IRA DAVENPORT MEMORIAL HOSPITAL INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: IRA DAVENPORT MEMORIAL HOSPITAL INC (EIN 16-0835446)
Tax period: 2015-01-01 to 2015-12-31
Filed: 2016-10-06
IRS object ID: 201622809349300832
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 O
Schedule R
Reasonable Cause Explanation

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-10-06T08:16:57-07:00	ReturnTs
Tax Period End	2015-12-31	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	160835446	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	IRA DAVENPORT MEMORIAL HOSPITAL INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	IRAD	BusinessNameControlTxt
Phone	6077768500	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7571 State Route 54	AddressLine1Txt
City	Bath	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14810	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Ronald Kintz	PersonNm
Person Title	CFO	PersonTitleTxt
Phone	6077374325	PhoneNum
Signature	2016-09-01	SignatureDt

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	Ronald J Kintz	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	600 Roe Ave	AddressLine1Txt
City	Elmira	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14905	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$22,835,005	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.arnothealth.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1910	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	IRA DAVENPORT MEMORIAL HOSPITAL IS DEDICATED TO ENHANCING THE QUALITY OF LIFE WITHIN THEIR RURAL COMMUNITY.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	361	TotalEmployeeCnt
Total Volunteers	28	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$269,522	PYContributionsGrantsAmt
CY Contributions Grants	$299,583	CYContributionsGrantsAmt
PY Program Service Revenue	$21,983,133	PYProgramServiceRevenueAmt
CY Program Service Revenue	$21,924,572	CYProgramServiceRevenueAmt
PY Investment Income	$266,655	PYInvestmentIncomeAmt
CY Investment Income	$35,149	CYInvestmentIncomeAmt
PY Other Revenue	$611,554	PYOtherRevenueAmt
CY Other Revenue	$554,581	CYOtherRevenueAmt
PY Total Revenue	$23,130,864	PYTotalRevenueAmt
CY Total Revenue	$22,813,885	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	$12,395,998	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$12,175,241	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$10,762,627	PYOtherExpensesAmt
CY Other Expenses	$11,860,327	CYOtherExpensesAmt
PY Total Expenses	$23,158,625	PYTotalExpensesAmt
CY Total Expenses	$24,035,568	CYTotalExpensesAmt
PY Revenues Less Expenses	-$27,761	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$1,221,683	CYRevenuesLessExpensesAmt
Total Assets BOY	$22,253,572	TotalAssetsBOYAmt
Total Assets EOY	$18,825,598	TotalAssetsEOYAmt
Total Liabilities BOY	$8,023,382	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$5,706,252	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$14,230,190	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$13,119,346	NetAssetsOrFundBalancesEOYAmt
Mission	IRA DAVENPORT MEMORIAL HOSPITAL IS DEDICATED TO ENHANCING THE QUALITY OF LIFE WITHIN THEIR RURAL COMMUNITY BY PROVIDING LOCAL HIGH QUALITY PRIMARY, ACUTE, RESTORATIVE AND RESIDENTIAL HEALTH SERVICES.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$18,076,946	ExpenseAmt
Grant	$299,583	GrantAmt
Revenue	$22,813,888	RevenueAmt
Desc	IRA DAVENPORT PROVIDED BOTH ACUTE CARE AND LONG-TERM CARE SERVICES TO PATIENTS DURING 2015. LONG-TERM CARE DAYS WERE 40,172 AND THE HOSPITAL HAD 604 DISCHARGES. THE FRED AND HARRIETT TAYLOR HEALTH CARE CENTER IS A 120 BED LONG-TERM CARE/SKILLED NURSING FACILITY. THE HEALTH CENTER PROVIDES A COMMUNITY FOR PEOPLE WHO REQUIRE ASSISTANCE WITH DAILY LIVING OR AROUND-THE-CLOCK NURSING SERVICES. THE HEALTH CARE CENTER ALSO PROVIDES DAY CARE SERVICES AND REHABILITATION SERVICES.	Desc
Total Other Prog Srvc Expense	$0	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$0	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$0	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$18,076,946	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	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	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	0	TaxExemptBondsInd
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	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	0	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	361	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
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	Yes (1)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	Yes (1)	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	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
Other Website	Yes (X)	OtherWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	RONALD KINTZ	PersonNm
Phone	6077374325	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	600 Roe Ave	AddressLine1Txt
City	Elmira	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14905	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Patrick J Rogers
Chairman of the Board	2	1.0	Yes (X)	$0	$0	$0
Scott Sprague
Vice Chairman	1	0	Yes (X)	$0	$0	$0
Bernard Burns
Secretary	1	0	Yes (X)	$0	$0	$0
Joseph F Meade
Treasurer	1	0	Yes (X)	$0	$0	$0
Jeffrey Albright
Board Member	1	0	Yes (X)	$0	$0	$0
Patricia Baroody
Board Member	1	0	Yes (X)	$0	$0	$0
Mary Hope Benedict
Board Member	1	0	Yes (X)	$0	$0	$0
Werner Brammer MD
Board Member	1	0	Yes (X)	$0	$0	$0
Mark Hagan
Board Member	1	0	Yes (X)	$0	$0	$0
Bridgette Lanphere
Board Member	1	0	Yes (X)	$0	$0	$0
David Nesbitt
Board Member	1	0	Yes (X)	$0	$0	$0
Dennis O' Connor MD
Medical Director	1	0	Yes (X)	$58,889	$0	$1,757	Yes (X)
Ronald J Kintz
Senior VP/CFO	1.00	49.00		$0	$392,468	$36,827		Yes (X)
Robert Lambert
President Arnot Health	1.00	49.00		$0	$630,621	$36,827		Yes (X)
H Fred Farley
Hospital President COO	1.00	44.00		$0	$394,339	$36,827		Yes (X)
James Watson
President IDMH	40.00	0.00		$0	$227,391	$9,740		Yes (X)	Yes (X)
Kevin Murray
Director of Pharmacy	40	0		$149,642	$0	$12,252			Yes (X)
Vandelinder AmyBeth
DIR LABORATORY SVS	40	0		$100,168	$0	$3,101			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$308,699	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,644,819	TotReportableCompRltdOrgAmt
Total Other Compensation	$137,331	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	6	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	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	Address Line2ContractorAddress/USAddress/AddressLine2Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Delphi Healthcare PLLC
1880 East Ride Road	Suite 6 Upper Level	Rochester	NY	14622	ER Doctor coverage	$745,595
Delphi Hospitalist Services
1880 East Ridge Road	Suite 6 Upper Level	Rochester	NY	14622	Emergency Physicians	$478,553
Kings Medical Group
1920 A Georgetown Road		Hudson	OH	44236	Medical Services	$219,820
Medical Solutions
1010 N 102nd Street Suite 300		Omaha	NE	68114	Contracted RN service	$216,362
Focusone Solutions LLC
13609 California St		Omaha	NE	68154	Contracted Employee	$152,454

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	8	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$0	RelatedOrganizationsAmt
Government Grants	$200,871	GovernmentGrantsAmt
All Other Contributions	$98,712	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$299,583	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Net Patient Service Revenue	622110	$23,722,072	$23,722,072	$0	$0
Bad Debt	622110	-$1,797,500	-$1,797,500	$0	$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$21,924,572	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$35,149	TotalRevenueColumnAmt
Related Or Exempt Func Income	$35,149	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$0	OtherAmt

Field	Value	IRS element (for citing)
Contri Rpt Fundraising Event	$0	ContriRptFundraisingEventAmt
Gross Sales Of Inventory	$102,668	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$21,120	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$81,548	TotalRevenueColumnAmt
Related Or Exempt Func Income	$81,548	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Managements Infromatins Services	900099	$244,286	$244,286	$0	$0
Contracted Therapy	900099	$12,518	$12,518	$0	$0
Miscellaneous	900099	$216,229	$216,229	$0	$0

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$473,033	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$22,813,885	TotalRevenueColumnAmt
Related Or Exempt Func Income	$22,514,302	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$9,916,344	TotalAmt
Program Services	$8,441,286	ProgramServicesAmt
Management And General	$1,475,058	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$186,308	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$186,308	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,339,993	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$1,339,993	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$732,596	TotalAmt
Program Services	$612,783	ProgramServicesAmt
Management And General	$119,813	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$413,385	TotalAmt
Program Services	$263,788	ProgramServicesAmt
Management And General	$149,597	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$27,575	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$27,575	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$5,375	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$5,375	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$4,069	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$4,069	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$2,858	TotalAmt
Program Services	$30	ProgramServicesAmt
Management And General	$2,828	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,810,077	TotalAmt
Program Services	$1,684,048	ProgramServicesAmt
Management And General	$126,029	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$13,548	TotalAmt
Program Services	$12	ProgramServicesAmt
Management And General	$13,536	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$719,038	TotalAmt
Program Services	$506,268	ProgramServicesAmt
Management And General	$212,770	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$179,999	TotalAmt
Program Services	$12,764	ProgramServicesAmt
Management And General	$167,235	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$384,633	TotalAmt
Program Services	$15,235	ProgramServicesAmt
Management And General	$369,398	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$14,723	TotalAmt
Program Services	$2,138	ProgramServicesAmt
Management And General	$12,585	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$3,538	TotalAmt
Program Services	$2,107	ProgramServicesAmt
Management And General	$1,431	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$27,136	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$27,136	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,341,080	TotalAmt
Program Services	$743,651	ProgramServicesAmt
Management And General	$597,429	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$199,980	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$199,980	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Medical/Surgical/Pharmaceutical Supplies	$1,914,217	$1,899,253	$14,964	$0
Maintenance Contracts/Purshased Services	$4,039,565	$1,991,843	$2,047,722	$0
Leases	$89,404	$58,106	$31,298	$0
Benefits Allocations	$0	$1,299,530	-$1,299,530	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$670,127	TotalAmt
Program Services	$544,104	ProgramServicesAmt
Management And General	$126,023	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$24,035,568	TotalAmt
Program Services	$18,076,946	ProgramServicesAmt
Management And General	$5,958,622	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$53,234	BOYAmt
EOY	$43,485	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$534,382	BOYAmt
EOY	$459,463	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$200,000	BOYAmt
EOY	$36,276	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$4,642,449	BOYAmt
EOY	$3,036,129	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$601,796	BOYAmt
EOY	$20,472	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$376,092	BOYAmt
EOY	$384,205	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$110,200	BOYAmt
EOY	$88,871	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$33,109,940	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$21,679,419	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$12,304,080	BOYAmt
EOY	$11,430,521	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$3,431,339	BOYAmt
EOY	$3,326,176	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$22,253,572	BOYAmt
EOY	$18,825,598	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,508,751	BOYAmt
EOY	$1,355,880	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$601,148	BOYAmt
EOY	$468,250	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,913,483	BOYAmt
EOY	$3,882,122	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$8,023,382	BOYAmt
EOY	$5,706,252	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$11,377,456	BOYAmt
EOY	$10,219,268	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,827,122	BOYAmt
EOY	$2,874,467	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$25,612	BOYAmt
EOY	$25,611	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$14,230,190	BOYAmt
EOY	$13,119,346	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$22,253,572	BOYAmt
EOY	$18,825,598	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$1,221,683	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$0	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Investment Expense	$0	InvestmentExpenseAmt
Prior Period Adjustments	$0	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$110,839	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	Yes (1)	AccountantCompileOrReviewInd

Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

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	$4,069	OtherActivitiesAmt
Total Lobbying Expenditures	$4,069	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1	FormAndLineReferenceDesc
Explanation	IDMH pays annual dues to American Hospital Associations, AHA and Healthcare Association of New York State, HANYS of which a percentage is for lobbying fees. The total fees paid to all in 2015 is $4,069	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$194,062	BeginningYearBalanceAmt
Contributions	$133,021	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$85,676	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$241,407	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$407,988	BeginningYearBalanceAmt
Contributions	$134,415	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$348,341	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$194,062	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$536,754	BeginningYearBalanceAmt
Contributions	$118,059	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$246,825	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$407,988	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$335,165	BeginningYearBalanceAmt
Contributions	$499,265	ContributionsAmt
Investment Earnings Or Losses	$2,324	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$300,000	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$536,754	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$25,612	BeginningYearBalanceAmt
Contributions	$309,553	ContributionsAmt
Investment Earnings Or Losses	$0	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$0	AdministrativeExpensesAmt
End Year Balance	$335,165	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.11	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.89	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (1)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (1)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$52,925	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Book Value	$52,925	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$16,717,636	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$7,902,519	DepreciationAmt
Book Value	$8,815,117	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$16,339,379	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$13,776,900	DepreciationAmt
Book Value	$2,562,479	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$11,430,521	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
IDMH Children's Department Fund (children Trust Fund)	$2,120,340
Deprecation Funds	$850,000
Interest in Net Assets of foundation	$355,836

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$3,326,176	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDesc	AmtAmt
Self Insurnace Reserve	$1,413,281
Accrued Pension Cost	$65,429
Accrued Reimbursement Pay Net	$1,172,085
Due to Arnot Health	$1,231,327

Field	Value	IRS element (for citing)
Total Liability	$3,882,122	TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt	$22,835,005	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$0	NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Recoveries Prior Year Grants	$0	RecoveriesPriorYearGrantsAmt
Other Revenue	$21,120	OtherRevenueAmt
Revenue Not Reported	$21,120	RevenueNotReportedAmt
Revenue Subtotal	$22,813,885	RevenueSubtotalAmt
Investment Expenses Not Incld	$0	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	$0	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$22,813,885	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$24,056,688	TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts	$0	DonatedServicesUseFcltsAmt
Prior Year Adjustments	$0	PriorYearAdjustmentsAmt
Losses Reported	$0	LossesReportedAmt
Other Expenses Included	$21,120	OtherExpensesIncludedAmt
Expenses Not Reported	$21,120	ExpensesNotReportedAmt
Expenses Subtotal	$24,035,568	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$0	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$0	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$24,035,568	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule D, Part V, Line 4	The Intended uses for the endowment funds are based upon the designation from the organization documents which include staff educations, community education, and charity care. The board endowment fund is a board designed or use in the highest area of need
Schedule D, Part XI, Line 2d	Nutritional Service Expense of 21,120 reclass to reduce Revenue on Cost of Goods Sold
Schedule D, Part XII, Line 2d	Nutritional services expense of 21,120 offset to nutritional service income

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
Percent150	Yes (X)	Percent150Ind
FPG Reference Discounted Care	Yes (1)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	134	PersonsServedCnt
Total Community Benefit Expns	$70,172	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,995	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$67,177	NetCommunityBenefitExpnsAmt
Total Expense	0.0028	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	9054	PersonsServedCnt
Total Community Benefit Expns	$3,176,294	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,649,849	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,526,445	NetCommunityBenefitExpnsAmt
Total Expense	0.0635	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	9188	PersonsServedCnt
Total Community Benefit Expns	$3,246,466	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,652,844	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,593,622	NetCommunityBenefitExpnsAmt
Total Expense	0.0663	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	23	ActivitiesOrProgramsCnt
Persons Served	2209	PersonsServedCnt
Total Community Benefit Expns	$10,567	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,567	NetCommunityBenefitExpnsAmt
Total Expense	0.0004	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	2	ActivitiesOrProgramsCnt
Persons Served	59	PersonsServedCnt
Total Community Benefit Expns	$206	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$206	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	9	ActivitiesOrProgramsCnt
Persons Served	87626	PersonsServedCnt
Total Community Benefit Expns	$10,190,696	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,730,956	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,459,740	NetCommunityBenefitExpnsAmt
Total Expense	0.0607	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	5	ActivitiesOrProgramsCnt
Persons Served	1720	PersonsServedCnt
Total Community Benefit Expns	$265	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$119	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$146	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	39	ActivitiesOrProgramsCnt
Persons Served	91614	PersonsServedCnt
Total Community Benefit Expns	$10,201,734	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,731,075	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,470,659	NetCommunityBenefitExpnsAmt
Total Expense	0.0611	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	39	ActivitiesOrProgramsCnt
Persons Served	100802	PersonsServedCnt
Total Community Benefit Expns	$13,448,200	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$10,383,919	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,064,281	NetCommunityBenefitExpnsAmt
Total Expense	0.1274	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$151,371	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$151,371	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$151,371	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$151,371	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	0	BadDebtExpenseReportedInd
Bad Debt Expense	$1,797,500	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$1,836,163	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$1,975,420	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$139,257	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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp

Entity Name EntityName

Field	Value	IRS element (for citing)
Business Name Line1	ARNOT OGDEN MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	ADMINISTRATION & CONSULTING	PrimaryActivitiesTxt
Org Profit Or Ownership	0	OrgProfitOrOwnershipPct
Ofcr Etc Profit Or Ownership	0	OfcrEtcProfitOrOwnershipPct
Physicians Profit Or Ownership	0	PhysiciansProfitOrOwnershipPct

Field	Value	IRS element (for citing)
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	IRA DAVENPORT MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	7571 ROUTE 54	AddressLine1Txt
City	BATH	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14810	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.arnothealth.org	WebsiteAddressTxt
Licensed Hospital	Yes (X)	LicensedHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	IRA DAVENPORT MEMORIAL HOSPITAL	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
CHNA Conducted	15	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	www.arnothealth.org	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Rpt Available Thru Other Method	Yes (X)	RptAvailableThruOtherMethodInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	15	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	www.arnothealth.org	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	150	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
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.arnothealth.org	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	www.arnothealth.org	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	www.arnothealth.org	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
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
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 All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (1)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	0	AmountsGenerallyBilledInd
Gross Charges	Yes (1)	GrossChargesInd

Supplemental Information SupplementalInformationGrp (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5-IRA DAVENPORT MEMORIAL HOSPITAL	Arnot Health remains committed to preventing chronic disease in the community through free preventative health screenings, health promotion programs and wellness education. In 2015 Arnot Health participated in over 100 community events and served over 2,500 individuals in Chemung, Steuben and Schuyler Counties. Free health screenings included: blood pressure, blood glucose, diabetes risk assessment, stroke assessments, body fat analysis, body mass index, tobacco use screening, carboxyhemoglobin, and lung age. In addition to community outreach events Arnot Health serves populations at risk for developing chronic disease by offering free monthly health screenings in medically underserved locations such as soup kitchens and senior centers within a medically underserved area. Arnot Health Heart Vascular Institute also offers free weekly blood pressure screenings for the community. Community Health and outreach also includes working with local schools and summer programs to offer highly interactive educational programs on topics such as nutrition, sun safety, physical activity, injury prevention and tobacco use prevention. Arnot Health continues to serve on the Elmira City School District Wellness Committee and collaborated with the school district to develop new wellness policies that included healthier options in vending machines and increased physical activity during class time. Arnot Health continued to inform school officials on important health issues impacting the community and contributed topics for discussion at student forums and interactive community activities. Arnot Health collaborated with health and human service agencies to provide the Graduate Medical Education Residents with community rotations such as Arnot Health HIV Primary Care and Disease Management, Economic Opportunity Program Inc, Head Start Program, Comprehensive Interdisciplinary Developmental Services Inc, Chemung County Home Health Agency and Community Immunization Clinics. Arnot Health's Health Center for Women and the Falck Cancer Center includes working collaboratively with the New York State Cancer Services Program to provide free breast, cervical and colorectal screenings for the un/underinsured. Other cancer prevention strategies include annual skin cancer screenings and a lung cancer screening program for community members with a history of long term tobacco use. Falck Cancer Center offers a wide range of free monthly support groups for cancer survivors in the community. Arnot Health Diabetes Center provides diabetes education, support and management, and served over 350 community members in 2015. Other services provided by the Diabetes Center include insulin pump instruction and nutritional counseling. All diabetes education offered by Arnot Health is provided by Certified Diabetes Educators and is in accordance with the American Diabetes Association Standards of Care. Arnot Health has a leadership role in the multicounty Southern Tier Diabetes Coalition and in the planning and implementation of an annual Diabetes Fair in the fall of each year. In 2015 over 300 community members received diabetes prevention and management education and preventative health screenings. Education and screening opportunities included blood pressure, body fat and blood glucose screenings; foot care education; diabetes risk assessments; nutrition education meal planning and information on diabetes medications and equipment; and information about support groups and chronic disease self management classes. pneumovax and influenza vaccines were also provided. Arnot Health continues to collaborate with preventative health partners in Chemung and Steuben Counties and participates in the promotion and facilitation of evidence based programs such as the Chronic Disease Self Management Program, the Diabetes Self Management Program, and the National Diabetes Prevention Program, and Living Healthy workshops. Lower socioeconomic status is associated with an increased risk of smoking initiation and progression to regular smoking, and a decreased likelihood of successful smoking cessation. Arnot Health is working with local health departments and diverse multicounty partnerships to update the 2013 Community Health Needs Assessment, and engage community members in identifying public health priorities and unmet needs in the community. The process will be completed and an updated Community Health Improvement Plan will be available to the community in December 2016. The following are the obesity prevention strategies implemented and the accomplishments of the CHP partnership over the last five years. Arnot Health and the CHP partnership rehabilitated, maintained and promoted parks and recreation facilities in underserved residential areas to offer safe and accessible opportunities for physical activity for persons of all ages and abilities. CHP partners and the City of Elmira enhanced parks and playgrounds for children to make them safe and accessible in the following locations: McKinnon Park, Grove Park, Millers Pond Park, Eldridge Park, McCanns Park, Blandford Park, Pulaski Park, Quatrano Park, Frank Rhode Park, Woodlawn Playground, and Mark Twain Riverfront Park. CHP partnership worked to improve a seven mile stretch of the Lackawanna Rail Trail by installing a fitness station, solar lights and a informational kiosk with Get Active Elmira maps that were created by the partnership to highlight the 23 parks and playgrounds. Safety assessments of parks and playgrounds were conducted by organizations serving the developmentally disabled populations, seniors and the visually impaired. Other strategies implemented to promote safe access to open spaces for physical activity include installation of visual impact signage at parks, playgrounds, trails and street crossings, installation of video cameras, improved street lighting, installation of cross walks and ADA compliant curb cut outs and tactile ramps and speed reduction with playground warning signs for traffic. To increase access to fresh fruit and vegetables, the CHP partnership created community gardens and enhanced existing vegetable gardens by working with community planning boards, neighborhood associations, schools, persons with disabilities, and senior and low income housing developments. Provided schools and youth community centers with community gardens, installed a tool shed and provided gardening supplies to establish and maintain community gardens in underserved areas, supported the development of a community garden for persons with developmental disabilities and supported the Food Bank of the Southern Tier with fresh fruits and vegetables grown in the community gardens. Community Gardens were established or enhanced in the following locations: Near Westside Victorian Garden, Katy Leary Park, Quatrano Park, and Economic Opportunity Program at Ernie Davis Community Center, Woodlawn Community Garden and the Elmira City School District. Strategies implemented by restaurants and the CHP partnership to prevent obesity and educate the community about healthier eating choices include developing 3 different long running TV ads promoting healthy eating at restaurants, table top displays of eating out health tips for each partnering restaurant and distributed educational materials on healthy food options at community outreach events. Worked with hospital system to adopt Healthy Meeting policy and offer daily Well Being meals in the hospitals cafeterias for employees and the public. Examples of programs offered in 2015 include Community Walking Program, Fit Families of the Southern Tier, Strong Kids Safe Kids, Girls on the Run of the Southern Tier and the Wineglass Marathon. Participants in the free six week Step it Up Community Walking Program receive pre and post program health screenings and over the last five years have had consistent outcomes averaging: 65% reduction in blood pressure, 41% reduction in blood glucose, 69% reduction in weight, 71% reduction in body fat or BMI, 55% reported making healthier food choices as a result of the program. Arnot Health offers the FFIST Program for obese children and their families to teach children how to make healthier food choices, and increase their physical activity through fun activities such as games and active play. Children in the eight week FFIST program also receive pre and post program weight, BMI and strength and endurance fitness testing. As a result of the program, children have shown gains in strength and endurance, and report making healthier food choices. Arnot Health serves on the Chemung County Board of Health, the Community Services Board, the Healthcare Association of New York State Community Health Taskforce and the New York State Department of Health Community Health Needs Assessment Ad Hoc Group.
Schedule H, Part V, Section B, Line 6a-IRA DAVENPORT MEMORIAL HOSPITAL	Arnot Health is comprised of three hospitals: Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative, and wellness services to meet the needs of residents in Chemung, Steuben, and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. Arnot Ogden Medical Center, located in Elmira, NY and founded in 1888, is a not-for-profit, 256-bed tertiary medical facility offering specialty services including, cardiovascular care, cancer care, women's health services, emergency medicine and surgical services. Ira Davenport Memorial Hospital, located in Bath, NY and founded in 1910, is a not-for profit 38-bed acute care hospital offer ancillary services and emergency medicine. The campus also hosts a 120-bed skilled nursing facility, Taylor Health Center. St. Joseph's Hospital, located in Elmira, NY and founded in 1908 by the Sisters of St. Joseph of Rochester, New York, is a not-for-profit Catholic 79 acute care hospital specializing in orthopedic care, physical rehabilitation, geriatric medicine, behavioral science and alcohol rehabilitation. The campus also hosts a 111 bed skilled nursing facility. Arnot Medical Services is a multispecialty physician group associated with Arnot Health offering care throughout the Southern Tier of New York and Northern Tier of Pennsylvania in the areas of Cardiology, Cardiovascular Surgery, Endocrinology, ENT, Family Practice, Gastroenterology, Infectious Diseases, Internal Medicine, Nephrology, Neurology, Orthopedics, Pain Management, Rheumatology, Women's Health and Wound Care.
Schedule H, Part V, Section B, Line 6b-IRA DAVENPORT MEMORIAL HOSPITAL	In 2013 Arnot Health in collaboration with the Chemung county health department, Steuben County Public Health and a diverse community partnership conducted a comprehensive Community Health Needs Assessment (CHNA) to identify public health priorities in Chemung and Steuben Counties. The CHNA identified some overlapping area of public health concerns in Chemung and Steuben Counties.
Schedule H, Part V, Section B, Line 7d-IRA DAVENPORT MEMORIAL HOSPITAL	Arnot Ogden Medical Center will use a variety of methods to disseminate the community Service Plan for Arnot Ogden Medical Center, St. Joseph's Hospital and Ira Davenport Memorial Hospital, and the CHIPs for Chemung and Steuben Counties: Web site documents will be posted on the healthcares system web site at the following URL: http://www.arnothealth.org/about us. Arnot Health developed a section of the system's web site dedicated to community outreach in 2016, budget permitting to bring community service work to a more prominent place within the website. This can be accessed at: https://www.arnothealth.org/community-service-plans. Partner web sites Chemung and Steuben counties will post links to their CHA and CHIP on their web sites. Presentations at Arnot Health's Community Health Department provide education about the healthcare system and community outreach strategies.
Schedule H, Part V, Section B, Line 11-IRA DAVENPORT MEMORIAL HOSPITAL	Arnot Health promotes and supports the health in the community in many ways. The system hosts a variety of programs and activities in their facilities to meet specific needs within the community, and donates meeting space for activities such as: Blood Drives, Cancer survivor support groups, Community lectures, health screenings and workshops, Melanoma Monday Skin Cancer Screenings, Maternal, Child Health Education and Breastfeeding Classes, Community lactation rooms , CPR classes, Alcoholics Anonymous meetings, Women's Narcotics Anonymous, Narcotics Anonymous, Community Interfaith Chaplaincy training programs, Suicide prevention trainings, Celiac Disease Support Group, Widow Support Group, Child Life Grief Support Program, Focus groups to gain insight on community needs, Annual MASH Camp for students interested in health professions, Osteopathic Medicine Manipulation Clinics, Healthy Kitchens Program, Amputee Support Group, Hip and Knee Seminars, Functional Assessment Workshops. In addition, Arnot Health aims to improve the health of the community through active participation and leadership in local, regional and state level preventative health coalitions and taskforces. Arnot Health serves on the Chemung County Board of Health, the Community Services Board, the Economic Opportunity Program Board, the Healthcare Association of New York State's (HANYS) Community Health Taskforce and the New York State Department of Health's (NYSDOH) Community Health Needs Assessment Ad Hoc Group. Arnot Health has a leadership role in the Southeastern region of the Finger Lakes Performing Provider System (FLPPS) and the planning and implementation of eleven DSRIP projects designed to meet the complex and challenging medical and social needs of the Medicaid population. Arnot Health's leadership in regional and state initiatives informs key stakeholders of the needs in our community and leverages a broad set of resources to meet those needs.
Schedule H, Part V, Section B, Line 20e-IRA DAVENPORT MEMORIAL HOSPITAL	Self pay collection staff reviews any prior accounts to check for commercial insurance or Medicaid that may need to be applied to current self pay accounts. These accounts are reviewed using the self pay work list. If insurance is located, the self pay collector must verify eligibility for the dates of service. The self pay staff will change the health plan to the correct plan for all covered dates of service and Arnot billing will submit the claim or claims. If no insurance is located, confirm if a patient may have qualified for Medicaid. If Medicaid coverage is approved self pay staff will change the health plan to Medicaid for all covered dates of service and follow correct billing processes. Self Pay Collection Staff attempts to collect the full balance due by check or credit card. If they are unable to make the full payment, the self pay staff will attempt to make payment arrangements and to notify the patient about the Arnot Ogden Medical Center Community Care Program. If the patient wants to apply for the community care program, the patients will be sent an application for the community care program and will be informed of documentation they will need to submit with the application. The self pay collectors document all activity in Soarian, and enter any necessary hold to support resolution. Self pay collections staff enters the payment plan and document comments in Soarian. Payment plan statements are demanded and sent to the patient. If the patient does not enter into a payment plan agreement, or fails to pay as agreed, the account will go through the standard dunning and collection agency activity. See Guarantor Billing and Collections.
Schedule H, Part V, Section B, Line 22d-IRA DAVENPORT MEMORIAL HOSPITAL	FAP eligible patients receive a percentage discount either charges for the uninsured or patient responsibility for the insured
Schedule H, Part V, Section B, Line 24-IRA DAVENPORT MEMORIAL HOSPITAL	Participants in the Medicare System are required to charge all patients the same amount regardless of insurance per the Medicare Participant Guidelines.

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 6a	Arnot Ogden Medical Center prepares the Community Benefit Report for three Hospitals, Arnot Ogden Medical Center, St Joseph's Hospital, Both in Elmira NY and Also for Ira Davenport Memorial Hospital in Bath NY
Schedule H, Part I, Line 7	Arnot Ogden Medical Center uses a cost to charges Ratio to calculate he financial Assistance and Community Benefit Section. The Medical Center Offers A Variety of services to the community it servers as part of an integrated delivery system. It is Necessary to Financially Subsidized some of these services as the revenue generates does not cover the cost of providing the services.
Schedule H, Part II	In 2010, Arnot Health was awarded a five-year Creating Healthy Places to Live, Work and Play (CHP) grant from the New York State Department of Health to promote healthy lifestyles and prevent obesity and type 2 diabetes through environmental, policy, and system changes. The CHP grant was lead by Arnot Health and a partnership of 30 community-based agencies and organizations, and engagement from community members. Over the past five-years, the CHP partnership had four areas of focus: To increase physical activity, Improve safety and access to open spaces for physical activity, Increase access to and consumption of fresh fruits and vegetables, and to work with local restaurants to make eating out healthier. Funding for the CHP grant ended on September 30, 2015. However, the CHP partnership remains committed and engaged in sustaining the work of CHP through Arnot Health's subcontract with Genesee Valley Educational Partnership to implement the community's portion of the "Creating Healthy Schools and Communities" grant. Creating Healthy Places to Live, Work, and Play has made progress over the last five years in establishing an environment where it is easier for the community to be physically active and make healthier food choices. The following are the obesity prevention strategies implemented and the accomplishments of the CHP partnership over the last five years: A. Increase Physical Activity, Arnot Health and the CHP partnership created, rehabilitated, maintained and promoted parks and recreation facilities in underserved residential areas to offer safe, accessible and attractive opportunities for physical activity for persons of all ages and abilities. CHP partners and the City of Elmira developed and/or enhanced parks and playgrounds for children to make them safe, attractive and accessible in the following locations: McKinnon Park, Grove Park, Miller's Pond Park, Eldridge Park, McCann's Memorial Park, Blandford Park, Pulaski Park and Quatrano Park. In addition to replacing unsafe equipment and enhancing parks and playgrounds, CHP partnership worked to improve a seven-mile stretch of the Lackawanna Rail Trail by installing a fitness station, solar lights for safe passage on the trail, and an informational kiosk with "Get Active Elmira" maps that were created by the partnership to highlight the city's 23 parks and playgrounds. Other enhancements to the Lackawanna Rail Trail included benches, bike racks and mile markers. To increase access to fresh fruit and vegetables, the CHP partnership created community gardens and enhanced existing vegetable gardens by working with community planning boards, neighborhood associations, schools, persons with disabilities, and senior and low-income housing developments. Examples of strategies implemented to promote access to and consumption of fresh fruits and vegetables include: Provided Mobile Edible Wall Units (portable community gardens) for schools and youth community centers. Installed a tool shed and provided gardening supplies to establish and maintain community gardens in underserved areas. Supported the development of a community garden for persons with developmental disabilities. Supported the Food Bank of the Southern Tier with fresh fruits and vegetables grown in the community gardens. Community Gardens were established or enhanced in the following locations: Near Westside Victorian Garden, Katy Leary Park, Quatrano Park, Economic Opportunity Program at Ernie Davis Community Center, Woodlawn Community Garden, and the Elmira City School District. To make eating out in restaurants healthier, CHP partners worked with local restaurants to add healthier menu items including healthier "side" items provided with a meal; modify existing menu items and offer affordable and appropriately sized portions; make healthier items standard for children's meals; and publicize the calorie, fat and sodium content of menu items. Developed and distributed educational materials on healthy food options at community outreach events. Worked with hospital system to adopt Healthy Meeting policy and offer daily "Well Being" meals in the hospitals' cafeterias for employees and the public. Healthier menu options were adopted at the following restaurants: Hill Top Inn, Starlite Room, Classic Café, Charlie's Café, and Turtle Leaf Cafe. Developed three different long-running TV ads promoting healthy eating at restaurants and featured three of the restaurant partners. Created table top displays of "Eating out Healthier" tips for each partnering restaurant. Arnot Health and CHP partners worked collaboratively to improve street-scale urban design for safer and easier access to parks, playgrounds and trails. Safety assessments of parks and playgrounds were conducted by organizations serving the developmentally disabled populations, seniors and the visually impaired. The Elmira Traffic Board conducted a speed study near one of the most highly utilized parks in an underserved area to determine if speed reduction signs were necessary for traffic calming and safer access. Other strategies implemented to promote safe access to open spaces for physical activity include: Installation of "high visual impact" signage at parks, playgrounds, trails and street crossings, Installation of video cameras in select parks, Improved street lighting, Installation of cross walks and ADA compliant curb cut outs and tactile ramps, and utilized speed reduction and playground warning signs for traffic calming.
Schedule H, Part III, Section A, Line 4	The Organization's allowance for doubtful accounts decreased from 11.1% of gross accounts receivable at December 31, 2014 to 10.5% of gross accounts receivable at December 31, 2015. In addition, the Organization's bad debt write-offs decreased from $22,828,514 for fiscal year 2014 to $14,550,590 in fiscal year 2015. The decrease in bad debt write-offs is to account for trends experienced in the collection of amounts from self-pay patients in fiscal year 2015. The Organization has not changed its charity care or uninsured discount policies during the fiscal year 2014 or 2015. The Organization does not maintain a material allowance for doubtful accounts from third party payors, not did it have significant write-offs from third party payors.
Schedule H, Part III, Section B, Line 8	Arnot Ogden Medical Center uses a Cost to Charges ratio to calculate the Financial Assistance and Community Benefit Section. The medical Center offers a variety of services to the community it serves as part of an integrated delivery system. It is necessary to financially subsidize some of these services as the revenue generated does not cover the cost of providing the services.
Schedule H, Part III, Section C, Line 9b	Self pay collection staff reviews any prior accounts to check for commercial insurance or Medicaid that may need to applied to current self pay accounts. These accounts are reviewed using the self pay worklist. If insurance is located, the self pay collector must verify eligibility for the dates of service. The self pay staff will change the health plan to the correct plan for all covered dates of service and Arnot billing will submit the claim or claims. If no insurance is located, confirm if a patient may have qualified for Medicaid. If Medicaid coverage is approved self pay staff will change the health plan to Medicaid for all covered dates of service and follow correct billing processes. Self Pay Collection Staff attempts to collect the full balance due by check or credit card. If they are unable to make the full payment, the self pay staff will attempt to make payment arrangements and to notify the patient about the Arnot Ogden Medical Center Community Care Program. If the patient wants to apply for the community care program, the patients will be sent an application for the community care program and will be informed of documentation they will need to submit with the application. The self pay collectors document all activity in Sorian, and enter any necessary hold to support resolution. Self pay collections staff enters the payment plan and document comments in Sorian. Payment plan statements are demanded and sent to the patient. If the patient does not enter into a payment plan agreement, or fails to pay as agreed, the account will go through the standard dunning and collection agency activity.
Schedule H, Part VI, Line 2	2015 Update to the Community Health Improvement Plan In 2013, Arnot Health in collaboration with the Chemung County Health Department, Steuben County Public Health and a diverse community partnership conducted a comprehensive Community Health Needs Assessment (CHNA) to identify public health priorities in Chemung and Steuben Counties. The CHNA identified some overlapping areas of public health concerns in Chemung and Steuben Counties. Chemung County Priority: Prevent Chronic Disease 1. Focus area: Reduce obesity in children and adults; and 2. Focus area: Reduce illness, disability, and death related to tobacco use and secondhand smoke exposure. Disparity: Reduce percentage of lower income individuals who smoke, including those with mental health and substance abuse issues. Steuben County Priority: Prevent Chronic Disease 1. Focus area: Reduce obesity in children and adults; and 2. Focus area: Reduce illness, disability and death related to heart disease and hypertension. Disparity: Promote tobacco cessation, especially among low socioeconomic populations and those with mental health illness. Over the last two years, Arnot Health and partners have been implementing and monitoring the effectiveness of the CHIP in Chemung and Steuben Counties. Since implementation of the 2013 CHIP, progress has been made in preventing chronic disease through strategies aimed at reducing obesity in children and adults, and reducing tobacco use. CHIP strategies to prevent chronic disease continued to focus on three key areas: 1) Health promotion activities to encourage healthy living and limit the onset of chronic diseases; 2) Early detection opportunities that include screening populations at risk; 3) Successful management strategies for existing diseases and related complications. Action plan strategies such as increasing physical activity, improving nutrition, and decreasing tobacco use from the core of the Preventing Chronic Diseases Action Plan for the New York State Prevention Agenda have been implemented (http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/docs/prevent_chronic_diseases.pdf).
Schedule H, Part VI, Line 3	The Arnot Ogden Medical Center communicates our Community Care Program in the following ways: Signage in waiting rooms, brochures in waiting rooms and Admission Packets, notations on billing notices, staff education so they can share availability of program and contact information with patients. Communication and education of our Certified Application Counselor for patient insurance enrollment are done so they are informed of the program details and contact information. Communication is also done with collection agencies and collection attorneys so they can also share the availability of the program and contact information with prospective enrollees. The information is also posted on our website at: www.arnothealth.org.
Schedule H, Part VI, Line 4	Arnot Health is comprised of three hospitals, Arnot Ogden Medical Center, St. Joseph's Hospital in Elmira, NY, and Ira Davenport Memorial Hospital in Bath, NY. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative and wellness services to meet the needs of residents in Chemung, Steuben and Schuyler Counties in the Southern Tier of New York and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. The distribution of patients from this service area, as measured by total patient encounters from system's hospitals is as follows: Chemung 65.0 percent, Steuben 21.0 percent, Schuyler 4.6 percent, Tioga 3.4, Bradford 2.9 percent and all other 3.0 percent.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
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 (7 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
Robert Lambert
President Arnot Health	$0	$527,380	$0	$103,241	$0	$0	$0	$13,250	$0	$23,577	$0	$667,448	$0	$0
Ronald J Kintz
Senior VP/CFO	$0	$331,952	$0	$60,516	$0	$0	$0	$13,250	$0	$23,577	$0	$429,295	$0	$0
H Fred Farley
Hospital President COO	$0	$353,789	$0	$40,550	$0	$0	$0	$13,250	$0	$23,577	$0	$431,166	$0	$0
James Watson
President IDMH	$0	$227,391	$0	$0	$0	$0	$0	$7,799	$0	$1,941	$0	$237,131	$0	$0
Kevin Murray
Director of Pharmacy	$149,642	$0	$0	$0	$0	$0	$0	$0	$12,252	$0	$161,894	$0	$0	$0
Vandelinder AmyBeth
DIR LABORATORY SVS	$75,768	$0	$24,400	$0	$0	$0	$3,101	$0	$0	$0	$103,269	$0	$0	$0
Dennis O' Connor MD
Medical Director	$58,889	$0	$0	$0	$0	$0	$1,757	$0	$0	$0	$60,646	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule J, Part I, Line 3	FormAndLineReferenceDesc
Explanation	Compensation for the president and vice president is set pursuant to a policy and compensation philosophy adopted by the boards. The AOMC Board has a compensation committee consisting of outside directors (AOMC board members are referred to as managers). The Compensation committee uses a consultant to advise it on compensation for the officers. The consultant collects and reports data on compensations for similar positions in similar nonprofit hospitals from upstate New York and western Pennsylvania. The compensation committee recommends any adjustments to the executive committee of the board which reviews the recommendations and approves them without employees in the room. This action is then reviewed with the entire board also in executive session	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Section A, Line 2	For Bernard Burns Board Secretary He is Executive Director of Arc of Steuben, Taylor SNF and Adult Day Care contracts with Arc for Transportation. Scott Sprague wife is Director of Keuka Health Care Foundation. Joseph F Meade is the president of Keuka Health Care Foundation
Form 990, Part VI, Section A, Line 3	as a result of Arnot Ogden Medical Center becoming the "active parent" of Ira Davenport Memorial Hospital the management of several departments were consolidated under a single manager
Form 990, Part VI, Section A, Line 7a	Ira Davenport Hospital Board of Directors can only elect the president and hire medical directors and board members at that facility. Affiliated Board of Directors of Arnot Health are responsible for operations of Ira Davenport Memorial Hospital.
Form 990, Part VI, Section A, Line 7b	Ira Davenport Hospital Board of Directors can only elect the president and hire medical directors and board members at that facility. Affiliated Board of Directors of Arnot Health are responsible for operations of Ira Davenport Memorial Hospital.
Form 990, Part VI, Section B, Line 11b	Once the 990 is in final form it is presented to the board committee and a copy is made available to all board members for review and questions.
Form 990, Part VI, Section B, Line 12c	All members of the Board of Managers, officers, and management employees shall be required annually to file a disclosure statement setting forth any respect in which such person, or any person associated with such person, has or may have any interest in any transaction in which there may be, or appear to be, a conflict between the interest of such person and the Arnot Ogden Medical Center, an associated included (1) Spouse, a descendant or an ancestor, of a spouse of a descendant of ancestor; (2) an organization in which the person of an associated is a partner of employee, or such person is an associated owns a more then 10% beneficial interest; (3) a trust in which such person is a trustee, or such person or an associate holds more than 10% beneficial interest and (4) a corporations in which such person or an associate is an officer or a director or employee, or such person or an associate is an owner of more than 10% of any class of securities
Form 990, Part VI, Section B, Line 15	Compensation for the president and vice president is set pursuant to a policy and compensation philosophy adopted by the boards. The AOMC Board has a compensation committee consisting of outside directors (AOMC board members are referred to as managers). The Compensation committee uses a consultant to advise it on compensation for the officers. The consultant collects and reports data on compensations for similar positions in similar nonprofit hospitals from upstate New York and western Pennsylvania. The compensation committee recommends any adjustments to the executive committee of the board which reviews the recommendations and approves them without employees in the room. This action is then reviewed with the entire board also in executive session
Form 990, Part VI, Section C, Line 19	Items required for public disclosure are made available for those who request the information and shared with guidestar.org and EMMA web site
Form 990, Part XI, Line 9	Keuka Foundation Net loss (3,811), Donations from Capital Funding 63,295, Net assets released from restrictions (85,676), Pension charge to equity 186,839, Donations 133,022, Change in Charitable Trust (182,819), Cost of Inventory Adj (11)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Direct Controlling NADirectControllingNACd	Controlled OrganizationControlledOrganizationInd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt
KEUKA HEALTH CARE FOUNDATION
7571 STATE ROUTE 54	BATH	NY	14810	161461215	PROVIDE FINANCIAL	NY	501(C)(3)	11	N/A	0
ARNOT OGDEN MEDICAL CENTER
600 ROE AVENUE	ELMIRA	NY	14905	160743905	AFFILIATE	NY	501 (C)(3)	11	N/A	0
ARNOT OGDEN MEDICAL CENTER FOUNDATION
600 ROE AVENUE	ELMIRA	NY	14905	161109472	CONTRIBUTION MGT	NY	501(C)(3)	11E	N/A	0
ARNOT HEALTH INC
600 ROE AVENUE	ELMIRA	NY	14905	453049405	MANAGEMENT	NY	501 (A)(3)	N/A		0	ARNOT HEALTH INC
ST JOSEPHS HOSPITAL
555 ST JOSEPHS BLVD	ELMIRA	NY	14901	160743163	AFFILIATE	NY	501(C)(3)	11	N/A	0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	IVY STREET DEVELOPMENT CORP	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	600 IVY STREET	AddressLine1Txt
City	ELMIRA	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	14905	ZIPCd

Field	Value	IRS element (for citing)
EIN	161009245	EIN
Primary Activities	REAL ESTATE RENTAL	PrimaryActivitiesTxt
Legal Domicile State	NY	LegalDomicileStateCd
Direct Controlling NA	N/A	DirectControllingNACd
Entity Type	C	EntityTypeTxt
Ownership	0	OwnershipPct

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	Yes (1)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	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	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
ARNOT OGDEN MEDICAL CENTER
o	$3,250,977	Arnot Ogden Medical Center provided employees who provide medical, management information system, and various administrative services to Ira Davenport Memorial Hospital. The method of determining the amount was cost.
KEUKA HEALTH CARE FOUNDATION
c	$63,295	A gift from Keuka Health Care Foundation to Ira Davenport Memorial Hospital for contribution to the Taylor SNF and remodel of Emergency room entrance

Reasonable Cause Explanation ReasonableCauseExplanation

Field	Value	IRS element (for citing)
Explanation	We have the form 8868 extension to November 15,2016	ExplanationTxt