2017-11-14T07:51:37-06:00 2016-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2016-01-01 141698269 ADIRONDACK HEALTH INSTITUTE INC ADIR 5184800111 101 Ridge Street glens falls NY 12801 GARY HICKS Interim CEO 5184800111 2017-08-31 1 THOMAS LANNING P00851654 2122970400 209.3.217.20 2017-11-08 09:22:45 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 60BF0225ED9631091DB686CFA622195BA7284DF5 2016 2017-02-10 21:41:12Z Eric Burton 101 Ridge Street glens falls NY 12801 20778574 0 X www.ahihealth.org X 1987 NY THE ADIRONDACK HEALTH INSTITUTES MISSION IS TO PROMOTE, SPONSOR, AND COORDINATE INITIATIVES AND PROGRAMS THAT IMPROVE HEALTH CARE QUALITY, ACCESS, AND SERVICE DELIVERY IN THE ADIRONDACK REGION. 13 13 88 13 0 0 4883911 17405409 3038421 3330907 21299 42258 0 0 7943631 20778574 0 0 0 0 3251526 4493787 0 0 0 6073188 16008694 9324714 20502481 -1381083 276093 22495358 18848989 21961491 18039029 533867 809960 The Adirondack Health Institutes mission is to promote, sponsor, and coordinate initiatives and programs that improve health care quality, access, and service delivery in the Adirondack region. 0 0 14988561 0 THE AHI PPS IS A PARTNERSHIP OF MORE THAN 100 ORGANIZATIONS FORMED TO PLAN FOR AND MANAGE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT (DSRIP) HEALTH CARE RESTRUCTURING IN THE NORTHERN NEW YORK/ DIRONDACK REGION. PARTNERS INCLUDE HOSPITALS, PRIMARY CARE PROVIDERS, MENTAL HEALTH AND SUBSTANCE ABUSE TREATMENT PROVIDERS, SKILLED NURSING FACILITIES, HOME AND COMMUNITY PROVIDERS, AND OTHERS. THE DSRIP PROJECT WILL ADDRESS SOCIAL FACTORS THAT IMPACT HEALTH, REQUIRING ENGAGEMENT AND COLLABORATION WITH MANY STAKEHOLDERS, INCLUDING COMMUNITY-BASED ORGANIZATIONS, FROM DIVERSE SECTORS. 2268231 2249580 AHI IS A NY STATE-DESIGNATED LEAD HEALTH HOME WITH NINE CARE MANAGEMENT AGENCIES WHICH PROVIDE OUTREACH AND CARE MANAGEMENT TO MEDICAID RECIPIENTS WITH HIV/AIDS, SERIOUS, PERSISTENT MENTAL ILLNESS, OR TWO OR MORE OTHER CHRONIC CONDITIONS. THE HEALTH HOME MODEL EXPANDS ON THE TRADITIONAL MEDICAL HOME MODEL BY PLACING A GREATER EMPHASIS ON LINKING COMMUNITY AND SOCIAL SUPPORTS WITH HEALTH CARE, AND PROVIDING ENHANCED COORDINATION OF MEDICAL AND BEHAVIORAL HEALTH CARE. AHI'S HEALTH HOME SERVES PATIENTS IN WARREN, WASHINGTON, HAMILTON, ESSEX, CLINTON, AND FRANKLIN COUNTIES AS WELL AS PARTS OF SARATOGA AND ST. LAWRENCE COUNTIES. 646360 800840 Adirondack Medical Home Initiative (AMHI) is a collaborative effort by health care providers and public and private insurers to transform the health care delivery system in our rural upstate New York region. The goal is to ensure quality, accessible care while working to contain costs. The Initiative serves six Adirondack counties in New York State - Clinton, Essex, Franklin, Hamilton, Warren, and Washington. 100+ primary care providers, five hospitals, and seven health insurance organizations are working together to develop an innovative, patient-centered model of health care that strengthens the role of primary care. 1324448 280687 1324448 280687 19227600 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 64 0 1 88 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X Eric Burton 5184800111 101 Ridge Street glens falls NY 12801 Becky Preve Board Member 1.00 X 0 0 0 Chandler Ralph Outgoing Board Member 1.00 X 0 0 0 Daniel Burke Chairman 1.00 X X 0 0 0 David Acker Board Member 1.00 X 0 0 0 Diana Scalise Board Member 1.00 X 0 0 0 Dianne Shugrue Vice Chairman 1.00 X X 0 0 0 Eileen Haynes Esq Secretary 1.00 X X 0 0 0 Gary Hicks Treasurer 1.00 X X 0 0 0 John Rugge MD Board Member 1.00 X 0 0 0 Neil Roberts Board Member 1.00 X 0 0 0 Stephens Mundy Board Member 1.00 X 0 0 0 Susan Delehanty Board Member 1.00 X 0 0 0 Sylvia getman Board Member 1.00 X 0 0 0 Sylvie Nelson Board Member 1.00 X 0 0 0 Cathy Homkey Outgoing CEO 40.00 X 126494 0 15986 Eric Burton CFO 40.00 X 109256 0 425 Margaret Vosburgh CEO 40.00 X 173806 0 578 Lottie Jameson Outgoing VP, Regional Planning & Development 40.00 X 113734 0 15215 523290 0 32204 4 0 1 0 GSI Health LLC PO Box 392467 Pittsburgh PA 152519467 Health Home 307300 KPMG LLP Dept 0608 PO Box 120608 Dallas TX 75312 DSRIP CONSULTING 186930 CohnReznick LLP 1301 Avenue of the Americas New York NY 10019 Audit 183035 Insignia Health 10900 Wayzata Blvd Suite 810 Minnetonka NM 55305 PAM LICENSE 149292 Manatt Phelps & Phillips 11355 West Olympic Blvd Los Angeles CA 900641614 Legal 130796 5 16451137 954272 17405409 CARE MANAGEMENT 900099 1975665 1975665 MANAGEMENT SERVICE 900099 1355242 1355242 3330907 42258 42258 20778574 3330907 0 42258 X 426546 353889 72657 3232844 2682187 550657 56937 47230 9707 464433 385254 79179 313027 259660 53367 143871 14989 128882 75851 75851 13080722 13067385 13337 38097 37892 205 321929 259381 62548 149492 121088 28404 150389 143631 6758 98498 94074 4424 67508 34255 33253 50614 50614 CARE MANAGEMENT 1640630 1640630 DUES AND SUBSCRIPTIONS 47356 26695 20661 Bad Debt 42670 42670 RECRUITMENT 29841 29679 162 71226 29681 41545 20502481 19227600 1274881 0 230 230 19395659 16317061 972082 719226 1890105 1561716 117165 151557 3790625 3691426 120117 99199 22495358 18848989 2400966 2069714 1275000 1505000 18285525 14464315 21961491 18039029 X 533867 809960 533867 809960 22495358 18848989 276093 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6237 1033 5204 260074 166079 93995 3524314 3524314 0 99199 REFUNDABLE ADVANCES 14464315 14464315 X 20778574 0 20778574 0 20778574 20502481 0 20502481 0 20502481 Part X, Line 2: THERE IS NO PROVISION FOR INCOME TAXES. IN ADDITION, AHI IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. AHI HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2016. AHI'S FEDERAL AND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2013 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. AHI RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS OPERATING EXPENSES AND INCLUDES ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE STATEMENT OF FINANCIAL POSITION. X X 1 0 0 0 0 0 0 1 0 Margaret Vosburgh CEO 169036 0 4200 0 570 0 0 0 578 0 174384 0 0 0 Part I, Line 4a Lottie Jameson received severance payment which totaled 28,002. Part I, Line 7 The amount included on Part II, B(II), represents bonus that were approved by the board. The amount was included in the individual's W-2. form 990, part iv, line 20a: The organization is licensed under article 28 of New York State Public Health Law. However, subsection 10 of article 28 excludes certain healthcare facilities from the definition of general hospital. Therefore, the organization is not including schedule H in the current year form 990 as they do not meet this definition. Form 990, Part VI, Section A, line 6 ADIRONDACK HEALTH INSTITUTE INC. IS A MEMBERSHIP CORPORATION. THE MEMBERS ARE AS FOLLOWS: HUDSON HEADWATERS HEALTH NETWORK 23.2% ADIRONDACK MEDICAL CENTER 13.3% COMMUNITY PROVIDERS, INC. 29.9% GLENS FALLS HOSPITAL 18.3% ST. LAWRENCE HEALTH SYSTEM 15.3% Form 990, Part VI, Section A, line 7a ADIRONDACK HEALTH INSTITUTE INC. IS A MEMBERSHIP CORPORATION. THE MEMBERS ARE AS FOLLOWS: HUDSON HEADWATERS HEALTH NETWORK 23.2% ADIRONDACK MEDICAL CENTER 13.3% COMMUNITY PROVIDERS, INC. 29.9% GLENS FALLS HOSPITAL 18.3% ST. LAWRENCE HEALTH SYSTEM 15.3% EACH MEMBER IS ENTITLED TO ONE VOTE FOR THE PURPOSES OF ACTIONS TAKEN BY THE MEMBERS. Form 990, Part VI, Section B, line 11b FORM 990 IS PREPARED BY THE INDEPENDENT ACCOUNTANT. A COPY OF THE RETURN IS THEN SENT TO THE FINANCE COMMITTEE for their REVIEW of THE RETURN. The return is then MADE AVAILABLE TO ALL BOD MEMBERS PRIOR TO FILING WITH THE IRS.. Form 990, Part VI, Section B, line 12c To ensure the Organization operates in a manner consistent with charitable purposes and does not engage in activities that could jeopardize its tax-exempt status, annual Conflict of Interest reviews shall be conducted. The annual review shall, at a minimum, include the following subjects: Whether compensation arrangements and benefits are reasonable, based on competent survey information, and the result of arms length bargaining. Whether partnerships, joint ventures, and arrangements with management organizations conform to the Organizations written policies, are properly recorded, reflect reasonable investment or payments for goods and services, further charitable purposes, and do not result in inurement, impermissible private benefit or in an excess benefit transaction. When conducting the periodic reviews as provided for herein, the Organization may, but need not, use outside advisors. If outside experts are used, their use shall not relieve the governing board of its responsibility for ensuring periodic reviews are conducted. Form 990, Part VI, Section B, line 15a COMPENSATION FOR CEO INCLUDES A PROCESS WHEREIN OBJECTIVE AND INDEPENDENT REVIEW PROCESS OF THE CEO'S COMPENSATION IS CONDUCTED WHICH INCLUDES BENCHMARKING AGAINST COMPARABLE ORGANIZATIONS. IT IS THEN VOTED ON BY THE BOARD OF DIRECTORS. Form 990, Part VI, Section C, line 19 the documents are Available upon request. Form 990, Part IX, line 11g other consultants: Program service expenses 13,067,385. Management and general expenses 0. Fundraising expenses 0. Total expenses 13,067,385. Data Processing: Program service expenses 0. Management and general expenses 13,337. Fundraising expenses 0. Total expenses 13,337. FORM 990, PART XII, LINE 2C: the process has not changed from the prior year.