DELAWARE VALLEY HOSPITAL INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- DELAWARE VALLEY HOSPITAL INC (EIN 15-0524324)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-03
- IRS object ID
- 201603089349301415
- Schema version
- 2015v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-03T12:38:03-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161226221 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUST CHARLES CHAMBERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5784 WIDEWATERS PARKWAY | AddressLine1Txt |
| City | SYRACUSE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 150524324 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAWARE VALLEY HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DELA | BusinessNameControlTxt |
| Phone | 6078652197 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 TITUS PLACE | AddressLine1Txt |
| City | WALTON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 138561457 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAUL SUMMERS | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 6078652160 | PhoneNum |
| Signature | 2016-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA M FRANCO | PreparerPersonNm |
| PTIN | P00589741 | PTIN |
| Phone | 3154463600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAUL SUMMERS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 TITUS PLACE | AddressLine1Txt |
| City | WALTON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 138561457 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,626,305 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UHS.NET/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1950 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE OUR PATIENTS IN AN EFFICIENT AND PATIENT-FOCUSED MANNER AND OFFER A RANGE OF ACUTE, OUTPATIENT, DIAGNOSTIC, RAHABILITATIVE, PRIMARY CARE AND WELLNESS SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 221 | TotalEmployeeCnt |
| Total Volunteers | 23 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $496,656 | PYContributionsGrantsAmt |
| CY Contributions Grants | $491,375 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,299,407 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,803,358 | CYProgramServiceRevenueAmt |
| PY Investment Income | $47,308 | PYInvestmentIncomeAmt |
| CY Investment Income | $43,318 | CYInvestmentIncomeAmt |
| PY Other Revenue | $935,656 | PYOtherRevenueAmt |
| CY Other Revenue | $288,254 | CYOtherRevenueAmt |
| PY Total Revenue | $18,779,027 | PYTotalRevenueAmt |
| CY Total Revenue | $21,626,305 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,453,297 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,465,037 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $113,196 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,703,340 | PYOtherExpensesAmt |
| CY Other Expenses | $12,175,307 | CYOtherExpensesAmt |
| PY Total Expenses | $18,156,637 | PYTotalExpensesAmt |
| CY Total Expenses | $20,640,344 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $622,390 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $985,961 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,390,107 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,094,367 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,729,410 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,451,663 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,660,697 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,642,704 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SERVE ITS PATIENTS WITH COMPASSION AND IN AN EFFICIENT AND PATIENT FOCUSED MANNER WHILE OFFERING A RANGE OF ACUTE, OUTPATIENT, DIAGNOSTIC, REHABILITATIVE, PRIMARY CARE AND WELLNESS SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,209,687 | ExpenseAmt |
| Revenue | $9,560,720 | RevenueAmt |
| Desc | INPATIENT AND ACUTE SERVICES: DELAWARE VALLEY HOSPITAL FULFILLS ITS MISSION BY WORKING TOGETHER WITH THE COMMUNITY, PHYSICIANS, AND OTHER HEALTHCARE PROVIDERS TO CONTINUOUSLY IMPROVE THE AVAILABILITY AND QUALITY OF SERVICES. THIS INCLUDES THE ABILITY TO PROVIDE A COMPREHENSIVE RANGE OF SHORT-TERM (96 HRS. OR LESS) INPATIENT ACUTECARE, SWING BED AND ADDICTION TREATMENT SERVICES VIA IT'S 25-BED HOSPITAL LOCATED ON THE MAIN CAMPUS IN WALTON IN DELAWARE COUNTY, NY. PATIENT DISCHARGES IN 2015 WERE COMPRISED OF 316 ACUTE, 187 SWING BED, AND 79 ADDICTION TREATMENT. ACUTE CARE REPRESENTED 943 PATIENT DAYS, IN ADDITION TO THE 1,801 PATIENT DAYS FOR SWING BED AND 1,222 PATIENT DAYS IN THE ADDICTION TREATMENT PROGRAM. INDICATIVE OF THE COMPREHENSIVE HEALTHCARE PROVIDED TO THESE PATIENTS, A TOTAL OF 6,348 LAB TESTS, 15,846 RESPIRATORY TREATMENTS, 336 X-RAYS, 842 PHYSICAL THERAPY SESSIONS, AND 181 EKG'S WERE ADMINISTERED. OTHER SERVICES INCLUDED OCCUPATIONAL AND SPEECH THERAPY, ENDOSCOPY, ECHO EXAMS, ULTRASOUNDS, CT EXAMS AND MAMMOGRAPHY. TO ENSURE OUR RURAL AREA RESIDENTS HAVE ACCESS TO HIGH QUALITY, EFFICIENT CARE IN A COMFORTABLE AND PRIVATE AREA, THE HOSPITAL'S IMAGING CENTER IS EQUIPPED WITH A 16-SLICE CT SUITE. MRI SERVICES ARE OFFERED ON SUNDAYS THROUGH AN AGREEMENT WITH A MOBILE VENDOR. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,208,310 | ExpenseAmt |
| Revenue | $4,421,606 | RevenueAmt |
| Desc | CLINICS: DELAWARE VALLEY HOSPITAL PROVIDES A WIDE RANGE OF PRIMARY AND PREVENTIVE CARE SERVICES THROUGH ITS PRIMARY CARE CENTERS LOCATED IN WALTON, DOWNSVILLE, AND ROSCOE. THESE PRIMARY CARE CENTERS FORM THE FOUNDATION NECESSARY TO SERVE OUR COMMUNITIES WITH A COORDINATED SYSTEM OF CARE WHILE PAYING SPECIAL ATTENTION TO UNDER-SERVED AREAS. IN 2015 OUR CLINICS PROVIDED CARE TO 14,518 PATIENTS IN WALTON, 1,211 IN ROSCOE, AND 1,341 IN DOWNSVILLE. WITH A FOCUS ON CONTINUOUS IMPROVEMENT THE PRIMARY CARE CENTERS OPERATE UNDER A NEW HEALTH INFORMATION MANAGEMENT SYSTEM AND CONTINUE TO BE SMOKE AND TOBACCO FREE. THEY HAVE ALSO BECOME A KEY TO THE IMPROVEMENT OF CHILDHOOD IMMUNIZATION LEVELS IN COORDINATION WITH DELAWARE COUNTY'S PUBLIC HEALTH NURSING SERVICES AND OTHER AREA HEALTHCARE PROVIDERS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,640,657 | ExpenseAmt |
| Revenue | $6,821,032 | RevenueAmt |
| Desc | OUTPATIENT AND AMBULATORY SERVICES: DELAWARE VALLEY HOSPITAL PROVIDES A COMPREHENSIVE RANGE OF OUTPATIENT DIAGNOSTIC CARDIOPULMONARY, IMAGING LAB AND TREATMENT SERVICES AT ITS WALTON CAMPUS. THESE INCLUDE A 7-BED EMERGENCY DEPARTMENT WHICH SERVES THE COMMUNITY 24/7. OTHER TREATMENT SERVICES INCLUDE PHYSICAL REHABILITATIVE SERVICES, AMBULATORY PROCEDURES, AND ACCESS TO SPECIALTY SERVICES. THE HOSPITAL ALSO CONDUCTS EXTENSIVE WELLNESS PROGRAMMING THAT INCLUDES NUTRITION AWARENESS AND DIABETES EDUCATION. A FREE PRESCRIPTION DELIVERY PROGRAM IS PROVIDED FOR ROSCOE AND DOWNSVILLE PATIENTS. DOWNSVILLE IS WITHOUT A LOCAL PHARMACY AND ROSCOE JUST RECENTLY HAD A NEW PHARMACY OPEN IN THE COMMUNITY. OCCUPATIONAL HEALTH PROGRAMMING MEETS THE NEEDS OF LOCAL BUSINESSES, FIRE DEPARTMENTS, AND EMERGENCY SQUADS BY PROVIDING PHYSICALS, DRUG TESTING, AND ERGONOMIC EDUCATION. IN 2015 THE EMERGENCY DEPARTMENT TREATED OR ADMITTED 5,606 RESIDENTS VIA ITS 5,000+ SQ. FT. FACILITY, THE LAB PERFORMED 68,939 TESTS, AND 6,410 PHYSICAL/OCCUPATIONAL THERAPY SESSIONS WERE CONDUCTED. THE IMAGING CENTER PERFORMED 7,888 X-RAYS, CT SCANS, MRI'S AND MAMMOGRAPHIES FOR OUTPATIENT SERVICES. OUTPATIENT SERVICES WERE ALSO PERFORMED IN 2015 FOR 137 AMBULATORY PROCEDURES, 1,200 OPIATED ADDICTION SESSIONS, AND 875 SERVICES ASSOCIATED WITH CARDIOPULMONARY REHABILITATION. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenue | $283,547 | RevenueAmt |
| Desc | OTHER PROGRAM SERVICES REVENUE IS PRIMARILY MADE UP OF MEANINGFUL USE MEDICARE FUNDING OF $283,547. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Revenue | $283,547 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $16,058,654 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 221 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PAUL SUMMERS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6078652197 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | DELAWARE VALLEY HOSPITAL 1 TITUS | AddressLine1Txt |
| City | WALTON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 138561457 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| HELEN JOHNSTON | ||||||||
| BOARD CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DR MICHAEL FREEMAN | ||||||||
| MEDICAL STAFF PRESIDENT | 56.00 | Yes (X) | Yes (X) | $248,091 | $0 | $36,566 | ||
| JOHN CARRIGG | ||||||||
| 2ND VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $524,410 | $33,429 | 55.00 | |
| LARRY LIGHT | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EDWARD SNOW | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ERIN NEALE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| AMANDA HALL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PAUL SUMMERS | ||||||||
| DIRECTOR/CEO | 55.00 | Yes (X) | Yes (X) | $192,783 | $0 | $16,632 | ||
| JOAN GUARNIERI | ||||||||
| V.P. COMM HEALTH SVCS | 55.00 | Yes (X) | $100,201 | $0 | $13,514 | |||
| DOTTIE KRUPPO | ||||||||
| V.P. ANCILLARY SVCS | 55.00 | Yes (X) | $80,279 | $0 | $16,952 | |||
| DEBORAH HITT | ||||||||
| V.P. QUALITY/SUPPORT SVCS | 55.00 | Yes (X) | $87,495 | $0 | $17,725 | |||
| VICTORIA CONKLING | ||||||||
| V.P. NURSING/CNO | 55.00 | Yes (X) | $104,564 | $0 | $6,228 | |||
| DR RAJESH DAVE | ||||||||
| FORMER 2ND VICE CHAIR | 1.00 | $0 | $598,971 | $33,584 | 55.00 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $813,413 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,123,381 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $174,630 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CARDINAL HEALTH DRUGS | |||||
| 7000 CARDINAL PLACE | DUBLIN | OH | 43017 | PHARMACEUTICAL | $571,506 |
| SECO PHYSICALOCCUPATIONAL THERAPY | |||||
| 26 CONKY AVE | NORWICH | NY | 13815 | PHYSICAL/OCC. THERAPY | $354,626 |
| MEDHOST OF TENNESSEE | |||||
| 2739 MOMENTUM PLACE | CHICAGO | IL | 60689 | INFORMATION TECHNOLOGY | $276,444 |
| LOCUMTENENS | |||||
| PO BOX 405547 | ATLANTA | GA | 30384 | STAFFING SERVICE | $240,663 |
| ALLIANCE HEALTHCARE SYSTEMS | |||||
| PO BOX 96485 | CHICAGO | IL | 60693 | MEDICAL SUPPORT | $207,306 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $477,115 | GovernmentGrantsAmt |
| All Other Contributions | $14,260 | AllOtherContributionsAmt |
| Total Contributions | $491,375 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $20,803,358 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,803,358 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,803,358 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,318 | TotalRevenueColumnAmt |
| Exclusion | $43,318 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| MEANINGFUL USE MEDICARE | 900099 | $216,810 | $216,810 | |
| PHYSICIAN OTHER REVENUE | 621498 | $48,763 | $48,763 | |
| VENDING MACHINE | 722210 | $4,707 | $4,707 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,974 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,974 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $288,254 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,626,305 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,086,905 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $48,025 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $636,374 | TotalAmt |
| Program Services | $460,098 | ProgramServicesAmt |
| Management And General | $176,276 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,214,699 | TotalAmt |
| Program Services | $4,298,260 | ProgramServicesAmt |
| Management And General | $1,916,439 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $189,066 | TotalAmt |
| Program Services | $122,893 | ProgramServicesAmt |
| Management And General | $66,173 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $924,998 | TotalAmt |
| Program Services | $587,373 | ProgramServicesAmt |
| Management And General | $337,625 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $499,900 | TotalAmt |
| Program Services | $329,934 | ProgramServicesAmt |
| Management And General | $169,966 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,818 | TotalAmt |
| Management And General | $2,818 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,405 | TotalAmt |
| Management And General | $7,405 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,406 | TotalAmt |
| Management And General | $81,406 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,849 | TotalAmt |
| Management And General | $6,849 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,557 | TotalAmt |
| Management And General | $4,557 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,157,495 | TotalAmt |
| Program Services | $4,531,153 | ProgramServicesAmt |
| Management And General | $538,722 | ManagementAndGeneralAmt |
| Fundraising | $87,620 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $310 | TotalAmt |
| Fundraising | $310 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,444,148 | TotalAmt |
| Program Services | $3,821,320 | ProgramServicesAmt |
| Management And General | $616,273 | ManagementAndGeneralAmt |
| Fundraising | $6,555 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,589 | TotalAmt |
| Management And General | $43,589 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $226,400 | TotalAmt |
| Program Services | $46,418 | ProgramServicesAmt |
| Management And General | $179,982 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,785 | TotalAmt |
| Program Services | $25,091 | ProgramServicesAmt |
| Management And General | $10,168 | ManagementAndGeneralAmt |
| Fundraising | $2,526 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,118 | TotalAmt |
| Program Services | $5,688 | ProgramServicesAmt |
| Management And General | $3,245 | ManagementAndGeneralAmt |
| Fundraising | $16,185 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $247,968 | TotalAmt |
| Management And General | $247,968 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $823,539 | TotalAmt |
| Program Services | $812,519 | ProgramServicesAmt |
| Management And General | $11,020 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,984 | TotalAmt |
| Program Services | $86,185 | ProgramServicesAmt |
| Management And General | $12,799 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $870,984 | $870,984 | |
| MISCELLANEOUS | $95,952 | $60,738 | $35,214 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,640,344 | TotalAmt |
| Program Services | $16,058,654 | ProgramServicesAmt |
| Management And General | $4,468,494 | ManagementAndGeneralAmt |
| Fundraising | $113,196 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,380,818 | BOYAmt |
| EOY | $2,554,440 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,352,899 | BOYAmt |
| EOY | $1,357,318 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,889,306 | BOYAmt |
| EOY | $2,153,339 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $440,094 | BOYAmt |
| EOY | $523,224 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $321,124 | BOYAmt |
| EOY | $464,907 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $21,370,461 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,367,630 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,026,058 | BOYAmt |
| EOY | $7,002,831 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,025,200 | BOYAmt |
| EOY | $1,017,387 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,909,608 | BOYAmt |
| EOY | $1,955,921 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,000 | BOYAmt |
| EOY | $65,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,390,107 | BOYAmt |
| EOY | $17,094,367 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $887,125 | BOYAmt |
| EOY | $971,189 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,116,920 | BOYAmt |
| EOY | $3,814,257 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $612,001 | BOYAmt |
| EOY | $527,784 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,645,482 | BOYAmt |
| EOY | $1,663,573 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $467,882 | BOYAmt |
| EOY | $474,860 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,729,410 | BOYAmt |
| EOY | $7,451,663 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,299,158 | BOYAmt |
| EOY | $9,318,035 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,329 | BOYAmt |
| EOY | $6,460 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $318,210 | BOYAmt |
| EOY | $318,209 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,660,697 | BOYAmt |
| EOY | $9,642,704 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,390,107 | BOYAmt |
| EOY | $17,094,367 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $985,961 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$26,261 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $22,307 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $6,849 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $6,849 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | AMOUNTS DISCLOSED ARE THE LOBBYING PORTIONS OF DUES PAID TO HEALTHCARE ASSOCIATION OF NY AND IROQUOIS HEALTHCARE. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $361,539 | BeginningYearBalanceAmt |
| Contributions | $5,286 | ContributionsAmt |
| Other Expenditures | $42,156 | OtherExpendituresAmt |
| End Year Balance | $324,669 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $348,578 | BeginningYearBalanceAmt |
| Contributions | $12,961 | ContributionsAmt |
| End Year Balance | $361,539 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $379,742 | BeginningYearBalanceAmt |
| Contributions | $1,700 | ContributionsAmt |
| Other Expenditures | $32,864 | OtherExpendituresAmt |
| End Year Balance | $348,578 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $381,035 | BeginningYearBalanceAmt |
| Contributions | -$1,293 | ContributionsAmt |
| End Year Balance | $379,742 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $342,832 | BeginningYearBalanceAmt |
| Contributions | $38,203 | ContributionsAmt |
| End Year Balance | $381,035 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.98010 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.01990 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $51,202 | OtherCostOrOtherBasisAmt |
| Book Value | $51,202 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,982,137 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,028,958 | DepreciationAmt |
| Book Value | $4,953,179 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,907,798 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,338,672 | DepreciationAmt |
| Book Value | $1,569,126 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $429,324 | OtherCostOrOtherBasisAmt |
| Book Value | $429,324 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,002,831 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| WELLS FARGO - PRIN. PMTS. ON BOND | $150,109 | F |
| TEMP.RESTRICTED DONATIONS | $14,147 | F |
| CAPITAL CONST(FUNDED DEPR) | $1,791,665 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $1,955,921 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE UNITED MED. ASSOC. / CHEN. MEM. | $252,281 |
| DUE UHS HOSPITALS | $157,579 |
| MALPRACTICE INSURANCE RESERVE | $65,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $474,860 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $21,626,305 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,626,305 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,626,305 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,640,344 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,640,344 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,640,344 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | PURCHASE OF CAPITAL EQUIPMENT (MEDICAL) AND IMPROVEMENT OF FACILITIES. |
| PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAXES ON UNRELATED BUSINESS INCOME UNDER SECTION 511 OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2015 AND 2014, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTERST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2012 THROUGH 2015. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $135,971 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $82,929 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $53,042 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $135,971 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $82,929 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $53,042 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $154,738 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $154,738 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00780 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $43,270 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $43,270 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,234,139 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,866,435 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,367,704 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11980 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $517 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $517 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,432,664 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,866,435 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,566,229 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12980 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,568,635 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,949,364 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,619,271 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13250 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $325,022 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $95,839 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $4,742,710 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,691,734 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $50,976 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAWARE VALLEY HOSPTITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 TITUS PLACE | AddressLine1Txt |
| City | WALTON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13856 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAWARE VALLEY HOSPTITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.UHS.NET | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.UHS.NET | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.UHS.NET | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.UHS.NET | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.UHS.NET | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| DELAWARE VALLEY HOSPTITAL | PART V, SECTION B, LINE 5: DELAWARE VALLEY HOSPITAL HAS MEMBERSHIP IN THE DELAWARE COUNTY HEALTHCARE ALLIANCE, A COALITION OF HEALTHCARE AND COMMUNITY ORGANIZATIONS THROUGHOUT THE COUNTY, AS WELL AS ON ITS WELLNESS COMMITTEE. A STAFF MEMBER ALSO SERVES ON THE COMMUNITY COMMITTEE OF THE LOCAL SCHOOL. THE HOSPITAL ALSO HAS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER). THE HOSPITAL'S COMMUNITY RELATIONS DIRECTOR PARTICIPATES IN ALL DVH VOLUNTEER MEETINGS AND ACTIVELY SEEKS THEIR INPUT AND FEEDBACK ABOUT THE HOSPITAL'S SERVICES. THE HOSPITAL'S BOARD OF DIRECTORS PROVIDES INPUT AS TO WHAT THEY HEAR FROM COMMUNITY MEMBERS. PATIENT SATISFACTION SURVEYS ARE ALSO USED IN GAINING INPUT FROM OUR PATIENTS. |
| DELAWARE VALLEY HOSPTITAL | PART V, SECTION B, LINE 6A: UNITED HEALTH SERVICE HOSPITALS, INC.CHENANGO MEMORIAL HOSPITAL |
| DELAWARE VALLEY HOSPTITAL | PART V, SECTION B, LINE 6B: DELAWARE COUNTY GOVERNMENT AGENCIES:DELAWARE COUNTY PUBLIC HEALTH, MENTAL HEALTH, OFFICE FOR THE AGING, DEPT OF SOCIAL SERVICES, SHERIFF'S DEPT, ALCOHOL AND DRUG ABUSE COUNCIL, PLANNING DEPT, EMERGENCY SERVICES, DRUG TREATMENT COURT, WATERSHED AFFAIRSHOSPITAL AND HEALTH SERVICES:UHS DELAWARE VALLEY HOSPITAL, BASSETT HEALTHCARE-O'CONNOR HOSPITAL AND TRI-TOWN, MARGARETVILLE HOSPITAL, CATSKILL AREA HOSPICEEDUCATION:ROXBURY CENTRAL SCHOOLNURSING HOMES:ROBINSON TERRACEALLIANCES:RURAL HEALTH NETWORK OF SOUTH CENTRAL NYOTHER HUMAN SERVICE AGENCIES:CORNELL COOPERATIVE EXTENSION, RURAL 3 FOR TOBACCO FREE COMMUNITIES, CANCER SERVICE PROGRAM OF DELAWARE, OTSEGO AND SCHOHARIE COUNTIES, DELAWARE OPPORTUNITIES, NY CONNECTS, FAMILY RESOURCE NETWORK, CATHOLIC CHARITIES |
| DELAWARE VALLEY HOSPTITAL | PART V, SECTION B, LINE 11: THREE YEAR PLAN OF ACTIONPROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSESUPPORT COLLABORATION AMONG LEADERS, PROFESSIONALS AND COMMUNITY MEMBERS WORKING IN MEB HEALTH PROMOTION, SUBSTANCE ABUSE AND OTHER MEB DISORDERS AND CHRONIC DISEASE PREVENTION, TREATMENT AND RECOVERY.OBJECTIVES:IDENTIFY AND STRENGTHEN OPPORTUNITIES FOR SHARING DATA ON ACCESS TO CARE, IDENTIFY SERVICE GAPS, STUDY COST EFFECTIVENESS STRATEGIES FOR INTEGRATION AND COORDINATION AND IMPACT OF INTERVENTIONS.SUPPORT EFFORTS TO INTEGRATE MEB DISORDER SCREENING AND TREATMENT INTO PRIMARY CARE.UHS DELAWARE VALLEY HOSPITAL ANTICIPATES IT WILL HAVE OTHER OBJECTIVES IT WILL WANT TO FOCUS ON WITHIN THIS PRIORITY BASED ON THE FINDINGS AND WORK OF THE COALITION.2015 SERVICE REPORT UPDATE IN OUR REGULAR CONTACT WITH OUR COUNTY MENTAL HEALTH DEPARTMENT, ESPECIALLY DURING TRAVEL TO DSRIP MEETINGS, WE CAME TO REALIZE THE SEVERE SHORTAGE OF MENTAL HEALTH PROFESSIONALS IN OUR AREA; AND THE EXTREME DIFFICULTY IN RECRUITING OTHERS WOULD ONLY BE SOLVED THROUGH THE ADVANCEMENT OF TELEPSYCH SERVICES. USING VAP GRANT FUNDING, DVH WAS ABLE TO HIRE A TELEMEDICINE CONSULTANT AND THE DECISION WAS MADE TO FOCUS FIRST ON TELEPSYCH SERVICES. UHS HAS AGREED TO SUPPLY THE PROFESSIONALS FOR THIS PROGRAM. THE GOAL IS TO OFFER A SPECIALTY CLINIC TO PATIENTS WHO ARE REFERRED FROM THEIR PRIMARY CARE PHYSICIANS FOR EVALUATION. BY OFFERING THIS SERVICE, THE COUNTY DEPARTMENT WILL HAVE MORE TIME TO CARE FOR THOSE WHO HAVE MORE SERIOUS CONDITIONS. TELEMEDICINE IS SCHEDULED TO BEGIN IN 2016, ONCE THE TELECOMMUNICATION VENDOR IS SELECTED. THE DVH VOLUNTEERS AGREED TO PURCHASE A MONITOR AND CAMERA WHICH WILL MAKE PATIENTS FEEL MORE COMFORTABLE THAN THEY MIGHT BE LOOKING AT AN IPAD OR COMPUTER SCREEN. THAT WILL BE COMPLETED IN THE 1ST QUARTER OF 2016. IN ADDITION, DVH IS ALSO CONSIDERING HAVING ONE OF ITS PRIMARY CARE PHYSICIANS ACCEPT PATIENTS FROM THE COUNTY MENTAL HEALTH DEPARTMENT WHO DO NOT HAVE A PRIMARY CARE PROVIDER AND WISH TO COME TO DVH. AGAIN THIS WILL ALLOW THE COUNTY DEPARTMENT MORE TIME FOR MORE SERIOUS CASES, AS THE PROVIDER WILL BE ABLE TO PRESCRIBE THE MEDICATIONS, THESE STABLE PATIENTS REQUIRE.PREVENT CHRONIC DISEASESREDUCE OBESITY IN CHILDREN AND ADULTS OBJECTIVES:BY 12/31/17, REDUCE THE % OF CHILDREN WHO ARE OBESE BY 5% IN PUBLIC SCHOOL CHILDREN.BY 12/31/15 10% OF ELEMENTARY SCHOOL CHILDREN IN GRADES 2-4 IN THE WALTON, ROSCOE, DOWNSVILLE AND LIVINGSTON MANOR SCHOOL DISTRICTS WILL PARTICIPATE IN THE UHS STAY HEALTHY! "TAKING SMALL STEPS TOGETHER" PROGRAM, WHICH ENCOURAGES CHILDREN TO EAT 5 SERVINGS OF FRUITS AND VEGETABLES PER DAY, HAVE 2 HOURS OR LESS OF SCREEN TIME AND 1 HOUR OR MORE OF PHYSICAL ACTIVITY.WORKING WITH THE SCHOOL NURSES AT ROSCOE, DOWNSVILLE AND LIVINGSTON MANOR SCHOOLS, CHILDREN WILL BE ENROLLED IN THE PROGRAM DURING 2015.WORKING WITH THE TOWNSEND SCHOOL PTA WALTON ELEMENTARY SCHOOL CHILDREN WILL BE ENROLLED IN THE PROGRAM DURING 2015.WORKING WITH EACH SCHOOL, CHILDREN WILL BE ENCOURAGED TO COMPLETE AT LEAST 2 ROUNDS OF THE 5 WEEK PROGRAM. CHILDREN COMPLETING EACH ROUND WILL RECEIVE A "CHARM" TO PUT ON A BRACELET.THE PROGRAM WILL BE REPEATED EACH YEAR OF THE COMMUNITY SERVICE PLAN.BY 12/31/15 AT LEAST 100 CHILDREN IN WALTON, ROSCOE, DOWNSVILLE AND LIVINGSTON MANOR SCHOOLS WILL PARTICIPATE IN AN AFTER SCHOOL COOKING CLASS LEARNING HOW TO MAKE AND CHOOSE HEALTHY SNACKS.IN 2015, UHS DELAWARE VALLEY HOSPITAL WILL WORK WITH THE 21ST CENTURY RISE PROGRAM TO OFFER AFTER SCHOOL COOKING CLASSES TO ROSCOE, DOWNSVILLE AND LIVINGSTON MANOR STUDENTS SO THEY CAN IDENTIFY AND MAKE HEALTHY SNACKS. STUDENTS WILL PREPARE SNACKS; RECEIVE RECIPE CARDS TO TAKE HOME AND HEALTHY SNACK TIP SHEETS FOR PARENTS.IN 2015, UHS DELAWARE VALLEY HOSPITAL WILL WORK WITH THE WALTON CENTRAL SCHOOL WELLNESS COMMITTEE TO OFFER AFTER SCHOOL COOKING CLASSES TO STUDENTS AS ABOVE.BY 12/31/17, REDUCE THE % OF ADULTS 18 AND OVER WHO ARE OBESE.DUE TO REQUESTS FROM COMMUNITY MEMBERS, BY 12/31/15 AT LEAST 20 ADULTS WILL PARTICIPATE IN HEALTHY COOKING CLASSES. EACH PARTICIPANT WILL RECEIVE RECIPE CARDS TO TAKE HOME AND THE CLASSES WILL FEATURE A MEAT, POULTRY, FISH AND VEGETABLE DISHES.2015 SERVICE REPORT UPDATE HEALTHY COOKING CLASSES ALTHOUGH THIS WAS AN INITIAL PLAN OF DVH, WE FOUND THAT WITH LIMITED RESOURCES THIS IS JUST NOT GOING TO BE A FEASIBLE PROJECT FOR US, OR THAT THE PLANNED EFFORTS WOULD REALLY MOVE THE NEEDLE IN TERMS OF MAKING A DIFFERENCE. ALTHOUGH WELL RECEIVED, OUR COOKING CLASSES CAN ONLY REACH A FEW PEOPLE AT A TIME. INSTEAD, WE HAVE TEAMED UP WITH THE UHS BARIATRIC SURGERY PROGRAM AND OUR DIETITIAN IS NOW COUNSELING MANY OF OUR AREA PATIENTS WHO ARE CONSIDERING THIS OPTION. SHE ALSO CONTINUES TO OFFER THE LIFESTEPS PROGRAM AT LEAST ONCE EACH YEAR AND GENERALLY REACHES APPROXIMATELY 10 PEOPLE.BY 12/31/17, INCREASE THE NUMBER OF TOWNS AND VILLAGES THAT HAVE PASSED COMPLETE STREETS POLICIES FROM 23-46. COMPLETE STREETS ARE DESIGNED TO ALLOW EASY AND SAFE TRAVEL BY WALKING, RIDING AND BIKING. (TRI-STATES TRANSPORTATION CAMPAIGN)OBJECTIVES:BY 12/31/17 50% OF DELAWARE COUNTY TOWNS WILL HAVE ONE TRAIL MAPPED AND/OR MARKED.BY 12/31/17 25% OF PRIMARY CARE PRACTICES WILL UTILIZE THE PRESCRIPTION TRAIL PROGRAM IN THEIR PRACTICES TO ENCOURAGE PATIENTS TO BE PHYSICALLY ACTIVE.WORKING WITH DELAWARE COUNTY PUBLIC HEALTH, O'CONNOR HOSPITAL, MARGARETVILLE HOSPITAL, THE CATSKILL MOUNTAIN CLUB, AND DELAWARE COUNTY CHAMBER OF COMMERCE EXISTING TRAILS WILL BE IDENTIFIED, THEIR DIFFICULTY LEVEL ASSESSED. POSSIBILITIES OF CREATING NEW TRAILS WILL BE EXPLORED.A WEBSITE WILL BE DEVELOPED TO ENCOURAGE USE OF THE TRAILS, AND MAKE MORE PEOPLE AWARE OF THEIR EXISTENCE AND ANY ACTIVITIES THAT MAY BE HELD ON THE TRAILS.PRIMARY CARE PROVIDERS WILL BE EDUCATED ABOUT THE PRESCRIPTION TRAILS PROGRAM AND THE EXISTING TRAILS.2015 SERVICE REPORT UPDATE IN ADDITION DVH SPOKE WITH WALTON VILLAGE BOARD MEMBERS, IN CONJUNCTION WITH DELAWARE COUNTY PUBLIC HEALTH ABOUT THE COMPLETE STREETS PROGRAM. SINCE SUBMITTING OUR COMMUNITY SERVICE PLAN, WE WERE TOLD THE VILLAGE OF WALTON DID PASS A COMPLETE STREETS POLICY IN DECEMBER, 2015. WE ALSO SPOKE WITH THE TOWN OF COLCHESTER BOARD MEMBERS. THEY TOO PASSED A COMPLETE STREETS POLICY LAST YEAR.IN 2015, WE EXPANDED THE PROFESSIONALS USING THE PRESCRIPTION TRAIL PROGRAM TO INCLUDE THE DIETITIAN, PHYSICAL THERAPY DEPARTMENT AND THE CARDIAC/PULMONARY REHAB DEPARTMENT.PROMOTE USE OF EVIDENCE-BASED CARE TO MANAGE CHRONIC DISEASES. OBJECTIVES:BY DECEMBER 31, 2017, INCREASE THE PERCENTAGE OF PATIENTS, AGES 18-85 YEARS WHO HAVE CONTROLLED THEIR BLOOD PRESSURE (BELOW 140/90)BY DECEMBER 31, 2017 INCREASE THE PERCENTAGE OF PATIENTS WITH DIABETES WHOSE BLOOD GLUCOSE IS IN GOOD CONTROL (HEMOGLOBIN A1C LESS THAN 9%).UHS IS CURRENTLY WORKING TO PROVIDE UHS DELAWARE VALLEY HOSPITAL WITH BASELINE DATA SO THAT TARGETS CAN BE ESTABLISHED FOR THESE 2 OBJECTIVES. THIS IS A SYSTEM FOCUS THAT IS TIED TO PATIENT CENTERED MEDICAL HOME STATUS.2015 SERVICE REPORT UPDATEFALL PREVENTION WITHIN THIS PRIORITY WE FOCUSED ON FALL PREVENTION. WE HAVE HAD 2 DELAWARE VALLEY HOSPITAL (DVH) STAFF TRAINED TO CONDUCT MATTER OF BALANCE CLASSES THROUGH THE DELAWARE COUNTY OFFICE OF THE AGING (OFA). ONE CLASS, WITH A DVH STAFF MEMBER AND A PUBLIC HEALTH STAFF MEMBER WAS HELD. 10 ENROLLED AND 8 COMPLETED ALL OF THE SESSIONS. THE OFA OFFERS THE CLASSES FOR FREE WITH A DONATIONS WELCOME MODEL. WHEN DVH SPONSORS THE CLASS, WE SUPPLY ALL OF THE MATERIALS, SNACKS AND VENUE FREE OF CHARGE TO THE OFA SO THAT ANY DONATIONS THEY RECEIVE CAN BE UTILIZED FOR OTHER CLASSES ELSEWHERE. DVH NEEDS TO IDENTIFY ADDITIONAL STAFF MEMBERS TO BE TRAINED IN THIS PROGRAM AS ONE OF THE TRAINERS HAS LEFT DVH'S EMPLOY. DVH ALSO LEARNED OF THE OPPORTUNITY TO HAVE VOLUNTEERS FROM DELAWARE COUNTY BECOME TAI CHI LEADERS, THROUGH A PROGRAM IN BROOME COUNTY. DVH BROUGHT THIS TO THE ATTENTION OF OFA AND THEY SENT 3 PEOPLE TO THE TRAINING. ALTHOUGH SENDING A STAFF MEMBER TO THE TRAINING AND HAVING THEM CONDUCT CLASSES IS JUST TOO TIME INTENSIVE FOR OUR LIMITED STAFF RESOURCES, DVH AGREED TO SPONSOR A TAI CHI PROGRAM IN WALTON DURING 2016. EVIDENCE-BASED PROGRAMMING CHRONIC DISEASE SELF MANAGEMENT PROGRAM IN OUR WORK ON CHRONIC DISEASE AND OUR PARTNERSHIPS WITHIN OUR PPS OF THE DSRIP INITIATIVE, WE ALLOTTED MONEY WITHIN OUR VAP GRANT FUNDING TO BE UTILIZED TO OFFER STANFORD UNIVERSITY'S EVIDENCE BASED CHRONIC DISEASE SELF MANAGEMENT PROGRAM'S MASTER TRAINER PROGRAM LOCALLY. WHILE WE HAD PLANNED TO HOLD THE CLASS IN 2015, IT WILL BE HELD IN JUNE OF 2016 SO THAT MORE ORGANIZATIONS WITHIN THE 9 COUNTY PPS CAN PREPARE TO PARTICIPATE. DVH WILL BE SENDING AT LEAST 2 STAFF MEMBERS TO THE CLASS, AS WELL AS 2 MEMBERS OF THE UHS STAY HEALTHY! STAFF. O'CONNOR HOSPITAL PLANS TO SEND PARTICIPANTS ALSO. IN ADDITION, DVH INTENDS TO UTILIZE TELECOMMUNICATION TO HELP PATIENTS HAVE ACCESS TO MORE WELLNESS PROGRAMMING. IT HAS SUBMITTED A GRANT APPLICATION TO THE |
| DELAWARE VALLEY HOSPTITAL | PART V, SECTION B, LINE 13H: FEDERAL POVERTY GUIDELINES (FPG) IS USED TO DETERMINE THE FAMILY INCOME LIMIT FOR FREE CARE ELIGIBILITY OF 200%. THE FPG IS NOT USED TO DETERMINE DISCOUNTED CARE ELIGIBILITY. HOWEVER THE FPG IS USED TO DETERMINE THE PERCENTAGE OF DISCOUNTED CARE A PATIENT WILL RECEIVE. |
| DELAWARE VALLEY HOSPTITAL | PART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY MAXIMUM CHARGE AMOUNT FOR FAP-ELIGIBLE INDIVIDUALS DID NOT EXCEED 65% OF THE HIGHEST VOLUME PAYOR GROSS CHARGE RATE. DURING 2015, THE HIGHEST VOLUME PAYOR WAS EXCELLUS BLUE CROSS & BLUE SHIELD. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - WALTON FAMILY HEALTH CENTER | ||||
| 2 TITUS PLACE | WALTON | NY | 13856 | OUTPATIENT PHYSICIAN CLINIC |
| 2 - DOWNSVILLE FAMILY HEALTH CENTER | ||||
| 28315 STATE HWY 206 | DOWNSVILLE | NY | 13755 | OUTPATIENT PHYSICIAN CLINIC |
| 3 - ROSCOE FAMILY HEALTH CENTER | ||||
| 1982 OLD ROUTE 17 | ROSCOE | NY | 12776 | OUTPATIENT PHYSICIAN CLINIC |
| 4 - PHYSICAL AND OCCUPATIONAL THERAPY | ||||
| 123 STOCKTON AVENUE | WALTON | NY | 13856 | REHABILITATION CLINIC |
| 5 - SPECIALTY CLINIC | ||||
| 121 STOCKTON AVENUE | WALTON | NY | 13856 | OUTPATIENT PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | DELAWARE VALLEY HOSPITAL IS A CRITICAL ACCESS HOSPITAL (CAH) AS DESIGNATED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES. UNLIKE NON-CAH'S THAT ARE REIMBURSED BASED ON A PROSPECTIVE REIMBURSEMENT METHODOLOGY, CAH'S ARE REIMBURSED THEIR ALLOWABLE COSTS FOR MEDICARE PURPOSES. THE MEDICARE COST REPORT (CMS 2552) AND THE MEDICAID INSTITUTIONAL COST REPORT (ICR) WAS UTILIZED FOR PURPOSES OF IDENTIFYING COSTS AND NET REVENUE. A. COSTS:I. FYE COSTS AS INDEPENDENTLY AUDITED. NON-ALLOWABLE COSTS (I.E.-PHYSICIANS, ETC.) ARE USED TO REDUCE COSTS TO ARRIVE AT ALLOWABLE COSTS.II. VARIOUS STATISTICAL BASIS ARE USED TO ALLOCATE GENERAL SERVICE COSTS (I.E.-ADMINISTRATION, PLANT OPERATIONS, HOUSEKEEPING, ETC.), VIA A "STEPDOWN" METHODOLOGY TO REVENUE PRODUCING COST CENTERS SUCH AS ANCILLARY COST CENTERS (I.E. - RADIOLOGY, LAB, PHYSICAL THERAPY, ETC.) ROUTINE COST CENTERS (MEDICAL SURGICAL, ETC.) AND OUTPATIENT COST CENTERS (EMERGENCY, CLINIC, ETC.). III. ROUTINE COSTS PER DAY ARE THEN CALCULATED BY DIVIDING DIRECT AND INDIRECT COSTS (STEPDOWN) BY TOTAL DAYS. THIS PER DAY COST CAN THEN BE MULTIPLIED BY PAYOR SPECIFIC DAYS TO ARRIVE AT ROUTINE PAYOR COSTS.IV. ANCILLARY AND OUTPATIENT COSTS RELATED TO SPECIFIC PAYORS CAN BE DETERMINED BASED ON THE RATIO OF COST TO CHARGES (RCC).1. THE RCC IS CALCULATED BY DIVIDING THE DIRECT AND INDIRECT COSTS (STEPDOWN COSTS)BY GROSS CHARGES. THE RCC CAN THEN BE MULTIPLIED BY PAYOR SPECIFIC GROSS CHARGES TO ARRIVE AT PAYOR SPECIFIC COSTS. B. REVENUE: I. MEDICARE: NET REVENUE IS BASED ON DVH'S ALLOWABLE COSTS (INPATIENT AND OUTPATIENT) AND ARE REIMBURSED WITH A 1% MARKUP. II. MEDICAID: NET REVENUE IS BASED ON THE FOLLOWING:A. INPATIENT - A BASE YEAR COST PER DAY TRENDED ANNUALLY FOR INFLATION.B. OUTPATIENT - MEDICAID PUBLISHED RATES.III. OTHER PAYORS: REVENUE IS BASED ON NEGOTIATED RATES OF PAYMENT. |
| PART I, LN 7 COL(F): | DELAWARE VALLEY HOSPITAL REPORTED BAD DEBT EXPENSE IN THE AMOUNT OF $870,984 IN PART IX, LINE 24A. THE AFOREMENTIONED BAD DEBT EXPENSE WAS NOT USED IN THE CALCULATIONS OF SCHEDULE H, PART 1, LINES 7A THRU 7K. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | DELAWARE VALLEY HOSPITAL PROMOTES THE HEALTH OF THE COMMUNITIES IT SERVES THROUGH ITS MEMBERSHIP AND PARTICIPATION IN THE DELAWARE COUNTY HEALTHCARE ALLIANCE, A COALITION OF HEALTHCARE AND COMMUNITY ORGANIZATIONS THROUGHOUT THE COUNTY. STAFF MEMBERS ALSO SERVE ON THE COMMUNITY COMMITTEE OF THE LOCAL SCHOOL. THE HOSPITAL ALSO HAS REPRESENTATION ON THE COUNTY'S EMERGENCY PREPAREDNESS COMMITTEE (BNICER). WEEKLY NARCOTICS ANONYMOUS MEETINGS ARE HELD AT THE HOSPITAL AND HOSPITAL STAFF PERFORMS DRUG TESTING COLLECTION FOR THE COUNTY'S DRUG COURT FREE OF CHARGE. THE WALTON PRIDE COMMITTEE HAS BEEN WORKING TO REVITALIZE THE COMMUNITY AFTER ITS DEVASTATING FLOOD IN 2006. THE HOSPITAL MADE A DONATION TO HELP THEM BRIGHTEN AND CLEAN A CORNER OF ITS MAIN STREET. IT ALSO SUPPORTED THE COMMUNITY HOLIDAY DINNER, THE TOWN'S LITTLE LEAGUE ORGANIZATION, AND THE WALTON VETS CLUB AUXILIARY BY COLLECTING ITEMS TO BE SENT TO OUR TROOPS. THE HOSPITAL ALSO WORKED WITH THE WALTON CENTRAL SCHOOL STUDENT COUNCIL AS THEY CREATED A HIGHLY IMPACTFUL SET OF VIDEOS DRAMATIZING A CHAIN OF EVENTS LEADING UP TO A DEADLY DWI ACCIDENT. DELAWARE VALLEY ALLOWED STUDENTS TO VIDEOTAPE IN ITS ED AND MANY DVH STAFF PARTICIPATED. THE FINAL VIDEO WAS SHOWN IN AN ASSEMBLY JUST BEFORE PROM NIGHT. DVH HOSTED SEVERAL PUBLIC EDUCATIONAL SESSIONS PRESENTED BY THE ALZHEIMER'S ASSOCIATION. THE HOSPITAL GROUNDS ARE ALSO HOST TO A FARMER'S MARKET FROM JULY THROUGH OCTOBER. THE PRESIDENT/CEO OF DELAWARE VALLEY IS AN ACTIVE MEMBER OF THE WALTON LIONS CLUB.IN 2015, THE WALTON MINISTERIAL ASSOCIATION BEGAN A HUNGER WALK TO RAISE MONEY FOR THE LOCAL FOOD BANK AND CHILDREN'S NUTRITION PROGRAMS. DELAWARE VALLEY WAS A LEADING SPONSOR OF THE EVENT AND STAFF SERVED ON THE PLANNING COMMITTEE. HOWEVER, THE SINGLE LARGEST COMMUNITY BUILDING ACTIVITY DVH ACCOMPLISHED WAS THE CREATION OF OFFICE SPACE FOR THE RURAL HEALTH NETWORK OF SOUTH CENTRAL NY'S OUTREACH STAFF. THE NETWORK'S MAIN OFFICE IS IN WHITNEY POINT, NY, OVER AN HOUR AWAY FROM DELAWARE COUNTY , ONE OF THEIR TARGET AREAS. BY PROVIDING THEM WITH FREE OFFICE SPACE, THEY WILL HAVE A HOME BASE MORE CENTRALLY LOCATED TO THOSE THEY ARE TRYING TO SERVE. THE ORGANIZATION OFFERS MANY NAVIGATION-TYPE PROGRAMS, MOST ESPECIALLY ACCESS TO TRANSPORTATION SERVICES. |
| PART III, LINE 4: | AN ALLOWANCE FOR DOUBTFUL ACCOUNTS RECEIVABLE IS ESTIMATED BY MANAGEMENT BASED ON PERIODIC REVIEWS OF THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE CONSIDERING HISTORICAL EXPERIENCE AND PREVAILING ECONOMIC CONDITIONS. |
| PART III, LINE 8: | BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE HOSPITAL HAS A POLICY TO PROVIDE A COMMUNITY BENEFIT TO UNINSURED PATIENTS THAT CONSISTS OF FEE DISCOUNTS. CERTAIN PATIENTS THAT WERE PROVIDED FEE DISCOUNTS WOULD HAVE LIKELY QUALIFIED UNDER THE CHARITY CARE POLICY. |
| PART III, LINE 9B: | UHS HOSPITALS POLICY CLEARLY STATES THAT THE FORCED SALE OR FORECLOSURE OF A PATIENT'S PRIMARY RESIDENCE, LIQUIDATION OF RETIREMENT ASSETS OR COLLEGE SAVINGS, AND THE SALE OF A CAR USED REGULARLY ARE NOT PERMITTED. THE POLICY ALSO PROHIBITS COLLECTION FROM PATIENTS WHO ARE DETERMINED TO BE ELIGIBLE FOR MEDICAID AT THE TIME OF SERVICE.UHSH REFRAINS FROM SENDING AN ACCOUNT TO COLLECTION AGENCIES IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION AND THE REQUIRED DOCUMENTATION ARE PROVIDED. UHSH PROVIDES WRITTEN NOTICE NO LESS THAN 30 DAYS PRIOR TO REFERRING DEBTS TO COLLECTION AGENCIES AND WILL REFRAIN FROM INITIATING ANY EXTRAORDINARY COLLECTION ACTS FOR AT LEAST 120 DAYS FROM THE DATE OF THE FIRST DISCHARGE BILLING STATEMENT. UHSH ALSO REQUIRES THAT COLLECTION AGENCIES FOLLOW THE FINANCIAL ASSISTANCE POLICY GUIDELINES AND MUST RECEIVE WRITTEN CONSENT FROM UHSH BEFORE COMMENDING LEGAL ACTION. |
| PART VI, LINE 2: | RECRUITMENT OF HEALTHCARE PROFESSIONALS IS ALWAYS A CHALLENGE, ESPECIALLY IN OUR RURAL AREA. DELAWARE VALLEY HOSPITAL (DVH) AND ITS 3 PRIMARY CARE CENTERS MAINTAIN THEIR STANDING AS APPROVED SITES FOR PROFESSIONALS SEEKING ASSISTANCE THROUGH THE NATIONAL HEALTH SERVICE CORPS. THE HOSPITAL ALSO HOSTS BOTH RN AND CNA STUDENTS, FROM OUR LOCAL COLLEGE, (SUNY DELHI) AND BOARD OF COOPERATIVE EDUCATIONAL SERVICES (BOCES). A VERY SUCCESSFUL MASH CAMP IS HELD DURING THE YEAR TO PROVIDE AN OPPORTUNITY FOR HIGH SCHOOL STUDENTS TO LEARN ABOUT HEALTHCARE CAREERS AND ENCOURAGE THEM TO PRACTICE IN OUR RURAL COMMUNITY. IN 2015 STUDENTS ATTENDED OVER A TWO DAY PERIOD. DURING 2015, THE HOSPITAL CONTINUED TO WORK HAND IN HAND WITH THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT AND A MULTITUDE OF COMMUNITY ORGANIZATIONS AND HEALTHCARE PROVIDERS TO ADDRESS NEEDS IDENTIFIED IN THE COMMUNITY HEALTH ASSESSMENT. CONTINUING ON OUR PREVIOUS EFFORTS, BOTH THE VILLAGE OF WALTON AND TOWN OF COLCHESTER ADOPTED COMPLETE STREETS POLICIES. MENTAL HEALTH AND SUBSTANCE ABUSE HAVE BEEN IDENTIFIED IN THE NEEDS ASSESSMENT AS A PRIORITY. IN 2015, MEETINGS CONTINUED WITH ORGANIZATIONS AND ENTITIES THAT ADDRESS MENTAL, EMOTIONAL, AND BEHAVIORAL HEALTH, AS WELL AS SUBSTANCE ABUSE. THE DIRECTOR OF COMMUNITY RELATIONS SITS ON THE MENTAL HEALTH COMMITTEE OF DELAWARE COUNTY. THE MOST CHALLENGING BARRIER TO ACCESS TO CARE IS THE LACK OF PROVIDERS TO CARE FOR THESE PATIENTS. DELAWARE VALLEY HIRED THE TELEMEDICINE CONSULTANT AND THROUGH HIS ASSISTANCE, AND THE FORMATION OF AN INTER-DISCIPLINARY TEAM , THE HOSPITAL NOW HAS ITS POLICIES AND PROCEDURES IN PLACE; IDENTIFIED LOCATIONS FOR EQUIPMENT; ASSESSED VARIOUS VENDORS TO PROVIDE SERVICES AND WILL BE RECEIVING EQUIPMENT, AS A LOAN, FROM BINGHAMTON UNIVERSITY, THROUGH ONE OF THEIR PROGRAMS. THE HOSPITAL IS CURRENTLY WORKING WITH ITS UHS COUNTERPARTS TO IDENTIFY PROFESSIONALS TO PROVIDE CARE. THE HOSPITAL ALSO PARTICIPATED IN THE UHS PPS FOR THE DSRIP PROGRAM, NOW CALLED CARE COMPASS NETWORK. THE COMMUNITY RELATIONS DIRECTOR SAT ON THE EXECUTIVE COMMITTEE AND WAS ACTIVELY INVOLVED IN THE ORGANIZATION'S EASTERN REGIONAL PERFORMANCE GROUP MEETINGS. CHRONIC DISEASE MANAGEMENT IS ANOTHER IDENTIFIED NEED AND THE DIRECTOR ALSO SAT ON THE TWO PROJECT COMMITTEES TO ADDRESS CARDIOVASCULAR HEALTH AND COPD. THE HOSPITAL IS PLANNING TO SPONSOR A STANFORD UNIVERSITY BASED, CHRONIC DISEASE SELF MANAGEMENT MASTER TRAINER TRAINING IN 2016. |
| PART VI, LINE 3: | DELAWARE VALLEY HOSPITAL IS COMMITTED TO PROVIDING OUR PATIENTS' THE KNOWLEDGE THAT WE OFFER FINANCIAL ASSISTANCE. EACH PATIENT CARE REGISTRATION AREA HAS SIGNS TELLING THE PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE TO THEM. THERE ARE ALSO BROCHURES REGARDING THE PROGRAM THROUGHOUT THE HOSPITAL'S FACILITIES AND THE INFORMATION IS ALSO POSTED ON THE WEBSITE. IF NEEDED, TRANSLATION SERVICES ARE AVAILABLE. A FINANCIAL ASSISTANCE HELP LINE IS ALSO AVAILABLE AND ADVERTISED ON ALL BILLINGS. IN 2015, THE HOSPITALS FINANCIAL ASSISTANCE POLICY CHANGED TO PROVIDE ALL SELF-PAY PATIENTS AN AUTOMATIC 30% DISCOUNT AT THE TIME OF SERVICE. IF FURTHER ASSISTANCE IS NEEDED, THE PATIENT APPLIES THROUGH THE FINANCIAL ASSISTANCE PROGRAM. DELAWARE VALLEY ALSO OFFERS PATIENTS EASY ACCESS TO A FIDELIS REPRESENTATIVE, BY PROVIDING A SITE FOR THEM TO INTERVIEW AND ENROLL RESIDENTS IN THEIR MEDICAID MANAGED CARE PRODUCT. FIDELIS IS THE ONLY PROVIDER OF THESE SERVICES FOR DELAWARE COUNTY. |
| PART VI, LINE 4: | DELAWARE VALLEY HOSPITAL'S SERVICE AREA IS CENTERED IN DELAWARE COUNTY, WITH 79% OF THE PATIENTS COMING FROM THE WESTERN HALF OF DELAWARE COUNTY, AND ANOTHER 15% FROM NORTHERN SULLIVAN, BROOME, OTSEGO, AND CHENANGO COUNTIES. DVH'S 85% ZIP CODE SERVICE AREA INCLUDES THE COMMUNITIES OF WALTON, DOWNSVILLE, ONEONTA, ROSCOE, HANCOCK, DELHI, EAST BRANCH, SIDNEY, SIDNEY CENTER, BINGHAMTON, UNADILLA, LONG EDDY, AND HAMDEN. DELAWARE COUNTY IS LOCATED ON THE WESTERN EDGE OF THE CATSKILL MOUNTAINS IN RURAL, UPSTATE NEW YORK. ENCOMPASSING 1446.37 SQUARE MILES, ITS SIZE APPROXIMATES THAT OF RHODE ISLAND AND IS THE FOURTH LARGEST OF NEW YORK STATE'S 62 COUNTIES. IN FACT, ITS SIZE IS SO GREAT THAT, SEVEN COUNTIES AND THE STATE OF PENNSYLVANIA BORDER DELAWARE COUNTY. IT ALSO RANKS AS THE SIXTH MOST RURAL COUNTY IN THE STATE WITH JUST 33 PERSONS PER SQUARE MILE. ITS TOPOGRAPHY IS CHARACTERIZED BY WINDING, AND TWISTING, TWO-LANE ROADS THAT TRANSVERSE A MOUNTAINOUS TERRAIN, MAKING TRAVEL CHALLENGING, ESPECIALLY DURING THE WINTER MONTHS. TRANSPORTATION IS AN EXTREMELY CHALLENGING BARRIER TO CARE. THE AREA DOES NOT HAVE PUBLIC TRANSPORTATION AND WHILE RECENTLY A COUPLE OF PRIVATE TRANSPORTATION SERVICES HAVE BEGUN, THEY ARE TOO COST PROHIBITIVE FOR MANY TO ACCESS. THE COUNTY IS HOME TO TWO OF THE STATE'S LARGEST RESERVOIRS IN THE NEW YORK CITY WATERSHED, WHICH HAS THE LARGEST UNFILTERED DRINKING WATER SUPPLY IN THE UNITED STATES. APPROXIMATELY 55% OF DELAWARE COUNTY'S POPULATION LIES WITHIN THE WATERSHED. NEW YORK CITY HAS WORKED TO PRESERVE AND SAFEGUARD THE WATERSHED FROM ENVIRONMENTAL DEGRADATION BY MEANS OF RESTRICTIONS AND REGULATIONS ON LAND USE WITHIN AND SURROUNDING THE WATERSHED. THE INITIAL IMPACT OF THE WATERSHED ON DELAWARE COUNTY HAS BEEN TO LIMIT ECONOMIC DEVELOPMENT WHICH PREVENTS EXPANSION OF THE TAX BASE. BECAUSE OF THE ENVIRONMENTAL ECOSYSTEM OF THE WATERSHED, THERE HAVE BEEN STRICT REGULATIONS PERTAINING TO AGRICULTURAL POLLUTION AND BUILDING CONSTRUCTION. LIMITING INFRASTRUCTURE GROWTH RESULTS IN DECREASED EMPLOYMENT OPPORTUNITIES. THESE UNIQUE CIRCUMSTANCES RESULT IN HEALTH CARE RELATED CHALLENGES FOR THE COUNTY RESIDENTS. THESE LIMITATIONS ALSO IMPACT THE LOCAL HEALTH AND SOCIAL SERVICE AGENCIES AND ORGANIZATIONS AND THE DELIVERY OF CARE AND SERVICES.THESE LIMITATIONS HAVE CAUSED RESIDENTS TO SEEK ALTERNATIVES TO STIMULATE ECONOMIC GROWTH. DELAWARE COUNTY FARMERS HAVE STARTED SPECIALTY INDUSTRIES. THIS IS REFLECTED IN THE INCREASED NUMBER OF SPECIALTY FARMS. OTHER ECONOMIC DEVELOPMENTS ARE TAKING THE FORM OF TOURISM (E.G. BED AND BREAKFAST), RECREATIONAL FACILITIES COMPATIBLE WITH THE ENVIRONMENT (E.G. GOLF, SKIING, HIKING, HUNTING AND FISHING), LOW POLLUTION FARMING, AND PROFESSIONAL/BUSINESS SERVICES COMPANIES.THE MEDIAN AGE IN DELAWARE COUNTY IS 45.4 YEARS, WHILE 35% ARE AGE 55 AND OVER, AND 20% OF THOSE ARE 65 YEARS AND OVER. 95.6% OF THE POPULATIONS ARE WHITE, SO THERE IS LITTLE ETHNIC DISPARITY. THE MEDIAN FAMILY INCOME IS $ 44,470 AND APPROXIMATELY 14% OF THE POPULATION LIVES IN POVERTY. ACCORDING TO THE 2009-2011 AMERICAN COMMUNITY SURVEY BY THE U.S. CENSUS BUREAU THE PERCENTAGE OF RELATED CHILDREN LIVING BELOW THE POVERTY LEVEL WITH A FEMALE HEAD OF HOUSEHOLD, NO HUSBAND PRESENT HAS RISEN TO 66.7% FOR CHILDREN UNDER 5 YEARS OF AGE IN DELAWARE COUNTY. THIS IS WELL ABOVE NEW YORK AND UNITED STATES COMPARISONS OF 42.8% AND 47% RESPECTIVELY. |
| PART VI, LINE 5: | DELAWARE VALLEY HOSPITAL, A CRITICAL ACCESS HOSPITAL, PROMOTES COMMUNITY HEALTH THROUGH ITS ONGOING EFFORTS TO PROVIDE THOSE SERVICES MOST OFTEN UTILIZED BY THOSE IT SERVES. ITS INPATIENT SERVICES INCLUDE ACUTE CARE FOR THOSE PATIENTS REQUIRING 96 HOURS OR LESS OF HOSPITALIZATION; LONGER TERM REHABILITATIVE CARE FOR THOSE NEEDING TIME TO GAIN STRENGTH OR STAMINA AFTER A DEBILITATING ILLNESS OR INJURY OR A SURGICAL PROCEDURE; AND INPATIENT ADDICTION TREATMENT. THE HOSPITAL ALSO PROVIDES 24 HOUR EMERGENCY CARE. DIAGNOSTIC AND TREATMENT SERVICES INCLUDE LABORATORY, CARDIOPULMONARY AND IMAGING SERVICES. THE HOSPITAL HAS THE CAPABILITY OF PERFORMING PULMONARY FUNCTION TESTING, EKGS, CARDIAC STRESS TESTING, AND PLACING HOLTER AND EVENT MONITORS, AS WELL AS HOME SLEEP STUDY EQUIPMENT. IN THE IMAGING CENTER X-RAY, FLUOROSCOPY, MAMMOGRAPHY, BONE DENSITOMETRY, ULTRASOUND, ECHOCARDIOGRAMS AND CT SCANS ARE PERFORMED. A MOBILE MRI SERVICE IS AVAILABLE TWICE WEEKLY. ITS OUTPATIENT REHABILITATION DEPARTMENT OFFERS PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY, AND A CARDIOPULMONARY REHABILITATION PROGRAM IS ALSO IN PLACE. THROUGH ITS THREE PRIMARY CARE OFFICES LOCATED IN WALTON, DOWNSVILLE AND ROSCOE, NY PATIENTS OF ALL AGES CAN RECEIVE ACUTE AND PREVENTIVE CARE. OCCUPATIONAL HEALTH SERVICES INCLUDE PRE-EMPLOYMENT AND DOT PHYSICALS, IMMUNIZATIONS, DRUG TESTING AND ANNUAL PHYSICALS FOR FIRE DEPARTMENT MEMBERS. VISITING SPECIALISTS INCLUDE A GENERAL SURGEON, CARDIOLOGIST AND PODIATRIST.DURING 2015, THE COMMUNITY RELATIONS DIRECTOR MET WITH THE STAFF OF THE UHS STAY HEALTHY AND NURSE DIRECT DEPARTMENTS, AS WELL AS THE NEW UHS CARDIAC NAVIGATOR TO PROVIDE THEM WITH INFORMATION ABOUT SERVICES AVAILABLE TO PATIENTS IN OUR AREA. OUT OF THIS MEETING THE BARIATRICS COUNSELOR DECIDED TO PRESENT A SEMINAR FOR DVH AREA RESIDENTS IN WALTON. DELAWARE VALLEY HOSPITAL'S CERTIFIED DIETICIAN/NUTRITIONIST HELD A LIFESTEPS CLASS WHICH FOCUSES ON PARTICIPANTS' LIFESTYLES AS IT RELATES TO DIET AND EXERCISE. 7 PEOPLE PARTICIPATED. THE HOSPITAL CONTINUED ITS ANNUAL PRESENCE AT THE WEEK-LONG DELAWARE COUNTY FAIR. DURING THE WEEK, THE HOSPITAL STAFF PROVIDED LOTS OF HEALTH AND NUTRITION INFORMATION TO FAIRGOERS, PERFORMING AT LEAST 384 BLOOD PRESSURE CHECKS; 155 PULSE OX (HEART RATE AND OXYGEN LEVEL TESTS); AND 17 BALANCE SCREENINGS. IN ADDITION, PROPER HANDWASHING WAS A FEATURE OF THE HOSPITAL'S BOOTH. 31 EMPLOYEES SPENT A TOTAL OF 189 HOURS AT THE 6 DAY LONG EVENT. IN AN EFFORT TO ASSIST THE LOCAL COOPERATIVE EXTENSION WITH THE PROMOTION OF HEALTHY EATING AND EATING FRESH, LOCAL FARM PRODUCTS THE HOSPITAL AGREED TO CONTINUE TO HOST A FARMER'S MARKET ON 8 WEDNESDAYS DURING THE SUMMER. THIS IS DOUBLE THE TIME THAT THEY WERE HELD LAST YEAR; REFLECTING THEIR POPULARITY. FALL PREVENTION IS A CONCERN FOR EVERYONE AS THE POPULATION AGES. DELAWARE VALLEY HOSPITAL HELD ITS SECOND, EIGHT WEEK MATTER OF BALANCE PROGRAM, WITH 14 PARTICIPANTS BEGINNING THE CLASS AND 11 RECEIVING COMPLETION CERTIFICATES. WHEN DVH STAFF HEARD OF A TAI CHI TRAINING BEING PRESENTED IN OUR AREA, STAFF RECRUITED OTHERS FROM OTHER ORGANIZATIONS TO TAKE THE TRAINING. SEVERAL DID AND BEGINNING IN 2016, CLASSES WILL BE HELD.BECAUSE TWO LOCAL COMMUNITIES HAD NO PHARMACY AND TRAVEL CAN BE DIFFICULT, THE HOSPITAL CONTINUED TO OFFER ITS FREE PRESCRIPTION DELIVERY PROGRAM TO RESIDENTS IN THE DOWNSVILLE AND ROSCOE AREA. IN 2015, 17 PATIENTS WERE SERVED, RECEIVING 143 PRESCRIPTIONS THROUGH THE SERVICE. THE ROSCOE COMMUNITY DID GET THEIR OWN PHARMACY DURING THE YEAR, REDUCING THE NEED TO CONTINUE THE SERVICE FOR THOSE COMMUNITY MEMBERS. IN ORDER TO ADDRESS A LONG-STANDING REQUEST BY MEMBERS OF THE COMMUNITY, THE HOSPITAL OPENED ITS RETAIL COMMUNITY PHARMACY IN OCTOBER. THE HOSPITAL OFFERS A FREE MAIL SERVICE FOR THOSE WHO ARE UNABLE TO COME TO THE PHARMACY TO PICK UP THEIR PRESCRIPTIONS.STAFF PARTICIPATED IN THE AMERICAN HEART ASSOCIATION'S GO RED FOR WOMEN EVENT AND HEART WALK; A LOCAL TOY DRIVE FOR CHILDREN; COMMUNITY FIT DAYS IN DELHI; AND THE DELAWARE COUNTY SENIOR PICNIC, WHERE MEDICATION SAFETY WAS A HIGHLIGHT. |
| PART VI, LINE 6: | DELAWARE VALLEY HOSPITAL, INC. IS AN IMPORTANT PART OF A LARGER SYSTEM OF INTEGRATED DELIVERY OF CARE, WHICH PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY. AS A RESULT OF THE FORMATION OF UHS IN 1981 AND THE SUBSEQUENT TRANSFORMATION OF THE COMBINED ORGANIZATION INTO A HEALTH CARE SYSTEM, OUR REGION TODAY OFFERS MORE COMPLETE AND ADVANCED CARE THAN MANY COMMUNITIES FIVE TIMES OUR SIZE. IN 2010, THE UNITED HEALTH SERVICES SYSTEM ENGAGED IN A STRATEGIC PLANNING PROCESS FOR THE YEARS 2010-2014. CONSISTENT WITH THE MISSION AND VISION, THE PLAN FOCUSED ON CONTINUING TO STRENGTHEN THE HEALTH SYSTEM AND ITS SERVICES TO THE REGION. THE STRATEGIC PLAN IS ORGANIZED AROUND FOUR OBJECTIVES: CLINICAL EXCELLENCE, SERVICE EXCELLENCE, MARKET GROWTH AND FINANCIAL STRENGTH. SPECIFIC DESTINATION METRICS OR MEASURES OF SUCCESS WERE DEVELOPED FOR EACH STRATEGIC OBJECTIVE. THE SPECIFIC INITIATIVES SUPPORTING ACHIEVEMENT OF THE OBJECTIVES ARE REVIEWED ON A REGULAR BASIS. EACH ENTITY CARRIES OUT INITIATIVES LOCALLY AND REGIONALLY. THE UHS COMMUNITY SERVICE REPORT CAPTURES THE BENEFITS SPECIFIC TO UHS WITH THE OTHER AFFILIATES SUBMITTING SEPARATE REPORTS. CLINICAL EXCELLENCE: UHS IS FOCUSED ON BUILDING UPON PREVIOUS EFFORTS THAT ESTABLISHED A CONSISTENT SYSTEM-WIDE FOCUS FOR EVALUATING AND ASSURING EXCELLENCE IN THE DELIVERY OF CLINICAL CARE. UHS IS FOCUSED ON THE DEVELOPMENT OF A COMPREHENSIVE OUTPATIENT CARE MODEL; IMPLEMENTATION OF SOARIAN CLINICAL SYSTEMS TO SUPPORT SERVICE QUALITY AND EXCELLENCE; IMPLEMENTATION OF A MULTI-YEAR PROVIDER RECRUITMENT AND RETENTION STRATEGY; ORGANIZE UHS PROVIDERS TO ACCOMMODATE FUTURE PAYMENT METHODOLOGIES; ALONG WITH THE DEVELOPMENT OF A TALENT MANAGEMENT INITIATIVE TO REALIZE THE LONG TERM STRATEGY FOR A SUSTAINABLE WORKFORCE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR MICHAEL FREEMAN | ||||||||||||||
| MEDICAL STAFF PRESIDENT | $248,091 | $0 | $0 | $0 | $0 | $0 | $14,141 | $0 | $22,425 | $0 | $284,657 | $0 | $0 | $0 |
| JOHN CARRIGG | ||||||||||||||
| 2ND VICE CHAIR | $0 | $451,780 | $0 | $72,630 | $0 | $0 | $0 | $16,165 | $0 | $17,264 | $0 | $557,839 | $0 | $0 |
| PAUL SUMMERS | ||||||||||||||
| DIRECTOR/CEO | $174,968 | $0 | $17,815 | $0 | $0 | $0 | $7,658 | $0 | $8,974 | $0 | $209,415 | $0 | $0 | $0 |
| DR RAJESH DAVE | ||||||||||||||
| FORMER 2ND VICE CHAIR | $0 | $506,732 | $0 | $81,489 | $0 | $10,750 | $0 | $16,165 | $0 | $17,419 | $0 | $632,555 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART VII, SECTION A, LINE 5, UNRELATED PARTY DETAIL: | FormAndLineReferenceDesc |
| Explanation | INDIVIDUAL: MICHAEL FREEMAN, MEDICAL STAFF PRESIDENT COMPENSATION RECEIVED FROM UNRELATED ORGANIZATION: UNITED MEDICAL ASSOCIATES (UMA) COMPENSATION: WAGES 248,091 | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF DELAWARE INDUSTRIAL DEVELOPMENT AGENCY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 161137407 | BondIssuerEIN |
| CUSIP | 245867AA4 | CUSIPNum |
| Bond Issued | 2007-06-29 | BondIssuedDt |
| Issue Price | $5,805,000 | IssuePriceAmt |
| Purpose | CONSTRUCTION OF NEW ER/IMAGING CENTER; REFINANCE HOSPITAL MORTGAGE | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $5,805,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $250,826 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $5,805,000 | CapitalExpendituresAmt |
| Substantial Completion | 2008 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (1) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | Yes (1) | Form8038TFiledInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MICHAEL LAYTON | |||
| BROTHER-IN-LAW OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES | $53,331 | EMPLOYEE WAGES | 0 |
| BONNIE CRAIG | |||
| SISTER OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES | $36,446 | EMPLOYEE WAGES | 0 |
| NANCY VOLLKOMMER | |||
| SISTER-IN-LAW OF VICKI CONKLING, V.P. NURSING ADMIN./CNO | $29,311 | EMPLOYEE WAGES | 0 |
| MILA KATANIC-TUCKER | |||
| STEP DAUGHTER OF EDWARD SNOW, BOARD OF DIRECTORS | $24,168 | EMPLOYEE WAGES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 PREPARATION AND FILING IS THE RESPONSIBILITY OF THE DELAWARE VALLEY HOSPITAL, INC. (DVH) BOARD OF DIRECTORS WHO DELEGATES THE TIMELY AND ACCURATE COMPLETION OF FORM 990 TO MANAGEMENT. THE UHS FINANCE DEPARTMENT PREPARES THE 990 WHICH IS THEN REVIEWED BY THE CORPORATE CFO,INDEPENDENT AUDITORS, AND THE DVH BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | DIRECTORS, OFFICERS AND KEY EMPLOYEES SUBMIT ANNUAL CONFLICT OF INTEREST STATEMENTS WHICH ARE REVIEWED BY THE CEO, BOARD CHAIRMAN AND THE ORGANIZATION'S AUDIT COMMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 15A | PERFORMANCE REVIEW OF PRESIDENT/CEO IS COMPLETED BY BOARD CHAIR AND 2ND VICE CHAIR/UHS, INC. LIAISON ANNUALLY. RESULTS PRESENTED TO EXECUTIVE COMPENSATION COMMITTEE, COMPRISED OF CHAIR, LIAISON, AND THREE OTHER BOARD MEMBERS. THE COMMITTEE USES SULLIVAN-COTTER, A PAID CONSULTING FIRM, TO OBTAIN NATIONAL CEO COMPENSATION DATA BY HOSPITAL TYPE, SIZE, ETC. AS BASIS FOR ESTABLISHING ACCEPTABLE RANGE OF COMPENSATION TO ENSURE COMPLIANCE WITH TREASURY REGULATION 53.4958-1(D)(4)(3). THE COMMITTEE THEN DETERMINES AND APPROVES THE PRESIDENT/CEO COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION PROVIDES FORM 990 AND OTHER INFORMATION REQUIRED UNDER INTERNAL REVENUE SERVICE REGULATIONS TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN SERVICES FEES: PROGRAM SERVICE EXPENSES 4,531,153. MANAGEMENT AND GENERAL EXPENSES 538,722. FUNDRAISING EXPENSES 87,620. TOTAL EXPENSES 5,157,495. |
| FORM 990, PART XI, LINE 9: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 22,307. |
| FORM 990, PART XII, LINE 2C | NO CHANGE FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| UNITED HEALTH SERVICES HOSPITALS INC | ||||||||||
| 10-42 MITCHELL AVENUE | BINGHAMTON | NY | 13903 | 161165049 | HOSPITAL | NY | 501(C)(3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| PROFESSIONAL HOME CARE | ||||||||||
| 601 RIVERSIDE DRIVE | JOHNSON CITY | NY | 13790 | 161261977 | HOME HEALTH CARE | NY | 501(C)(3) | 9 | UNITED HEALTH SERVICES INC | 0 |
| IDEAL SENIOR LIVING CENTER | ||||||||||
| 508 HIGH STREET | ENDICOTT | NY | 13760 | 222902896 | SENIOR LIVING CENTER | NY | 501(C)(3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| IDEAL SENIOR LIVING CENTER HOUSING | ||||||||||
| 508 HIGH STREET | ENDICOTT | NY | 13760 | 222902899 | SENIOR HOUSING | NY | 501(C)(3) | 9 | UNITED HEALTH SERVICES INC | 0 |
| CHENANGO MEMORIAL HOSPITAL | ||||||||||
| 179 NORTH BROAD STREET | NORWICH | NY | 13815 | 150532180 | HOSPITAL | NY | 501(C)(3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| UNITED HEALTH SERVICES INC | ||||||||||
| 20-40 MITCHELL AVENUE | BINGHAMTON | NY | 13903 | 222682421 | PARENT COMPANY | NY | 501(C)(3) | 9 | UNITED HEALTH SERVICES INC BOARD OF DIRECTORS | 0 |
| TWIN TIER HOME HEALTH INC | ||||||||||
| 601 RIVERSIDE DRIVE | JOHNSON CITY | NY | 13790 | 222438211 | HOME HEALTH CARE | NY | 501(C)(3) | 7 | UNITED HEALTH SERVICES INC | 0 |
| PROJECT HEAR INC | ||||||||||
| 601 RIVERSIDE DRIVE | JOHNSON CITY | NY | 13790 | 161462675 | HOME EMERGENCY ALARM SYSTEM | NY | 501(C)(3) | 9 | TWIN TIER HOME HEALTH INC | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | Yes (1) | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
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