ALICE HYDE MEDICAL CENTER: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
ALICE HYDE MEDICAL CENTER (EIN 15-0346515)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-17
IRS object ID
201423219349302837
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 ReturnHeader

FieldValueIRS element (for citing)
Return2014-11-17T10:02:43-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN454051133PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FREED MAXICK CPAS PCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1424 MAIN STREET SUITE 800AddressLine1
CityBUFFALOCity
StateNYState
ZIP Code142023508ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN150346515EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ALICE HYDE MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlALICBusinessNameControlTxt
Phone5184833000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PARK STREETAddressLine1
CityMALONECity
StateNYState
ZIP Code12953ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDOUGLAS DIVELLOPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone5184833000PhoneNum
Signature2014-11-06SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMARY MADONIAPreparerPersonNm
PTINP00405803PTIN
Phone7168472651PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDOUGLAS DIVELLOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PARK STREETAddressLine1
CityMALONECity
StateNYState
ZIP Code12953ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$76,251,875GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ALICEHYDE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1905FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTO SERVE THE COMMUNITY THROUGH ACUTE, LONG TERM AND PRIMARY HEALTHCARE.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee700TotalEmployeeCnt
Total Volunteers53TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,372,179PYContributionsGrantsAmt
CY Contributions Grants$9,472,295CYContributionsGrantsAmt
PY Program Service Revenue$67,247,947PYProgramServiceRevenueAmt
CY Program Service Revenue$64,979,554CYProgramServiceRevenueAmt
PY Investment Income$101,036PYInvestmentIncomeAmt
CY Investment Income$207,838CYInvestmentIncomeAmt
PY Other Revenue-$59,353PYOtherRevenueAmt
CY Other Revenue-$102,661CYOtherRevenueAmt
PY Total Revenue$69,661,809PYTotalRevenueAmt
CY Total Revenue$74,557,026CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$42,464,846PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$41,415,481CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$68,367CYTotalFundraisingExpenseAmt
PY Other Expenses$26,314,357PYOtherExpensesAmt
CY Other Expenses$26,293,207CYOtherExpensesAmt
PY Total Expenses$68,779,203PYTotalExpensesAmt
CY Total Expenses$67,708,688CYTotalExpensesAmt
PY Revenues Less Expenses$882,606PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,848,338CYRevenuesLessExpensesAmt
Total Assets BOY$39,770,508TotalAssetsBOYAmt
Total Assets EOY$77,817,559TotalAssetsEOYAmt
Total Liabilities BOY$16,620,003TotalLiabilitiesBOYAmt
Total Liabilities EOY$47,746,219TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$23,150,505NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$30,071,340NetAssetsOrFundBalancesEOYAmt
MissionALICE HYDE MEDICAL CENTER WILL DISTINGUISH ITSELF AS A TRUSTED AND RESPECTED HEALTH CARE LEADER AND PROVIDER OF CHOICE, EXCEEDING EXPECTATIONS THROUGH SERVICE EXCELLENCE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$57,030,806ExpenseAmt
Revenue$64,979,554RevenueAmt
DescPATIENT CARE, GENERAL MEDICAL/SURGICAL HOSPITAL, PROVIDED INPATIENT SERVICES FOR 2,435 PEOPLE, OUTPATIENT SERVICES FOR 816,891 VISITS, AND PROVIDED 26,869 DAYS OF SKILLED NURSING FACILITY CARE.Desc
Total Program Service Expenses$57,030,806TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document26IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee700EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SEAN CURTIN VP OF FINANCEBusinessNameLine1
FieldValueIRS element (for citing)
Phone5184833000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PARK STREETAddressLine1
CityMALONECity
StateNYState
ZIP Code12953ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ANJNI BHAGAT MD
DIRECTOR10.00Yes (X)$41,452$0$0
WILLIAM BOND REV
DIRECTOR10.00Yes (X)$0$0$0
DANIEL CLARK
VICE-CHAIRMAN10.00Yes (X)$0$0$0Yes (X)
WAYNE DUSO
DIRECTOR10.00Yes (X)$0$0$0
JERRY GRIFFIN
DIRECTOR10.00Yes (X)$0$0$0
BRYAN J HUGHES
DIRECTOR10.00Yes (X)$0$0$0
DEAN JOHNSTON
CHAIRMAN10.00Yes (X)$0$0$0Yes (X)
BENSON KELLY MD
DIRECTOR10.00Yes (X)$0$0$0
CRAIG LAVIGNE
SECRETARY10.00Yes (X)$0$0$0Yes (X)
THOMAS LEITZ
DIRECTOR10.00Yes (X)$0$0$0
BRIAN MONETTE
TREASURER10.00Yes (X)$0$0$0Yes (X)
SHARON NOREAULT
DIRECTOR10.00Yes (X)$0$0$0
PAUL KOEHLER
DIRECTOR10.00Yes (X)$0$0$0
DOUG DIVELLO
PRESIDENT/CEO40.00$258,802$0$3,433Yes (X)
LEONARDO DISHMAN MD
CHIEF MEDICAL OFFICER40.00$185,160$0$5,537Yes (X)
SEAN CURTIN
VP OF FINANCE - JUNE-DEC40.00$77,165$0$0Yes (X)
D CHRIS FRAUENHOFER
VP OF FINANCE - JAN-MAY40.00$97,138$0$3,978Yes (X)
DRAGOS MACELARU MD
PHYSICIAN40.00$789,585$0$9,720Yes (X)
MARCO BERARD MD
PHYSICIAN40.00$697,503$0$8,342Yes (X)
RAHUL GUPTA MD
PHYSICIAN40.00$462,297$0$7,904Yes (X)
NIKALESH REDDY MD
PHYSICIAN40.00$398,740$0$8,190Yes (X)
VARGHESE NOEL MD
PHYSICIAN40.00$400,812$0$7,853Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,408,654TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$54,957TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K12IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
PC CONSTRUCTION
193 TILLEY DRIVESOUTH BURLINGTONVT05403CONSTRUCTION SERVICES$2,294,670
RLPS II
250 VALLEYBROOK DRIVELANCASTERPA17601ARCHITECTURAL SERVICES$1,181,992
APOGEE
2525 E CAMELBACK ROADPHOENIXAZ85016HOSPITALIST PROFESSIONAL$904,454
WEATHERBY LOCUMS
6440 MILLROC DRIVESALT LAKE CITYUT84121LOCUMS SERVICES$605,368
MEDICAL SVCS SUFFOLK COUNTY
PO BOX 27701ATLANTAGA30384EMERGENCY MEDICINE$586,830
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Fundraising$40,979FundraisingAmt
Government Grants$9,285,051GovernmentGrantsAmt
All Other Contributions$146,265AllOtherContributionsAmt
Total Contributions$9,472,295TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT CAREDesc
Business622000BusinessCd
Total Revenue Column$64,979,554TotalRevenueColumnAmt
Related Or Exempt Func Income$64,979,554RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$64,979,554TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,225TotalRevenueColumnAmt
Exclusion$34,225ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$167,639RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$263,342RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$95,703RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$95,703TotalRevenueColumnAmt
Exclusion-$95,703ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,586,992SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,413,379SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$173,613SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$173,613TotalRevenueColumnAmt
Exclusion$173,613ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$11,170FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$40,979ContriRptFundraisingEventAmt
Fundraising Direct Expenses$18,128FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$6,958TotalRevenueColumnAmt
Exclusion-$6,958ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$74,557,026TotalRevenueColumnAmt
Related Or Exempt Func Income$64,979,554RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$105,177ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$770,891TotalAmt
Program Services$41,452ProgramServicesAmt
Management And General$729,439ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$32,662,516TotalAmt
Program Services$28,115,879ProgramServicesAmt
Management And General$4,509,950ManagementAndGeneralAmt
Fundraising$36,687FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$976,126TotalAmt
Program Services$839,468ProgramServicesAmt
Management And General$136,658ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,680,729TotalAmt
Program Services$4,025,427ProgramServicesAmt
Management And General$655,302ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,325,219TotalAmt
Program Services$1,996,888ProgramServicesAmt
Management And General$325,531ManagementAndGeneralAmt
Fundraising$2,800FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$1,300,291TotalAmt
Program Services$1,041,060ProgramServicesAmt
Management And General$259,231ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$263,743TotalAmt
Management And General$263,743ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$129,601TotalAmt
Management And General$129,601ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$33,117TotalAmt
Management And General$33,117ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$74,154TotalAmt
Program Services$63,222ProgramServicesAmt
Management And General$10,382ManagementAndGeneralAmt
Fundraising$550FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$361,170TotalAmt
Program Services$310,606ProgramServicesAmt
Management And General$50,564ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,436,311TotalAmt
Program Services$1,235,227ProgramServicesAmt
Management And General$201,084ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$148,601TotalAmt
Program Services$127,775ProgramServicesAmt
Management And General$20,804ManagementAndGeneralAmt
Fundraising$22FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$336,130TotalAmt
Program Services$289,072ProgramServicesAmt
Management And General$47,058ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,968,883TotalAmt
Program Services$2,553,239ProgramServicesAmt
Management And General$415,644ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$743,626TotalAmt
Program Services$639,518ProgramServicesAmt
Management And General$104,108ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
DIRECT EXPENSES$8,792,736$7,333,445$1,430,983$28,308
MEDICAL SUPPLIES & IMPL$3,601,444$3,097,242$504,202
PHARMACEUTICALS$3,297,106$2,835,511$461,595
UTILITIES$1,362,270$1,171,552$190,718

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,444,024TotalAmt
Program Services$1,314,223ProgramServicesAmt
Management And General$129,801ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$67,708,688TotalAmt
Program Services$57,030,806ProgramServicesAmt
Management And General$10,609,515ManagementAndGeneralAmt
Fundraising$68,367FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,162,831BOYAmt
EOY$2,112,878EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$9,210,679BOYAmt
EOY$8,731,088EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$1,190,757BOYAmt
EOY$6,674,594EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$617,856BOYAmt
EOY$628,092EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$566,612BOYAmt
EOY$2,355,903EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$76,211,287LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$43,259,414LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$23,614,650BOYAmt
EOY$32,951,873EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,366,366BOYAmt
EOY$2,437,939EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,040,757BOYAmt
EOY$21,925,192EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$39,770,508BOYAmt
EOY$77,817,559EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,504,770BOYAmt
EOY$16,950,815EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,759,082BOYAmt
EOY$26,899,131EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,356,151BOYAmt
EOY$2,712,715EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,183,558EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,620,003BOYAmt
EOY$47,746,219EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$22,332,059BOYAmt
EOY$29,150,582EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$634,500BOYAmt
EOY$736,812EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$183,946BOYAmt
EOY$183,946EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$23,150,505BOYAmt
EOY$30,071,340EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$39,770,508BOYAmt
EOY$77,817,559EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$6,848,338ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$72,497NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$33,117OtherActivitiesAmt
Total Lobbying Expenditures$33,117TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION RETAINS AN OUTSIDE LOBBYIST FOR CONTACT WITH STATE AND FEDERAL ELECTED OFFICIALS REGARDING HEALTH CARE ISSUES AND GRANT FUNDING OPPORTUNITIES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$183,946BeginningYearBalanceAmt
End Year Balance$183,946EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$183,946BeginningYearBalanceAmt
End Year Balance$183,946EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$183,946BeginningYearBalanceAmt
End Year Balance$183,946EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$183,946BeginningYearBalanceAmt
End Year Balance$183,946EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$183,946BeginningYearBalanceAmt
End Year Balance$183,946EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$364,054OtherCostOrOtherBasisAmt
Book Value$364,054BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$34,718,039OtherCostOrOtherBasisAmt
Depreciation$23,733,919DepreciationAmt
Book Value$10,984,120BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$27,731,923OtherCostOrOtherBasisAmt
Depreciation$19,525,495DepreciationAmt
Book Value$8,206,428BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$13,397,271OtherCostOrOtherBasisAmt
Book Value$13,397,271BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$32,951,873TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescRESTRICTED PROJECT FUND - BONDSDesc
Book Value$21,925,192BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$21,925,192TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescLINE OF CREDITDesc
Amt$1,183,558Amt
FieldValueIRS element (for citing)
Total Liability$1,183,558TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$74,647,649TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$72,495NetUnrealizedGainsInvstAmt
Other Revenue$18,128OtherRevenueAmt
Revenue Not Reported$90,623RevenueNotReportedAmt
Revenue Subtotal$74,557,026RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$74,557,026TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$67,726,816TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$18,128OtherExpensesIncludedAmt
Expenses Not Reported$18,128ExpensesNotReportedAmt
Expenses Subtotal$67,708,688ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$67,708,688TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE MEDICAL CENTER IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE), AND ACCORDINGLY, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE MEDICAL CENTER ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH U.S. GAAP, WHICH REQUIRES THE RECOGNITION AND MEASUREMENT OF UNCERTAIN INCOME TAX POSITIONS THAT THE MEDICAL CENTER HAS TAKEN OR EXPECTS TO TAKE IN THE MEDICAL CENTER'S TAX RETURN. THE MEDICAL CENTER HAS NOT RECORDED ANY AMOUNTS RELATING TO UNCERTAIN TAX POSITIONS. IN ADDITION, THE MEDICAL CENTER IS NO LONGER SUBJECT TO FEDERAL AND NYS INCOME TAX EXAMINATION FOR YEARS PRIOR TO 2010.
PART XI, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES NETTED AGAINST REVENUE 18,128.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EXPENSES NETTED AGAINST REVENUE 18,128.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1GOLF BENEFITNameOfEvent1Amt
Gross Receipts Event1$31,304GrossReceiptsEvent1Amt
Charitable Contri Event1$25,137CharitableContriEvent1Amt
Gross Revenue Event1$6,167GrossRevenueEvent1Amt
Non Cash Prizes Event1$200NonCashPrizesEvent1Amt
Rent Facility Costs Event1$6,168RentFacilityCostsEvent1Amt
Other Direct Expenses Event1$5,029OtherDirectExpensesEvent1Amt
Name Of Event2GALANameOfEvent2Amt
Gross Receipts Event2$20,845GrossReceiptsEvent2Amt
Charitable Contri Event2$15,842CharitableContriEvent2Amt
Gross Revenue Event2$5,003GrossRevenueEvent2Amt
Food And Beverage Event2$3,004FoodAndBeverageEvent2Amt
Entertainment Event2$800EntertainmentEvent2Amt
Other Direct Expenses Event2$2,927OtherDirectExpensesEvent2Amt
Gross Receipts Total$52,149GrossReceiptsTotalAmt
Charitable Contributions Tot$40,979CharitableContributionsTotAmt
Gross Revenue Total Events$11,170GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$200NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$6,168RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$3,004FoodAndBeverageTotalEventsAmt
Entertainment Total Events$800EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$7,956OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$18,128DirectExpenseSummaryEventsAmt
Net Income Summary-$6,958NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,132,155TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,175,812DirectOffsettingRevenueAmt
Net Community Benefit Expns$956,343NetCommunityBenefitExpnsAmt
Total Expense0.01410TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,639,913TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,316,585DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,323,328NetCommunityBenefitExpnsAmt
Total Expense0.07860TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,772,068TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,492,397DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,279,671NetCommunityBenefitExpnsAmt
Total Expense0.09270TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$63,304TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,021DirectOffsettingRevenueAmt
Net Community Benefit Expns$60,283NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$63,304TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,021DirectOffsettingRevenueAmt
Net Community Benefit Expns$60,283NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$16,835,372TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,495,418DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,339,954NetCommunityBenefitExpnsAmt
Total Expense0.09360TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$2,397,645BadDebtExpenseAmt
Bad Debt Expense Attributable$1,389,975BadDebtExpenseAttributableAmt
Reimbursed By Medicare$15,410,729ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$14,264,982CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$1,145,747MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ALICE HYDE MEDICAL CENTERBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PARK STREETAddressLine1
CityMALONECity
StateNYState
ZIP Code12953ZIPCode
FieldValueIRS element (for citing)
Website AddressALICEHYDE.COMWebsiteAddressTxt
State License1624000HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ALICE HYDE MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTP://ALICEHYDE.COMOwnWebsiteURLTxt
Rpt Available Upon RequestYes (X)RptAvailableUponRequestInd
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Exec Community Wide PlanYes (X)ExecCommunityWidePlanInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care300.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt Care0FPGUsedDetermEligDscntCareInd
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Insurance StatusYes (X)InsuranceStatusInd
Uninsured DiscountYes (X)UninsuredDiscountInd
Medicaid MedicareYes (X)MedicaidMedicareInd
State RegulationYes (X)StateRegulationInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Provided On AdmissionYes (X)ProvidedOnAdmissionInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Permit LawsuitYes (X)PermitLawsuitInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
LawsuitYes (X)LawsuitInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Lowest Negotiated RatesYes (X)LowestNegotiatedRatesInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
ALICE HYDE MEDICAL CENTERPART V, SECTION B, LINE 3: IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL RECEIVED INPUT FROM:JOSY DELANEY - ALICE HYDE COMMUNITY WELLNESSADIRONDACK MEDICAL HOME/PEDIATRIC OBESITY INITIATIVEADIRONDACK RURAL HEALTHCARE NETWORKADIRONDACK TOBACCO FREE NETWORKBREASTFEEDING COUNCIL OF MALONECANCER SERVICES PROGRAMEASTERN ADIRONDACK HEALTH CARE NETWORKMALONE COMPLETE STREETS PARTNERSHIPNORTH COUNTRY HEALTHCARE PROVIDERSNORTH COUNTRY HEALTHY HEART NETWORK
ALICE HYDE MEDICAL CENTERPART V, SECTION B, LINE 11: ANY PATIENT WIHOUT INSURANCE IS GIVEN A DISCOUNT EQUAL TO THE LOWEST NEGOCIATED COMMERICAL INSURANCE RATE.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ALICE HYDE NURSING HOMEBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PARK STREETAddressLine1
CityMALONECity
StateNYState
ZIP Code12953ZIPCode
FieldValueIRS element (for citing)
FacilitySKILLED NURSING FACILITYFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:UTILIZED IRS WORKSHEETS FOR SCHEDULE H AND RATIO OF COST TO CHARGES.
PART I, LN 7 COL(F):BAD DEBT WAS NOT INCLUDED IN CALCULATIONS IN SCHEDULE H, PART I, LINE 7.
PART III, LINE 4:THE MEDICAL CENTER RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALITY FOR CHARITY CARE, THE MEDICAL CENTER RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). BASED UPON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE MEDICAL CENTER'S UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED.
PART III, LINE 8:THE MEDICARE BENEFICIARIES WHO ALICE HYDE PROVIDES SERVICES TO ARE PART OF OUR COMMUNITY OF MALONE, NEW YORK, AND THEREFORE, SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE SOURCE FOR THE COST METHODOLOGY IS THE 2013 MEDICARE COST REPORT.
PART III, LINE 9B:THE CENTER PROVIDES CARE TO CLIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CENTER'S POLICY IS NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE THESE AMOUNTS ARE NOT REPORTED IN NET OPERATING REVENUES OR IN PROVISIONS FOR DOUBTFUL ACCOUNTS. THE ESTIMATED COST OF PROVIDING UNCOMPENSATED CARE TO PATIENTS WAS APPROXIMATELY $1,086,000 FOR THE YEAR ENDED DECEMBER 31, 2013 ($1,000,000 - 2012), AS MEASURED UTILIZING A CALCULATED RATIO OF COSTS TO CHARGES.
PART III, LINE #2OUR BAD DEBT METHODOLOGY IS BASED ON HISTORICAL AMOUNTS WHICH WERE TYPICALLY 3.3% OF NET REVENUE.
PART III, LINE #3WE USE THE BAD DEBT EXPENSE AND ALLOCATE BASED ON THE ACTUAL WRITE-OFFS.
PART VI, LINE 3:THE ALICE HYDE MEDICAL CENTER (AHMC) BELIEVES THAT FEAR OF A MEDICAL BILL SHOULD NOT PRECLUDE A RESIDENT OF ITS COMMUNITY FROM SEEKING OR OBTAINING ESSENTIAL HEALTH CARE SERVICES. TO HELP THOSE WHO ARE UNINSURED, AHMC PARTNERS WITH VARIOUS ORGANIZATIONS, INCLUDING THE FRANKLIN COUNTY DEPARTMENT OF SOCIAL SERVICES, PUBLIC HEALTH, FIDELIS, AND EXCELLUS, TO ENSURE ACCURATE INFORMATION AND RESOURCES ARE AVAILABLE THROUGHOUT THE COMMUNITY, INCLUDING A FACILITATED ENROLLMENT PROGRAM FOR ITS UNINSURED. THIS PROGRAM ASSISTS THE INDIVIDUAL IN APPLYING FOR STATE SPONSORED HEALTH INSURANCE, INCLUDING MEDICAID, CHILD HEALTH PLUS AND FAMILY HEALTH PLUS. THE GOAL OF THIS INITIATIVE IS TO PROVIDE CONVENIENT LOCATION FOR PATIENTS AND COMMUNITY MEMBERS TO ACCESS THE PROGRAM AND TO PROVIDE ASSISTANCE IN COMPLETING HEALTH INSURANCE APPLICATIONS. THESE GOALS ARE MET THROUGH A PATERNERSHIP BETWEEN AHMC AND UPPER HUDSON PRIMARY CARE CONSORTIUM. AHMC HAS AN EMPLOYEE DEDICATED TO FINANCIAL COUNSELING AND ASSISTANCE.
PART VI, LINE 4:ALICE HYDE MEDICAL CENTER (AHMC) PRIMARILY SERVES TOWNS, VILLAGES, AND THE NATIVE AMERICAN RESERVATION IN FRANKLIN COUNTY. AHMC'S PRIMARY SERVICE AREA COVERS THE FOLLOWING TOWNS (BY ZIP CODE) - MALONE (12953), NORTH BANGOR (12966), CHATEAUGAY (12920), CONSTABLE (12926), BRUSHTON (12916), MOIRA (12957), BURKE (12917), FORT COVINGTON (12937), HOGANSBURG (13655), SAINT REGIS FALLS (12980), BOMBAY (12914), OWLS HEAD (12969), DICKINSON CENTER (12930). THE SECONDARY SERVICE AREAS SERVED BY AHMC INCLUDE CHURUBUSCO (12923), ELLENBURG CENTER (12934), NORTH LAWERENCE (12967), LYON MOUNTAIN (12955), NICHOLVILLE (12965). IN ADDITION, AHMC PROVIDES SERVICES TO THE INMATE POPULATION FOR THE FRANKLIN COUNTY JAIL AND THE CLINTON, FRANKLIN, UPSTATE, BAREHILL, CHATEAUGAY, ALTONA AND ADIRONDACK CORRECTIONAL FACILITIES.
PART VI, LINE 7, REPORTS FILED WITH STATESNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DOUG DIVELLO
PRESIDENT/CEO$253,802$0$5,000$0$0$0$2,181$0$1,252$0$262,235$0$0$0
LEONARDO DISHMAN MD
CHIEF MEDICAL OFFICER$185,160$0$0$0$0$0$5,537$0$0$0$190,697$0$0$0
DRAGOS MACELARU MD
PHYSICIAN$539,585$0$250,000$0$0$0$7,650$0$2,070$0$799,305$0$0$0
MARCO BERARD MD
PHYSICIAN$447,503$0$250,000$0$0$0$7,650$0$692$0$705,845$0$0$0
RAHUL GUPTA MD
PHYSICIAN$462,297$0$0$0$0$0$7,650$0$254$0$470,201$0$0$0
NIKALESH REDDY MD
PHYSICIAN$398,740$0$0$0$0$0$7,650$0$540$0$406,930$0$0$0
VARGHESE NOEL MD
PHYSICIAN$250,812$0$150,000$0$0$0$7,356$0$497$0$408,665$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1FRANKLIN COUNTY CIVIC DEVELOPMENT CORPBusinessNameLine1
FieldValueIRS element (for citing)
Bond Issuer EIN800627350BondIssuerEIN
CUSIP35313PAA0CUSIPNum
Bond Issued2013-10-31BondIssuedDt
Issue Price$27,375,000IssuePriceAmt
PurposeCONSTRUCTION OF 135 BED SKILLED NURSING FACILITY.PurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Total Proceeds$27,375,000TotalProceedsAmt
In Reserve Fund$20,380,946InReserveFundAmt
Issuance Costs From Proceeds$1,675,004IssuanceCostsFromProceedsAmt
Capital Expenditures$2,620,242CapitalExpendituresAmt
Unspent$2,698,808UnspentAmt
Substantial Completion2014SubstantialCompletionYr
Current Refunding0CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation Made0FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor Reqs0WrittenProcToMonitorReqsInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2BOARD MEMBERS WAYNE DUSO AND BRIAN MONETTE HAVE A FAMILY RELATIONSHIP. BOARD MEMBERS CRAIG LAVIGNE AND BRIAN MONETTE HAVE A BUSINESS RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 IS PREPARED BY AN INDEPENDENT OUTSIDE ACCOUNTING FIRM. IT IS PROVIDED TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE BOARD OF DIRECTORS. SPECIFICALLY, THE POLICY REQUIRES A DISCLOSURE OF ANY POTENTIAL CONFLICT TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS THEN REFERS THE POTENTIAL CONFLICT TO THE AUDIT AND COMPLIANCE COMMITTEE TO REVIEW THE MATTER. THE AUDIT AND COMPLIANCE COMMITTEE REVIEWS THE PROPOSED TRANSACTION OR ARRANGEMENT TO DETERMINE IF REASONABLE ATLTERNATIVES TO THE PROPOSED TRANSACTION EXIST. BASED ON REVIEW, THE AUDIT AND COMPLIANCE COMMITTEE SHALL APPROVE OR DISAPPROVE THE TRANSACTION. ALL FINDINGS AND ACTIONS TAKEN BY THE AUDIT AND COMPLIANCE COMMITTEE ARE REPORTED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED MEETING OF THE BOARD OF DIRECTORS. IN ADDITION, THE AUDIT AND COMPLIANCE COMMITTEE AND THE ORGANIZATION COMPLIANCE OFFICER IS RESPONSIBLE FOR REVIEWING AND RETAINING ANNUAL DISCLOSURE STATEMENTS COMPLETED BY EACH DIRECTOR, OFFICER, COMMITTEE MEMBER AND KEY EMPLOYEE.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION AND BENEFITS OF THE PRESIDENT/CEO ARE REVIEWED ANNUALLY. THE BOARD OF DIRECTORS REVIEWS IN DEPTH THE RECOMMENDATIONS OF THE PRESIDENT/CEO EVALUATION AND COMPENSATION COMMITTEE ("COMPENSATION COMMITTEE") REGARDING THE PRESIDENT/CEO'S COMPENSATION AND BENEFITS. THE PRESIDENT/CEO IS NOT PRESENT AT THIS MEETING OR ANY OTHER MEETING AT WHICH HIS COMPENSATION IS CONSIDERED. AS PART OF ITS REVIEW AND DISCUSSION, THE FULL BOARD OF DIRECTORS DISCUSSES THE DATA PREVIOUSLY REVIEWED BY THE COMPENSATION COMMITTEE. THIS DATA INCLUDES, BUT IS NOT LIMITED TO, COMPARABILITY DATA COMPILED BY YAFFEE AND COMPANY, INC. AS PROVIDED TO AHMC BY THE IROQUOIS HOSPITAL ASSOCIATION. SPECIFICALLY, THE COMPENSATION COMMITTEE REVIEWS THE DATA AND REPORTS THE RESULTS OF THIS REVIEW TO THE BOARD OF DIRECTORS, CONCERNING BASE SALARY AND TOTAL COMPENSATION FOR ALL THE OFFICERS AT FACILITIES LOCATED WITHIN THE RANGE FOR SIMILARY SITUATED OFFICERS. THE COMPENSATION COMMITTEE ALSO REVIEWS DATA COMPILED BY THE IROQUOIS HEALTHCARE ASSOCIATION, ROCHESTER REGIONAL HOSPITAL ASSOCIATION, AND WESTERN NEW YORK HOSPITAL ASSOCIATION RELATED TO COMPARABLE CEO INCENTIVE PLANS, LIFE INSURANCE (BASIC AND SUPPLEMENTAL), LONG TERM DISABILITY PLANS, SUPPLEMENTAL/EXECUTIVE RETIREMENT PLANS, CONTRACT LENGTH INFORMATION, SEVERANCE PAY INFORMATION AND PREREQUISITES SUMMARY. IT IS THEN DETERMINED WHETHER THE PRESIDENT/CEO'S PROPOSED CONTRACT IS REASONABLE AND COMPARABLE IN LIGHT OF THE AFOREMENTIONED INFORMATION. THE PROCESS FOR DETERMINING THE COMPENSATION FOR KEY EMPLOYEES OF THE ORGANIZATION INCLUDES A REVIEW OF EXECUTIVE COMPENSATION SURVEYS. THIS REVIEW IS COMPLETED BY THE HUMAN RESOURCES DIRECTOR AND THE PRESIDENT/CEO. COMPENSATION IS DETERMINED BASED ON THE SPECIFIC RESPONSIBILIES DELEGATED TO THE POSITION HELD BY THE KEY EMPLOYEE.
FORM 990, PART VI, SECTION C, LINE 18THE COMPLETED FORMS 1023, 990, AND 5500 FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VII, SECTION AANJNI BHAGAT, MD AND BENSON KELLY, MD WERE BOTH COMPENSATED AS PHYSICIANS OF THE MEDICAL CENTER. NEITHER RECEIVED ANY COMPENSATION FOR THEIR ROLE AS BOARD MEMBERS.
FORM 990, PART XI, LINE 2CTHERE HAVE BEEN NO CHANGES FROM THE PRIOR YEAR TO THE PROCESS THAT THE ORGANIZATION HAS IN PLACE FOR THE OVERSIGHT OF THE AUDIT OR THE SELECTION OF AN INDEPENDENT ACCOUNTANT.

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