NICHOLAS H NOYES MEMORIAL HOSPITAL: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- NICHOLAS H NOYES MEMORIAL HOSPITAL (EIN 16-0743979)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-17
- IRS object ID
- 201413219349301696
- 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 C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-17T09:37:36-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 264298079 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EFP ROTENBERG LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 280 KENNETH DRIVE | AddressLine1 |
| City | ROCHESTER | City |
| State | NY | State |
| ZIP Code | 14623 | 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 | 160743979 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NICHOLAS H NOYES MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NICH | BusinessNameControlTxt |
| Phone | 5853356001 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 CLARA BARTON STREET | AddressLine1 |
| City | DANSVILLE | City |
| State | NY | State |
| ZIP Code | 14437 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMY POLLARD | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 5853356001 | PhoneNum |
| Signature | 2014-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WILLIAM MCDONALD | PreparerPersonNm |
| PTIN | P01600766 | PTIN |
| Phone | 5854278900 | PhoneNum |
| Preparation | 2014-11-13 | PreparationDt |
| 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 | AMY POLLARD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 CLARA BARTON STREET | AddressLine1 |
| City | DANSVILLE | City |
| State | NY | State |
| ZIP Code | 14437 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,330,307 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NOYES-HEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1927 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | NICHOLAS H. NOYES MEMORIAL HOSPITAL IS A 72 BED HOSPITAL WHICH PROVIDES ACUTE, SUB-ACUTE, EMERGENCY AND OTHER OUTPATIENT CARE AND WHOSE MISSION IS TO SUPPORT AND PROMOTE THE HEALTH OF OUR COMMUNITIES THROUGH COMPASSIONATE QUALITY CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 579 | TotalEmployeeCnt |
| Total Volunteers | 92 | TotalVolunteersCnt |
| Total Gross UBI | $878,931 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$470,269 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $535,141 | PYContributionsGrantsAmt |
| CY Contributions Grants | $374,206 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $44,963,366 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $44,674,685 | CYProgramServiceRevenueAmt |
| PY Investment Income | $65,961 | PYInvestmentIncomeAmt |
| CY Investment Income | $68,268 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,465,350 | PYOtherRevenueAmt |
| CY Other Revenue | $1,866,387 | CYOtherRevenueAmt |
| PY Total Revenue | $47,029,818 | PYTotalRevenueAmt |
| CY Total Revenue | $46,983,546 | 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 | $25,484,324 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,354,966 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $51,384 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $23,209,089 | PYOtherExpensesAmt |
| CY Other Expenses | $24,043,917 | CYOtherExpensesAmt |
| PY Total Expenses | $48,693,413 | PYTotalExpensesAmt |
| CY Total Expenses | $48,398,883 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,663,595 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,415,337 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $38,233,892 | TotalAssetsBOYAmt |
| Total Assets EOY | $44,386,301 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,788,711 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $22,710,156 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,445,181 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $21,676,145 | NetAssetsOrFundBalancesEOYAmt |
| Mission | NICHOLAS H. NOYES MEMORIAL HOSPITAL SUPPORTS AND PROMOTES THE HEALTH OF OUR COMMUNITIES THROUGH COMPASSIONATE QUALITY CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $37,103,928 | ExpenseAmt |
| Revenue | $44,674,685 | RevenueAmt |
| Desc | NICHOLAS H. NOYES MEMORIAL HOSPITAL IS A 72 BED HOSPITAL WHICH PROVIDES ACUTE, SUB-ACUTE, AND OUTPATIENT CARE. | Desc |
| Total Program Service Expenses | $37,103,928 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 79 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 579 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Excess Business Holdings | 0 | ExcessBusinessHoldingsInd |
| Taxable Distributions | 0 | TaxableDistributionsInd |
| Distribution To Donor | 0 | DistributionToDonorInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (1) | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAY MASLYN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5853354306 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 CLARA BARTON STREET | AddressLine1 |
| City | DANSVILLE | City |
| State | NY | State |
| ZIP Code | 14437 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 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 |
|---|---|---|---|---|---|---|---|
| GRAHAM FRAZER | |||||||
| SECOND VICE CHAIRPERSON | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN LOCKHART | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL JOHNSEN | |||||||
| CHAIRPERSON | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| LESLIE COLE JR | |||||||
| FIRST VICE CHAIRPERSON | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOE BUCCI JR | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| AMY POLLARD | |||||||
| PRESIDENT/CEO | 40.00 | Yes (X) | $177,591 | $0 | $19,647 | Yes (X) | |
| JOAN FLENDER MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GEOFFREY WITTIG MD | |||||||
| PRESIDENT ELECT, MEDICAL STAFF | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK LYONS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DOMENICK MARTELLO | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DOUGLAS MAYHLE MD | |||||||
| MEDICAL DIRECTOR | 40.00 | Yes (X) | $366,243 | $0 | $14,434 | ||
| LINDSAY QUINTILONE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ARIF QURESHI MD | |||||||
| PRESIDENT, MEDICAL STAFF | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BERNARD SWEENEY MD | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARILYN MOORE | |||||||
| PAST CHAIRPERSON/SECRETARY | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES CULBERTSON | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAY MASLYN | |||||||
| CFO | 40.00 | $136,540 | $0 | $3,289 | Yes (X) | ||
| ROBERT CAPECCI MD | |||||||
| PHYSICIAN-ORTHOPEDIST | 40.00 | $630,949 | $0 | $17,282 | Yes (X) | ||
| KEVIN WENTWORTH | |||||||
| PHYSICIANS ASSISTANT | 40.00 | $182,270 | $0 | $16,486 | Yes (X) | ||
| JACOB TALLMAN | |||||||
| FAMILY PRACTITIONER | 40.00 | $217,606 | $0 | $17,258 | Yes (X) | ||
| BRIAN FORESMAN | |||||||
| GENERAL SURGEON | 40.00 | $452,739 | $0 | $17,038 | Yes (X) | ||
| MICHAEL PARKOT | |||||||
| PHYSICIANS ASSISTANT | 40.00 | $179,045 | $0 | $16,828 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,342,983 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $122,262 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | 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 |
|---|---|---|---|---|---|
| DANSVILLE ANESTHESIA & PAIN MGMT | |||||
| PO BOX 33058 | PALM BEACH GARDENS | FL | 33420 | ANESTHESIOLOGIST | $2,162,922 |
| ARUP LABORATORIES | |||||
| 500 CHIPETA WAY | SALT LAKE CITY | UT | 841081221 | LAB TESTING SERVICES | $783,254 |
| GARDNER PLUS ARCHITECTS PLCC | |||||
| 40 WILDBRIAR RD | ROCHESTER | NY | 14623 | ARCHITECTS | $418,642 |
| SLEEP INSIGHTS MANAGEMENT SVC | |||||
| 10 HAGEN DR SUITE 200 | ROCHESTER | NY | 14625 | POLYSOMNOGRAPHY SVC | $292,182 |
| RONDON RAFAEL MD | |||||
| 84 ASHLAND AVENUE | BUFFALO | NY | 14222 | EMERGENCY PHYSICIAN | $251,320 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $275,568 | GovernmentGrantsAmt |
| All Other Contributions | $98,638 | AllOtherContributionsAmt |
| Total Contributions | $374,206 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $44,674,685 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,674,685 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $44,674,685 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $51,916 | TotalRevenueColumnAmt |
| Exclusion | $51,916 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $280,594 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $264,242 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,352 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,352 | TotalRevenueColumnAmt |
| Exclusion | $16,352 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $24,051 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $9,901 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,150 | TotalRevenueColumnAmt |
| Exclusion | $14,150 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $191,421 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $72,618 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $118,803 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $118,803 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| OTHER REVENUE | 541380 | $1,602,783 | $748,280 | $854,503 |
| SEAGATE ALLIANCE, LLC | 900000 | $130,651 | $130,651 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,733,434 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,983,546 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,793,488 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $878,931 | UnrelatedBusinessRevenueAmt |
| Exclusion | $936,921 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $717,744 | TotalAmt |
| Program Services | $262,832 | ProgramServicesAmt |
| Management And General | $454,912 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,242,387 | TotalAmt |
| Program Services | $14,980,769 | ProgramServicesAmt |
| Management And General | $4,233,325 | ManagementAndGeneralAmt |
| Fundraising | $28,293 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $256,259 | TotalAmt |
| Program Services | $199,467 | ProgramServicesAmt |
| Management And General | $54,088 | ManagementAndGeneralAmt |
| Fundraising | $2,704 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,761,126 | TotalAmt |
| Program Services | $2,175,027 | ProgramServicesAmt |
| Management And General | $582,786 | ManagementAndGeneralAmt |
| Fundraising | $3,313 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,377,450 | TotalAmt |
| Program Services | $1,030,923 | ProgramServicesAmt |
| Management And General | $344,363 | ManagementAndGeneralAmt |
| Fundraising | $2,164 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,938 | TotalAmt |
| Program Services | $13,850 | ProgramServicesAmt |
| Management And General | $1,088 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,265 | TotalAmt |
| Management And General | $85,265 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,900 | TotalAmt |
| Management And General | $61,900 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,603 | TotalAmt |
| Management And General | $61,603 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,147 | TotalAmt |
| Management And General | $66,147 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,007,584 | TotalAmt |
| Program Services | $3,232,034 | ProgramServicesAmt |
| Management And General | $775,550 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,321 | TotalAmt |
| Program Services | $39,072 | ProgramServicesAmt |
| Management And General | $86,356 | ManagementAndGeneralAmt |
| Fundraising | $893 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,713,237 | TotalAmt |
| Program Services | $8,012,407 | ProgramServicesAmt |
| Management And General | $686,813 | ManagementAndGeneralAmt |
| Fundraising | $14,017 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $984,339 | TotalAmt |
| Program Services | $738,254 | ProgramServicesAmt |
| Management And General | $246,085 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,489,641 | TotalAmt |
| Program Services | $366,515 | ProgramServicesAmt |
| Management And General | $1,123,126 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,191 | TotalAmt |
| Program Services | $8,871 | ProgramServicesAmt |
| Management And General | $4,320 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,215 | TotalAmt |
| Program Services | $57,711 | ProgramServicesAmt |
| Management And General | $15,504 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,355 | TotalAmt |
| Program Services | $48,932 | ProgramServicesAmt |
| Management And General | $16,423 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,277,551 | TotalAmt |
| Program Services | $1,267,848 | ProgramServicesAmt |
| Management And General | $1,009,703 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $510,309 | TotalAmt |
| Program Services | $401,723 | ProgramServicesAmt |
| Management And General | $108,586 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $2,001,783 | $2,001,783 | |
| OTHER PURCHASED SERVICE | $1,465,352 | $973,914 | $491,438 |
| EQUIPMENT RENTAL | $942,269 | $548,852 | $393,417 |
| REPAIRS & MAINTENANCE | $762,584 | $497,877 | $264,707 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,333 | TotalAmt |
| Program Services | $245,267 | ProgramServicesAmt |
| Management And General | $76,066 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,398,883 | TotalAmt |
| Program Services | $37,103,928 | ProgramServicesAmt |
| Management And General | $11,243,571 | ManagementAndGeneralAmt |
| Fundraising | $51,384 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,716 | BOYAmt |
| EOY | $5,399 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,593,512 | BOYAmt |
| EOY | $977,243 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,099,254 | BOYAmt |
| EOY | $6,492,042 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $833,562 | BOYAmt |
| EOY | $892,523 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $653,881 | BOYAmt |
| EOY | $816,599 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $53,894,293 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $34,358,713 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,876,135 | BOYAmt |
| EOY | $19,535,580 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,464,688 | BOYAmt |
| EOY | $1,582,668 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,707,144 | BOYAmt |
| EOY | $14,084,247 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,233,892 | BOYAmt |
| EOY | $44,386,301 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,988,225 | BOYAmt |
| EOY | $6,599,184 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $936,052 | BOYAmt |
| EOY | $4,471,895 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,502,949 | BOYAmt |
| EOY | $7,839,581 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,361,485 | BOYAmt |
| EOY | $3,799,496 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,788,711 | BOYAmt |
| EOY | $22,710,156 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,660,248 | BOYAmt |
| EOY | $20,552,522 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,227 | BOYAmt |
| EOY | $379,917 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $743,706 | BOYAmt |
| EOY | $743,706 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,445,181 | BOYAmt |
| EOY | $21,676,145 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,233,892 | BOYAmt |
| EOY | $44,386,301 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,415,337 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $78,306 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $4,567,995 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $50,000 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $11,603 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $61,603 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | AS MEMBERS OF 3 ASSOCIATIONS (AHA - AMERICAN HOSPITAL ASSOCIATION, HANYS-THE HEALTHCARE ASSOCIATION OF NEW YORK STATE & RRHA/SEAGATE ALLIANCE) A PORTION OF THE DUES (TOTAL REFLECTED ABOVE) ARE PAID AS PART OF MEMBERSHIP AND REPRESENT AMOUNTS DESIGNATED FOR LOBBYING ACTIVITIES. THESE ASSOCIATE ORGANIZATIONS OF WHICH WE ARE MEMBERS HANDLE THE DIRECT LOBBYING/ADVOCACY ACTIVITIES ON BEHALF OF THEIR MEMBERS. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,561,127 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $138,137 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $10,726 | AdministrativeExpensesAmt |
| End Year Balance | $1,688,538 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,449,363 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $121,879 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $10,115 | AdministrativeExpensesAmt |
| End Year Balance | $1,561,127 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,434,453 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $24,558 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $9,648 | AdministrativeExpensesAmt |
| End Year Balance | $1,449,363 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,335,945 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $107,551 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $9,043 | AdministrativeExpensesAmt |
| End Year Balance | $1,434,453 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,155,614 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $188,466 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $8,135 | AdministrativeExpensesAmt |
| End Year Balance | $1,335,945 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.61880 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.38120 | 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 | $372,690 | OtherCostOrOtherBasisAmt |
| Book Value | $372,690 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,458,238 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,480,440 | DepreciationAmt |
| Book Value | $8,977,798 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,383,902 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,878,273 | DepreciationAmt |
| Book Value | $3,505,629 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,679,463 | OtherCostOrOtherBasisAmt |
| Book Value | $6,679,463 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $19,535,580 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION | $12,392,365 |
| DEBT ORIGINATION COSTS - NET | $432,400 |
| MORTGAGE REPAYMENT ESCROW FUNDS | $805,638 |
| OTHER | $453,844 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $14,084,247 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED ENTITY | $8,288 |
| DUE TO THIRD PARTY PAYORS- LONG TERM | $1,103,190 |
| DUE TO THIRD PARTY PAYORS- SHORT TERM | $629,959 |
| LINE OF CREDIT | $685,000 |
| PENSION LIABILITY | $1,225,379 |
| WORKERS COMPENSATION | $147,680 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,799,496 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $45,142,588 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $78,306 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $78,306 | RevenueNotReportedAmt |
| Revenue Subtotal | $45,064,282 | RevenueSubtotalAmt |
| Other Revenues Not Included | $1,919,264 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $1,919,264 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $46,983,546 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $46,479,619 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $82,519 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $82,519 | ExpensesNotReportedAmt |
| Expenses Subtotal | $46,397,100 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,001,783 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,001,783 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $48,398,883 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | EMPLOYEE EDUCATION. |
| PART X, LINE 2: | IN ACCORDANCE WITH ASC 740-10-50, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, THE SYSTEM RECOGNIZES THE TAX BENEFITS FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES. MANAGEMENT BELIEVES THAT THE SYSTEM IS CURRENTLY OPERATING IN COMPLIANCE WITH THE APPLICABLE REQUIREMENTS OF THE INTERNAL REVENUE CODE. THEREFORE, NO LIABILITY FOR UNRECOGNIZED TAX BENEFITS HAS BEEN INCLUDED ON THE SYSTEMS FINANCIAL STATEMENTS. THE EXEMPT SYSTEMS INFORMATIONAL RETURNS ARE SUBJECT TO AUDIT BY VARIOUS TAXING AUTHORITIES AND ITS OPEN AUDIT PERIODS ARE 2010 THROUGH 2012. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 2,001,783. FUNDRAISING EXPENSES -9,901. COST OF GOODS SOLD -72,618. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES 9,901. COST OF GOODS SOLD 72,618. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 2,001,783. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF TOURNAMENT | NameOfEvent1Amt |
| Gross Receipts Event1 | $17,729 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $17,729 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $120 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $1,815 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $3,526 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $889 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | FLOWER SALE | NameOfEvent2Amt |
| Gross Receipts Event2 | $6,322 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $6,322 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $3,551 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $24,051 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $24,051 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $120 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,815 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $3,526 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,440 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $9,901 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $14,150 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | 0 | FPGReferenceFreeCareInd |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $643,075 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $643,075 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01330 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,608,444 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,176,022 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $432,422 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00890 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 380 | PersonsServedCnt |
| Total Community Benefit Expns | $278,631 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $229,429 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $49,202 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 380 | PersonsServedCnt |
| Total Community Benefit Expns | $8,530,150 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,405,451 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,124,699 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02320 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 17 | ActivitiesOrProgramsCnt |
| Persons Served | 17654 | PersonsServedCnt |
| Total Community Benefit Expns | $116,105 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,290 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $106,815 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 3 | ActivitiesOrProgramsCnt |
| Persons Served | 209 | PersonsServedCnt |
| Total Community Benefit Expns | $176,738 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $169,738 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,087,312 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,385,562 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $701,750 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01450 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 4 | ActivitiesOrProgramsCnt |
| Persons Served | 2029 | PersonsServedCnt |
| Total Community Benefit Expns | $33,645 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,986 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $26,659 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 24 | ActivitiesOrProgramsCnt |
| Persons Served | 19892 | PersonsServedCnt |
| Total Community Benefit Expns | $4,413,800 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,408,838 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,004,962 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02080 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 24 | ActivitiesOrProgramsCnt |
| Persons Served | 20272 | PersonsServedCnt |
| Total Community Benefit Expns | $12,943,950 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $10,814,289 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,129,661 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04400 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 111 | PersonsServedCnt |
| Total Community Benefit Expns | $14,116 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,116 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 111 | PersonsServedCnt |
| Total Community Benefit Expns | $14,116 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,116 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,001,783 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $838,949 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,299,955 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $7,419,232 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $880,723 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NICHOLAS H NOYES MEMORIAL HOSPITAL | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 CLARA BARTON STREET | AddressLine1 |
| City | DANSVILLE | City |
| State | NY | State |
| ZIP Code | 14437 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | NICHOLAS H NOYES MEMORIAL 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.NOYES-HEALTH.ORG/COMMUNITY-SERVICES | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| 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 | 0 | FPGUsedDeterEligFreeCareInd |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| NICHOLAS H NOYES MEMORIAL HOSPITAL | PART V, SECTION B, LINE 5D: CHNA UPDATES PROVIDED IN 2014 FOR NOYES EXECUTIVE BOARD, LIVINGSTON COUNTY BOARD OF SUPERVISORS, LIVINGSTON COUNTY BOARD OF HEALTH, CHNA LEADERSHIP AND GENERAL PUBLIC. |
| NICHOLAS H NOYES MEMORIAL HOSPITAL | PART V, SECTION B, LINE 10: THE HOSPITAL DOES NOT GIVE FREE CARE TO ANY PATIENTS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| AFTER HOURS CARE CENTER | ||||
| 4440 LAKEVILLE ROAD | GENESEO | NY | 14454 | URGENT CARE CENTER |
| LIVINGSTON HEALTH SERVICES | ||||
| 50 EAST SOUTH STREET | GENESEO | NY | 14454 | OUTPATIENT SURGERY AND DIAGNOSTIC |
| MENTAL HEALTH CLINIC | ||||
| 1 MAIN STREET | DANSVILLE | NY | 14437 | MENTAL HEALTH CLINIC |
| NOYES CTR FOR KIDNEY DISEASE & DIALYSIS | ||||
| 4616 MELLENIUM DRIVE | GENESEO | NY | 14454 | CHRONIC DIALYSIS CENTER AND NEPHROLOGIST |
| OB-GYN ASSOC OF THE FINGER LAKES | ||||
| 253 MAIN STREET | DANSVILLE | NY | 14437 | OUTPATIENT PHYSICIAN CLINIC |
| CREEKSIDE FAMILY MEDICINE | ||||
| 12 NORTH CHURCH ST | CANASERAGA | NY | 14822 | PRIMARY CARE PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART II, COMMUNITY BUILDING ACTIVITIES: | NOYES HOSPITAL STAFF ACTIVELY PARTICIPATES IN MULTIPLE COMMUNITY COALITIONS AND PARTNERSHIPS TO COLLABORATIVELY ADDRESS THE HEALTH CARE NEEDS OF OUR COMMUNITY. THE FOLLOWING IS A LIST OF AGENCY AND ORGANIZATIONAL COMMITTEES/TEAMS THAT NOYES PARTICIPATES ON TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE: GENESEE VALLEY HEALTH PARTNERSHIP (GVHP): EXECUTIVE BOARD AND GENERAL MEMBERSHIP GVHP LIVINGSTON COUNTY COMMUNITY HEALTH IMPROVEMENT (CHIP) WORK GROUPS: PREVENTION AND MANAGEMENT OF CHRONIC DISEASE (NOYES MEMBER) IMPROVE ACCESS TO HEALTH CARE STRENGTHEN SOCIAL AND EMOTIONAL HEALTH (NOYES MEMBER) PROMOTE SAFE COMMUNITIES (NOYES MEMBER) LIVINGSTON WELLNESS PARTNERSHIP LIVINGSTON COUNTY LONG TERM CARE COUNCIL LIVINGSTON COUNTY ACHIEVE (ACTION COMMUNITIES FOR HEALTH, INNOVATIONS AND ENVIRONMENTAL CHANGE) GRANT COMMITTEE LIVINGSTON COUNTY MATERNAL CHILD HEALTH COALITION (NOYES LEAD) LIVINGSTON COUNTY DIABETES COALITION (NOYES LEAD) LIVINGSTON COUNTY SEXUAL RESPONSIBILITY COALITION LIVINGSTON COUNTY TOBACCO ACTION COALITION LIVINGSTON COUNTY TRAFFIC SAFETY COALITION LIVINGSTON COUNTY OFFICE FOR AGING ADVISORY BOARD FAITH IN ACTION ADVISORY BOARD |
| PART III, LINE 4: | COSTING METHOD FOR BAD DEBT EXPENSE AT COST IS RATIO OF PATIENT CARE COST TO CHARGES FROM WORKSHEET 2 MULTIPLIED BY THE DEMOGRAPHICS OF PRIMARY SERVICE AREA FOR THOSE WHO WOULD RECEIVE CHARITY CARE IF GIVEN ENOUGH INFORMATION. |
| PART III, LINE 8: | THE SOURCE OF THE MEDICARE ALLOWABLE COSTS IS THE 2013 CMS 2552 WORKSHEET I-4. |
| PART VI, LINE 2: | PUBLIC PARTICIPATION: COMMUNITY HEALTH ASSESSMENTA. IN MARCH 2013, THE LIVINGSTON COUNTY DEPARTMENT OF HEALTH STARTED WORKING WITH NOYES HEALTH TO COMPLETE THE LIVINGSTON COUNTY COMMUNITY HEALTH ASSESSMENT (CHA). A CHA LEADERSHIP TEAM WAS CREATED UNDER THE DIRECTION OF CO-COORDINATORS FROM THE LIVINGSTON COUNTY DEPARTMENT OF HEALTH AND NOYESHEALTH. THE CO-COORDINATORS MET FREQUENTLY BETWEEN LEADERSHIP MEETINGS TO IMPLEMENT THE CHA PROCESS.INVITATIONS TO JOIN THE TEAM WERE EXTENDED TO ALL MEMBERS OF THE GENESEE VALLEY HEALTH PARTNERSHIP (GVHP), A NON-PROFIT, RURAL HEALTH NETWORK OF MORE THAN 40 DIFFERENT ORGANIZATIONS THAT ARE EITHER BASED IN LIVINGSTON COUNTY OR PROVIDE SERVICES TO LIVINGSTON COUNTY RESIDENTS. GVHP IS A 501(C)3 ORGANIZATION WHOSE MISSION IS TO IMPROVE THE HEALTH AND WELL-BEING OF THE LIVINGSTON COUNTY COMMUNITY THROUGH COLLABORATION, EDUCATION AND PREVENTION. THEIR TAGLINE IS "CREATING A HEALTHY FUTURE NOW".THE CHA LEADERSHIP TEAM CONSISTS OF 22 MEMBERS FROM THE FOLLOWING 19 COMMUNITY HEALTH CARE ORGANIZATIONS, COUNTY AND GOVERNMENT AGENCIES, FAITH BASED ORGANIZATIONS, LOCAL SCHOOLS AND ACADEMIA, AND HUMAN SERVICE ORGANIZATIONS THAT PARTICIPATED IN THE CHA PROCESS THROUGHOUT THE FIVE MONTH PERIOD:- THE ARC OF LIVINGSTON-WYOMING COUNTY/KIDSTART- CATHOLIC CHARITIES OF LIVINGSTON COUNTY- CORNELL COOPERATIVE EXTENSION OF LIVINGSTON COUNTY- HEALTH AND WELLNESS- LITERACY VOLUNTEERS LIVINGSTON COUNTY OFFICE FOR AGING- LIVINGSTON COUNTY CENTER FOR NURSING AND REHAB- LIVINGSTON COUNTY EMS- LIVINGSTON COUNTY PLANNING DEPARTMENT- LIVINGSTON COUNTY DEPARTMENT OF SOCIAL SERVICES- LIVINGSTON COUNTY DEPARTMENT OF HEALTH- LIVINGSTON COUNTY BOARD OF HEALTH- LIVINGSTON COUNTY PROBATION- LIVINGSTON COUNTY WORKFORCE DEVELOPMENT AND YOUTH BUREAU- LIVINGSTON COUNTY CHAMBER OF COMMERCE- LIVINGSTON COUNTY MENTAL HEALTH- NOYES HEALTH/COMMUNITY OUTREACH SERVICES- NOYES MENTAL HEALTH- STUDENT SUPPORT SERVICES CENTER GENESEE VALLEY EDUCATION PARTNERSHIPB. PUBLIC INPUT OUTCOMESMAY 2013: THE FIRST ORGANIZATIONAL MEETING OF THE CHA LEADERSHIP TEAM WAS HELD TO ESTABLISH THE CHA ASSESSMENT PROCESS TO IDENTIFY HEALTH CARE PRIORITIES. THE FIRST ACTION ITEM WAS TO COMPLETE THE COMMUNITY HEALTH SURVEY.JUNE 2013: THE LEADERSHIP TEAM THEN REVIEWED THE SURVEY RESULTS: 427 SURVEYS WERE COMPLETED USING BOTH SURVEY MONKEY AND PAPER SURVEYS AT MANY AGENCY LOCATIONS THROUGHOUT COUNTY. SURVEY RESULTS DEMONSTRATED GOOD ZIP CODE REPRESENTATION AND CROSS SECTIONAL DATA, INCLUDING: ANNUAL HOUSEHOLDINCOME, EMPLOYMENT, EDUCATION, AND RACE/ETHNICITY DISTRIBUTION. THE TEAM THEN PLANNED FOR TWO COMMUNITY FORUMS IN JULY.JULY 2013: THE COMMUNITY HEALTH STATUS DATA/REPORT CARD WAS PRESENTED WITH EXTENSIVE DISCUSSION FOCUSED ON CURRENT COUNTY-WIDE POSITIVE HEALTH OUTCOMES, ALONG WITH NEW OPPORTUNITIES FOR HEALTH IMPROVEMENT.JULY 2013: ATTENDEES REVIEWED COMMUNITY FORUM RESULTS AND COMPARED THEM TO THE COMMUNITY HEALTH STATUS DATA. THE ATTENDANCE WAS LOW AT THE FORUMS (APPROXIMATELY 15), BUT THE MEETINGS WERE PRODUCTIVE AND FEEDBACK WAS GOOD. IT WAS NOTED FOR FUTURE CHA PROCESSES, THAT IN ORDER TO INCREASE COMMUNITY PARTICIPATION AT FORUMS, WE NEED TO CONSIDER TAKING THE FORUMS TO THE COMMUNITY MEETINGS AND GROUPS, RATHER THAN EXPECT THE COMMUNITY TO COME TO US.AUGUST 2013: THE TEAM REVIEWED DATA FROM TWO AUGUST FOCUS GROUPS: A SENIOR NUTRITION SITE AND THE ARC OF LIVINGSTON-WYOMING COUNTY. (ADDITIONAL NOTE: ATTEMPT TO HOLD FOCUS GROUP WITH LIVINGSTON MENTAL HEALTH WAS UNSUCCESSFUL DUE TO INABILITY TO GET PARTICIPATE COMMITMENT). A DATA MATRIX WAS PRESENTED TO THE LEADERSHIP TEAM THAT INCLUDED ALL ASSESSMENT AND DATA ANALYSIS OUTCOMES (SEE #4 BELOW). EACH MEMBER OF THE LEADERSHIP TEAM THEN VOTED FOR THEIR TOP TWO PRIORITIES FROM THE TWELVE PRIORITIES IDENTIFIED THROUGHOUT THE CHA PROCESS.C. PUBLIC NOTIFICATION: LOCAL PENNYSAVER ADS AND GVHP MEMBERSHIP OUTREACH VIA STAFF AND INTERNET (WEBSITES/E-BLASTS/SURVEY MONKEY) WERE USED TO PROMOTE AND COMPLETE ALL CHA INITIATIVES.ASSESSMENT AND SELECTION OF PUBLIC HEALTH PRIORITIESTHE LEADERSHIP TEAM COMPILED ALL ASSESSMENT RESULTS AND REVIEWED ALL COUNTY-WIDE HEALTH CARE DATA. SUMMARY OF ALL ASSESSMENT RESULTS IS DOCUMENTED IN TABLE BELOW:ALL CHA HEALTH PRIORITIES IDENTIFIED:COMMUNITY SURVEY (427) COMMUNITY FORUMS(2) FOCUS GROUPS (2) LIV CO HEALTH DATA/REPORT CARDCHA LEADERSHIP VOTING - PRIORITIES (CONSENSOGRAM):MENTAL HEALTH 12CHRONIC DISEASE 10ALCOHOL/SUBSTANCE ABUSE 9AGING 1TOBACCO USECHILD ABUSE/NEGLECTACCESS TO HEALTH CARE 9DOMESTIC (FAMILY) VIOLENCEINJURY PREVENTION/SAFETY 2ORAL HEALTHIMMUNIZATIONS/INFECTIOUS DISEASEMATERNAL/CHILD HEALTH 1AN OUTSIDE CONTRACTOR FACILITATED THE DISCUSSION WITH THE LEADERSHIP TEAM ON ALL ASSESSMENT OUTCOMES TO HELP EACH MEMBER IDENTIFY THEIR TOP TWO HEALTH PRIORITIES (RESULTS IN TABLE ABOVE). ONCE TOP TWO PRIORITIES WERE IDENTIFIED, THE FOLLOWING OUTCOME OBJECTIVES WERE DEFINED:TOP 2 HEALTH CARE PRIORITIES 2013 LIVINGSTON COUNTY1. PREVENT CHRONIC DISEASE: OBESITY AND DIABETES2. PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSENOTED: FEEDBACK FROM MENTAL HEALTH SERVICE PROVIDERS - LIVINGSTON COUNTY COUNCILFOR SUBSTANCE ABUSE IS UNDER-UTILIZED AND LOCAL COUNTY MENTAL HEALTH SERVICES NEED TO INCREASE CAPACITY TO MEET NEED.STAFF FROM THE LIVINGSTON COUNTY HEALTH DEPARTMENT AND NOYES HEALTH THEN LED SEPARATE WORK SESSIONS UTILIZING COMMUNITY PARTNERS TO IDENTIFY THE STRATEGIES, OBJECTIVES, ACTIVITIES, PARTNERS, TIMEFRAMES AND OUTCOME MEASUREMENTS FOR THREE YEAR PLAN OF ACTION OF TOP TWO PRIORITIES IDENTIFIED. |
| PART VI, LINE 3: | FOR 2013, WE CONTINUED OUR EFFORTS TO COMMUNICATE OUR FINANCIAL AID POLICY. EVERY UNINSURED AND UNDERINSURED PATIENT RECEIVED A FINANCIAL AID PACKET THAT CONSISTED OF THE FINANCIAL AID PROGRAM SUMMARY AND BROCHURE, A FINANCIAL AID (FA) APPLICATION AND INSTRUCTIONS ON HOW TO APPLY, AS WELL AS HOW TO RECEIVE ASSISTANCE IN APPLYING. WE HAVE A SOCIAL WORKER AND A DEDICATED FA BILLING REPRESENTATIVE WHO WORK SPECIFICALLY WITH ALL UNINSURED PATIENTS UPON ADMISSION. ONGOING CHALLENGE IS GETTING PATIENTS TO PARTICIPATE IN THE FINANCIAL ASSISTANCE PROCESS. WE GIVE MANY CHARITY CARE APPLICATIONS AND BROCHURES OUT AT THE TIME OF SERVICE AND THEN AGAIN WHEN BILLING STATEMENTS GO OUT TO PATIENTS. WE, LIKE MANY HOSPITALS, TRY TO EDUCATE PATIENTS ON FINANCIAL ASSISTANCE AVAILABLE VIA A VARIETY OF AVENUES, BUT STRUGGLE WITH THE CHALLENGE OF GETTING PATIENTS TO TAKE ADVANTAGE OF THE AVAILABLE ASSISTANCE. |
| PART VI, LINE 4: | NOYES MEMORIAL HOSPITAL SERVES A RURAL COMMUNITY IN THE NEW YORK FINGER LAKES AREA. OUR PRIMARY MARKET SHARE ZIP CODE REPORT DEMONSTRATES THAT LIVINGSTON COUNTY IS OUR HEALTH CARE SYSTEMS PRIMARY SERVICE AREA AND WE ALSO SERVE RESIDENTS IN THE SURROUNDING COUNTIES INCLUDING STEUBEN, ALLEGANY, WYOMING AND ONTARIO RESPECTIVELY. LIVINGSTON COUNTY WAS RANKED #5 IN 2012 AND #1 IN 2013 FOR HEALTH RANKINGS ACCORDING TO COUNTY HEALTH RANKINGS AND ROADMAPS REPORT.DEMOGRAPHIC DATA AS FOLLOWS:LIVINGSTON COUNTY IS A RURAL COUNTY (55%) IN WESTERN NEW YORK COVERING 640 SQUARE MILES WITH POPULATION OF 65,393.14% OF POPULATION OF 65+, 20% BELOW 18 YEARS OF AGE, 92% NON-HISPANIC WHITE, AND ONLY 1% NOT PROFICIENT IN ENGLISH. MEDIAN HOUSEHOLD INCOME IS $50,186 AND 22% CHILDREN ELIGIBLE FOR FREE LUNCH. HEALTH CARE SERVICES ARE PROVIDED AT THE FOLLOWING LOCATIONS THROUGHOUT LIVINGSTON COUNTY: NICHOLAS H. NOYES MEMORIAL HOSPITAL: A 72-BED ACUTE CARE HOSPITAL LOCATED IN DANSVILLE PROVIDING MEDICAL, SURGICAL, AND EMERGENCY INPATIENT/OUTPATIENT SERVICES THAT ALSO INCLUDE COMMUNITY OUTREACH WELLNESS, EDUCATION AND PREVENTION PROGRAMS. NOYES HEALTH SERVICES: AN AMBULATORY CARE FACILITY IN GENESEO THAT PROVIDES OUTPATIENT SURGICAL, RADIOLOGY, LABORATORY, PHYSICAL THERAPY, PAIN MANAGEMENT, AND PHYSICIAN SERVICES. NOYES AFTER HOUR CLINIC: WALK-IN URGENT CARE CLINIC HAS BEEN IN GENESEO (MID-COUNTY LOCATION) SINCE 2003 AND A NEW CLINIC WAS OPENED EARLY 2013 FOR DANSVILLE COMMUNITY (SOUTHERN COUNTY LOCATION). BOTH LOCATIONS SERVE PATIENTS EVENINGS AND WEEKENDS WHEN PHYCIAN OFFICES ARE CLOSED. NOYES MENTAL HEALTH: AN OUT-PATIENT CLINIC PROVIDING INDIVIDUAL, GROUP AND FAMILY COUNSELING SERVICES. NOYES PHYSICIAN SERVICE OFFICES: GENESEE REGIONAL ORTHOPEDICS: DANSVILLE CREEKSIDE FAMILY PRACTICE: CANASERAGA NOYES SURGICAL SERVICS NOYES CENTER FOR KIDNEY DISEASE AND DIALYSIS: A 16 STATION OUTPATIENT DIALYSIS AND RENAL DISEASE MANAGEMENT CENTER IN GENESEO. |
| PART VI, LINE 5: | THE NOYES BOARD OF DIRECTORS HAS 13 ACTIVE COMMUNITY REPRESENTATIVES ON THEIR 20 MEMBER BOARD. NOYES HAS AN OPEN MEDICAL STAFF PROVIDING A VARIETY OF MEDICAL SERVICES INCLUDING: CARDIOLOGY, EARS/NOSE/THROAT, FAMILY MEDICINE, GASTROENTEROLOGY, ORTHOPEDICS, GENERAL AND VASCULAR SURGERY, INTERNAL MEDICINE, OB/GYN, NEPHROLOGY, OPHTHALMOLOGY, PEDIATRICS, PAIN MANAGEMENT, AND UROLOGY. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMY POLLARD | ||||||||||||||
| PRESIDENT/CEO | $176,522 | $0 | $0 | $0 | $1,069 | $0 | $0 | $0 | $19,647 | $0 | $197,238 | $0 | $0 | $0 |
| DOUGLAS MAYHLE MD | ||||||||||||||
| MEDICAL DIRECTOR | $359,481 | $0 | $0 | $0 | $6,762 | $0 | $0 | $0 | $14,434 | $0 | $380,677 | $0 | $0 | $0 |
| ROBERT CAPECCI MD | ||||||||||||||
| PHYSICIAN-ORTHOPEDIST | $629,365 | $0 | $0 | $0 | $1,584 | $0 | $0 | $0 | $17,282 | $0 | $648,231 | $0 | $0 | $0 |
| KEVIN WENTWORTH | ||||||||||||||
| PHYSICIANS ASSISTANT | $171,969 | $0 | $10,000 | $0 | $301 | $0 | $0 | $0 | $16,486 | $0 | $198,756 | $0 | $0 | $0 |
| JACOB TALLMAN | ||||||||||||||
| FAMILY PRACTITIONER | $169,163 | $0 | $23,580 | $0 | $24,863 | $0 | $0 | $0 | $17,258 | $0 | $234,864 | $0 | $0 | $0 |
| BRIAN FORESMAN | ||||||||||||||
| GENERAL SURGEON | $427,384 | $0 | $25,000 | $0 | $355 | $0 | $0 | $0 | $17,038 | $0 | $469,777 | $0 | $0 | $0 |
| MICHAEL PARKOT | ||||||||||||||
| PHYSICIANS ASSISTANT | $178,938 | $0 | $0 | $0 | $107 | $0 | $0 | $0 | $16,828 | $0 | $195,873 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 5 | FormAndLineReferenceDesc |
| Explanation | PHYSICIAN ENTITLED TO INCENTIVE COMPENSATION FROM POSITIVE PRACTICE NET INCOME ASSOCIATED WITH WORKED RVU'S AT A RATE OF 70% OF EACH ADDITIONAL WORKED RVU TIMES THE CURRENT MGMA CONVERSION FACTOR FOR FAMILY PRACTICE WITHOUT OBSTETRICS UP TO A MAXIMUM AMOUNT OF 50% OF THE PHYSICIAN'S BASE SALARY. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| LIVINGSTON COUNTY INDUSTRIAL DEVELOPMENT AGENCY | ||||||||
| A | 161136853 | 538655AD3 | 2005-06-29 | $9,471,914 | SEE PART VI | 0 | 0 | 0 |
| LIVINGSTON COUNTY INDUSTRIAL DEVELOPMENT AGENCY | ||||||||
| B | 161136853 | 538655AE1 | 2007-12-20 | $615,060 | REFUND OF PRIOR BONDS (06/30/99) | 0 | 0 | Yes (1) |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | In Reserve FundInReserveFundAmt | Capitalized InterestCapitalizedInterestAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Other Spent ProceedsOtherSpentProceedsAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Credit EnhancementCreditEnhancementAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $2,480,000 | $9,763,548 | $805,638 | $625,676 | $189,438 | $6,449,941 | $1,692,856 | 2006 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| B | $267,444 | $615,060 | $12,301 | $10,309 | $589,366 | 2003 | Yes (1) | 0 | Yes (1) | Yes (1) | $3,084 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Engage Bond Counsel ContractsEngageBondCounselContractsInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | Yes (1) | 0 | 0.02400 | 0.02400 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | Yes (1) | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE A, COLUMN (F): | ACQUISITION, RENOVATION, CONSTRUCTION AND EQUIPPING OF IMPROVEMENTS TO A HOSPITAL FACILITY; REFUNDING OF PRIOR BONDS (9/17/1998) |
| PART I, LINE B, COLUMN (E) AND PART II, LINES 1 - 12, COLUMN B | REPRESENTS AM ALLOCATION OF 12.24% OF THIS BOND ISSUE; THE REMAINING 87.76% IS ALLOCATED TO RED JACKET CENTER, INC., A RELATED ORGANIZATION. |
| PART II, LINE 3, COLUMN A | THE TOTAL PROCEEDS DO NOT AGREE WITH THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVESTMENTS EARNINGS. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT BONVINO | PersonNm |
| Relationship With Org | FORMER EMPLOYEE | RelationshipWithOrgTxt |
| Loan Purpose | START-UP | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $173,535 | OriginalPrincipalAmt |
| Balance Due | $163,527 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $163,527 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NANCY JOHNSEN | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | WIFE OF BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $58,013 | TransactionAmt |
| Transaction | COMPENSATION | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 IS REVIEWED BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD OF DIRECTORS REGULARLY REVIEWS THE CONFLICT OF INTEREST POLICY AND ASSURES ITS COMPLIANCE. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE GOALS AND OBJECTIVES OF THE CEO ALONG WITH COMPARABILITY DATA TO DETERMINE HER/HIS COMPENSATION. THE DELIBERATION AND DECISION IS RECORDED IN THE MINUTES OF THE EXECUTIVE COMMITTEE MEETING. |
| FORM 990, PART VI, SECTION C, LINE 18 | BY REQUEST TO THE CEO, CFO OR ADMINISTRATIVE ASSISTANT. ALSO AVAILABLE ON GUIDESTAR WEBSITE. |
| FORM 990, PART VI, SECTION C, LINE 19 | BY REQUEST TO THE CEO, CFO OR ADMINISTRATIVE ASSISTANT. |
| FORM 990, PART VII | GRAHAM FRAZER - 8889 REEDS CORNERS ROAD, DANSVILLE, NY 14437. JOHN LOCKHART - 32 MAIN STREET, GENESEO, NY 14454. MICHAEL JOHNSEN - 3927 COLTON HILL ROAD, DALTON, NY 14836. LESLIE COLE, JR. - 3186 BRONSON HILL ROAD, LIVONIA, NY 14487. JOE BUCCI, JR. - 35 CAVALRY ROAD, GENESEO, NY 14454. JOAN FLENDER, MD - P.O. BOX 499, DANSVILLE, NY 14437. GEOFFREY WITTIG, M.D. - 10055 MCNINCH RD, DANSVILLE, NY 14437. MARK LYONS - 3822 CENTER STREET, LIVONIA, NY 14487. DOMENICK MARTELLO - 4939 BLANK HILL ROAD, DANSVILLE, NY 14437. LINDSAY QUINTILONE - 2 COURT STREET, GENESEO, NY 14454. BERNARD SWEENEY, M.D. - 4380 RESERVOIR RD, GENESEO, NY 14454. MARILYN MOORE - 1856 DUNKLEY RD, LEICESTER, NY 14481. JAMES CULBERTSON - 5879 DIETER ROAD, DANSVILLE, NY 14437. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN FOUNDATION 2,131,477. PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COSTS 2,436,518. |
| FORM 990, PART XII, LINE 2(C): | THE HOSPITAL DID NOT CHANGE THE OVERSIGHT PROCESS IN THE CURRENT YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| THE FOUNDATION FOR NOYES MEMORIAL HEALTH SYSTEM INC | |||||||||
| 111 CLARA BARTON ST | DANSVILLE | NY | 14437 | 161584778 | TO PROVIDE FUNDS FOR BENEFIT OF THE HOSPITAL | NY | 501(C)(3) | 170(B)(1)(A) (VI) | 0 |
| RED JACKET CENTER INC | |||||||||
| 111 CLARA BARTON ST | DANSVILLE | NY | 14437 | 161037658 | TO MAINTAIN A BUILDING AND LEASE SPACE TO THE HOSPITAL | NY | 501(C)(3) | SECTION 509 (A)(3) | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 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 | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | 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 (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| RED JACKET CENTER INC | |
| Q | $1,849,230 |
| FOUNDATION FOR NOYES MEMORIAL HEALTH SYSTEM INC | |
| P | $1,849,230 |
| RED JACKET CENTER INC | |
| K | $502,278 |
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