2013-11-13T11:38:10-08:00 2012-12-31 990 2012-01-01 272153849 Burdett Care Center Inc BURD 5182713393 2215 Burdett Ave Troy NY 12180 Lori Santos 2013-11-13 2012 2016-02-24 21:20:13Z Debbie Lajeunesse 2215 Burdett Avenue Troy NY 12180 6786557 false false X www.burdettcarecenter.org X 2010 NY 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. 6 6 83 0 0 1435193 6779213 4742 1245 2602 1436438 6786557 0 0 895908 3905982 0 0 1496626 3764343 2392534 7670325 -956096 -883768 7773496 7934777 8752355 9797404 -978859 -1862627 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. false false 6298476 6779213 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. 6298476 true false false false false false false false false false true false false false true false true false false false false false false false false false true true false false false false false false false false false false false false false false false false false false false false false false false false true 4 0 true 83 true false false false false false false false false 0 false false false false false false false false false false X 6 6 false false false false false false false true true false false true true true true true true true false false NY X Lori Santos 5184713135 2215 Burdett Ave 200 Troy NY 12180 Lisa Thorn MD 2.00 0.00 X X 0 0 0 Margaret Holcomb 2.00 0.00 X 0 0 0 Ann G DiSarro 2.00 0.00 X X 0 0 0 Robert G Burke 2.00 0.00 X X 0 0 0 Charlotte Buchanan Esq 2.00 0.00 X X 0 0 0 Dr Melody Bruce 2.00 0.00 X 0 0 0 Debbie Lajeunesse 40.00 0.00 X 110814 0 7520 Debra Griner 40.00 0.00 X 110681 0 6249 221495 13769 2 false false false Samaritan Hospital 2215 Burdett Avenue Troy NY 12180 Reimburse expenses 756835 Favorite Healthcare Staffing PO Box 803356 Kansas City MO 64180 Patient Services 247548 2 0 Net Patient Revenue 6779213 6779213 6779213 4742 4742 0 0 0 0 0 0 0 Other Miscellaneous 2602 2602 2602 6786557 6786557 0 0 0 0 221628 110814 110814 0 3096437 3095778 659 151751 146653 5098 189048 182697 6351 247118 238816 8302 0 0 21084 21084 0 0 0 189543 161138 28405 34844 2603 32241 817908 795297 22611 0 0 97947 97947 7560 7545 15 0 0 0 0 563775 563775 134517 134517 Books/Periodicals 1662 1662 Other Fees 5873 5873 NYS Assessment 126084 126084 Master Service Agmt-Samaritan 1763145 865215 897930 401 399 2 7670325 6298476 1371849 0 104604 1525899 0 0 1447394 770550 0 0 0 13537 170848 199331 6175944 752293 5944017 5423651 0 0 0 0 106633 1809 7773496 7934777 412618 423556 4705459 4468208 3034164 3634164 600114 1271476 8752355 9797404 X -978859 -1862627 -978859 -1862627 7773496 7934777 -883768 X false true X true false X 4835681 166060 4669621 1340263 586233 754030 5423651 Third Party Settlements, Estimated 188724 Due to Non-Affiliated Company 1082752 1271476 6786557 6786557 6786557 7670325 7670325 7670325 true true true X true X true false false false false false 8457 8457 0.00110 392231 291816 100415 0.01310 3394274 2329088 1065186 0.13890 3794962 2620904 1174058 0.15310 156526 8200 148326 0.01930 156526 8200 148326 0.01930 3951488 2629104 1322384 0.17240 true 55324 342 56223 80877 -24654 X true true 1 1 Burdett Care Center Inc

2215 Burdett Ave 200 Troy NY 12180

X true X X X X X X X X X 12 true false true X X X X X X true false false true true 100.0000 true 300.0000 true X X true true X X X X X X true false X X X X true X false false 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". Number of Hospital Faciltiy - 1 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. 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. 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.