ALICE HYDE MEDICAL CENTER: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ALICE HYDE MEDICAL CENTER (EIN 15-0346515)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-10-15
- IRS object ID
- 201322889349300547
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-10-15T12:59:39-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454051133 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREED MAXICK CPAS PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 LIBERTY BLDG 420 MAIN ST | AddressLine1 |
| City | BUFFALO | City |
| State | NY | State |
| ZIP Code | 142023508 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 150346515 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALICE HYDE MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ALIC | NameControl |
| Phone | 5184833000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1 |
| City | MALONE | City |
| State | NY | State |
| ZIP Code | 12953 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DOUGLAS DIVELLO | Name |
| Title | PRESIDENT | Title |
| Phone | 5184833000 | Phone |
| Date Signed | 2013-10-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARY MADONIA | Name |
| PTIN | P00405803 | PTIN |
| Phone | 7168472651 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DOUGLAS DIVELLO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1 |
| City | MALONE | City |
| State | NY | State |
| ZIP Code | 12953 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 70231628 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ALICEHYDE.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1905 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | TO SERVE THE COMMUNITY THROUGH ACUTE, LONG TERM AND PRIMARY HEALTHCARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 731 | TotalNbrEmployees |
| Total Nbr Volunteers | 842 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 679381 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2372179 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 65478952 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 67247947 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -36587 | InvestmentIncomePriorYear |
| Investment Income Current Year | 101036 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1241898 | OtherRevenuePriorYear |
| Other Revenue Current Year | -59353 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 67363644 | TotalRevenuePriorYear |
| Total Revenue Current Year | 69661809 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 42510371 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 42464846 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 7500 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 93982 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 26655328 | OtherExpensePriorYear |
| Other Expenses Current Year | 26314357 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 69173199 | TotalExpensesPriorYear |
| Total Expenses Current Year | 68779203 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -1809555 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 882606 | RevenuesLessExpensesCY |
| Total Assets BOY | 40880625 | TotalAssetsBOY |
| Total Assets EOY | 39770508 | TotalAssetsEOY |
| Total Liabilities BOY | 18689138 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 16620003 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 22191487 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 23150505 | NetAssetsOrFundBalancesEOY |
| Mission Description | ALICE HYDE MEDICAL CENTER WILL DISTINGUISH ITSELF AS A TRUSTED AND RESPECTED HEALTH CARE LEADER AND PROVIDER OF CHOICE, EXCEEDING EXPECTATIONS THROUGH SERVICE EXCELLENCE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 57793274 | Expense |
| Revenue | 67247947 | Revenue |
| Description | PATIENT CARE, GENERAL MEDICAL/SURGICAL HOSPITAL, PROVIDED INPATIENT SERVICES FOR 3,005 PEOPLE, OUTPATIENT SERVICES FOR 838,456 VISITS, AND PROVIDED 27,061 DAYS OF SKILLED NURSING FACILITY CARE. | Description |
| Total Program Service Expense | 57793274 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 27 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 731 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SANDRA MACDONALD CONTROLLER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5184833000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1 |
| City | MALONE | City |
| State | NY | State |
| ZIP Code | 12953 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| ANJNI BHAGAT MD | |||||||
| DIRECTOR | 10.00 | X | 46008 | 0 | 0 | ||
| WILLIAM BOND REV | |||||||
| DIRECTOR | 10.00 | X | 0 | 0 | 0 | ||
| DANIEL CLARK | |||||||
| VICE-CHAIRMAN | 10.00 | X | 0 | 0 | 0 | X | |
| WAYNE DUSO | |||||||
| DIRECTOR | 10.00 | X | 0 | 0 | 0 | ||
| JERRY GRIFFIN | |||||||
| DIRECTOR | 10.00 | X | 0 | 0 | 0 | ||
| BRYAN J HUGHES | |||||||
| DIRECTOR | 10.00 | X | 0 | 0 | 0 | ||
| DEAN JOHNSTON | |||||||
| CHAIRMAN | 10.00 | X | 0 | 0 | 0 | X | |
| BENSON KELLY MD | |||||||
| DIRECTOR | 10.00 | X | 0 | 0 | 0 | ||
| CRAIG LAVIGNE | |||||||
| SECRETARY | 10.00 | X | 0 | 0 | 0 | X | |
| THOMAS LEITZ | |||||||
| DIRECTOR | 10.00 | X | 0 | 0 | 0 | ||
| BRIAN MONETTE | |||||||
| TREASURER | 10.00 | X | 0 | 0 | 0 | X | |
| SHARON NOREAULT | |||||||
| DIRECTOR | 10.00 | X | 0 | 0 | 0 | ||
| JOHN JOHNSON | |||||||
| PRESIDENT/CEO - 1/1/12-7/6/12 | 40.00 | 251426 | 0 | 10652 | X | ||
| D CHRIS FRAUENHOFER | |||||||
| VP OF FINANCE | 40.00 | 196227 | 0 | 8278 | X | ||
| LEONARDO DISHMAN MD | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | 185870 | 0 | 5558 | X | ||
| DOUG DIVELLO | |||||||
| PRESIDENT/CEO - 7/7/12-12/31/12 | 40.00 | 106648 | 0 | 1903 | X | ||
| JOHN AUFDENGARTEN | |||||||
| VP ADMINISTRATION | 40.00 | 174964 | 0 | 395 | X | ||
| DRAGOS MACELARU MD | |||||||
| PHYSICIAN | 40.00 | 786703 | 0 | 9570 | X | ||
| MARCO BERARD MD | |||||||
| PHYSICIAN | 40.00 | 776992 | 0 | 8400 | X | ||
| RAHUL GUPTA MD | |||||||
| PHYSICIAN | 40.00 | 399199 | 0 | 5077 | X | ||
| NIKALESH REDDY MD | |||||||
| PHYSICIAN | 40.00 | 355912 | 0 | 3011 | X | ||
| MYRNA SANCHEZ MD | |||||||
| PHYSICIAN | 40.00 | 280964 | 0 | 6970 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3560913 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 59814 | TotalOtherCompensation |
| Number Individuals GT100 K | 35 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| RLPS II | |||||
| 1910 HARRINGTON DRIVE | LANCASTER | PA | 17601 | ARCHITECT | 1347690 |
| APOGEE MEDICAL MANAGEMENT | |||||
| 2525 E CAMELBACK ROAD | PHOENIX | AZ | 85016 | HOSPITALIST PROFESSIONAL | 931214 |
| MEMS PC | |||||
| 484 TEMPLE HILL ROAD | NEW WINDSOR | NY | 12553 | EMERGENCY PROFESSIONAL | 924343 |
| FLETCHER ALLEN HEALTHCARE | |||||
| PO BOX 1870 | BURLINGTON | VT | 054021870 | UROLOGY & CARDIOLOGY PROFESSIONALS | 574005 |
| WEATHERBY LOCUMS | |||||
| 6440 MILLROC DRIVE | SALT LAKE CITY | UT | 84121 | LOCUMS SERVICES | 491317 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Fundraising Events | 50825 | FundraisingEvents |
| Government Grants | 2174275 | GovernmentGrants |
| All Other Contributions | 147079 | AllOtherContributions |
| Total Contributions | 2372179 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT CARE | Description |
| Business Code | 622000 | BusinessCode |
| Total Revenue Column | 67247947 | TotalRevenueColumn |
| Related Or Exempt Function Income | 67247947 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 67247947 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 33141 | TotalRevenueColumn |
| Exclusion | $33,141 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 203579 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 268492 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -64913 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -64913 | TotalRevenueColumn |
| Exclusion | -$64,913 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 353039 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 285144 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 67895 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 67895 | TotalRevenueColumn |
| Exclusion | $67,895 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 21743 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 50825 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 16183 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5560 | TotalRevenueColumn |
| Exclusion | $5,560 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 69661809 | TotalRevenueColumn |
| Related Or Exempt Function Income | 67247947 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $41,683 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 941921 | Total |
| Management And General | 941921 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33147462 | Total |
| Program Services | 28466228 | ProgramServices |
| Management And General | 4608449 | ManagementAndGeneral |
| Fundraising | 72785 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1005235 | Total |
| Program Services | 864030 | ProgramServices |
| Management And General | 139021 | ManagementAndGeneral |
| Fundraising | 2184 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4918833 | Total |
| Program Services | 4212809 | ProgramServices |
| Management And General | 695106 | ManagementAndGeneral |
| Fundraising | 10918 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2451395 | Total |
| Program Services | 2121917 | ProgramServices |
| Management And General | 324383 | ManagementAndGeneral |
| Fundraising | 5095 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2386336 | Total |
| Program Services | 2052249 | ProgramServices |
| Management And General | 334087 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 367016 | Total |
| Management And General | 367016 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 196845 | Total |
| Management And General | 196845 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33117 | Total |
| Management And General | 33117 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3000 | Total |
| Fundraising | 3000 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88103 | Total |
| Program Services | 75769 | ProgramServices |
| Management And General | 12334 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 212668 | Total |
| Program Services | 182894 | ProgramServices |
| Management And General | 29774 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1249630 | Total |
| Program Services | 1074682 | ProgramServices |
| Management And General | 174948 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 94160 | Total |
| Program Services | 80978 | ProgramServices |
| Management And General | 13182 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 377617 | Total |
| Program Services | 324751 | ProgramServices |
| Management And General | 52866 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3022401 | Total |
| Program Services | 2599265 | ProgramServices |
| Management And General | 423136 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 721870 | Total |
| Program Services | 620808 | ProgramServices |
| Management And General | 101062 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES & IMPL | 7189827 | 6183251 | 1006576 |
| DIRECT EXPENSES | 4918428 | 4229848 | 688580 |
| PHARMACEUTICALS | 3251587 | 2796365 | 455222 |
| UTILITIES | 1474349 | 1267940 | 206409 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 727403 | Total |
| Program Services | 639490 | ProgramServices |
| Management And General | 87913 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 68779203 | Total |
| Program Services | 57793274 | ProgramServices |
| Management And General | 10891947 | ManagementAndGeneral |
| Fundraising | 93982 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46408 | BOY |
| EOY | 1162831 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10612866 | BOY |
| EOY | 9210679 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1010379 | BOY |
| EOY | 1190757 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 812837 | BOY |
| EOY | 617856 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1008806 | BOY |
| EOY | 566612 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 64855968 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 41241318 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23304091 | BOY |
| EOY | 23614650 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3057252 | BOY |
| EOY | 2366366 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1027986 | BOY |
| EOY | 1040757 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40880625 | BOY |
| EOY | 39770508 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11088840 | BOY |
| EOY | 9504770 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2752835 | BOY |
| EOY | 2759082 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4847463 | BOY |
| EOY | 4356151 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18689138 | BOY |
| EOY | 16620003 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21391821 | BOY |
| EOY | 22332059 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 615720 | BOY |
| EOY | 634500 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 183946 | BOY |
| EOY | 183946 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22191487 | BOY |
| EOY | 23150505 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40880625 | BOY |
| EOY | 39770508 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 882606 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 76412 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $33,117 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 33117 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | THE ORGANIZATION RETAINS AN OUTSIDE LOBBYIST FOR CONTACT WITH STATE AND FEDERAL ELECTED OFFICIALS REGARDING HEALTH CARE ISSUES AND GRANT FUNDING OPPORTUNITIES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 183946 | BeginningOfYearBalance |
| End Of Year Balance | 183946 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 183946 | BeginningOfYearBalance |
| End Of Year Balance | 183946 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 183946 | BeginningOfYearBalance |
| End Of Year Balance | 183946 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 183946 | BeginningOfYearBalance |
| End Of Year Balance | 183946 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 183946 | BeginningOfYearBalance |
| End Of Year Balance | 183946 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 364054 | OtherCostOrOtherBasis |
| Book Value | 364054 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 34636287 | OtherCostOrOtherBasis |
| Depreciation | 22381308 | Depreciation |
| Book Value | 12254979 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 27595105 | OtherCostOrOtherBasis |
| Depreciation | 18860010 | Depreciation |
| Book Value | 8735095 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2260522 | OtherCostOrOtherBasis |
| Book Value | 2260522 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 23614650 | TotalOfBookValueLandBuildings |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 69754404 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 76412 | NetUnrealizedGainsInvestments |
| Other Revenues | 16183 | OtherRevenues |
| Revenue Not Rptd F990 | 92595 | RevenueNotRptdF990 |
| Revenue Subtotal | 69661809 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 69661809 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 68795386 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 16183 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 16183 | ExpensesNotRptdF990 |
| Expenses Subtotal | 68779203 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 68779203 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE MEDICAL CENTER IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE), AND ACCORDINGLY, IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE MEDICAL CENTER ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH U.S. GAAP, WHICH REQUIRES THE RECOGNITION AND MEASUREMENT OF UNCERTAIN INCOME TAX POSITIONS THAT THE MEDICAL CENTER HAS TAKEN OR EXPECTS TO TAKE IN THE MEDICAL CENTER'S TAX RETURN. THE MEDICAL CENTER HAS NOT RECORDED ANY AMOUNTS RELATING TO UNCERTAIN TAX POSITIONS. IN ADDITION, THE MEDICAL CENTER IS NO LONGER SUBJECT TO FEDERAL AND NYS INCOME TAX EXAMINATION FOR YEARS PRIOR TO 2009. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES NETTED AGAINST REVENUE 16,183. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES NETTED AGAINST REVENUE 16,183. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF BENEFIT | NameOfEvent1 |
| Gross Receipts Event1 | 33758 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 28850 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 4908 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 8103 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 131 | FoodAndBeverageEvent1 |
| Other Direct Expenses Event1 | 2636 | OtherDirectExpensesEvent1 |
| Name Of Event2 | GALA | NameOfEvent2 |
| Gross Receipts Event2 | 38810 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 21975 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 16835 | GrossRevenueEvent2 |
| Food And Beverage Event2 | 3122 | FoodAndBeverageEvent2 |
| Entertainment Event2 | 800 | EntertainmentEvent2 |
| Other Direct Expenses Event2 | 1391 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 72568 | GrossReceiptsTotal |
| Charitable Contributions Total | 50825 | CharitableContributionsTotal |
| Gross Revenue Total Events | 21743 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 8103 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 3253 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 800 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 4027 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 16183 | DirectExpenseSummaryEvents |
| Net Income Summary | 5560 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 155 | PersonsServed |
| Total Community Benefit Expense | 943014 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 902604 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 40410 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00060 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15106219 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12031392 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3074827 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04470 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 155 | PersonsServed |
| Total Community Benefit Expense | 16049233 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12933996 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3115237 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04530 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2337 | PersonsServed |
| Total Community Benefit Expense | 83878 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 27757 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 56121 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 37181 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 37181 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00050 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2337 | PersonsServed |
| Total Community Benefit Expense | 121059 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 27757 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 93302 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Persons Served | 2492 | PersonsServed |
| Total Community Benefit Expense | 16170292 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12961753 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3208539 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04660 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,336,277 | BadDebtExpenseAmount |
| Amount Attributable To | 1173367 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11479258 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12340156 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -860898 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALICE HYDE MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1 |
| City | MALONE | City |
| State | NY | State |
| ZIP Code | 12953 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | ALICEHYDE.COM | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALICE HYDE MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 300.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALICE HYDE NURSING HOME | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1 |
| City | MALONE | City |
| State | NY | State |
| ZIP Code | 12953 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | SKILLED NURSING FACILITY | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: UTILIZED IRS WORKSHEETS FOR SCHEDULE H AND RATIO OF COST TO CHARGES. | ||
| PART I, L7 COL(F): BAD DEBT WAS NOT INCLUDED IN CALCULATIONS IN SCHEDULE H, PART I, LINE 7. | ||
| PART III, LINE 4: THE MEDICAL CENTER RECOGNIZES PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALITY FOR CHARITY CARE, THE MEDICAL CENTER RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). BASED UPON HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF THE MEDICAL CENTERS UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE MEDICAL CENTER RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. | ||
| PART III, LINE 8: THE MEDICARE BENEFICIARIES WHO ALICE HYDE PROVIDES SERVICES TO ARE PART OF OUR COMMUNITY OF MALONE, NEW YORK, AND THEREFORE, SHOULD BE TREATED AS COMMUNITY BENEFIT. THE SOURCE FOR THE COST METHODOLOGY IS THE 2012 MEDICARE COST REPORT. | ||
| PART III, LINE 9B: THE CENTER PROVIDE CARE TO CLIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CENTERS POLICY IS NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE THESE AMOUNTS ARE NOT REPORTED IN NET OPERATING REVENUES OR IN PROVISIONS FOR DOUBTFUL ACCOUNTS. THE ESTIMATED COST OF PROVIDING UNCOMPENSATED CARE TO PATIENTS WAS APPROXIMATELY $1,000,000 FOR THE YEAR ENDED DECEMBER 31, 2012 ($731,000- 2011), AS MEASURED UTILIZING A CALCULATED RATIO OF COSTS TO CHARGES. | ||
| PART V, SECTION B, LINE 11: ANY PATIENT WIHOUT INSURANCE IS GIVEN A DISCOUNT EQUAL TO THE LOWEST NEGOCIATED COMMERICAL INSURANCE RATE. | ALICE HYDE MEDICAL CENTER | |
| THE ALICE HYDE MEDICAL CENTER (AHMC) BELIEVES THAT FEAR OF A MEDICAL BILL SHOULD NOT PRECLUDE A RESIDENT OF ITS COMMUNITY FROM SEEKING OR OBTAINING ESSENTIAL HEALTH CARE SERVICES. TO HELP THOSE WHO ARE UNINSURED, AHMC PARTNERS WTIH VARIOUS ORGANIZATIONS, INCLUDING THE FRANKLIN COUNTY DEPARTMENT OF SOCIAL SERVICES, PUBLIC HEALTH, FIDELIS, AND EXCELLUS, TO ENSURE ACCURATE INFORMATION AND RESOURCES ARE AVAILABLE THROUGHOUT THE COMMUNITY, INCLUDING A FACILITATED ENROLLMENT PROGRAM FOR ITS UNINSURED PATIENTS. THIS PROGRAM ASSISTS INDIVIDUALS IN APPLYING FOR STATE SPONSORED HEALTH INSUANCE INCLUDING MEDICAID, CHILD HEALTH PLUS AND FAMILY HEALTH PLUS. THE GOAL OF THIS INITATIVE IS TO PROVIDE A CONVENIENT LOCATION FOR PATIENTS AND COMMUNITY MEMBERS TO ACCESS THE PROGRAM AND TO PROVIDE ASSISTANCE IN COMPLETING HEALTH INSURANCE APPLICATIONS. THESE GOALS ARE MET THROUGH A PARTNERSHIP BETWEEN AHMC AND UPPER HUDSON PRIMARY CARE CONSORTIUM. AHMC HAS AN EMPLOYEE DEDICATED TO FINANCIAL COUNSELING AND ASSISTANCE. | FORM 990, SCHEDULE H, PART VI, LINE 3 | |
| ALICE HYDE MEDICAL CENTER (AHMC) PRIMARILY SERVES TOWNS, VILLAGES, AND THE NATIVE AMERICAN RESERVATION IN FRANKLIN COUNTY. AHMC'S PRIMARY SERVICE AREA COVERS THE FOLLOWING TOWNS (BY ZIP CODE) - MALONE (12953), NORTH BANGOR (12966), CHATEAUGAY (12920), CONSTABLE (12926), BRUSHTON (12916), MOIRA(12957), BURKE (12917), FORT COVINGTON (12937), HOGANSBURG (13655), SAINT REGIS FALLS (12980),BOMBAY (12914), OWLS HEAD (12969), DICKINSON CENTER (12930). THE SECONDARY SERVICE AREAS SERVED BY AHMC INCLUDE CHURUBUSCO (12923), ELLENBURG CENTER (12934), NORTH LAWRENCE (12967), LYON MOUNTAIN (12955), NICHOLVILLE (12965). IN ADDITION, AHMC PROVIDES SERVICES TO THE INMATE POPULATION FOR THE FRANKLIN COUNTY JAIL AND THE CLINTON, FRANKLIN, UPSTATE, BAREHILL, CHATEAUGAY, ALTONA AND ADIRONDACK CORRECTIONAL FACILITIES. | FORM 990, SCHEDULE H, PART VI, LINE 4 | |
| NEW YORK STATE | FORM 990, SCHEDULE H, PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Written Policy Re T And E Expenses | 0 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 0 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN JOHNSON | ||||||||||||||
| PRESIDENT/CEO - 1/1/12-7/6/12 | 249846 | 0 | 0 | 0 | 1580 | 0 | 8322 | 0 | 2330 | 0 | 262078 | 0 | 0 | 0 |
| D CHRIS FRAUENHOFER | ||||||||||||||
| VP OF FINANCE | 196227 | 0 | 0 | 0 | 0 | 0 | 7663 | 0 | 615 | 0 | 204505 | 0 | 0 | 0 |
| LEONARDO DISHMAN MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | 185870 | 0 | 0 | 0 | 0 | 0 | 5558 | 0 | 0 | 0 | 191428 | 0 | 0 | 0 |
| JOHN AUFDENGARTEN | ||||||||||||||
| VP ADMINISTRATION | 174964 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 395 | 0 | 175359 | 0 | 0 | 0 |
| DRAGOS MACELARU MD | ||||||||||||||
| PHYSICIAN | 536703 | 0 | 250000 | 0 | 0 | 0 | 7500 | 0 | 2070 | 0 | 796273 | 0 | 0 | 0 |
| MARCO BERARD MD | ||||||||||||||
| PHYSICIAN | 526992 | 0 | 250000 | 0 | 0 | 0 | 7500 | 0 | 900 | 0 | 785392 | 0 | 0 | 0 |
| RAHUL GUPTA MD | ||||||||||||||
| PHYSICIAN | 399199 | 0 | 0 | 0 | 0 | 0 | 5077 | 0 | 0 | 0 | 404276 | 0 | 0 | 0 |
| NIKALESH REDDY MD | ||||||||||||||
| PHYSICIAN | 355912 | 0 | 0 | 0 | 0 | 0 | 2513 | 0 | 498 | 0 | 358923 | 0 | 0 | 0 |
| MYRNA SANCHEZ MD | ||||||||||||||
| PHYSICIAN | 280964 | 0 | 0 | 0 | 0 | 0 | 5590 | 0 | 1380 | 0 | 287934 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 1B | ReturnReference |
| Explanation | AS PART OF THE PRESIDENT'S COMPENSATION PACKAGE CONSIDERED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, THE ALICE HYDE MEDICAL CENTER (AHMC) PROVIDED FOR THE CONTINUED FORGIVENESS OF CERTAIN OBLIGATIONS UNDER A NOTE EXECUTED BY THE PRESIDENT ON JULY 27, 2004 CONTEMPORANEOUS WITH THE TRANSFER OF A CERTAIN LIFE INSURANCE POLICY AND FOR TAX INDEMNIFICATION AND GROSS UP PAYMENTS RELATED THERETO. THE PRESIDENT'S RIGHT TO SUCH ADDITIONAL COMPENSATION IS SPECIFICALLY CONDITIONED ON HIS CONTINUTED PERFORMANCE OF SUBSTANTIAL SERVICES IN ACCORDANCE WITH THE PRESIDENT'S EMPLOYMENT AGREEMENT, AS AMENDED. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS PREPARED BY AN INDEPENDENT OUTSIDE ACCOUNTING FIRM. IT IS PROVIDED TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE BOARD OF DIRECTORS. SPECIFICALLY, THE POLICY REQUIRES A DISCLOSURE OF ANY POTENTIAL CONFLICT TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS THEN REFERS THE POTENTIAL CONFLICT TO THE AUDIT AND COMPLIANCE COMMITTEE TO REVIEW THE MATTER. THE AUDIT AND COMPLIANCE COMMITTEE REVIEWS THE PROPOSED TRANSACTION OR ARRANGEMENT TO DETERMINE IF REASONABLE ATLTERNATIVES TO THE PROPOSED TRANSACTION EXIST. BASED ON REVIEW, THE AUDIT AND COMPLIANCE COMMITTEE SHALL APPROVE OR DISAPPROVE THE TRANSACTION. ALL FINDINGS AND ACTIONS TAKEN BY THE AUDIT AND COMPLIANCE COMMITTEE ARE REPORTED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED MEETING OF THE BOARD OF DIRECTORS. IN ADDITION, THE AUDIT AND COMPLIANCE COMMITTEE AND THE ORGANIZATION COMPLIANCE OFFICER IS RESPONSIBLE FOR REVIEWING AND RETAINING ANNUAL DISCLOSURE STATEMENTS COMPLETED BY EACH DIRECTOR, OFFICER, COMMITTEE MEMBER AND KEY EMPLOYEE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMING THE BEGINNING OF THE YEAR PRESIDENT/CEO'S COMPENSATION WAS ESTABLISHED AT CONTRACT RENEWAL IN 2012. THE PROCESS IS AS FOLLOWS: THE BOARD OF DIRECTORS REVIEWED IN DEPTH THE RECOMMENDATION OF THE PRESIDENT/CEO EVALUATION AND COMPENSATION COMMITTEE ("COMPENSATION COMMITTEE") RELATING TO THE EXTENSION OF THE EMPLOYMENT CONTRACT OF THE CURRENT PRESIDENT/CEO AND UNANIMOUSLY APPROVED SUCH EXTENSION. THE PRESIDENT/CEO WAS NOT PRESENT AT THIS MEETING OR ANY OTHER MEETING AT WHICH HIS COMPENSATION WAS CONSIDERED. AS PART OF ITS REVIEW AND DISCUSSION, THE FULL BOARD OF DIRECTORS DISCUSSED THE DATA PREVIOUSLY REVIEWED BY THE COMPENSATION COMMITTEE. THIS DATA INCLUDED, BUT WAS NOT LIMITED TO, COMPARABILITY DATA COMPILED BY YAFFEE AND COMPANY, INC. AS PROVIDED TO AHMC BY THE IROQUOIS HOSPITAL ASSOCIAITON FOR THE YEAR 2012. SPECIFICALLY, THE COMPENSATION COMMITTEE REVIEWED THE DATA AND REPORTED RESULTS OF THIS REVIEW TO THE BOARD OF DIRECTORS, CONCERNING BASE SALARY AND TOTAL COMPENSATION FOR ALL THE OFFICERS AT FACILITIES LOCATED WITHIN THE RANGE FOR SIMILARY SITUATED OFFICERS. THE COMPENSATION COMMITTEE ALSO REVIEWD DATA COMPILED BY THE IROQUOIS HEALTHCARE ASSOCIATION/ROCHESTER REGIONAL HOSPITAL ASSOCIATION WESTERN NEW YORK HOSPITAL ASSOCIATION FOR 2012 RELATING TO COMPARABLE CEO INCENTIVE PLANS, LIFE INSURANCE (BASIC AND SUPPLEMENTAL), LONG TERM DISABILITY PLANS, SUPPLEMENTAL/EXECUTIVE RETIREMENT PLANS, CONTRACT LENGTH INFORMATION, SEVERANCE PAY INFORMATION AND PREREQUISITES SUMMARY. IT WAS FINALLY DETERMINED THAT THE PRESIDENT/CEO'S PROPOSED CONTRACT EXTENSION WAS REASONABLE AND COMPARABLE IN LIGHT OF THE AFOREMENTIONED INFORMATION. THE PROCESS FOR DETERMINING THE PRESIDENT/CEO AT THE END OF THE YEAR'S COMPENSATION WAS SIMILIAR. THE PROCESS FOR DETERMINING THE COMPENSATION FOR KEY EMPLOYEES OF THE ORGANIZATION INCLUDES A REVIEW OF EXECUTIVE COMPENSATION SURVEYS. THIS REVIEW IS COMPLETED BY THE HUMAN RESOURCES DIRECTOR AND THE PRESIDENT/CEO. COMPENSATION IS DETERMINED BASED ON THE SPECIFIC RESPONSIBILIES DELEGATED TO THE POSITION HELD BY THE KEY EMPLOYEE. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE COMPLETED FORMS 1023, 990, AND 5500 FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 2C | THERE HAVE BEEN NO CHANGES FROM THE PRIOR YEAR TO THE PROCESS THAT THE ORGANIZATION HAS IN PLACE FOR THE OVERSIGHT OF THE AUDIT OR THE SELECTION OF AN INDEPENDENT ACCOUNTANT. |
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