2016-11-15T07:49:07-06:00 2015-12-31 KPMG LLP 515 Broadway 4th Floor Albany NY 122072974 990 2015-01-01 141338413 Glens Falls Hospital % WILLIAM WALBRIDGE CONTROLLE GLEN 5189265012 100 Park Street Glens Falls NY 12801 DIANNE SHUGRUE PRESIDENT/CEO 5189265012 2016-11-14 true Todd P Teresco P00247720 5184274600 2016-11-09 2015 2017-02-10 21:41:12Z DIANNE SHUGRUE 100 Park Street Glens Falls NY 12801 344602476 false X glensfallshospital.org X 1897 NY SEE SCHEDULE O 17 15 3222 570 1033915 -141829 3073526 5886844 302012567 325663063 4601269 3034569 1260983 -3161955 310948345 331422521 0 0 0 0 172407198 184733595 0 0 431497 132515609 147340352 304922807 332073947 6025538 -651426 260963700 272462584 129685726 142927578 131277974 129535006 X SEE SCHEDULE O false false 260276087 321372381 Glens Falls Hospital provides a comprehensive health care system that stretches across 3,000 square miles in upstate NY. We provide high quality care to people, regardless of their ability to pay. We are a 410 bed facility with more than 225 certified physicians in over 25 specialties. Our services include, but are not limited to, emergency care, surgical services, mental health, cancer care, primary care and preventative health education. In 2015, we had 71,726 patient days and 14,391 discharges. The Emergency Care Center provided care to 51,698 patients. Our Mental Health department provided 76,837 outpatient treatments and 7,313 inpatient days. Our Surgery Center performed 12,423 procedures. 260276087 true true false true false false false false false true true false false false true true false true false false false false false false false false true true false false true true false false false false false false false true true false false false false false false true true true true false true 244 0 true 3222 true true true false false false false false false false false false X 17 15 true false false false false false false true true false false false true true true true true true true true true NY X WILLIAM WALBRIDGE CONTROLLE 5189265005 100 PARK STREET GLENS FALLS NY 12801 X MICHAEL B CLARKE CHAIRMAN 1.0 0.0 X X 0 0 0 GLENDA KELMAN RN VICE CHAIRMAN 1.0 0.0 X X 0 0 0 JOSEPH F RACCUIA SECRETARY 1.0 0.0 X X 0 0 0 MARK BEHAN DIRECTOR 1.0 0.0 X 0 0 0 JOHN C BIENIEK DIRECTOR 1.0 0.0 X 0 0 0 MICHAEL T BITTEL DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM BORGOS DIRECTOR 1.0 0.0 X 0 0 0 TENEE' CASACCIO DIRECTOR 1.0 0.0 X 0 0 0 JAMES E CULLUM DIRECTOR 1.0 0.0 X 0 0 0 KATHIE L DUNCAN DIRECTOR 1.0 0.0 X 0 0 0 GEORGE FERONE DIRECTOR 1.0 0.0 X 0 0 0 KEVIN J HERLIHY MD DIRECTOR 1.0 0.0 X 0 0 0 GARY R HICKS DIRECTOR 1.0 0.0 X 0 0 0 THOMAS J MURPHY DIRECTOR 1.0 0.0 X 0 0 0 WILLIAM H REYNOLDS MD DIRECTOR 1.0 0.0 X 0 0 0 SHARON RUGGI DIRECTOR 1.0 0.0 X 0 0 0 DAVID WESTFALL MD DIRECTOR 1.0 0.0 X 0 0 0 DIANNE SHUGRUE PRESIDENT/CEO 40.0 0.0 X 560826 0 11160 MITCH AMADO CFO 40.0 0.0 X 375413 0 8384 PAUL SCIMECA SR VP OPERATIONS 40.0 0.0 X 347690 0 18566 BRIAN MCDERMOTT MD SR VP CLINICAL INTEGRATION 40.0 0.0 X 354855 0 12150 KYLE BROCK VP HUMAN RESOURCES 40.0 0.0 X 252003 0 2980 ROBERT PRINGLE MD VP MED AFFAIRS & CMO 40.0 0.0 X 320821 0 14817 DONNA KIRKER VP PATIENT SERVICES 40.0 0.0 X 262629 0 7991 CELESTE STEELE VP QUALITY 40.0 0.0 X 177367 0 5147 JOHN B KELLEHER CIO 40.0 0.0 X 266948 0 6715 Eric Pillemer MD Cancer Center Physician 40.0 0.0 X 747205 0 16323 JOHN P STOUTENBURG MD CANCER CENTER PHYSICIAN 40.0 0.0 X 641035 0 19340 Greg Kelly MD Cardiac Physician 40.0 0.0 X 607461 0 19340 IQBAL BASHIR MD CARDIAC PHYSICIAN 40.0 0.0 X 605749 0 19340 Robert Hogan MD Cardiac Physician 40.0 0.0 X 596961 0 19340 6116963 0 181593 14 false true false HUDSON HEADWATERS HEALTH NETWORK 9 CAREY RD QUEENSBURY NY 12804 MEDICAL SERVICES 3326272 LEADERS FOR TODAY 981 WORCESTER STREET WELLESLEY MA 02482 CONTRACT LABOR 746774 Healogics Wound Care Services 3087 Momentum Place CHICAGO IL 60689 Wound care services 692090 Healthcare Management Consultants PO Box 56 VAILS GATE NY 12584 Healthcare Consultin 646250 Optimus Architecture 187 E Market Street RHINEBECK NY 12575 Architects 511929 5 793749 5093095 5886844 PATIENT SERVICE REVENUE 900099 317076052 317076052 HOSPITAL LAB SERVICES 621500 1047691 1047691 CENTER FOR OCCUPATIONAL HEALTH 900099 1462762 1462762 OUTPATIENT PHARMACY 900099 2650353 2650353 PHYSICIAN ANSWERING SERVICE 900099 251906 233488 18418 3174299 3174299 325663063 1688654 1688654 0 0 0 0 0 14492868 33002 13123439 56516 1369429 -23514 1345915 1345915 0 0 0 GAIN ON INVESTMENT IN ISNENY 621990 326858 326858 INVESTMENT IN YANKEE ALLIANCE 333398 365592 -32194 INVESTMENT IN MCGREGOR REALTY 712820 712820 -4535031 -5695952 1160921 -3161955 331422521 320306272 1033915 4195490 X 0 0 0 0 3006462 3006462 0 146793996 121924345 24705090 164561 3945787 3213408 728042 4337 21162542 17306148 3833036 23358 9824808 8001222 1812787 10799 3014800 1149509 1865291 743323 743323 184612 134040 50572 45929 45929 0 0 28597743 15474319 13073237 50187 598459 8860 579478 10121 77246752 72718343 4493955 34454 4698511 112341 4586170 0 4210988 1420528 2790460 350181 181955 168226 0 493528 271685 221843 3186583 2141477 1045106 0 14657296 11719956 2937340 4139982 3225540 914442 OTHER EXPENSES 5171665 1406451 3682106 83108 332073947 260276087 71366363 431497 24784983 20803845 9923637 13483922 0 0 27389293 32534049 0 0 0 0 235833 204066 3260555 3814463 2379228 5207154 309392872 202090413 103785823 107302459 79003896 79958249 0 0 0 0 0 0 10200452 9154377 260963700 272462584 46288353 43410486 0 0 0 0 53010000 62797417 0 0 0 0 15425721 15095358 0 0 14961652 21624317 129685726 142927578 X 125639745 123014406 4131557 5013928 1506672 1506672 131277974 129535006 260963700 272462584 X -651426 -2864439 1772897 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 45929 45929 false false Part IIB, Line 1I IN 2015, GLENS FALLS HOSPITAL PAID DUES TO THE AMERICAN HOSPITAL ASSOCIATION AND THE HOSPITAL ASSOCIATION OF NEW YORK, A PORTION OF WHICH WENT TOWARDS LOBBYING EXPENSES, AS DETERMINED BY THE ASSOCIATIONS. IN 2015, GLENS FALLS HOSPITAL RETAINED A TECHNICAL CONSULTANT TO PROVIDE COUNSEL RELATIVE TO STATE AND FEDERAL HEALTHCARE REGULATIONS. THE HOSPITAL CONTRACTED WITH A FIRM THAT IS WELL VERSED IN GOVERNMENT RELATIONS IN ORDER TO COMMUNICATE TO ELECTED OFFICIALS THE FINANCIAL IMPACT THAT PROPOSED STATE AND FEDERAL LEGISLATION WILL HAVE ON THE HOSPITAL AND TO PURSUE ADDITIONAL FUNDING STREAMS FOR COMMUNITY SERVICES. 1506672 602863 16200 586663 1506672 1506672 0 355034 16000 53115 285919 1506672 1506672 0 284363 12810 45395 226158 1506672 1506672 0 114227 12000 20545 81682 1506672 1506672 0 44224 16900 27324 1506672 1.00000 false false 7910023 7910023 169485545 102007109 67478436 131997304 100083304 31914000 0 107302459 0 DEFERRED COMP PAYABLE 5697535 SELF INSURED LIABILITY RESERVE 15435851 ASSET RETIREMENT OBLIGATION 490931 21624317 X 330330979 -2864439 1772897 -1091542 331422521 331422521 332073947 332073947 332073947 Part V, Line 4 Permanently restricted net assets are investments to be held in perpetuity, the income from which is expendable to support the following: Dental Free Care 1,053,285 Indigent Care 148,927 Gen. Operating Expenses 169,975 Health Education 134,485 Total 1,506,672 Part X, Line 2 The Hospital recognized the effect of income tax positions only if those positions are more likely than not of being sustained. Recognized income tax positions are measured at the largest amount that is greater than fifty percent likely of being realized upon settlement. Changes in recognition in measurement are reflected in the period in which the change in judgment occurs. The Hospital did not recognize the effect of any uncertain tax positions in 2015. PART XI, LINE 2D Unrestricted Net Assets: Net assets released from restrictions 351,203 Net actuarial GAIN on accrued post retirement benefits 280,867 Temporary Restricted Net Assets: Restricted gifts & distributions from GFH Foundation 1,098,432 Change in interest in net assets of GFH Foundation 938,394 Restricted income 248,953 Net Assets released from restrictions (1,144,952) ---------------- Total 1,772,897 true true true X 130. true X 330. true true false true true 2299702 1883930 415772 0.00130 53310427 34157744 19152682 0.05770 55610129 36041674 19568454 0.05900 1837587 1475789 361799 0.00110 468032 468032 0.00140 116320686 114637862 1682824 0.00510 134059 39297 94762 0.00030 101503 101503 0.00030 118861867 116152948 2708920 0.00820 174471996 152194622 22277374 0.06720 126590 43000 83590 0.00030 290290 290290 0.00090 416880 43000 373880 0.00120 true 620027 616529 70400197 83990469 -13590272 X true false Imaging Serv NENY Diagnostic Radiology 0.5 0.5 0.5 North Country Eye Ce Eye center 0.3 0.3 0.3 1 1 Glens Falls Hospital 100 Park Street Glens Falls NY 12801 glensfallshospital.org 5601000H X Glens Falls Hospital 1 false false true X X X X X X X X X 13 true false false true X GLENSFALLSHOSPITAL.ORG/SERVICES/HEALTH- PROMOTION-CENTER.CFM X true 15 true GLENSFALLSHOSPITAL.ORG/SERVICES/HEALTHPROMOTI false false true X 130. 330. X X X true true X X X X true X GLENSFALLSHOSPITAL.ORG X X X X true X false X X X X true X false false Part V Line 5 In 2013-2015, GFH WORKED WITH THE ADIRONDACK REGIONAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY OF STAKEHOLDERS REPRESENTING HEALTH CARE AND SERVICE PROVIDING AGENCIES WITHIN THE EIGHT COUNTY REGION. THE RESULTS OF THE SURVEY PROVIDE AN OVERVIEW OF REGIONAL HEALTH NEEDS AND PRIORITIES, AND INFORM FUTURE PLANNING AND THE DEVELOPMENT OF A REGIONAL HEALTH CARE AGENDA. THE SURVEY RESULTS WERE PRESENTED AT BOTH THE COUNTY AND REGIONAL LEVELS. RESPONDENTS OF THE SURVEY REPRESENT A WIDE RANGE OF ORGANIZATIONS FROM HEALTH PROVIDERS, PLANNED PARENTHOOD, WIC PROGRAMS, YMCA, FAMILY COUNSELING, NURSING HOMES, SCHOOLS, SENIOR CITIZENS, COUNTY HEALTH OFFICES, MENTAL HEALTH PROVIDERS AND MANY MORE. ARHN provides guidance and technical assistance to the Community Health Planning Committee (CHPC), a regional forum for hospitals, county health departments and community partners, who provide oversight of planning and assessment activities. The group is further comprised of subcommittees developed to address areas specific to hospital, public health and data-specific requirements. Regular meetings of each subcommittee and the full CHPC have resulted in a systematic approach to community health planning and the development of regional and local strategies to address health care priorities. PART V LINE 11 ALL OF THE COMMUNITY HEALTH ASSESSMENT NEEDS ARE LONG-TERM GOALS AND ARE ACTIVELY BEING WORKED ON. 25 Advanced Imaging at Baybrook 22 Willowbrook Road Queensbury NY 12804 Hosp. Extension Clinic - Diagnostic OP Radiology CT Scanner Behavioral Health ServicesRidge Commons 1 Lawrence Street Glens Falls NY 12801 Hosp. Extension Clinic - O/P Mental Health Services Cambridge Family Health Clinic 35 Gilbert Street Cambridge NY 12816 Hosp. Extension Clinic - Primary Medical Care, O/P Radiology, MHU, PT Center for Recovery 101 Ridge Street Glens Falls NY 12801 Hosp. Extension Clinic - Chemical dependence, O/P Rehab Evergreen Health Center Evergreen Plaza 13 Palmer Avenue Corinth NY 12822 Hosp. Extension Clinic - Primary Medical Care, O/P Radiology, PT Fort Edward Family Medicine 327 Broadway Fort Edward NY 12828 HOsp. Extension Clinic - Primary Medical Care O/P GFH Outpatient Renal Dialysis Center 3 Broad Street Glens Falls NY 12801 HOsp. Extension Clinic - O/P Renal Dialysis, Home Dialysis training GFH Sleep Lab 92 Broad Street Glens Falls NY 12801 Hosp. Extension Clinic - Primary Medical Care, Sleep studies GFH Broad Street Campus 2 Broad Street Glens Falls NY 12801 HOsp. Extension Clinic - Primary Medical Care GFH Cardiac Rehab 6 Hearts Way Queensbury NY 12804 Hosp. Extension Clinic - Cardiac Rehab GRANVILLE HEALTH CENTER 79 North Street Granville NY 12832 Hosp. Extension Clinic - Primary Medical Care, O/P Radiology, Lab, PT Greenwich Family Health Center 1112 County Rt 29 Greenwich NY 12834 Hosp. Extension Clinic - Primary Medical Care, O/P Radiology, PT Hoosick Falls Family Health Center 16 Danforth Street Hoosick Falls NY 12090 HOsp. Extension Clinic - Primary Medical Care, O/P Radiology, PT Hudson Falls Internal Medicine 325 Main Street Hudson Falls NY 12839 Hosp. Extension Clinic - Primary Medical Care Main Street Physical Therapy 17 Main Street Glens Falls NY 12801 Hosp. Extension Clinic - Physical Therapy O/P Mobile Pediatric Dental Van 100 Park Street Glens Falls NY 12801 Hosp. Extension Clinic - O/P Dental Services Salem Family Health Center 213 Main Street Salem NY 12865 Hosp. Extension Clinic - Primary Medical Care, O/P Physical Therapy The Center for Recovery 340 Main Street Glens Falls NY 12801 Hosp. Extension Clinic - Chemical dependency O/P Rehab THE MEDICAL CENTER AT WILTON 135 North Road Gansevoort NY 12831 Hosp. Extension Clinic - PRIMARY MEDICAL CARE, O/P RADIOLOGY, LAB, PT THE REHAB CENTER & HEARING CENTER 2 Country Club Rd Queensbury NY 12804 Hosp. Extension Clinic - PT, OT, Speech, Audiology Whitehall Health Center 65 Poultney Street Whitehall NY 12887 Hosp. Extension Clinic - Primary Medical Care, O/P Radiology, Rehab Wilton Health Center 11 Carpenter Lane Wilton NY 12866 HOsp. Extension Clinic - Primary Medical Care, Lab Services Stuart M Townsend Middle School 27 Hyland Drive Lake Luzerne NY 12846 School Based HOsp. Ext.Clinic- Health Ed, Immunology, Screenings Whitehall Elementary School Buckley Road Whitehall NY 12887 School Based HOsp. Ext.Clinic- Health Ed, Immunology, Screenings THE REHAB CENTER & HEARING CENTER 4 IRONGATE CENTER GLENS FALLS NY 12801 HOSP. EXTENSION CLINIC - PT, OT, SPEECH, AUDIOLOGY Part 1, Line 6a GLENS FALLS HOSPITAL PROVIDES AN ANNUAL REPORT TO THE COMMUNITY WHICH INCLUDES AN OVERVIEW OF OUR COMMUNITY BENEFIT PROGRAM DESCRIPTIONS. The report is mailed to donors, Board Members and members of the community. Hard copies are also available in the Foundation office and at various locations throughout the community at free of charge. Part 1, Line 7 THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN THE TABLE WAS A COST-TO-CHARGE RATIO AS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TOCHARGES. Part II, Community Building Activities Glens Falls Hospital regularly assesses the makeup of the region's physician population, paying particular attention to physicians who may be approaching retirement age and specialties that may have a physician shortage due to retirement or relocation. To insure that there is never a shortage of physicians across all specialties the Hospital now employs a physician recruiter. The position actively recruits for vacancies and shortages among hospital employed physicians, and partners with independent practices to help them keep a full complement of physicians across specialties. The Hospital also monitors and actively engages in preventing the spread of infectious disease through school based health and the Hospital's infection control program. This includes vaccinations for children, and access to flu vaccines for the residents of our service area, (free or at a significantly reduced cost), including an annual HPODS drill. The Hospital meets regularly with community groups in planning for emergency preparedness. Coordinating with police depts., fire departments, EMS and county officials. Emergency drills are carried out for such things as natural disasters, terrorism, accidents with mass casualties and bio hazards. Community members play an active roll in these drills. Part III, Section A, Line 2 Glens Falls Hospital considers 100% of the amount reported in Part III, line 2 & 3 a community benefit. Glens Falls Hospital is the only comprehensive acute-care hospital serving a predominately rural, 3,000-square mile area of upstate New York that encompasses Warren, Washington, Hamilton, Essex and northern Saratoga counties. In a very real sense, it is the safety-net hospital for the patients in these communities. THE HOSPITAL PROVIDES SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY AND GRANTS CREDIT TO ALL PATIENTS REGARDLESS OF CREDITWORTHINESS AND WITHOUT COLLATERAL. WHILE THE HOSPITAL PRUSUES COLLECTIONS OF AMOUNTS OWED INCLUDING THE USE OF COLLECTION AGENCIES, IT DOES SO IN A MANNER THAT IS RESPECTFUL OF THE NEEDS OF OUR PATIENTS, IN ADHERENCE WITH ALL APPLICABLE LAWS AND IS REFLECTIVE OF OUR VALUES AND PUBLIC MISSION. WE ENTERTAIN REASONABLE SETTLEMENT OFFERS, INCLUDING PROVIDING DISCOUNTS FOR PAYMENT AND OFFERING PAYMENT PLANS WHERE WE ACCEPT REASONABLE MONTHLY INSTALLMENTS BASED ON THE INDIVIDUAL'S MEANS. LITIGATION IS COMMENCED SELECTIVELY AND ONLY AS A LAST RESORT. APPROXIMATELY 60% OF THE AMOUNTS WRITTEN OFF AS BAD DEBT ARE FOR PATIENTS WHO HAVE NO INSURANCE COVERAGE FOR THE SERVICES PROVIDED. THE HOSPITAL APPROVES 98% OF APPLICATIONS IT RECIEVES FOR PATIENT ASSISTANCE. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON PART III, LINE 2 IS AS FOLLOWS. GROSS BAD DEBT PER THE GENERAL LEDGER IS MULTIPLIED BY THE RATIO OF COST TO CHARGES TO GET AN ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS. EXPECTED POOL PAYMENTS ARE ADDED TO THIS RESULT TO GET A TOTAL COMMUNITY BENEFIT. THIS ESTIMATED COMMUNITY BENEFIT IS REDUCED BY RECOVERIES, REVENUE FROM UNCOMPENSATED CARE POOLS AND MEDICARE BAD DEBT REIMBURSEMENT TO ARRIVE AT A NET COMMUNITY BENEFIT REPORTABLE ON LINE 2. PART III, SECTION A, LINE 3 A LARGE PORTION OF PATIENT ACCOUNT BALANCES THAT END UP AS BAD DEBT WOULD LIKELY QUALIFY FOR BENEFITS UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM, BUT NOT ALL PATIENTS TAKE THE OPPORTUNITY TO APPLY FOR SUCH BENEFITS OR SUPPLY DOCUMENTATION ALLOWING US TO ASSESS THEIR ABILITY TO QUALIFY. AN ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS ARRIVED AT BY TAKING TOTAL CHARITY CARE CHARGES FROM THE ICR, REDUCED BY THE FREE CARE ALLOWANCE ON THE ICR. THIS RESULT IS MULTIPLIED BY A RATIO OF COST TO CHARGES. THE NET RESULT IS FURTHER REDUCED BY PAYMENTS FOR UNCOMPENSATED CARE PARTIAL PAYMENTS BY PATIENTS APPROVED FOR CHARITY CARE. Part III, Section A, Line 4 FOOTNOTE G OF THE AUDITED FINANCIAL STATEMENTS STATES THAT THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS PATIENT FINANCIAL ASSISTANCE PROGRAM WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS PATIENT SERVICE REVENUE. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE COST OF CHARITY CARE WAS DETERMINE BASED ON THE APPLICATION OF A RATIO OF OVERALL HOSPITAL COSTS TO PATIENT CHARGES. THE HOSPITAL GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD PARTY AGREEMENTS. ADDITIONS TO THE ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR BAD DEBTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE. THE AMOUNT OF THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS. SERVICES RENDERED TO INDIVIDUALS WHEN PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED ARE WRITTEN OFF TO THE ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS. Part III, Section B, Lines 5,6,7 In addition to the amount included in the Medicare Cost Report and reported on lines 5,6 & 7, the hospital incurred losses on services provided to Medicare patients and paid for under the Part B fee schedule and not reportable on the Medicare Cost Report. A complete reconciliation of amounts reportable in Section B. Total revenues included on the Medicare Cost Report, reported on line 5 $70,400,197 Total revenues from Medicare Part B services, not reported on line 5 $1,398,750 ---------------------------------------------------------------- Total revenues for Medicare services $71,798,947 Total costs included on the Medicare Cost report, reported on line 6 $83,990,469 Total costs from Medicare Part B services, not reported on line 6 $ 1,823,663 ----------------------------------------------------------------- Total costs from Medicare services $ 85,814,132 Total (shortfall) included on the Medicare Cost Report, reported on line 7 $13,590,272 Total (shortfall) from Medicare Part B services, not reported on line 7 $ 424,913 ------------------------------------------------------------------ Total (Shortfall) for Medicare services $14,015,185 Part III, Line 8 The costing methodology used to determine the Medicare allowable costs reported in the organization's Medicare Cost Report, as reflected on line 6, is the methodology prescribed by Medicare in the completion for Form CMS-2552-96 and conforms to the requirements and principals set forth in 42 CFR, Part 412, 42 CFR, Part 413 and in the Provider Reimbursement manual, Part 1. GLENS FALLS HOSPITAL CONSIDERS 100% OF THE AMOUNT REPORTED IN PART III, LINE 7 A COMMUNITY BENEFIT. GLENS FALLS HOSPITAL IS THE ONLY COMPREHENSIVE ACUTE-CARE HOSPITAL SERVING A PREDOMINATELY RURAL, 3,000 SQUARE MILE AREA OF UPSTATE NEW YORK THAT ENCOMPASSES WARREN, WASHINGTON, HAMILTON, ESSEX AND NORTHERN SARATOGA COUNTIES. IN A VERY REAL SENSE, IT IS THE SAFETY NET HOSPITAL FOR THE MEDICARE PATIENTS IN THESE COMMUNITIES. DESPITE THE FACT THAT THE PAYMENTS RECEIVED FROM MEDICARE FOR THE SERVICES PROVIDED ARE GENERALLY BELOW THE RATES THAT THE HOSPITAL RECEIVES FROM MANAGED CARE PAYERS AND PRIVATE INSURERS THE HOSPITAL REMAINS COMMITTED TO SERVING ELDERLY PATIENTS AND IMPROVING THE HEALTH STATUS OF THE ELDERLY. Part III, Section C, Line 9b It is Glens Falls Hospital policy to delay final collections efforts while a patient financial assistance application is in process. A final determination is required before outside collection efforts are initiated. Part V, Line 22d The Hospital determined the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care based on the amounts paid by the hospital's highest volume contracted payor. Part VI, Line 2 Needs Assessment Glens Falls Hospital completes a NY State Department of Health required Community Needs Assessment in partnership with the Public Health Departments of the counties we serve (Warren, Washington, Hamilton, Essex, and Saratoga) and the NYS Department of Health. This assessment is available via PDF (http://www.arhn.org/regional-health-assessment.php), through the county public health department. Part VI, Line 3 Patient education of eligibility for assistance - Brochures are given at the point of service. All patient's statements advertise charity care programs. Customer Service reps are trained to outline and encourage participation in the program. Vender Medicaid eligibility process includes charity care screening step for all inpatient and outpatient. Website contains information on charity care programs and web portal gives the ability to complete an online application. Part VI, Line 4-Community Information The Glens Falls Hospital healthcare system serves a large area of upstate New York that includes all or portions of the following counties: Warren, Washington, Hamilton, Essex and Northern Saratoga. The service area covers approximately 400,000 people; the population is largely white, non-Hispanic (93.5%). Approximately 18% of the female population is of child-bearing age. People over the age of 65 constitute 15.9% of the population; children under the age of 17 make up 20.5% of the population. The average household income is $69,353, lower than the national average of $85,736. Just over 1/4 of the population has obtained a Bachelor's degree or higher level of education (26.5%). Two age groups that will see the greatest growth are people aged 65 to 74 years and those over 75 years of age. It is estimated that these two segments of the population together will constitute 28.1 % of the total population. Part VI, Line 5 Promotion of Community Health GFH IS GOVERNED BY A 15 MEMBER BOARD OF GOVERNORS, ALL OF WHOM LIVE IN THE HOSPITAL'S SERVICE AREA. ANY AND ALL PHYSICIANS LIVING IN THE SERVICE AREA WHO ARE QUALIFIED, AND WHO MEET REQUIREMENTS AS DOCUMENTED IN THE MEDICAL STAFF BYLAWS, ARE EXTENDED PRIVILEGES. FUND IN EXCESS OF EXPENSES ARE ALLOCATED FOR CAPITAL PROJECTS, MEDICAL RESEARCH AND CLINICAL TRIALS, PATIENT CARE IMPROVEMENTS AND SYSTEM IMPROVEMENTS. CAPITAL PROJECTS ARE PRIORITIZED BY AN INTERDISCIPLINARY COMMITTEE, CONSISTING OF PHYSICIAN FROM DIFFERENT SPECIALTIES, AS WELL AS HOSPITAL MANAGEMENT. Part VI, Line 7 STATE IN WHICH THE ORGANIZATION FILES A COMMUNITY BENEFIT REPORT NEW YORK STATE X X X X X X false false false false false false false true false DIANNE SHUGRUE PRESIDENT/CEO 496753 0 64073 0 0 0 10428 0 732 0 571986 0 0 0 MITCH AMADO CFO 321563 0 53033 0 817 0 0 0 8384 0 383797 0 0 0 PAUL SCIMECA SR VP OPERATIONS 301006 0 40559 0 6125 0 10278 0 8288 0 366256 0 0 0 BRIAN MCDERMOTT MD SR VP CLINICAL INTEGRATION 282152 0 72161 0 542 0 5382 0 6768 0 367005 0 0 0 KYLE BROCK VP HUMAN RESOURCES 216300 0 35018 0 685 0 2602 0 378 0 254983 0 0 0 ROBERT PRINGLE MD VP MED AFFAIRS & CMO 289670 0 26843 0 4308 0 8715 0 6102 0 335638 0 0 0 DONNA KIRKER VP PATIENT SERVICES 227255 0 34841 0 533 0 7425 0 566 0 270620 0 0 0 CELESTE STEELE VP QUALITY 175448 0 0 0 1919 0 1485 0 3662 0 182514 0 0 0 JOHN B KELLEHER CIO 239740 0 26391 0 817 0 0 0 6715 0 273663 0 0 0 Eric Pillemer MD Cancer Center Physician 543459 0 200974 0 2772 0 9645 0 6678 0 763528 0 0 0 JOHN P STOUTENBURG MD CANCER CENTER PHYSICIAN 591944 0 48591 0 500 0 10600 0 8740 0 660375 0 0 0 Greg Kelly MD Cardiac Physician 384724 0 206144 0 16593 0 10600 0 8740 0 626801 0 0 0 IQBAL BASHIR MD CARDIAC PHYSICIAN 399324 0 206005 0 420 0 10600 0 8740 0 625089 0 0 0 Robert Hogan MD Cardiac Physician 390325 0 205670 0 966 0 10600 0 8740 0 616301 0 0 0 Part 1, Line 7 Physicians are eligible and did receive additional compensation through participation in an incentive program that addressed quality, patient satisfaction and their personal productivity. A Glens Falls Civic Development Corp Series 2015 451673501 2015-09-21 67000000 Refund '03 bonds, capital projects false false false A 3350000 0 67000000 0 0 0 360205 0 0 9521892 49118939 7998964 2015 true false false true A false true true true false 0.01500 0.00000 0.01500 false false false true A false true false false false false 0 false false false 0 false true A true Mark Behan Director 563527 Marketing Services false DR DAVID WESTFALL DIRECTOR 10981 FAMILY MEMBER EMPLOYEE false DR DAVID WESTFALL DIRECTOR 70000 JOINT VENTURE false FORM 990, SCHEDULE L, PART V Mark Behan is a director of the Glens Falls Hospital Board. Mr. Behan is the owner of Behan Communications, a marketing firm. Glens Falls Hospital has a business relationship with Behan Communications. DR. WESTFALL IS A DIRECTOR OF THE GLENS FALLS HOSPITAL BOARD AND HAS A FAMILY MEMBER THAT IS EMPLOYED AT THE HOSPITAL AND WAS PAID MORE THAN $10,000 DURING THE YEAR. DR. WESTFALL IS A DIRECTOR OF THE GLENS FALLS HOSPITAL BOARD AND IS ALSO A MEMBER IN AN ENTITY INVOLVED IN A JOINT VENTURE WITH GLENS FALLS HOSPITAL. GLENS FALLS HOSPITALS INVESTMENT IN THIS JOINT VENTURE (NEW YORK EYE SURGERY CENTER, LLC) EXCEEDS $10,000. All of Glens Falls Hospital Board members are required to sign a conflict of interest policy, to ensure that the Hospital operates in a manner consistent with its charitable purposes. Activities, arrangements and services are the result of arms length bargaining reflecting reasonable payments for goods and services. Board bylaws stipulate that board members recuse themselves regarding any subject that pertains to a potential conflict of interest. Part I, Line 1 & Part III, Line 1 Glens Falls Hospital is an acute care facility and is the largest hospital between Albany and Montreal. It serves 6 counties and operates 24 regional care facilities. We have more than 225 affiliated, board certified physicians, ranging from primary care to surgical specialties. Glens Falls Hospital provides access to primary care and preventative health education and outreach activities, services offered to the community for free or reduced costs including patient financial assistance and charity care. The mission of Glens Falls Hospital is to improve the health of the people in our region by providing access to exceptional, affordable, and patient-centered care every day and in every setting. Our fundamental values are C.A.R.E.S. Collaboration, Accountability, Respect, Excellence and Safety. Part VI, Section A, Line 2 Current board members Mark Behan, Tenee' Casaccio, Michael B. Clarke, and Thomas J. Murphy have a business relationship. Part VI, Section A, Line 11 A copy of Form 990 was given to the Hospital's audit and compliance committee to review and comment on at their regular meeting. The form was approved by the committee and filed on a timely basis. The form was also given to the CFO, Controller, and Director of Finance to review and comment on. In addition, the form was reviewed by an independent accountant, KPMG, to make sure it was filled out completely and accurately. Part VI, Section B, Line 12b Each director, principal officer and member of a committee with board delegated powers shall annually sign a statement which affirms that such person, a) has received a copy of the conflicts of interest policy, b) has read and understands the policy, c) has agreed to comply with the policy and d) understands that the corporation is a charitable organization and that in order to maintain its Federal exemption it must engage primarily in activities which accomplish one or more of its tax exempt purposes. To ensure that the corporation operates in a manner consistent with its charitable purposes and that it does not engage in activities that could jeopardize its status as an organization exempt from federal income tax, periodic reviews shall be conducted. Reviews shall include the following subjects: A) whether compensation arrangements and benefits are reasonable and are the result of arm's length bargaining. B) whether acquisitions of physician practices and other provider services result in inurement or impermissible private benefit. C) whether partnership and joint venture arrangements and arrangements with management service organizations and physician hospital organizations conform to written policies, are properly recorded, reflect reasonable payments for goods and services, further the corporation's charitable purposes and do not result in inurement or impermissible private benefit. In conducting reviews, the corporation may use outside advisors. Part VI, Section B, Line 15b Glens Falls Hospital is committed to developing and maintaining a total compensation program that is competitive with programs offered by other health care organizations that are comparable to Glens Falls Hospital in revenue, structure, mission and scope of services. The compensation philosophy includes: base salary ranges positioned in the 50th percentile of a national and regional peer group, annual incentive opportunities tied to performance goals established by the Board, benefits delivered in the 50th percentile of a national peer group and total compensation positioned at approximately the 50th percentile for expected performance, and somewhat above that for exceptional performance. Executive pay is reviewed annually by a third party consultant. This review includes comparison of Glens Falls Hospital executive pay practices with national and regional benchmark studies as appropriate. The consultant is engaged directly by the Glens Falls Hospital Board of Governors and reports their findings to the Board Personnel Committee for review and action. Part IV, Section C, Line 19 The organization makes its governing documents, conflicts of interest policy and financial statements available TO THE PUBLIC upon request. Part XI, Line 9 Unrestricted Net Assets: Net assets released from restrictions 351,203 Net actuarial GAIN on accrued post retirement benefits 280,867 Temporary Restricted Net Assets: Restricted gifts & distributions from GFH Foundation 1,098,432 Change in interest in net assets of GFH Foundation 938,394 Restricted income 248,953 Net Assets released from restrictions (1,144,952) ---------------- Total 1,772,897 Glens Falls Hopital Foundation 100 Park Street Glens Falls NY 12801 141790805 Support Org NY 501(c)(3) 11,Type III NA false Adirondack Health Services Inc 100 Park Street Glens Falls NY 12801 141667492 Parent Org. NY 501(c)(3) 11, Type I NA false McGregor Realty Corporation 100 Park Street Glens Falls NY 12801 141560380 Property rent NY 501(c)(2) GFH true Imag Svc of NENY 100 Park Street Glens Falls NY 12801 141820955 Diag. radiolo NY NA Related 345669 157212 false 0 false 0.50000 No Country Eye Ctr 465B Maple Ave Saratoga NY 128665531 453715451 Eye Center NY NA Related 14676 -137712 false 0 false 0.30000 false false false false false false false false false false true true false false false false false false false McGregor Realty k 4750 Check Register McGregor Realty l 44 Financial Stats