2014-08-13T15:52:40-05:00 2013-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2013-01-01 141731786 ADIRONDACK MEDICAL CENTER ADIR 5188914141 PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 CHANDLER M RALPH CFO 5188914141 2014-08-07 1 ANGELA M FRANCO P00589741 3154463600 2013 2015-11-30 17:44:51Z TRISTAN GLANVILLE PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 102906601 0 X WWW.ADIRONDACKHEALTH.ORG X 1991 NY THE MEDICAL CENTER PROVIDES ACUTE, SKILLED NURSING AND OUTPATIENT SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHIC REGION. 13 11 1052 78 0 0 897941 1067325 97784775 97127185 -675069 357296 3399208 2782544 101406855 101334350 0 0 0 0 56776608 55145186 0 0 0 47700596 44800631 104477204 99945817 -3070349 1388533 67870297 69732137 30406779 30744189 37463518 38987948 THE MEDICAL CENTER PROVIDES EXCELLENT HEALTHCARE CLOSE TO HOME. 0 0 24699788 30467367 ADIRONDACK MEDICAL CENTER IS A 97-BED ACUTE CARE FACILITY IN SARANAC LAKE AND A 2-BED FACILITY IN LAKE PLACID. IT PROVIDES A FULL RANGE OF INPATIENT SERVICES(SURGICAL, MATERNITY AND PEDIATRIC) AS WELL AS MAINTAINS A 60 BED LONG-TERM CARE FACILITY. 48048923 59268659 REFERRED AMBULATORY, AMBULATORY SURGERY AND EMERGENCY SERVICES. 6615956 7391161 FREE STANDING NURSING HOME THAT HAS 156 BEDS. 79364667 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 62 0 1 1052 1 0 0 0 0 0 0 0 0 0 0 X 13 11 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X TRISTAN GLANVILLE 5188914141 PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 LAURIE BERGAMINI TRUSTEE 1.00 X 0 0 0 BARRY BROGAN TRUSTEE 1.00 X 0 0 0 JULIE CONNORS TRUSTEE 1.00 X 0 0 0 CHARLES CARROLL TRUSTEE 1.00 X 0 0 0 JEANNIE CROSS VICE CHAIR 1.00 X X 0 0 0 SUSAN M DELEHANTY SECRETARY/TREASURER 1.00 X X 0 0 0 STANLEY T URBAN CHAIR 1.00 X X 0 0 0 RICHARD M MOCCIA MD TRUSTEE 1.00 X 0 0 0 F RAYMOND AGNEW TRUSTEE 1.00 X 0 0 0 PETER G BEATTY PHD TRUSTEE 1.00 X 0 0 0 DOUGLAS L HOFFMAN CPA TRUSTEE 1.00 X 0 0 0 CHERYL MAID TRUSTEE 1.00 X 0 0 0 WAGUIH KIROLLOS MD EX-OFFICIO 1.00 X 0 0 0 CHANDLER M RALPH EX-OFFICIO PRESIDENT/CEO 40.00 X 0 0 0 GREG MOORE CFO 40.00 X 193781 0 18836 JOHN BRODERICK MD CMO 40.00 X 272350 0 26843 CYNTHIA MCGUIRE COO 40.00 X 155071 0 20170 WILLIAM VISCARDO MD PHYSICIAN 40.00 X 256126 0 18986 ANTHONY DOWIDOWICZ PHYSICIAN 42.00 X 281740 0 16544 FRANK NOCILLA PHYSICIAN 42.00 X 217240 0 16110 NICHOLAS BRODYN PHYSICIAN 40.00 X 440207 0 14274 MANDEEP SALUJA PHYSICIAN 42.00 X 215893 0 13375 2032408 0 145138 51 0 1 0 MATRIX HEALTH SYSTEMS 86 LAKE STREET BURLINGTON VT 05401 PHYSICIAN FEES 828134 HEALTHTECH MANAGEMENT SERVICES INC 405 DUKE DRIVE SUITE 10 FRANKLIN TN 37067 MANAGEMENT SERVICES 732776 REHAB RESOURCES 159 WEST FIRST STREET OSWEGO NY 13126 REHABILITATION SERVICES 565369 INSIGHT HEALTH SERVICES CORP PO BOX 847689 DALLAS TX 75284 MRI SERVICES 503052 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 433487 25 576372 490953 1067325 NET PATIENT SERVICE REVENUE 900099 97127185 97127185 97127185 53560 53560 413893 0 413893 413893 413893 1854474 21513 1572251 0 282223 21513 303736 303736 DIETARY REVENUE 900099 171158 171158 PURCHASE DISCOUNTS 900099 128226 128226 REBATES & REFUNDS 900099 73623 73623 1995644 1995644 2368651 101334350 97127185 0 3139840 X 687051 687051 44059437 36285565 7773872 1008710 834115 174595 6234960 5102014 1132946 3155028 2562228 592800 732776 732776 139116 139116 158403 158403 10320798 6600274 3720524 183140 17503 165637 1401001 567601 833400 2267173 3502 2263671 140761 80449 60312 585533 585533 4744707 4744707 881631 881631 MEDICAL SUPPLIES 14816920 14803399 13521 BAD DEBT 3328392 3328392 CASH ASSESSMENT 954672 954672 LEASE EXPENSE 939867 814532 125335 3205741 2080181 1125560 99945817 79364667 20581150 0 11257449 12103781 14128496 14312157 1964432 2088390 3587422 3537482 88704310 59448268 32533837 29256042 3214620 6302363 1184041 2131922 67870297 69732137 11596903 12923939 1163791 1572402 13327680 12046459 933000 933000 3385405 3268389 30406779 30744189 X 36472103 37995869 56353 57017 935062 935062 37463518 38987948 67870297 69732137 1388533 135897 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 991415 4116 3452 992079 987179 4236 991415 987165 4018 -4004 987179 982116 5049 987165 0.94250 0.05750 0 0 328567 328567 43247912 22654393 20593519 43894324 35850268 8044056 1233507 943607 289900 29256042 DEBT-CURRENT 1278899 RESIDENT FUNDS LIABILITY 84842 ASSET RETIREMENT AND OTHER LT 994223 ESTIMATED THIRD PARTY LIABILITY 910425 3268389 X PART V, LINE 4: THE SYSTEM'S ENDOWMENTS CONSIST OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. ITS ENDOWMENTS INCLUDE DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS AN ENDOWMENT. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. TEMPORARILY RESTRICTED FUNDS ARE AVAILABLE FOR NURSING EDUCATION & OTHER PROGRAMS. PERMANENTLY RESTRICTED FUNDS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE FOR VARIOUS HEALTHCARE SERVICES. PART X, LINE 2: THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN ADIRONDACK HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS. THESE STANDARDS HAD NO IMPACT ON THE ACCOMPANYING FINANCIAL STATEMENTS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2010 THROUGH 2013. 1 1 X 1 X 1 X 1 1 0 1 1 117359 18075 99284 0.00100 19913182 17501066 2412116 0.02410 20030541 17519141 2511400 0.02510 30 1228 151889 151889 0.00150 11 414 764182 764182 0.00760 19590973 17922795 1668178 0.01670 2 5 5067 5067 0.00010 43 1647 20512111 17922795 2589316 0.02590 43 1647 40542652 35441936 5100716 0.05100 1 5855 5855 0.00010 4 19806 19806 0.00020 1 875 875 0.00000 6 26536 26536 0.00030 1 1586023 717064 21312666 24559757 -3247091 X 1 1 2 1 ADIRONDACK MEDICAL CENTER 2233 STATE ROUTE 86-PO BOX 471 SARANAC LAKE NY 12983 X X 97 ACUTE BEDS; NURSING HOME WITH 60 BEDS; NURSING HOME WITH 157 BEDS A 2 ADIRONDACK MEDICAL CENTER-LAKE PLACID 29 CHURCH STREET LAKE PLACID NY 12946 X X 2 ACUTE BEDS; OUTPATIENT SERIVCES, EMERGENCY ROOM A FACILITY REPORTING GROUP - A 1 X X X X X X X X X 13 1 1 1 X WWW.ADIRONDACKHEALTH.ORG X X X 0 0 1 1 200.000000000000 1 400.000000000000 1 X X X X 1 1 X X X X X 0 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ADIRONDACK MEDICAL CENTER, - FACILITY 2: ADIRONDACK MEDICAL CENTER-LAKE PLACID FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 3: ADIRONDACK MEDICAL CENTER AND OUR COLLABORATING PARTNERS, COUNTY PUBLIC HEALTH DEPARTMENTS AND REGIONAL HOSPITALS, WORKED THROUGH THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY THAT GAVE US INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY WE SERVE. ARHN ENGAGED THE CENTER FOR HUMAN SERVICES RESEARCH (CHSR) AT THE UNIVERSITY AT ALBANY, STATE UNIVERSITY OF NEW YORK TO WORK WITH A SUBCOMMITTEE TO DEVELOP THE SURVEY. THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO A REGIONAL EMAIL CONTACT LIST OF 624. ULTIMATELY, 285 SURVEYS WERE COMPLETED DURING THE SIX-WEEK SURVEY PERIOD, A RESPONSE RATE OF 45.7 PERCENT. OF ALL 285 RESPONSES, 86 INDICATED THAT ESSEX COUNTY WAS PART OF THEIR SERVICE AREA AND 83 INDICATED THAT FRANKLIN COUNTY WAS PART OF THEIR SERVICE AREA; HOWEVER, IT SHOULD BE NOTED THAT MANY OF THE RESPONDING HEALTH CARE STAKEHOLDERS SERVICE MULTIPLE COUNTIES WITHIN THE LARGER ARHN REGION. SURVEY PARTICIPANTS REPRESENTED A DIVERSE ARRAY OF DIFFERENT AGENCIES, POPULATION GROUPS, AND SERVICE-AREAS WITHIN THE OVERALL EIGHT-COUNTY ARHN REGION. BELOW, TABLE A.1 SHOWS THE PRIMARY FUNCTIONS SELECTED BY RESPONDENTS AND TABLE A.2 SHOWS THE POPULATIONS THAT THEIR AGENCIES SERVE. HEALTH CARE AND EDUCATIONAL AGENCIES ARE WELL REPRESENTED, AND THE MAJORITY PROVIDES SERVICES TO CHILDREN AND ADOLESCENTS, AS WELL AS PEOPLE LIVING AT OR NEAR THE POVERTY LEVEL. TABLE A.1. PRIMARY FUNCTIONS INDICATED BY SURVEY RESPONDENTSORGANIZATION PRIMARY FUNCTION / PERCENT OF ALL APPLICANTS HEALTH CARE / 36.8 EDUCATION / 36.5 BEHAVIORAL HEALTH / 17.5 HEALTHY ENVIRONMENT / 14.7 EARLY CHILDHOOD SVCS. / 14.4 SOCIAL SERVICES / 11.9 SENIOR SERVICES / 11.2 OTHER SERVICES / 9.1 DEVELOPMENTAL DISABILITY SVCS. / 8.4 EMPLOY & TRAINING / 8.4 HOUSING SERVICES / 8.1 STI/HIV PREVENTION / 6.0 PHYSICAL DISABILITY SVCS. / 4.9 GOVERNMENT AGENCY / 2.1 TESTING AND PREVENTION / 2.1 NOTE: RESPONDENTS COULD SELECT MORE THAN ONE PRIMARY FUNCTION. TABLE A.2. POPULATIONS SERVED BY SURVEY RESPONDENT AGENCIESPOPULATION SERVED / PERCENT OF ALL RESPONDENTS CHILDREN/ADOLESCENTS / 59.6 PEOPLE LIVING AT OR NEAR POVERTY LEVEL / 50.9 SENIORS/ELDERLY / 44.9 PEOPLE WITH DISABILITIES / 38.9 PEOPLE WITH MENTAL HEALTH ISSUES / 32.3 WOMEN OF REPRODUCTIVE AGE / 31.9 PEOPLE WITH SUBSTANCE ABUSE ISSUES / 25.6 SPECIFIC HEALTH CONDITION OR DISEASE / 24.6 FARMERS / 14.0 MIGRANT WORKERS / 11.2 OTHER / 10.5 SPECIFIC RACIAL OR ETHNIC GROUPS / 8.4 SPECIFIC GEOGRAPHIC AREA / 5.3 EVERYONE / 5.3 SPECIFIC AGE GROUP / 3.5 NOTE: RESPONDENTS COULD SELECT MULTIPLE POPULATIONS FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 4: OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH OUR PARTNERS ESSEX COUNTY PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, ALICE HYDE MEDICAL CENTER, ELIZABETHTOWN COMMUNITY HOSPITAL, MOSES LUDINGTON HOSPITAL, AND ADIRONDACK RURAL HEALTH NETWORK. FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 7: ADIRONDACK HEALTH STRIVES TO MEET AS MANY THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS AS POSSIBLE. IN MANY CASES, WE PARTNER WITH APPROPRIATE ORGANIZATIONS AND AGENCIES TO ADDRESS NEEDS THAT ADIRONDACK HEALTH DOES NOT. ON INITIATIVES THAT ARE NOT HOSPITAL-LED, ADIRONDACK HEALTH PARTNERS AND WORKS WITH THE LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, SUBSTANCE ABUSE PREVENTION AND TREATMENT PROVIDERS, HOME CARE, AND MANY OTHERS TO INSURE THAT THE NEEDS OF OUR COMMUNITY MEMBERS ARE MET. THE FOLLOWING ARE THE NYS PREVENTION AGENDA ITEMS THAT ADIRONDACK HEALTH DOES NOT DIRECTLY ADDRESS IN OUR IMPLEMENTATION STRATEGY: PROMOTE A HEALTHY AND SAFE ENVIRONMENT FOCUS AREA: INJURIES, VIOLENCE AND OCCUPATIONAL HEALTH THE RATE OF CRIME AND ASSAULT ARE LOW IN ADIRONDACK HEALTH'S SERVICE AREA. FALLS IN THE HOME AND OCCUPATIONAL HEALTH ARE ISSUES THAT COMMUNITY PARTNERS ARE BETTER POSITIONED TO ADDRESS. FOCUS AREA: OUTDOOR AIR AND WATER QUALITYTHE AIR AND WATER QUALITY INDICATORS ARE GOOD. DATA INDICATES THAT IT IS ONLY A FEW DAYS EACH YEAR THAT OUTDOOR AIR QUALITY IS POOR, AND THE LIKELY CAUSE OF THIS IS INDUSTRIAL POLLUTION FROM THE MID- WEST CARRIED HERE ON THE JET STREAM. ADIRONDACK HEALTH DOES NOT HAVE A STRATEGY TO DIRECTLY ADDRESS THIS AT THIS TIME, BUT NATIONAL GROUPS HAVE MADE PROGRESS AND ARE STILL WORKING TO IMPROVE OUTPUTS FROM THESE INDUSTRIAL AREAS.FOCUS AREA: BUILT ENVIRONMENT IN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD PASSING COMPLETE STREETS POLICIES, IMPROVING PARKS AND OTHER RECREATIONAL AREAS, PASSING TOBACCO FREE GROUNDS POLICIES, IMPROVING ACCESS TO FRESH FRUITS AND VEGETABLES IN STORES AND RESTAURANTS, AND OTHER PROJECTS THAT IMPROVE ACCESS TO HEALTHY FOODS AND IMPROVE THE BUILT ENVIRONMENT SO COMMUNITY MEMBERS OF ALL LEVELS OF MOBILITY CAN FEEL SAFE AS PEDESTRIANS AND USING ALTERNATIVE FORMS OF TRANSPORTATION. PREVENT HIV/STDS, VACCINE-PREVENTABLE DISEASE AND HEALTHCARE ASSOCIATED INFECTIONSFOCUS AREA: PREVENT HIV AND STDSTHE RATE OF HIV IS EXTREMELY LOW IN ADIRONDACK HEALTH'S SERVICE AREA. ADIRONDACK HEALTH'S PROVIDERS CONTINUE TO WORK WITH PUBLIC HEALTH AND OTHER PROVIDERS TO DELIVER THE HIGHEST LEVEL OF CARE TO PATIENTS WITH HIV. FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 20D: SELF-PAY PATIENTS THAT VISITED OUR MEDICAID SCREENER, AND WERE NOT DETERMINED TO BE FAP-ELIGIBLE, RECEIVED A 30% DISCOUNT. THOSE WHO WERE FAP-ELIGIBLE WERE WRITTEN OFF AT 100%. FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 3: ADIRONDACK MEDICAL CENTER AND OUR COLLABORATING PARTNERS, COUNTY PUBLIC HEALTH DEPARTMENTS AND REGIONAL HOSPTIALS, WORKED THROUGH THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY THAT GAVE US INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY WE SERVE. ARHN ENGAGED THE CENTER FOR HUMAN SERVICES RESEARCH (CHSR) AT THE UNIVERSITY AT ALBANY, STATE UNIVERSITY OF NEW YORK TO WORK WITH A SUBCOMMITTEE TO DEVELOP THE SURVEY. THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO A REGIONAL EMAIL CONTACT LIST OF 624. ULTIMATELY, 285 SURVEYS WERE COMPLETED DURING THE SIX-WEEK SURVEY PERIOD, A RESPONSE RATE OF 45.7 PERCENT. OF ALL 285 RESPONSES, 86 INDICATED THAT ESSEX COUNTY WAS PART OF THEIR SERVICE AREA AND 83 INDICATED THAT FRANKLIN COUNTY WAS PART OF THEIR SERVICE AREA; HOWEVER, IT SHOULD BE NOTED THAT MANY OF THE RESPONDING HEALTH CARE STAKEHOLDERS SERVICE MULTIPLE COUNTIES WITHIN THE LARGER ARHN REGION. SURVEY PARTICIPANTS REPRESENTED A DIVERSE ARRAY OF DIFFERENT AGENCIES, POPULATION GROUPS, AND SERVICE-AREAS WITHIN THE OVERALL EIGHT-COUNTY ARHN REGION. BELOW, TABLE A.1 SHOWS THE PRIMARY FUNCTIONS SELECTED BY RESPONDENTS AND TABLE A.2 SHOWS THE POPULATIONS THAT THEIR AGENCIES SERVE. HEALTH CARE AND EDUCATIONAL AGENCIES ARE WELL REPRESENTED, AND THE MAJORITY PROVIDES SERVICES TO CHILDREN AND ADOLESCENTS, AS WELL AS PEOPLE LIVING AT OR NEAR THE POVERTY LEVEL. TABLE A.1. PRIMARY FUNCTIONS INDICATED BY SURVEY RESPONDENTSORGANIZATION PRIMARY FUNCTION / PERCENT OF ALL APPLICANTS HEALTH CARE / 36.8 EDUCATION / 36.5 BEHAVIORAL HEALTH / 17.5 HEALTHY ENVIRONMENT / 14.7 EARLY CHILDHOOD SVCS. / 14.4 SOCIAL SERVICES / 11.9 SENIOR SERVICES / 11.2 OTHER SERVICES / 9.1 DEVELOPMENTAL DISABILITY SVCS. / 8.4 EMPLOY & TRAINING / 8.4 HOUSING SERVICES / 8.1 STI/HIV PREVENTION / 6.0 PHYSICAL DISABILITY SVCS. / 4.9 GOVERNMENT AGENCY / 2.1 TESTING AND PREVENTION / 2.1 NOTE: RESPONDENTS COULD SELECT MORE THAN ONE PRIMARY FUNCTION. TABLE A.2. POPULATIONS SERVED BY SURVEY RESPONDENT AGENCIESPOPULATION SERVED / PERCENT OF ALL RESPONDENTS CHILDREN/ADOLESCENTS / 59.6 PEOPLE LIVING AT OR NEAR POVERTY LEVEL / 50.9 SENIORS/ELDERLY / 44.9 PEOPLE WITH DISABILITIES / 38.9 PEOPLE WITH MENTAL HEALTH ISSUES / 32.3 WOMEN OF REPRODUCTIVE AGE / 31.9 PEOPLE WITH SUBSTANCE ABUSE ISSUES / 25.6 SPECIFIC HEALTH CONDITION OR DISEASE / 24.6 FARMERS / 14.0 MIGRANT WORKERS / 11.2 OTHER / 10.5 SPECIFIC RACIAL OR ETHNIC GROUPS / 8.4 SPECIFIC GEOGRAPHIC AREA / 5.3 EVERYONE / 5.3 SPECIFIC AGE GROUP / 3.5 NOTE: RESPONDENTS COULD SELECT MULTIPLE POPULATIONS FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 4: OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH OUR PARTNERS ESSEX COUNTY PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, ALICE HYDE MEDICAL CENTER, ELIZABETHTOWN COMMUNITY HOSPITAL, MOSES LUDINGTON HOSPITAL, AND ADIRONDACK RURAL HEALTH NETWORK. FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 7: ADIRONDACK HEALTH STRIVES TO MEET AS MANY THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS AS POSSIBLE. IN MANY CASES, WE PARTNER WITH APPROPRIATE ORGANIZATIONS AND AGENCIES TO ADDRESS NEEDS THAT ADIRONDACK HEALTH DOES NOT. ON INITIATIVES THAT ARE NOT HOSPITAL-LED, ADIRONDACK HEALTH PARTNERS AND WORKS WITH THE LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, SUBSTANCE ABUSE PREVENTION AND TREATMENT PROVIDERS, HOME CARE, AND MANY OTHERS TO INSURE THAT THE NEEDS OF OUR COMMUNITY MEMBERS ARE MET. THE FOLLOWING ARE THE NYS PREVENTION AGENDA ITEMS THAT ADIRONDACK HEALTH DOES NOT DIRECTLY ADDRESS IN OUR IMPLEMENTATION STRATEGY: PROMOTE A HEALTHY AND SAFE ENVIRONMENT FOCUS AREA: INJURIES, VIOLENCE AND OCCUPATIONAL HEALTH THE RATE OF CRIME AND ASSAULT ARE LOW IN ADIRONDACK HEALTH'S SERVICE AREA. FALLS IN THE HOME AND OCCUPATIONAL HEALTH ARE ISSUES THAT COMMUNITY PARTNERS ARE BETTER POSITIONED TO ADDRESS. FOCUS AREA: OUTDOOR AIR AND WATER QUALITYTHE AIR AND WATER QUALITY INDICATORS ARE GOOD. DATA INDICATES THAT IT IS ONLY A FEW DAYS EACH YEAR THAT OUTDOOR AIR QUALITY IS POOR, AND THE LIKELY CAUSE OF THIS IS INDUSTRIAL POLLUTION FROM THE MID- WEST CARRIED HERE ON THE JET STREAM. ADIRONDACK HEALTH DOES NOT HAVE A STRATEGY TO DIRECTLY ADDRESS THIS AT THIS TIME, BUT NATIONAL GROUPS HAVE MADE PROGRESS AND ARE STILL WORKING TO IMPROVE OUTPUTS FROM THESE INDUSTRIAL AREAS.FOCUS AREA: BUILT ENVIRONMENT IN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD PASSING COMPLETE STREETS POLICIES, IMPROVING PARKS AND OTHER RECREATIONAL AREAS, PASSING TOBACCO FREE GROUNDS POLICIES, IMPROVING ACCESS TO FRESH FRUITS AND VEGETABLES IN STORES AND RESTAURANTS, AND OTHER PROJECTS THAT IMPROVE ACCESS TO HEALTHY FOODS AND IMPROVE THE BUILT ENVIRONMENT SO COMMUNITY MEMBERS OF ALL LEVELS OF MOBILITY CAN FEEL SAFE AS PEDESTRIANS AND USING ALTERNATIVE FORMS OF TRANSPORTATION. PREVENT HIV/STDS, VACCINE-PREVENTABLE DISEASE AND HEALTHCARE ASSOCIATED INFECTIONSFOCUS AREA: PREVENT HIV AND STDSTHE RATE OF HIV IS EXTREMELY LOW IN ADIRONDACK HEALTH'S SERVICE AREA. ADIRONDACK HEALTH'S PROVIDERS CONTINUE TO WORK WITH PUBLIC HEALTH AND OTHER PROVIDERS TO DELIVER THE HIGHEST LEVEL OF CARE TO PATIENTS WITH HIV. FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 20D: SELF-PAY PATIENTS THAT VISITED OUR MEDICAID SCREENER, AND WERE NOT DETERMINED TO BE FAP-ELIGIBLE, RECEIVED A 30% DISCOUNT. THOSE WHO WERE FAP-ELIGIBLE WERE WRITTEN OFF AT 100%. 6 TUPPER LAKE MEDICAL OFFICE BUILDING 7 STETSON ROAD TUPPER LAKE NY 12986 CLINIC; LABORATORY; RADIOLOGY MOUNTAIN HEALTH CENTER 2841 NYS ROUTE 73 KEENE NY 12942 CLINIC UIHLEIN LIVING CENTER 185 OLD MILITARY ROAD LAKE PLACID NY 12946 NURSING HOME WITH 156 BEDS MERCY LIVING CENTER 114 WAWBEEK AVENUE TUPPER LAKE NY 12986 NURSING HOME WITH 60 BEDS; DIALYSIS, REHABILITATION LAKE PLACID HEALTH CENTER 29 CHURCH STREET LAKE PLACID NY 12946 CLINC; ER; LABORATORY; RADIOLOGY; REHABILITATION WOUND CARE MEDICAL OFFICE BUILDING 285 COUNTY ROUTE 47 SARANAC LAKE NY 12983 CLINIC PART I, LINE 7: AMOUNTS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 (TOTAL OPERATING EXPENSE MINUS MEDICAID/PROVIDER TAXES, TOTAL COMMUNITY BENEFIT EXPENSE, AND TOTAL COMMUNITY BUILDING EXPENSE DIVIDED BY GROSS PATIENT CHARGES), AND ADDRESSES ALL PATIENT SEGMENTS. PART I, LN 7 COL(F): BAD DEBT EXPENSE, REMOVED FROM DENOMINATOR, EQUALS 3,328,392. PART II, COMMUNITY BUILDING ACTIVITIES: THE CEO ATTENDED AMERICAN HOSPITAL ASSOCIATION BOARD MEETINGS. THIS IS A MEMBERSHIP ORGANIZATION THAT HELPS HOSPITALS TO HELP THEIR COMMUNITIES TO ACHIEVE THE HIGHEST MEASURE OF HEALTH THROUGH EDUCATION, RESEARCH, SUPPORT SYSTEMS, DISSEMINATION OF BEST CLINICAL QUALITY PRACTICES, AND COALITION BUILDING TO IMPROVE THE HEALTH OF OUR COMMUNITIES. ALSO, THE CEO ATTENDED ADIRONDACK HEALTH INSTITUTE MEETINGS. AHI IS A REGIONAL ORGANIZATION THAT INCLUDES THE TRI-LAKES, PLATTSBURGH, AND GLENNS FALLS COMMUNITIES WHOSE PURPOSE IS TO IMPROVE THE OVERALL HEALTH OF THESE ADIRONDACK COMMUNITIES BY WORKING TOGETHER ON A REGIONAL BASIS. THE CHIEF NURSING OFFICER SPENT TIME EDUCATING LOCAL, STATE, AND FEDERAL LEGISLATORS ABOUT IMPORTANT ISSUES IN HEALTHCARE AND COMMUNITY HEALTH. THE CHIEF MEDICAL OFFICER SPENT TIME AT A LOCAL IRON MAN COMPETITION TO PROVIDE MEDICAL COVERAGE OF THE ATHLETES AND PROMOTE HEALTHY EXERCISE ROUTINES. PART III, LINE 4: "IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, ADIRONDACK HEALTH ANALYZES PAST PAYMENT HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, ADIRONDACK HEALTH ANALYZES CONTRACTUALY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATES WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), ADIRONDACK HEALTH RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNT RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS."PART III, LINE 3:THE ORGANIZATION'S BAD DEBT EXPENSES IS CALCULATED USING A PERCENTAGE OF BAD DEBT THAT CONTAINS POSSIBLE CHARITY CARE CASES AND APPLYING IT TO LINE 2. RATIONALE FOR WHAT PORTION OF BAD DEBT SHOULD CONSTITUTE COMMUNITY BENEFIT: THE PROVISION OF HEALTH CARE IS DIFFERENT FROM PROVIDING OTHER SERVICES, IN THAT HOSPITALS, ALTHOUGH THEY MAY ATTEMPT TO OBTAIN FINANCIAL INFORMATION BEFORE SERVICE IS PROVIDED, FOCUS ON PROVIDING THE PATIENT WITH NEEDED HEALTH CARE AND LATER TRY TO OBTAIN PAYMENT. IN OTHER INDUSTRIES, THE SERVICE PROVIDER CAN CHECK THE CUSTOMER'S CREDIT RATING, ASK FOR PAYMENT IN ADVANCE, ETC AND IS USUALLY ASKING THIS INFORMATION WHEN THE CONSUMER IS NOT IN A HEALTH CRISIS AND UNDER GREAT STRESS AND WORRY. AT A LATER TIME, WHEN THE PROVIDER ATTEMPTS TO COLLECT PAYMENT AND FINDS THE PATIENT UNWILLING TO PAY, THEIR OPTIONS ARE AGAIN LIMITED GIVEN THE NATURE OF THE SERVICE PROVIDED AND THE INABILITY TO REPOSSESS THE SERVICE.PART III, LINE 2:THE ORGANIZATION'S BAD DEBT EXPENSE IS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND BAD DEBT EXPENSE. PART III, LINE 8: CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND APPLYING IT TO GROSS MEDICARE CHARGES. SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE PATIENT SERVICES ARE PROVIDED AT A COST THAT IS GREATER THAN REIMBURSEMENT. PART III, LINE 9B: ACCORDING TO OUR CHARITY CARE POLICY, FAP-ELIGIBLE PATIENTS ARE WRITTEN-OFF AT 100% SO NO COLLECTION PRACTICES ARE NECESSARY. PART VI, LINE 2: ADIRONDACK MEDICAL CENTER USES A NUMBER OF ASSESSMENT METHODS TO DETERMINE HOW WELL WE ARE MEETING COMMUNITY NEEDS AND WHAT ADDITIONAL SERVICES WE CAN OFFER OUR COMMUNITY MEMBERS. AMC USES THE PRESS-GANEY PATIENT SATISFACTION SURVEY FOR CONTINUAL PATIENT FEEDBACK. THE SURVEYS ARE MAILED TO RANDOMLY SELECTED PATIENTS BY PRESS-GANEY, A NATIONALLY RECOGNIZED PATIENT SURVEY FIRM, AND PRESS-GANEY PROCESSES THE RESULTS. THEY GIVE AMC THE RESULTS BENCHMARKED AGAINST OTHER HOSPITALS TO HELP US UNDERSTAND HOW WELL WE ARE SERVING OUR COMMUNITY. THE MAJORITY OF AMC'S STRATEGIC INITIATIVES ARE DRIVEN BY A THREE-YEAR STRATEGIC PLAN, WHICH IS DEVELOPED THROUGH THE COLLABORATION OF THE BOARD, MEDICAL STAFF, AMC STAFF AND COMMUNITY MEMBERS. THE GOALS THAT ARE SET FORTH EVERY THREE YEARS IN THE STRATEGIC PLAN ARE INCORPORATED INTO AMC'S MANAGEMENT ACTION PLAN (MAP), WHICH IS REVIEWED AND REVISED EACH YEAR. AT THE BEGINNING OF EACH YEAR EVERY DEPARTMENT CREATES A MAP THAT OUTLINES THE CONCRETE STEPS THAT THE DEPARTMENT WILL ACCOMPLISH IN MOVING THE HOSPITAL CLOSER TO COMPLETING THE STRATEGIC PLAN GOALS. THE SUCCESS OF AMC, EACH DEPARTMENT, AND EACH EMPLOYEE IS MEASURED BY THE MAP AND THE PROGRESS MADE TOWARD ACCOMPLISHING THE GOALS SET OUT IN THE STRATEGIC PLAN. FOR NEW SERVICES, AMC STAFF DEVELOPS A NEEDS ASSESSMENT USING A VARIETY OF DATA INCLUDING REGIONAL DEMAND FOR THE SPECIFIC SERVICE, DEMOGRAPHICS, AND FINANCIAL ANALYSIS. THE BOARD OF TRUSTEES CAREFULLY REVIEWS THE ANALYSIS AND EITHER SUPPORTS THE RECOMMENDATION OR ASKS FOR FURTHER INFORMATION. PART VI, LINE 3: ANY PATIENT THAT CONTACTS SCHEDULING OR PRESENTS TO ANY AMC DEPARTMENT (INCLUDING ADMITTING, EMERGENCY ROOM, ETC.) THAT DOES NOT IDENTIFY AN INSURANCE COMPANY OR IDENTIFIES THEMSELVES AS SELF-PAY ARE INFORMED OF OUR SELF-PAY PROCESS. THIS PROCESS INCLUDES INFORMATION ABOUT AMC'S CHARITY CARE POLICY AND THE BENEFITS OF VISITING WITH A CERTIFIED FACILITATED ENROLLER WHO CAN CHECK THE PATIENT'S ELIGIBILITY FOR STATE AND FEDERAL HEALTH INSURANCE PROGRAMS. PART VI, LINE 4: ADIRONDACK MEDICAL CENTER IS LOCATED IN THE HEART OF THE ADIRONDACK PARK IN RURAL, UPSTATE NEW YORK. THE ADIRONDACK PARK IS A UNIQUE, SIX MILLION ACRE PATCHWORK OF PUBLIC AND PRIVATE LAND. IT IS BEST KNOWN FOR ITS MOUNTAINS - THE HIGHEST IN NEW YORK STATE - AND ITS LAKES. THE REGION HAS AN AVERAGE SEASONAL SNOWFALL IN EXCESS OF 90 INCHES AND THE AVERAGE MEAN TEMPERATURE IN JANUARY IS 16 DEGREES FAHRENHEIT.AMC IS DESIGNATED A SOLE COMMUNITY PROVIDER HOSPITAL WITH THE CLOSEST COMPARABLE FACILITY 50 MILES AWAY FROM OUR MAIN CAMPUS IN SARANAC LAKE. AMC IS AN INTEGRAL PART OF THE COMMUNITY AS THE ONLY ACUTE CARE FACILITY, THE PREDOMINANT PROVIDER OF AMBULATORY SERVICES, AND THE LARGEST PRIVATE EMPLOYER IN THE ADIRONDACK PARK. AMC PROVIDES CARE FOR 71.2% OF THE 24,266 RESIDENTS IN OUR PRIMARY SERVICE AREA AND 24.5% OF THE 12,100 RESIDENTS IN OUR SECONDARY SERVICE AREA. THIS SERVICE AREA COVERS OVER 1,200 SQUARE MILES, HAS AN AVERAGE OF JUST OVER 30 PEOPLE PER SQUARE MILE, AND INCLUDES PORTIONS OF 5 COUNTIES.THE HOSPITAL'S SERVICE AREA IS DESIGNATED AS THE FOLLOWING FEDERAL HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA):-PRIMARY CARE-DENTAL-PSYCHIATRYAMC IS SERVING AN AGING POPULATION WITH HIGH CANCER AND CHRONIC DISEASE RATES, AND VERY LOW INCOME LEVELS. THE PERCENTAGE OF THE POPULATION THAT FALLS INTO THE "BABY BOOMER" AGE GROUP, 55-64 YEARS OF AGE, IS INCREASING, WITH A CORRESPONDING DECREASE IN YOUNGER AGE GROUPS.THE AVERAGE UNEMPLOYMENT RATE IN 2013 FOR NEW YORK STATE WAS 7.7% AND THE UNEMPLOYMENT RATES IN THE COUNTIES THAT WE SERVE WAS A SLIGHTLY MORE THAN ONE PERCENTAGE POINT ABOVE THAT AVERAGE. THE NYS DEPARTMENT OF LABOR INDICATES THAT THE PER CAPITA INCOME FOR THE COUNTIES THAT AMC SERVES IS BETWEEN 35% AND 44% BELOW THE STATE AVERAGE. PART VI, LINE 5: AS THE LARGEST EMPLOYER AND ONLY FULL SERVICE HOSPITAL IN THE ADIRONDACK PARK AMC IS AN IMPORTANT PARTNER IN COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF OUR COMMUNITY MEMBERS.- OPENED PRIMARY CARE CLINIC IN SARANAC LAKE TO FILL THE NEED CREATED BY RETIRING PHYSICIANS- OUR PRIMARY CARE HEALTH CENTERS WERE AMONG THE FIRST IN NEW YORK TO PARTNER WITH THE STATE SMOKERS' QUITLINE TO HELP PATIENTS WHO WANT TO KICK THE HABIT WITH A NEW STOP SMOKING AND REFERRAL PROCESS THROUGH THE ELECTRONIC MEDICAL RECORD- RECRUITED AN ASTHMA AND ALLERGY SPECIALIST TO THE REGION TO REPLACE A RETIRING PHYSICIAN- EXPANDED THE PAIN MANAGEMENT CLINIC IN RESPONSE TO COMMUNITY NEED PART VI, LINE 6: AMC'S BOARD OF TRUSTEES IS COMPRISED OF COMMUNITY MEMBERS WHO LISTEN CLOSELY TO THEIR NEIGHBORS, FRIENDS AND FAMILY MEMBERS, WHO ARE OUR PATIENTS. THIS IS AN ACTIVE BOARD WITH MEMBERS SITTING ON MANY OF THE HOSPITAL COMMITTEES. THIS CIRCLE OF INTERACTION HELPS INFORM OUR STAFF AND ENABLES THEM TO MAKE CONTINUOUS IMPROVEMENTS BASED ON COMMUNITY INPUT.AS THE LARGEST EMPLOYER AND ONLY FULL SERVICE HOSPITAL IN THE ADIRONDACK PARK AMC IS AN IMPORTANT PARTNER IN COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF OUR COMMUNITY MEMBERS.- OPENED PRIMARY CARE CLINIC IN SARANAC LAKE TO FILL THE NEED CREATED BY RETIRING PHYSICIANS- OUR PRIMARY CARE HEALTH CENTERS WERE AMONG THE FIRST IN NEW YORK TO PARTNER WITH THE STATE SMOKERS' QUITLINE TO HELP PATIENTS WHO WANT TO KICK THE HABIT WITH A NEW STOP SMOKING AND REFERRAL PROCESS THROUGH THE ELECTRONIC MEDICAL RECORD- RECRUITED AN ASTHMA AND ALLERGY SPECIALIST TO THE REGION TO REPLACE A RETIRING PHYSICIAN- EXPANDED THE PAIN MANAGEMENT CLINIC IN RESPONSE TO COMMUNITY NEED PART VI, LINE 7, REPORTS FILED WITH STATES NY 1 X X X X 0 0 0 0 0 0 0 0 0 GREG MOORE CFO 193781 0 0 0 0 0 2112 0 16724 0 212617 0 0 0 JOHN BRODERICK MD CMO 272350 0 0 0 0 0 10119 0 16724 0 299193 0 0 0 CYNTHIA MCGUIRE COO 155071 0 0 0 0 0 6155 0 14015 0 175241 0 0 0 WILLIAM VISCARDO MD PHYSICIAN 256126 0 0 0 0 0 2263 0 16723 0 275112 0 0 0 ANTHONY DOWIDOWICZ PHYSICIAN 281740 0 0 0 0 0 9620 0 6924 0 298284 0 0 0 FRANK NOCILLA PHYSICIAN 217240 0 0 0 0 0 2094 0 14016 0 233350 0 0 0 NICHOLAS BRODYN PHYSICIAN 440207 0 0 0 0 0 2550 0 11724 0 454481 0 0 0 MANDEEP SALUJA PHYSICIAN 215893 0 0 0 0 0 6451 0 6924 0 229268 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 ADIRONDACK MEDICAL CENTER CONTRACTS WITH HEALTH TECH MANAGEMENT SERVICES TO FILL THE POSITION OF PRESIDENT/CEO. THE MANAGEMENT FEE PAID TO HEALTHTECH MANAGEMENT SERVICES IS $732,776, WHICH INCLUDES THE CEO SALARY AND BENEFITS AND A MANAGEMENT FEE. FORM 990, PART VI, SECTION B, LINE 11 THE 990 IS PRESENTED AND REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING THE 990. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF TRUSTEES ARE REQUIRED TO COMPLETE AND SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY. THESE ARE THEN REVIEWED BY THE BOARD CHAIR. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION DECISIONS ARE DEVELOPED BASED ON THE USE OF NATIONAL, REGIONAL, AND HEALTHTECH SALARY SURVEY DATA AND THE BOARD OF TRUSTEE'S INPUT. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,565,408. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,565,408. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 849,465. MANAGEMENT AND GENERAL EXPENSES 967,049. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,816,514. CONSULTING FEES: PROGRAM SERVICE EXPENSES 250. MANAGEMENT AND GENERAL EXPENSES 66,085. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 66,335. LATE CHARGES/FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 189. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 189. LAUNDRY EXPENSE: PROGRAM SERVICE EXPENSES 217,807. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 217,807. CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,697. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,697. CONTRACTED SERVICE: PROGRAM SERVICE EXPENSES 3,967,344. MANAGEMENT AND GENERAL EXPENSES 2,378,566. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,345,910. TRASH REMOVAL: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 142,894. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 142,894. COLLECTION AGENCY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 164,044. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 164,044. ADIRONDACK MEDICAL CENTER FOUNDATION PO BOX 471 LAKE COLBY DRIVE SARANAC LAKE NY 12983 161528554 SUPPORT AND ASSIST ADIRONDACK MEDICAL CENTER NY 501(C)3 BOX 11 ADIRONDACK MEDICAL CENTER 0 TRUDEAU HEALTH SYSTEMS LLC PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 141788211 CONTACTING - HEALTH SERVICES NY AMC AND TRUDEAU HEALTH SYSTEMS C 0.50000 0 TRUDEAU HEALTH SYSTEMS IPA PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 141795284 CONTACTING - HEALTH SERVICES NY AMC AND TRUDEAU HEALTH SYSTEMS C 32625 0.50000 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0