CROUSE HEALTH HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CROUSE HEALTH HOSPITAL INC (EIN 16-0960470)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201313199349307856
Schema version
2012v2.1
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)
Timestamp2013-11-15T14:00:01-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1677 BROADWAYAddressLine1
CityALBANYCity
StateNYState
ZIP Code12207ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN160960470EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CROUSE HEALTH HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% KIMBERLY BOYNTONInCareOfName
Name ControlCROUNameControl
Phone3154707111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1736 IRVING AVENUEAddressLine1
Address Line2SuiteAddressLine2
CitySYRACUSECity
StateNYState
ZIP Code132101687ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKIMBERLY BOYNTONName
TitleCFOTitle
Phone3154707589Phone
Date Signed2013-11-14DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJeffrey C HamiltonName
Phone5184622030Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1CROUSE HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonPaul Kronenberg MD CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1736 Irving AvenueAddressLine1
CitySyracuseCity
StateNYState
ZIP Code13210ZIPCode
FieldValueIRS element (for citing)
Gross Receipts374748041GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.CROUSE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1913YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF CROUSE HEALTH HOSPITAL, INC. IS TO PROVIDE THE BEST IN PATIENT CARE AND TO PROMOTE COMMUNITY HEALTH.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees3122TotalNbrEmployees
Total Nbr Volunteers400TotalNbrVolunteers
Total Gross UBI203175TotalGrossUBI
Contributions Grants Prior Year174218ContributionsGrantsPriorYear
Contributions Grants Current Year222101ContributionsGrantsCurrentYear
Program Service Revenue Prior Year358132185ProgramServiceRevenuePriorYear
Program Service Revenue CY362823789ProgramServiceRevenueCY
Investment Income Prior Year1432723InvestmentIncomePriorYear
Investment Income Current Year1628333InvestmentIncomeCurrentYear
Other Revenue Prior Year9216341OtherRevenuePriorYear
Other Revenue Current Year10004235OtherRevenueCurrentYear
Total Revenue Prior Year368955467TotalRevenuePriorYear
Total Revenue Current Year374678458TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year194824815SalariesEtcPriorYear
Salaries Etc Current Year200669362SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year175903976OtherExpensePriorYear
Other Expenses Current Year181362123OtherExpensesCurrentYear
Total Expenses Prior Year370728791TotalExpensesPriorYear
Total Expenses Current Year382031485TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-1773324RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-7353027RevenuesLessExpensesCY
Total Assets BOY256697384TotalAssetsBOY
Total Assets EOY252459763TotalAssetsEOY
Total Liabilities BOY281763343TotalLiabilitiesBOY
Total Liabilities EOY275881641TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-25065959NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-23421878NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF CROUSE HEALTH HOSPITAL, INC. IS TO PROVIDE THE BEST IN PATIENT CARE AND TO PROMOTE COMMUNITY HEALTH.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense246896379Expense
Revenue362823789Revenue
DescriptionPROVISION OF HEALTHCARE SERVICES. CROUSE HEALTH HOSPITAL, INC. PROVIDES A VARIETY OF HEALTHCARE SERVICES TO A 15-COUNTY AREA IN CENTRAL NEW YORK. THE HOSPITAL OPERATES 506 ACUTE-CARE BEDS and 57 BASSINETS. crouse hospital serves more than 24,000 inpatients, 69,000 emergency service patients, and more than 270,000 outpatients annually. CROUSE HOSPITAL PROVIDED APPROXIMATELY $6.9 million IN CHARITY CARE IN 2012. Additional details on crouse hospital's exempt purpose achievements are found in "crouse hospital's 2010-2013 community service plan" which can be accessed on the hospital website. www.crouse.orgDescription
Total Program Service Expense246896379TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096297NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3122NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKIMBERLY BOYNTONNamePerson
Telephone Number3154707376TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1736 IRVING AVENUEAddressLine1
CitySYRACUSECity
StateNYState
ZIP Code13210ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
ELIZABETH HARNETT ESQ
DIRECTOR, BOARD VICE CHAIR1.01.0X
Patrick Mannion
director, board chair1.01.0XX
PAUL KRONENBERG MD
director, board president, ceo38.03.0XX6490612712738220
MELVIN STITH PHD
Director1.01.0X
MARY COTTER
Director1.01.0X
LOUIS GREEN MD
director1.041.0X02487958829
Ellen Bifano MD
Director1.01.0X
James Carrick
Director1.01.0X
RICHARD RUSSELL
DIRECTOR1.01.0X
robert miron
director1.01.0X
BARBARA ASKIN
DIRECTOR1.01.0X
JAMES HUGHES
DIRECTOR1.01.0X
PATTY BLACK
DIRECTOR1.01.0X
ALBERT WERTHEIMER
DIRECTOR 1/1-8/24/12 Deceased1.01.0X
PAM REILLY
DIRECTOR, AUXILIARY REP1.01.0X
MICHAEL DUFFY MD
DIRECTOR, MEDICAL STAFF REP1.01.0X750000
Derrick Suehs
board secretary, chief quality40.01.0X235248032541
KIMBERLY BOYNTON
BOARD TREASURER, CFO38.03.0X4286531768544836
Mary Agnew
Chief Nursing Officer40.0201561030303X
Ronald Stahl MD
Chief Medical Officer40.0342617038307X
Michael Dupuis
VP Support Services40.0182408034518X
Richard Steinmann MD
PHYSICIAN EMERGENCY DEPARTMENT40.0387341067254X
Michael Jorolemon MD
Physician Emergency Department40.0337089066693X
sami abdul-malak md
physician neurology40.0345336043802X
HECTOR BIAGGI MD
PHYSICIAN CHEMICAL DEPENDANCY40.0346304035199X
CRISTINA TOPOR MD
PHYSICIAN HOSPITALIST40.0324341045215X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3787459TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs293607TotalReportableCompFrmRltdOrgs
Total Other Compensation485717TotalOtherCompensation
Number Individuals GT100 K201NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CROUSE MEDICAL GROUP PC
401 N SALINA STREET SUITE 400SYRACUSENY13203Professional Medical2510882
CNY Anesthesia Group PC
736 IRVING AVESYRACUSENY13210Professional medical2266033
haynor hoyt corporation
625 erie blvd wSYRACUSENY13204construction3644759
MAGNETIC DIAGNOSTIC RESOURCES OF CN
4567 CROSSROADS PARK DRIVELIVERPOOLNY13088professional medical1617000
UNIVERSITY MEDICAL ASSOCIATES
750 EAST ADAMS STREET CAB 322SYRACUSENY13210PROFESSIONAL MEDICAL1673194
FieldValueIRS element (for citing)
Number Of Contractors GT100 K53NumberOfContractorsGT100K
Government Grants133961GovernmentGrants
All Other Contributions88140AllOtherContributions
Total Contributions222101TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE REV623000174395828174395828
MEDICARE/MEDICAID PAYMENTS623000182890535182890535
PARKING81293020143352014335
PROPERTY MGT REV FROM AFFILIATE531310942912942912
RENT532000522372522372

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column2057807TotalRevenueColumn
Related Or Exempt Function Income2057807RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue362823789TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1613318TotalRevenueColumn
Exclusion$1,613,318ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other84598Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other69583Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other15015Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column15015TotalRevenueColumn
Exclusion$15,015ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
OTHER INVESTMENT INCOME5259901290067203175$1,086,892
CAFETERIA7211101664963$1,664,963
COLLEGE OF NURSING6116002117744$2,117,744

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column4931461TotalRevenueColumn
Exclusion$4,931,461ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue10004235TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column374678458TotalRevenueColumn
Related Or Exempt Function Income362823789RelatedOrExemptFunctionIncome
Unrelated Business Revenue203175UnrelatedBusinessRevenue
Exclusion$11,429,393ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2039548Total
Management And General2039548ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total157043631Total
Program Services100222403ProgramServices
Management And General56821228ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1494049Total
Program Services957464ProgramServices
Management And General536585ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total28556253Total
Program Services17867235ProgramServices
Management And General10689018ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total11535881Total
Program Services7190315ProgramServices
Management And General4345566ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total754925Total
Management And General754925ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total262880Total
Management And General262880ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total127390Total
Management And General127390ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total16988994Total
Program Services10611336ProgramServices
Management And General6377658ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1199444Total
Program Services747614ProgramServices
Management And General451830ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1688970Total
Program Services1047161ProgramServices
Management And General641809ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2817972Total
Program Services1747143ProgramServices
Management And General1070829ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total10806333Total
Program Services6699926ProgramServices
Management And General4106407ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total158115Total
Program Services98031ProgramServices
Management And General60084ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total323841Total
Program Services200781ProgramServices
Management And General123060ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2509835Total
Management And General2509835ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total17687700Total
Program Services11024744ProgramServices
Management And General6662956ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total3989152Total
Program Services2486438ProgramServices
Management And General1502714ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PENSION EXPENSE1587151698927165978800
MAINTENANCE CONTRACTS379458323526421441941
SUPPLIES650600064447492520585081
PURCHASED SERVICES18972098178995191072579

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total18348369Total
Program Services11375986ProgramServices
Management And General6972383ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total382031485Total
Program Services246896379ProgramServices
Management And General135135106ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY8375BOY
EOY8425EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY20602292BOY
EOY21123757EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

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BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY40993483BOY
EOY37667853EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY4336266BOY
EOY4661847EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY6425966BOY
EOY7092876EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4901146BOY
EOY5323237EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis272206004LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec153287083LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY124397892BOY
EOY118918921EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY208027BOY
EOY208027EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY54823937BOY
EOY57454820EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY256697384BOY
EOY252459763EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY25370796BOY
EOY25967636EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY67320000BOY
EOY67630000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY10527051BOY
EOY2203251EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY178545496BOY
EOY180080754EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY281763343BOY
EOY275881641EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-46220526BOY
EOY-46229557EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY9819329BOY
EOY11322706EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY11335238BOY
EOY11484973EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-25065959BOY
EOY-23421878EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY256697384BOY
EOY252459763EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-7353027ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-310929ReconciliationUnrealizedInvest
Reconcilation Other Changes9308037ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$154,390DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB154390TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierORG. EXEMPT UNDER SEC. 501(c)(3) - DIRECT CONTACT WITH LEGISLATORSIdentifier
Return ReferencePART II-B LINE 1GReturnReference
ExplanationCrouse Health Hospital, Inc. contracted with the firm of Wilson, Elser, Moskowitz, Edelman & Dicker, LLP effective 2/11/12 to 3/10/13 to serve as legislative counsel to the Hospital. The fee for these services is $120,000 annually plus expenses. As of December 31, 2012, Crouse Hospital has paid the firm $120,000 in professional service fees and $7,390 in administrative expense reimbursement. Professional services include: legislative advocacy encompassing presentation of Hospital views to the legislative and executive branches of New York state government. Review and analysis of all proposed New York state legislation of potential impact. Preparation of affirmative legislation. Preparation of memoranda supporting or opposing legislation. Attendance at public health hearings, committee meeting, and other related activities to insure that legislators are aware of Hospital views and informed of the impact of the legislation affecting Hospital interests. Preparation of regular reports advising the current status of pending legislation. Discussions and recommendations regarding an affirmative legislation program. Conferences with the Hospital or its representatives as necessary. Administrative expense reimbursement includes: telephone, faxes and all other wireless forms of communications, postage and delivery services, reproduction and presentation materials, in-house computer services, research and database interfaces. Paid staff of Crouse Health Hospital, Inc. had direct contact with legislators, their staffs, government officials and legislative bodies. The cost of these activities is $27,000. Crouse Health Hospital, Inc. belongs to professional organizations that provide lobbying on behalf of its members. These organizations are: Greater New York Hospital Association, Hospital Association of New York State, and Centerstate CEO.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance19814130BeginningOfYearBalance
Contributions50269Contributions
Investment Earnings Or Losses2546629InvestmentEarningsOrLosses
Grants Or Scholarships38000GrantsOrScholarships
Other Expenditures809092OtherExpenditures
Administrative Expenses28637AdministrativeExpenses
End Of Year Balance21535299EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance21220353BeginningOfYearBalance
Contributions259960Contributions
Investment Earnings Or Losses-742382InvestmentEarningsOrLosses
Grants Or Scholarships41500GrantsOrScholarships
Other Expenditures843933OtherExpenditures
Administrative Expenses38368AdministrativeExpenses
End Of Year Balance19814130EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance19569523BeginningOfYearBalance
Contributions57126Contributions
Investment Earnings Or Losses2430827InvestmentEarningsOrLosses
Grants Or Scholarships28500GrantsOrScholarships
Other Expenditures770515OtherExpenditures
Administrative Expenses38108AdministrativeExpenses
End Of Year Balance21220353EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance16978156BeginningOfYearBalance
Contributions63493Contributions
Investment Earnings Or Losses3388889InvestmentEarningsOrLosses
Grants Or Scholarships28750GrantsOrScholarships
Other Expenditures797265OtherExpenditures
Administrative Expenses35000AdministrativeExpenses
End Of Year Balance19569523EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance24198431BeginningOfYearBalance
Contributions129183Contributions
Investment Earnings Or Losses-6351133InvestmentEarningsOrLosses
Grants Or Scholarships34000GrantsOrScholarships
Other Expenditures929075OtherExpenditures
Administrative Expenses35250AdministrativeExpenses
End Of Year Balance16978156EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.40000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.50000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.10000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis285832OtherCostOrOtherBasis
Book Value285832BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis164721450OtherCostOrOtherBasis
Depreciation76483639Depreciation
Book Value88237811BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis16374087OtherCostOrOtherBasis
Depreciation14799155Depreciation
Book Value1574932BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis83232467OtherCostOrOtherBasis
Depreciation62004289Depreciation
Book Value21228178BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7592168OtherCostOrOtherBasis
Book Value7592168BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings118918921TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
CROUSE HEALTH FOUNDATION21353601
ASSETS WHOSE USE IS LIMITED32042802
FUNDS HELD IN TRUST BY OTHERS1454078
BOND ISSUANCE/CLOSING COSTS2604339
FieldValueIRS element (for citing)
Total Book Value Other Assets57454820TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
SELF INSURED PROFESS. LIAB.$20,664,026
ACCRUED PENSION LIABILITY$129,363,821
POSTRETIREMENT OBLIGATION$13,320,080
ASSET RETIREMENT OBLIGATION$2,732,728
DUE TO/FROM RELATED PARTIES (N$2,157,824
FUNDS HELD IN TRUST$234,336
LIABILITIES TO THIRD PARTY PAY$11,188,970
DEFERRED RENT & REBATE$418,969
FieldValueIRS element (for citing)
Total Of Amounts180080754TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt373305376TotRevenueEtcAuditedFinclStmt
Revenue Subtotal373305376RevenueSubtotal
Investment Expenses Not Included1373082InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt1373082RevenueNotRptdOnFinStmt
Total Revenue Per Form990374678458TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt382031485TotExpensesEtcAuditedFinclStmt
Expenses Subtotal382031485ExpensesSubtotal
Total Expenses Per Form990382031485TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Reconciliation of Revenue Per Audited FS with Revenue Per ReturnPart XII, Line 2d & Line 4bnet income from equity investments 1,290,067 investment income 68,000 net gain on sale of assets other than inventory 15,015 ___________ TOTAL 1,373,082 ===========
Endowment FundPart V, Line 4endowment funds: crouse health foundation, inc., a related organization, is in possession of endowment funds to support crouse health hospital, inc. these endowment funds are valued at approximately $21.5 million at december 31, 2012. the principal, with an approximate value of $10.0 million, remains untouched; while the investment income is used to fund equipment and programs required for hospital services and initatives.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6146663TotalCommunityBenefitExpense
Direct Offsetting Revenue2499863DirectOffsettingRevenue
Net Community Benefit Expense3646800NetCommunityBenefitExpense
Percent Of Total Expense0.00960PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense85899947TotalCommunityBenefitExpense
Direct Offsetting Revenue62198247DirectOffsettingRevenue
Net Community Benefit Expense23701700NetCommunityBenefitExpense
Percent Of Total Expense0.06230PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense92046610TotalCommunityBenefitExpense
Direct Offsetting Revenue64698110DirectOffsettingRevenue
Net Community Benefit Expense27348500NetCommunityBenefitExpense
Percent Of Total Expense0.07190PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense289694TotalCommunityBenefitExpense
Net Community Benefit Expense289694NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense10219731TotalCommunityBenefitExpense
Direct Offsetting Revenue5956745DirectOffsettingRevenue
Net Community Benefit Expense4262986NetCommunityBenefitExpense
Percent Of Total Expense0.01120PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense4642090TotalCommunityBenefitExpense
Direct Offsetting Revenue4368714DirectOffsettingRevenue
Net Community Benefit Expense273377NetCommunityBenefitExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense133022TotalCommunityBenefitExpense
Net Community Benefit Expense133022NetCommunityBenefitExpense
Percent Of Total Expense0.00040PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense15284537TotalCommunityBenefitExpense
Direct Offsetting Revenue10325459DirectOffsettingRevenue
Net Community Benefit Expense4959079NetCommunityBenefitExpense
Percent Of Total Expense0.01300PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense107331147TotalCommunityBenefitExpense
Direct Offsetting Revenue75023569DirectOffsettingRevenue
Net Community Benefit Expense32307579NetCommunityBenefitExpense
Percent Of Total Expense0.08490PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense43309TotalCommunityBuildingExpense
Net Community Building Expense43309NetCommunityBuildingExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense2810TotalCommunityBuildingExpense
Net Community Building Expense2810NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Total Community Building Expense46119TotalCommunityBuildingExpense
Net Community Building Expense46119NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$13,082,903BadDebtExpenseAmount
Amount Reimbursed By Medicare88197784AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare93148629CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-4950845MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (3 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
LACNY INC
LABORATORY SERVICES0.33300
MDR LLC
MAGNETIC RESONANCE IMAGING0.250000.75000
SEA LLC
ENDOSCOPY SERVICES0.400000.60000
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Crouse Health Hospital IncBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1736 Irving AveAddressLine1
CitySyracuseCity
StateNYState
ZIP Code13210ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1CROUSE HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Take Into AccounttrueTakeIntoAccount
Other FacilitiestrueOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent300.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Uninsured DiscountXUninsuredDiscount
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Permit Other ActionsXPermitOtherActions
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Other ActionsXOtherActions
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities9NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
CROUSE HOSPITAL-410 SOUTH CROUSE DIVISIO
410 SOUTH CROUSE AVENUESYRACUSENY13210CHEMICAL DEPENDENCY OUTPATIENT TREATMENT SERVICES
CNY MEDICAL IMAGING CENTER
739 IRVING AVENUESYRACUSENY13210MEDICAL IMAGING TESTING CENTER
CNY PROMPTCARE
739 IRVING AVENUESYRACUSENY13210URGENT CARE CENTER
CROUSE HOSPITAL-COMMONWEALTH DIVISION
6010 EAST MOLLY RDSYRACUSENY13211RESIDENTIAL CHEMICAL DEPENDENCY REHABILITATION
PHYSICAL THERAPY-LIVERPOOL
7375 OSWEGO ROADLIVERPOOLNY13090PHYSICAL THERAPY CENTER
CROUSE ENDOSCOPY
739 IRVING AVENUESYRACUSENY13210ENDOSCOPY TESTING CENTER
POB SURGERY CENTER
723 IRVING AVENUESYRACUSENY13210OUTPATIENT AMBULATORY SURGERY CENTER
PHYSICAL THERAPY-DEWITT
5823 WIDEWATERS PARKWAYEAST SYRACUSENY13057PHYSICAL THERAPY CENTER
MADISON IRVING SURGERY CENTER
475 IRVING AVENUESYRACUSENY13210OUTPATIENT AMBULATORY SURGERY CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
SCHEDULE H PART VILINE 1. Crouse Hospital's Community Health Outreach Manager spends 50% of her time (12 hours per week) working with health and social service agencies throughout the county and region to enhance healthcare for those living in poverty and/or with little access to care. These activities include serving on the boards of the Healthy Syracuse Coalition and the Onondaga County Health Department's Cancer Services Program, as well as the health committees for the Syracuse City School District, the school district's Say Yes to Education program, and Hughes Elementary School. The goal of this participation is to influence and positively affect health policies, as well as to enhance coalitions for improvement. Additionally, the hospital's Employee Wellness Coordinator and Asthma Education Staff work with the Healthy Syracuse Coalition specifically to reduce and eliminate tobacco consumption in Onondaga County, and to increase employers' knowledge and application of worksite wellness policies and procedures. Crouse was a major sponsor of the first Worksite Wellness Conference in Syracuse in 2012.
SCHEDULE H PART VILINE 2. Onondaga County Community Health Needs Assessment Community Engagement Process To assess the health care needs of the communities Crouse Hospital serves, the hospital and the Onondaga County Health Department (LHD) partnered with the other two hospitals in Onondaga County to conduct a community health assessment process that engaged health improvement efforts already underway and drew on local resources. The process was designed to result in a clear picture of the health of the community and to identify meaningful and realistic community health improvement initiatives that are supported by key constituencies. The process began with meetings between the leadership of the Onondaga County Health Department (Commissioner of Health and Chair of the Advisory Board of Health) with the chief executive officers of the three hospitals in the community (St. Joseph's Hospital Health Center, Crouse Hospital and Upstate University Hospital (including the Golisano Children's Hospital and Upstate at Community General)) to discuss the process and gain support of the leadership. The outcome of the meeting was an agreement that the community health assessment process would be a collaborative effort that would focus on building on existing partnerships to ensure that the outcome would incorporate initiatives that have a strong base of support. The community health assessment process undertaken in Onondaga County was also structured to meet the requirements of the New York State Prevention Agenda and Title IX of the Patient Protection and Affordable Care Act of 2010. The process was supported by work done by graduate students in the Central New York Master of Public Health program (CNYMPH), a graduate program in public health sponsored by Syracuse University and Upstate Medical University. The graduate students began their work by convening and facilitating five forums in October and November 2011. The Lerner Center for Public Health Promotion at the Maxwell School for Citizenship and Public Affairs at Syracuse University provided logistical support and assistance with recruiting forum participants in collaboration with the Onondaga County Advisory Board of Health, the Syracuse City Schools, and Say YES to Education. The forums were held at the Central New York Community Foundation Philanthropy Center; the school-focused forum was held at the Say Yes to Education offices. Altogether, 92 people participated in the forums. The purpose of the forums was to find out what health issues are perceived to be of importance in the community. These qualitative findings provided a backdrop against which data was collected and analyzed to better understand the concerns raised by community members. The results of the forum are summarized in a report issued in January of 2012 (included in an Appendix to Crouse Hospital's 2013 CHNA). The data collection and analysis phase followed. Data from a number of sources were utilized, including the New York State Prevention Agenda, the 2013 Community Needs Assessment Report developed by the United Way of CNY as well as internal information from the LHD and hospitals. Again, students from the CNYMPH program were engaged to support the community health assessment effort. Teams of students were paired with the hospitals and with the LHD to support data collection and analysis. The teams, at the direction of the hospital and LHD, collected and organized data that was used by the leadership of the organizations to understand the health needs of the community. The students provided formal reports to each of the organizations in the Spring of 2013. Over the course of 2012/2013, a task force composed of representatives from the LHD and the hospitals met regularly to review the data and explore areas for collaboration. During the course of the community health assessment, an issue related to neonatal abstinence syndrome, drug withdrawal in a baby, surfaced. The issue was identified initially by local physicians and hospital staff; it was brought to the Onondaga County Advisory Board of Health by a neonatologist. A review of the data revealed that Onondaga County has the highest rate of hospital discharges for newborns with drug-related issues. A community solution, detailed in later sections of the community health assessment, is under development and is one of the priority/focus areas chosen in Onondaga County. The findings of the community health assessment revealed that one of the priority issues revolved around chronic disease and more specifically physical activity and nutrition as it relates to chronic disease. The data supports the community perception that chronic disease is an important issue and will be discussed in later sections of the community health assessment as one of the priority/focus area chosen in Onondaga County. Through discussions with the task force and the leadership of the LHD and the hospitals, two priority areas were chosen: " Prevent Chronic Disease " Promote Mental Health and Substance Abuse o Neonatal Abstinence Syndrome At a meeting on May 1, 2013 of the Thursday Morning Roundtable, a community forum sponsored by Syracuse University, the Commissioner of Health and Chair of the Advisory Board of Health presented "The State of our County's Health: An Assessment of Onondaga County's Health". This presentation is also included as Appendix II. With the priority areas identified, the LHD and hospitals have collaborated to refine the focus areas and strategies, building on community health initiatives that are underway, that will be undertaken to address these issues.
SCHEDULE H PART VILINE 3. There are several ways Crouse Hospital informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs, as well as under our organization's financial assistance policy. Those methods include: - A dedicated hospital department with four full-time employees whose sole responsibility is to help individuals apply for government or other free insurance programs, as well as to navigate patients through the Crouse Hospital Financial Assistance policy. - The policy is posted on the Crouse Hospital website, www.crouse.org, and there is a link on every page of the website that people can click to find Help with Your Hospital Bill. - Following best practice models, Crouse Hospital has developed an online application for financial aid. It appears on the hospital's website along with the financial aid policy.http://www.crouse.org/visit/patients/financial-assistance/ - Crouse Hospital developed a simpler, one-page application that is easier to fill out and eliminates duplication of paperwork and documentation. - The Hospital's financial assistance staff bring computers directly to patients' bedsides to electronically complete financial aid applications. This procedure is intended to eliminate barriers to accessing care and financial assistance by avoiding literacy concerns, allowing patients to ask questions in real time and receive translation services as necessary. - Every Crouse Hospital billing notification includes a statement at the bottom referencing the availability of financial assistance by calling Crouse Hospital's Financial Assistance Program please contact 315/470-5664 or 315/470-7030, and/or accessing the policy through the Crouse website, www.crouse.org - Crouse Hospital's financial assistance is posted in the facility's emergency room, PromptCare, and waiting rooms, as well as in the hospital's admissions offices. - The policy is provided, in writing, to patients on admission to the hospital facility. - The policy is always available on request, and is explained in Crouse Hospital's annual Community Service Plan, which is widely distributed to the public and is posted on the hospital's website.
SCHEDULE H PART VILINE 4. No changes to Crouse Hospital's service area were made in 2012. Crouse Hospital serves a 15-county region in New York that extends south to Binghamton and north to Malone. Its primary service area is Onondaga County and the contiguous surrounding counties. Seventy-five percent of inpatient and outpatient admissions are from Onondaga County; 25 percent are from outside Onondaga County. A major contributor to out-of-county admissions is the fact that Crouse is the New York State-designated regional referral center for perinatal and neonatal intensive care services (60% of NICU admissions at Crouse come from outside Onondaga County). Onondaga County is included in the Syracuse, NY Metropolitan Statistical Area (MSA). The US Census data estimates the county's 2011 population at 467,000, with approximately 145,000 people residing in Syracuse.
SCHEDULE H PART VILINE 5. Crouse Hospital staff provide an abundance of community health improvement promotion throughout our service area, and in conjunction with community partners. Below are descriptions of actions taken to address the three priority areas outlined in Crouse Hospital's New York Prevention Agenda. They were selected in conjunction with the Onondaga County Health Department and the other local hospitals, for collaborative interventions from 2010-2012 in Onondaga County. Crouse Hospital Programs Addressing Tobacco Use " As a smoke-free hospital, Crouse provides ongoing smoking cessation programs for patients, employees, volunteers and college of nursing students. " All patients who identify themselves as smokers are counseled about quitting smoking before they leave the hospital. " Smoking cessation counselors provide necessary education to all patients in our outpatient diabetes program and to the nearly 2,000 individuals who annually participate in free community heart-health and pulmonary function screenings, as well as health fairs sponsored by the hospital. " Crouse staff members provide annual on-site smoking prevention/avoidance programs for students at Hughes Magnet Elementary School, a Syracuse city school located in an economically disadvantaged area, as well as for the Onondaga County BOCES middle school alternative program, for students at risk of dropping out of school. Crouse Hospital Programs Addressing Healthy Mothers, Healthy Babies, Healthy Children " Crouse Hospital, in partnership with SUNY Upstate Medical University, serves as the only New York State-designated Regional Perinatal Center Program in Central New York, caring for the highest risk and most complicated obstetrical and neonatal (NICU) patients in the 15-county region. Annually, Crouse sees 4,000 births and 900 NICU admissions. The region averages 19,000 births per year, with 1,582 of those births receiving NICU care. " Crouse Hospital's Walter R.G. Baker Neonatal Intensive Care Unit annually admits more than 900 premature and critically ill infants, with an on-site, round-the-clock staff of neonatologists, neonatal nurse practitioners and highly skilled registered nurses. " Unique pediatric care services at Crouse include extracorporeal membrane oxygenation for infants and the region's only pediatric cardiac catheterization program. " Crouse staff members facilitate a monthly infant-loss support group for parents and their families throughout the region. The infant-loss bereavement staff also provides training for medical residents and other OB/GYN staff. " Preventive healthcare offerings include a pediatric first-aid program and comprehensive childbirth education programs that promote the maternal/child benefits of waiting until 39 weeks for any scheduled birth, and breastfeeding, plus lactation consultant services for any mother needing assistance during and/or after her hospital stay. " Crouse continues working with the Children's Consortium of Central New York to offer parents the Baby Beginnings program (previously Ready, Set, Parent) to help reduce the risk of child abuse and increase parenting skills for those with children from infancy to age three. Offered free to parents, Crouse is the only local hospital that provides this program. Annually, the Baby Beginnings staff meets one-on-one with 2,000 mothers and teaches newborn care classes to nearly 800 mothers. " Since 1976 Crouse Hospital has been educating first-grade students throughout Onondaga County (more than 3,000 in the 2012-2013 school year) with our free Visit to Hospital-Land community service program. The program is designed to lessen the fears and confusion of young children who may have to visit a loved one in the hospital, or stay in a hospital themselves. " Crouse offers Babysitters Training Course for sixth grade students in several elementary schools across Onondaga County. In 2012 we equipped about 40 students with the skills and tools needed to provide safe care for younger children, as well as for staying home alone. " Crouse Hospital also continues its partnership with Hughes Magnet School in Syracuse and in 2012 launched a new nutrition education/cooking instruction program through a grant from a local foundation. The grant was renewed and expanded for the 2012/13 school year. " In addition, Crouse works with the Syracuse City School District to serve as wellness advisors and provide support for its health and wellness initiatives. The hospital provides: o health speakers for each grade; o free continuing medical education training for school nurses; o free heart health screenings for staff; and o placement of Crouse Hospital College of Nursing students in schools to assist school nurses. " Crouse Hospital Chemical Dependency Treatment Services provides comprehensive care that improves the health of our community's mothers, babies and children. - Staff provides substance abuse prevention education for parents, teachers and students in the Syracuse City School District and other rural school districts where substance abuse rates are highest. - Crouse Hospital provides a continuum of care for pregnant and post-partum mothers with alcohol and other substance abuse issues. Pregnant women can enter our residential treatment program at any time before delivery; continue to receive pre-natal care and then deliver at Crouse Hospital. Mothers also may return to treatment at any time following delivery. - Crouse Hospital's Chemical Dependency Treatment Services program serves teens between the ages of 13 and 17 with substance abuse disorders using gender-specific group training. - In collaboration with the Elmcrest Children's Center in Syracuse, Crouse Hospital supports an on-site chemical dependency treatment unit addressing the recovery needs of the children. We are integrating addiction treatment for children to provide them with a comprehensive system of support while they are residing at Elmcrest and when they move on to after-care in their community. - In 2012 Chemical Dependency Treatment Services continued a health and wellness fair for female clients focusing on heart health, breast health, nutrition and diabetes. " The Crouse Breast Health Center offers women the services of three dedicated Breast Health Navigators. The navigators help lessen the anxiety and apprehension of having routine mammograms and other diagnostic imaging or procedures, and guide women through any additional needed tests or procedures. Current Crouse Hospital Programs Addressing Access to Care " Crouse Hospital staff work closely with many local heath and social service agencies to provide free screenings for blood pressure, cholesterol and blood glucose levels to more than 2,000 individuals annually, most of whom are from underserved or underinsured groups. We also support dozens of community education health fairs and other events annually. " As a member of the Onondaga County Get Health Connected Consortium, Crouse annually plans and participates in an inner-city free health screening fair promoted to underinsured and uninsured individuals. In 2013 and 2011, Crouse Hospital served as the event organizer. In 2012, Crouse oversaw event publicity and advertising for the event. " Serving as a sponsor of Syracuse's annual Juneteenth Health Pavilion, Crouse nursing staff are on site providing free blood pressure checks, healthcare proxy cards, medication records and a wide variety of helpful health-related information. In 2011, 2012 and 2013, more than 300 people had their blood pressure checked and reviewed. " Working with the Syracuse Say Yes to Education staff and volunteers, Crouse provides leadership support and healthcare expertise for the program. Syracuse University and the Syracuse City School District have joined forces to develop and launch this first district-wide program that will promote lifelong success for Syracuse school district students and their families by increasing both high school and college graduation rates. " Crouse Hospital's Chemical Dependency Treatment Services Program provides several services that focus on access to care, including: a hospital intervention service for patients identified with addictive complications in their primary care that provides in-hospital clinical intervention and access to treatment after discharge; - the region's only medical detoxification unit; - the region's only opioid maintenance treatment program; - the region's only service for older adults suffering with addiction - and serving as the area's largest provider of addiction treatment to the Hispanic community in the patients' primary language and with cultural enhanced understanding of the Hispanic community. " As Central New York's first hospital designated as a NICHE organization (Nurses Improving Care for Healthcare Elders), Crouse continued its innovative Care Transitions program for patients with a variety of cardiac conditions (CHF, AFib, MI), COPD patients and patients with comp
SCHEDULE H PART V SECTION BLINE 7. Crouse Hospital files a community benefit report in New York State only.
SCHEDULE H PART V SECTION BLINE 16- Other Actions - Wage garnishments and liens on bank accounts
SCHEDULE H PART V SECTION BLINE 17 - Other Actions - Wage garnishments and liens on bank accounts
SCHEDULE H PART V SECTION BLINE 19 - Other -. Uninsured patients who receive emergency or other medically necessary care are informed of a range of financial assistance options that include assistance in applying for Medicaid and for charity care discounts. The hospital charges consistently across all payors. Therefore, the bill for uninsured patients who receive emergency or other medically necessary care is at gross charges. The uninsured individual adjustment to gross charges is based on the hospitals income guidelines adjusted against our lowest commercial insurance rate.
SCHEDULE H PART V SECTION BLINE 22 - Other - The hospital makes every attempt to work with patients to secure financial assistance to allow the charge to be reduced to a lower rate for payment.
SCHEDULE H PART VQUESTION 3 - Crouse Hospital took into account input from persons who represent the broad interests of the community it serves, including those with special knowledge of and expertise in public health. Our staff has worked closely with the Onondaga County Department of Health (most frequently the commissioner) on our CHNA since 2010. We were guided by Dr. Tom Dennison, Director of Syracuse University's Program in Health Services Management and Policy. He also is the Associate Director of the CNY MPH Program and Director for the Lerner Center of Public Health. Crouse Hospital also worked with colleagues from two other local hospitals, a mutlitude of health agencies, like the American Cancer Society, ACR Health, March of Dimes and social support agenices like the Spanish Action League of CNY, the NorthEast Community Center, YMCA, etc. Using MPH students and a recent community assessment from the United Way, we conducted focus groups, and interviewed CEOS and Executive Directors of various agencies and businesses, as well as the Syracuse City School District, the largest and most impoverished district in our service area.SECTION B
SCHEDULE H PART VQUESTION 4 - The CHNA was conducted in conjunction with St. Joseph's Hospital Health Center and Upstate Medical Center University.SECTION B
SCHEDULE H PART VQUESTION 5 - Other means of distributing CHNA: Mailing and e-mailing the report to public libraries, community organizations, local officials, business leaders, media, hospital employees, volunteers and physicians, the hospitals board of directors and Crouse Health Foundation trustees and donors; provide copies at community health fairs/screenings and other educational events as well as to potential employees and our College of Nursing students.SECTION B
SCHEDULE H PART VQUESTION 7 - Due to limited resources, and the availability of other providers to help, Crouse Hospital will not be focusing its efforts on the following health needs of our community: improved sidewalks and transportation; primary care for an ever-growing refugee population; and suicide prevention.SECTION B

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
PAUL KRONENBERG MD
director, board president, ceo509138265951375785322345014056740228485766859652844300
Derrick Suehs
board secretary, chief quality23044804800000131340194070267789000
KIMBERLY BOYNTON
BOARD TREASURER, CFO347711173158094237000118116223129311104717571941700
LOUIS GREEN MD
director024524303552000008829025762400
Mary Agnew
Chief Nursing Officer1995020205900023990279040231864000
Richard Steinmann MD
PHYSICIAN EMERGENCY DEPARTMENT373725013616000194680477860454595000
Ronald Stahl MD
Chief Medical Officer3358170680000077300305770380924000
Michael Dupuis
VP Support Services1786680374000065390279790216926000
Michael Jorolemon MD
Physician Emergency Department32423301285600093100573830403782000
sami abdul-malak md
physician neurology3395360580000081570356450389138000
HECTOR BIAGGI MD
PHYSICIAN CHEMICAL DEPENDANCY3415220478200091030260960381503000
CRISTINA TOPOR MD
PHYSICIAN HOSPITALIST3189710537000089130363020369556000

Form990 Schedule J Part III Form990ScheduleJPartIII (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Continuation of Officers, Directors, Trustees, Key Employees, & HighestCompensatedPart I 1a Health or social club dues: Paul Kronenberg was reimbursed for his social club dues.
officers, directors, trustees, key employees & highest compensated employePart IIall individuals listed with the exception of #4 are employees of and compensated by Crouse Health Hospital, Inc. individual 4 is an employee of and compensated by a related organization, crouse medical practice, pllc. Compensation is disclosed for services provided to the Hospital or its related organizations. All members of the Board of Directors of the Hospital except the Ex-Officio members are voluntary. No compensation, employee benefits or expense account allowances are received for Board services.
CHIEF EXECUTIVE OFFICERPART I, QUESTION 7As stipulated by employment contract, the Hospital CEO receives incentive compensation in an amount determined by the Board of Directors, not to exceed 25% of base salary. The incentive is based upon the Executive's achievement of objectives that are mutually agreed upon by the Executive and the Board of Directors or a committee thereof. The objectives are established annually. The Board of Directors determines the amount of incentive compensation. Incentive compensation received in 2011 was based on achievement of 2011 objectives.
CHIEF FINANCIAL OFFICERPART I, QUESTION 7As stipulated by employment contract, the Hospital CFO receives incentive compensation in an amount to be determined by the Board of Directors, not to exceed 25% of base salary, based upon the CFO's achievement of reasonable objectives that are mutually agreed upon by the CFO and by the CEO and the Board or a committee thereof. The objectives are established annually and are not based upon the Hospital's financial performance. The Board in consultation with the CEO determines the amount of incentive compensation. Incentive compensation received in 2011 was based upon achievement of 2011 objectives.
emergency department physicianspart 1, question 7In 2012 the emergency department physicians received incentive compensation. this compensation was based on productivity benchmarks and successful outcomes of patient satisfaction survey conducted during 2011.
Severance PaymentPart 1, Question 4aMary Agnew received a severance of $110,812 during 2012.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (4 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
2003a onondaga county industrial development agenc
A161093714682747ea42003-09-257510000refund portion of o/s series 96 bdfalsefalsefalse
2003a syracuse industrial development agency
B521380308871720bt42003-09-2520000000refund portion of o/s series 96 bdfalsefalsefalse
2007a onondaga county industrial development agen
C161093714682747gp92007-06-259000000capital improvement projectfalsefalsefalse
2007a syracuse industrial development agency
D521380308871720bw72007-12-1420000000capital improvement projectfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (4 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A0000000000002003truefalsetruetrue
B0000000000002003truefalsetruetrue
C0000002512600670747002009falsefalsetruetrue
D0000061375000019646952002010falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyEngage Bond Counsel ContractsEngageBondCounselContractsAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePrcntge Bond Financed PropPrcntgeBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
Afalsefalsefalsefalsefalsefalse0.000000.000000.000000.00000true
Bfalsefalsefalsefalsefalsefalse0.000000.000000.00000true
Cfalsefalsefalsefalsefalsefalse0true
Dfalsefalsefalsefalsefalsefalse0.000000.000000.00000true

Form990 Schedule K Part IV Form990ScheduleKPartIV (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledException To RebateExceptionToRebateVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqsNo Rebate DueNoRebateDue
0
Afalsetruetruefalsefalsefalsefalse0falsetrue
0
Bfalsetruetruefalsefalsefalsefalse0falsetrue
0
Cfalsetruefalsefalsefalsefalse0falsetruetrue
0
Dfalsetruefalsefalsefalsefalse0falsetruetrue

Form990 Schedule K Part V Form990ScheduleKPartV (4 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Atrue
Btrue
Ctrue
Dtrue

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierDates of Rebate CalculationsIdentifier
Return ReferencePart IV, Line 2CReturnReference
Explanation2007A Onondaga County IDA - September 30, 2013 2007A Syracuse IDA - September 30, 2013 2007B Syracuse IDA - September 30, 2013Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line12007b syracuse industrial devel agencyBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN521380308IssuerEIN
CUSIP Number871720bx5CUSIPNumber
Date Issued2007-12-14DateIssued
Issue Price7850000IssuePrice
Description Of Purposecapital improvement projectDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds0TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds0IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2008YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Engage Bond Counsel ContractsfalseEngageBondCounselContracts
Any Research AgreementsfalseAnyResearchAgreements
Engage Bond Counsel ResearchfalseEngageBondCounselResearch
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiled
No Rebate DuetrueNoRebateDue
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Superintegrated HedgefalseSuperintegratedHedge
Hedge TerminatedfalseHedgeTerminated
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Written Proc To Monitor ReqstrueWrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective ActiontrueProcToUndertkCorrectiveAction

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
ELLEN BIFANO MD
SEE PART V EXPLANATION317931SEE PART V EXPLANATIONfalse
PAUL KRONENBERG MD
SEE PART V EXPLANATIONSEE PART V EXPLANATIONfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierSCHEDULE L, PART IVIdentifier
ExplanationLINE 1: Ellen Bifano, MD is a partner in neonatal associates of cny which provides neonatal services to the hospital and for which payments totaling $317,931 were received from the hospital in 2012. LINE 2: PAUL KRONENBERG MD IS THE PHYSICIAN CEO AND SOLE MEMBER OF CROUSE MEDICAL PRACTICE PLLC. to SEE A MORE DETAILED EXPLANATION OF CROUSE MEDICAL PRACTICE, PLCC AND THE HOSPITAL'S TRANSACTIONS WITH THIS ENTITY, PLEASE REFER TO SCHEDULE 0 AND SCHEDULE R.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VIQuestion 1: Two ex officio directors of the hospital board of directors, the hospital ceo and the president of the hospital auxiliary, serve without vote. the hospital bylaws authorize the use of an executive committee which has the right to exercise all the authority of the board of directors between meetings of the board and with the general power to discharge the duties of the board, except as such power may be limited by law, the bylaws or the board itself. Question 2: Richard Russell, a Director, provided accounting and tax advice to Albert Wertheimer, who is also a Director. Patrick Mannion has utilized services of MacKenzie Hughes law firm where Ms. Hartnett is a partner. QUESTION 6: CROUSE HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF CROUSE HEALTH HOSPITAL, INC. QUESTION 7A: CROUSE HEALTH SYSTEM, INC. APPROVES AND ELECTS THE BOARD OF DIRECTORS OF CROUSE HEALTH HOSPITAL, INC. QUESTION 7B: CERTAIN DECISIONS OF THE BOARD OF DIRECTORS OF CROUSE HEALTH HOSPITAL, INC., SUCH AS APPOINTMENT OF THE HOSPITAL PRESIDENT, ARE SUBJECT TO APPROVAL BY CROUSE HEALTH SYSTEM, INC. QUESTION 11b: HOSPITAL ACCOUNTING STAFF PROVIDES DATA TO AN INDEPENDENT ACCOUNTING FIRM (PRICEWATERHOUSECOOPERS, LLP) THAT PREPARES THE FORM 990 AND ALL REQUIRED SCHEDULES. IT IS REVIEWED BY LEGAL COUNSEL AND THE HOSPITAL CFO. THE REVIEWED FORM IS THEN PRESENTED TO THE FINANCE AND AUDIT COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL. COPIES OF FORM 990 AND ALL REQUIRED SCHEDULES ARE MADE AVAILABLE TO OTHER MEMBERS OF THE BOARD OF DIRECTORS, UPON THEIR REQUEST, PRIOR TO FILING. QUESTION 12C: CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE COMPLETED ANNUALLY BY THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES OF CROUSE HEALTH HOSPITAL, INC. ONCE COLLECTED, THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY MEMBERS OF THE CORPORATE COMPLIANCE OFFICE. ALL REPORTED POTENTIAL CONFLICTS OF INTEREST ARE EVALUATED AND DISCUSSED AMONG THE PARTIES. A REPORT IS PROVIDED TO THE BOARD OF DIRECTORS UPON COMPLETION OF THE COMPLIANCE REVIEW. QUESTIONS 15A & 15B: The compensation for the CEO is based on an annual finance/compensation committee review in conjunction with human resources. The compensation for all key employees, officers, and the rest of senior management is determined by the CEO and reviewed by the finance/compensation committee. Current compensation is compared to the national salary survey and any necessary adjustments are reviewed by the finance and audit committee of the board. Question 19: The conflict of interest policy of Crouse Hospital can be found on the Hospital's website www.crouse.org under "Corporate Compliance Handbook". Audited financial statements are available upon request. The governing documents of Crouse Hospital are not made available to the public.
GENERAL DISCLOSURE, CROUSE MEDICAL PRACTICE, PLLCIn 2010 the Hospital formed Crouse Medical Practice, PLLC ("PLLC") with paul kronenberg, m.d. hospital ceo and non-voting member of the hospital board of directors and sole member of the pllc. The PLLC was formed to further the Hospital's charitable purposes through the acquisition of physician practices and the employment of physicians. The PLLC borrowed its start-up capital on a fair market note from the Hospital, which accrues interest daily. Because the Hospital effectively controls the PLLC through contractual arrangements and maintains significant financial support of the PLLC, the PLLC's financial statements are consolidated with the System for financial statement purposes. dr. kronenberg's son is employed as a physician by the pllc. Louis Green, MD, a voting member of the Board of Directors, is an employee of the pllc. as a result, dr. green is considered as not an independent voting member of the hospital's board. All members of the Hospital's Board of Directors complete annual conflict of interest disclosures. The Board's conflict of interest policy would prevent Dr. Green from using his voting powers on the hospital Board of Directors to his own advantage as an employee of the PLLC.
Part XI Reconciliation of net assetsContributions for property acquisitions 1,794,487 Pension & post retirement changes other than periodic costs 5,860,438 Net decrease in interest in net assets of Crouse Health Foundation,Inc. 1,569,735 decrease in funds held in trust by others 83,377 ___________ TOTAL 9,308,037 ===========part xi line 5
PART VII, LINE 2All members of the Board of Directors of the Hospital except ex-officio member Paul Kronenberg are voluntary. No compensation, employee benefits or expense account allowances are received for Board services. Compensation is disclosed for employee services provided to the Hospital or its related organizations.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CROUSE HEALTH SYSTEM INC
736 IRVING AVENUESYRACUSENY13210161560473SEE PART VIINY501 C 311ANAfalse
CROUSE HEALTH FOUNDATION INC
736 IRVING AVENUESYRACUSENY13210161035427SEE PART VIINY501 C 37NAfalse
crouse medical practice pllc
730 s crouse avenue ste 204syracuseNY13210800548096SEE PART VIINYSEE PT VII7SEE PART VIItrue
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
crouse medical practice pllc
d10052155loan agreement
crouse medical practice pllc
o292423interco agrmt

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierSCHEDULE R, PART IIIdentifier
Explanationcolumn b, line 1 - crouse health system, inc.'s primary activity is to provide off-site space and secure captial. column b, line 2 - crouse health foundation, inc.'s primary activity is fundraising for crouse health hospital, inc. column b, line 3 - crouse medical practice, pllc was formed to further the hospital's charitable purproses through the acquisition of physician practices and the employment of physicians. column d, line 3 - crouse medical practice, pllc filed irs form 1023, application for tax exempt status as a 501(c)(3) corporation on april 30, 2012. column f, line 3 - direct controlling entity is crouse health hospital, inc.Explanation

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