UPMC CHAUTAUQUA AT WCA: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- UPMC CHAUTAUQUA AT WCA (EIN 16-0743226)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-05
- IRS object ID
- 201403099349301805
- Schema version
- 2013v3.0
- 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 D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-05T13:52:38-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 454051133 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREED MAXICK CPAS PC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 424 MAIN STREET SUITE 800 | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 142023508 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 160743226 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WOMAN'S CHRISTIAN ASSOCIATION HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WOMA | BusinessNameControlTxt |
| Phone | 7164870141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 FOOTE AVENUE / PO BOX 840 | AddressLine1 |
| City | JAMESTOWN | City |
| State | NY | State |
| ZIP Code | 147020840 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BETSY WRIGHT | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7164870141 | PhoneNum |
| Signature | 2014-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS DALTON | PreparerPersonNm |
| PTIN | P00645802 | PTIN |
| Phone | 7168472651 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BETSY WRIGHT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 FOOTE AVENUE / PO BOX 840 | AddressLine1 |
| City | JAMESTOWN | City |
| State | NY | State |
| ZIP Code | 147020840 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $105,385,662 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WCAHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1885 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE OF CHAUTAUQUA COUNTY AND THE SURROUNDING AREA IN A WAY THAT INCLUDES COMPASSION, DEDICATION, A COMMITMENT TO QUALITY, WHILE MAINTAINING ECONOMIC VIABILITY AND A VISION FOR THE FUTURE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 1261 | TotalEmployeeCnt |
| Total Volunteers | 107 | TotalVolunteersCnt |
| Total Gross UBI | -$64,380 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$66,319 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,639,358 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,559,552 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $85,239,918 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $81,499,972 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,609,782 | PYInvestmentIncomeAmt |
| CY Investment Income | $239,589 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,898,465 | PYOtherRevenueAmt |
| CY Other Revenue | $12,691,465 | CYOtherRevenueAmt |
| PY Total Revenue | $98,387,523 | PYTotalRevenueAmt |
| CY Total Revenue | $95,990,578 | 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 | $56,507,247 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $55,002,021 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $65,688 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $40,428,511 | PYOtherExpensesAmt |
| CY Other Expenses | $42,030,563 | CYOtherExpensesAmt |
| PY Total Expenses | $96,935,758 | PYTotalExpensesAmt |
| CY Total Expenses | $97,032,584 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,451,765 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,042,006 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $88,156,771 | TotalAssetsBOYAmt |
| Total Assets EOY | $88,727,318 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $77,748,831 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $65,525,223 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,407,940 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,202,095 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE OF CHAUTAUQUA COUNTY AND THE SURROUNDING AREA IN A WAY THAT INCLUDES COMPASSION, DEDICATION, A COMMITMENT TO QUALITY, WHILE MAINTAINING ECONOMIC VIABILITY AND A VISION FOR THE FUTURE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $66,909,935 | ExpenseAmt |
| Revenue | $94,286,931 | RevenueAmt |
| Desc | OPERATING A HOSPITAL TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE OF CHAUTAUQUA COUNTY AND THE SURROUNDING AREA. | Desc |
| Total Program Service Expenses | $66,909,935 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | 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 | 120 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1261 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 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 | Yes (1) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (1) | WrittenPolicyOrProcedureInd |
| 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 | BETSY WRIGHT | PersonNm |
| Phone | 7166648300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 FOOTE AVENUE PO BOX 840 | AddressLine1 |
| City | JAMESTOWN | City |
| State | NY | State |
| ZIP Code | 147020840 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| BARBARA S BUMSTED | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BETSY T WRIGHT | |||||||
| PRESIDENT/CEO | 40.00 | Yes (X) | $340,098 | $0 | $50,554 | Yes (X) | |
| JUDITH BURGETT | |||||||
| PAST CHAIR | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| HOWARD T HOWLETT JR | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVEN KILBURN | |||||||
| VICE CHAIR | 10.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DR RONALD KLIZEK | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BRENDA IRELAND | |||||||
| CHAIR | 10.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JANET CHEW | |||||||
| EMPLOYEE/BOARD MEMBER | 40.00 | Yes (X) | $44,075 | $0 | $11,575 | ||
| MICHAEL P SULLIVAN | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| TIMOTHY BLACK | |||||||
| ASSISTANT TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MAYNARD COTTER | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES ROACH | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ANNA DIBBLE | |||||||
| TREASURER | 4.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DR WILLIAM GEARY | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DR TIMOTHY BROWN | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JEFFREY PIAZZA | |||||||
| SECRETARY | 4.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| TERRY HAVENS-TURNER | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DR PATRICK COLLINS | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $952 | $0 | $0 | ||
| LARRY SENN | |||||||
| VP ADMINISTRATION | 40.00 | $177,852 | $0 | $23,100 | Yes (X) | ||
| CHARLES C NAZZARO | |||||||
| CFO | 40.00 | $152,780 | $0 | $23,527 | Yes (X) | ||
| DR MARLENE GARONE | |||||||
| VP MEDICAL AFFAIRS | 40.00 | $225,572 | $0 | $32,580 | Yes (X) | ||
| ANN DOWNING | |||||||
| VP NURSING | 40.00 | $137,560 | $0 | $17,904 | Yes (X) | ||
| JONATHAN BLASIUS | |||||||
| MEDICAL DIRECTOR-HOSPITALI | 40.00 | $396,709 | $0 | $45,338 | Yes (X) | ||
| GALO GRIJALVA | |||||||
| GENERAL SURGERY SURGEON | 40.00 | $330,941 | $0 | $11,456 | Yes (X) | ||
| MARIO GENTILE | |||||||
| HOSPITALIST | 40.00 | $271,416 | $0 | $18,742 | Yes (X) | ||
| WILLIAM D FRITZ | |||||||
| ORTHOPEDIC SURGEON | 40.00 | $684,581 | $0 | $21,167 | Yes (X) | ||
| THERESA PAGLIUCA | |||||||
| RADIOLOGY THERAPEUTIC PHYS | 40.00 | $356,862 | $0 | $12,091 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,119,398 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $268,034 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 25 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PREMIER ANESTHESIA OF NY PC | |||||
| 2655 NORTHWINDS PKWY | ALPARETTA | GA | 30009 | ANESTHESIA PHYSICIAN SERVICES | $939,297 |
| JAMESTOWN PSYCHIATRIC PC | |||||
| 305 E FAIRMOUNT AVENUE | LAKEWOOD | NY | 14750 | PSYCHIATRIC PHYSICIAN SERVICES | $858,846 |
| JAMESTOWN AREA MEDICAL ASSOCIATION | |||||
| 15 S MAIN ST | JAMESTOWN | NY | 14701 | PHYSICIAN SERVICES | $418,786 |
| CDW DIRECT LLC | |||||
| 75 REMITTANCE DRIVE SUITE 1515 | CHICAGO | IL | 60675 | COMPUTER EQUIPMENT AND SUPPLIES | $390,706 |
| M MODAL SERVICES LTD | |||||
| PO BOX 538504 | ATLANTA | GA | 30353 | TRANSCRIPTION SERVICES | $358,763 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $487,852 | RelatedOrganizationsAmt |
| Government Grants | $40,000 | GovernmentGrantsAmt |
| All Other Contributions | $1,031,700 | AllOtherContributionsAmt |
| Total Contributions | $1,559,552 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| HOSPITAL REVENUE | 621500 | $81,135,998 | $81,135,998 | |
| TRI-STATE REGIONAL ASSOCIATES | 621500 | $257,829 | $257,829 | |
| 31 SHERMAN INVESTORS | 621500 | $56,347 | $56,347 | |
| CHAUTAUQUA INTEGRATED DELIVERY SY | 621500 | $51,527 | $51,527 | |
| CHAUTAUQUA REGION ASSOC. MEDICAL | 621500 | -$1,729 | -$1,729 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $81,499,972 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,290 | TotalRevenueColumnAmt |
| Exclusion | $24,290 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $235,686 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $380,978 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$145,292 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$145,292 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$114,178 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$31,114 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $347,586 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $132,287 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $215,299 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $215,299 | TotalRevenueColumnAmt |
| Exclusion | $215,299 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $16,993,347 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $8,881,819 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,111,528 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,111,528 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OTHER MISCELLANEOUS REVENUE | 900099 | $4,007,635 | $4,007,635 |
| MEALS ON WHEELS | 621990 | $472,998 | $472,998 |
| TECHNOLOGY SCHOOL REVENUE | 621990 | $90,396 | $90,396 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $154,200 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $154,200 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,725,229 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $95,990,578 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $94,286,931 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$64,380 | UnrelatedBusinessRevenueAmt |
| Exclusion | $208,475 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,252,576 | TotalAmt |
| Program Services | $1,017,836 | ProgramServicesAmt |
| Management And General | $231,782 | ManagementAndGeneralAmt |
| Fundraising | $2,958 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,587,689 | TotalAmt |
| Program Services | $32,655,506 | ProgramServicesAmt |
| Management And General | $8,832,576 | ManagementAndGeneralAmt |
| Fundraising | $99,607 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,580,782 | TotalAmt |
| Program Services | $2,027,529 | ProgramServicesAmt |
| Management And General | $547,077 | ManagementAndGeneralAmt |
| Fundraising | $6,176 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,644,830 | TotalAmt |
| Program Services | $5,217,247 | ProgramServicesAmt |
| Management And General | $1,411,692 | ManagementAndGeneralAmt |
| Fundraising | $15,891 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,936,144 | TotalAmt |
| Program Services | $2,306,711 | ProgramServicesAmt |
| Management And General | $622,407 | ManagementAndGeneralAmt |
| Fundraising | $7,026 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,891 | TotalAmt |
| Program Services | -$231,425 | ProgramServicesAmt |
| Management And General | $405,316 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $328,440 | TotalAmt |
| Management And General | $328,440 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,439 | TotalAmt |
| Management And General | $89,439 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,880,706 | TotalAmt |
| Program Services | $2,460,125 | ProgramServicesAmt |
| Management And General | $1,420,581 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,675 | TotalAmt |
| Management And General | $34,290 | ManagementAndGeneralAmt |
| Fundraising | -$24,615 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,902,633 | TotalAmt |
| Program Services | $3,000,521 | ProgramServicesAmt |
| Management And General | $1,902,112 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,047,922 | TotalAmt |
| Management And General | $4,047,922 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,336,922 | TotalAmt |
| Program Services | $1,313,359 | ProgramServicesAmt |
| Management And General | $1,023,563 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $310,845 | TotalAmt |
| Program Services | $44,517 | ProgramServicesAmt |
| Management And General | $266,328 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,390,441 | TotalAmt |
| Management And General | $2,390,441 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,104,643 | TotalAmt |
| Program Services | $2,447,940 | ProgramServicesAmt |
| Management And General | $2,656,703 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $996,257 | TotalAmt |
| Management And General | $996,257 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| UNRELATED BUSINESS INCO | $88,263 | $88,263 | ||
| PHYSICAN FEES | $7,332,002 | $501,511 | $6,830,491 | |
| MEDICAL SUPPLIES | $4,755,123 | $430,996 | $4,324,127 | |
| OTHER | $1,782,749 | $1,698,938 | $125,166 | -$41,355 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,500,612 | TotalAmt |
| Program Services | $3,370,285 | ProgramServicesAmt |
| Management And General | $130,327 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,032,584 | TotalAmt |
| Program Services | $66,909,935 | ProgramServicesAmt |
| Management And General | $30,056,961 | ManagementAndGeneralAmt |
| Fundraising | $65,688 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,580,825 | BOYAmt |
| EOY | $3,561,550 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,437,378 | BOYAmt |
| EOY | $14,305,098 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,942 | BOYAmt |
| EOY | $694 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,571,180 | BOYAmt |
| EOY | $2,655,210 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,762,185 | BOYAmt |
| EOY | $1,655,669 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $131,458,256 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $86,228,430 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,745,826 | BOYAmt |
| EOY | $45,229,826 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,492 | BOYAmt |
| EOY | $231,583 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,874,905 | BOYAmt |
| EOY | $5,343,864 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,973,038 | BOYAmt |
| EOY | $15,743,824 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,156,771 | BOYAmt |
| EOY | $88,727,318 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,421,671 | BOYAmt |
| EOY | $13,855,952 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,114,828 | BOYAmt |
| EOY | $809,141 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,006,942 | BOYAmt |
| EOY | $30,045,018 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,205,390 | BOYAmt |
| EOY | $20,815,112 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,748,831 | BOYAmt |
| EOY | $65,525,223 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,921,676 | BOYAmt |
| EOY | $6,635,798 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,569,575 | BOYAmt |
| EOY | $13,765,079 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,760,041 | BOYAmt |
| EOY | $2,801,218 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,407,940 | BOYAmt |
| EOY | $23,202,095 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,156,771 | BOYAmt |
| EOY | $88,727,318 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,042,006 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $165,881 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $13,670,280 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,670,769 | BeginningYearBalanceAmt |
| Contributions | $28,522 | ContributionsAmt |
| Investment Earnings Or Losses | $2,378,655 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $207,144 | OtherExpendituresAmt |
| End Year Balance | $12,870,802 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,614,225 | BeginningYearBalanceAmt |
| Contributions | $40,166 | ContributionsAmt |
| Investment Earnings Or Losses | $1,412,256 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $395,878 | OtherExpendituresAmt |
| End Year Balance | $10,670,769 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,071,576 | BeginningYearBalanceAmt |
| Contributions | $38,185 | ContributionsAmt |
| Investment Earnings Or Losses | -$362,147 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $133,389 | OtherExpendituresAmt |
| End Year Balance | $9,614,225 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,221,623 | BeginningYearBalanceAmt |
| Contributions | $62,590 | ContributionsAmt |
| Investment Earnings Or Losses | $1,222,066 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $434,703 | OtherExpendituresAmt |
| End Year Balance | $10,071,576 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $7,758,562 | BeginningYearBalanceAmt |
| Contributions | $59,230 | ContributionsAmt |
| Investment Earnings Or Losses | $1,803,046 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $399,215 | OtherExpendituresAmt |
| End Year Balance | $9,221,623 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.74140 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.25860 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,342,941 | OtherCostOrOtherBasisAmt |
| Book Value | $1,342,941 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $52,931,580 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,753,180 | DepreciationAmt |
| Book Value | $21,178,400 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,690,653 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,960,167 | DepreciationAmt |
| Book Value | $730,486 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $74,091,295 | OtherCostOrOtherBasisAmt |
| Depreciation | $52,515,083 | DepreciationAmt |
| Book Value | $21,576,212 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $401,787 | OtherCostOrOtherBasisAmt |
| Book Value | $401,787 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $45,229,826 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $162,048 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| OTHER CASH & EQUIVALENTS | $4,210,058 | C |
| MUTUAL FUNDS | $971,758 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $5,343,864 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| CONTRIBUTIONS RECEIVABLE | $1,118,379 |
| ASSETS HELD BY OTHERS | $12,859,179 |
| DEFERRED FINANCING COSTS, NET | $1,251,266 |
| OTHER ASSETS | $15,000 |
| OTHER LONG TERM RECEIVABLE | $500,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $15,743,824 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED PENSION LIABILITY | $18,257,238 |
| ESTIMATED THIRD PARTY PAYOR SETTLEMENTS | $2,057,874 |
| OTHER LONG TERM LIABILITY | $500,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $20,815,112 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE INCOME FROM THE ENDOWMENT FUND IS UNRESTRICTED AND ITS USES ARE DETERMINED BY THE BOARD. |
| PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE (THE "CODE"), AND ACCORDINGLY, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN REFLECTED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE HOSPITAL ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH U.S. GAAP, WHICH REQUIRES THE RECOGNITION AND MEASUREMENT OF UNCERTAIN INCOME TAX POSITIONS THAT THE HOSPITAL HAS TAKEN OR EXPECTS TO TAKE IN THE HOSPITAL'S TAX RETURNS. THE HOSPITAL HAS NOT RECORDED ANY AMOUNTS RELATING TO UNCERTAIN TAX POSITIONS. IN ADDITION, THE HOSPITAL IS NO LONGER SUBJECT TO FEDERAL AND NYS INCOME TAX EXAMINATION FOR YEARS PRIOR TO 2010. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | 0 | 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) |
|---|---|---|
| Total Community Benefit Expns | $296,299 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,315 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $288,984 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,725,371 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,292,933 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,432,438 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07660 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,021,670 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,300,248 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,721,422 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07960 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $216,617 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $43,318 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $173,299 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00180 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $214,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $90,296 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $123,704 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $430,617 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $133,614 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $297,003 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,452,287 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,433,862 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,018,425 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08270 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,307,355 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $38,076 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $29,172,962 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $27,072,974 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $2,099,988 | 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 | 0 | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 WCA 31 SHERMAN LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | REAL ESTATE PROJECTS | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0.50000 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0.00000 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0.00000 | 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 | WCA HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 FOOTE AVENUE / PO BOX 840 | AddressLine1 |
| City | JAMESTOWN | City |
| State | NY | State |
| ZIP Code | 147020840 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.WCAHOSPITAL.ORG | WebsiteAddressTxt |
| State License | 10-65-60 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WCA HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.WCAHOSPITAL.ORG | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Exec Community Wide Plan | Yes (X) | ExecCommunityWidePlanInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Adopt Budget | Yes (X) | AdoptBudgetInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 300.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | 0 | FPGUsedDetermEligDscntCareInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Permit Lawsuit | Yes (X) | PermitLawsuitInd |
| Permit Lien On Residence | Yes (X) | PermitLienOnResidenceInd |
| Permit Other Actions | Yes (X) | PermitOtherActionsInd |
| Collection Activities | Yes (1) | CollectionActivitiesInd |
| Reporting To Credit Agency | Yes (X) | ReportingToCreditAgencyInd |
| Lawsuit | Yes (X) | LawsuitInd |
| Liens On Residences | Yes (X) | LiensOnResidencesInd |
| Other Actions | Yes (X) | OtherActionsInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| WCA HOSPITAL | PART V, SECTION B, LINE 3: THE CHAUTAUQUA COUNTY HEALTH PLANNING TEAM (CCCHPT) PARTNERS INVOLVED WITH WCA HOSPITAL IN THE JOINT PLANNING SESSIONS FOR THE CHAUTAUQUA COUNTY COMMUNITY HEALTH ASSESSMENT (CHA), THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND INDIVIDUAL COMMUNITY SERVICE PLAN (CSP) PROCESSES ARE: CHAUTAUQUA COUNTY HEALTH DEPARTMENT, CHAUTAUQUA COUNTY HEALTH NETWORK, CHAUTAUQUA COUNTY MENTAL HEALTH, LAKE ERIE REGIONAL HEALTH SYSTEM OF NEW YORK (BROOKS HOSPITAL AND TLC), THE CHAUTAUQUA CENTER, WESTFIELD HOSPITAL AND P2 COLLABORATION OF WNY. P2 WORKS WITH INDIVIDUALS AND ORGANIZATIONS IN ALLEGANY, CATTARAUGUS, CHAUTAUQUA, ERIE, GENESEE, NIAGARA, ORLEANS AND WYOMING COUNTIES TO IMPROVE THE HEALTH OF WESTERN NEW YORKERS.IDENTIFICATION OF COMMUNITY HEALTH NEEDS AND SELECTION OF PREVENTION AGENDA PRIORITIES WERE DONE THROUGH COMMUNITY INPUT THROUGH COMMUNITY FOCUS GROUPS AND ASSESSING COUNTY DATA. PUBLIC OUTREACH FOR THE COMMUNITY HEALTH PLANNING PROCESS BEGAN WITH A WEB-BASED SURVEY. THE LINK FOR THE SURVEY WAS SHARED THROUGH FACEBOOK, THE CCDHS WEBSITE, WAS FEATURED IN A PRESS RELEASE TO LOCAL NEWSPAPERS, AND SENT ELECTRONICALLY TO A NUMBER OF EMAIL DISTRIBUTION LISTS. PAPER COPIES OF THE SURVEY WERE DISTRIBUTED IN EMERGENCY ROOMS, REPRODUCTIVE HEALTH CLINICS, THE FEDERALLY QUALIFIED HEALTH CENTER, SOCIAL SERVICES TEMPORARY ASSISTANCE OFFICES, MENTAL HEALTH CLINICS, CANCER SERVICES PROGRAM CLINICS AND THE CHAUTAUQUA COUNTY JAIL. IN THE SURVEY, THE CCHPT ASKED RESPONDENTS WHAT ISSUES THEY CONSIDERED TO BE COMMUNITY PROBLEMS, WHAT HEALTH ISSUES WERE MOST CONCERNING, ABOUT THEIR PERSONAL HEALTH, AND ALSO REQUESTED DEMOGRAPHIC INFORMATION. THE SURVEY ALSO ASKED RESIDENTS WHICH MEDICAL SERVICES THEY LEAVE THE COUNTY FOR AND WHY. THE SURVEYS WERE COLLECTED FROM MARCH 28 TO JUNE 2, 2013, 1,170 SURVEY RESPONSES WERE COLLECTED. THE TOP THREE HEALTH ISSUES INDIVIDUALS WERE MORE CONCERNED ABOUT WERE HEALTH INSURANCE, OBESITY OR OVERWEIGHT, AND CANCER. THERE WERE ALSO THREE "COMMUNITY CONVERSATIONS" HELD IN DUNKIRK, JAMESTOWN AND WESTFIELD SPONSORED BY THE P2 COLLABORATIVE OF WNY AND THE CHAUTAUQUA COUNTY HEALTH NETWORK. |
| WCA HOSPITAL | PART V, SECTION B, LINE 10: WCA HOSPITAL USES THE FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE. THE FPG FAMILY INCOME LIMIT FOR ELIGIBILITY FOR FREE CARE IS 300%. |
| WCA HOSPITAL | PART V, SECTION B, LINE 11: WCA HOSPITAL USES A SLIDING SCALE TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE. |
| WCA HOSPITAL | PART V, SECTION B, LINE 14G: THE AVAILABILITY OF CHARITY CARE WILL BE MADE KNOWN TO ALL PATIENTS VIA THE HOSPITAL WEBSITE, PATIENT STATEMENTS, AND APPLICATIONS AVAILABLE IN ADMISSIONS, CASE MANAGEMENT DEPARTMENT, EMERGENCY DEPARTMENT, CUSTOMER SERVICE, WELLNESS/OUTREACH CENTERS, OUTPATIENT REGISTRATIONS WHERE PATIENTS ACCESS OR INQUIRE ABOUT HOSPITAL SERVICES AND OTHER LOCATIONS DEEMED APPROPRIATE. |
| WCA HOSPITAL | PART V, SECTION B, LINE 16E: WCA MAKES REASONABLE ATTEMPTS TO QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE VIA AN APPLICATION ON THE WEBSITE, DURING THE PRE-COLLECTION PROCESS AND OTHER VISIBLE/VERBAL COMMUNICATIONS. WCA HOSPITAL REPORTS DELINQUENT ACCOUNTS TO A CREDIT AGENCY. THE CREDIT AGENCY PURSUES LAWSUITS, LIENS ON RESIDENCES, JUDGMENTS AND GARNISHMENTS AS PER THE HOSPITAL'S COLLECTION POLICY. |
| WCA HOSPITAL | PART V, SECTION B, LINE 17E: WCA MAKES REASONABLE ATTEMPTS TO QUALIFY PATIENTS FOR FINANCIAL ASSISTANCE VIA AN APPLICATION ON THE WEBSITE, DURING THE PRE-COLLECTION PROCESS AND OTHER VISIBLE/VERBAL COMMUNICATIONS. WCA HOSPITAL REPORTS DELINQUENT ACCOUNTS TO A CREDIT AGENCY. THE CREDIT AGENCY PURSUES LAWSUITS, LIENS ON RESIDENCES, JUDGMENTS AND GARNISHMENTS AS PER THE HOSPITAL'S COLLECTION POLICY. |
| WCA HOSPITAL | PART V, SECTION B, LINE 20D: ALL PATIENTS ARE CHARGED THE SAME (GROSS CHARGES) REGARDLESS OF TYPE OF INSURANCE AND ABILITY TO PAY. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. |
| WCA HOSPITAL | PART V, SECTION B, LINE 22: ALL PATIENTS ARE CHARGED THE SAME (GROSS CHARGES) REGARDLESS OF TYPE OF INSURANCE AND ABILITY TO PAY. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. PAYMENT ARRANGEMENTS INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE, REIMBURSED COSTS, DISCOUNTED CHARGES, AND PER DIEM PAYMENTS. NET PATIENT SERVICE REVENUE IS REPORTED AT THE ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYORS, AND OTHERS FOR SERVICES RENDERED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS UNDER REIMBURSEMENT AGREEMENTS WITH THIRD-PARTY PAYORS. |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | WCA USES FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR PROVIDING FREE CARE TO LOW INCOME INDIVIDUALS. THE FAMILY INCOME LIMIT FOR ELIGIBILITY IS 300%. WCA USES A SLIDING FEE SCALE TO DETERMINE ELIGIBILITY FOR PROVIDING DISCOUNTED CARE TO LOW INCOME INDIVIDUALS. |
| PART I, LINE 7: | PATIENT CHARGE AND REIMBURSEMENT INFORMATION WAS OBTAINED FROM THE NEW YORK STATE INSTITUTIONAL COST REPORT ("NYSICR") EXHIBIT 46 WHICH INCORPORATES ALL PATIENT SEGMENTS AND FINANCIAL CLASSES. THE RATIO OF PATIENT CARE COST TO CHARGES RATIO WAS DEVELOPED USING WORKSHEET 2. TOTAL AUDITED OPERATING EXPENSES EXCLUDED BAD DEBT AND WERE OFFSET BY NON-PATIENT CARE ACTIVITY REVENUE AND COMMUNITY BENEFIT EXPENSE. GROSS PATIENT CHARGES WERE OBTAINED FROM NYSICR EXHIBIT 46. |
| PART I, LINE 7G: | THERE WERE NO SUBSIDIZED HEALTH SERVICES REPORTED FOR 2013 REPORTED ON LINE 7G. |
| PART I, LN 7 COL(F): | THE BAD DEBT EXPENSES (AT COST) WAS CALCULATED BY APPLYING THE RATIO OF PATIENT CARE COST TO CHARGES TO THE GROSS BAD DEBT: $5,093,189 X 45.30% = $2,307,355.THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS CALCULATED BY DEVELOPING AN AVERAGE COST PER CLAIM AND MULTIPLYING THAT AVERAGE COST BY THE NUMBER OF INCOMPLETE OR DENIED CLAIMS. $296,299 / 428 = $692.29 X 55 = $38,076. |
| PART I, LINE 6A | THE COMMUNITY SERVICE BENEFIT REPORT IS PREPARED INTERNALLY BY WCA EMPLOYEES COORDINATED BY LARRY SENN, VP ADMINISTRATION. THIS REPORT IS FILED WITH NEW YORK STATE ON A PERIODIC BASIS. |
| PART III, LINE 4: | PATIENT ACCOUNTS RECEIVABLE IS PRESENTED NET OF AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL COLLECTIONS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION, AND EXISTING ECONOMIC CONDITIONS. PATIENT ACCOUNTS RECEIVABLE ARE DUE 30 DAYS AFTER THE DATE OF DISCHARGE. RECEIVABLES PAST DUE MORE THAN 120 DAYS ARE GENERALLY WRITTEN OFF BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE PATIENT AND OTHER THIRD-PARTY PAYORS. |
| PART III, LINE 8: | MEDICARE REVENUE (INCLUDING DSH ) WAS OBTAINED FROM THE ORGANIZATION'S MEDICARE PS&R. MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE ORGANIZATION'S MEDICARE COST REPORT. THERE WAS NO SHORTFALL REPORTED: $29,172,962 - 27,072,974 = $2,099,988 SURPLUS. |
| PART III, LINE 9B: | THE APPLICATION AND ACCOMPANYING DOCUMENTATION IS REQUIRED AND WILL SERVE TO VERIFY THE INCOME AND MEDICAID ELIGIBILITY OF THE APPLICANT. CHARITY CARE WILL BE APPROVED BASED UPON INCOME, RELATIVE TO FAMILY SIZE, THAT FALLS WITHIN A RANGE BETWEEN 0 AND 300% OF THE POVERTY GUIDELINES ISSUED EACH YEAR BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE APPLICANT MUST BE UNINSURED OR UNDERINSURED, AND BE INELIGIBLE FOR MEDICAID COVERAGE. IF UNDERINSURED, A DENIAL OF COVERAGE FOR THE HOSPITAL SERVICES MUST ALSO ACCOMPANY THE DOCUMENTATION. SERVICES REFERRED TO AN OUTSIDE COLLECTION AGENCY ARE EXCLUDED FROM CONSIDERATION FOR CHARITY CARE. |
| PART VI, LINE 5: | WCA IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN JAMESTOWN, NY. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES, AND MENTAL HEALTH AND CHEMICAL DEPENDENCY REHABILITATION FOR RESIDENTS OF THE LOCAL GEOGRAPHIC REGION. THE MISSION OF WCA HOSPITAL IS TO IMPROVE THE HEALTH AND WELL BEING OF THE PEOPLE OF CHAUTAUQUA COUNTY AND THE SURROUNDING AREA IN A WAY THAT INCLUDES COMPASSION, DEDICATION, AND A COMMITMENT TO QUALITY, WHILE MAINTAINING ECONOMIC VIABILITY AND A VISION FOR THE FUTURE. THE PRIMARY SERVICE AREA OF THE HOSPITAL INCLUDES JAMESTOWN, ASHVILLE, BEMUS POINT, CELORON, FALCONER, FREWSBURG, GERRY, GREENHURST, KENNEDY, LAKEWOOD AND RANDOLPH. WCA IS LOCATED IN CHAUTAUQUA COUNTY IN WESTERN NEW YORK. THE PRIMARY SERVICE AREA IS A RURAL POPULATION. THE ORGANIZATION'S SERVICE AREA IS REVIEWED PERIODICALLY AS PART OF THE ORGANIZATION STRATEGIC PLAN. THE REVIEW INCLUDES MARKET SHARE DATA OF SERVICES PROVIDED BY ZIP CODES ALONG WITH POPULATION AND DEMOGRAPHIC DATA. WCA SUBMITTED THE CHAUTAUQUA COUNTY COMMUNITY HEALTH ASSESSMENT 2014-2017 IN NOVEMBER 2013. WCA HAS IDENTIFIED COMMUNITY HEALTH PRIORITIES AS CHRONIC DISEASE PREVENTION (INC OBESITY, CARDIOVASCULAR DISEASE, STROKE, CANCER) PROMOTE HEALTH WOMEN, INFANTS AND CHILDREN (INC PRENATAL CARE, MATERNAL HEALTH, BIRTH SPACING, BREASTFEEDING RATES, NEWBORN DRUG-RELATED HOSPITAL DISCHARGES) AND PROMOTION OF MENTAL HEALTH AND PREVENTION OF SUBSTANCE ABUSE.THE CHAUTAUQUA COUNTY HEALTH PLANNING TEAM (CCCHPT) PARTNERS INVOLVED WITH WCA HOSPITAL IN THE JOINT PLANNING SESSIONS FOR THE CHAUTAUQUA COUNTY COMMUNITY HEALTH ASSESSMENT (CHA), THE COMMUNITY HEALTH IMPROVEMENT PLAN (CHIP) AND INDIVIDUAL COMMUNITY SERVICE PLAN (CSP) PROCESSES ARE: CHAUTAUQUA COUNTY HEALTH DEPARTMENT, CHAUTAUQUA COUNTY HEALTH NETWORK, CHAUTAUQUA COUNTY MENTAL HEALTH, LAKE ERIE REGIONAL HEALTH SYSTEM OF NEW YORK (BROOKS HOSPITAL AND TLC), THE CHAUTAUQUA CENTER, WESTFIELD HOSPITAL AND P2 COLLABORATION OF WNY. P2 WORKS WITH INDIVIDUALS AND ORGANIZATIONS IN ALLEGANY, CATTARAUGUS, CHAUTAUQUA, ERIE, GENESEE, NIAGARA, ORLEANS AND WYOMING COUNTIES TO IMPROVE THE HEALTH OF WESTERN NEW YORKERS. IDENTIFICATION OF COMMUNITY HEALTH NEEDS AND SELECTION OF PREVENTION AGENDA PRIORITIES WERE DONE THROUGH COMMUNITY INPUT THROUGH COMMUNITY FOCUS GROUPS AND ASSESSING COUNTY DATA. PUBLIC OUTREACH FOR THE COMMUNITY HEALTH PLANNING PROCESS BEGAN WITH A WEB-BASED SURVEY. THE LINK FOR THE SURVEY WAS SHARED THROUGH FACEBOOK, THE CCDHS WEBSITE, WAS FEATURED IN A PRESS RELEASE TO LOCAL NEWSPAPERS, AND SENT ELECTRONICALLY TO A NUMBER OF EMAIL DISTRIBUTION LISTS. PAPER COPIES OF THE SURVEY WERE DISTRIBUTED IN EMERGENCY ROOMS, REPRODUCTIVE HEALTH CLINICS, THE FEDERALLY QUALIFIED HEALTH CENTER, SOCIAL SERVICES TEMPORARY ASSISTANCE OFFICES, MENTAL HEALTH CLINICS, CANCER SERVICES PROGRAM CLINICS AND THE CHAUTAUQUA COUNTY JAIL. IN THE SURVEY, THE CCHPT ASKED RESPONDENTS WHAT ISSUES THEY CONSIDERED TO BE COMMUNITY PROBLEMS, WHAT HEALTH ISSUES WERE MOST CONCERNING, ABOUT THEIR PERSONAL HEALTH, AND ALSO REQUESTED DEMOGRAPHIC INFORMATION. THE SURVEY ALSO ASKED RESIDENTS WHICH MEDICAL SERVICES THEY LEAVE THE COUNTY FOR AND WHY. THE SURVEYS WERE COLLECTED FROM MARCH 28 TO JUNE 2, 2013, 1,170 SURVEY RESPONSES WERE COLLECTED. THE TOP THREE HEALTH ISSUES INDIVIDUALS WERE MORE CONCERNED ABOUT WERE HEALTH INSURANCE, OBESITY OR OVERWEIGHT, AND CANCER. THERE WERE ALSO THREE "COMMUNITY CONVERSATIONS" HELD IN DUNKIRK, JAMESTOWN AND WESTFIELD SPONSORED BY THE P2 COLLABORATIVE OF WNY AND THE CHAUTAUQUA COUNTY HEALTH NETWORK.WCA COMMUNITY HEALTH ACTIVITIES IN 2013 INCLUDED BUT NOT LIMITED TO:CARDIOVASCULAR:-COMMUNITY EVENTS WHICH INCLUDED HEART HEALTH EDUCATION AND AWARENESS ACTIVITIES IN SCHOOLS, OUTREACH ORGANIZATIONS, CHURCHES, INDUSTRY LOCATIONS AND SCHOOLS.-WCA STRIKE OUT HEART DISEASE- A COMMUNITY BOWL A THON FOR HEART DISEASE AWARENESS.-CARDIOVASCULAR SCREENINGS: BLOOD PRESSURE, BODY COMPOSITION TESTING, TOBACCO USE ANALYSIS, DIABETES RISK FACTOR SCREENING.-WCA EMPLOYEE WORKSITE WELLNESS ACTIVITIES PROMOTING HEALTHY HEART CHOICES, HEALTH RISK ASSESSMENTS, BLOOD PRESSURES, BODY COMPOSITION TESTING, PHYSICAL ACTIVITY AND NUTRITION PROGRAMS, MONTHLY HEALTH E-TIPS, WALKING PROGRAMS, TOBACCO CESSATION COUNSELING.-NAVIGATION OF THE COMMUNITY AND EMPLOYEES TO ALL RESOURCES AVAILABLE TO THEM FOR WEIGHT MANAGEMENT, PHYSICAL ACTIVITIES AND TOBACCO CESSATION SERVICES.-FREE TOBACCO CESSATION EDUCATION AND SERVICES TO EMPLOYEES AND COMMUNITY.-MAINTAINED A TOBACCO FREE ENVIRONMENT ON ALL WCA PROPERTY SINCE 2010.DIABETES:-DIABETES TASK FORCE IMPLEMENTATION WITH AREA HEALTHCARE FACILITIES/CSP.-DIABETES PREVENTION PROGRAM-16 WEEK CLASS FOR PRE-DIABETICS WITH ONE YEAR FOLLOW UP.-DIABETES EDUCATION SERVICES PROVIDED BY CERTIFIED DIABETES EDUCATOR.-WCA FARMERS MARKET EXPRESS-EASY ACCESS OF FRUITS AND VEGETABLES FOR EMPLOYEE AND COMMUNITY MEMBERS.-WCA RAISED GARDENS-PROVIDES FRUITS AND VEGETABLES TO WCA EMPLOYEES AND COMMUNITY MEMBERS.CARDIOVASCULAR HEALTH:-BLOOD PRESSURE SCREENINGS.-BODY COMPOSITION TESTING AND HEALTH RISK ASSESSMENTS.TOBACCO:-2013 WCA HOSPITAL CONTINUES TO MAINTAIN TOBACCO FREE FACILITY STATUS.-TWO MINUTE-TOBACCO CESSATION INITIATIVE-ALL IDENTIFIED PATIENTS ARE ASKED "ARE YOU READY TO QUIT TOBACCO USE?" BY NURSING STAFF WITH REFERRAL TO WELLNESS FOR TOBACCO CESSATION CONSULT.-FREE TOBACCO CESSATION TO COMMUNITY MEMBERS AS WELL AS WCA EMPLOYEES-FRESH START PROGRAM.-PARTICIPANT IN THE TRI-COUNTY TOBACCO CONTROL PROGRAM FOR COUNTY RESOURCE AND ADVOCACY PROGRAMS.-REFERRALS TO NYS QUIT LINE FOR NICOTINE REPLACEMENT THERAPY.CANCER:-MAINTAINED WCA TOBACCO FREE FACILITY AND POLICIES.-CONTINUED THE PATIENT NAVIGATION CANCER RESOURCE PROGRAM.-RE-CERTIFICATION OF TWO WCA BREAST HEALTH NURSE NAVIGATORS IN MAMMOGRAPHY IN CONJUNCTION WITH SUSAN G. KOMEN FOR THE CURE WNY AFFILIATE.-OCTOBER-BREAST CANCER AWARENESS RISK FACTOR AWARENESS CAMPAIGN FOR COMMUNITY AND WCA EMPLOYEES-ONE-TO-ONE TOBACCO CESSATION COUNSELING SESSIONS FOR SELF-REFERRED, REFERRED FROM PHYSICIANS AND CATH LAB PROGRAM.-GREAT AMERICAN SMOKEOUT BLITZ FOR WCA EMPLOYEES, LOCAL MIDDLE SCHOOLS AND HIGH SCHOOL WITH PRESENTATIONS ON TOBACCO.-WCA ATTENDANCE AT REGIONAL AND COUNTY CANCER COALITIONS, DIALOGUE SESSIONS AND CANCER EDUCATION/NETWORKING PROGRAMS IN THE COUNTY,-COMMUNITY PRESENTATIONS AND MEDIA EDUCATION ON RISK FACTORS AND PREVENTION OF CANCER.-PROMOTION OF ACCESS TO WCA CANCER CARE SERVICES AND CANCER CARE RESOURCES AVAILABLE TO THE COMMUNITY.-MONTHLY MEETINGS OF WCA CANCER TREATMENT COMMITTEE.-LAB PARTICIPATION IN COMMUNITY PROSTATE SCREENING.-COALITION PARTNERSHIPS WITH CHAUTAUQUA COUNTY CANCER SERVICES PROGRAM, WNY CANCER COALITION, REGIONAL ROUND TABLE DISCUSSIONS AND P2 COLLABORATIVE OF WNY.-CEO GOLD ACCREDITATION 2013-"LILY'S HOPE"-COLLABORATION WITH ZONTA CLUB OF JAMESTOWN TO PROVIDE WIGS AND TURBANS FOR THOSE GOING THROUGH CHEMO OR HAIR LOSS FROM MEDICAL CONDITION ACCESSED THROUGH WCA PATIENT NAVIGATION.-FACILITATION OF MAXIMIZING MAMMOGRAPHY PARTICIPATION PROGRAM FOR INCREASED ADHERENCE TO BREAST SCREENING GUIDELINES OF WOMEN 40 YEARS AND OVER WHO MISS, CANCEL OR HAVE NOT HAD A MAMMOGRAM.-FACILITATION AND IMPLEMENTATION OF WCA PALLIATIVE CARE PROGRAM.-FACILITATED THREE AMERICAN CANCER SOCIETY LOOK GOOD FEEL BETTER PROGRAMS AT THE WCA CANCER TREATMENT CENTER.-DEVELOPED DISTRESS SCREENING TOOL FOR INPATIENT CANCER PATIENTS.-PRESENTED PLANT BASED NUTRITION CLASSES FOR CANCER PATIENTS AND THEIR FAMILIES. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BETSY T WRIGHT | ||||||||||||||
| PRESIDENT/CEO | $340,098 | $0 | $0 | $0 | $0 | $0 | $29,580 | $0 | $20,974 | $0 | $390,652 | $0 | $0 | $0 |
| LARRY SENN | ||||||||||||||
| VP ADMINISTRATION | $177,852 | $0 | $0 | $0 | $0 | $0 | $17,817 | $0 | $5,283 | $0 | $200,952 | $0 | $0 | $0 |
| CHARLES C NAZZARO | ||||||||||||||
| CFO | $152,780 | $0 | $0 | $0 | $0 | $0 | $15,915 | $0 | $7,612 | $0 | $176,307 | $0 | $0 | $0 |
| DR MARLENE GARONE | ||||||||||||||
| VP MEDICAL AFFAIRS | $225,572 | $0 | $0 | $0 | $0 | $0 | $22,555 | $0 | $10,025 | $0 | $258,152 | $0 | $0 | $0 |
| ANN DOWNING | ||||||||||||||
| VP NURSING | $137,560 | $0 | $0 | $0 | $0 | $0 | $13,312 | $0 | $4,592 | $0 | $155,464 | $0 | $0 | $0 |
| JONATHAN BLASIUS | ||||||||||||||
| MEDICAL DIRECTOR-HOSPITALI | $396,709 | $0 | $0 | $0 | $0 | $0 | $33,588 | $0 | $11,750 | $0 | $442,047 | $0 | $0 | $0 |
| GALO GRIJALVA | ||||||||||||||
| GENERAL SURGERY SURGEON | $330,941 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $11,456 | $0 | $342,397 | $0 | $0 | $0 |
| MARIO GENTILE | ||||||||||||||
| HOSPITALIST | $271,416 | $0 | $0 | $0 | $0 | $0 | $7,560 | $0 | $11,182 | $0 | $290,158 | $0 | $0 | $0 |
| WILLIAM D FRITZ | ||||||||||||||
| ORTHOPEDIC SURGEON | $684,581 | $0 | $0 | $0 | $0 | $0 | $8,160 | $0 | $13,007 | $0 | $705,748 | $0 | $0 | $0 |
| THERESA PAGLIUCA | ||||||||||||||
| RADIOLOGY THERAPEUTIC PHYS | $356,862 | $0 | $0 | $0 | $0 | $0 | $6,554 | $0 | $5,537 | $0 | $368,953 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHAUTAUQUA COUNTY CAPITAL RESOURCE CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 371595176 | BondIssuerEIN |
| CUSIP | 162542ABO | CUSIPNum |
| Bond Issued | 2011-02-10 | BondIssuedDt |
| Issue Price | $29,030,000 | IssuePriceAmt |
| Purpose | REFINANCE OLD DEBT AND BUILD A NEW EMERGENCY ROOM | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Bond Defeased | $15,258,292 | BondDefeasedAmt |
| Total Proceeds | $27,773,529 | TotalProceedsAmt |
| In Reserve Fund | $2,777,353 | InReserveFundAmt |
| Issuance Costs From Proceeds | $555,471 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $9,037,861 | CapitalExpendituresAmt |
| Other Spent Proceeds | $144,552 | OtherSpentProceedsAmt |
| Substantial Completion | 2011 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (1) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | ALL BOARD MEMBERS HAVE A VOTE EXCEPT THE PRESIDENT ELECT OF THE MEDICAL STAFF WHO IS A BOARD MEMBER WITHOUT VOTING RIGHTS. |
| FORM 990, PART VI, SECTION A, LINE 6 | WCA GROUP, INC., A PARENT HOLDING COMPANY, IS THE SOLE CORPORATE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | WCA GROUP, INC. MAY ELECT DIRECTORS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS OF THE GOVERNING BODY RELATIVE TO A MAJOR TRANSFER OF ASSETS ARE SUBJECT TO APPROVAL BY WCA GROUP, INC. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM. THE CEO, CFO, AND BOARD OF DIRECTORS ALL REVIEW THE FORM 990 AND RELATED SCHEDULES PRIOR TO FILING AT A BOARD MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | WCA HOSPITAL REQUIRES ALL BOARD MEMBERS TO COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY. SUCH STATEMENTS ARE REVIEWED BY THE BOARD CHAIR AND MAINTAINED ON FILE. BOARD MEMBERS ARE EXCUSED WHEN A CONFLICT EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | WCA HOSPITAL ENGAGES AN INDEPENDENT FIRM TO EVALUATE THE COMPENSATION OF THE CEO AND THE CFO EVERY THREE YEARS. THE COMPENSATION COMMITTEE SETS THE COMPENSATION LEVELS ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE AUDITED FINANCIAL STATEMENTS ARE PUBLISHED AND MADE AVAILABLE UPON REQUEST. IN ADDITION THE HOSPITAL PUBLISHES AN INFORMATIONAL BOOKLET CONTAINING AUDITED DATA AND DISTRIBUTES THROUGH THE LOCAL NEWSPAPER. |
| FORM 990, PART XI, LINE 9: | CHANGE IN MINIMUM PENSION LIABILITY 11,523,446. CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF W.C.A. FOUNDATION 2,115,114. BOOK TO TAX ADJUSTMENT - PARTNERSHIP INTERESTS 31,720. |
| FORM 990, PART XI, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WCA 31 SHERMAN LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4 CENTRE DRIVE | AddressLine1 |
| City | ORCHARD PARK | City |
| State | NY | State |
| ZIP Code | 14127 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454867695 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Total Income | $223,080 | TotalIncomeAmt |
| End Of Year Assets | $114,420 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WCA HOSPITAL | BusinessNameLine1 |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WCA GROUP INC | |||||||||||
| PO BOX 840 | JAMESTOWN | NY | 147020840 | 222393582 | A PARENT HOLDING COMPANY | NY | 501(C)(3) | 11 | N/A | 0 | |
| WCA FOUNDATION INC | |||||||||||
| PO BOX 214 | JAMESTOWN | NY | 147020214 | 222393584 | PROMOTE/SUPPORT COMMUNITY HEALTH THROUGH SUPPORT OF WCA HOSP & AFFILIATE | NY | 501(C)(3) | 7 | N/A | 0 | |
| STARFLIGHT INC | |||||||||||
| PO BOX 840 | JAMESTOWN | NY | 147020840 | 161557878 | MEDICAL AVIATION SERV JOINTLY OPER WITH WCA SERVICES & CHAUTAUQUA SHERIFFS | NY | 501(C)(3) | 7 | 0 | WCA GROUP INC | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 31 SHERMAN STREET INVESTORS LLC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4 CENTRE DRIVE | AddressLine1 |
| City | ORCHARD PARK | City |
| State | NY | State |
| ZIP Code | 14127 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 264629631 | EIN |
| Primary Activities | REAL ESTATE | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 31 SHERMAN STREET LLC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | UNRELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | $56,347 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $114,420 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WCA SERVICES CORPORATION | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 28 MAPLE STREET | AddressLine1 |
| City | JAMESTOWN | City |
| State | NY | State |
| ZIP Code | 14701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161151438 | EIN |
| Primary Activities | PROVIDES PATIENT TRANSPORTATION AND MEDICAL BILLING SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WCA GROUP INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | Yes (1) | 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 | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| WCA FOUNDATION INC | |
| C | $501,985 |
| WCA SERVICES CORPORATION | |
| O | $91,323 |
| WCA SERVICES CORPORATION | |
| P | $360,474 |
| WCA SERVICES CORPORATION | |
| Q | $51,000 |
| WCA SERVICES CORPORATION | |
| D | $100,000 |
| WCA FOUNDATION INC | |
| L | $84,604 |
| WCA SERVICES CORPORATION | |
| C | $10,650 |
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