CORNING HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
CORNING HOSPITAL (EIN 16-0393490)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-13
IRS object ID
201203189349304405
Schema version
2011v1.3
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)
Timestamp2012-11-13T16:14:10-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

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 Line12001 MARKET ST SUITE 1700AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN160393490EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CORNING HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% FRANCIS M MACAFEEInCareOfName
Name ControlCORNNameControl
Phone6099377200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1176 DENISON PARKWAY EAddressLine1
CityCORNINGCity
StateNYState
ZIP Code148302814ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameFRANCIS M MACAFEEName
TitleCFOTitle
Date Signed2012-11-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone2673303000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonShirley MaganaNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1176 Denison Parkway eAddressLine1
CityCorningCity
StateNYState
ZIP Code14830ZIPCode
FieldValueIRS element (for citing)
Gross Receipts258016300GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitehttp://www.corninghospital.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1900YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionPROVIDE MEDICAL CARE SERVICES TO THE PUBLIC. HELP EACH PERSON ATTAIN OPTIMAL, LIFE-LONG HEALTH AND WELL-BEING BY PROVIDING CLINICALLY- ADVANCED SERVICES TO PREVENT, DIAGNOSE AND TREAT DISEASE.ActivityOrMissionDescription
Nbr Voting Members Governing Body25NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees683TotalNbrEmployees
Total Nbr Volunteers88TotalNbrVolunteers
Total Gross UBI606665TotalGrossUBI
Net Unrelated Business Txbl Income21705NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year257009ContributionsGrantsPriorYear
Contributions Grants Current Year545477ContributionsGrantsCurrentYear
Program Service Revenue Prior Year75805048ProgramServiceRevenuePriorYear
Program Service Revenue CY82086631ProgramServiceRevenueCY
Investment Income Prior Year4543782InvestmentIncomePriorYear
Investment Income Current Year67364InvestmentIncomeCurrentYear
Other Revenue Prior Year-408504OtherRevenuePriorYear
Other Revenue Current Year218462OtherRevenueCurrentYear
Total Revenue Prior Year80197335TotalRevenuePriorYear
Total Revenue Current Year82917934TotalRevenueCurrentYear
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 Year33001870SalariesEtcPriorYear
Salaries Etc Current Year31430568SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year132963TotalFundrsngExpCurrentYear
Other Expense Prior Year34434485OtherExpensePriorYear
Other Expenses Current Year41118113OtherExpensesCurrentYear
Total Expenses Prior Year67436355TotalExpensesPriorYear
Total Expenses Current Year72548681TotalExpensesCurrentYear
Revenues Less Expenses Prior Year12760980RevenuesLessExpensesPriorYear
Revenues Less Expenses CY10369253RevenuesLessExpensesCY
Total Assets BOY113005196TotalAssetsBOY
Total Assets EOY132327686TotalAssetsEOY
Total Liabilities BOY42362792TotalLiabilitiesBOY
Total Liabilities EOY57943683TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY70642404NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY74384003NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionHELP EACH PERSON ATTAIN OPTIMAL, LIFE-LONG HEALTH AND WELL-BEING BY PROVIDING INTEGRATED CLINICALLY-ADVANCED SERVICES THAT DIAGNOSE, PREVENT AND TREAT DISEASE WITHIN AN ENVIRONMENT OF COMPASSION, LEARNING AND DISCOVERY. MAKING A MEANINGFUL DIFFERENCE IN LIVES OF THOSE WE SERVE THROUGH COMPASSION AND EXCELLENCE IN HEALTH CARE. EVERY PERSON. EVERY TIME.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense54521168Expense
Revenue82086631Revenue
DescriptionWe are a 99-bed acute care facility with 24 hour emergency services and a full compliment of inpatient and out-patient treatment services. Inpatient days of 14,963 and outpatient visits of 122,376. Run a Cancer Center therapeutic radiology extension clinic with medical oncology and cancer support services, and a Wellness & Fitness Center that is a medical fitness & rehabilitation extension clinic. Other programs include cardiac rehab/wellness, diabetes classes, JointCamp, Smoke Stoppers, executive health, and screening programs. No one denied emergency care based on ability to pay. Have a charity care policy for medically necessary services.Description
Total Program Service Expense54521168TotalProgramServiceExpense
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 AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
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 BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
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 OrgtrueTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees683NumberOfEmployees
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 ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members25NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
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 VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonFRANCIS M MACAFEENamePerson
Telephone Number6079377917TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1176 DENSION PARKWAY EAddressLine1
CityCORNINGCity
StateNYState
ZIP Code14830ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (35 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
DAVID E IOCCO
MEMBER - BOD1.0X000
MICHAEL W DONNELLY
MEMBER - BOD1.0X000
ARTHUR D FIELD
MEMBER - BOD1.0X000
JUDITH ROWE
MEMBER - BOD1.0X000
DAVID AUSTIN MD
MEMBER-BOD-MED STAFF VP1.0X035365444293
JOHN E BENJAMIN
MEMBER - BOD1.0X000
DANIEL BOWER
MEMBER - BOD1.0X000
CHARLES A CORRAO
MEMBER - BOD1.0X000
LOUIS R DUBOIS MD
MEMBER-BOD-Med Staff Pres.1.0X036416144293
ALAN LEWIS
MEMBER - BOD1.0X000
DAVID LYONS
MEMBER - BOD1.0X000
J MICHAEL SCALZONE MD
MEMBER - BOD Med Staff Sec.1.0X031726844293
MARK STENSAGER
MEMBER - BOD1.0X058493020217
G THOMAS TRANTER JR
1st VICE CHAIR-BOD1.0X000
JOHN VAN ZANTEN
MEMBER - BOD1.0X000
MARCIA WEBER
MEMBER - BOD1.0X000
RUSSELL C WOGLOM MD
MEMBER - BOD1.0X030176144293
JEFFREY KENEFICK
TREASURER - BOD1.0X000
CHRISTOPHER FORTIER
MEMBER - BOD1.0X000
David McCorvey MD
MEMBER-BOD-Med Staff Treas.1.0X022607532896
Philip J Roche ESQ
CHAIRMAN - BOD1.0X000
Mary Beth Grimaldi-Maxa
MEMBER - BOD1.0X000
Shirley Magana
President/COO40.0X248740014992X
KEVIN CORLISS
MEMBER - BOD1.0X000
FRAN OLMSTEAD
MEMBER-BOD1.0X000
DANIEL ROURKE
MEMBER-BOD1.0X000
CATHY WEIL
MEMBER-BOD1.0X000
FRANCIS M MACAFEE
CFO/VP FINANCE40.0166357012193X
LAURA MANNING
DIRECTOR HR OPERATIONS40.001193796708X
DEBRA RAUPERS
CHIEF NURSING OFFICER40.0124363018043X
AMYBETH MILLER
PHARMACIST40.0106524010331X
Gregory Kriel
Pharmacist40.0147157016082X
Scott Stevens
Pharmacist40.0127577014417X
Lori Wade
Director Pharmacy40.0106089010730X
Evan Davis
Pharmacist40.0128141018504X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1154948TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2267228TotalReportableCompFrmRltdOrgs
Total Other Compensation352285TotalOtherCompensation
Number Individuals GT100 K9NumberIndividualsGT100K
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
BEACON PARTNERS
97 LIBBEY PARKWAY STE 310WEYMOUTHMA02189IMPLEMENT & TESTING391694
Quest Diagnostics
2249 COLLECTION CENTER DRIVECHICAGOIL60693Lab Pathology Servs312871
SIEMENS MEDICAL
51 VALLEY STREAM PARKWAYMALVERNPA19355MAINT SVCE AGREEMT293674
EXECUTIVE HEALTH RESOURCE
PO Box 822688PHILADELPHIAPA19182CONSULT-HEALTHRECORD236200
STEVENS AND LEE
PO Box 679READINGPA19603LEGAL SERVICES218275
FieldValueIRS element (for citing)
Number Of Contractors GT100 K11NumberOfContractorsGT100K
Government Grants367277GovernmentGrants
All Other Contributions178200AllOtherContributions
Total Contributions545477TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENUE6219907915064479150644
OTHER OPERATING INCOME90009923293222329322
MEDICAL LAB SERVICES621500606665606665
FieldValueIRS element (for citing)
Total Program Service Revenue82086631TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2334667TotalRevenueColumn
Exclusion$2,334,667ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real81041Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real-137421Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real218462Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column218462TotalRevenueColumn
Exclusion$218,462ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities172959684Securities
Other8800Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities174989848Securities
Other245939Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-2030164Securities
Other-237139Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-2267303TotalRevenueColumn
Exclusion-$2,267,303ExclusionAmount

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
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column82917934TotalRevenueColumn
Related Or Exempt Function Income81479966RelatedOrExemptFunctionIncome
Unrelated Business Revenue606665UnrelatedBusinessRevenue
Exclusion$285,826ExclusionAmount

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)
Total584688Total
Management And General584688ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23354438Total
Program Services20162559ProgramServices
Management And General3166111ManagementAndGeneral
Fundraising25768Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1598322Total
Program Services1345316ProgramServices
Management And General251285ManagementAndGeneral
Fundraising1721Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4129018Total
Program Services3465200ProgramServices
Management And General660300ManagementAndGeneral
Fundraising3518Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1764102Total
Program Services1482817ProgramServices
Management And General279406ManagementAndGeneral
Fundraising1879Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2330472Total
Management And General2330472ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total258437Total
Management And General258437ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total648418Total
Management And General648418ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

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)
Total8316658Total
Program Services5290402ProgramServices
Management And General3024070ManagementAndGeneral
Fundraising2186Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total53614Total
Program Services132ProgramServices
Management And General53482ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2090726Total
Program Services1197724ProgramServices
Management And General804002ManagementAndGeneral
Fundraising89000Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2474094Total
Program Services668868ProgramServices
Management And General1805226ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1875723Total
Program Services232710ProgramServices
Management And General1640918ManagementAndGeneral
Fundraising2095Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total95218Total
Program Services36770ProgramServices
Management And General58416ManagementAndGeneral
Fundraising32Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total69228Total
Program Services8825ProgramServices
Management And General60403ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total99020Total
Management And General99020ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3615121Total
Program Services2695782ProgramServices
Management And General915626ManagementAndGeneral
Fundraising3713Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total659942Total
Management And General659942ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBT EXPENSE39974914297656-300165
ACCRETION453216453216
CAFETERIA AND CATERING1338599613570734-18482183
UBI AND SALES TAX-138835-1410952260

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total833574Total
Program Services206768ProgramServices
Management And General623838ManagementAndGeneral
Fundraising2968Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total72548681Total
Program Services54521168ProgramServices
Management And General17894550ManagementAndGeneral
Fundraising132963Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY8646592BOY
EOY4211759EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY34000BOY
EOY184983EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7585230BOY
EOY9201235EOY

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)
BOY955415BOY
EOY3004673EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1292955BOY
EOY1486453EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1590553BOY
EOY1594703EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis64084456LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec46972116LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY16355268BOY
EOY17112340EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY76482239BOY
EOY94529755EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY62944BOY
EOY1001785EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY113005196BOY
EOY132327686EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6370836BOY
EOY8272724EOY

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)
BOY1425000BOY
EOY5935604EOY

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)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY34566956BOY
EOY43735355EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY42362792BOY
EOY57943683EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY69421750BOY
EOY73164249EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY392230BOY
EOY391330EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY828424BOY
EOY828424EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY70642404BOY
EOY74384003EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY113005196BOY
EOY132327686EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses10369253ReconcilationRevenueExpenses
Reconcilation Other Changes-6627654ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

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
VolunteerstrueVolunteers
Paid Staff Or ManagementtruePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$2,160DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$18,823OtherActivitiesAmount
Total Lobbying Expenditures IIB20983TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifierExplanationExplanation
PART II-B LINE 1JAmerican Hospital Association, Hospital Association of New York State, and Rochester Regional Healthcare Associates memberships
PART II-B LINE 1GMEETINGS WITH VARIOUS LEGISLATORS

Schedule D IRS990ScheduleD

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

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1220654BeginningOfYearBalance
Contributions476603Contributions
Investment Earnings Or Losses6849InvestmentEarningsOrLosses
Other Expenditures484352OtherExpenditures
End Of Year Balance1219754EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1100445BeginningOfYearBalance
Contributions205846Contributions
Investment Earnings Or Losses47423InvestmentEarningsOrLosses
Other Expenditures133060OtherExpenditures
End Of Year Balance1220654EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1511610BeginningOfYearBalance
Contributions405722Contributions
Investment Earnings Or Losses100939InvestmentEarningsOrLosses
Other Expenditures917826OtherExpenditures
End Of Year Balance1100445EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1632599BeginningOfYearBalance
Contributions497193Contributions
Investment Earnings Or Losses-114295InvestmentEarningsOrLosses
Other Expenditures503887OtherExpenditures
End Of Year Balance1511610EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.68000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.32000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1537489OtherCostOrOtherBasis
Book Value1537489BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis27348127OtherCostOrOtherBasis
Depreciation22838023Depreciation
Book Value4510104BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1815098OtherCostOrOtherBasis
Depreciation760158Depreciation
Book Value1054940BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis32224399OtherCostOrOtherBasis
Depreciation23373935Depreciation
Book Value8850464BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1159343OtherCostOrOtherBasis
Book Value1159343BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings17112340TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
DUE TO THIRD PARTY PAYORS$6,970,828
ACCRUED PENSION COST$11,825,894
WORKERS COMP. AND LIABILITY$15,747,875
ASSET RETIREMENT OBLIGATION$9,079,107
DUE TO RELATED PARTIES$111,651
FieldValueIRS element (for citing)
Total Of Amounts43735355TotalOfAmounts

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 Expense489498TotalCommunityBenefitExpense
Net Community Benefit Expense489498NetCommunityBenefitExpense
Percent Of Total Expense0.00710PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense6335535TotalCommunityBenefitExpense
Direct Offsetting Revenue5646071DirectOffsettingRevenue
Net Community Benefit Expense689464NetCommunityBenefitExpense
Percent Of Total Expense0.01010PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense6825033TotalCommunityBenefitExpense
Direct Offsetting Revenue5646071DirectOffsettingRevenue
Net Community Benefit Expense1178962NetCommunityBenefitExpense
Percent Of Total Expense0.01720PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense71669TotalCommunityBenefitExpense
Net Community Benefit Expense71669NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense71669TotalCommunityBenefitExpense
Net Community Benefit Expense71669NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense6896702TotalCommunityBenefitExpense
Direct Offsetting Revenue5646071DirectOffsettingRevenue
Net Community Benefit Expense1250631NetCommunityBenefitExpense
Percent Of Total Expense0.01820PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,862,801BadDebtExpenseAmount
Amount Reimbursed By Medicare27002512AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare32712542CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5710030MedicareSurplusOrShortfall
Costing Methodology UsedCostingMethodologyUsed
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
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 Line1Corning HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1176 Denison Pkwy EAddressLine1
CityCorningCity
StateNYState
ZIP Code14830ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Corning HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent300.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Uninsured DiscountXUninsuredDiscount
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1HealthworksBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line19768 Liberty DriveAddressLine1
CityPainted PostCity
StateNYState
ZIP Code14870ZIPCode
FieldValueIRS element (for citing)
Facility TypeWellness and Fitness Center, a portion is dedicated to not for profit fitness centerFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (6 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 6ACORNING HOSPITAL FILES A COMMUNITY SERVICE PLAN IN RESPONSE TO NEW YORK STATE DEPARTMENT OF HEALTH REQUIREMENTS. PART I, LINE 7 - Information reported on Schedule H Part I, Line 7 was derived utilizing the ratio of cost to charges calculated using Worksheet 2 except Line 7b which was based upon an internal cost accounting system that addresses all patient segments.
PART III, LINE 4FOOTNOTE FROM AUDITED FINANCIALS Charity Care and Community Service The Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The direct and indirect costs associated with these services for charity care provided by the Company approximate $212,971 and $279,589 in 2011 and 2010, respectively. The Company estimated these costs by application of the standard cost-to-charge ratio. As part of its charitable mission, the Hospital provides care through its emergency department. It ensures that an emergency admission or treatment is not delayed or denied pending determination of coverage or a requirement for prepayment or deposit. As a result of this policy, the Hospital had approximately $1,213,670 and $1,072,148 in bad debts in 2011 and 2010, respectively. Revenues generated from patients who participate in the Medicaid program are subject to substantial discounts that result in reimbursement for services rendered below the cost of providing such services. In order for patients to meet the guidelines for the Medicaid program, various income-based criteria must be met that validate the patient's inability to pay for services and ineligibility under other programs. The estimated loss incurred from providing services to Medicaid patients amounted to approximately $2,022,050 and $2,139,099 in 2011 and 2010, respectively. The provision for bad debts is net of pool receipts of approximately $1,651,500 and $1,603,500 in 2011 and 2010, respectively. PART III, LINE 8 Internal cost accounting system utilized to identify Medicare revenue and Medicare cost. PART III, LINE 9B The current collection policy does not specifically address and segregate collection efforts during the charity care application process. PART V, LINE 19D FAP eligible patients whose income falls between 0-100% of Federal Poverty Guidelines receives 100% discount of eligible charges. Patients whose income falls between 101-200% of FPG receives an 80% discount of eligible charges.
PART VI, LINE 2Needs Assessment Description of Service Area The Hospital's primary service area encompasses all of Steuben County, NY, with a number of patients coming from Chemung and Schuyler counties, NY as well as Tioga County, Pa. In addition to Corning and Painted Post, NY, patients utilizing the Hospital also come from the surrounding communities of Addison, Bath, Big Flats, Beaver Dams, Campbell, and Savona, NY. Participants and the Hospital role Participants The Hospital's Board of Directors, Auxiliary members, medical staff and leadership team represent a cross-section of the community and are actively involved in helping assess local health needs. In addition, the Board-appointed Planning and Community Relations Committee is responsible for providing oversight of the Hospital's community-based activities and has multiple connections within the greater Corning area's community and service organizations. Members of the Hospital's Planning and Community Relations Committee have met regularly with representatives of the Steuben County Department of Health, the Steuben Rural Health Network, and other providers to assess and plan for addressing Steuben County's most pressing health issues. The objective assessment of the current health priorities for the Hospital's service area was developed by Steuben County Public Health (see description in Section IV). Identification of Public Health Priorities A. The Community Health Assessment in six of the seven counties included in the S2AY Rural Health Network (Seneca, Schuyler, Steuben, Ontario, Wayne and Yates) continues to be used to identify and compare data between Network counties and develop common objectives. The priority areas selected for Corning Hospital are: 1. Access to Care 2. Chronic Disease B. Status of Priorities The Hospital's Fit and Strong Together (FAST) committee, formed to address prevention priorities, has been successful at initiating and/or implementing a number of programs relating to chronic disease that are aimed at impacting the resulting health-related issues documented as arising from childhood obesity and poor nutrition and fitness. They have made numerous presentations to insurers, providers, corporations, civic groups and others to raise awareness of their efforts and to engage the entire community. FAST has also successfully obtained funding for training, supplies, equipment and materials related to the programs being implemented. The goal of this more focused approach is to have a definitive impact on access to care for obese children (and their families) in need of lifestyle management that will improve their health. Aligning this priority with the Hospital's work to address childhood obesity utilizes the expertise and synergy of FAST to address an unmet community health need. C. Plan of Action Update PE4Life program: PE4Life is geared at reducing childhood obesity in school age children. Corning Hospital and the Fit and Strong Together Community Coalition has worked with the Corning-Painted Post School District (C-PP) to successfully implement the PE4Life (fitness for life) program in the second grades for three of its six elementary schools during the last school year. Additionally, students in the PE4Life program last year stayed with the program during the next school year as third graders. One of the goals of implementing PE4Life was to provide PE (Physical Education) five days/week. This was quite challenging for the C-PP District due to lack of appropriate space and curriculum mandates in the elementary schools. This goal was met through the commitment and collaboration of District PE educators, administrators, and classroom teachers. Funding acquired through FAST paid for PE4Life training for PE teachers and other C-PP staff as well as pull-up bars, age-appropriate heart-rate monitors and other equipment for the children in the program. More funding is being secured to train additional C-PP personnel and purchase more equipment to allow for further expansion of the program. PE4Life is using BMI as the metric - and any change in BMI - as the performance measure for this program. BMI data was obtained for students participating in the program at the start of the 2010-2011 school year and compared to BMI data taken at the end of the school year. The second graders in the PE4LIfe program for the year 2010-11 did show a decrease in BMI Percentile, and the data for 2011-12 is currently incomplete and will be analyzed in fall 2012 when we have complete data. Cool 2B Fit: This program is funded by Excellus Blue Cross/Blue Shield and was introduced in C-PP elementary schools two years ago. The program includes second, third and fourth grade students and provides them with tools (correct portion-sized plate, wrist-watch heart rate monitor, backpack, etc.) and information to take home and share with their families. The program engages students in interactive activities, such as food tastings, making healthy snacks, grocery shopping and reading food labels. The goal is to help students, and their families, make healthy food choices at school and at home. CPP tracks the numbers of students involved in this program, and uses surveys to assess student reactions and perceptions of the program. 5-2-1-0: This program offers children a simple way to remember the healthy choices they should strive to make each day. Specifically, the numbers represent the following daily health guidelines: 5 servings of fruits/vegetables, no more than 2 hours of screen time, 1 hour of vigorous activity/play, and no sugary drinks. Informational posters and flyers about 5-2-1-0 have been distributed throughout the C-PP District, the Corning Community Y, Southeast Steuben County Library, Corning City Parks and Recreation program and other organizations throughout the region. May 5-12, 2012, a 5-2-1-0 Week was declared in Corning, NY. Over 20,000 informational flyers were distributed at Wegman's grocery store. A declaration was read in the town square in conjunction with Corning Clean Up day and an hour long Zumba class was held in the square for the community. Childhood Obesity Referral Program: The Fit and Strong Together community coalition is attempting to acquire funding to establish a program to which pediatricians and other providers can refer obese children for guidance with lifestyle issues. In terms of program design, a number of avenues are being evaluated, including: duplication of a similar program (Fit Families in The Southern Tier, serving Chemung Co, NY); Healthy Kids Day: Healthy Kids Day for the greater Corning area, held May 12, 2012. This event was well attended with hundreds of children and their families availing themselves of information on a host of health topics as well as watching demonstrations and engaging in activities. This event will be held again in 2013 at the Corning Community YMCA. D. Non-Prevention Priorities Considered in the Assessment Process The Hospital is actively engaged with the community on many levels and hosts or participates in a variety of activities related to community health and well-being, including health education and health screenings.
PART VI, LINE 3Patients are aware of charity care assistance through signage and handout materials samples of the content is as follows: Signage content: Patient Notice of Financial Assistance for the Uninsured and/or Underinsured Guthrie Health is proud of its mission to provide quality care to all who need it. If you do not have health insurance or worry that you may not be able to pay for part or all of your care, we may be able to help. Guthrie Health provides financial aid to patients based on their income, assets, and financial needs. In addition, we may be able to help you get free or low-cost health insurance or work with you to arrange a manageable payment plan. Federal and state laws require all hospitals / clinics to seek payment for care provided. This means we could ultimately turn unpaid bills over to a collections agency, which could affect your credit status. Therefore, it is important that you let us know if there may be a problem paying your bill. For more information, please contact our patient financial services office at 570-882-2051. We will treat your questions and any information you provide us with confidentiality and courtesy. Guthrie Health Financial Assistance Summary Guthrie Health recognizes that there are times when patients in need of care will have difficulty paying for the services provided. Guthrie Health Charity Care Program provides discounts to qualifying individuals based on your income. In addition, we can help you apply for free or low-cost insurance if you qualify. Just visit or contact our Corning Hospital Financial Counselor at (607) 937-7518 for free, confidential assistance. You may also visit our website at www.guthrie.org to download the Guthrie Health financial assistance application and instructions. Who qualifies for a discount? Financial Assistance is available for those patients with limited incomes, and who do not have health insurance and are worried about paying for part or all of their care. Everyone in New York State who needs emergency services can receive care and get a discount if they meet the income limits. Everyone who lives in Bradford, Sullivan, and Tioga counties in Pennsylvania, and Allegany, Chemung, Livingston, Ontario, Schuyler, Steuben, Tioga, Tompkins, and Yates counties in New York may receive a discount, by completing an application for medically necessary services at Corning Hospital if they meet the income limits. You cannot be denied medically necessary care because you need financial assistance. What are the income limits? The amount of the discount varies based on your income and the size of your family. If you have no health insurance, these are the income limits: Fam size Ann Fam Income* Mthly Fam Income Wkly Fam Income 1 Up to $21,780 Up to $1,815 Up to $419 2 Up to $29,420 Up to $2,452 Up to $566 3 Up to $37,060 Up to $3,088 Up to $713 4 Up to $44,700 Up to $3,752 Up to $860 5 Up to $52,340 Up to $4,362 Up to $1,007 6 Up to $59,980 Up to $4,998 Up to $1,153 *Based on 2011 Federal Poverty Guidelines Can someone explain the discount? Can someone help me apply? Yes, free, confidential help is available. Our Corning Hospital Financial Counselor is available at (607) 937-7518 or our Patient Financial Services office at (570) 882-2051 to assist you and/ or answer any questions you may have. The Financial Counselor can tell you if you qualify for free or low-cost insurance, such as Medicaid, Child Health Plus and Family Health Plus. If the Financial Counselor finds that you don't qualify for low-cost insurance, they will help you apply for a discount. The Counselor will help you fill out all the forms and tell you what documents you need to bring. What do I need to apply for a discount? The following documents should be attached to the application: -Bank & Investment Account Statements -Pay Stubs -Receipts as referenced in the Financial Assistance application -Latest Federal Income Tax Return -Medicaid Denial Letter (if applicable) -Health Savings Account (HSS) Statement showing current balance, if Applicable What services are covered? All medically necessary services provided by Corning Hospital are covered by the discount. This includes outpatient services, emergency care, and inpatient admissions. Services provided by non-Guthrie providers are not covered. You should talk to your non-Guthrie providers to see if they offer a discount or payment plan. How much do I have to pay? Our Patient Financial Services Department will give you the details about your specific discount(s) once your application is processed. How do I get the discount? You have to fill out the application form. As soon as we have proof of your income, we can process your application for a discount according to your income level. You can apply for a discount before you have an appointment, when you come to the hospital to get care, or when the bill comes in the mail. Send the completed form to: Guthrie Clinic Patient Financial Service Department One Guthrie Square Sayre, PA 18840 Attn: Patient Representative-Charity Care Office or deliver to the Corning Hospital Financial Counselor's office located on the 1st Level of Corning Hospital. You have up to 180 days after receiving services to submit the application. How will I know if I was approved for the discount? The Patient Financial Services Department will send you a letter generally within 30 days after completion and submission of documentation, telling you if you have been approved and the level of discount received. What if I receive a bill while I'm waiting to hear if I can get a discount? You cannot be required to pay a hospital bill while your application for a discount is being considered. If your application is turned down, the hospital must tell you why in writing and must provide you with a way to appeal this decision to a higher level within the hospital. What if I have a problem I cannot resolve with the hospital? You may call the New York State Department of Health complaint hotline at 1-800-804-5447.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE
PART VI, LINE 4A.Hospital Service Area The Hospital's service area remains unchanged. It considers its service area to encompass communities within several counties, based on the utilization of its three facilities, as described below: Its primary facility is a 99-bed acute care hospital that provides 24-hour emergency services and a complement of inpatient and outpatient services, located at 176 Denison Parkway East, Corning, N.Y. The Hospital also provides a range of treatment, diagnostic and preventive health services and programs. The Guthrie Cancer Center at Corning Hospital, a separate facility located at 114 Columbia Street, Corning, N.Y., provides therapeutic radiology, medical oncology and cancer support services, including access to clinical trials. The Hospital also operates HealthWorks, a 43,000-square-foot wellness and fitness center located at 9768 Liberty Drive, Painted Post, N.Y. HealthWorks' services are based on a medical model. In addition to traditional fitness center services, it also offers a range of physical rehabilitation services. The Hospital employs 683 individuals and has a medical staff of 162 physicians. The Hospital also uses physicians and mid-level providers as hospitalists, who provide continuity of care for inpatient services. B.Description of Service Area The Hospital's primary service area encompasses all of Steuben County, NY, with a number of patients coming from Chemung and Schuyler counties, NY as well as Tioga County, Pa. In addition to Corning and Painted Post, NY, patients utilizing the Hospital also come from the surrounding communities of Addison, Bath, Big Flats, Beaver Dams, Campbell, and Savona, NY.Community Information
PART VI, LINE 5The following overview provides examples of the Hospital's successes in providing access to high quality health care as well as other service and activity beyond the provision of direct care. Access to High Quality Care Corning Hospital was ranked as the tenth best in New York State for overall hospital care by the Delta Group as part of its 2012 Quality Awards from Care Chex, a division of the Delta Group, Inc. The rankings below include types of care/specialties for which Corning Hospital ranked in the top 10 percent in the state, and in the country. Medical Excellence Awards - Top 10 percent in New York: Overall Hospital Care (#10 in NY) Overall Medical Care (#12 in NY) Gall Bladder Removal (#2 in NY) GI Hemorrhage (#9 in NY) Neurological Care (#12 in NY) Stroke Care (#10 in NY) Medical Excellence - Top 10 percent in Nation: Gall Bladder Removal Patient Safety Awards - Top 10 percent in New York Cancer Care Overall Medical Care The Hospital has received Gold Plus designation by the American Heart Association for stroke care. The Hospital recently implemented the electronic health record (Epic) used throughout Guthrie Health. This required a significant investment of resources, all dedicated at providing safe and effective patient care and improving communication among providers, using a secure system to put important health information about patients at providers' fingertips. The Hospital continues to offer cancer screenings in collaboration with the Cancer Service Partnership of Steuben County, providing low-cost mammograms to women who meet the program's criteria Community Outreach: Hospital Board members and members of the Administrative team have held a number of community and neighborhood-based informational sessions to provide more in-depth information about the new Corning Hospital and to answer questions and address concerns. The response to these open meetings has been very positive. The Hospital received the Bronze Award in recognition of its participation in the local United Way fund drive. The Hospital is a partner in the Red Cross program Unite for Life Plus. At the time of this report, the Hospital has held four blood drives planned in 2011 and a total of 114 units were collected, with 5 new donors identified. The Hospital participated as the primary sponsor, providing $10,000 in funding, in the local American Cancer Society's Relay for Life event. It raised money, formed teams and hosted the pre-event survivor dinner. The Hospital participated in an awareness and fund raising activity for Catholic Charities of Steuben County. The "Walk a Mile in Their Shoes" event, held in three Steuben County communities, raised awareness about poverty in Steuben County. The Hospital also sponsored the Joel Stephens Memorial Golf Tournament, an annual event that raises funds used to increase awareness in the community about colorectal cancer. The Hospital's Auxiliary holds a number of fund raising events in the community throughout the year to support the Hospital's need for new equipment. Proceeds from the Auxiliary's primary event have amounted to more than $1 million since its inception in 1997. Fitness and Nutrition: HealthWorks sponsored a 5k run to raise awareness about, and funding for, United Way agencies. The Hospital sponsored the annual Pop Can Fund run, held for youth ages 2 to 10, with approximately 300 children participating in age-appropriate races. HealthWorks participated in Healthy Kids Day, a program developed by the Corning Community Y, which attracted hundreds of children and their families. HealthWorks staff developed a number of interactive activities for children to help them be better informed about the health benefits of exercise. Wellness and Prevention Education: HealthWorks hosted several Community Wellness Days, open to the public, offering free blood pressure screenings, body fat analysis, and informational materials regarding disease prevention. The Hospital provided 1,487 seasonal flu shots to staff, volunteers and community members. HealthWorks continues to provide a monthly Diabetes Support Group open to the public in which guest speakers are available each month to discuss topics of interest for individuals with diabetes to help them better understand and manage their health needs. The Hospital now has two RNs trained as certified car seat safety instructors, which enables the Hospital to participate in health fairs/community education days that demonstrate the correct age/weight-appropriate for children using car seats. These staff members will be assisting the Steuben County Public Health educators in bringing this important information to parents throughout Steuben County. PART VI, LINE 6 See Schedule O Form 990 Part III, Line 1 Statement of Program Service Accomplishments PART VI, LINE 7 The 2012 Community Service Plan will be made available to the public through a downloadable pdf file on the Hospital's website: www.corninghospital.org. When completed and issued to the NYS DOH, a news release was issued advising the public that the report has been submitted.PROMOTION OF COMMUNITY HEALTH

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Severance PaymentfalseSeverancePayment
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 PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base 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
FRANCIS M MACAFEE
14564502071200000121930178550000
DAVID AUSTIN MD
03286540250000000044293039794700
LOUIS R DUBOIS MD
0364161000000044293040845400
J MICHAEL SCALZONE MD
03035180137500000044293036156100
MARK STENSAGER
047600909815001077100020217060514700
RUSSELL C WOGLOM MD
02892610125000000044293034605400
David McCorvey MD
0226075000000032896025897100
Shirley Magana
22010802863200000149920263732000
Gregory Kriel
1471570000000160820163239000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierExplanationExplanation
Part 1 line 1aHOUSING ALLOWANCES AND GROSS-UP PAYMENTS ARE PERIODICALLY PROVIDED TO EMPLOYEES. ALL PAYMENTS ARE MADE PURSUANT TO WRITTEN ORGANIZATIONAL POLICIES.
Part 1 line 3EXECUTIVE COMPENSATION IS ESTABLISHED WITHIN A WRITTEN EMPLOYMENT AGREEMENT. COMPENSATION IS DETERMINED BASED ON MARKET STUDIES PRESENTED TO THE GUTHRIE HEALTH COMPENSATION COMMITTEE AND SUBSEQUENTLY APPROVED BY THE GUTHRIE HEALTH BOARD OF DIRECTORS.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (19 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, Part III, Line 1Statement of Program Service Accomplishments : Guthrie Health is a nonprofit health care organization that serves to coordinate the activity of Guthrie Clinic (Clinic) and the affiliates within Guthrie Healthcare System (GHS; see Form 990, Schedule R, for a listing of affiliates of GHS, including Robert Packer Hospital (RPH)). Through the activities of the Clinic, GHS, RPH, and its other affiliates (collectively referred to as "Guthrie"), Guthrie Health provides charitable community-based health care services and programs to improve the health and well-being of the people and communities served by its facilities and providers. These charitable activities include providing primary care and specialty physician services, as well as operating a tertiary care teaching hospital, community hospitals, a research institute, home care, hospice care, and a long-term care facility. The Guthrie Research Institute and Guthrie Clinical Research functions of the Guthrie Foundation for Medical Education and Research (Research Institute), a subsidiary of GHS, furthers these charitable activities through providing patient access to the region's largest panel of clinical trials. The facilities and provider offices of Guthrie are located in 23 communities throughout the northern tier of Pennsylvania and southern tier of New York, with the greatest concentration of services provided principally in Bradford County, Pennsylvania and Chemung and Steuben Counties, New York. The vision of Guthrie is to help shape the delivery of health care in the region through working collaboratively with physicians and other providers, and by distributing its services throughout the region based on community needs. Guthrie seeks to be the provider of choice for patients in the Twin Tier region, and to be recognized for its superior quality and service. It also strives to advance the practice of medicine through its commitment to teaching and research. In keeping with this vision, the core values of Guthrie Health are as follows: patient-centeredness, excellence, and teamwork. Guthrie providers and facilities provide care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because it does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue on the financial statements of Guthrie entities. Costs for services and supplies furnished under Guthrie's charity care policy amounted to approximately $2.46 million in 2012 and $2.56 million in 2011 when measured at the appropriate entity's established rates. As part of its charitable mission, Guthrie provides care through its hospital emergency departments. It ensures that an emergency-based treatment or hospital admission is not delayed or denied pending determination of coverage or a requirement for prepayment or deposit. As a result of this policy, Guthrie experienced approximately $3.16 million and $3.10 million in bad debts for 2012 and 2011, respectively. In addition to the charity care program and the emergency department bad debts discussed above, Guthrie supports numerous other charitable community activities. Examples of these activities include medical education for physicians and nurses, the trauma program, and medical research. The estimated cost, net of reimbursement, for these programs was $13.2 million and $10.0 million in 2012 and 2011, respectively. Guthrie also provides services to patients who participate in the Medicaid programs. Revenues generated from patients who participate in the Medicaid program are subject to substantial discounts that result in reimbursement for services rendered below the cost of providing such services. In order for patients to meet the guidelines for the Medicaid program, various income-based criteria must be met that validate patients' inability to pay for services and ineligibility under other programs. The estimated loss incurred by Guthrie from providing services to Medicaid patients amounted to $18.8 million and $18.5 million in 2012 and 2011, respectively. The total cost to Guthrie in supporting these charitable mission programs was approximately $37.3 million and $33.6 million in 2012 and 2011, respectively. As discussed, RPH and the Clinic work closely together in fulfilling Guthrie's charitable mission. A regional Level II trauma center, RPH is a tertiary care teaching hospital, located in Sayre, Pennsylvania, serving the southern tier of New York and the northern tier of Pennsylvania. It also provides residency programs in family practice, internal medicine, and general surgery as well as a fellowship program in vascular surgery and cardiovascular disease. Medical student training is provided for students from affiliated medical schools. Allied health education is also provided for respiratory therapy, nursing, laboratory science, and radiologic technology for students from Pennsylvania and New York colleges and universities. Centers of Excellence within RPH include the following: Advanced & Minimally Invasive Surgery; Behavioral Health Services; Breast and Imaging Center; Comprehensive Cancer Center; Cardiovascular Care Center; the Center for Wound Care and Hyperbaric Medicine; Dialysis Centers; Joint Camp Program for Orthopedic Surgery; Sports Medicine; Kidney Stone Treatment Center; First Impressions Birthing Center; Sleep Disorders Testing; and Specialty Eye Care.
FORM 990, PART III, LINE 1 (CONT'D)RPH strives to enhance the quality of life in the communities it serves by providing superior health care services and by leading continuous improvement of community health. It achieves this mission by organizing services and directing resources toward meeting community health needs through collaboration with community agencies and by compassionate, effective, and affordable means. RPH works closely with the Clinic to ensure that the skills and knowledge of the medical staff produce the maximum community health benefit. As a member of the Guthrie Healthcare System, RPH integrates its programs and activities with those of the long-term care and education and research divisions, so that continuity and synergy result. As part of GHS, the vision of RPH is to play a leadership role in the development and provision of tertiary-level acute care services. Evidence that RPH is successfully fulfilling this role can be seen in its accomplishments this past year. Highlights of those achievements include accreditation by the Pennsylvania Trauma Systems Foundation Board as a Level II Trauma Center, recipient of Thomson Reuters Everest Award (one of only 23 hospitals in the country) for two consecutive years, as well as receiving the Thomson Reuters 100 Top Hospital: National Benchmarks award for the fourth consecutive year. RPH, a magnet designated hospital, has also been named a Thomson Reuters 100 Top Hospital: Cardiovascular six times. GHS has been named one of the top 50 healthcare systems in the country by Thomson Reuters. As part of a fully-integrated health delivery system that organizes its services on a regional basis and is accountable for improving the health of the population it serves, RPH accepts responsibility for meeting the health care needs of the community and is able to document the cost effectiveness and quality of services provided. The Clinic is a multi-specialty physician group practice that includes nearly 350 specialist and primary care physicians and mid-level providers, headquartered in a facility adjacent to RPH. Physicians within the Clinic provide comprehensive medical care using advanced technologies and methodologies for both diagnosis and treatment. Further, the Clinic provides a broad range of educational opportunities for physicians and other health care providers. It also works closely with the Research Institute, where research contributes to recruiting and retaining physician specialists to serve the region and sustaining proficient medical practices. The Clinic is committed to the advancement of medical knowledge and skills, and every effort is made to provide personal, compassionate medical care. The Clinic operates a regional office network in 23 communities in Pennsylvania and New York, encompassing all of the major population centers in the Twin Tiers area. The Clinic and GHS have developed certain guiding principles for the provision of patient care, which include a commitment the following: Practice of clinical excellence, Utilization of the synergy of a multi-specialty medical group practice, Development of an integrated system that provides a continuum of care, Provision of local access to care through support of a regional medical office network, Provision of services to a distinct geographic region, and Proactive operations. The Clinic, through the provision of primary care services with ease of access to specialty and sub-specialty care, focuses on making an integrated system of health care easily accessible to patients. With its primary concern the diagnosis and treatment of disease and illness, it also seeks to actively improve the health of the community it serves through prevention, health screenings, and education. The Clinic welcomes any patient seeking care.
FORM 990, PART IV, LINE 12The organization's financial statements were audited on a consolidated basis with Guthrie Health and Affiliates. FORM 990, PART VI, LINE 6 Guthrie Healthcare System is the sole member of Corning Hospital.
FORM 990, PART VI, LINE 7AAs the sole member of Corning Hospital, Guthrie Healthcare System appoints the organization's Board of Directors.
FORM 990, PART VI, LINE 7BAs the sole member of Corning Hospital, Guthrie Healthcare System has approval rights of certain board decisions.
FORM 990, PART VI, LINE 11A & 11BThe Form 990 of the organization is presented to the Board of Directors for review and is also reviewed by the organization's finance personnel and an independent accounting firm prior to filing with the IRS.
FORM 990, PART VI, LINE 12CThe Conflict of Interest Disclosure Policy sets forth that all persons, including employees, agents and Board/Committee members, particularly those involved in decision-making for Guthrie Health (GH) act in an appropriate manner and will not participate in any actions that might create a personal or professional conflict of interest and/or not be in the best interest of GH. All members of any GH Board/Committee and GH senior management must make full disclosure of any possible conflict of interest through the use of the Conflict of Interest Disclosure Form and refrain from voting or participating in decision-making involving any possible conflict of interest. The form is distributed to all Board/Committee members, and employees (when applicable) annually by the GH Administration office. GH Board/Committee members or employees must complete the Conflict of Interest Disclosure Form. This form should be completed when there is any situation where a possible conflict of interest exists, and/or on an annual basis and/or at the time of appointment or election of new Board/Committee members. If the form is not completed within 13 months of the last signing, the GH Board Chairman will be advised. Any individual having a conflict of interest or possible conflict of interest on any matter should excuse themselves from the portion of the meeting or meetings where the matter is discussed and not vote or use his or her personal influence on the matter. The minutes of the meeting or meetings should reflect the disclosure, the abstention from voting, and any action taken to determine whether a conflict of interest existed.
FORM 990, PART VI, LINE 15AExecutive compensation is generally established within a written employment agreement. Compensation is determined based on market studies, presented to the Executive Compensation Committee, and subsequently approved by the Board of Directors.
FORM 990, PART VI, LINE 15BExecutive compensation is generally established within a written employment agreement. Compensation is determined based on market studies, presented to the indpendent Executive Compensation Committee and subsequently approved by the Board of Directors.
FORM 990, PART VI, LINE 18The organization's Form 1023, 990 and 990-T are available for public inspection upon request.
FORM 990, PART VI, LINE 19The organization does not make its governing documents, conflict of interest policy, and financial statements available to the public.
FORM 990, PART XII, LINE 2BThe organization's financial statements were audited on a consolidated basis with Guthrie Health and Affiliates.
FORM 990, PART XI, LINE 5The Change in Net Assets is related to a chnage in Pension Obligation of $(6,627,654).
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:DAVID AUSTIN MD TITLE:MEMBER-BOD-MED STAFF VP HOURS:40FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:LOUIS R DUBOIS MD TITLE:MEMBER-BOD-Med Staff Pres. HOURS:40FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:J MICHAEL SCALZONE MD TITLE:MEMBER - BOD Med Staff Sec. HOURS:40FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:MARK STENSAGER TITLE:MEMBER - BOD HOURS:40FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:RUSSELL C WOGLOM MD TITLE:MEMBER - BOD HOURS:40FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:David McCorvey MD TITLE:MEMBER-BOD-Med Staff Treas. HOURS:40FORM 990 PART VII

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Guthrie Healthcare System
One Guthrie SquareSayrePA18840232200910SUPPORTPA501(c)(3)11C TypeIIIGHfalse
Guthrie Health
One Guthrie SquareSayrePA18840233055017SupportPA501(c)(3)11B Type IINAfalse
Sayre House of Hope
One Guthrie SquareSayrePA18840203979472Enhance accesPA501(c)(3)7GHStrue
Robert Packer Hospital
One Guthrie SquareSayrePA18840240795463Health CarePA501(c)(3)3GHStrue
Donald Guthrie Foundation for Education
200 south wilbur avesayrePA18840246022957ResearchPA501(c)(3)4GHStrue
Robert Packer Hospital School of Nursing
200 South Wilbur AveSayrePA18840236408773EducationPA501(c)(3)2GHStrue
Troy Community Hospital Inc
100 John StreetTroyPA16947240800337HealthcarePA501(c)(3)3GHStrue
TIOGA HEALTHCARE FACILITY
ONE GUTHRIE SQUARESAYREPA18840150532257HOUSINGPA501(c)(3)3GHStrue
SAYRE HOUSE INC
1001 NORTH ELMER AVESAYREPA18840231643404NURSINGPA501(c)(3)9GHStrue
GUTHRIE HOME CARE
R R 1 bOX 154SAYREPA18840232394345HOME HEALTHPA501(c)(3)9GHStrue
GUTHRIE CORNING DEVELOPMENT COMPANY
176 DENISON pKWY ECORNINGNY14830161594628SUPPORTNY501(c)(3)11B TYPE IIGHStrue
GUTHRIE SAME DAY SURGERY CENTER INC
ONE GUTHRIE SQUARESAYREPA18840020551081AMBULATORYNY501(c)(3)9GHStrue
GUTHRIE RISK RETENTION GROUP
151 MEETING STREETCHARLESTONSC29401201090801SUPPORTSC501(c)(3)11A TYPE IGHtrue
TIOGA NURSING FACILITY
ONE GUTHRIE SQUARESAYREPA18840150532257NURSINGPA501(c)(3)3GHStrue
GUTHRIE CLINIC LTD
ONE GUTHRIE SQUARESAYREPA18840250815795HEALTHCAREPA501(c)(3)3GHtrue
DARWAY NURSING HOME INC
ONE GUTHRIE SQUARESAYREPA18840231733967NURSINGPA501(c)(3)9GHStrue

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1TWIN TIER MANAGEMENT CORP INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1p o bOX 310AddressLine1
CitySAYRECity
StatePAState
ZIP Code18840ZIPCode
FieldValueIRS element (for citing)
EIN232209439EIN
Primary ActivitymANAGEMENT COPrimaryActivity
Legal Domicile StatePALegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
Share Of Total Income5907461ShareOfTotalIncome
Share Of EOY Assets5406163ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
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 OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
GUTHRIE CORNING DEVELOPMENT COMPANY
A143856FMV
GUTHRIE CORNING DEVELOPMENT COMPANY
J550352FMV
GUTHRIE CLINIC
I188061FMV
GUTHRIE CLINIC
K203287FMV
GUTHRIE CLINIC
L1345861FMV
GUTHRIE HEALTHCARE SYSTEM
L4922695FMV
ROBERT PACKER HOSPITAL
L1032601FMV
ROBERT PACKER HOSPITAL
N69383FMV
GUTHRIE SAME DAY SURGERY CENTER
N64294FMV

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