2017-11-09T17:29:28-06:00 2016-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2016-01-01 141731786 ADIRONDACK MEDICAL CENTER ADIR 5188914141 PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 TRISTAN GLANVILLE CFO 5188914141 2017-11-09 1 KELLY A REDMOND P00443718 3154463600 2017-11-09 24.39.85.114 2017-11-09 11:28:31 ES P 9ED0318F8F0D15647C4BFB992883BD7B1D0B79EC 517AEBE328CBAAA90E396C2FD1060AA56161F780 2016 2018-03-14 21:41:22Z TRISTAN GLANVILLE PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 109958572 0 X WWW.ADIRONDACKHEALTH.ORG X 1991 NY THE MEDICAL CENTER PROVIDES ACUTE, SKILLED NURSING AND OUTPATIENT SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHIC REGION. 16 13 1077 70 0 0 896959 949836 103069385 100818078 4694 41627 2223343 2298476 106194381 104108017 0 0 0 0 50023664 53595991 0 0 0 50830153 50810977 100853817 104406968 5340564 -298951 70141172 83373282 25520087 38541117 44621085 44832165 X THE MEDICAL CENTER PROVIDES ACUTE, SKILLED NURSING AND OUTPATIENT SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHICAL AREA. 0 1 22331642 29850856 ADIRONDACK MEDICAL CENTER IS A 95-BED ACUTE CARE FACILITY IN SARANAC LAKE. IT PROVIDES A FULL RANGE OF INPATIENT SERVICES(SURGICAL, MATERNITY AND PEDIATRIC) AS WELL AS MAINTAINS A 60 BED LONG-TERM CARE FACILITY. 56440281 65186628 REFERRED AMBULATORY, AMBULATORY SURGERY AND EMERGENCY SERVICES IN SARANAC LAKE, LAKE PLACID, TUPPER LAKE AND KEENE. 6234596 5780593 DISCONTINUED OPERATIONS FROM UIHLEIN LIVING CENTER, FREE STANDING NURSING HOME THAT HAS 156 BEDS. SALE OCCURRED ON OCTOBER 4, 2016. 1878220 MISCELLANEOUS PROGRAM SERVICE REVENUE DERIVED FROM SUPPORT OF ADIRONDACK MEDICAL CENTER, INCLUDING: DIETARY REVENUE, REBATES AND REFUNDS, PURCHASE DISCOUNTS AND OTHER REVENUE. 1878220 85006519 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 312 0 1 1077 1 0 0 0 0 0 0 0 0 0 0 X 16 13 0 1 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X TRISTAN GLANVILLE 5188914141 PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 JEANNIE CROSS CHAIR 4.00 X X 0 0 0 BARRY BROGAN TRUSTEE 3.00 X 0 0 0 CHERYL MAID SECRETARY/TREASURER 4.00 X X 0 0 0 F RAYMOND AGNEW VICE CHAIR 4.00 X X 0 0 0 PETER G BEATTY PHD TRUSTEE 3.00 X 0 0 0 CHARLES CARROLL TRUSTEE 3.00 X 0 0 0 BETH LAWYER TRUSTEE 3.00 X 0 0 0 PATRICIA MONROE MD TRUSTEE 3.00 X 0 0 17055 RANDY QUAYLE TRUSTEE 3.00 X 0 0 0 WAGUIH KIROLLOS MD EX-OFFICIO MEDICAL STAFF PRESIDENT 3.00 X 0 0 9658 GERALD GOLDMAN TRUSTEE 3.00 X 0 0 0 DOUGLAS L HOFFMAN CPA TRUSTEE 3.00 X 0 0 0 REBECCA LEAHY TRUSTEE 3.00 X 0 0 0 RICHARD M MOCCIA MD TRUSTEE 3.00 X 0 0 37603 GLENN KEET TRUSTEE 3.00 X 0 0 0 CHANDLER M RALPH EX-OFFICIO PRESIDENT/CEO ENDING 6/16 40.00 X 0 0 0 CHARLES GLANVILLE CFO 40.00 X 210208 0 17033 SYLVIA GETMAN EX-OFFICIO PRESIDENT/CEO BEG. 6/16 40.00 X 175641 0 5898 ANTHONY DOWIDOWICZ CMO ENDING 8/16 40.00 X 291895 0 19218 PATTI HAMMOND COO 40.00 X 217254 0 16513 LINDA MCCLARIGAN CNO 40.00 X 163535 0 15156 DARCI BEIRAS CMO BEG. 8/16 40.00 X 297238 0 40467 ANTHONY TRAMANTANO PHYSICIAN 40.00 X 468512 0 21893 JONATHAN KRANT PHYSICIAN 40.00 X 376503 0 23602 ANTHONY F LOMBARDI PHYSICIAN 40.00 X 290515 0 18662 MATTHEW L MORGAN PHYSICIAN 40.00 X 289994 0 9426 WILLIAM M VISCARDO JR PHYSICIAN 40.00 X 274273 0 21249 3055568 0 273433 67 0 1 0 LAVALLEEBRENSINGER ASSOCIATION 155 DOW STREET SUITE 400 MANCHESTER NH 03101 ARCHITECTURE SERVICES 1769049 PREMIER ANESTHESIA ON NEW YORKPC 2655 NORTHWINDS PARKWAY ALPHARETTA GA 30368 PHYSICIAN FEES 1013702 MATRIX HEALTH SYSTEMS 86 LAKE STREET BURLINGTON VT 05401 PHYSICIAN FEES 731628 INSIGHT HEALTH SERVICES CORP PO BOX 847689 DALLAS TX 75284 MRI SERVICES 514173 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 511275 37 550434 200333 199069 949836 NET PATIENT SERVICE REVENUE 900099 95037485 95037485 UIHLEIN REVENUE- DISCONTINUED OPE 900099 5780593 5780593 100818078 236664 236664 420257 0 420257 420257 420257 5052731 602787 5114845 735710 -62114 -132923 -195037 -195037 DIETARY REVENUE 900099 307867 307867 PURCHASE DISCOUNTS 900099 149462 149462 REBATES & REFUNDS 900099 108202 108202 1312688 1312688 1878219 104108017 102696297 0 461884 X 1534371 516396 1017975 43578519 35707505 7871014 1147877 943005 204872 4182831 3391901 790930 3152393 2539874 612519 459843 459843 137678 137678 125271 125271 10955530 7024946 3930584 186487 7142 179345 1209071 643206 565865 1041775 1041775 248448 168631 79817 450399 450399 3639020 3639020 651996 651996 MEDICAL SUPPLIES 16785918 16768351 17567 UIHLEIN EXPENSES- DISCO 6234598 6234598 BAD DEBT 2952037 2952037 LEASE EXPENSE 998201 869928 128273 4734705 3149580 1585125 104406968 85006519 19400449 0 8132804 8398677 13510782 12700059 2894858 3007647 2734588 2623560 95881243 70394681 25155376 25486562 16382873 28770690 1329891 2386087 70141172 83373282 10413220 11805781 562453 1003787 10533360 20375830 933000 1172000 3078054 4183719 25520087 38541117 X 43621452 43841316 64571 55787 935062 935062 44621085 44832165 70141172 83373282 -298951 510031 0 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 999633 4486 13270 990849 995626 4007 999633 992079 3547 995626 991415 4116 3452 992079 987179 4236 991415 0.94370 0.05630 0 0 328567 328567 44133345 28496166 15637179 46927777 40840541 6087236 4491554 1057974 3433580 25486562 DEBT-CURRENT 690405 RESIDENT FUNDS LIABILITY 24680 ASSET RETIREMENT AND OTHER LT 1036373 ESTIMATED THIRD PARTY LIABILITY 2432261 4183719 X PART V, LINE 4: THE SYSTEM'S ENDOWMENTS CONSIST OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. ITS ENDOWMENTS INCLUDE DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS AN ENDOWMENT. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. TEMPORARILY RESTRICTED FUNDS ARE AVAILABLE FOR NURSING EDUCATION & OTHER PROGRAMS. PERMANENTLY RESTRICTED FUNDS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE FOR VARIOUS HEALTHCARE SERVICES. PART X, LINE 2: ADIRONDACK HEALTH IS A NOT-FOR-PROFIT CORPORATION AND IS AN EXEMPT ORGANIZATION QUALIFIED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ADIRONDACK HEALTH HAS BEEN CLASSIFIED BY THE INTERNAL REVENUE SERVICE (IRS) AS AN ENTITY THAT IS NOT A PRIVATE FOUNDATION. THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN ADIRONDACK HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS. THESE STANDARDS HAD NO IMPACT ON THE ACCOMPANYING FINANCIAL STATEMENTS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2013 THROUGH 2016. 1 1 X 1 X 1 X 1 1 0 1 1 95663 8149 87514 0.00090 23973358 18924169 5049189 0.04980 24069021 18932318 5136703 0.05070 45392 0 45392 0.00040 690379 0 690379 0.00680 4878259 2770790 2107469 0.02080 8902 0 8902 0.00010 5622932 2770790 2852142 0.02810 29691953 21703108 7988845 0.07880 354 354 0.00000 354 354 0.00000 1 1238941 427068 23684668 29116996 -5432328 X 1 1 2 1 ADIRONDACK MEDICAL CENTER 2233 STATE ROUTE 86-PO BOX 471 SARANAC LAKE NY 12983 X X 95 ACUTE BEDS; NURSING HOME WITH 60 BEDS; NURSING HOME WITH 157 BEDS A 2 ADIRONDACK MEDICAL CENTER-LAKE PLACID 29 CHURCH STREET LAKE PLACID NY 12946 X X OUTPATIENT SERIVCES, EMERGENCY ROOM A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 16 1 1 1 1 X WWW.ADIRONDACKHEALTH.ORG X 1 16 1 WWW.ADIRONDACKHEALTH.ORG 0 1 X 150.000000000000 400.000000000000 X X 1 1 X X X 1 X WWW.ADIRONDACKHEALTH.ORG X WWW.ADIRONDACKHEALTH.ORG X WWW.ADIRONDACKHEALTH.ORG X X X X X X 0 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ADIRONDACK MEDICAL CENTER, - FACILITY 2: ADIRONDACK MEDICAL CENTER-LAKE PLACID GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 5: ADIRONDACK MEDICAL CENTER AND OUR COLLABORATING PARTNERS, COUNTY PUBLIC HEALTH DEPARTMENTS AND REGIONAL HOSPTIALS, WORKED THROUGH THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY THAT GAVE US INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY WE SERVE. ARHN ENGAGED THE CENTER FOR HEALTH WORKFORCE STUDIES (CHWS) AT THE UNIVERSITY AT ALBANY SCHOOL OF PUBLIC HEALTH FOR QUANTITATIVE AND QUALITATIVE DATA COLLECTION.THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO A REGIONAL EMAIL CONTACT LIST OF 658. ULTIMATELY, 217 SURVEYS WERE COMPLETED DURING THE SIX-WEEK SURVEY PERIOD, A RESPONSE RATE OF 33 PERCENT. OF ALL 217 RESPONSES, 79 INDICATED THAT ESSEX COUNTY WAS PART OF THEIR SERVICE AREA AND 56 INDICATED THAT FRANKLIN COUNTY WAS PART OF THEIR SERVICE AREA; HOWEVER, IT SHOULD BE NOTED THAT MANY OF THE RESPONDING HEALTH CARE STAKEHOLDERS SERVICE MULTIPLE COUNTIES WITHIN THE LARGER ARHN REGION. SURVEY PARTICIPANTS REPRESENTED A DIVERSE ARRAY OF DIFFERENT AGENCIES, POPULATION GROUPS, AND SERVICE-AREAS WITHIN THE OVERALL EIGHT-COUNTY ARHN REGION. BELOW, TABLE A.1 SHOWS THE PRIMARY FUNCTIONS SELECTED BY RESPONDENTS AND TABLE A.2 SHOWS THE POPULATIONS THAT THEIR AGENCIES SERVE. HEALTH CARE AND EDUCATIONAL AGENCIES ARE WELL REPRESENTED, AND THE MAJORITY PROVIDES SERVICES TO CHILDREN AND ADOLESCENTS, AS WELL AS PEOPLE LIVING AT OR NEAR THE POVERTY LEVEL. TABLE A.1. PRIMARY FUNCTIONS INDICATED BY SURVEY RESPONDENTSORGANIZATION PRIMARY FUNCTION / PERCENT OF ALL APPLICANTS EDUCATION / 56.2PREVENTION/WELLNESS SERVICES / 53.0HEALTH CARE SERVICES / 44.2OTHER SERVICES / 31.8HEALTHY ENVIRONMENT / 30.0SOCIAL SERVICES / 24.4EMPLOYMENT & TRAINING / 23.0HOUSING/RESIDENTIAL SERVICES / 15.7DAY PROGRAM SERVICES / 13.4NOTE: RESPONDENTS COULD SELECT MORE THAN ONE PRIMARY FUNCTION.TABLE A.2. POPULATIONS SERVED BY SURVEY RESPONDENT AGENCIESPOPULATION SERVED / PERCENT OF ALL RESPONDENTS SCHOOL AGED CHILDREN/ADOLESCENTS / 75.1INDIVIDUALS LIVING AT OR NEAR THE FEDERAL POVERTY LEVEL / 68.7ADULTS / 67.3INDIVIDUALS WITH BEHAVIORAL HEALTH ISSUES / 56.7INDIVIDUALS WHO ARE SENIOR CITIZENS/ELDERLY / 56.2INDIVIDUALS WITH DEVELOPMENT DISABILITIES / 55.8PRE-SCHOOL CHILDREN / 53.9INDIVIDUALS WITH SUBSTANCE ABUSE ISSUE / 47.9WOMEN OF REPRODUCTIVE AGE / 46.5BABIES / 40.1FARMERS / 33.6MIGRANT WORKERS / 27.2SPECIFIC RACIAL/ETHNIC MINORITIES / 23OTHER / 21.2NOTE: RESPONDENTS COULD SELECT MULTIPLE POPULATIONS GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 6A: OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH OUR PARTNERS ESSEX COUNTY PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UVM HEALTH NETWORK-ALICE HYDE MEDICAL CENTER, ELIZABETHTOWN COMMUNITY HOSPITAL, MOSES LUDINGTON HOSPITAL, AND ADIRONDACK RURAL HEALTH NETWORK. GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 6B: SEE QUESTION 6A ABOVE GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 11: ADIRONDACK HEALTH STRIVES TO MEET AS MANY OF THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS AS POSSIBLE. IN MANY CASES, WE PARTNER WITH APPROPRIATE ORGANIZATIONS AND AGENCIES TO ADDRESS NEEDS THATADIRONDACK HEALTH DOES NOT. ON INITIATIVES THAT ARE NOT HOSPITAL-LED, ADIRONDACK HEALTH PARTNERS AND WORKS WITH THE LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, SUBSTANCE ABUSE PREVENTION AND TREATMENT PROVIDERS, HOME CARE, AND MANY OTHERS TO ENSURE THAT THE NEEDS OF OUR COMMUNITY MEMBERS ARE MET.THE FOLLOWING ARE THE NYS PREVENTION AGENDA ITEMS THAT ADIRONDACK HEALTH DOES NOT DIRECTLY ADDRESS IN OUR IMPLEMENTATION STRATEGY:PROMOTE A HEALTHY AND SAFE ENVIRONMENTFOCUS AREA: INJURIES, VIOLENCE AND OCCUPATIONAL HEALTH THE RATE OF CRIME AND ASSAULT ARE LOW IN ADIRONDACK HEALTH'S SERVICE AREA. FALLS IN THE HOME AND OCCUPATIONAL HEALTH ARE ISSUES THAT COMMUNITY PARTNERS ARE BETTER POSITIONED TO ADDRESS.FOCUS AREA: OUTDOOR AIR AND WATER QUALITYTHE AIR AND WATER QUALITY INDICATORS ARE GOOD. DATA INDICATES THAT IT IS ONLY A FEW DAYS EACH YEAR THAT OUTDOOR AIR QUALITY IS POOR, AND THE LIKELY CAUSE OF THIS IS INDUSTRIAL POLLUTION FROM THE MID-WEST CARRIED HERE ON THE JET STREAM. ADIRONDACK HEALTH DOES NOT HAVE A STRATEGY TO DIRECTLY ADDRESS THIS AT THIS TIME, BUT NATIONAL GROUPS HAVE MADE PROGRESS AND ARE STILL WORKING TO IMPROVE OUTPUTS FROM THESE INDUSTRIAL AREAS.FOCUS AREA: BUILT ENVIRONMENTIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD PASSING COMPLETE STREETS POLICIES, IMPROVING PARKS AND OTHER RECREATIONAL AREAS, PASSING TOBACCO FREE GROUNDS POLICIES, IMPROVING ACCESS TO FRESH FRUITS AND VEGETABLES IN STORES AND RESTAURANTS, AND OTHER PROJECTS THAT IMPROVE ACCESS TO HEALTHY FOODS AND IMPROVE THE BUILT ENVIRONMENT SO COMMUNITY MEMBERS OF ALL LEVELS OF MOBILITY CAN FEEL SAFE AS PEDESTRIANS AND USINGALTERNATIVE FORMS OF TRANSPORTATION.PREVENT HIV/STDS, VACCINE-PREVENTABLE DISEASE AND HEALTHCARE ASSOCIATED INFECTIONSFOCUS AREA: PREVENT HIV AND STDS THE RATE OF HIV IS EXTREMELY LOW IN ADIRONDACK HEALTH'S SERVICE AREA. ADIRONDACK HEALTH'S PROVIDERS CONTINUE TO WORK WITH PUBLIC HEALTH AND OTHER PROVIDERS TO DELIVER THE HIGHEST LEVEL OF CARE TO PATIENTS WITH HIV. GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 16J: AN INTERPRETER IS AVAILABLE TO ASSIST LEP POPULATIONS AND STAFF IS AVAILABLE TO HELP PATIENTS FILL OUT DOCUMENTATION AND ANSWER ANY QUESTIONS GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 5: ADIRONDACK MEDICAL CENTER AND OUR COLLABORATING PARTNERS, COUNTY PUBLIC HEALTH DEPARTMENTS AND REGIONAL HOSPTIALS, WORKED THROUGH THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY THAT GAVE US INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY WE SERVE. ARHN ENGAGED THE CENTER FOR HEALTH WORKFORCE STUDIES (CHWS) AT THE UNIVERSITY AT ALBANY SCHOOL OF PUBLIC HEALTH FOR QUANTITATIVE AND QUALITATIVE DATA COLLECTION.THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO A REGIONAL EMAIL CONTACT LIST OF 658. ULTIMATELY, 217 SURVEYS WERE COMPLETED DURING THE SIX-WEEK SURVEY PERIOD, A RESPONSE RATE OF 33 PERCENT. OF ALL 217 RESPONSES, 79 INDICATED THAT ESSEX COUNTY WAS PART OF THEIR SERVICE AREA AND 56 INDICATED THAT FRANKLIN COUNTY WAS PART OF THEIR SERVICE AREA; HOWEVER, IT SHOULD BE NOTED THAT MANY OF THE RESPONDING HEALTH CARE STAKEHOLDERS SERVICE MULTIPLE COUNTIES WITHIN THE LARGER ARHN REGION. SURVEY PARTICIPANTS REPRESENTED A DIVERSE ARRAY OF DIFFERENT AGENCIES, POPULATION GROUPS, AND SERVICE-AREAS WITHIN THE OVERALL EIGHT-COUNTY ARHN REGION. BELOW, TABLE A.1 SHOWS THE PRIMARY FUNCTIONS SELECTED BY RESPONDENTS AND TABLE A.2 SHOWS THE POPULATIONS THAT THEIR AGENCIES SERVE. HEALTH CARE AND EDUCATIONAL AGENCIES ARE WELL REPRESENTED, AND THE MAJORITY PROVIDES SERVICES TO CHILDREN AND ADOLESCENTS, AS WELL AS PEOPLE LIVING AT OR NEAR THE POVERTY LEVEL. TABLE A.1. PRIMARY FUNCTIONS INDICATED BY SURVEY RESPONDENTSORGANIZATION PRIMARY FUNCTION / PERCENT OF ALL APPLICANTS EDUCATION / 56.2PREVENTION/WELLNESS SERVICES / 53.0HEALTH CARE SERVICES / 44.2OTHER SERVICES / 31.8HEALTHY ENVIRONMENT / 30.0SOCIAL SERVICES / 24.4EMPLOYMENT & TRAINING / 23.0HOUSING/RESIDENTIAL SERVICES / 15.7DAY PROGRAM SERVICES / 13.4NOTE: RESPONDENTS COULD SELECT MORE THAN ONE PRIMARY FUNCTION.TABLE A.2. POPULATIONS SERVED BY SURVEY RESPONDENT AGENCIESPOPULATION SERVED / PERCENT OF ALL RESPONDENTS SCHOOL AGED CHILDREN/ADOLESCENTS / 75.1INDIVIDUALS LIVING AT OR NEAR THE FEDERAL POVERTY LEVEL / 68.7ADULTS / 67.3INDIVIDUALS WITH BEHAVIORAL HEALTH ISSUES / 56.7INDIVIDUALS WHO ARE SENIOR CITIZENS/ELDERLY / 56.2INDIVIDUALS WITH DEVELOPMENT DISABILITIES / 55.8PRE-SCHOOL CHILDREN / 53.9INDIVIDUALS WITH SUBSTANCE ABUSE ISSUE / 47.9WOMEN OF REPRODUCTIVE AGE / 46.5BABIES / 40.1FARMERS / 33.6MIGRANT WORKERS / 27.2SPECIFIC RACIAL/ETHNIC MINORITIES / 23OTHER / 21.2NOTE: RESPONDENTS COULD SELECT MULTIPLE POPULATIONS GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 6A: OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH OUR PARTNERS ESSEX COUNTY PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UVM HEALTH NETWORK-ALICE HYDE MEDICAL CENTER, ELIZABETHTOWN COMMUNITY HOSPITAL, MOSES LUDINGTON HOSPITAL, AND ADIRONDACK RURAL HEALTH NETWORK. GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 6B: SEE QUESTION 6A ABOVE GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 11: : ADIRONDACK HEALTH STRIVES TO MEET AS MANY OF THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS AS POSSIBLE. IN MANY CASES, WE PARTNER WITH APPROPRIATE ORGANIZATIONS AND AGENCIES TO ADDRESS NEEDS THATADIRONDACK HEALTH DOES NOT. ON INITIATIVES THAT ARE NOT HOSPITAL-LED, ADIRONDACK HEALTH PARTNERS AND WORKS WITH THE LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, SUBSTANCE ABUSE PREVENTION AND TREATMENT PROVIDERS, HOME CARE, AND MANY OTHERS TO ENSURE THAT THE NEEDS OF OUR COMMUNITY MEMBERS ARE MET.THE FOLLOWING ARE THE NYS PREVENTION AGENDA ITEMS THAT ADIRONDACK HEALTH DOES NOT DIRECTLY ADDRESS IN OUR IMPLEMENTATION STRATEGY:PROMOTE A HEALTHY AND SAFE ENVIRONMENTFOCUS AREA: INJURIES, VIOLENCE AND OCCUPATIONAL HEALTH THE RATE OF CRIME AND ASSAULT ARE LOW IN ADIRONDACK HEALTH'S SERVICE AREA. FALLS IN THE HOME AND OCCUPATIONAL HEALTH ARE ISSUES THAT COMMUNITY PARTNERS ARE BETTER POSITIONED TO ADDRESS.FOCUS AREA: OUTDOOR AIR AND WATER QUALITYTHE AIR AND WATER QUALITY INDICATORS ARE GOOD. DATA INDICATES THAT IT IS ONLY A FEW DAYS EACH YEAR THAT OUTDOOR AIR QUALITY IS POOR, AND THE LIKELY CAUSE OF THIS IS INDUSTRIAL POLLUTION FROM THE MID-WEST CARRIED HERE ON THE JET STREAM. ADIRONDACK HEALTH DOES NOT HAVE A STRATEGY TO DIRECTLY ADDRESS THIS AT THIS TIME, BUT NATIONAL GROUPS HAVE MADE PROGRESS AND ARE STILL WORKING TO IMPROVE OUTPUTS FROM THESE INDUSTRIAL AREAS.FOCUS AREA: BUILT ENVIRONMENTIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD PASSING COMPLETE STREETS POLICIES, IMPROVING PARKS AND OTHER RECREATIONAL AREAS, PASSING TOBACCO FREE GROUNDS POLICIES, IMPROVING ACCESS TO FRESH FRUITS AND VEGETABLES IN STORES AND RESTAURANTS, AND OTHER PROJECTS THAT IMPROVE ACCESS TO HEALTHY FOODS AND IMPROVE THE BUILT ENVIRONMENT SO COMMUNITY MEMBERS OF ALL LEVELS OF MOBILITY CAN FEEL SAFE AS PEDESTRIANS AND USINGALTERNATIVE FORMS OF TRANSPORTATION.PREVENT HIV/STDS, VACCINE-PREVENTABLE DISEASE AND HEALTHCARE ASSOCIATED INFECTIONSFOCUS AREA: PREVENT HIV AND STDS THE RATE OF HIV IS EXTREMELY LOW IN ADIRONDACK HEALTH'S SERVICE AREA. ADIRONDACK HEALTH'S PROVIDERS CONTINUE TO WORK WITH PUBLIC HEALTH AND OTHER PROVIDERS TO DELIVER THE HIGHEST LEVEL OF CARE TO PATIENTS WITH HIV. GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 16J: AN INTERPRETER IS AVAILABLE TO ASSIST LEP POPULATIONS AND STAFF IS AVAILABLE TO HELP PATIENTS FILL OUT DOCUMENTATION AND ANSWER ANY QUESTIONS 6 1 - TUPPER LAKE MEDICAL OFFICE BUILDING 7 STETSON ROAD TUPPER LAKE NY 12986 CLINIC; LABORATORY; RADIOLOGY 2 - MOUNTAIN HEALTH CENTER 2841 NYS ROUTE 73 KEENE NY 12942 CLINIC 3 - UIHLEIN LIVING CENTER 185 OLD MILITARY ROAD LAKE PLACID NY 12946 NURSING HOME WITH 156 BEDS; THROUGH OCTOBER 4, 2016 4 - MERCY LIVING CENTER 114 WAWBEEK AVENUE TUPPER LAKE NY 12986 NURSING HOME WITH 60 BEDS; DIALYSIS, REHABILITATION 5 - LAKE PLACID HEALTH CENTER 29 CHURCH STREET LAKE PLACID NY 12946 CLINIC 6 - WOUND CARE MEDICAL OFFICE BUILDING 285 COUNTY ROUTE 47 SARANAC LAKE NY 12983 CLINIC, PRIMARY CARE HEALTH CENTER PART I, LINE 7: AMOUNTS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 (TOTAL OPERATING EXPENSE MINUS MEDICAID/PROVIDER TAXES, TOTAL COMMUNITY BENEFIT EXPENSE, AND TOTAL COMMUNITY BUILDING EXPENSE DIVIDED BY GROSS PATIENT CHARGES), AND ADDRESSES ALL PATIENT SEGMENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,952,037. PART II, COMMUNITY BUILDING ACTIVITIES: THE CEO ATTENDED ADIRONDACK HEALTH INSTITUTE MEETINGS. AHI IS A REGIONAL ORGANIZATION THAT INCLUDES THE TRI-LAKES, PLATTSBURGH, AND GLENS FALLS COMMUNITIES WHOSE PURPOSE IS TO IMPROVE THE OVERALL HEALTH OF THESE ADIRONDACK COMMUNITIES BY WORKING TOGETHER ON A REGIONAL BASIS. THE INFECTION PREVENTIONIST PREPARED AND CONDUCTED A BLOOD BORN PATHOGENS PROGRAM FOR THE GABRIELS FIRE DEPARTMENT, AND ALSO SERVES AS A COMMUNITY MEMBER FOR THE TRUDEAU INSTITUTE BIOSAFETY COMMITTEE. PART III, LINE 2: THE ORGANIZATION'S BAD DEBT EXPENSE OF $1,238,941 IS CALCULATED USING THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND BAD DEBT EXPENSE. PART III, LINE 3: THE ORGANIZATION'S BAD DEBT EXPENSE IS CALCULATED USING A PERCENTAGE OF BAD DEBT THAT CONTAINS POSSIBLE CHARITY CARE CASES AND APPLYING IT TO LINE 2. RATIONALE FOR WHAT PORTION OF BAD DEBT SHOULD CONSTITUTE COMMUNITY BENEFIT: THE PROVISION OF HEALTH CARE IS DIFFERENT FROM PROVIDING OTHER SERVICES, IN THAT HOSPITALS, ALTHOUGH THEY MAY ATTEMPT TO OBTAIN FINANCIAL INFORMATION BEFORE SERVICE IS PROVIDED, FOCUS ON PROVIDING THE PATIENT WITH NEEDED HEALTH CARE AND LATER TRY TO OBTAIN PAYMENT. IN OTHER INDUSTRIES, THE SERVICE PROVIDER CAN CHECK THE CUSTOMER'S CREDIT RATING, ASK FOR PAYMENT IN ADVANCE, ETC AND IS USUALLY ASKING THIS INFORMATION WHEN THE CONSUMER IS NOT IN A HEALTH CRISIS AND UNDER GREAT STRESS AND WORRY. AT A LATER TIME, WHEN THE PROVIDER ATTEMPTS TO COLLECT PAYMENT AND FINDS THE PATIENT UNWILLING TO PAY, THEIR OPTIONS ARE AGAIN LIMITED GIVEN THE NATURE OF THE SERVICE PROVIDED AND THE INABILITY TO REPOSSESS THE SERVICE. PART III, LINE 4: IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, ADIRONDACK HEALTH ANALYZES PAST PAYMENT HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, ADIRONDACK HEALTH ANALYZES CONTRACTUALY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), ADIRONDACK HEALTH RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNT RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. PART III, LINE 8: CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND APPLYING IT TO GROSS MEDICARE CHARGES. SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE PATIENT SERVICES ARE PROVIDED AT A COST THAT IS GREATER THAN REIMBURSEMENT. PART III, LINE 9B: ACCORDING TO OUR CHARITY CARE POLICY,THE LARGEST NUMBER OF OUR FAP-ELIGIBLE PATIENTS ARE WRITTEN-OFF AT 100% SO NO COLLECTION EFFORTS ARE NECESSARY. PART VI, LINE 2: ADIRONDACK MEDICAL CENTER USES A NUMBER OF ASSESSMENT METHODS TO DETERMINE HOW WELL WE ARE MEETING COMMUNITY NEEDS AND WHAT ADDITIONAL SERVICES WE CAN OFFER OUR COMMUNITY MEMBERS. AMC USES THE PRESS-GANEY PATIENT SATISFACTION SURVEY FOR CONTINUAL PATIENT FEEDBACK. THE SURVEYS ARE MAILED TO RANDOMLY SELECTED PATIENTS BY PRESS-GANEY, A NATIONALLY RECOGNIZED PATIENT SURVEY FIRM, AND PRESS-GANEY PROCESSES THE RESULTS. THEY GIVE AMC THE RESULTS BENCHMARKED AGAINST OTHER HOSPITALS TO HELP US UNDERSTAND HOW WELL WE ARE SERVING OUR COMMUNITY. THE MAJORITY OF AMC'S STRATEGIC INITIATIVES ARE DRIVEN BY A THREE-YEAR STRATEGIC PLAN, WHICH IS DEVELOPED THROUGH THE COLLABORATION OF THE BOARD, MEDICAL STAFF, AMC STAFF AND COMMUNITY MEMBERS. THE GOALS THAT ARE SET FORTH EVERY THREE YEARS IN THE STRATEGIC PLAN ARE INCORPORATED INTO AMC'S MANAGEMENT ACTION PLAN (MAP), WHICH IS REVIEWED AND REVISED EACH YEAR. AT THE BEGINNING OF EACH YEAR EVERY DEPARTMENT CREATES A MAP THAT OUTLINES THE CONCRETE STEPS THAT THE DEPARTMENT WILL ACCOMPLISH IN MOVING THE HOSPITAL CLOSER TO COMPLETING THE STRATEGIC PLAN GOALS. THE SUCCESS OF AMC, EACH DEPARTMENT, AND EACH EMPLOYEE IS MEASURED BY THE MAP AND THE PROGRESS MADE TOWARD ACCOMPLISHING THE GOALS SET OUT IN THE STRATEGIC PLAN. FOR NEW SERVICES, AMC STAFF DEVELOPS A NEEDS ASSESSMENT USING A VARIETY OF DATA INCLUDING REGIONAL DEMAND FOR THE SPECIFIC SERVICE, DEMOGRAPHICS, AND FINANCIAL ANALYSIS. THE BOARD OF TRUSTEES CAREFULLY REVIEWS THE ANALYSIS AND EITHER SUPPORTS THE RECOMMENDATION OR ASKS FOR FURTHER INFORMATION. PART VI, LINE 3: ANY PATIENT THAT CONTACTS SCHEDULING OR PRESENTS TO ANY AMC DEPARTMENT (INCLUDING ADMITTING, EMERGENCY ROOM, ETC.) THAT DOES NOT IDENTIFY AN INSURANCE COMPANY OR IDENTIFIES THEMSELVES AS SELF-PAY ARE INFORMED OF OUR SELF-PAY PROCESS. THIS PROCESS INCLUDES INFORMATION ABOUT AMC'S CHARITY CARE POLICY AND THE BENEFITS OF VISITING WITH A CERTIFIED FACILITATED ENROLLER WHO CAN CHECK THE PATIENT'S ELIGIBILITY FOR STATE AND FEDERAL HEALTH INSURANCE PROGRAMS. PART VI, LINE 4: ADIRONDACK MEDICAL CENTER IS LOCATED IN THE HEART OF THE ADIRONDACK PARK IN RURAL, UPSTATE NEW YORK. THE ADIRONDACK PARK IS A UNIQUE, SIX MILLION ACRE PATCHWORK OF PUBLIC AND PRIVATE LAND. IT IS BEST KNOWN FOR ITS MOUNTAINS - THE HIGHEST IN NEW YORK STATE - AND ITS LAKES. THE REGION HAS AN AVERAGE SEASONAL SNOWFALL IN EXCESS OF 90 INCHES AND THE AVERAGE MEAN TEMPERATURE IN JANUARY IS 16 DEGREES FAHRENHEIT.AMC IS DESIGNATED A SOLE COMMUNITY PROVIDER HOSPITAL WITH THE CLOSEST COMPARABLE FACILITY 50 MILES AWAY FROM OUR MAIN CAMPUS IN SARANAC LAKE. AMC IS AN INTEGRAL PART OF THE COMMUNITY AS THE ONLY ACUTE CARE FACILITY, THE PREDOMINANT PROVIDER OF AMBULATORY SERVICES, AND THE LARGEST PRIVATE EMPLOYER IN THE SIX MILLION ACRE ADIRONDACK PARK. AMC IS THE PRINCIPAL PROVIDER OF ACUTE CARE FOR 70.7% OF THE ALMOST 23,000 RESIDENTS IN OUR PRIMARY SERVICE AREA AND WE CARE FOR APPROXIMATELY 25.1% OF THE 13,000 RESIDENTS IN OUR SECONDARY SERVICE AREA. THIS SERVICE AREA COVERS OVER 1,200 SQUARE MILES, HAS AN AVERAGE OF JUST OVER 30 PEOPLE PER SQUARE MILE, AND INCLUDES PORTIONS OF 5 COUNTIES.THE HOSPITAL'S SERVICE AREA IS DESIGNATED AS THE FOLLOWING FEDERAL HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA):- PRIMARY CARE- DENTAL HEALTH- MENTAL HEALTHAMC IS SERVING AN AGING POPULATION WITH HIGH CANCER AND CHRONIC DISEASE RATES, AND VERY LOW INCOME LEVELS. THE PERCENTAGE OF THE POPULATION THAT FALLS INTO THE "BABY BOOMER" AGE GROUP, 55+ YEARS OF AGE, IS INCREASING, WITH A CORRESPONDING DECREASE IN YOUNGER AGE GROUPS.THE AVERAGE UNEMPLOYMENT RATE IN 2016 FOR NEW YORK STATE WAS 4.8% AND THE UNEMPLOYMENT RATES IN THE COUNTIES THAT WE SERVE WERE 1.2 PERCENTAGE POINTS ABOVE THAT AVERAGE. THE NYS DEPARTMENT OF LABOR INDICATES THAT THE PER CAPITA INCOME FOR THE COUNTIES THAT AMC SERVES IS APPROXIMATELY 25% BELOW THE STATE AVERAGE. PART VI, LINE 5: AS THE LARGEST EMPLOYER AND ONLY FULL-SERVICE HOSPITAL IN THE ADIRONDACKPARK, ADIRONDACK HEALTH IS AN IMPORTANT PARTNER IN COMMUNITY BUILDING ACTIVITIES THATPROMOTE THE HEALTH AND WELLBEING OF OUR COMMUNITY MEMBERS, INCLUDING:-COLLABORATION WITH THE ESSEX AND FRANKLIN COUNTY HEALTH COMMUNITY SERVICE COMMITTEES IN PREPARING THE 2016-2018 COMMUNITY SERVICE PLAN FOR THE NEW YORK STATE PREVENTION AGENDA.-COLLABORATION WITH THE NORTH COUNTRY HEALTHY HEART NETWORK TO IDENTIFY AND REFER PATIENTS WITH PREDIABETES IN TUPPER LAKE - YEAR TWO.-NEW YORK STATE PREVENTION AGENDA PRIORITY OF PROMOTING HEALTHY WOMEN, INFANT AND CHILDREN WITH A PERINATAL QUALITY COLLABORATIVE SAFE SLEEP PROJECT TO REDUCE SUDDEN INFANT DEATH SYNDROME AND INCREASE BREASTFEEDING IN OUR REGION. LACTATION CONSULTANTS WERE TRAINED AND AVAILABLE TO ALL OB/GYN PATIENTS.-CONTINUED OUR PROGRAM OF HAVING A WOMEN'S HEALTH NAVIGATOR TO AID WOMEN AND THEIR FAMILIES THROUGH OUR NEW WOMEN'S HEALTH CENTER AND UPDATED AND REPUBLISHED THE WOMEN'S HEALTH GUIDEBOOK AS A COMMUNITY RESOURCE-SPONSORED ADIRONDACK HEALTH PROGRAMS AND EMPLOYEE WELLNESS PROGRAMS WHICH INCLUDED FREE PHYSICAL ACTIVITY EVENTS FOR THE COMMUNITY WITH CHAIR YOGA, CHAIR MASSAGE, CROSS COUNTRY SKIING AND SNOWSHOE CLASSES WITH MORE PLANNED FOR 2017; -PROVIDED A PRE-DIABETES PROGRAM THROUGH CDC TRAINED NURSES - FREE TO EMPLOYEES AND COMMUNITY- CONTINUATION OF PARTICIPATION IN DSRIP (DELIVERY SYSTEM REFORM INCENTIVE PAYMENT) WITH SEVEN PROJECTS ALL OF WHICH ARE PART OF A COMPREHENSIVE MEDICAID REFORM PROGRAM TO REDUCE AVOIDABLE HOSPITAL ADMISSIONS AND EMERGENCY DEPARTMENT ADMISSIONS BY 25% OVER 5 YEARS. THESE PROJECTS INCLUDE HOME TELEMONITORING EQUIPMENT, FACILITATOR TRAINING WITH RESPECTING CHOICES (A PALLIATIVE CARE INITIATIVE), CHRONIC DISEASE PREVENTION, INTEGRATING BEHAVIORAL HEALTH INTO PRIMARY CARE, HEALTH CENTER CERTIFICATION UNDER NCQA AND MANY OTHER POPULATION HEALTH EFFORTS.-CONDUCTED A LYME DISEASE STUDY WITH FREE SCREENINGS FOR THOSE RESIDENTS WHO WERE BITTEN BY A TICK AND FELT THEY MIGHT HAVE LYME DISEASE.-TWELVE COMMUNITY FORUMS WERE HELD IN 2016 CONDUCTED BY OUR COMMUNICATIONS DEPARTMENT FOR COMMUNITY STAKEHOLDERS TO BECOME EDUCATED IN TRENDING HEALTHCARE ISSUES INCLUDING POPULATION HEALTH, SUBSTANCE ABUSE, WOMEN'S HEALTH, LGBTQ AND OTHER TOPICS.- OUR YEARLY WOMEN'S HEALTH SYMPOSIUM FEATURING HEART DISEASE WAS ATTENDED BY OVER 100 WOMEN AND MEN IN 2016.- RECEIPIENT OF VITAL ACCESS PROVIDER PROGRAM FOR TELESTROKE TELEMEDICINE PROGRAM FOR 2016 AND 2017. PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES NY 1 X X X X X 1 1 0 0 0 0 0 0 0 CHARLES GLANVILLE CFO 210208 0 0 0 0 0 8300 0 8733 0 227241 0 0 0 SYLVIA GETMAN EX-OFFICIO PRESIDENT/CEO BEG. 6/16 175641 0 0 0 0 0 0 0 5898 0 181539 0 0 0 ANTHONY DOWIDOWICZ CMO ENDING 8/16 291895 0 0 0 0 0 10109 0 9109 0 311113 0 0 0 PATTI HAMMOND COO 217254 0 0 0 0 0 8194 0 8319 0 233767 0 0 0 LINDA MCCLARIGAN CNO 163535 0 0 0 0 0 6423 0 8733 0 178691 0 0 0 DARCI BEIRAS CMO BEG. 8/16 297238 0 0 0 0 0 28491 0 11976 0 337705 0 0 0 ANTHONY TRAMANTANO PHYSICIAN 468512 0 0 0 0 0 10600 0 11293 0 490405 0 0 0 JONATHAN KRANT PHYSICIAN 376503 0 0 0 0 0 10600 0 13002 0 400105 0 0 0 ANTHONY F LOMBARDI PHYSICIAN 290515 0 0 0 0 0 10600 0 8062 0 309177 0 0 0 MATTHEW L MORGAN PHYSICIAN 289994 0 0 0 0 0 1850 0 7576 0 299420 0 0 0 WILLIAM M VISCARDO JR PHYSICIAN 274273 0 0 0 0 0 9021 0 12228 0 295522 0 0 0 PART I, LINES 4A-B IN 2016, MATTHEW MORGAN RECEIVED SEVERANCE PAYMENTS IN THE AMOUNT OF $56,434. PART 1 LINE 4B THE HOSPITAL HAS A DEFERRED COMPENSATION PLAN FOR PARTICIPATING PHYSICIANS WHO PROVIDE SERVICES THROUGH THE HOSPITAL'S "ON-CALL" PROGRAM. PATRICIA MONROE, MD HAD $17,055 CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HER BEHALF IN 2016. RICHARD MOCCIA, MD RECEIVED $39,267 FROM THIS DEFERRED COMPENSATION PLAN AND $37,603 WAS CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HIS BEHALF IN 2016. WAGUIH KIROLLOS, MD HAD $9,658 CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HIS BEHALF IN 2016. DARCI BEIRAS, MD HAD $18,082 CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HER BEHALF IN 2016. A FRANKLIN COUNTY CIVIC DEVELOPMENT CO 800627350 2016-10-18 24455000 MULTI-MODE REVENUE BONDS FOR CAPITAL PROJECTS- REFINANCE 0 0 0 A 110000 24455000 479474 14335658 349674 2018 1 0 0 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 FORM 990, PART III, LINE 3 ON OCTOBER 4, 2016, ADIRONDACK HEALTH SOLD UIHLEIN LIVING CENTER INCLUDING THE OPERATING LICENSE AND CERTAIN EQUIPMENT FOR $573,963. ALL OTHER ASSETS AND LIABILITIES REMAINED WITH ADIRONDACK HEALTH. ADIRONDACK HEALTH RECORDED A LOSS IN CONNECTION WITH THE SALE OF $135,710. AS A CONDITION OF THE SALE, A GROUND LEASE HAS BEEN SIGNED FOR APPROXIMATELY $24,000 PER YEAR FOR 49 YEARS. FORM 990, PART VI, SECTION A, LINE 3 IN 2016 ADIRONDACK MEDICAL CENTER CONTRACTED WITH HEALTHTECH MANAGEMENT SERVICES, AND PAID $459,853. THIS INCLUDES A CEO LEASE AGREEMENT AND A CONSULTING CONTRACT. FORM 990, PART VI, SECTION A, LINE 4 CURRENT BY-LAWS CHANGED THE MAXIMUM NUMBER OF ACTIVE MEDICAL STAFF ALLOWED TO BE ON THE BOARD OF TRUSTEES FROM THREE TO TWO. THE CHAIRPERSON OF THE FOUNDATION WAS ADDED AS AN EX-OFFICIO MEMBER OF THE BOARD OF TRUSTEES AND HAS ONE VOTE. THEY WERE ALSO AMENDMENED REQUIRING THE BYLAWS BE REVIEWED EVERY TWO YEARS. THEY MAY BE AMENDED BY VOTE OF A MAJORITY OF THE ENTIRE BOARD AT ANY REGULAR OR SPECIAL MEETING, PROVIDED A FULL STATEMENT OF THE PROPOSED AMENDMENT WAS SET FORTH IN A WRITTEN NOTICE, MAILED OR PERSONALLY DELIVERED TO EACH TRUSTEE AT LEAST THREE DAYS PRIOR TO THE MEETING AT WHICH THE VOTE TO AMEND THE BYLAWS SHALL BE TAKEN. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PRESENTED AND REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING THE 990. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF TRUSTEES ARE REQUIRED TO COMPLETE AND SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY. THESE ARE THEN REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION DECISIONS ARE DEVELOPED BASED ON THE USE OF NATIONAL, REGIONAL, AND HEALTHTECH SALARY SURVEY DATA WHICH IS ANALYZED BY THE COMPENSATION COMMITTEE AND THEN APPROVED BY THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 7,024,946. MANAGEMENT AND GENERAL EXPENSES 3,930,584. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,955,530. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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