BURDETT CARE CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- BURDETT CARE CENTER INC (EIN 27-2153849)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201313179349303676
- Schema version
- 2012v2.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-13T11:38:10-08:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 272153849 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Burdett Care Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BURD | NameControl |
| Phone | 5182713393 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2215 Burdett Ave | AddressLine1 |
| City | Troy | City |
| State | NY | State |
| ZIP Code | 12180 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Lori Santos | Name |
| Title | Director of Finance | Title |
| Date Signed | 2013-11-13 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Debbie Lajeunesse | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2215 Burdett Avenue | AddressLine1 |
| City | Troy | City |
| State | NY | State |
| ZIP Code | 12180 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 6786557 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.burdettcarecenter.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2010 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | The Burdett Care Center is a new not-for-profit hospital in Troy, New York, that offers high quality maternity services and other reproductive services, including sterilization services but not including abortions, to women and men in the area. Its mission is to provide high-quality, accessible reproduction-related health care services; to be the provider of choice in the community for women who are having children, as well as women and men who opt not to have children; to be an organization where employees find professional fulfillment and are proud to work. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 6 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 83 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1435193 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6779213 | ProgramServiceRevenueCY |
| Investment Income Current Year | 4742 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1245 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2602 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1436438 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6786557 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 895908 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 3905982 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1496626 | OtherExpensePriorYear |
| Other Expenses Current Year | 3764343 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 2392534 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7670325 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -956096 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -883768 | RevenuesLessExpensesCY |
| Total Assets BOY | 7773496 | TotalAssetsBOY |
| Total Assets EOY | 7934777 | TotalAssetsEOY |
| Total Liabilities BOY | 8752355 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9797404 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -978859 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -1862627 | NetAssetsOrFundBalancesEOY |
| Mission Description | The Burdett Care Center's mission is to provide high-quality, accessible reproduction-related health care services; to be the provider of choice in the community for women who are having children, as well as women and men who opt not to have children; to be an organization where employees find professional fulfillment and are proud to work. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 6298476 | Expense |
| Revenue | 6779213 | Revenue |
| Description | The Burdett Care Center ("Burdett Care") is a new not-for-profit hospital in Troy, New York that commenced operations on October 1, 2011. Burdett Care is located on the second floor of Samaritan Hospital, in new condominium space previously occupied by Samaritan's maternity department. Burdett Care is dedicated to maternity and reproductive services, other than abortion. Burdett Care was formed to offer high quality maternity services to women in the area and to preserve access by those women to reproductive services (i.e. tubal ligation, Essure and Adiana) in conjunction with maternity services. The Burdett Care concept arose out of merger discussions among Northeast Health, St. Peter's Health Care Services and Seton Health System. The merger parties agreed that Northeast Health would remain secular in connection with its affiliation with the two Catholic systems, but that Northeast Health and its affiliates, including Samaritan Hospital, would abide by the Ethical and Religious Directives for Catholic Health Care Services (the "ERDs"). The merger parties further agreed that, in order to pursue the merger of health systems while preserving reproductive services in Troy, a new hospital - later named The Burdett Care Center - would be formed within the Samaritan facility, with an independent governing board, independent medical staff and independent nursing staff. Burdett Care is not bound by the ERDs.Burdett Care is a 15-bed hospital facility providing high quality inpatient and outpatient reproductive services including maternity, labor, delivery, nursery, contraceptive and sterilization. In 2012 Burdett Care delivered 1,154 babies, and provided sterilization services in connection with 37 of those deliveries. | Description |
| Total Program Service Expense | 6298476 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 4 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 83 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 6 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Lori Santos | NamePerson |
| Telephone Number | 5184713135 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2215 Burdett Ave 200 | AddressLine1 |
| City | Troy | City |
| State | NY | State |
| ZIP Code | 12180 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (8 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Lisa Thorn MD | ||||||||
| Secretary | 2.00 | 0.00 | X | X | 0 | 0 | 0 | |
| Margaret Holcomb | ||||||||
| Board Member | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| Ann G DiSarro | ||||||||
| Chairman | 2.00 | 0.00 | X | X | 0 | 0 | 0 | |
| Robert G Burke | ||||||||
| Treasurer | 2.00 | 0.00 | X | X | 0 | 0 | 0 | |
| Charlotte Buchanan Esq | ||||||||
| Vice Chair | 2.00 | 0.00 | X | X | 0 | 0 | 0 | |
| Dr Melody Bruce | ||||||||
| Board Member | 2.00 | 0.00 | X | 0 | 0 | 0 | ||
| Debbie Lajeunesse | ||||||||
| Executive Direc | 40.00 | 0.00 | X | 110814 | 0 | 7520 | ||
| Debra Griner | ||||||||
| Registered Nurse | 40.00 | 0.00 | 110681 | 0 | 6249 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 221495 | TotalReportableCompFromOrg |
| Total Other Compensation | 13769 | TotalOtherCompensation |
| Number Individuals GT100 K | 2 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Samaritan Hospital | |||||
| 2215 Burdett Avenue | Troy | NY | 12180 | Reimburse expenses | 756835 |
| Favorite Healthcare Staffing | |||||
| PO Box 803356 | Kansas City | MO | 64180 | Patient Services | 247548 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Revenue | Description |
| Total Revenue Column | 6779213 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6779213 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6779213 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4742 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4742 | RelatedOrExemptFunctionIncome |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Other Miscellaneous | Description |
| Total Revenue Column | 2602 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2602 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2602 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6786557 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6786557 | RelatedOrExemptFunctionIncome |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 221628 | Total |
| Program Services | 110814 | ProgramServices |
| Management And General | 110814 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3096437 | Total |
| Program Services | 3095778 | ProgramServices |
| Management And General | 659 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151751 | Total |
| Program Services | 146653 | ProgramServices |
| Management And General | 5098 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 189048 | Total |
| Program Services | 182697 | ProgramServices |
| Management And General | 6351 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 247118 | Total |
| Program Services | 238816 | ProgramServices |
| Management And General | 8302 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21084 | Total |
| Management And General | 21084 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 189543 | Total |
| Program Services | 161138 | ProgramServices |
| Management And General | 28405 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34844 | Total |
| Program Services | 2603 | ProgramServices |
| Management And General | 32241 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 817908 | Total |
| Program Services | 795297 | ProgramServices |
| Management And General | 22611 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97947 | Total |
| Management And General | 97947 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7560 | Total |
| Program Services | 7545 | ProgramServices |
| Management And General | 15 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 563775 | Total |
| Program Services | 563775 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 134517 | Total |
| Management And General | 134517 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Books/Periodicals | 1662 | 1662 | |
| Other Fees | 5873 | 5873 | |
| NYS Assessment | 126084 | 126084 | |
| Master Service Agmt-Samaritan | 1763145 | 865215 | 897930 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 401 | Total |
| Program Services | 399 | ProgramServices |
| Management And General | 2 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7670325 | Total |
| Program Services | 6298476 | ProgramServices |
| Management And General | 1371849 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104604 | BOY |
| EOY | 1525899 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1447394 | BOY |
| EOY | 770550 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 13537 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 170848 | BOY |
| EOY | 199331 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 6175944 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 752293 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5944017 | BOY |
| EOY | 5423651 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106633 | BOY |
| EOY | 1809 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7773496 | BOY |
| EOY | 7934777 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 412618 | BOY |
| EOY | 423556 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4705459 | BOY |
| EOY | 4468208 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3034164 | BOY |
| EOY | 3634164 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 600114 | BOY |
| EOY | 1271476 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8752355 | BOY |
| EOY | 9797404 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -978859 | BOY |
| EOY | -1862627 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -978859 | BOY |
| EOY | -1862627 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7773496 | BOY |
| EOY | 7934777 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -883768 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4835681 | OtherCostOrOtherBasis |
| Depreciation | 166060 | Depreciation |
| Book Value | 4669621 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1340263 | OtherCostOrOtherBasis |
| Depreciation | 586233 | Depreciation |
| Book Value | 754030 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5423651 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Third Party Settlements, Estimated | $188,724 |
| Due to Non-Affiliated Company | $1,082,752 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1271476 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 6786557 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 6786557 | RevenueSubtotal |
| Total Revenue Per Form990 | 6786557 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7670325 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 7670325 | ExpensesSubtotal |
| Total Expenses Per Form990 | 7670325 | TotalExpensesPerForm990 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | false | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
| Report Publically Available | false | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8457 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8457 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00110 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 392231 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 291816 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 100415 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01310 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3394274 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2329088 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1065186 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.13890 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3794962 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2620904 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1174058 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.15310 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 156526 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8200 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 148326 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01930 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 156526 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8200 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 148326 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01930 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3951488 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2629104 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1322384 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.17240 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $55,324 | BadDebtExpenseAmount |
| Amount Attributable To | 342 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 56223 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 80877 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -24654 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Burdett Care Center Inc | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2215 Burdett Ave 200 | AddressLine1 |
| City | Troy | City |
| State | NY | State |
| ZIP Code | 12180 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
| Field | Value | IRS element (for citing) |
|---|---|---|
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Adopt Budget | X | AdoptBudget |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | true | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| File Form4720 Report Excise Tax | false | FileForm4720ReportExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100.0000 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300.0000 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| State Regulation | X | StateRegulation |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part VI - Additional Information | 1.7 line b, c, - Burdett Care Center used the total ratio of cost to charges from the 2012 cost report to calculate the amounts used in the table. The Hospital applied this ratio to the charges associated with the straight Medicaid payer classification and the Medicaid Managed Care payer classifications.III.8- Burdett Care Center used the total ratio of cost to charges from the 2012 cost report to calculate the amounts used in the table. The Hospital applied this ratio to the charges associated with the Medicare payer classification. | |
| Part VI - Community Building Activities | As described in Part III Line 4a of the main form, Burdett Care was opened in 2011 to preserve access to sterilization service in the Troy, New York area in the context of the merging of secular and Catholic health systems in the area. In connection with this purpose and to promote womens health generally, Burdett Care continued to hold community forums in 2012, one of which celebrated its One Year Anniversary. Attendees included representatives from a non-profit organization whose mission is to educate the public about maternity care and other community members. Burdett Care also provides Lamaze Childbirth education, Breastfeeding education and support groups, infant massage, and sibling classes.In addition, Burdett Care is managed by a board of directors composed primarily of independent leaders in the community. Burdett Care has an open medical staff. Burdett Care presently operates at a deficit, but any future surpluses will certainly be used to fund the capital and operational needs of Burdett Care's services. | |
| Part VI - Community Information | Burdett Care considers the community it serves to comprise Albany and Rensselaer Counties. There are several reasons why residents of the Capital Region outside of Albany and Rensselaer Counties are unlikely to seek services from Burdett Care, and should not be considered part of "the Community." First, for most such persons, Burdett Care is more distant than other maternity and reproductive services resources, such as Ellis Hospital, Saratoga Hospital, Albany Medical Center or St. Peter's Hospital. Second, it is significant that Burdett Care is on the Troy side of the Hudson River. While residents of Albany County - particularly eastern Albany County - do use the services in Troy, to residents in population centers further west, northwest or southwest, the river is perceived as a barrier or border. Burdett Care is new, and does not yet have the name recognition or perceived prestige as competing services. But within Rensselaer and Albany counties, Burdett Care is seen as a successor provider to the maternity and reproductive services previously provided by Samaritan Hospital and Seton Health System, which were discontinued when Burdett Care opened. Over 70% of the births performed at Samaritan and Seton in 2010 came from Albany and Rensselaer Counties. | |
| Part VI - Patient Education of Eligibility for Assistance | In addition to posting Burdett Care Center's financial assistance policy on the hospital's website, Burdett Care Center physically posts the policy at almost all inpatient and outpatient intake desks. All registration personnel are trained to know the procedures for assisting patients who have no insurance. Burdett Care Center has also contracted with a firm that supplies the services of a Medicaid enroller "on-site". | |
| Part V, Line 20d - Other Billing Determination of Individuals Without Insurance | The hospital used the commercial insurance rates negotiated with its highest volume commercial payer, which is consistent with New York State Public Health Law Article 28 requirements. | Number of Hospital Faciltiy - 1 |
| Part V, Line 14g - Other Means Hospital Facility Publicized the Policy | Information regarding the availability of a financial assistance program and who to contact is included on billing invoices to patients. | Number of Hospital Faciltiy - 1 |
| Part V, Line 3 - Account Input from Person Who Represent the Community | The Burdett Care Center ("Burdett Care") concluded a community health needs assessment intended to comply with Internal Revenue Code 501(r) in February 2012, but much of the work on the assessment was performed during the three-year period from 2009 through 2011. During this period the staff of Northeast Health, which helped form Burdett Care, conducted an assessment of the need for maternity and reproductive-related services in the service area served by Burdett Care. They conducted this assessment through the collection and analysis of discharge and other health data, through interviews and other communications with key stakeholders, and through public hearings. This information was used to complete the community health needs assessment and for the planning necessary for the opening of Burdett Care and the design of its services. | Number of Hospital Faciltiy - 1 |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | If a patient qualifies for financial assistance, their account will not be subject to the usual collection practices during this process. If the patient does not submit the necessary documentation within 120 days, then their account could be forwarded to collections. | |
| Part III, Line 4 - Bad Debt Expense | The financial statements for Burdett Care Center contain the following note regarding bad debt expense.Patient service revenue, net of contractual allowances and discounts, is reduced by the provision for bad debts, and net patient accounts receivable are reduced by an allowance for uncollectible accounts. These amounts are based primarily on management's assessment of historical and expected write-offs and net collections along with the aging status of each major payor source. Management regularly reviews data about these major payor sources of revenue in evaluation the sufficiency of the allowance for uncollectible accounts. Based on historical experience, a portion of Burdett Care Center's self-pay patients who do not qualify for charity care will be unable or unwilling to pay for the services provided. Thus, a provision is recorded for bad debts in the period services are provided related to those patients. After all reasonable collection efforts have been exhausted in accordance with Burdett Care Center's policies, accounts receivable are written off and charged against the allowance for uncollectible accounts.Burdett Care Center provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because BCC does not pursue collection of amounts determined to qualify as charity care, they are not reported in patient service revenue.Charity and Uncompensated Care"Burdett Care Center provides care without charge or at a reduced rate to patients who qualify for charity care accoring to BCC's policy. To the extent that patients do not have the ability to pay, they are reported as charity care. BCC provides care to public program enrollees, which are typically reimbursed at amounts less than the costs. BCC also provides care in which charges are uncollected beyond what is provided under the definition of charity care. BCC calculaes the cost of providing charity and uncompensated care using a cost-to-charge ratio method. The amount of charity care and other uncompensated care at cost, provided the community for the year ended December 31,2012 is as follows:"Charity Care $ 4,215Costs in excess of public program reimburements 164,985 (Medicaid and Medicare) Provision for bad debts 66,093 _________ $235,293 | |
| Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit | The Hospital's estimate of bad debt expense at cost attributable to patients that may have been eligible under organization's charity care policy, but for whom sufficient information was unable to be obtained in order to make a determination, is based on the following: - We then took the number of incomplete and denied applications for 2012 and researched each account to see what amount was transferred to bad debt and multplied that amount by the appropriate RCC to calculate the bad debt at cost - Accounts are denied or incomplete due to insufficient information or refusal to provide information. We only selected accounts that then actually had balance transferred to bad debt with our rationale being that these patients would have qualified for charity care had they completed the process since they didn't the means to pay and the balances were transferred to bad debt. | |
| Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense | The Hospital's bad debt expense is calculated on an allowance/reserve basis. Each month, account balances, net of payments, discounts and contractual allowances, are sorted by the age of the receivable and payor group. Each payor and aging group is assigned a percentage that will be used to calculate a reserve/allowance for bad debt. This allowance for doubtful account total is combined with our bad debt account receivable balance to arrive at a total estimated allowance for doubtful accounts. This total is compared to our total allowance for doubtful accounts recorded in the Hospital's general ledger. The difference is recorded as bad debt expense.Account balances on patient accounts are transferred to bad debt accounts receivable once they are determined to be uncollectible. The balances are net of discounts, adjustments and payments that have been applied to these accounts.In order to determine the Hospital's bad debt expense at cost for Part III, line 2, we first identified what portion of the bad debt was inpatient and what portion was outpatient. We then applied the appropriate cost to charge ratio (I/P or O/P) as reported in our 2012 Medicare Cost Report to the bad debt expense amounts (I/P and O/P) to determine bad debt expense at cost. The Hospital's estimate of bad debt expense at cost attributable to patients that may have been eligible under organization's charity care policy, but for whom sufficient information was unable to be obtained in order to make a determination, is based on the following: - We then took the number of incomplete and denied applications for 2012 and researched each account to see what amount was transferred to bad debt and multplied that amount by the appropriate RCC to calculate the bad debt at cost - Accounts are denied or incomplete due to insufficient information or refusal to provide information. We only selected accounts that then actually had balance transferred to bad debt with our rationale being that these patients would have qualified for charity care had they completed the process since they didn't have the means to pay and the balances were transferred to bad debt. | |
| Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used) | Burdett Care Center financial assistance policy uses the Federal Poverty Guidelines to determine eligiblity, and does not use an asset test. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | In 2012, Burdett Care Center, Inc. did not make the above-named documents available to the public, although certifications of incorporation were available from the NYS Secretary of State |
| Form 990, Part VI, Line 15a | Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | The executive director's evaluation is completed by the board president with input from a 360 degree evaluation process including input from direct reports and board members. The evaluation includes a review of performace and progress on meeting established goals for the year under review. It also includes goal setting related to the strategic direction established by the board. The executive director's salary is reviewed annually using 3 to 4 national healthcare compensation surveys considering location, type of hospital, number of beds, operating revenue and budget. The target for compensation is to pay at the 50th percentile of the market. |
| Form 990, Part VI, Line 12c | Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Burdett Care Center has two system-wide conflict of interest policies, one applicable to the board of directors and one applicable to administrative staff and select employees and medical staff. Together, the two policies require annual disclosure of conflicts of interest by all directors, officers and key employees, and prescribe various responses to such conflicts applying customary conflicts of interest principles. Employee disclosure forms are reviewed annually by the compliance officer for a determination of any conflicts impact on the integrity of the disclosing individuals acts and decisions. Violation of the policy subjects an employee to potential disciplinary action. Board of directors conflict of interest disclosure forms are reviewed and summarized by the compliance officer. Customary procedures are followed, including non-participation by affected individuals in the deliberation and vote on any matters that potentially conflict with the individuals outside interests. Appropriate corrective action is taken by the Board in the event of a directors failure to disclose a conflict of interest or other violation of the policy. |
| Form 990, Part VI, Line 11b | Form 990, Part VI, Line 11b: Form 990 Review Process | Burdett Care took steps to educate the board of directors on the compliance requirements mandated by the From 990. The form 990 is provided to the full board prior to filing. Members are updated on the major areas included in the return. |
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