ALICE HYDE MEDICAL CENTER: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ALICE HYDE MEDICAL CENTER (EIN 15-0346515)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-10-20
- IRS object ID
- 201612949349300626
- 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 G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-10-20T12:46:21-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 454051133 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREED MAXICK CPAS PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 424 MAIN STREET SUITE 800 | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 142023508 | 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 | 150346515 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALICE HYDE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ALIC | BusinessNameControlTxt |
| Phone | 5184833000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOUGLAS DIVELLO | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 5184833000 | PhoneNum |
| Signature | 2016-09-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARY MADONIA | PreparerPersonNm |
| PTIN | P00405803 | PTIN |
| Phone | 7168472651 | PhoneNum |
| Preparation | 2016-09-26 | PreparationDt |
| 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 | DOUGLAS DIVELLO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $90,768,342 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ALICEHYDE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE THE COMMUNITY THROUGH ACUTE, LONG TERM AND PRIMARY HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 981 | TotalEmployeeCnt |
| Total Volunteers | 49 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,687,803 | PYContributionsGrantsAmt |
| CY Contributions Grants | $409,448 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $69,646,523 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $81,694,870 | CYProgramServiceRevenueAmt |
| PY Investment Income | $881,748 | PYInvestmentIncomeAmt |
| CY Investment Income | -$9,778 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$126,010 | PYOtherRevenueAmt |
| CY Other Revenue | $7,735 | CYOtherRevenueAmt |
| PY Total Revenue | $72,090,064 | PYTotalRevenueAmt |
| CY Total Revenue | $82,102,275 | 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 | $43,087,518 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,740,595 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $81,320 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,470,517 | PYOtherExpensesAmt |
| CY Other Expenses | $32,767,556 | CYOtherExpensesAmt |
| PY Total Expenses | $71,558,035 | PYTotalExpensesAmt |
| CY Total Expenses | $82,508,151 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $532,029 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$405,876 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $73,050,537 | TotalAssetsBOYAmt |
| Total Assets EOY | $68,368,603 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $42,863,341 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $43,584,505 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,187,196 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $24,784,098 | NetAssetsOrFundBalancesEOYAmt |
| Mission | ALICE HYDE MEDICAL CENTER WILL DISTINGUISH ITSELF AS A TRUSTED AND RESPECTED HEALTH CARE LEADER AND PROVIDER OF CHOICE, EXCEEDING EXPECTATIONS THROUGH SERVICE EXCELLENCE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $65,209,020 | ExpenseAmt |
| Revenue | $81,694,870 | RevenueAmt |
| Desc | PATIENT CARE, GENERAL MEDICAL/SURGICAL HOSPITAL, PROVIDED INPATIENT SERVICES FOR 2,237 PEOPLE, OUTPATIENT SERVICES FOR 160,633 VISITS, AND PROVIDED 41,009 DAYS OF SKILLED NURSING FACILITY CARE. | Desc |
| Total Program Service Expenses | $65,209,020 | 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 | 0 | 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 | 0 | 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 | Yes (1) | 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 | 0 | 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 | 0 | 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 |
| Employee | 981 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | Yes (1) | 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 | SEAN CURTIN VP OF FINANCE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5184833000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| MORDI REHANY MD | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM BOND REV | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| DANIEL CLARK | |||||||
| CHAIRMAN | 10.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| WAYNE DUSO | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| JERRY GRIFFIN | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| BRYAN J HUGHES | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| DEAN JOHNSTON | |||||||
| TREASURER | 10.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BENSON KELLY MD | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| CRAIG LAVIGNE | |||||||
| SECRETARY | 10.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BRIAN MONNETTE | |||||||
| VICE-CHAIRMAN | 10.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| PAUL KOEHLER | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| SHARON NOREAULT | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN HART | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| DOUG DIVELLO | |||||||
| PRESIDENT/CEO | 50.00 | $311,533 | $0 | $10,757 | Yes (X) | ||
| WILLIAM LATREILLE MD | |||||||
| CHIEF MEDICAL OFFICER | 50.00 | $331,450 | $0 | $15,570 | Yes (X) | ||
| SEAN CURTIN | |||||||
| VP OF FINANCE | 50.00 | $193,522 | $0 | $5,961 | Yes (X) | ||
| DRAGOS MACELARU MD | |||||||
| PHYSICIAN | 40.00 | $733,058 | $0 | $10,020 | Yes (X) | ||
| RAHUL GUPTA MD | |||||||
| PHYSICIAN | 40.00 | $443,764 | $0 | $8,550 | Yes (X) | ||
| ELEMER RAFFAI MD | |||||||
| PHYSICIAN | 40.00 | $787,538 | $0 | $6,092 | Yes (X) | ||
| RAYFORD PETROSKI MD | |||||||
| PHYSICIAN | 40.00 | $541,319 | $0 | $9,196 | Yes (X) | ||
| NIKALESH REDDY MD | |||||||
| PHYSICIAN | 40.00 | $398,042 | $0 | $8,550 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,740,226 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $74,696 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 49 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDICAL SVCS SUFFOLK COUNTY | |||||
| PO BOX 27701 | ATLANTA | GA | 30384 | EMERGENCY MEDICINE | $1,552,151 |
| APOGEE | |||||
| 2525 E CAMELBACK ROAD | PHOENIX | AZ | 85016 | HOSPITALIST PROFESSIONAL | $1,434,606 |
| PC CONSTRUCTION | |||||
| 193 TILLEY DRIVE | SOUTH BURLINGTON | VT | 05403 | CONSTRUCTION SERVICES | $1,088,590 |
| WEATHERBY LOCUMS | |||||
| 6440 MILLROC DRIVE | SALT LAKE CITY | UT | 84121 | LOCUMS SERVICES | $647,545 |
| RLPS II | |||||
| 250 VALLEYBROOK DRIVE | LANCASTER | PA | 17601 | ARCHITECTURAL SERVICES | $126,772 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $67,711 | FundraisingAmt |
| Government Grants | $226,370 | GovernmentGrantsAmt |
| All Other Contributions | $115,367 | AllOtherContributionsAmt |
| Total Contributions | $409,448 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT CARE | Desc |
| Business | 622000 | BusinessCd |
| Total Revenue Column | $81,694,870 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $81,694,870 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $81,694,870 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $56,570 | TotalRevenueColumnAmt |
| Exclusion | $56,570 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $99,212 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $80,117 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,095 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,095 | TotalRevenueColumnAmt |
| Exclusion | $19,095 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,478,359 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,456,136 | SecuritiesAmt |
| Other | $88,571 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $22,223 | SecuritiesAmt |
| Other | -$88,571 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$66,348 | TotalRevenueColumnAmt |
| Exclusion | -$66,348 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $29,883 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $67,711 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $41,243 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$11,360 | TotalRevenueColumnAmt |
| Exclusion | -$11,360 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $82,102,275 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $81,694,870 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$2,043 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $836,505 | TotalAmt |
| Management And General | $836,505 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,721,516 | TotalAmt |
| Program Services | $32,935,470 | ProgramServicesAmt |
| Management And General | $6,743,480 | ManagementAndGeneralAmt |
| Fundraising | $42,566 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,260,731 | TotalAmt |
| Program Services | $1,090,222 | ProgramServicesAmt |
| Management And General | $170,509 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,380,067 | TotalAmt |
| Program Services | $4,519,257 | ProgramServicesAmt |
| Management And General | $860,810 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,541,776 | TotalAmt |
| Program Services | $2,132,115 | ProgramServicesAmt |
| Management And General | $406,674 | ManagementAndGeneralAmt |
| Fundraising | $2,987 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,831 | TotalAmt |
| Management And General | $307,831 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $202,681 | TotalAmt |
| Management And General | $202,681 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,106 | TotalAmt |
| Management And General | $58,106 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,171,664 | TotalAmt |
| Program Services | $1,824,198 | ProgramServicesAmt |
| Management And General | $347,466 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,020 | TotalAmt |
| Program Services | $98,313 | ProgramServicesAmt |
| Management And General | $11,591 | ManagementAndGeneralAmt |
| Fundraising | $1,116 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,911 | TotalAmt |
| Program Services | $312,195 | ProgramServicesAmt |
| Management And General | $58,716 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,595,633 | TotalAmt |
| Program Services | $1,372,513 | ProgramServicesAmt |
| Management And General | $223,120 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,687 | TotalAmt |
| Program Services | $157,761 | ProgramServicesAmt |
| Management And General | $33,786 | ManagementAndGeneralAmt |
| Fundraising | $140 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,285 | TotalAmt |
| Management And General | $120,285 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,162,607 | TotalAmt |
| Management And General | $4,162,607 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $774,011 | TotalAmt |
| Management And General | $774,011 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| DIRECT EXPENSES | $12,502,626 | $10,568,482 | $1,899,633 | $34,511 |
| PHARMACEUTICALS | $4,212,416 | $4,212,416 | ||
| MEDICAL SUPPLIES & IMPL | $3,947,452 | $3,947,452 | ||
| UTILITIES | $1,143,359 | $1,143,359 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $895,267 | TotalAmt |
| Program Services | $895,267 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,508,151 | TotalAmt |
| Program Services | $65,209,020 | ProgramServicesAmt |
| Management And General | $17,217,811 | ManagementAndGeneralAmt |
| Fundraising | $81,320 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,376,728 | BOYAmt |
| EOY | $1,372,608 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,198,732 | BOYAmt |
| EOY | $9,777,916 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $670,217 | BOYAmt |
| EOY | $1,129,394 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $763,246 | BOYAmt |
| EOY | $716,162 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,215,427 | BOYAmt |
| EOY | $1,876,305 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $98,800,262 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $49,934,256 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,918,313 | BOYAmt |
| EOY | $48,866,006 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,577,258 | BOYAmt |
| EOY | $127,845 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,330,616 | BOYAmt |
| EOY | $2,527,762 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,974,605 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,050,537 | BOYAmt |
| EOY | $68,368,603 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,860,220 | BOYAmt |
| EOY | $14,841,664 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,152,869 | BOYAmt |
| EOY | $26,057,459 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $816,692 | BOYAmt |
| EOY | $1,201,822 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,033,560 | BOYAmt |
| EOY | $1,483,560 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,863,341 | BOYAmt |
| EOY | $43,584,505 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,003,250 | BOYAmt |
| EOY | $24,600,152 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $183,946 | BOYAmt |
| EOY | $183,946 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,187,196 | BOYAmt |
| EOY | $24,784,098 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,050,537 | BOYAmt |
| EOY | $68,368,603 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$405,876 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$118,165 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$4,879,057 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 | $58,106 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $58,106 | 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 | THE ORGANIZATION RETAINS AN OUTSIDE LOBBYIST FOR CONTACT WITH STATE AND FEDERAL ELECTED OFFICIALS REGARDING HEALTH CARE ISSUES AND GRANT FUNDING OPPORTUNITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $183,946 | BeginningYearBalanceAmt |
| End Year Balance | $183,946 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $183,946 | BeginningYearBalanceAmt |
| End Year Balance | $183,946 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $183,946 | BeginningYearBalanceAmt |
| End Year Balance | $183,946 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $183,946 | BeginningYearBalanceAmt |
| End Year Balance | $183,946 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $183,946 | BeginningYearBalanceAmt |
| End Year Balance | $183,946 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $364,054 | OtherCostOrOtherBasisAmt |
| Book Value | $364,054 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $62,461,467 | OtherCostOrOtherBasisAmt |
| Depreciation | $44,814,505 | DepreciationAmt |
| Book Value | $17,646,962 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,831,050 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,119,751 | DepreciationAmt |
| Book Value | $30,711,299 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $143,691 | OtherCostOrOtherBasisAmt |
| Book Value | $143,691 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $48,866,006 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LINE OF CREDIT | Desc |
| Amt | $1,483,560 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,483,560 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $82,025,355 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$118,165 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $41,245 | OtherRevenueAmt |
| Revenue Not Reported | -$76,920 | RevenueNotReportedAmt |
| Revenue Subtotal | $82,102,275 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $82,102,275 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $87,428,453 | TotExpnsEtcAuditedFinclStmtAmt |
| Prior Year Adjustments | $4,879,057 | PriorYearAdjustmentsAmt |
| Other Expenses Included | $41,245 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $4,920,302 | ExpensesNotReportedAmt |
| Expenses Subtotal | $82,508,151 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $82,508,151 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE MEDICAL CENTER IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE), AND ACCORDINGLY, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE MEDICAL CENTER ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH U.S. GAAP, WHICH REQUIRES THE RECOGNITION AND MEASUREMENT OF UNCERTAIN INCOME TAX POSITIONS THAT THE MEDICAL CENTER HAS TAKEN OR EXPECTS TO TAKE IN THE MEDICAL CENTER'S TAX FILINGS. THE MEDICAL CENTER HAS NOT RECORDED ANY AMOUNTS RELATING TO UNCERTAIN TAX POSITIONS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES NETTED AGAINST REVENUE 41,245. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES NETTED AGAINST REVENUE 41,245. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA | Event1Nm |
| Gross Receipts Event1 | $38,781 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $34,281 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $4,500 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $1,829 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $8,008 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $61 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $4,625 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF BENEFIT | Event2Nm |
| Gross Receipts Event2 | $29,926 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $22,171 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $7,755 | GrossRevenueEvent2Amt |
| Non Cash Prizes Event2 | $75 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $4,179 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $3,033 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $1,805 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $28,887 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $11,259 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $17,628 | GrossRevenueOtherEventsAmt |
| Entertainment Other Events | $2,351 | EntertainmentOtherEventsAmt |
| Oth Direct Expnss Other Events | $15,277 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $97,594 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $67,711 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $29,883 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $75 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $6,008 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $11,041 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $2,412 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $21,707 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $41,243 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$11,360 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,659,650 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,286,170 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $373,480 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00450 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,772,439 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,138,739 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,633,700 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12890 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,432,089 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,424,909 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,007,180 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13340 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $67,735 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $67,735 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $67,735 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $67,735 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,499,824 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,424,909 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,074,915 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.13420 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,242,020 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $896,808 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $16,497,024 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $17,892,651 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,395,627 | 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 | ALICE HYDE MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | ALICEHYDE.COM | WebsiteAddressTxt |
| State License | 1624000H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALICE HYDE MEDICAL CENTER | 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 | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.ALICEHYDE.COM | 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 | WWW.ALICEHYDE.COM | 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 | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 | WWW.ALICEHYDE.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.ALICEHYDE.COM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.ALICEHYDE.COM | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Legal Judicial Process | Yes (X) | PermitLegalJudicialProcessInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Engaged Legal Judicial Process | Yes (X) | EngagedLegalJudicialProcessInd |
| 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 |
| Lowest Negotiated Rates | Yes (X) | LowestNegotiatedRatesInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ALICE HYDE MEDICAL CENTER | PART V, SECTION B, LINE 5: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL RECEIVED INPUT FROM:JOSY DELANEY - ALICE HYDE COMMUNITY WELLNESSADIRONDACK MEDICAL HOME/PEDIATRIC OBESITY INITIATIVEADIRONDACK RURAL HEALTHCARE NETWORKADIRONDACK TOBACCO FREE NETWORKBREASTFEEDING COUNCIL OF MALONECANCER SERVICES PROGRAMEASTERN ADIRONDACK HEALTH CARE NETWORKMALONE COMPLETE STREETS PARTNERSHIPNORTH COUNTRY HEALTHCARE PROVIDERSNORTH COUNTRY HEALTHY HEART NETWORK |
| ALICE HYDE MEDICAL CENTER | PART V, SECTION B, LINE 11: ALICE HYDE MEDICAL CENTER'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED "PREVENTING CHRONIC DISEASE" AS THE MOST SIGNIFICANT NEED IN OUR AREA. WITHIN THAT PRIORITY AREA, WE SELECTED TWO FOCUS AREAS AND ASSOCIATED GOALS. OUR FIRST OBJECTIVE WAS TO REDUCE THE PERCENTAGE OF CHILDREN WHO ARE OBESE BY EXPANDING THE ROOF HEALTH CARE AND HEALTH SERVICE PROVIDERS IN OBESITY PREVENTION. TOWARDS THAT OBJECTIVE, WE HAVE IMPLEMENTED THE "LET'S GO! 5210" CAMPAIGN THROUGH THE MEDIA AND THROUGH OUR PEDIATRIC SERVICES. THE INITIATIVE IS DESIGNED TO SUPPORT THE PEDIATRICIAN AND HER STAFF IN TEACHING CHILDREN AND THEIR FAMILIES ABOUT HEALTHY EATING AND PHYSICAL ACTIVITY. WE HAVE ALSO IMPLEMENTED THE "GREAT BEGINNINGS NY: THE FUTURE STARTS WITH BREASTFEEDING" INITIATIVE IN ORDER TO INCREASE THE PERCENTAGE OF INFANTS BORN AT ALICE HYDE MEDICAL CENTER WHO ARE EXCLUSIVELY BREASTFED AT DISCHARGE. OUR SECOND OBJECTIVE WAS TO INCREASE ACCESS TO HIGH QUALITY CHRONIC DISEASE PREVENTION CARE AND MANAGEMENT IN BOTH CLINICAL AND COMMUNITY SETTINGS. TOWARDS THAT OBJECTIVE, WE HAVE WORKED TO INCREASE THE PERCENTAGE OF ADULTS WITH PRE-DIABETES ATTENDING OUR CDC REGISTERED DIABETES PREVENTION PROGRAM. WE HAVE ENCOUNTERED SOME BARRIERS WITH ATTAINING PARTICIPANTS, BUT WE ARE WORKING TO IMPLEMENT A PROVIDER REFERRAL SYSTEM TO HELP OVERCOME THAT BARRIER. WE ALSO OFFER A DIABETES SELF-MANAGEMENT EDUCATION COURSE, WHICH IS CERTIFIED BY THE AMERICAN DIABETES ASSOCIATION. WE HAVE ALSO BEGUN WORK ON OTHER AREAS OF NEED. WE HAVE DEVELOPED A WELL RECEIVED FALLS PREVENTION EXERCISE CLASS, AND ARE LOOKING TO EXPAND THAT INTO A MORE ROBUST FALLS PREVENTION PROGRAM. ANOTHER AREA OF NEED WAS THE PROMOTION OF MENTAL AND BEHAVIORAL HEALTH SERVICES. WE HAVE BEEN FOCUSING ON THE INTEGRATION OF BEHAVIORAL HEALTH INTO OUR PRIMARY CARE SERVICES, AND ARE PARTNERING WITH OTHER LOCAL AGENCIES TOWARD INCREASING ACCESS TO BEHAVIORAL HEALTH SERVICES. SUBSTANCE ABUSE WAS A TOPIC THAT ALSO RANKED HIGHLY IN OUR NEEDS ASSESSMENT. WE HAVE BEGUN WORK WITH ANOTHER COMMUNITY AGENCY THROUGH THE DSRIP PROCESS TO INCREASE ACCESS TO SUBSTANCE ABUSE SERVICES.ONE NEED THAT WAS REVEALED THROUGH THE CHNA, WHICH HAS NOT BEEN AS WELL ADDRESSED IS TOBACCO USE AND SECOND HAND SMOKE EXPOSURE. THIS WAS NOT TAKEN ON AS A TOP PRIORITY BECAUSE COMMUNITY PARTICIPANTS IN THE ASSESSMENT FELT THAT RESOURCES AND STAFF ARE ALREADY IN PLACE TO IMPLEMENT EVIDENCE BASED INTERVENTIONS. THERE ARE CURRENTLY TWO FUNDED PARTNERS WORKING ON THIS ISSUE IN FRANKLIN COUNTY. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - ALICE HYDE NURSING HOME | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | SKILLED NURSING FACILITY | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | UTILIZED IRS WORKSHEETS FOR SCHEDULE H AND RATIO OF COST TO CHARGES. |
| PART I, LN 7 COL(F): | BAD DEBT WAS NOT INCLUDED IN CALCULATIONS IN SCHEDULE H, PART I, LINE 7. |
| PART III, LINE 4: | THE MEDICAL CENTER RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALITY FOR CHARITY CARE, THE MEDICAL CENTER RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). BASED UPON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE MEDICAL CENTER'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. |
| PART III, LINE 8: | THE MEDICARE BENEFICIARIES WHO ALICE HYDE PROVIDES SERVICES TO ARE PART OF OUR COMMUNITY OF MALONE, NEW YORK, AND THEREFORE, SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE SOURCE FOR THE COST METHODOLOGY IS THE 2015 MEDICARE COST REPORT.THE MEDICAL CENTER EXPERIENCED A SHORTFALL IN MEDICARE REVENUE OVER COSTS. DESPITE THIS SHORTFALL, THE MEDICAL CENTER CONTINUES TO PROVIDE QUALITY CARE TO THE COMMUNITY OF MALONE, NEW YORK. |
| PART III, LINE 9B: | THE CENTER PROVIDES CARE TO CLIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CENTER'S POLICY IS NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE THESE AMOUNTS ARE NOT REPORTED IN NET OPERATING REVENUES OR IN PROVISIONS FOR DOUBTFUL ACCOUNTS. THE ESTIMATED COST OF PROVIDING UNCOMPENSATED CARE TO PATIENTS WAS APPROXIMATELY $1,719,253 FOR THE YEAR ENDED DECEMBER 31, 2015 ($1,290,444 - 2014), AS MEASURED UTILIZING A CALCULATED RATIO OF COSTS TO CHARGES. |
| PART III, LINE #2 | OUR BAD DEBT METHODOLOGY IS BASED ON HISTORICAL AMOUNTS WHICH WERE TYPICALLY 3.3% OF NET REVENUE. |
| PART III, LINE #3 | WE USE THE BAD DEBT EXPENSE AND ALLOCATE BASED ON THE ACTUAL WRITE-OFFS. |
| PART VI, LINE 3: | THE ALICE HYDE MEDICAL CENTER (AHMC) BELIEVES THAT FEAR OF A MEDICAL BILL SHOULD NOT PRECLUDE A RESIDENT OF ITS COMMUNITY FROM SEEKING OR OBTAINING ESSENTIAL HEALTH CARE SERVICES. TO HELP THOSE WHO ARE UNINSURED, AHMC PARTNERS WITH VARIOUS ORGANIZATIONS, INCLUDING THE FRANKLIN COUNTY DEPARTMENT OF SOCIAL SERVICES, PUBLIC HEALTH, FIDELIS, AND EXCELLUS, TO ENSURE ACCURATE INFORMATION AND RESOURCES ARE AVAILABLE THROUGHOUT THE COMMUNITY, INCLUDING A FACILITATED ENROLLMENT PROGRAM FOR ITS UNINSURED. THIS PROGRAM ASSISTS THE INDIVIDUAL IN APPLYING FOR STATE SPONSORED HEALTH INSURANCE, INCLUDING MEDICAID AND CHILD HEALTH PLUS. THE GOAL OF THIS INITIATIVE IS TO PROVIDE A CONVENIENT LOCATION FOR PATIENTS AND COMMUNITY MEMBERS TO ACCESS THE PROGRAM AND TO PROVIDE ASSISTANCE IN COMPLETING HEALTH INSURANCE APPLICATIONS. THESE GOALS ARE MET THROUGH A PATERNERSHIP BETWEEN AHMC AND ADIRONDACK HEALTH INSTITUTE. AHMC HAS AN EMPLOYEE DEDICATED TO FINANCIAL COUNSELING AND ASSISTANCE. |
| PART VI, LINE 4: | ALICE HYDE MEDICAL CENTER (AHMC) PRIMARILY SERVES TOWNS, VILLAGES, AND THE NATIVE AMERICAN RESERVATION IN FRANKLIN COUNTY. AHMC'S PRIMARY SERVICE AREA COVERS THE FOLLOWING TOWNS (BY ZIP CODE) - MALONE (12953), NORTH BANGOR (12966), CHATEAUGAY (12920), CONSTABLE (12926), BRUSHTON (12916), MOIRA (12957), BURKE (12917), FORT COVINGTON (12937), HOGANSBURG (13655), SAINT REGIS FALLS (12980), BOMBAY (12914), OWLS HEAD (12969), DICKINSON CENTER (12930). THE SECONDARY SERVICE AREAS SERVED BY AHMC INCLUDE CHURUBUSCO (12923), ELLENBURG CENTER (12934), NORTH LAWERENCE (12967), LYON MOUNTAIN (12955), NICHOLVILLE (12965). IN ADDITION, AHMC PROVIDES SERVICES TO THE INMATE POPULATION FOR THE FRANKLIN COUNTY JAIL AND THE CLINTON, FRANKLIN, UPSTATE, BAREHILL AND ALTONA CORRECTIONAL FACILITIES. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DOUG DIVELLO | ||||||||||||||
| PRESIDENT/CEO | $298,033 | $0 | $13,500 | $0 | $0 | $0 | $7,950 | $0 | $2,807 | $0 | $322,290 | $0 | $0 | $0 |
| WILLIAM LATREILLE MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $331,450 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $7,620 | $0 | $347,020 | $0 | $0 | $0 |
| SEAN CURTIN | ||||||||||||||
| VP OF FINANCE | $191,258 | $0 | $2,264 | $0 | $0 | $0 | $5,674 | $0 | $287 | $0 | $199,483 | $0 | $0 | $0 |
| DRAGOS MACELARU MD | ||||||||||||||
| PHYSICIAN | $533,058 | $0 | $200,000 | $0 | $0 | $0 | $7,950 | $0 | $2,070 | $0 | $743,078 | $0 | $0 | $0 |
| RAHUL GUPTA MD | ||||||||||||||
| PHYSICIAN | $443,764 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $600 | $0 | $452,314 | $0 | $0 | $0 |
| ELEMER RAFFAI MD | ||||||||||||||
| PHYSICIAN | $537,538 | $0 | $250,000 | $0 | $0 | $0 | $5,192 | $0 | $900 | $0 | $793,630 | $0 | $0 | $0 |
| RAYFORD PETROSKI MD | ||||||||||||||
| PHYSICIAN | $491,319 | $0 | $50,000 | $0 | $0 | $0 | $7,950 | $0 | $1,246 | $0 | $550,515 | $0 | $0 | $0 |
| NIKALESH REDDY MD | ||||||||||||||
| PHYSICIAN | $398,042 | $0 | $0 | $0 | $0 | $0 | $7,950 | $0 | $600 | $0 | $406,592 | $0 | $0 | $0 |
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 | FRANKLIN COUNTY CIVIC DEVELOPMENT CORP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 800627350 | BondIssuerEIN |
| CUSIP | 35313PAA0 | CUSIPNum |
| Bond Issued | 2013-10-31 | BondIssuedDt |
| Issue Price | $27,375,000 | IssuePriceAmt |
| Purpose | CONSTRUCTION OF 135 BED SKILLED NURSING FACILITY. | 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 | $27,375,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $1,675,004 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $6,213,316 | CapitalExpendituresAmt |
| Unspent | $65,618 | UnspentAmt |
| Substantial Completion | 2015 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | 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 | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | 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 O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BOARD MEMBERS WAYNE DUSO AND BRIAN MONETTE HAVE A FAMILY RELATIONSHIP. BOARD MEMBERS CRAIG LAVIGNE AND BRIAN MONETTE HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY AN INDEPENDENT OUTSIDE ACCOUNTING FIRM. IT IS PROVIDED TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE BOARD OF DIRECTORS. SPECIFICALLY, THE POLICY REQUIRES A DISCLOSURE OF ANY POTENTIAL CONFLICT TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS THEN REFERS THE POTENTIAL CONFLICT TO THE AUDIT AND COMPLIANCE COMMITTEE TO REVIEW THE MATTER. THE AUDIT AND COMPLIANCE COMMITTEE REVIEWS THE PROPOSED TRANSACTION OR ARRANGEMENT TO DETERMINE IF REASONABLE ATLTERNATIVES TO THE PROPOSED TRANSACTION EXIST. BASED ON REVIEW, THE AUDIT AND COMPLIANCE COMMITTEE SHALL APPROVE OR DISAPPROVE THE TRANSACTION. ALL FINDINGS AND ACTIONS TAKEN BY THE AUDIT AND COMPLIANCE COMMITTEE ARE REPORTED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED MEETING OF THE BOARD OF DIRECTORS. IN ADDITION, THE AUDIT AND COMPLIANCE COMMITTEE AND THE ORGANIZATION COMPLIANCE OFFICER IS RESPONSIBLE FOR REVIEWING AND RETAINING ANNUAL DISCLOSURE STATEMENTS COMPLETED BY EACH DIRECTOR, OFFICER, COMMITTEE MEMBER AND KEY EMPLOYEE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION AND BENEFITS OF THE PRESIDENT/CEO ARE REVIEWED ANNUALLY. THE BOARD OF DIRECTORS REVIEWS IN DEPTH THE RECOMMENDATIONS OF THE PRESIDENT/CEO EVALUATION AND COMPENSATION COMMITTEE ("COMPENSATION COMMITTEE") REGARDING THE PRESIDENT/CEO'S COMPENSATION AND BENEFITS. THE PRESIDENT/CEO IS NOT PRESENT AT THIS MEETING OR ANY OTHER MEETING AT WHICH HIS COMPENSATION IS CONSIDERED. AS PART OF ITS REVIEW AND DISCUSSION, THE FULL BOARD OF DIRECTORS DISCUSSES THE DATA PREVIOUSLY REVIEWED BY THE COMPENSATION COMMITTEE. THIS DATA INCLUDES, BUT IS NOT LIMITED TO, COMPARABILITY DATA COMPILED BY YAFFEE AND COMPANY, INC. AS PROVIDED TO AHMC BY THE IROQUOIS HOSPITAL ASSOCIATION. SPECIFICALLY, THE COMPENSATION COMMITTEE REVIEWS THE DATA AND REPORTS THE RESULTS OF THIS REVIEW TO THE BOARD OF DIRECTORS, CONCERNING BASE SALARY AND TOTAL COMPENSATION FOR ALL THE OFFICERS AT FACILITIES LOCATED WITHIN THE RANGE FOR SIMILARY SITUATED OFFICERS. THE COMPENSATION COMMITTEE ALSO REVIEWS DATA COMPILED BY THE IROQUOIS HEALTHCARE ASSOCIATION, ROCHESTER REGIONAL HOSPITAL ASSOCIATION, AND WESTERN NEW YORK HOSPITAL ASSOCIATION RELATED TO COMPARABLE CEO INCENTIVE PLANS, LIFE INSURANCE (BASIC AND SUPPLEMENTAL), LONG TERM DISABILITY PLANS, SUPPLEMENTAL/EXECUTIVE RETIREMENT PLANS, CONTRACT LENGTH INFORMATION, SEVERANCE PAY INFORMATION AND PREREQUISITES SUMMARY. IT IS THEN DETERMINED WHETHER THE PRESIDENT/CEO'S PROPOSED CONTRACT IS REASONABLE AND COMPARABLE IN LIGHT OF THE AFOREMENTIONED INFORMATION. THE PROCESS FOR DETERMINING THE COMPENSATION FOR KEY EMPLOYEES OF THE ORGANIZATION INCLUDES A REVIEW OF EXECUTIVE COMPENSATION SURVEYS. THIS REVIEW IS COMPLETED BY THE HUMAN RESOURCES DIRECTOR AND THE PRESIDENT/CEO. COMPENSATION IS DETERMINED BASED ON THE SPECIFIC RESPONSIBILIES DELEGATED TO THE POSITION HELD BY THE KEY EMPLOYEE. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE COMPLETED FORMS 1023, 990, AND 5500 FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 2C | THERE HAVE BEEN NO CHANGES FROM THE PRIOR YEAR TO THE PROCESS THAT THE ORGANIZATION HAS IN PLACE FOR THE OVERSIGHT OF THE AUDIT OR THE SELECTION OF AN INDEPENDENT ACCOUNTANT. |
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