2014-10-22T13:19:54-05:00 2013-12-31 221478099 COHNREZNICK LLP 1212 AVENUE OF THE AMERICAS NEW YORK NY 10036 990 2013-01-01 141628237 HUDSON HEADWATERS HEALTH NETWORK INC HUDS 5187610300 9 CAREY ROAD QUEENSBURY NY 12804 CHRISTOPHER TOURNIER CFO 5187610300 2014-10-20 1 THOMAS LANNING P00851654 2122970400 2013 2015-11-30 17:44:51Z JOHN RUGGE MD 9 CAREY ROAD QUEENSBURY NY 12804 63728441 0 X WWW.HHHN.ORG X 1981 NY FQHC - OUR MISSION IS TO PROVIDE THE BEST HEALTH CARE AND ACCESS TO THAT CARE FOR EVERYONE IN OUR COMMUNITIES. 19 19 776 0 1637296 36830 7548405 7396642 45267011 54134482 13512 7473 1471455 2189844 54300383 63728441 791809 0 0 0 33708583 38968644 0 0 0 16776057 19349222 51276449 58317866 3023934 5410575 27101441 31703996 10600624 9792604 16500817 21911392 X WE ARE A COMMUNITY BASED HEALTH CLINIC WHICH SERVICED 297,383 PATIENTS IN 2013. TO FURTHER THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES TO THE GENERAL POPULATION OF WARREN, WASHINGTON, SARATOGA, HAMILTON AND ESSEX COUNTIES. TO PROMOTE, SPONSOR, FOSTER AND DELIVER PROGRAMS, ACTIVITIES AND SERVICES WHICH SHALL HAVE THE PURPOSE OF IMPROVING THE HEALTH AND WELL-BEING OF THE POPULATION SERVED BY THIS CORPORATION AND TO CONTINUALLY SEEK NEW AND INNOVATIVE METHODS OF IMPROVING HEALTH CARE DELIVERY AND ITS FINANCING TO THE COMMUNITY SERVED. TO CARRY OUT ANY EDUCATION AND TEACHING ACTIVITIES RELATED TO RENDERING HEALTH CARE OR TO THE PROMOTION OF HEALTH THAT IN THE OPINION OF THE BOARD OF DIRECTORS MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS OR OTHER RESOURCES THAT ARE FOR, OR CAN BE, MADE. 0 0 45644776 41785728 THE CENTER IS A COMMUNITY BASED HEALTH CENTER CLINIC WITH MULTIPLE LOACTIONS. IN 2013 WE SERVICED 67,820 PATIENTS WITH 297,383 VISITS. 4769075 12797302 340B PHARMACY PROGRAM - AS A FEDERALLY QUALIFIED HEALTH CENTER WE ARE ABLE TO ACQUIRE DRUGS AT THE LOWER PRICES MANDATED BY THE FEDERAL 340B DRUG PURCHASING PROGRAM, THIS ALLOWS US TO ASSIST INDIGENT PATIENTS WITH THE SOMETIME OVERWHELMING COSTS OF PRESCRIPTION MEDICATIONS. FACILITATE THE HUDSON HEADWATERS HEALTH NETWORK PATIENT ASSISTANCEPROGRAM WHICH ENABLES NEEDY PATIENTS TO RECEIVE MEDICATIONS FREE OF CHARGE FROM THE DRUG MANUFACTURERS AND GENERATE REVENUE TO SUPPORT HHHN'S OVERALL OPERATIONALY VIABILITY. 50413851 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 57 0 1 776 1 1 1 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X AMY GERSTEN 5187610300 9 CAREY ROAD QUEENSBURY NY 12804 BARBARA SWEET BOARD MEMBER 1.00 0.10 X 0 0 0 CELINE RACINE-PAQUETTE BOARD MEMBER 1.00 X 0 0 0 DANA HOGAN BOARD MEMBER 1.00 X 0 0 0 EILEEN HAYNES BOARD MEMBER 1.00 0.10 X 0 0 0 EUGENE ARSENAULT BOARD MEMBER 1.00 0.10 X 0 0 0 GRAHAM GREELEY TREASURER 1.00 0.10 X X 0 0 0 HARRY ROBINSON BOARD MEMBER 1.00 0.10 X 0 0 0 IKE WOLGIN BOARD MEMBER 1.00 X 0 0 0 JEAN CRONIN BOARD MEMBER 1.00 1.10 X 0 0 0 JOSEPH KELLY VICE CHAIR 1.00 X X 0 0 0 MICHAEL MCCARTHY BOARD MEMBER 1.00 X 0 0 0 MILDRED ANZALONE BOARD MEMBER 1.00 X 0 0 0 PATRICIA HUNT BOARD MEMBER 1.00 0.10 X 0 0 0 RANDOLPH RAPPLE BOARD MEMBER 1.00 X 0 0 0 SHARON CALLAHAN CHAIRMAN 1.00 0.10 X X 0 0 0 THOMAS GOODROW BOARD MEMBER 1.00 0.10 X 0 0 0 THOMAS LYONS BOARD MEMBER 1.00 0.10 X 0 0 0 THOMAS ROSS SECRETARY 1.00 X X 0 0 0 WILLIAM O'DWYER MD BOARD MEMBER 1.00 1.00 X 0 0 0 CHRISTOPHER TOURNIER CFO 40.00 1.10 X 161142 0 26321 CYNTHIA REYNOLDS VICE PRESIDENT 40.00 X 137604 0 22459 DANIEL LARSON MD CMO 40.00 X 240075 0 26543 DEBORAH BARDIN VICE PRESIDENT 40.00 X 139265 0 13088 EDWARD SHANNON CDO 40.00 X 157467 0 28128 GEORGE PURDUE CAO 40.00 X 195200 0 29384 JAMES DONNELLY VICE PRESIDENT PHARMACY SERVICES 40.00 X 153148 0 26027 JOHN RUGGE MD CEO 40.00 1.10 X 409482 0 41602 JOHN SAWYER MD CMO 40.00 X 212602 0 29462 LORI GRAVELLE VICE PRESIDENT 40.00 X 88688 0 16160 MARLENE BURNLEY VICE PRESIDENT 40.00 X 120415 0 20559 PAUL BACHMAN MD CMO 40.00 X 208844 0 28424 DAVID SLINGERLAND PHYSICIAN 40.00 X 220246 0 25572 FRANCES BOLLINGER PHYSICIAN 40.00 X 217587 0 26459 IRENE FLATAU PHYSICIAN 40.00 X 212593 0 14686 MARY C KILAYKO PHYSICIAN 40.00 X 207914 0 19655 TODD WALDORF PHYSICIAN 40.00 X 222639 0 28225 3304911 0 422754 63 0 1 0 RICHARD E JONES ASSOCIATES 339 AVIATION RD QUEENSBURY NY 12804 ARCHIECTURAL SERVICES 805165 FRANCIS AND EILEEN COLLINS PO BOX 64 GLENS FALLS NY 12801 RENT 126609 COHNREZNICK LLP 1212 AVENUE OF AMERICAS NEW YORK NY 10036 ACCOUNTING SERVICES 103334 3 33314 5461981 1901347 7396642 OTHER THIRD-PARTY PAYORS 621400 28317132 28317132 MEDICARE 621400 8738625 8738625 SELF-PAY 621400 5561839 5561839 MEDICAID MANAGED CARE 621400 4582620 4582620 MEDICAID 621400 3180113 3180113 3754153 3754153 54134482 7473 7473 195170 0 195170 195170 91170 104000 403B CONSULTING 541610 1546126 1546126 MEANINGFUL USE 621400 402275 402275 MEDICAL RECORDS 621400 23194 23194 23079 23079 1994674 63728441 54583030 1637296 111473 2532089 2285838 246251 29322939 26471216 2851723 1076802 972081 104721 3727692 3365166 362526 2309122 2084555 224567 11551 11551 129605 129605 135076 135076 35281 35281 4737202 2878510 1858692 197262 143101 54161 1268950 989483 279467 692553 564276 128277 1419418 1249269 170149 296960 201888 95072 106946 72707 34239 89842 1558 88284 1322577 978168 344409 222547 119452 103095 MEDICAL SUPPLIES 5022729 4608915 413814 PROVISION FOR BAD DEBT 2258785 2258785 REPAIRS AND MAINTENANCE 660855 583961 76894 DUES AND SUBSCRIPTIONS 285603 194225 91378 455480 390697 64783 58317866 50413851 7904015 0 584527 1107549 1228674 3092515 1265698 586787 6650080 7287402 350000 350000 941026 444849 24803720 8177247 14284738 16626473 300000 270000 1496698 1938421 27101441 31703996 5585751 6584332 2414025 2600848 3208272 10600624 9792604 X 16500817 21911392 16500817 21911392 27101441 31703996 5410575 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 35281 35281 0 PART II-B, LINE 1: LOBBYING ACTIVITIES WERE RELATED TO FILING A MEDICAID RATE APPEAL. 2154566 2154566 9967235 1887077 8080158 3949261 2023267 1925994 2803158 1741258 1061900 5929500 2525645 3403855 16626473 DEFERRED COMPENSATION ASSET 1918122 SECURITY DEPOSIT 19319 INTEREST IN HUDSON 980 1938421 DEFERRED COMPENSATION PAYABLE 1918122 DUE TO THIRD PARTY 1290150 3208272 X 63208881 42093 -561653 -519560 63728441 0 63728441 56326380 42093 225206 267299 56059081 2258785 2258785 58317866 PART X, LINE 2: THE COMPANY IS INCORPORATED AS NOT-FOR-PROFIT CORPORATIONS UNDER THE LAWS OF THE STATE OF NEW YORK AND ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AS WELL AS FROM STATE INCOME TAXES. THEREFORE, THERE IS NO PROVISION FOR INCOME TAXES. THE COMPANY HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2013. THE COMPANY'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2010 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED PARTIES REVENUE 1,736,732. INTERCOMPANY ELIMINATION -39,600. BAD DEBT EXPENSE -2,258,785. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED PARTIES EXPENSES 264,806. INTERCOMPANY ELIMINATION -39,600. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,258,785. X X X 0 0 0 0 0 0 0 1 0 CHRISTOPHER TOURNIER CFO 140990 0 19750 0 402 0 8841 0 17480 0 187463 0 0 0 CYNTHIA REYNOLDS VICE PRESIDENT 121413 0 15250 0 941 0 6015 0 16444 0 160063 0 0 0 DANIEL LARSON MD CMO 203109 0 32750 0 4216 0 10739 0 15804 0 266618 0 0 0 DEBORAH BARDIN VICE PRESIDENT 123429 0 14933 0 903 0 5880 0 7208 0 152353 0 0 0 EDWARD SHANNON CDO 136576 0 19750 0 1141 0 9209 0 18919 0 185595 0 0 0 GEORGE PURDUE CAO 158386 0 36124 0 690 0 11461 0 17923 0 224584 0 0 0 JAMES DONNELLY VICE PRESIDENT PHARMACY SERVICES 118025 0 34640 0 483 0 8148 0 17879 0 179175 0 0 0 JOHN RUGGE MD CEO 337728 0 61460 0 10294 0 24218 0 17384 0 451084 0 0 0 JOHN SAWYER MD CMO 206326 0 250 0 6026 0 11253 0 18209 0 242064 0 0 0 PAUL BACHMAN MD CMO 203492 0 250 0 5102 0 10675 0 17749 0 237268 0 0 0 DAVID SLINGERLAND PHYSICIAN 208770 0 11250 0 226 0 9426 0 16146 0 245818 0 0 0 FRANCES BOLLINGER PHYSICIAN 215726 0 250 0 1611 0 10157 0 16302 0 244046 0 0 0 IRENE FLATAU PHYSICIAN 208119 0 2250 0 2224 0 10211 0 4475 0 227279 0 0 0 MARY C KILAYKO PHYSICIAN 189841 0 13250 0 4823 0 3496 0 16159 0 227569 0 0 0 TODD WALDORF PHYSICIAN 221939 0 250 0 450 0 12016 0 16209 0 250864 0 0 0 PART I, LINE 7 THE ORGAIZATION PROVIDED BONUSES TO VARIOUS OFFICERS, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(II). FORM 990, PART VI, SECTION B, LINE 11 AN INDEPENDENT ACCOUNTANT PREPARES THE FORM 990. AFTER PREPARATION A MEETING WILL BE SCHEDULED WITH THE BOARD OF DIRECTORS AND OFFICERS TO REVIEW THE COMPLETED 990 AT OUR CAREY ROAD FACILITY PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS ITS' CONFLICT OF INTEREST POLICY WITH AN ANNUAL UPDATE OF ALL INTEREST THAT COULD POTENTIALLY LEAD TO A CONFLICT OF INTEREST FOR ALL EMPLOYEES. IF A CONFLICT OF INTEREST POTENTIAL IS RECOGNIZED THE BOARD SHALL DETERMINE WHETHER A CONFLICT EXISTS AND WHETHER SUCH DIRECTOR SHOULD ABSTAIN FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15 WHEN A NEW KEY EMPLOYEE IS HIRED IN THE PAST YEAR, COMPENSATION WAS DETERMINED THROUGH COMPARISON OF SIMILAR POSITIONS WITHIN THE ORGANIZATION. WE ALSO SURVEY WHERE POSSIBLE, COMPARABLE POSITIONS WITHIN THE REGION. COMPENSATION IS DETERMINED BY A COMBINATION OF SENIOR MANAGEMENT, FINANCE AND HUMAN RESOURCES TO ENSURE FAIRNESS AND CONSISTENCY IN SETTING PAY RATE AND BENEFIT LEVELS. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON WRITTEN REQUEST. THEY WILL BE MADE AVAILABLE AT OUR ADMINISTRATIVE OFFICE AT 9 CAREY ROAD, QUEENSBURY, NY. FORM 990, PART XII, LINE 2C: THE SELECTION AND OVERSIGHT PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. FORM 990, PART IV, QUESTION 20A: THE ORGANIZATION IS LICENSED UNDER ARTICLE 28 OF NEW YORK STATE PUBLIC HEALTH LAW. HOWEVER, SUBSECTION 10 OF ARTICLE 28 EXCLUDES CERTAIN HEALTHCARE FACILITIES FROM THE DEFINITION OF GENERAL HOSPITAL. THEREFORE, THE ORGANIZATION IS NOT INCLUDING SCHEDULE H IN THE CURRENT YEAR FORM 990 AS THEY DO NOT MEET THIS DEFINITION. HUDSON HEADWATERS HEALTH FOUNDATION 9 CAREY RD QUEENSBURY NY 12804 651261242 FINANCIAL SUPPORT TO HUDSON HEADWATERS HEALTH NETWORK NY 501(C)(3) LINE 11A, I HUDSON HEADWATERS HEALTH NETWORK 0 COMPRE CARE INC 9 CAREY RD QUEENSBURY NY 12804 141692479 IDLE HEALTH CENTER OPERATION NY 501(C)(3) LINE 3 HUDSON HEADWATERS HEALTH NETWORK 0 HUDSON HEADWATERS HEALTH MANAGEMENT PO BOX 357 GLEN FALLS NY 12801 141467175 MANAGMENT SERVICES NY HUDSON HEADWATERS HEALTH NETWORK C 245 112971 1.00000 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 1 0 1 0 0