NURSING FACILITY
2 - CRMC OUTPATIENT SERVICE CENTER
4005 WEST ROAD - ROUTE 281CORTLANDNY13045WOUND CARE AND IMAGING SERVICE
3 - CRMC LONG TERM HOME HEALTH CARE
134 HOMER AVENUECORTLANDNY13045LONG TERM HOME HEALTH CARE
4 - CRMC OUTPATIENT REHAB SERVICES
1259 FISHER AVENUECORTLANDNY13045PHYSICAL & OCCUPATIONAL THERAPY
5 - CRMC LABORATORY SERVICE CENTER
4077 WEST ROAD - ROUTE 281CORTLANDNY13045LABORATORY SERVICES
6 - CRMC LABORATORY SERVICE CENTER
6 EUCLID AVENUECORTLANDNY13045LABORATORY SERVICES

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE COST WAS CALCULATED USING WORKSHEET 2 RATIO OF PATIENT CARE COST TO CHARGES FROM SCHEDULE H INSTRUCTIONS.
PART I, LINE 7G:MANY PHYSICIANS NO LONGER WANT TO BE IN PRIVATE PRACTICE, BUT SEEK EMPLOYMENT ARRANGEMENTS WITH HOSPITALS OR HOSPITAL-AFFILIATED PHYSICIAN GROUPS. REGIONAL MEDICAL PRACTICE (RMP), A MULTI-SPECIALTY PHYSICIAN GROUP CONTROLLED AND SUPPORTED BY THE HOSPITAL, WAS FORMED TO FURTHER THE MEDICAL CENTER'S CHARITABLE PURPOSES TO HELP RECRUIT SPECIALTY PHYSICIANS INTO THE RURAL CORTLAND AREA. THROUGH RMP, WE HAVE BEEN ABLE TO RECRUIT SPECIALTY PHYSICIANS FOR CARDIOLOGY, INTERNAL MEDICINE/INFECTOUS DISEASE, HOSPITALIST, HEMATOLOGY/ONCOLOGY, ORTHOPEDICS, MIDWIVES, OPHTHALMOLOGY, PULMONOLOGIST, GASTROENTEROLOGIST, ENDOCRINOLOGIST AND PSYCHIATRIST. PRIOR TO RMP, THERE WERE NO CARDIOLOGISTS OR ENDOCRINOLOGIST AT ALL IN CORTLAND, NO ORTHOPEDIC SURGEONS PERFORMING SURGERY IN CORTLAND, SO PATIENTS HAD TO TRAVEL OVER 30 MILES FOR THESE SERVICES. THE HOSPITAL IS CLASSIFIED AS A SOLE COMMUNITY PROVIDER BY MEDICARE BECAUSE OF THE DISTANCE FROM OTHER HOSPITALS, SO IT IS VERY IMPORTANT TO HAVE THESE PHYSICIAN SERVICES IN CORTLAND AND NOT OVER 30 MILES AWAY. THE AMOUNTS SHOWN ON PART I, LINE 7G REPRESENT REVENUES, EXPENSES, AND THE RESULTING LOSS FOR THE YEAR. THESE LOSSES ARE CONSIDERED SUBSIDIZED HEALTH SERVICES FOR 990 REPORTING PURPOSES BECAUSE IF THE HOSPITAL DID NOT SUPPORT THESE RMP PHYSICIAN SPECIALTIES, THESE VITAL SERVICES WOULD NOT BE AVAILABLE IN THE CORTLAND COMMUNITY. RMP HAS OBTAINED ITS EXEMPTION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE".
PART I, LN 7 COL(F):BAD DEBT EXPENSE FROM THE INCOME STATEMENT IS SUBTRACTED OUT.GUIDELINES FOR CREDIT AND COLLECTIONSPOLICY:THE HOSPITAL WILL FOLLOW BILLING AND DEBT COLLECTION PRACTICES THAT:(I)COMPLY WITH ALL REQUIREMENTS OF FEDERAL AND STATE LAW, INCLUDING THE FAIR DEBT COLLECTION PRACTICE ACTS AND IRS 501R STANDARDS FOR TAX-EXEMPT HOSPITALS; (II)BALANCE THE NEED TO DILIGENTLY PURSUE FUNDS OWED TO THE ORGANIZATION WITH THE NEED TO PROVIDE FINANCIAL ASSISTANCE TO ELIGIBLE PATIENTS AND TO TREAT ALL PATIENTS WITH RESPECT AND COMPASSION; AND (III) REFLECT THE MISSION AND VALUES OF THIS ORGANIZATION.PROCEDUREI.BILLINGA.INSURED PATIENTS (E.G., MEDICARE, MEDICAID OR COMMERCIAL PAYOR)1.WHERE THE PATIENT IS INSURED (AND HAS ASSIGNED TO THE HOSPITAL HIS OR HER RIGHT TO PAYMENT), THE HOSPITAL WILL SUBMIT ITS CLAIM FOR PAYMENT TO THE INSURER AND NOT BILL THE PATIENT DIRECTLY, EXCEPT AS SET FORTH IN PARAGRAPH 2.THE HOSPITAL MAY STILL BILL AN INSURED PATIENT WHO HAS ASSIGNED CLAIMS:(A)FOR PATIENT COST-SHARING AMOUNTS (E.G., CO-PAYS, COINSURANCE OR DEDUCTIBLES); AND(B)FOR SERVICES NOT COVERED BY THE PATIENT'S HEALTH PLAN, OR SERVICES COVERED BY THE PLAN BUT FOR WHICH PAYMENT IS DENIED IN WHOLE OR PART BY THE PLAN, OR BALANCES DUE AFTER INSURANCE PAYMENT, TO THE EXTENT BILLING FOR SUCH AMOUNTS ARE PERMITTED BY LAW AND BY THE HOSPITAL'S CONTRACT WITH THE INSURER.WHEN BILLING FOR SUCH AMOUNTS, THE HOSPITAL WILL FOLLOW THE PRACTICES SET FORTH IN SECTION I.B BELOW, TO THE EXTENT SUCH PRACTICES ARE PERMITTED BY LAW AND BY THE HOSPITAL'S CONTRACT WITH THE INSURER. B.UNINSURED PATIENTS (I.E., SELF-PAY PATIENTS). 1.BILLING AMOUNT. WHERE THE PATIENT IS UNINSURED (OR HAS NOT ASSIGNED TO THE HOSPITAL HIS OR HER RIGHT TO PAYMENT), THE HOSPITAL WILL DETERMINE THE BILLING AMOUNT AS FOLLOWS: (A)THE HOSPITAL WILL INFORM THE PATIENT OF ITS FINANCIAL ASSISTANCE POLICY IN ACCORDANCE WITH POLICY #13-7000-03. IF THE PATIENT APPLIES FOR AND IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE BILL WILL BE DISCOUNTED IN ACCORDANCE WITH SUCH POLICY. (B)PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE WILL BE OFFERED A 30% PROMPT PAYMENT DISCOUNT OFF GROSS CHARGES IF THE FULL BALANCE MINUS DISCOUNT IS RECEIVED WITHIN 45 DAYS OF THE DATE APPEARING ON THEIR FIRST STATEMENT. (THIS DISCOUNT IS NOT AVAILABLE FOR ANY PATIENT COST-SHARING BALANCE DUE BY AN INSURED PATIENT).(C)PATIENTS WHO DO NOT QUALIFY FOR FINANCIAL ASSISTANCE, AND WHO DO NOT PAY WITHIN 45 DAYS OF THE DATE APPEARING ON THEIR FIRST STATEMENT, WILL THEREAFTER BE BILLED GROSS CHARGES.2. BILLING PROCEDURE. (A)THE HOSPITAL WILL SEND SUCH PATIENT A MINIMUM OF THREE STATEMENTS OVER A 120 DAY PERIOD. EACH SUCH STATEMENT WILL PROVIDE INFORMATION ABOUT THE FINANCIAL ASSISTANCE POLICY (OR A REFERENCE TO SUCH A WEB ADDRESS WITH SUCH INFORMATION). DURING SUCH PERIOD, THE HOSPITAL SHALL NOT ENGAGE IN ANY EXTRAORDINARY COLLECTION ACTIONS. (B)AT 120 DAYS AFTER THE INITIAL STATEMENT, IF FULL PAYMENT HAS NOT BEEN RECEIVED OR OTHER PAYMENT ARRANGEMENTS NEGOTIATED, THE ACCOUNT MAY BE REFERRED TO THE HOSPITAL'S COLLECTION AGENCY, WHICH MAY COMMENCE EXTRAORDINARY COLLECTION ACTIONS.II.EXTRAORDINARY COLLECTION ACTIONS.A.BASIC LIMITATION ON EXTRAORDINARY COLLECTION ACTIONS. 1.THE HOSPITAL SHALL NOT ENGAGE IN EXTRAORDINARY COLLECTION ACTIONS AS DEFINED IN PARAGRAPH B BELOW, AGAINST AN INDIVIDUAL UNTIL THE HOSPITAL HAS MADE REASONABLE EFFORTS, AS DESCRIBED IN PARAGRAPH C BELOW, TO DETERMINE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE UNDER THE HOSPITAL FINANCIAL ASSISTANCE POLICY (FAP).B.EXTRAORDINARY COLLECTION ACTIONS DEFINED 1.EXTRAORDINARY COLLECTION ACTIONS ARE ACTIONS TAKEN RELATED TO OBTAINING PAYMENT OF A BILL FOR HOSPITAL SERVICES THAT EITHER:(A)REQUIRE A LEGAL OR JUDICIAL PROCESS, (B)INVOLVE SELLING AN INDIVIDUALS' DEBT TO ANOTHER PARTY, OR (C)INVOLVE REPORTING ADVERSE INFORMATION ABOUT THE INDIVIDUAL TO CONSUMER CREDIT REPORTING AGENCIES OR CREDIT BUREAUS. 2.ACTIONS THAT REQUIRE LEGAL OR JUDICIAL PROCESS INCLUDE, BUT ARE NOT LIMITED TO, ACTIONS TO-(A) PLACE A LIEN ON AN INDIVIDUAL'S PROPERTY;(B) FORECLOSE ON AN INDIVIDUAL'S REAL PROPERTY;(C) ATTACH OR SEIZE AN INDIVIDUAL'S BANK ACCOUNT OR ANY OTHER PERSONAL PROPERTY;(D) COMMENCE A CIVIL ACTION AGAINST AN INDIVIDUAL;(E) CAUSE AN INDIVIDUAL'S ARREST;(F) CAUSE AN INDIVIDUAL TO BE SUBJECT TO A WRIT OF BODY ATTACHMENT; AND(G) GARNISH AN INDIVIDUAL'S WAGES.C.REASONABLE EFFORTS. 1.REASONABLE EFFORTS MEANS THAT THE HOSPITAL: (A)GAVE A PLAIN LANGUAGE SUMMARY OF ITS FINANCIAL ASSISTANCE PLAN (FAP) AND OFFER AN APPLICATION FORM, TO THE PATIENT BEFORE DISCHARGE FROM THE HOSPITAL;(B)INCLUDED INFORMATION ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND ABOUT HOW TO ACCESS THE FAP SUMMARY WITH ALL (AND AT LEAST THREE) BILLING STATEMENTS FOR THE CARE AND ALL OTHER WRITTEN COMMUNICATIONS REGARDING THE BILL PROVIDED TO THE INDIVIDUAL DURING THE PERIOD OF DATE OF HOSPITALIZATION UNTIL 120 DAYS AFTER THE FIRST BILLINGS STATEMENT (THE NOTIFICATION PERIOD.")(C)INFORMS THE INDIVIDUAL ABOUT THE FAP IN ALL ORAL COMMUNICATIONS WITH THE INDIVIDUAL REGARDING THE AMOUNT DUE FOR THE CARE THAT OCCUR DURING THE NOTIFICATION PERIOD; AND (D)PROVIDES THE INDIVIDUAL WITH AT LEAST ONE WRITTEN NOTICE THAT (I) INFORMS THE INDIVIDUAL ABOUT THE EXTRAORDINARY COLLECTION EFFORTS THE HOSPITAL OR OTHER AUTHORIZED PARTY MAY TAKE IF THE INDIVIDUAL DOES NOT SUBMIT A FAP APPLICATION OR PAY THE AMOUNT DUE BY A DEADLINE (SPECIFIED IN THE NOTICE) THAT IS NO EARLIER THAN THE LAST DAY OF THE NOTIFICATION PERIOD; AND (II) IS PROVIDED TO THE INDIVIDUAL AT LEAST 30 DAYS BEFORE THE DEADLINE SPECIFIED IN THE WRITTEN NOTICE.2.WITH RESPECT TO A PATIENT WHO SUBMITTED AN INCOMPLETE FAP APPLICATION, REASONABLE EFFORTS MEANS THAT THE HOSPITAL:(A)SUSPENDS EXTRAORDINARY COLLECTION EFFORTS AGAINST THE PATIENT;(B)PROVIDES THE PATIENT WITH A WRITTEN NOTICE THAT DESCRIBES THE ADDITIONAL INFORMATION AND/OR DOCUMENTATION REQUIRED, AND INCLUDES A COPY OF THE FAP; (C)COMPLIES WITH C.1.(D) ABOVE. 3.HOSPITAL WILL NOT PERMIT A THIRD PARTY COLLECTION AGENT TO COMMENCE AN EXTRAORDINARY COLLECTION EFFORT AGAINST A PERSON FOR AN UNPAID HOSPITAL SERVICES BILL UNLESS AND UNTIL A HOSPITAL OFFICIAL HAS AUTHORIZED THE SPECIFIC ACTION(S) AGAINST THE SPECIFIC PERSON. III.FAIR DEBT COLLECTION PRACTICES. A.HOSPITAL SHALL, DIRECTLY OR THROUGH COLLECTION AGENTS, COMPLY WITH THE REQUIREMENTS OF THE FEDERAL FAIR DEBT COLLECTION PRACTICES ACT. SPECIFICALLY, THE HOSPITAL SHALL NOT ENGAGE IN ANY OF THE FOLLOWING ABUSIVE AND DECEPTIVE PRACTICES WHEN ATTEMPTING TO COLLECT DEBTS: 1.HOURS FOR PHONE CONTACT: CONTACTING CONSUMERS BY TELEPHONE OUTSIDE OF THE HOURS OF 8:00 A.M. TO 9:00 P.M. LOCAL TIME;2.FAILURE TO CEASE COMMUNICATION UPON REQUEST: COMMUNICATING WITH CONSUMERS IN ANY WAY (OTHER THAN LITIGATION) AFTER RECEIVING WRITTEN NOTICE THAT SAID CONSUMER WISHES NO FURTHER COMMUNICATION OR REFUSES TO PAY THE ALLEGED DEBT, WITH CERTAIN EXCEPTIONS, INCLUDING ADVISING THAT COLLECTION EFFORTS ARE BEING TERMINATED OR THAT THE COLLECTOR INTENDS TO FILE A LAWSUIT OR PURSUE OTHER REMEDIES WHERE PERMITTED;3.CAUSING A TELEPHONE TO RING OR ENGAGING ANY PERSON IN TELEPHONE CONVERSATION REPEATEDLY OR CONTINUOUSLY: WITH INTENT TO ANNOY, ABUSE, OR HARASS ANY PERSON AT THE CALLED NUMBER; 4.COMMUNICATING WITH CONSUMERS AT THEIR PLACE OF EMPLOYMENT AFTER HAVING BEEN ADVISED THAT THIS IS UNACCEPTABLE OR PROHIBITED BY THE EMPLOYER;5.CONTACTING CONSUMER KNOWN TO BE REPRESENTED BY AN ATTORNEY;6.COMMUNICATING WITH CONSUMER AFTER REQUEST FOR VALIDATION HAS BEEN MADE: COMMUNICATING WITH THE CONSUMER OR THE PURSUING COLLECTION EFFORTS BY THE DEBT COLLECTOR AFTER RECEIPT OF A CONSUMER'S WRITTEN REQUEST FOR VERIFICATION OF A DEBT MADE WITHIN THE 30 DAY VALIDATION PERIOD (OR FOR THE NAME AND ADDRESS OF THE ORIGINAL CREDITOR ON A DEBT) AND BEFORE THE DEBT COLLECTOR MAILS THE CONSUMER THE REQUESTED VERIFICATION OR ORIGINAL CREDITOR'S NAME AND ADDRESS7.MISREPRESENTATION OR DECEIT: MISREPRESENTING THE DEBT OR USING DECEPTION TO COLLECT THE DEBT, INCLUDING A DEBT COLLECTOR'S MISREPRESENTATION THAT HE OR SHE IS AN ATTORNEY OR LAW ENFORCEMENT OFFICER;8.PUBLISHING THE CONSUMER'S NAME OR ADDRESS ON A "BAD DEBT" LIST;9.SEEKING UNJUSTIFIED AMOUNTS, WHICH WOULD INCLUDE DEMANDING ANY AMOUNTS NOT PERMITTED UNDER AN APPLICABLE CONTRACT OR AS PROVIDED UNDER APPLICABLE LAW;10.THREATENING ARREST OR LEGAL ACTION THAT IS EITHER NOT PERMITTED OR NOT ACTUALLY CONTEMPLATED;11.ABUSIVE OR PROFANE LANGUAGE USED IN THE COURSE OF COMMUNICATION RELATED TO THE DEBT;12.COMMUNICATION WITH THIRD PARTIES: REVEALING OR DISCUSSING THE NATURE OF DEBTS WITH THIRD PARTIES (OTHER THAN THE CONSUMER'S SPOUSE OR ATTORNEY, OR OTHERS TO THE ETXENT PERMITTED BY THE FDPA.
PART III, LINE 4:AUDITED FINANCIAL STATEMENT FOOTNOTE (PAGE 12) PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST PAYMENT HISTORY AND IDENTIFIES TRENDS FOR EACH MAJOR PAYOR SOURCE OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS AND FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL ALSO ANALYZES AMOUNTS DUE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE BASED ON PAST EXPERIENCE, INCLUDING CONSIDERATION OF CURRENT BUSINESS AND ECONOMIC CONDITIONS. WHEN THE HOSPITALS ESTABLISHES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IT TAKES INTO CONSIDERATION THE FACT THAT MANY SELF-PAY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS 31.3% OF THE RELATED PATIENT ACCOUNTS RECEIVABLE, NET OF CONTRACTUAL ALLOWANCES AT DECEMBER 31, 2016 AND 2015. RESPECTIVELY. THE INCREASE RELATES TO A HIGHER CONCENTRATION OF PRIVATE PAYOR RECEIVABLE AT DECEMBER 31, 2016 AND NEGATIVE TRENDS EXPERIENCE IN THE COLLECTION OF SELF-PAY ACCOUNTS DURING 2016.
PART III, LINE 8:THE MEDICARE COST WAS CALCULATED USING THE WORKSHEET IN THE SCHEDULE H INSTRUCTIONS.FINANCIAL ASSISTANCE POLICY:PURPOSE: ALIGNED WITH OUR VALUES, WE PROVIDE CARE FOR PERSONS WHO ARE IN NEED AND GIVE SPECIAL CONSIDERATION TO THOSE WHO ARE MOST VULNERABLE, INCLUDING THOSE WHO ARE UNABLE TO PAY AND THOSE WHOSE LIMITED MEANS MAKE IT EXTREMELY DIFFICULT TO MEET THE HEALTH CARE EXPENSES INCURRED. CORTLAND REGIONAL MEDICAL CENTER IS COMMITTED TO:"PROVIDING ACCESS TO QUALITY HEALTH CARE SERVICES WITH COMPASSION, DIGNITY AND RESPECT FOR THOSE WE SERVE. "CARING FOR ALL PERSONS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES; AND"ASSISTING PATIENTS WHO CANNOT PAY FOR PART OR ALL OF THE CARE THAT THEY RECEIVE.DEFINITIONS: EMERGENT (SERVICE LEVEL) - MEDICAL SERVICES NEEDED FOR A CONDITION THAT MAY BE LIFE THREATENING OR THE RESULT OF A SERIOUS INJURY AND REQUIRING IMMEDIATE MEDICAL ATTENTION. THIS MEDICAL CONDITION IS GENERALLY GOVERNED BY EMERGENCY MEDICAL TREATMENT AND ACTIVE LABOR ACT (EMTALA).EXTRAORDINARY COLLECTION ACTIONS (ECA) - EXTRAORDINARY COLLECTIONS INCLUDE BUT ARE NOT LIMITED TO LAWSUITS, WAGE GARNISHMENTS OR OTHER SIMILAR COLLECTIONS PROCESSES.FAMILY -AS DEFINED BY THE U.S. CENSUS BUREAU, A GROUP OF TWO OR MORE PEOPLE WHO RESIDE TOGETHER AND WHO ARE RELATED BY BIRTH,MARRIAGE,OR ADOPTION. IF A PATIENT CLAIMS SOMEONE AS A DEPENDENT ON THEIR INCOME TAX RETURN, ACCORDING TO THE INTERNAL REVENUE SERVICE RULES, THEY MAY BE CONSIDERED A DEPENDENT FOR THE PURPOSE OF DETERMINING ELIGIBILITY UNDER THE CRMC FINANCIAL ASSISTANCE POLICY.INCOME -INCOME INCLUDES WAGES, SALARIES, SALARY AND SELF-EMPLOYMENT INCOME, UNEMPLOYMENT COMPENSATION, WORKER'S COMPENSATION,PAYMENTS FROM SOCIAL SECURITY,VETERAN'S BENEFITS, ALIMONY, SURVIVOR'S BENEFITS,PENSIONS,RETIREMENT INCOME AND ANNUITY PAYMENTS,INCOME FROM ESTATES AND TRUSTS,RENTS RECEIVED,INTEREST/DIVIDENDS, AND INCOME FROM OTHER MISCELLANEOUS SOURCES.FAMILY INCOME - A PERSON'S FAMILY INCOME INCLUDES THE INCOME OF ALL FAMILY MEMBERS IN THE HOUSEHOLD WHO CAN BE CLAIMED UPON THE TAX RETURN FILED BY THE APPLICANT. FOR PATIENTS UNDER 18 YEARS OF AGE, FAMILY INCOME INCLUDES THAT OF THE PARENTS AND/OR STEP-PARENTS, OR CARETAKER RELATIVES. TOTAL HOUSEHOLD INCOME IS INCOME FROM ALL MEMBERS OF A HOUSEHOLD FROM THE FOLLOWING SOURCES: WAGES, UNEMPLOYMENT INCOME, WORKERS COMPENSATION, VETERANS BENEFITS, SOCIAL SECURITY INCOME, DISABILITY INCOME, ALIMONY, AND OTHER CASH INCOME INCLUDING PENSION/RETIREMENT.PROOF OF EARNINGS MAY BE DETERMINED BY ANNUALIZING THE YEAR-TO-DATE FAMILY INCOME, TAKING INTO CONSIDERATION THE CURRENT EARNINGS RATE. FINANCIAL SUPPORT - SUPPORT (FINANCIAL AID, DISCOUNTS, ETC.) PROVIDED TO PATIENTS FOR WHOM IT WOULD BE A HARDSHIP TO PAY FOR THE FULL COST OF MEDICALLY NECESSARY SERVICES PROVIDED BY CRMC WHO MEET THE ELIGIBILITY CRITERIA FOR SUCH ASSISTANCE. OUR FINANCIAL AID PROGRAM IS IN THE FORM OF A DISCOUNT OFF OF CRMC'S AVG. CONTRACTUAL ADJUSTMENT AMOUNT FOR MEDICARE FOR THE SERVICES PROVIDED. THE AVERAGE ADJUSTMENT AMOUNT IS CALCULATED ON AN ANNUAL BASIS USING MEDICARE PAYMENT DATA FOR THE PREVIOUS 12 MONTH PERIOD. FOR OUR UNINSURED PATIENTS OUR FINANCIAL AID PROGRAM IS IN THE FORM OF A DISCOUNT OFF OF CRMC'S AVG. CONTRACTUAL ADJUSTMENT AMOUNT FOR MEDICARE FOR THE SERVICES PROVIDED. THE DISCOUNT IS A SLIDING SCALE, DEPENDING ON YOUR INCOME. FOR OUR INSURED PATIENTS: ANY OPEN BALANCE INCLUDING CO-PAY AND DEDUCTIBLE ARE ELIGIBLE TO BE CONSIDERED FOR A FINANCIAL ASSISTANCE DISCOUNT WHICH WOULD BE APPLIED TO THE BALANCE THE PATIENT/GUARANTOR IS RESPONSIBLE TO PAY. THE DISCOUNT IS A SLIDING SCALE DEPENDING ON YOUR INCOME.UNINSURED PATIENT -AN INDIVIDUAL WHO IS UNINSURED, HAVING NO THIRD-PARTY COVERAGE BY A COMMERCIAL THIRD-PARTY INSURER, AN ERISA PLAN, A FEDERAL HEALTH CARE PROGRAM (INCLUDING WITHOUT LIMITATION MEDICARE, MEDICAID, SCHIP, AND CHAMPUS), WORKER'S COMPENSATION, OR OTHER THIRD PARTY ASSISTANCE TO COVER ALL OR PART OF THE COST OF CARE, INCLUDING CLAIMS AGAINST THIRD PARTIES COVERED BY INSURANCE TO WHICH CRMC IS SUBROGATED, BUT ONLY IF PAYMENT IS ACTUALLY MADE BY SUCH INSURANCE COMPANY. URGENT (SERVICE LEVEL) - MEDICAL SERVICES FOR A CONDITION NOT LIFE THREATENING, BUT REQUIRING TIMELY MEDICAL SERVICES.SERVICE AREA - A SERVICE AREA IS THE LIST OF ZIP CODES COMPRISING CRMC'S SERVICE MARKET AREA FOR PRIMARY HEALTH CARE SERVICES. PROCEDURE:I.QUALIFYING CRITERIA FOR FINANCIAL ASSISTANCE CRMC WILL ESTABLISH AND MAINTAIN A FINANCIAL ASSISTANCE POLICY (FAP) DESIGNED TO ADDRESS THE NEED FOR FINANCIAL ASSISTANCE AND SUPPORT TO PATIENTS FOR ALL ELIGIBLE SERVICES REGARDLESS OF RACE, CREED, SEX, OR AGE. ELIGIBILITY FOR FINANCIAL ASSISTANCE AND SUPPORT FROM CRMC WILL BE DETERMINED ON AN INDIVIDUAL BASIS USING SPECIFIC CRITERIA AND EVALUATED ON AN ASSESSMENT OF THE PATIENT'S AND/OR FAMILY'S HEALTH CARE NEEDS, FINANCIAL RESOURCES AND OBLIGATIONS. A.SERVICES ELIGIBLE FOR FINANCIAL SUPPORT:I.ALL MEDICALLY NECESSARY SERVICES, INCLUDING MEDICAL AND SUPPORT SERVICES PROVIDED BY CRMC WILL BE ELIGIBLE FOR FINANCIAL SUPPORT. II.EMERGENCY MEDICAL CARE SERVICES WILL BE PROVIDED TO ALL PATIENTS WHO PRESENT TO THE CRMC EMERGENCY DEPARTMENT, REGARDLESS OF THE PATIENT'S ABILITY TO PAY. SUCH MEDICAL CARE WILL CONTINUE UNTIL THE PATIENT'S CONDITION HAS BEEN STABILIZED PRIOR TO ANY DETERMINATION OF PAYMENT ARRANGEMENTS.B.SERVICES NOT ELIGIBLE FOR FINANCIAL SUPPORT: I.COSMETIC SERVICES, OTHER ELECTIVE PROCEDURES AND SERVICES THAT ARE NOT MEDICALLY NECESSARY. II.SERVICES PROVIDED IN CRMC'S SKILLED NURSING FACILITY AND SWING BED SERVICES.III.THIS POLICY ONLY COVERS SERVICES PROVIDED BY THE HOSPITAL. THIS POLICY DOES NOT APPLY TO OTHER BILLS YOU MAY RECEIVE FROM PRIVATE PHYSICIANS WHO MAY BE INVOLVED IN YOUR CARE INCLUDING BUT NOT LIMITED TO: RADIOLOGY, PATHOLOGITS, ANESTHESIOLOGISTS OR EMERGENCY ROOM PHYSICIANS.IV.AS PROVIDED IN SECTION II. CRMC WILL MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS. CRMC MAY DENY FINANCIAL SUPPORT TO THOSE INDIVIDUALS WHO DO NOT COOPERATE IN APPLYING FOR PROGRAMS THAT MAY PAY FOR THEIR HEALTH CARE SERVICES, BUT SHALL NOT ENGAGE IN EXTRAORDINARY COLLECTION EFFORTS THAT COULD JEOPARDIZE CRMC'S TAX EXEMPT STATUS.C. RESIDENCY REQUIREMENTSI. CRMC WILL PROVIDE FINANCIAL SUPPORT TO PATIENTS WHO RESIDE WITHIN ITS SERVICE AREA AND QUALIFY UNDER CRMC'S FAP. II.SERVICE AREA ZIP CODES: 13045, 13077, 13073, 13118, 13068, 13053, 13159, 13803, 13040, 13092, 13101, 13052, 13158, 13141, 13136III.CRMC WILL PROVIDE FINANCIAL SUPPORT TO PATIENTS FROM OUTSIDE ITS SERVICE AREA WHO QUALIFY UNDER CRMC FAP AND WHO PRESENT WITH AN URGENT, EMERGENT OR LIFE-THREATENING CONDITION.IV.CRMC WILL PROVIDE FINANCIAL SUPPORT TO PATIENTS IDENTIFIED AS NEEDING SERVICE BY PHYSICIAN FOREIGN MISSION PROGRAMS CONDUCTED BY ACTIVE MEDICAL STAFF FOR WHICH PRIOR APPROVAL HAS BEEN OBTAINED FROM CRMCS PRESIDENT OR DESIGNEE.D.DOCUMENTATION FOR ESTABLISHING INCOMEI.INFORMATION PROVIDED TO CRMC BY THE PATIENT AND/OR FAMILY SHOULD INCLUDE EARNED INCOME, INCLUDING MONTHLY GROSS WAGES, SALARY AND SELF-EMPLOYMENT INCOME; BANK STATEMENTS UNEARNED INCOME INCLUDING ALIMONY, RETIREMENT BENEFITS, DIVIDENDS, INTEREST AND INCOME FROM ANY OTHER SOURCE; NUMBER OF DEPENDENTS IN HOUSEHOLD; AND OTHER INFORMATION TO DETERMINE THE PATIENT'S FINANCIAL RESOURCES. II.SUPPORTING DOCUMENTS SUCH AS PAYROLL STUBS, MAY BE REQUESTED TO SUPPORT INFORMATION REPORTED AND SHALL BE MAINTAINED WITH THE COMPLETED APPLICATION AND ASSESSMENT.HOW TO APPLY: APPLICATIONS AND/OR CONFIDENTIAL ASSISTANCE WITH COMPLETION OF THE APPLICATIN IS AVAILABLE FROM ANY REGISTRAR OF FROM OUR PATIENT ACCOUNTING OFFICE BY CALLING 607-756-3838.E.PRESUMPTIVE SUPPORT - UNINSURED PATIENTS ONLYI.CRMC RECOGNIZES THAT NOT ALL PATIENTS ARE ABLE TO PROVIDE COMPLETE FINANCIAL INFORMATION. THEREFORE, APPROVAL FOR FINANCIAL SUPPORT MAY BE DETERMINED BASED ON LIMITED AVAILABLE INFORMATION. WHEN SUCH APPROVAL IS GRANTED IT IS CLASSIFIED AS "PRESUMPTIVE SUPPORT". CRMC MAY UTILIZE CERTAIN TOOLS USING DEMOGRAPHIC INFORMATION COMMONLY AVAILABLE IN CONJUNCTION WITH A "FAST TRAK" FINANCIAL ASSISTANCE APPLICATION. APPROVAL IS FOR 6 MONTHS FROM THE DATE OF APPLICATION, SERVICE DATES PRIOR TO APPLICATION DATE ARE NOT ELIGIBLE FOR PRESUMPTIVE FINANCIAL ASSISTANCE.II. ANY TOOL USED AS PART OF THE PRESUMPTIVE ELIGIBILITY APPLICATION PROCESS CANNOT BE USED AS THE SOLE BASIS TO DENY A FINANCIAL AID APPLICATION.III.EXAMPLES OF PRESUMPTIVE CASES INCLUDE:"DECEASED PATIENTS WITH NO KNOWN ESTATE "HOMELESS "UNEMPLOYED PATIENTS "NON-COVERED MEDICALLY NECESSARY SERVICES PROVIDED TO PATIENTS QUALIFYING FOR PUBLIC ASSISTANCE PROGRAMS "PATIENT BANKRUPTCIES(CHAPTER 7), AND "MEMBERS OF RELIGIOUS ORGANIZATIONS WHO HAVE TAKEN A VOW OF POVERTY AND HAVE NO RESOURCES INDIVIDUALLY OR THROUGH THE RELIGIOUS ORDER.SEE SCHEDULE O FOR CONTINUATION
PART III, LINE 9B:SEE FINANCIAL ASSISTANCE POLICY FROM PART III, LINE 8.
PART VI, LINE 2:NEEDS ASSESSMENT: CRMC WORKS COLLABORATIVELY WITH THE CORTLAND COUNTY HEALTH DEPARTMENT, SUNY CORTLAND, UNITED WAY FOR CORTLAND COUNTY, FAMILY HEALTH NETWORK, AND SEVEN VALLEYS HEALTH COALITION ON AN ANNUAL BASIS TO DO A COUNTY WIDE INTEGRATED ASSESSMENT. THIS ASSESSMENT LOOKS AT 1) HEALTH & WELLNESS; 2) SOCIAL COHESION, CULTURE & RECREATION; 3) EMPLOYMENT, ECONOMY, & WELFARE; 4) HOUSING & ENVIRONMENT; 5) POSITIVE DEVELOPMENT THROUGH THE LIFE STAGES & HOW THEY ALL INTERSECT WITH EACH OTHER TO EFFECT A COMMUNITIES WELL-BEING. IT IS THRU THESE ASSESSMENTS, IN CONJUCTION WITH RESOURCE AVAILABILITY THAT PUBLIC HEALTH PRIORITIES ARE ESTABLISHED.ASSESSMENT OF PUBLIC HEALTH PRIORITIES: CRITERIA OF PUBLIC HEALTH PRIORITIES-CRITERIA:FOCUS GROUPS IDENTIFIED THE PRIORITY AS ONE OF THE COUNTY'S MOST SIGNIFICANT HEALTH ISSUES.COUNTY HEALTH DEPARTMENT MEASURES RELATED TO HEALTH PRIORITIES SUPPORT THE PUBLIC'S SUBJECTIVE OPINION, I.E. THE PRIORITY-SPECIFIC COUNTY MEASURES PUBLISHED IN CORTLAND COUNTS DEVIATE FROM STATE AND NATIONAL BENCHMARKS AND HEALTHY PEOPLE 2020 GOALS.MEDICAL CENTER INTERNAL DATA SUPPORTS ISSUES AS PRIORITIES BASED ON PATIENT VOLUME AND UTILIZATION OF SERVICES ASSOCIATED WITH THEM. USE OF DATA: THE FOLLOWING WERE THE PRIMARY SOURCES OF DATA USED TO TARGET A POPULATION:COMMUNITY FORUM HEALTH TRACK, FOCUS GROUPS, AND COMMUNITY SURVEY RESULTS-AS DESCRIBED ABOVE, THESE ACTIVITIES ELICITED SUBJECTIVE DATA REGARDING HEALTH PRIORITIES. ISSUES CONSISTENTLY NAMED "TOP HEALTH PRIORITIES" INCLUDE ACCESS TO QUALITY HEALTHCARE, HEALTHY MOTHERS/HEALTHY BABIES, CHRONIC DISEASE, HEALTHY ENVIRONMENT, AND MENTAL HEALTH AND SUBSTANCE ABUSE.CORTLAND COUNTS 2016: COUNTY STATISTICS (SEE FOLLOWING TABLE) THAT DEVIATED MOST SIGNIFICANTLY FROM STATE, REGIONAL, NATIONAL, AND HEALTHY PEOPLE 2020 GOALS WERE CONSIDERED IN DEFINING COUNTY PUBLIC HEALTH PRIORITIES.INDICATOR - CORTLAND COUNTY; UPSTATE NY; NYS; NATIONAL; HEALTHY PEOPLE 2020 GOALCIGARETTE USE IN WOMEN DURING PREGNANCY- 24.6%; 13.7%; 8.0; 8.4%; 1.4%*COLORECTAL CANCER INCIDENCE WOMEN- 45.0; 36.7; 36.6; 36.0; N/A MEN-50.3; 46.7; 47.9, 47.1; N/A*LUNG/BRONCHUS CANCERMEN - 94.6; 77.6; 72.0; 67.9; N/A WOMEN- 67.8; 62.8; 54.7; 49.4; N/A*CEREBROVASCULAR DISEASE MORTALITY RATE - 35.1; 27.8;24.9; 36.5; 34.8*CLRD OR COPD MORTALITY RATE - 39.2; 32.6; 27.9; 40.5; 102.6+*RATE PER 100,000NEW YORK STATES PREVENTION QUALITY INDICATORS (PQI): REVIEW OF HOSPITALIZATION RATES BY ZIP CODE FOR CONDITIONS GENERALLY CONSIDERED PREVENTABLE WHEN GOOD PRIMARY CARE IS ACCESSIBLE (PQI) AIDED IN DETERMINING HEALTH PRIORITIES. BECAUSE CORTLAND COUNTY IS A HPSA FOR PRIMARY MEDICAL CARE (LOW-INCOME POPULATION), THE AREAS PQIS ARE EXPECTED TO BE HIGH. PQIS WERE DETERMINED USING THE FOLLOWING PARAMETERS:THE TWELVE CONDITIONS IN THE AREAS OF CIRCULATORY, DIABETES-RELATED, RESPIRATORY, AND ACUTE ILLNESSES. CORTLAND COUNTY ZIP CODES INDIVIDUALLY AND IN SUM.CORTLAND REGIONAL MEDICAL CENTER'S SERVICE AREA ZIP CODES INDIVIDUALLY AND IN SUM.RESULTS:CONDITIONS ASSOCIATED WITH HIGHEST PQI SCORES IN THE CORTLAND AREA ARE PNEUMONIA, COPD, AND CHF (ADMISSIONS AS PERCENT EXPECTED: 207%, 139%, AND 80%, RESPECTIVELY).FURTHER ASSESSMENT INDICATES THAT CORTLAND ZIP CODE 13045 IS ASSOCIATED WITH HIGHEST PNEUMONIA & COPD PQI'S (ADMISSION AS PERCENT EXPECTED: 249% & 168%, RESPECTIVELY). RACIAL/ETHNIC DISPARITIES ARE NOT INDICATED FOR ANY CONDITION PER PQI TOOL. ADMISSIONS AS PERCENT EXPECTED BY RACE/ETHNICITY FOR HISPANIC, AFRICAN, ASIAN, AND OTHER GROUPS WERE BELOW POPULATION THRESHOLD.CORTLAND REGIONAL MEDICAL CENTER DATA - INPATIENT CASE VOLUMES BY SERVICE LINE (MEASURED AS DISCHARGES) WERE CONSIDERED IN IDENTIFICATION OF HEALTH PRIORITIES. HIGHEST VOLUMES OF INPATIENT DISCHARGES HAVE CONSISTENTLY INCLUDED THE FOLLOWING: 2012; 2013; 2014; 2015; 2016PULMONARY/MEDICAL - 785; 696; 594; 553; 453CARDIOVASCULAR DISEASES- 547; 395; 355; 290; 313OBSTETRICS/DELIVERY - 585; 427; 411; 431; 444NEW BORN - 485; 436; 431; 428; 464MARKET EXPERT 2016MEASUREMENTS OF THE MEDICAL CENTER'S AMBULATORY CARE SENSITIVE CONDITIONS (ACSC), THOSE ADMISSIONS THAT COULD HAVE BEEN TREATED AS OUTPATIENTS, WERE ALSO CONSIDERED IN DETERMINING HEALTH PRIORITIES. ACCESSIBILITY OF PRIMARY CARE IS A COMMON REASON FOR ASCS ADMISSIONS, AND AS PREVIOUSLY STATED, CORTLAND COUNTY IS A HPSA FOR PRIMARY MEDICAL CARE (LOW-INCOME). DATA ANALYSIS INDICATES THE FOLLOWING TRENDS TOWARD IMPROVEMENT IN CRMC'S TOP ACSC SEVERITY 1 CASES.UNINSURED ENCOUNTERS AT CORTLAND REGIONAL MEDICAL CENTER(2)2012; 2014; 2015; 2016TOTAL ENCOUNTERS 144,421; 146,905; 144,002; 135,455NUMBER OF UNINSURED ENCOUNTERS 5818; 4716; 6449; 7705% UNINSURED ENCOUNTERS 4.1%; 3.2%; 4.5%; 5.7%(2)CORTLAND REGIONAL MEDICAL CENTER SELECTED PREVENTION AGENDA PRIORITIESBASED ON DATA ANALYSIS, THE CORTLAND COUNTY HEALTH DEPARTMENT AND CORTLAND REGIONAL MEDICAL CENTER WILL COLLABORATE ON THE FOLLOWING PUBLIC HEALTH PRIORITIES:CHRONIC DISEASE: FOCUS WILL BE ON EXPANDING THE ROLE OF HEALTH CARE AND HEALTH SERVICE PROVIDERS IN OBESITY PREVENTION; DECREASING THE NUMBER OF WOMEN WHO SMOKE DURING PREGNANCY; AND INCREASING THE ACCESS OF DIABETIC PATIENTS TO SCREENING AND HEALTH CARE.HEALTHY MOTHERS/HEALTHY BABIES/HEALTHY CHILDREN:THE PRIMARY FOCUS WILL BE TO REDUCE PREMATURE BIRTHS AND INCREASE THE PROPORTION OF BABIES THAT ARE BREASTFED.MENTAL HEALTH AND PREVENTION SUBSTANCE ABUSE: THE PRIMARY FOCUS WILL BE TO IDENTIFY AND BEGIN TO CLOSE THE GAPS IN MENTAL HEALTH AND ADDICTION SCREENING AND SERVICES.STATUS OF PRIORITIESALL PRIORITIES REPRESENT EXISTING PROGRAMS EITHER AT CORTLAND REGIONAL MEDICAL CENTER OR THE CORTLAND COUNTY HEALTH DEPARTMENT; HOWEVER, A GOAL OF THIS PROJECT IS TO INCREASE COMMUNITY AWARENESS OF EXISTING PROGRAMS BY INVOLVING MORE COMMUNITY MEMBERS IN THE IMPLEMENTATION OF NEW INITIATIVES RELATED TO IDENTIFIED PRIORITIES.THREE-YEAR PLAN OF ACTIONSTRATEGIES FOR SELECTED PRIORITIESTHE PRIORITIES SELECTED THROUGH THE COLLABORATIVE ASSESSMENT PROCESS DESCRIBED IN THE PREVIOUS SECTION ARE ALL PUBLIC HEALTH ISSUES THAT HAVE BEEN RECOGNIZED IN THE PAST AS PRIORITIES FOR THE GREATER CORTLAND COMMUNITY AND TO WHICH CRMC AND ITS COMMUNITY PARTNERS HAVE DEDICATED RESOURCES.CHRONIC DISEASECORTLAND REGIONAL MEDICAL CENTER AND ITS COMMUNITY PARTNERS WILL FOCUS ON REDUCING ILLNESS, DISABILITY AND DEATH RELATED TO OBESITY, TOBACCO USE AND SECOND HAND SMOKE EXPOSURE. THESE WILL ALL BE IMPLEMENTED USING THE MOST CURRENT EVIDENCE-BASED RECOMMENDATIONS. OBESITY:RECRUIT PRIMARY CARE PROVIDERS TO THE COMMUNITY AND EDUCATE PROVIDERS/PARENTS/ AGENCIES ON AVAILABLE PRIMARY CARE SERVICES. EDUCATE PROVIDERS/AGENCIES/RESIDENTS ON COMMUNITY PROGRAMS THAT WILL INCREASE PHYSICAL ACTIVITY. TOBACCO USE: PRENATAL PROVIDERS WILL EDUCATION PREGNANT WOMEN ABOUT PUBLIC HEALTH REFERRALS AND EVIDENCED BASED SMIKING CESSATION STRATEGIES. (CONTINUED IN SCHEDULE O)
PART VI, LINE 3:FINANCIAL AID PROGRAMSUCCESSES AND CHALLENGESPROCESS IMPROVEMENTS AND GENERAL ACCOMPLISHMENTS:A PAMPHLET HIGHLIGHTING CRMC'S FINANCIAL AID PROGRAM AND HOW TO APPLY IS AVAILABLE AT ALL REGISTRATION LOCATIONS, ON AND OFFSITE.POLICY IS TO PROVIDE FINANCIAL AID TO INCOME LEVELS UP TO 300% OF THE FEDERAL POVERTY LEVEL.SIGNAGE ABOUT CRMC'S FINANCIAL AID PROGRAM IS IN ALL REGISTRATION AREAS, BOTH ON AND OFFSITE, AS WELL IN THE BUSINESS OFFICE AND MAIN LOBBY.DISTRIBUTED CRMC FINANCIAL AID PAMPHLETS AND APPLICATIONS AT FAMILY HEALTH NETWORK CLINIC SITESBEST PRACTICES:PROVIDE A FULL-TIME, ONSITE PATIENT FINANCIAL NAVIGATOR (CERTIFIED APPLICATION COUNSELOR THROUGH NYS) TO ASSIST IN ENROLLING THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED IN THE NYS MARKETPLACECONTRACT WITH AN OUTSIDE AGENCY, CARDON, TO ASSIST ELIGIBLE INPATIENT SELF-PAY POPULATION TO OBTAIN MEDICAID.SCREEN SELF-PAY REGISTRATIONS FOR BLUE CROSS, MEDICAID, AND/OR FIDELIS COVERAGE. PATIENTS WITHOUT COVERAGE ARE CALLED FOR CURRENT INSURANCE INFORMATION, AND IF THEY HAVE NONE, THEY ARE OFFERED FINANCIAL ASSISTANCE AND/OR MONTHLY PAYMENT OPTIONS.PARTICIPATE IN ANNUAL HEALTH INSURANCE FAIR TO HELP RAISE AWARENESS OF THE OPTIONS AVAILABLE TO INDIVIDUALS WHO HAVE NO INSURANCE OR ARE UNDER INSURED.CHALLENGES:DIFFICULTY GAINING PATIENT COOPERATION WITH THE APPLICATION PROCESS AND PATIENTS' NON-COMPLIANCE WITH POLICY.LACK OF VALID PATIENT DEMOGRAPHIC INFORMATION, INCLUDING TELEPHONE NUMBERS.APPLICANTS DISHONESTY.ALSO, SEE WRITE UP FOR PART III, LINE 9
PART VI, LINE 4:HOSPITAL SERVICE AREACORTLAND REGIONAL MEDICAL CENTER IS LOCATED IN THE CITY OF CORTLAND, COUNTY OF CORTLAND, IN THE CENTRAL REGION OF NEW YORK STATE. THE MEDICAL CENTER IS APPROXIMATELY 35 MILES SOUTH OF SYRACUSE, NEW YORK; 40 MILES NORTH OF BINGHAMTON, NEW YORK; AND 24 MILES NORTHEAST OF ITHACA, NEW YORK. AS THE ONLY HOSPITAL IN CORTLAND COUNTY, CRMC IS FEDERALLY DESIGNATED A SOLE COMMUNITY HOSPITAL. THE MEDICAL CENTER SERVES ALL OF CORTLAND COUNTY AND NEIGHBORING PARTS OF SEVEN CONTIGUOUS COUNTIES, INCLUDING ONONDAGA, MADISON, CHENANGO, BROOME, TIOGA, TOMPKINS, AND CAYUGA.DESCRIPTION OF SERVICE AREACORTLAND REGIONAL MEDICAL CENTER DEFINES ITS PRIMARY SERVICE AREA AS AN 18-ZIP-CODE AREA IN AND AROUND CORTLAND PROPER. IT ACCOUNTS FOR APPROXIMATELY 93% OF CORTLAND REGIONAL MEDICAL CENTER'S TOTAL INPATIENT ADMISSIONS; THIS REPRESENTS APPROXIMATELY 43.2% MARKET SHARE. CORTLAND REGIONAL MEDICAL CENTER IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVICES BY USING AVAILABLE RESOURCES TO MEET THE NEEDS OF THE PEOPLE WHO LIVE OR WORK IN ITS SERVICE AREA.
PART VI, LINE 5:ACCESS TO QUALITY HEALTH CARETHE MEDICAL CENTER PARTNERS WITH COMMUNITY ORGANIZATIONS TO INCREASE MEDICAID ENROLLMENT, EXPAND ACCESS TO PROVIDERS, AND RECRUIT NEW PROVIDERS TO ENSURE A SUFFICIENT NUMBER OF PRIMARY CARE AND SPECIALTY PHYSICIANS TO MEET THE COMMUNITY'S NEEDS.MEDICAID ENROLLMENT:EMPLOY A FULL-TIME PATIENT FINANCIAL NAVIGATOR THROUGH CRMC. THIS STAFF MEMBER IS A CAC (CERTIFIED APPLICATION COUNSELOR) THROUGH NYS. ASSISTING IN ENROLLING THOSE INDIVIDUALS WHO ARE UNINSURED OR UNDERINSURED IN THE NYS MARKETPLACE. THIS STAFF IS ALSO ABLE TO ASSIST IN ENROLLING PATIENTS INTO MEDICAID AND MEDICAID MANAGED CARE PRODUCTS. THEY ARE ALSO IN CHARGE OF THE HOSPITALS FINANCIAL ASSISTANCE PROGRAM AND WORK WITH PATIENTS TO APPLY FOR FINANCIAL AID IN ORDER TO REDUCE HOSPITAL BILLS IN ACCORDANCE TO FPL REGULATIONS. THE GOAL IS TO REDUCE THE NUMBER OF UNINSURED PEOPLE IN CORTLAND COUNTY AND THE NUMBER OF PEOPLE THAT ARE SENT TO COLLECTION DUE TO HIGH COST MEDICAL BILLS. CRMC ALSO CONTRACTS WITH CARDON GROUP TO ASSIST INPATIENTS WHO ARE MEDICAID ELIGIBLE TO OBTAIN COVERAGE. -PARTICIPATE IN ANNUAL HEALTH INSURANCE FAIR TO RAISE AWARENESS OF AVAILABLE COVERAGE. GOAL: REDUCE THE NUMBER OF UNINSURED INDIVIDUALS IN CORTLAND COUNTY. EXPAND ACCESS TO PROVIDERS:PROVIDE INCREASED ACCESS FOR MEDICAID RECIPIENTS BY HAVING PHYSICIANS EMPLOYED BY REGIONAL MEDICAL PRACTICE, P.C. ACCEPT MEDICAID AND OTHER INSURANCES THAT MANY PHYSICIAN PRACTICES DO NOT ACCEPT. GOAL: PROVIDE MEDICAID RECIPIENTS GREATER ACCESS TO OFFICE-BASED MEDICAL CARE. MEASUREMENT: NUMBER OF MEDICAID RECIPIENTS IN RMP PHYSICIAN PRACTICES.APPROXIMATELY 22.3% OF CORTLAND COUNTY RESIDENTS ARE MEDICAID RECIPIENTS WHILE NEARLY 20.53% OF THE PATIENTS SEEN BY RMP PHYSICIANS ARE INSURED BY MEDICAID. THESE STATISTICS SUGGEST THAT CRMC'S EFFORTS TO IMPROVE MEDICAID RECIPIENTS' ACCESS TO MEDICAL CARE HAVE BEEN SUCCESSFUL. PROVIDE SUFFICIENT NUMBERS OF PROVIDERS:PHYSICIAN RECRUITMENT AND RETENTION PLAN - CORTLAND REGIONAL MEDICAL CENTER ADOPTED A COMPREHENSIVE PHYSICIAN RECRUITMENT AND RETENTION PLAN THAT ESTABLISHES RECRUITMENT PRIORITIES OVER THE NEXT FIVE YEARS BASED ON A SURVEY OF COMMUNITY PHYSICIANS, INTERNAL DATA INCLUDING MEDICAL STAFF AGES AND ANTICIPATED RETIREMENTS, AND EXTERNAL DATA ON THE SUPPLY AND DISTRIBUTION OF PHYSICIANS. -PRIORITY SPECIALTY RECRUITMENT YEARS 1-3 -PRIMARY CARE: FAMILY PRACTICE, INTERNAL MEDICINE, ORTHOPEDICS, OB/GYN, GENERAL SURGERY, CARDIOLOGY, UROLOGY, PSYCHIATRY, ONCOLOGY AND PULMONOLOGIST. RECRUITMENT EFFORTS HAVE BEEN SUCCESSFUL IN THE AREAS OF ORTHOPEDICS, OBSTETRICS/ GYNECOLOGY, ONCOLOGY, INTERNAL MEDICINE AND CARDIOLOGY. -PRIORITY SPECIALTY RECRUITMENT YEARS 3-5 - NEUROLOGY, GASTROENTEROLOGY, PRIMARY CARE: FAMILY PRACTICE, AND INTERNAL MEDICINE. GOAL: SUCCESSFUL RECRUITMENT OF ADDITIONAL PHYSICIANS. MEASUREMENT: NUMBER OF NEW PHYSICIANS OPENING OR JOINING EXISTING PRACTICES. HEALTHY MOTHERS/HEALTHY BABIES/HEALTHY CHILDRENCORTLAND REGIONAL MEDICAL CENTER, TOGETHER WITH COMMUNITY PARTNERS, IS FOCUSING ON IMPROVING THE QUALITY OF OBSTETRICAL AND PEDIATRIC CARE, PROVIDING EDUCATION TO PREGNANT WOMEN AND NEW MOTHERS, AND ENSURING THERE ARE SUFFICIENT NUMBERS OF PHYSICIANS IN THE COMMUNITY TO PROVIDE IMPROVED ACCESS TO OBSTETRICAL AND PEDIATRIC CARE. EDUCATION:-CHILD BIRTH CLASSES -EVERY OTHER MONTH, CRMC OFFERS A FULL TWO-DAY, WEEKEND CHILD BIRTH CLASS FOR EXPECTANT PARENTS THAT COVERS A VARIETY OF TOPICS, INCLUDING: NUTRITION; THE ROLE OF THE COACH; BREATHING AND RELAXATION TECHNIQUES FOR LABOR; CARE AND CHARACTERISTICS OF THE NEWBORN; BREASTFEEDING; PARENTING SKILLS; POST PARTUM ISSUES; AND INFANT SAFETY. CRMC ALSO PROVIDES SPACE FOR ITS COMMUNITY PARTNER, FAMILY HEALTH NETWORK, TO HOLD CHILD BIRTH CLASSES.-POSTPARTUM AND NEWBORN CARE EDUCATION - MATERNITY STAFF PROVIDE EDUCATION TO NEW MOTHERS ABOUT HOW TO CARE FOR THEMSELVES AND THEIR NEWBORNS.-POST DISCHARGE BREASTFEEDING SUPPORT - A FOLLOW UP SERVICE PROVIDED AFTER MOTHER AND BABY HAVE GONE HOME TO IMPROVE BREASTFEEDING SUCCESS AND ENCOURAGE THAT IT CONTINUES TO PROVIDE THE NEW INFANT A HEALTHY START.-HEALTHY BEGINNINGS PROGRAM - IN COLLABORATION WITH THE CORTLAND COUNTY HEALTH DEPARTMENT, CRMC DISTRIBUTES PACKETS THAT EMPHASIZE THE IMPORTANCE OF IMMUNIZATIONS AND ALSO PROVIDES INFORMATION ON LEAD POISONING PREVENTION; INFANT/CHILD SAFETY; NUTRITION; AND HEALTH AND DENTAL CARE. CRMC REGISTERS MOTHERS FOR HEALTHY BEGINNINGS NEWSLETTERS, WHICH THE HEALTH DEPARTMENT SENDS TO PARENTS AT OR AROUND THE TIME THEIR CHILD IS DUE FOR A WELL-CHILD VISIT DURING THE FIRST TWO YEARS OF LIFE.(CONTINUED IN SCHEDULE O)
PART VI, LINE 6:PARTICIPANTSCORTLAND REGIONAL MEDICAL CENTER COLLABORATES WITH THE CORTLAND COUNTY HEALTH DEPARTMENT, SUNY CORTLAND, AND THE UNITED WAY FOR CORTLAND COUNTY TO MAINTAIN AN ONGOING COMMUNITY NEEDS ASSESSMENT UNDER THE AUSPICES OF THE SEVEN VALLEYS HEALTH COALITION. A COMMUNITY ASSESSMENT TEAM (CAT) COMPRISED OF THE MEDICAL CENTER'S CEO'S DESIGNEE AND THE CORTLAND COUNTY PUBLIC HEALTH DIRECTOR, AS WELL AS REPRESENTATIVES FROM EACH OF THE OTHER INVOLVED ORGANIZATIONS, OVERSEES THE ANNUAL UPDATING OF THE ASSESSMENT. THE FIRST EDITION OF CORTLAND COUNTS: AN ASSESSMENT OF HEALTH AND WELL BEING IN CORTLAND COUNTY WAS RELEASED IN 2001, AND COMPREHENSIVE ASSESSMENTS HAVE THEREAFTER BEEN CONDUCTED EVERY FIVE YEARS. IN THE YEARS BETWEEN FULL ASSESSMENTS, AN ABBREVIATED VERSION, THE COMMUNITY REPORT CARD, IS PUBLISHED TO PROVIDE UPDATED HIGHLIGHTS OF THE COMPREHENSIVE ASSESSMENT IN AN "AT-A-GLANCE" FORMAT. THE COMPREHENSIVE REPORT WAS RELEASED IN SEPTEMBER 2016.OUTCOMESA BLUE RIBBON COMMITTEE (BRC) THAT INCLUDES BROAD COMMUNITY REPRESENTATION WAS ESTABLISHED IN 2002 TO REVIEW THE CORTLAND COUNTS ASSESSMENT IN LIGHT OF DATA PROVIDED BY FOCUS GROUPS AND CITIZEN SURVEYS CONDUCTED BY THE COMMUNITY ASSESSMENT TEAM, AS WELL AS OTHER COMMUNITY RESEARCH AND FEEDBACK. USING BOTH SUBJECTIVE AND OBJECTIVE DATA, THE BRC SET PRIORITIES AND DEVELOPED A STRATEGIC PLAN THAT CURRENTLY INCLUDES FOUR BROAD TRACKS: ECONOMIC DEVELOPMENT, YOUTH, HOUSING, AND HEALTH. A COMMUNITY ORGANIZATION, OR COALITION OF ORGANIZATIONS, IS TAKING THE LEAD TO ADDRESS EACH BROAD TRACK:THE CORTLAND COUNTY BUSINESS DEVELOPMENT CORPORATION IS SPEARHEADING ECONOMIC DEVELOPMENT INITIATIVES.THE CORTLAND AREA COMMUNITIES THAT CARE COALITION (CACTC) IS COORDINATING EFFORTS TO IMPROVE SERVICES AND EXPAND OPPORTUNITIES FOR THE YOUTH IN THE GREATER CORTLAND COMMUNITY.SEVERAL AGENCIES ARE INVOLVED IN ADDRESSING THE NEED FOR BETTER QUALITY, AFFORDABLE HOUSING.THE SEVEN VALLEYS HEALTH COALITION, IN COLLABORATION WITH CORTLAND REGIONAL MEDICAL CENTER, THE CORTLAND COUNTY HEALTH DEPARTMENT, FAMILY HEALTH NETWORK, AND OTHER COMMUNITY-BASED AGENCIES, IS DIRECTING THE FOCUS ON COMMUNITY HEALTH.THE BLUE RIBBON COMMITTEE MEETS ANNUALLY AND INVITES THE ENTIRE COMMUNITY TO PARTICIPATE IN REDEFINING PRIORITIES AND UPDATING THE STRATEGIC PLAN. CORTLAND COUNTS IS A KEY DOCUMENT THAT THE MEDICAL CENTER AND MANY COMMUNITY AGENCIES UTILIZE IN SETTING PRIORITIES FOR THE CONTINUATION OF EXISTING SERVICES AND THE DEVELOPMENT OF NEW/ENHANCED PROGRAMS AND SERVICES.PUBLIC INPUTA COMMUNITY FORUM WAS HELD IN JANUARY 2016 THAT INCLUDED STAKEHOLDERS REPRESENTING EACH OF THE FOUR STRATEGIC PLAN TRACKS. TWO ADDITIONAL MEETINGS CONCERNING THE HEALTH TRACK WERE HELD IN FEBRUARY AND MAY TO ENSURE THAT THE HEALTH GOALS HAD BEEN CLEARLY IDENTIFIED AND WERE BEING ADDRESSED. CORTLAND COUNTS IS A KEY DOCUMENT THAT THE MEDICAL CENTER AND MANY COMMUNITY AGENCIES UTILIZE IN SETTING PRIORITIES FOR THE CONTINUATION OF EXISTING SERVICES AND THE DEVELOPMENT OF NEW/ENHANCED PROGRAMS AND SERVICES.BARRIERS TO CARE/GAPS IN SERVICEACCESS TO QUALITY HEALTH CARE:THE SURVEYS REVEALED RESIDENTS OF CORTLAND COUNTY WERE CONCERNED ABOUT THEIR ABILITY TO ACCESS HIGH QUALITY SPECIALTY AND PRIMARY CARE. A SHORTAGE OF PRIMARY CARE PROVIDERS AND SPECIALISTS IS FORCING RESIDENTS TO TRAVEL TO SYRACUSE, BINGHAMTON, ITHACA, OR FURTHER TO RECEIVE THE CARE THEY NEED.MENTAL HEALTH SERVICES:THE INADEQUACY OF MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES IN CORTLAND WAS IDENTIFIED AS A PRIMARY GAP IN SERVICE. EXPANSION OF EXISTING CLINICS AND EXPLORATION OF PARTNERING WITH LARGER MEDICAL FACILITIES THROUGH TELEMEDICINE GRANT OPPORTUNITIES WERE PROPOSED AS POSSIBLE SOLUTIONS.PUBLIC NOTIFICATION OF OPPORTUNITIES TO PROVIDE INPUTADVERTISEMENTS WERE PLACED IN THE LOCAL NEWSPAPER AND ANNOUNCEMENTS WERE DISTRIBUTED VIA E-MAIL AND LISTSERVS. PUBLIC ASSISTANCE PROGRAMS WERE ALSO ENCOURAGED TO POST THE NOTIFICATIONS AND TO ADVISE CLIENTS OF OPPORTUNITIES TO PARTICIPATE. UPON EVALUATION, THE PROCESS OF NOTIFYING THE PUBLIC COULD BE IMPROVED BY PLACING NOTICES WHERE THOSE RESIDENTS WHOSE ACCESS TO HEALTHCARE IS LIMITED WOULD BE MORE LIKELY TO SEE THEM. SUGGESTED LOCATIONS INCLUDE THE COUNTYS SENIOR CENTERS, LOCAL FOOD PANTRIES, CORTLAND-CHENANGO RURAL SERVICES, AND THROUGH CONTACT WITH THE FAITH COMMUNITY.
PART VI, LINE 7, REPORTS FILED WITH STATESNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
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 (8 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
MARK WEBSTER
PRESIDENT/CEO$424,811$0$0$0$1,496$0$41,329$0$25,541$0$493,177$0$0$0
TRACY GATES
VICE PRESIDENT - COO$175,108$0$0$0$0$0$0$0$17,070$0$192,178$0$0$0
MARY WRIGHT
VICE PRESIDENT-NURSING SER$188,669$0$0$0$258$0$6,967$0$21,017$0$216,911$0$0$0
DENISE WRINN
VICE PRESIDENT - CFO$236,445$0$0$0$258$0$12,561$0$18,828$0$268,092$0$0$0
ROGER SCOTT MD
VICE PRESIDENT MEDICAL AFF$338,656$50,192$0$0$90$0$15,477$0$20,682$0$374,905$50,192$0$0
JOE DALLAIRD
DIRECTOR - REVENUE CYCLE$156,567$0$0$0$0$0$4,818$0$15,818$0$177,203$0$0$0
ROBERT DUTHE
DIRECTOR - IT$163,968$0$0$0$0$0$0$0$7,952$0$171,920$0$0$0
MICHELLE TUCKER
PHARMACIST$122,647$0$0$0$0$0$5,165$0$22,723$0$150,535$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CORTLAND COUNTY DEVELOPMENT CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN455122714BondIssuerEIN
Bond Issued2013-02-26BondIssuedDt
Issue Price$21,300,000IssuePriceAmt
PurposeSEE PART VIPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$21,300,000TotalProceedsAmt
Issuance Costs From Proceeds$637,047IssuanceCostsFromProceedsAmt
Capital Expenditures$5,967,331CapitalExpendituresAmt
Other Spent Proceeds$14,695,622OtherSpentProceedsAmt
Substantial Completion2014SubstantialCompletionYr
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And RecYes (1)HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line1KEY BANK (FORMERLYBusinessNameLine1Txt
Business Name Line2FIRST NIAGRA BANK)BusinessNameLine2Txt
FieldValueIRS element (for citing)
Term Of Hedge10.000000000000TermOfHedgePct
Superintegrated Hedge0SuperintegratedHedgeInd
Hedge Terminated0HedgeTerminatedInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE A, COLUMN (F)FormAndLineReferenceDesc
ExplanationBONDS WERE USED FOR THE PURPOSE OF ASSISTING IN FINANCING AND/OR REFINANCING ALL OR A PORTION OF THE COSTS OF A CERTAIN PROJECT, WHICH DID NOT INVOLVE ANY EXTERIOR CONSTRUCTION AND/OR EXPANSION OF THE EXTERIOR OF THE FACILITY CONSISTING OF: A) ACQUISITION AND INSTALLATION OF IMAGING EQUIPMENT, CARDIAC MONITORS, WIRELESS UPGRADES FOR IV PUMPS, BOILERS, AND RELATED HOSPITAL EQUIPMENT FOR USE AT THE FACILITY. B) THE REFUNDING OF ALL OR A PORTION OF THE OUTSTANDING PRINCIPAL AMOUNT OF THE CORTLAND COUNTY INDUSTRIAL DEVELOPMENT AGENCY CIVIC FACILITY RESERVE BONDS, SERIES 2002, ISSUED JUNE 20, 2002. PART II, LINE 11 - OTHER SPENT PROCEEDS OF $14,695,622 WERE USED TO REFUND A PORTION OF THE SERIES 2002 BONDS DESCRIBED IN PART I, LINE A, COLUMN (F). PART IV, LINE 2C - NO REBATE DUE BECAUSE THERE WAS ZERO INVESTMENT PROCEEDS. PART IV, LINE 7 - NO WRITTEN PROCEDURES SINCE NO ARBITRAGE WAS INVOLVED. PART V - THERE WAS A TAX COMPLIANCE AGREEMENT COMPLETED AT THE TIME OF ISSUANCE. THE VP FINANCE/CFO IS RESPONSIBLE FOR MONITORING COMPLIANCE AND CONSULTS WITH OUR BOND ATTORNEY AS NEEDED.ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
JOHANNA AMES
TRUSTEE$397,776OFFICER OF AMES LINEN SERVICES0
DAVID MAYO MD
TRUSTEE$56,406RENTS A BUILDING FROM REGIONAL MEDICAL PRACTICE. REGIONAL MEDICAL PRACTICE IS CONTROLLED BY THE HOSPITAL.0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (14 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2CORTLAND REGIONAL MEDICAL CENTER CONDUCTS BUSINESS WITH AMES LINEN, WHOSE OWNER, JOHANNA AMES, IS A TRUSTEE ON THE CORTLAND REGIONAL MEDICAL CENTER BOARD. LEE SHURTLEFF IS THE PRESIDENT OF THE BOARD OF TRUSTEES FOR GROTON NURSING FACILITY AND IS ALSO A TRUSTEE FOR CORTLAND REGIONAL MEDICAL CENTER. CORTLAND REGIONAL MEDICAL CENTER HAS A MANAGEMENT AGREEMENT WITH GROTON NURSING FACILITY.
FORM 990, PART VI, SECTION A, LINE 6THE PARENT, CMH GROUP, INC, IS THE SOLE MEMBER. CMH GROUP, INC. APPOINTS THE HOSPITAL BOARD MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7ANO SINGLE PERSON, ONLY THE ORGANIZATION CMH GROUP, MAY ELECT OR APPOINT ONE OR MORE MEMBERS.
FORM 990, PART VI, SECTION A, LINE 7BTHE SOLE MEMBER OF THE CORPORATION (THE C.M.H. GROUP) SHALL APPOINT ANNUALLY INDIVIDUALS TO FILL THE THEN-EXISTING VACANCIES ON THE BOARD (OF TRUSTEES) SO LONG AS THE BOARD HAS PROPOSED THAT THE VACANCY BE FILLED.
FORM 990, PART VI, SECTION B, LINE 11BBEFORE THE 990 IS SUBMITTED, IT IS MADE AVAILABLE TO THE BOARD OF TRUSTEES FINANCE COMMITTEE FOR THEIR REVIEW. QUESTIONS ARE THEN DIRECTED TO THE CFO/CONTROLLER. THE 990 IS THEN MADE AVAILABLE TO THE FULL BOARD PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CCORTLAND REGIONAL MEDICAL CENTER ENFORCES ITS CONFLICT OF INTEREST POLICY REQUIRING OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES TO SUBMIT ANNUAL CONFLICT OF INTEREST STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 15CORTLAND REGIONAL MEDICAL CENTER EXECUTIVE COMMITTEE COMPENSATION PHILOSOPHY AND RESPONSIBILITY PURPOSE: AS DELEGATED REPRESENTATIVES OF THE BOARD OF TRUSTEES, THE EXECUTIVE COMMITTEE HAS THE POWER, DUTY AND RESPONSIBILITY TO DETERMINE THE ORGANIZATION'S OVERALL COMPENSATION PHILOSOPHY AND TO ESTABLISH THE GUIDELINES, RULES AND PROCEDURES NECESSARY FOR THE PROPER AND EFFICIENT ADMINISTRATION OF THE EXECUTIVE COMPENSATION PROGRAM. FURTHER, THE COMMITTEE ACKNOWLEDGES ITS RESPONSIBILITY TO ENSURE THAT THE EXECUTIVE COMPENSATION PROGRAM IS APPROPRIATE IN VIEW OF ITS MISSION, TAX-EXEMPT STATUS, CHARITABLE PURPOSE, AND THAT ITS COMPENSATION AND BENEFITS ARE REASONABLE AND NOT EXCESSIVE. TO THAT END, THE EXECUTIVE COMMITTEE WILL REVIEW AND APPROVE ALL FORMS OF EXECUTIVE COMPENSATION AND BENEFITS IN A MANNER NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTIONS RULES OF SECTION 4958 OF THE IRC. MEMBERSHIP: THE COMMITTEE WILL CONSIST OF THE BOARD OF TRUSTEES EXECUTIVE COMMITTEE. COMPENSATION PHILOSOPHY: THE EXECUTIVE COMPENSATION PROGRAM IS DESIGNED TO ESTABLISH AND MAINTAIN A COMPENSATION PACKAGE WHICH WILL ENABLE THE ORGANIZATION TO ATTRACT, RETAIN, MOTIVATE AND REWARD THE MANAGEMENT TEAM LEADERSHIP NEEDED TO SUCCESSFULLY ACCOMPLISH THE ORGANIZATION'S STRATEGIC AND OPERATIONAL GOALS. THE FOLLOWING GUIDELINES WILL BE USED: A TOTAL COMPENSATION CONCEPT WILL BE USED EMPLOYING A COMBINATION OF BASE SALARY, INCENTIVE OPPORTUNITY, FLEXIBLE BENEFITS, DEFERRED COMPENSATION AND OTHER PERQUISITES AS MAY BE NEEDED FROM TIME TO TIME TO MAINTAIN A COMPETITIVE POSITION WITH PEER INSTITUTIONS IN THE REGION. BASE SALARY WILL BE TARGETED AT APPROXIMATELY THE 60TH PERCENTILE OF SIMILAR POSITIONS IN PEER INSTITUTIONS FOR EXPERIENCED PROFESSIONALS. PAY LEVELS FOR INDIVIDUALS WILL DEPEND UPON EXPERIENCE, OVERALL PERFORMANCE, AND CONTRIBUTION TO THE SUCCESS OF THE ORGANIZATION. ANNUAL REVIEWS WILL TAKE PLACE AS OF JANUARY 1 EACH YEAR. INCREASING EMPHASIS WILL BE PLACED ON INCENTIVE COMPENSATION TO THE EXTENT CONSISTENT WITH THE OBJECTIVE TO MAINTAIN THE TAX EXEMPT STATUS OF THE VARIOUS CORPORATE ENTITIES. THE MANAGEMENT TEAM WILL HAVE THE OPPORTUNITY TO REACH THE MAXIMUM PERCENTAGE OF TOTAL COMPENSATION AVAILABLE AT THE TOP OF THE RANGE PAID AMONG PEER INSTITUTIONS BASED ON ACHIEVING OUTSTANDING PERFORMANCE WITH STRATEGIC GOALS IN THE INCENTIVE PLAN. TARGET OPPORTUNITIES WILL BE GEARED TO THE 75TH PERCENTILE OF TOTAL COMPENSATION. DEFERRED COMPENSATION AND PREQUISITE OPPORTUNITIES WILL BE DEVELOPED TO OPTIMIZE WHATEVER TAX DEFERRAL OPPORTUNITIES EXIST WITHIN THE TAX CODE AND TO BE COMPETITIVE WITH PEER INSTITUTIONS. THIS PHILOSOPHY SHALL BE APPLIED EXCEPT AS REQUIRED TO RECRUIT HIGHLY MARKET SENSITIVE POSITIONS. THE EXECUTIVE COMPENSATION PROGRAM SHALL OPERATE AND BE CONSISTENT WITH ALL FEDERAL AND STATE LAWS, CODES, AND PROCEDURES SO LEGISLATED. COMMITTEE RESPONSIBILITIES: THE EXECUTIVE COMMITTEE HAS THE RESPONSIBILITY TO: -SET THE OVERALL COMPENSATION PHILOSOPHY -SET, MONITOR AND REVIEW THE BASE SALARY OF THE CEO AND OTHER MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM AS SET FORTH IN APPLICABLE LEGISLATION -ESTABLISH, MONITOR AND DETERMINE ACCOMPLISHMENT OF INCENTIVE AWARD GOALS FOR THE CEO AND OTHER APPLICABLE EXECUTIVES -OVERSEE THE CLEAR AND ACCURATE DISCLOSURE OF THE TOTAL VALUE OF COMPENSATION PAID TO EXECUTIVES AND OTHER KEY INDIVIDUALS ON THE HOSPITAL'S FORM 990 -RESOLVE AND DETERMINE ALL DISPUTES OR QUESTIONS ARISING UNDER THE PROGRAM, INCLUDING THE POWER TO DETERMINE THE RIGHTS OF EMPLOYEES AND TO REMEDY ANY AMBIGUITIES, INCONSISTENCIES OR OMISSIONS -AMEND OR RESTRUCTURE THE PROGRAM AT ANY TIME AND FOR ANY REASON ANNUAL PROCESS: BEGINNING OF CYCLE ACTIVITIES: -MEET WITH THE CEO TO IDENTIFY APPROPRIATE GOALS AND SUPPORTING OBJECTIVES TO BE INCLUDED IN THE INCENTIVE AWARD PROGRAM -PRIORITIZE OBJECTIVES, ESTABLISH/REVIEW STANDARDS OF PERFORMANCE AND AWARD LEVELS FOR THE CEO AND OTHER APPROPRIATE PARTIES -DETERMINE THE FUNDING MECHANISM FOR THE INCENTIVE AWARD -SECURE MARKET INFORMATION WITH REGARD TO THE POSITIONING OF THE CHIEF EXECUTIVE OFFICER AND OTHER APPROPRIATE EXECUTIVES AND SET BASE SALARY FOR THE PERIOD INTERIM ACTIVITY: CONDUCT PROGRESS REVIEW OF CEO'S STATED OBJECTIVES AND STANDARDS OF PERFORMANCE, AS NECESSARY END OF CYCLE ACTIVITY: -REVIEW THE STANDARDS OF PERFORMANCE FOR THE KEY OBJECTIVES AND MEASURE RESULTS -CONSIDER FACTORS INVOLVED IN MANAGERIAL EFFECTIVENESS -CONSIDER ANY UNANTICIPATED RESPONSIBILITIES OR SPECIAL ACCOMPLISHMENTS -SOLICIT PERFORMANCE EVALUATION FROM ALL BOARD MEMBERS -CONDUCT A PERFORMANCE REVIEW OF THE CEO -DETERMINE THE OVERALL EVALUATION AND AWARD LEVEL -RECEIVE A PERFORMANCE REVIEW FROM THE CEO FOR ALL OTHER MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM AND A SUMMARY OF PROPOSED SALARY AND INCENTIVE AWARDS
FORM 990, PART VI, SECTION C, LINE 18CORTLAND REGIONAL MEDICAL CENTER'S 990 IS AVAILABLE UPON WRITTEN REQUEST.
FORM 990, PART VI, SECTION C, LINE 19CORTLAND REGIONAL MEDICAL CENTER'S GOVERNING DOCUMENTS, FINANCIAL STATEMENT AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN FOUNDATION 249,692. PENSION AND POST RETIREMENT 338,816. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 148,229. EQUITY ADJUSTMENT -39,103,963.
FORM 990 PART XII LINE 2CTHE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.
FORM 990, SCHEDULE H, PART III, LINE 8CONTINUATION: FINANCIAL ASSISTANCE POLICY "PATIENTS WHO ARE NON-RESIDENTS OF NYS WHO HAVE BEEN APPROVED FOR MEDICAID BY THEIR STATE OF RESIDENCE. III. FOR PATIENTS WHO ARE NON-RESPONSIVE TO THE APPLICATION PROCESS, OTHER SOURCES OF INFORMATION, IF AVAILABLE, MAY BE USED TO MAKE AN INDIVIDUAL ASSESSMENT OF FINANCIAL NEED. THIS INFORMATION WILL ENABLE CRMC TO MAKE AN INFORMED DECISION ON THE FINANCIAL NEED OF NON-RESPONSIVE PATIENTS. IV.FOR THE PURPOSE OF HELPING FINANCIALLY NEEDY PATIENTS, A THIRD-PARTY MAY BE UTILIZED TO CONDUCT A REVIEW OF PATIENT INFORMATION TO ASSESS FINANCIAL NEED. CRMC DOES NOT UTILIZE A CREDIT SCORING TOOL AS PART OF THIS PROCESS. F.TIMELINE FOR ESTABLISHING FINANCIAL ELIGIBILITY I.EVERY EFFORT SHOULD BE MADE TO DETERMINE A PATIENT'S ELIGIBILITY FOR FINANCIAL SUPPORT PRIOR TO OR AT THE TIME OF ADMISSION OR SERVICE. FINANCIAL ASSISTANCE APPLICATIONS WILL BE ACCEPTED UP TO 240 DAYS AFTER THE FIRST BILLING STATEMENT TO THE PATIENT. II.DETERMINATION FOR FINANCIAL SUPPORT MAY BE MADE PRESUMPTIVELY, HOWEVER PATIENT IS ENCOURAGED TO CONTINUE ALL EFFORTS TO QUALIFY FOR GOVERNMENTAL FINANCIAL ASSISTANCE OR OTHER PROGRAMS. III.CRMC WILL MAKE EVERY EFFORT TO MAKE A FINANCIAL SUPPORT DETERMINATION WITHIN 20 DAYS OF RECEIPT OF COMPLETED APPLICATION. IF OTHER AVENUES OF FINANCIAL SUPPORT ARE BEING PURSUED, CRMC WILL COMMUNICATE WITH THE PATIENT REGARDING THE PROCESS AND EXPECTED TIMELINE FOR DETERMINATION AND SHALL NOT ATTEMPT COLLECTION EFFORTS WHILE SUCH DETERMINATION IS BEING MADE. IV.A PATIENT MAY SUBMIT A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME WITHIN 240 DAYS AFTER THE FIRST BILLING STATEMENT. HOWEVER, EXTRAORDINARY COLLECTION EFFORTS MAY BE COMMENCED AFTER 120 DAYS FROM THE FIRST BILLING STATEMENT, IF NO APPLICATION HAS BEEN SUBMITTED. V.APPROVALS FOR FINANCIAL SUPPORT WILL BE FOR A PERIOD OF 6 MONTHS. ANY SERVICES PROVIDED BEYOND THE FAP APPROVAL PERIOD WILL REQUIRE A NEW APPLICATION. G.TERMS FOR FINANCIAL ASSISTANCE - FULL APPLICATION ONLY I.THE COMPLETED FULL APPLICATION MUST BE ACCOMPANIED WITH THE REQUIRED SUPPORTING DOCUMENTATION AND RETURNED TO CRMC FOR PROCESSING WITHIN 30 DAYS OF RECEIPT OF THE APPLICATION. ONCE THE COMPLETED APPLICATION AND REQUIRED DOCUMENTATION HAS BEEN RECEIVED, CRMC HAS 20DAYS TO PROCESS A WRITTEN APPROVAL OR WRITTEN DENIAL. DETERMINATION OF NEED FOR FINANCIAL ASSISTANCE WILL BE MADE BASED UPON THE INFORMATION PROVIDED ON THE FINANCIAL ASSISTANCE APPLICATION ALONG WITH DATA OBTAINED BY CRMC OR SUCH OTHER FIRM RETAINED TO ASSIST THE HOSPITAL IN PROCESSING SUCH APPLICATIONS. APPROVALS FOR FINANCIAL SUPPORT WILL BE FOR A PERIOD OF 6 MONTHS, IN ADDITION FOR APPROVED FULL APPLICATIONS ANY OPEN BALANCES (NOT IN BAD DEBT / COLLECTION) WITHIN 2 YEARS OF APPROVAL DATE ARE ALSO ELIGIBLE FOR THE FAP AWARD. II.PATIENTS HAVE 20 DAYS FROM THE DATE OF THE APPROVAL OR DENIAL TO APPEAL THE DETERMINATION. APPEALS MUST BE SUBMITTED IN WRITING TO: CORTLAND REGIONAL MEDICAL CENTER, 134 HOMER AVENUE, CORTLAND, NY 13045 ATTN: PATIENT FINANCIAL NAVIGATOR. III.INCOMPLETE APPLICATIONS AND/OR MISSING DOCUMENTATION CAN RESULT IN A DENIAL. CRMC WILL ATTEMPT TO GET THE MISSING INFORMATION AFTER THE REVIEW OF THE ORIGINAL APPLICATION. APPLICATIONS DEEMED TO BE INCOMPLETE WILL BE RETURNED TO THE APPLICANT WITH NOTIFICATION THAT FAILURE TO PROVIDE ALL REQUIRED DATA WITHIN 20 DAYS OF RECEIPT OF THE RETURNED APPLICATION WILL RESULT IN A DENIAL FOR FINANCIAL AID. IV.CRMC WILL HOLD THE BILLING FOR ANY ACCOUNTS THAT ARE BEING CONSIDERED FOR FINANCIAL AID. CRMC WILL INFORM THE PATIENT OF SUCH. V.A SEPARATE POLICY, CRMC POLICY # OP-020-23 - BILLING AND COLLECTIONS, ADDRESSES THE ACTIONS THAT THE HOSPITAL MAY TAKE IN THE EVENT OF NONPAYMENT. THOSE ACTIONS SPECIFY 1.OUR CONTRACTED COLLECTION AGENCIES COMPLY WITH CRMC'S FINANCIAL ASSISTANCE POLICY AND WILL PROVIDE APPLICATION INFORMATION TO INDIVIDUALS 2. PROHIBITS THE FORCED SALE OF FORECLOSURE OF AN INDIVIDUAL'S PRIMARY RESIDENCE 3. REQUIRES THE COLLECTION AGENCY TO OBTAIN CRMC'S APPROVAL BEFORE COMMENCING LEGAL ACTION 4. PAYMENT PLANS MONTHLY INSTALLMENTS CANNOT EXCEED 10% OF THE INDIVIDUAL'S MONTHLY GROSS INCOME. A FREE COPY OF CRMC'S BILLING AND COLLECTION POLICY IS AVAILABLE UPON REQUEST BY CALLING 607-756-3838 OR BY WRITTEN REQUEST MAILED TO: CORTLAND REGIONAL MEDICAL CENTER, 134 HOMER AVENUE, CORTLAND, NY 13045 ATTN: PATIENT FINANCIAL NAVIGATOR. H.LEVEL OF FINANCIAL SUPPORT I.CRMC WILL FOLLOW THE INCOME GUIDELINES ESTABLISHED BELOW IN EVALUATING A PATIENT'S ELIGIBILITY FOR FINANCIAL SUPPORT. A PERCENTAGE OF THE FEDERAL POVERTY GUIDELINES (FAP), WHICH IS UPDATED ON AN ANNUAL BASIS, IS USED FOR DETERMINING A PATIENT'S ELIGIBILITY FOR FINANCIAL SUPPORT. HOWEVER, OTHER FACTORS, AS IDENTIFIED ABOVE, ALSO SHOULD BE CONSIDERED SUCH AS THE PATIENT'S FINANCIAL STATUS AND/OR ABILITY TO PAY AS DETERMINED THROUGH THE ASSESSMENT PROCESS. II.FAMILY INCOME AT OR BELOW 200% OF FEDERAL POVERTY INCOME GUIDELINES: III.A FULL 100% DISCOUNT OFF ALL UNINSURED PATIENT BALANCES AND/OR INSURED PATIENT RESPONSIBLE BALANCES SPECIFIED BY THEIR INSURANCE CARRIER WILL BE PROVIDED FOR PATIENTS WHOSE FAMILY'S INCOME IS AT OR BELOW 200% OF THE MOST RECENT FEDERAL POVERTY INCOME GUIDELINES. PATIENTS WITH FAMILY INCOME UP TO AND INCLUDING 200% OF THE FEDERAL POVERTY INCOME GUIDELINES WILL BE ELIGIBLE FOR FINANCIAL SUPPORT FOR CO-PAY AND DEDUCTIBLE AMOUNTS PROVIDED THAT THERE IS NO CONFLICT WITH CONTRACTUAL ARRANGEMENTS WITH THE PATIENT'S INSURER AND THAT THEY APPLY FOR FINANCIAL ASSISTANCE. IV.FAMILY INCOME BETWEEN 201% AND 300% OF FEDERAL POVERTY INCOME GUIDELINES: A DISCOUNT OFF ALL UNINSURED PATIENT BALANCES AND/OR PATIENT RESPONSIBLE BALANCES SPECIFIED BY THEIR INSURANCE CARRIER WILL BE PROVIDED FOR PATIENTS WHOSE FAMILY'S INCOME FALLS WITHIN 201% TO 300 %OF FPL. DISCOUNT WILL BE BASED UPON FAMILY SIZE AND INCOME, SEE ATTACHMENT A FOR INCOME AND DISCOUNT GUIDELINES. V.MEDICALLY INDIGENT SUPPORT / CATASTROPHIC: FINANCIAL SUPPORT IS ALSO PROVIDED FOR MEDICALLY INDIGENT PATIENTS. MEDICAL INDIGENCE OCCURS WHEN A PERSON IS UNABLE TO PAY SOME OR ALL OF THEIR MEDICAL BILLS BECAUSE THEIR MEDICAL EXPENSES EXCEED A CERTAIN PERCENTAGE OF THEIR FAMILY OR HOUSEHOLD INCOME (FOR EXAMPLE, DUE TO CATASTROPHIC COSTS OR CONDITIONS), REGARDLESS OF WHETHER THEY HAVE INCOME OR ASSETS THAT OTHERWISE EXCEED THE FINANCIAL ELIGIBILITY REQUIREMENTS FOR FREE OR DISCOUNTED CARE UNDER CRMC'S FAP. CATASTROPHIC COSTS OR CONDITIONS OCCUR WHEN THERE IS A LOSS OF EMPLOYMENT, DEATH OF PRIMARY WAGE EARNER, EXCESSIVE MEDICAL EXPENSES OR OTHER UNFORTUNATE EVENTS. MEDICAL INDIGENCE / CATASTROPHIC CIRCUMSTANCES WILL BE EVALUATED ON A CASE-BY-CASE BASIS THAT INCLUDES A REVIEW OF THE PATIENT'S INCOME, EXPENSES AND ASSETS. IF AN INSURED PATIENT CLAIMS CATASTROPHIC CIRCUMSTANCES AND APPLIES FOR FINANCIAL ASSISTANCE, MEDICAL EXPENSES FOR AN EPISODE OF CARE THAT EXCEED 20% OF INCOME WILL PERMIT CO-PAYS AND DEDUCTIBLES TO QUALIFY AS CATASTROPHIC FINANCIAL ASSISTANCE DISCOUNTS FOR MEDICALLY INDIGENT CARE FOR THE UNINSURED WILL NOT BE LESS THAN CRMC'S AVERAGE CONTRACTUAL ADJUSTMENT AMOUNT FOR MEDICARE FOR THE SERVICES PROVIDED OR AN AMOUNT TO BRING THE PATIENTS CATASTROPHIC MEDICAL EXPENSE TO INCOME RATIO BACK TO 20%. MEDICAL INDIGENT AND CATASTROPHIC FINANCIAL ASSISTANCE WILL BE APPROVED BY CRMC DIRECTOR OF REVENUE CYCLE AND/OR MANAGER OF PATIENT FINANCIAL SERVICES VI.WHILE FINANCIAL SUPPORT SHOULD BE MADE IN ACCORDANCE WITH CRMC'S ESTABLISHED WRITTEN CRITERIA, IT IS RECOGNIZED THAT OCCASIONALLY THERE WILL BE A NEED FOR GRANTING ADDITIONAL FINANCIAL SUPPORT TO PATIENTS BASED UPON INDIVIDUAL CONSIDERATIONS. SUCH INDIVIDUAL CONSIDERATIONS WILL BE APPROVED BY CRMC CFO.
FORM 990, SCHEDULE H, PART III, LINE 8CONTINUATION: FINANCIAL ASSISTANCE POLICY G.ACCOUNTING AND REPORTING FOR FINANCIAL SUPPORT I.IN ACCORDANCE WITH THE GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, FINANCIAL SUPPORT PROVIDED BY CRMC IS RECORDED SYSTEMATICALLY AND ACCURATELY IN THE FINANCIAL STATEMENTS AS A DEDUCTION FROM REVENUE IN THE CATEGORY FINANCIAL ASSISTANCE. FOR THE PURPOSES OF COMMUNITY BENEFIT REPORTING, FINANCIAL ASSISTANCE IS REPORTED AT ESTIMATED COST. II.THE FOLLOWING GUIDELINES ARE PROVIDED FOR THE FINANCIAL STATEMENT RECORDING OF FINANCIAL SUPPORT: "FINANCIAL SUPPORT PROVIDED TO PATIENTS UNDER THE PROVISIONS OF "FINANCIAL ASSISTANCE PROGRAM", INCLUDING THE ADJUSTMENT FOR AMOUNTS GENERALLY ACCEPTED AS PAYMENT FOR PATIENTS WITH INSURANCE, WILL BE RECORDED UNDER "FINANCIAL ASSISTANCE ALLOWANCE." "WRITE-OFF OF CHARGES FOR PATIENTS WHO HAVE NOT QUALIFIED FOR FINANCIAL SUPPORT UNDER THIS PROCEDURE AND WHO DO NOT PAY WILL BE RECORDED AS "BAD DEBT." "PROMPT PAY DISCOUNTS WILL BE RECORDED UNDER "OPERATIONAL ADJUSTMENTS- ADMINISTRATIVE OR "CONTRACTUAL ALLOWANCE." "ACCOUNTS INITIALLY WRITTEN-OFF TO BAD DEBT AND SUBSEQUENTLY RETURNED FROM COLLECTION AGENCIES WHERE THE PATIENT WAS DETERMINED TO HAVE MET THE FINANCIAL SUPPORT CRITERIA BASED ON INFORMATION OBTAINED BY THE COLLECTION AGENCY WILL BE RECLASSIFIED FROM "BAD DEBT" TO FINANCIAL ASSISTANCE ALLOWANCE". II.ASSISTING PATIENTS WHO MAY QUALIFY FOR COVERAGE A.CRMC WILL MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY ASSIST THEM IN OBTAINING AND PAYING FOR HEALTH CARE SERVICES. B.CRMC WILL HAVE UNDERSTANDABLE, WRITTEN PROCEDURES TO HELP PATIENTS DETERMINE IF THEY QUALIFY FOR PUBLIC ASSISTANCE PROGRAMS OR CRMC'S FINANCIAL ASSISTANCE POLICY. III.EFFECTIVE COMMUNICATIONS A.CRMC WILL PROVIDE FINANCIAL COUNSELING TO PATIENTS ABOUT THEIR HEALTH CARE BILLS RELATED TO THE SERVICES THEY RECEIVED AT CRMC AND WILL MAKE THE AVAILABILITY OF SUCH COUNSELING. COUNSELING IS AVAILABLE AT TIME OF ADMISSION, DISCHARGE OR AT ANY TIME THE PATIENT CHOOSES TO REQUEST ASSISTANCE. CRMC'S PATIENT FINANCIAL NAVIGATOR IS AVAILABLE BETWEEN THE HOURS OF 8:00 AM AND 4:00 PM MONDAY THROUGH FRIDAY. THE NAVIGATORS OFFICE IS LOCATED ON THE HOSPITALS FIRST FLOOR NEXT TO THE CASHIERS OFFICE. IN ADDITION THE NAVIGATOR WILL ROUTINELY CALL OR WHERE ABLE, VISIT ALL PATIENTS ADMITTED WITH NO INSURANCE. THIS POLICY ONLY COVERS SERVICES PROVIDED BY THE HOSPITAL. THIS POLICY DOES NOT APPLY TO OTHER BILLS YOU MAY RECEIVE FROM PRIVATE PHYSICIANS WHO MAY BE INVOLVED IN YOUR CARE INCLUDING BUT NOT LIMITED TO: RADIOLOGISTS, PATHOLOGISTS, ANESTHESIOLOGISTS OR EMERGENCY ROOM PHYSICIANS. B.RMC WILL RESPOND PROMPTLY AND COURTEOUSLY TO PATIENTS' QUESTIONS ABOUT THEIR BILLS AND REQUESTS FOR FINANCIAL ASSISTANCE. C.CRMC WILL UTILIZE A BILLING PROCESS THAT IS CLEAR, CONCISE, CORRECT AND PATIENT FRIENDLY. PATIENT STATEMENTS WILL INCLUDE INFORMATION ON THE AVAILABILITY OF OUR FINANCIAL AID POLICY AND HOW TO CONTACT CRMC FOR MORE INFORMATION. D.CRMC WILL MAKE AVAILABLE FOR REVIEW BY THE PUBLIC SPECIFIC INFORMATION IN AN UNDERSTANDABLE FORMAT ABOUT WHAT THEY CHARGE FOR SERVICES. E.CRMC WILL POST SIGNS AND DISPLAY BROCHURES THAT PROVIDE BASIC INFORMATION ABOUT THEIR FINANCIAL ASSISTANCE POLICY (FAP) IN PUBLIC LOCATIONS: INCLUDING ALL OUTPATIENT REGISTRATION SITES, AND ER. IN ADDITION COPIES OF CRMC'S PLAIN LANGUAGE SUMMARY WILL BE PROVIDED TO ALL INPATIENT AND OBSERVATION PATIENTS AT TIME OF ADMISSION AND OFFERED TO ALL OUTPATIENTS AT INTAKE. F.CRMC WILL MAKE THE FINANCIAL ASSISTANCE POLICY (FAP), A PLAIN LANGUAGE SUMMARY OF THE FAP AND THE FAP APPLICATION FORM AVAILABLE TO PATIENTS UPON REQUEST, IN PUBLIC PLACES IN CRMC - INCLUDING ALL OUTPATIENT REGISTRATION SITES, ER AND PROMPT CARE, VIA MAIL AND ON THE CRMC WEBSITE. CRMC OFFERS ACCESS TO THE INTERNET FOR PATIENTS TO BE ABLE TO VIEW, DOWNLOAD AND PRINT A HARD COPY OF THESE DOCUMENTS. CRMC WILL PROVIDE ANY INDIVIDUAL WHO ASKS INFORMATION ON HOW TO ACCESS A COPY OF THE FAP, FAP APPLICATION FORM, OR PLAIN LANGUAGE SUMMARY OF THE FAP ONLINE WITH THE DIRECT WEBSITE ADDRESS, OR URL, WHERE THESE DOCUMENTS ARE POSTED. G.THESE DOCUMENTS WILL BE MADE AVAILABLE IN ENGLISH AND IN THE PRIMARY LANGUAGE OF ANY POPULATION WITH LIMITED PROFICIENCY IN ENGLISH THAT CONSTITUTES MORE THAN 100 PEOPLE OR 5 PERCENT OF THE RESIDENTS OF THE COMMUNITY SERVED BY CRMC. CRMC WILL LIST ITS FINANCIAL ASSISTANCE POLICY AND SUPPORTING DOCUMENTS ON THEIR WEBSITE. H.CRMC WILL PROVIDE A DESCRIPTION IN THE FAP OF THE MEASURES TAKEN TO NOTIFY MEMBERS OF THE COMMUNITY SERVED BY CRMC ABOUT THE FAP. SUCH MEASURES MAY INCLUDE, FOR EXAMPLE, THE DISTRIBUTION OF INFORMATION SHEETS SUMMARIZING THE FAP TO LOCAL PUBLIC AGENCIES AND NONPROFIT ORGANIZATIONS THAT ADDRESS THE HEALTH NEEDS OF THE COMMUNITY'S LOW INCOME POPULATIONS. IV.IMPLEMENTATION OF ACCURATE AND CONSISTENT POLICIES A.PATIENT FINANCIAL SERVICES AND PATIENT ACCESS WILL EDUCATE STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING THOSE WORKING IN PATIENT REGISTRATION AND ADMITTING, FINANCIAL ASSISTANCE, CUSTOMER SERVICE, BILLING AND COLLECTIONS, PHYSICIAN OFFICES) ABOUT BILLING, FINANCIAL ASSISTANCE, COLLECTION POLICIES AND PRACTICES, AND TREATMENT OF ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR THEIR ABILITY TO PAY FOR SERVICES. B.CRMC WILL HONOR FINANCIAL SUPPORT COMMITMENTS THAT WERE APPROVED UNDER PREVIOUS FINANCIAL ASSISTANCE GUIDELINES. AT THE END OF THAT ELIGIBILITY PERIOD THE PATIENT MAY BE RE-EVALUATED FOR FINANCIAL SUPPORT USING THE GUIDELINES ESTABLISHED IN THIS PROCEDURE. REFERENCES: "PATIENT PROTECTION AND AFFORDABLE CARE ACT STATUTORY SECTION 501(R) "INTERNAL REVENUE SERVICE SCHEDULE H (FORM 990) DEPARTMENT OF TREASURY, INTERNAL REVENUE SERVICE, ADDITIONAL REQUIREMENTS FOR CHARITABLE HOSPITALS; PROPOSED RULE: VOLUME 77, NO. 123, PART II, 26 CFR,
SCHEDULE H, PART I, LN 7 COL (F):CONTINUATION COLLECTION POLICY: 13.CONTACT BY EMBARRASSING MEDIA, SUCH AS COMMUNICATING WITH A CONSUMER REGARDING A DEBT BY POST CARD, OR USING ANY LANGUAGE OR SYMBOL, OTHER THAN THE DEBT COLLECTOR'S ADDRESS, ON ANY ENVELOPE WHEN COMMUNICATING WITH A CONSUMER BY USE OF THE MAILS OR BY TELEGRAM, EXCEPT THAT A DEBT COLLECTOR MAY USE HIS BUSINESS NAME IF SUCH NAME DOES NOT INDICATE THAT HE IS IN THE DEBT COLLECTION BUSINESS; 14.REPORTING FALSE INFORMATION ON A CONSUMER'S CREDIT REPORT OR THREATENING TO DO SO IN THE PROCESS OF COLLECTION. PAYMENT PLAN POLICY: PURPOSE TO ESTABLISH GUIDELINES BY WHICH CORTLAND REGIONAL MEDICAL CENTER WILL OFFER PATIENTS EXTENDED TIME PERIODS TO MAKE PAYMENT IN FULL ON OUTSTANDING SELF PAY BALANCES. DEFINITIONS "PAYMENT PLANS" ARE DEFINED AS INSTALLMENT ARRANGEMENTS FOR PATIENTS WHO ARE NOT ABLE TO PAY ACCOUNT BALANCES IN FULL AT THE TIME OF RECEIPT OF BILL. POLICY: TO PROVIDE PATIENTS OPTIONS ON PAYING OFF DEBT OWED TO CRMC FOR BILLS INCURRED FOR SERVICES PROVIDED BY THE MEDICAL CENTER. PROCEDURE 1)PATIENTS WILL RECEIVE BILLS ON TYPICAL BILLING CYCLE IN WHICH A DEBT IS OWED. 2)PATIENTS WILL BE CONTACTED THROUGH OUTSOURCED BUSINESS OFFICE FOR FOLLOW-UP AND SET UP OF PAYMENT PLAN. IF PATIENT REQUESTS FINANCIAL ASSISTANCE AND APPLICATION WILL BE SENT TO THE PATIENT. THE FOLLOWING CRITERIA WILL BE USED TO DETERMINE THE ALLOWABLE INSTALLMENT TERMS BY WHICH MONTHLY PAYMENTS WILL BE MADE INTERNALLY TO CRMC. PATIENT BALANCE CONTRACT PAYMENT AMOUNT MAXIMUM TERM BELOW $200.00 EXPECTED PAYMENT IN FULL - MINIMUM PAYMENT OF $50.00 $200.00 - $500.00 MINIMUM OF $50.00/MONTH 4-6 MONTHS $501.00 - $1000.00 MINIMUM OF 75.00/MONTH 7-13 MONTHS $1001.00 - $1500.00 MINIMUM OF 100.00/MONTH 10-15 MONTHS $1501.00 - $2000.00 MINIMUM OF 125.00/MONTH 12-16 MONTHS $2001.00 - $3000.00 MINUMUM OF 150.00/MONTH 13-20 MONTHS $3001.00 - OVER BALANCE IN FULL EXTEND UP TO 24 MONTHS MAX - 24 MONTHS 3)EXTENDED PAYMENT PLANS THROUGH HEALTH FIRST UP TO 24 MONTHS WILL BE AT 0% INTEREST. PAYMENT PLANS FROM 25 TO 60 MONTHS WILL BE AT 4% INTEREST. 4)BUSINESS OFFICE WILL PROVIDE THE PATIENT WITH THE PHONE NUMBER AND WILL CONTINUE TO SEND REGULAR BILLING STATEMENTS UNTIL APPROVAL IS COMPLETE. 5)IF PATIENT FAILS TO SIGN UP FOR EXTENDED LOAN CRMC WILL CONTINUE SELF-PAY COLLECTION CYCLE UNTIL SUCH TIME PATIENT WOULD QUALIFY FOR BAD DEBT. 6)LOANS THROUGH HEALTHFIRST ARE SET UP PER AGENCY DISCRETION AND MINIMUM PAYMENT STANDARDS. 7)IF LOAN DEFAULTS THROUGH HEALTHFIRST, ACCOUNT WILL RETURN TO CRMC FOR DEBT COLLECTION PROCESS AND FUNDED LOAN REMAINING BALANCE WILL BE RECOURSE BACK TO HEALTHFIRST. 8)PAYMENT PLAN REQUESTS FROM PATIENTS AND/OR GUARANTORS CAN BE EVALUATED, APPROVED, AND SET UP BY ALL BUSINESS OFFICE EMPLOYEES AS LONG AS THEY ARE IN COMPLIANCE WITH POLICY GUIDELINES, BUT SHOULD GO THROUGH PATIENT FINANCIAL NAVIGATOR UNLESS UNAVAILABLE. ANY EXCEPTIONS MUST BE REVIEWED AND APPROVED BY THE RELEVANT MANAGEMENT STAFF IN THE ABOVE LISTED AREAS. 9)EXISTING PAYMENT PLAN TERMS MAY BE ALTERED OR EXTENDED ON A TEMPORARY OR PERMANENT BASIS AS LONG AS THEY ARE IN COMPLIANCE WITH POLICY GUIDELINES. ANY EXCEPTIONS MUST BE REVIEWED AND APPROVED BY THE REVENUE CYCLE SUPERVISOR. 10)PATIENTS ON ESTABLISHED PAYMENT PLANS WHO DEFAULT IN THEIR MONTHLY PAYMENTS FOR TWO CONSECUTIVE MONTHS MAY BE REFERRED TO A COLLECTION AGENCY. 11)IF ANY NEW BALANCES ARE TRANSFERRED TO SELF-PAY RESPONSIBILITY AFTER A PAYMENT PLAN HAS ALREADY BEEN IMPLEMENTED, THEY ARE ELIGIBLE TO BE ROLLED INTO THE EXISTING PAYMENT PLAN AND WILL BE ADJUSTED IN ORDER TO COMPLY WITH THE ABOVE CRITERIA.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CMH FOUNDATION
134 HOMER AVENUECORTLANDNY13045222230692RAISE FUNDS ONLY FOR THE HOSPITALNY501(C)(3)7CMH GROUP0
REGIONAL MEDICAL PRACTICE
134 HOMER AVENUECORTLANDNY13045204848729PHYSICIAN GROUPNY501(C)(3)3CORTLAND REGIONAL MEDICAL CENTER0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
CMH SERVICES
134 HOMER AVENUECORTLANDNY13045161370440DURABLE MEDICAL EQUIPMENTNYCM GROUPC0
CMH GROUP
134 HOMER AVENUECORTLANDNY13045222933722PARENT CORPORATIONNYC0
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 OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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