SAMARITAN HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- SAMARITAN HOSPITAL (EIN 14-1338544)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-08-12
- IRS object ID
- 201112289349301121
- Schema version
- 2010v3.2
- 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 D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-08-12T10:47:05-07:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141338544 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Samaritan Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SAMA | NameControl |
| Phone | 5184713135 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2215 Burdett Avenue | AddressLine1 |
| City | Troy | City |
| State | NY | State |
| ZIP Code | 12180 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Lori Santos | Name |
| Title | VP Finance/CFO | Title |
| Date Signed | 2011-08-12 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Norman Dascher | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Northern Blvd | AddressLine1 |
| City | Albany | City |
| State | NY | State |
| ZIP Code | 12204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 124205555 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.nehealth.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1898 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | Samaritan Hospital's mission is to improve the health of the community by providing high quality, cost effective inpatient, outpatient, primary care and community outreach services with an emphasis on patient safety and satisfaction. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 22 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 18 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1741 | TotalNbrEmployees |
| Total Nbr Volunteers | 225 | TotalNbrVolunteers |
| Total Gross UBI | 1954823 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 583416 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1846543 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1449671 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 125273153 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 116968271 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 6278441 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3590585 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1378325 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2197028 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 134776462 | TotalRevenuePriorYear |
| Total Revenue Current Year | 124205555 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 65835799 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 64201047 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 56822159 | OtherExpensePriorYear |
| Other Expenses Current Year | 54322693 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 122657958 | TotalExpensesPriorYear |
| Total Expenses Current Year | 118523740 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 12118504 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5681815 | RevenuesLessExpensesCY |
| Total Assets BOY | 116785371 | TotalAssetsBOY |
| Total Assets EOY | 122102086 | TotalAssetsEOY |
| Total Liabilities BOY | 31058194 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 31699176 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 85727177 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 90402910 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | To provide a high-quality, accessible continuum of healthcare, supportive housing and community services. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 36308015 | Expense |
| Revenue | 45845362 | Revenue |
| Description | 238 (certified) bed acute facility providing inpatient services including medical, surgical, progressive care, intensive care and coronary care. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 27748703 | Expense |
| Revenue | 23095526 | Revenue |
| Description | Diagnostic treatment and ancillary servcies including laboratory, blood bank, diagnostic imaging, nuclear medicine, pharmacy, respiratory, physical medicine, audiology and speech. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 18095463 | Expense |
| Revenue | 15971247 | Revenue |
| Description | Outpatient and community outreach services including emergency room, cancer treatment, primary care preventive health care and injury management services. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 10809577 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 32056136 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 92961758 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | true | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | true | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 98 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1741 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 22 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 18 | NumberIndependentVotingMembers |
| Family Or Business Relationship | true | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Lori Santos | NamePerson |
| Telephone Number | 5184713135 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Northern Boulevard | AddressLine1 |
| City | Albany | City |
| State | NY | State |
| ZIP Code | 12204 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (35 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | OfficerOfficer | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| William J Foley PhD | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| Vinita Singh | ||||||||
| Physician | 40.00 | 309459 | 0 | 16638 | X | |||
| Thomas Nowak | ||||||||
| Treasurer | 4.00 | X | 0 | 0 | 0 | X | ||
| Sergio Biguzzi | ||||||||
| Physician | 40.00 | 350643 | 0 | 6598 | X | |||
| Russell Oster | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| Ronald L Guzior | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| Robert W Johnson III Esq | ||||||||
| Chairman | 4.00 | X | 0 | 0 | 0 | X | ||
| Robert Smith | ||||||||
| Vice President | 20.00 | 142118 | 0 | 12391 | X | |||
| Robert Fortune | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| Robert C Davenport | ||||||||
| 0.00 | 0 | 107273 | 7300 | X | ||||
| Robert Bylancik | ||||||||
| Board Member | 2.00 | X | 0 | 50000 | 0 | |||
| Norman Dascher | ||||||||
| CEO | 20.00 | 347762 | 0 | 22931 | X | |||
| Naveen Achar | ||||||||
| Physician | 40.00 | 254188 | 0 | 11498 | X | |||
| Mark Cartwright | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| Lori Santos | ||||||||
| CFO | 20.00 | 0 | 207284 | 11573 | X | |||
| Lisa Thorn MD | ||||||||
| Board Member | 5.00 | X | 25000 | 0 | 0 | |||
| Karen Tassey | ||||||||
| COO | 20.00 | 0 | 211803 | 9235 | X | |||
| John Lang | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| John Collins MD | ||||||||
| CMO | 2.90 | 0 | 291317 | 25207 | X | |||
| Jane Altes PhD | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| James V Puleo MD | ||||||||
| Board Member | 2.00 | X | 0 | 25000 | 0 | |||
| James Slavin MD | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| James K Reed MD | ||||||||
| Board Member | 2.40 | X | 0 | 508073 | 28508 | X | ||
| James H Puleo MD | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| James E Prout Esq | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| Indra Singh | ||||||||
| Physician | 0.00 | 247556 | 0 | 10641 | X | |||
| Harry L Robinson Esq | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| Harold Gordon Esq | ||||||||
| Vice Chair | 4.00 | X | 0 | 0 | 0 | X | ||
| Gregory Field | ||||||||
| Physician | 40.00 | 291731 | 0 | 24795 | X | |||
| Daniel Silverman MD | ||||||||
| Vice President | 20.00 | 202740 | 0 | 21003 | X | |||
| Craig Duncan | ||||||||
| 0.00 | 0 | 402637 | 0 | X | ||||
| Chester Opalka | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| Anthony Tartaglia MD | ||||||||
| Secretary | 4.00 | X | 0 | 0 | 0 | X | ||
| Ann DiSarro | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| Alan Goldberg | ||||||||
| Board Member | 2.00 | X | 0 | 0 | 0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2171197 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1803387 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 208318 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Morison Management Services | |||||
| PO Box 102289 | Atlanta | GA | 30368 | Food Mgmt Services | 1256573 |
| Labcorp of America Holdings | |||||
| PO Box 1214 | Burlington | NC | 27216 | Laboratory Services | 1391441 |
| Hyman Hayes Associates Inc | |||||
| 6 Wembly Court | Albany | NY | 12205 | Architecture Service | 357717 |
| HMP of Samaritan PLLC | |||||
| 4535 Dressler Road NW | Canton | OH | 44718 | Medical Services | 1370750 |
| Favorite Healthcare Staffing Inc | |||||
| PO Box 803356 | Kansas City | MO | 64180 | Patient Services | 751945 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 16 | NumberOfContractorsGT100K |
| Government Grants | 154824 | GovernmentGrants |
| All Other Contributions | 1294847 | AllOtherContributions |
| Total Contributions | 1449671 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Revenue | Description |
| Total Revenue Column | 116968271 | TotalRevenueColumn |
| Related Or Exempt Function Income | 115013448 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1954823 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 116968271 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3590585 | TotalRevenueColumn |
| Exclusion | $3,590,585 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|
| School of Nursing | 854651 | 854651 | |
| Laundry | 477307 | 477307 | |
| Consulting/Mgmt Food Serv | 622424 | $622,424 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 242646 | TotalRevenueColumn |
| Related Or Exempt Function Income | 80134 | RelatedOrExemptFunctionIncome |
| Exclusion | $162,512 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2197028 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 124205555 | TotalRevenueColumn |
| Related Or Exempt Function Income | 116425540 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1954823 | UnrelatedBusinessRevenue |
| Exclusion | $4,375,521 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2171197 | Total |
| Management And General | 2171197 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51517430 | Total |
| Program Services | 43871297 | ProgramServices |
| Management And General | 7646133 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2397715 | Total |
| Program Services | 1960492 | ProgramServices |
| Management And General | 437223 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4178278 | Total |
| Program Services | 3416370 | ProgramServices |
| Management And General | 761908 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3936427 | Total |
| Program Services | 3218621 | ProgramServices |
| Management And General | 717806 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4470402 | Total |
| Program Services | 1395174 | ProgramServices |
| Management And General | 3075228 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87446 | Total |
| Program Services | 43111 | ProgramServices |
| Management And General | 44335 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 84289 | Total |
| Program Services | 689 | ProgramServices |
| Management And General | 83600 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7093444 | Total |
| Program Services | 6132952 | ProgramServices |
| Management And General | 960492 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 318580 | Total |
| Program Services | 204665 | ProgramServices |
| Management And General | 113915 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21532896 | Total |
| Program Services | 18347793 | ProgramServices |
| Management And General | 3185103 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3749751 | Total |
| Program Services | 740002 | ProgramServices |
| Management And General | 3009749 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 138984 | Total |
| Program Services | 88997 | ProgramServices |
| Management And General | 49987 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66489 | Total |
| Program Services | 51257 | ProgramServices |
| Management And General | 15232 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7459028 | Total |
| Program Services | 5750216 | ProgramServices |
| Management And General | 1708812 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 877731 | Total |
| Management And General | 877731 | ManagementAndGeneral |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Other Fees | 270165 | 12758 | 257407 |
| NYS Assessment | 372936 | 372937 | |
| Licenses/Permits | 279913 | 96343 | 183570 |
| Gift Shop Purchases | 136606 | 136606 | |
| Bad Debt | 7082670 | 7082670 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 301363 | Total |
| Program Services | 175414 | ProgramServices |
| Management And General | 125948 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118523740 | Total |
| Program Services | 92961758 | ProgramServices |
| Management And General | 25561982 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12363160 | BOY |
| EOY | 17597971 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10048121 | BOY |
| EOY | 10364863 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1637199 | BOY |
| EOY | 1732291 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 804526 | BOY |
| EOY | 941712 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 153023416 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 112054320 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40583724 | BOY |
| EOY | 40969096 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28429326 | BOY |
| EOY | 32148907 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8879501 | BOY |
| EOY | 8649203 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14039814 | BOY |
| EOY | 9698043 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116785371 | BOY |
| EOY | 122102086 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9291829 | BOY |
| EOY | 10754390 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1031061 | BOY |
| EOY | 712607 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20735304 | BOY |
| EOY | 20232179 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31058194 | BOY |
| EOY | 31699176 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81364384 | BOY |
| EOY | 86525468 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2647351 | BOY |
| EOY | 1908995 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1715442 | BOY |
| EOY | 1968447 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85727177 | BOY |
| EOY | 90402910 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 116785371 | BOY |
| EOY | 122102086 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 5681815 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1006082 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
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 D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1715442 | BeginningOfYearBalance |
| Contributions | 450849 | Contributions |
| Investment Earnings Or Losses | -208589 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1968447 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1522807 | BeginningOfYearBalance |
| Contributions | -12300 | Contributions |
| Investment Earnings Or Losses | 204935 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1715442 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1787938 | BeginningOfYearBalance |
| Contributions | 58330 | Contributions |
| Investment Earnings Or Losses | -323461 | InvestmentEarningsOrLosses |
| End Of Year Balance | 1522807 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | true | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | true | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2108212 | OtherCostOrOtherBasis |
| Book Value | 2108212 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 61898703 | OtherCostOrOtherBasis |
| Depreciation | 35280739 | Depreciation |
| Book Value | 26617964 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1637170 | OtherCostOrOtherBasis |
| Depreciation | 1176776 | Depreciation |
| Book Value | 460394 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 77180515 | OtherCostOrOtherBasis |
| Depreciation | 65685894 | Depreciation |
| Book Value | 11494621 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10198816 | OtherCostOrOtherBasis |
| Depreciation | 9910911 | Depreciation |
| Book Value | 287905 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 40969096 | TotalOfBookValueLandBuildings |
Financial Derivatives FinancialDerivatives
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 8649203 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 8649203 | TotalOfBookValueSecurities |
Other Assets OtherAssets (9 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Tuition Receivable | 440981 |
| Rubin Dialysis Receivable | 1849850 |
| Rounding | 1 |
| Other Current Assets | 2262053 |
| Interest in Northeast Health Foundation | 2188927 |
| Goodwill | 5834 |
| Due to/from Affiliates | 1888434 |
| Deferred Compensation Agreements | 371710 |
| Assets Whose Use is Limited | 690253 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 9698043 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Professional Liability Reserve | $692,489 |
| Estimated Third Party Settlements | $9,782,960 |
| Due to Affiliates | $286,054 |
| Deferred Compensation Payable | $371,710 |
| Asset Retirement Obligation | $1,387,830 |
| Accrued Pension Liability | $7,711,136 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 20232179 | TotalOfAmounts |
| Total Revenue | 124205555 | TotalRevenue |
| Total Expenses | 118523740 | TotalExpenses |
| Excess Or Deficit For Year | 5681815 | ExcessOrDeficitForYear |
| Other | -$1,006,082 | OtherAmount |
| Total Adjustments | -1006082 | TotalAdjustments |
| Excess Or Deficit Per FS | 4675733 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 124043043 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 124043043 | RevenueSubtotal |
| Other Revenues Not Included | 162512 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 162512 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 124205555 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 118346848 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 118346848 | ExpensesSubtotal |
| Other Expenses Not Included | 176892 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 176892 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 118523740 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X | Part X : FIN48 Footnote | Northeast Health, the health system to which Samaritan Hospital belongs, is classified for tax purposes as an organization under 501(c)(3) of the Internal Revenue Code (the Code), and as such it is generally exempt from income taxes under the provisions of Section 501(a) of the Code. |
| Part XIII, Line 4b | Part XIII, Line 4b: Other revenue amounts included on 990 but not included in F/S | Gift Shop $176892 |
| Part XII, Line 4b | Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/S | Gift Shop Revenue $162512 |
| Part XI, Line 8 | Part XI, Line 8: Other Changes in Net Assets or Fund Balances | Increase in Temporarily Restricted Net Assets $0 Increase in Permanently Restricted Net Assets $253004 Prepaid Pension Writedown $284781 Transfer to Northeast Health $ -793018 Net assets released from restrictions $ -12494 Decrease in Temporarily Restricted Net Assets $ -738355 |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | true | ExpensesExceededBudget |
| Unable To Provide Care | false | UnableToProvideCare |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2000006 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2000006 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01690 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13430627 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10986404 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2444223 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02060 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15430633 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10986404 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4444229 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03750 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 724 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 724 | NetCommunityBenefitExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1548170 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1389238 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 158932 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00130 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1055693 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 791574 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 264119 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00220 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 314829 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 314829 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2919416 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2180812 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 738604 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00620 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18350049 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13167216 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5182833 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04370 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 98 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 98 | NetCommunityBuildingExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6086 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6086 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 6184 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 6184 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $2,047,544 | BadDebtExpenseAmount |
| Amount Attributable To | 32061 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 23876371 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 25145769 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -1269398 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost Accounting System | X | CostAccountingSystem |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 8 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (8 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | OtherOther | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours |
|---|---|---|---|---|---|---|---|---|
| Continuing Treatment Services | ||||||||
| 8 | 1801 Sixth Avenue | Troy | NY | 12180 | Outpatient Continuing Treatment Svc/MICA | |||
| Waterford Health Center | ||||||||
| 7 | 158 Saratoga Avenue | Waterford | NY | 12188 | Primary Care Center | |||
| South Troy Health Center | ||||||||
| 6 | 300 Fourth Street | Troy | NY | 12180 | Primary Care Center | |||
| Riverside Family Medical Group | ||||||||
| 5 | 35 Lower Hudson Ave | Green Island | NY | 12183 | Primary Care Center | |||
| Family Medical Group | ||||||||
| 4 | 279 Troy Road Route 4 | Rensselaer | NY | 12144 | Primary Care Center | |||
| Cohoes Family Care | ||||||||
| 3 | 95 Remsen Street | Cohoes | NY | 12047 | Primary Care Center | |||
| Rensselaer Regional Heart Inst | ||||||||
| 2 | 2215 Burdett Ave | Troy | NY | 12180 | Outpatient cardiac catheterizaton svc | X | ||
| Samaritan Hospital | ||||||||
| 1 | 2215 Burdett Ave | Troy | NY | 12180 | X | X | X | |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (8 entries)
| Hospital Facility NumberHospitalFacilityNumber | CHNA ConductedCHNAConducted | Eligibility Criteria ExplainedEligibilityCriteriaExplained | Uses FPG FreeUsesFPGFree | Uses FPG DiscountedUsesFPGDiscounted | Explains BasisExplainsBasis | Explains Application MethodExplainsApplicationMethod | Includes Publicity MeasuresIncludesPublicityMeasures | Actions On NonpaymentActionsOnNonpayment | Collection ActivitiesCollectionActivities | Nondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicy | Amounts Generally BilledAmountsGenerallyBilled | Gross ChargesGrossCharges |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Continuing Treatment Services | ||||||||||||
| 8 | false | false | false | false | false | false | false | false | false | true | false | false |
| Waterford Health Center | ||||||||||||
| 7 | false | false | false | false | false | false | false | false | false | true | false | false |
| South Troy Health Center | ||||||||||||
| 6 | false | false | false | false | false | false | false | false | false | true | false | false |
| Riverside Family Medical Group | ||||||||||||
| 5 | false | false | false | false | false | false | false | false | false | true | false | false |
| Family Medical Group | ||||||||||||
| 4 | false | false | false | false | false | false | false | false | false | true | false | false |
| Cohoes Family Care | ||||||||||||
| 3 | false | false | false | false | false | false | false | false | false | true | false | false |
| Rensselaer Regional Heart Inst | ||||||||||||
| 2 | false | false | false | false | false | false | false | false | false | true | false | false |
| Samaritan Hospital | ||||||||||||
| 1 | false | false | false | false | false | false | false | false | false | true | false | false |
Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| Part VI - States Where Community Benefit Report Filed | NY |
| Part VI - Affilated Health Care System Roles and Promotion | Samaritan Hosptial is affiliated with Northeast Health, a network of healthcare, supportive housing and community services. The affiliation furthers Samaritan Hospital's ability to promote health care in many ways. Northeast Health affiliation helps ensure Samaritan Hospital's financial stability through reduced administrative overhead costs, access to capital and supply chain management, among other things. Samaritan Hospital's affiliation with Northeast Health also enables greater collaboration with affiliated hospitals and other providers of services. In addition to sharing policies and procedures and ideas for best operational and management practices, system affiliates participate jointly in quality improvement activities. The Northeast Health Board Quality Committee oversees quality improvement activities in the system's acute care hospitals, rehabilitation hospital, skilled nursing facilities, primary care network, visiting nurse and community service programs, adult housing and program for all-inclusive care for the elderly ("PACE" program). Through this committee and other joint activities, the system seeks to ensure collaboration on quality initiatives among varied provider types. For example, several quality initiatives commenced in 2009 that are intended to lead to measurable improvements in patient care transitions between hospitals, nursing homes, home health and supportive housing. Northeast Health has also successfully deployed the Lean Thinking and Tools developed by the Toyota Production System, in its integrated health care delivery system. This sophisticated system of process improvement is used by Northeast Health affiliates to improve and optimize managerial, operational and clinical processes. Samaritan Hospital's affiliation with Northeast Health has enabled it to adopt Lean Thinking and Tools with a degree of success unlikely to have been attained but for the affiliation. Lean Thinking and Tools have enabled Samaritan Hospital to provide better care and services to the community. |
| Part VI - Explanation Of How Organization Furthers Its Exempt Purpose | In addition to its activities in delivering health care services to the community as described elsewhere in this filing, Samaritan Hospital furthers its exempt purposes through the following means:1. Samaritan Hospital is managed by a community board of directors, on which the substantial majority of directors are residents of the hospital's primary or secondary service area and who are neither employees nor contractors of the hospital;2. With the exception of certain departments which, in the interests of efficiency, quality and proper administration, are traditionally reserved to a single physician group having an exclusive arrangement with respect to the department (e.g., radiology, anesthesia, pathology, etc.), Samaritan Hospital maintains an open medical staff that extends privileges to all qualified physician applicants; and3. The organization generally applies all surplus funds to ensuring financially prudent availability of funds, capital maintenance and improvements, and the addition of services that benefit the community.In 2010 Northeast Health, the health system to which Samaritan Hospital belongs, entered into an affiliation agreement with St. Peters Health Care Services, principally located in Albany, and Seton Health System, principally located in Troy, under which the parties will form of a new not-for-profit entity that will become the parent of the constituent systems. The parties intend to consummate the affiliation transaction in the fall of 2011. The affiliation parties believe that by combining their complementary strengths, they can significantly improve their ability to meet the healthcare needs of the region through more coordination, improved efficiency, reduced fragmentation of care, and improved access for the poor and underserved people in the Capital Region and beyond. The parties recognize that whether they merge their health systems or not, change will and must occur in their organizations in light of emerging changes in health care delivery, and changes in public and private systems for paying for health care. The affiliation will better position the parties to address such challenges and to meet the needs of the community. |
| Part VI - Community Information | General DescriptionSamaritan Hospital is part of the Northeast Health network, a regional, comprehensive, not-for-profit provider of health care and community services. Northeast Health was formed in 1995 by the merger of Samaritan Hospital and The Eddy, joined by Albany Memorial Hospital in 1997 and Sunnyview Rehabilitation Hospital in 2007. The components of Northeast Health are deeply rooted in their communities, each with a long tradition of providing high quality care and services.Serving 22 counties in the greater Capital Region of Upstate New York, Northeast Health cares for approximately 175,000 people each year and provides a vast array of senior care, hospital services, rehabilitation, specialty services and retirement living options. Our Primary Care Network offers a full range of medical, preventive and diagnostic services for people of all ages at nine locations throughout the region.Communities ServedSamaritan Hospital (238 beds) serves primarily the population of Albany and Rensselaer counties, New York. These contiguous counties (separated north to south by the Hudson River) contain 458,764 persons. Their populations are concentrated along the Hudson River in the cities of Albany, Cohoes, Rensselaer and Troy, which accounts for about 40% of the population. The balance of the population is dispersed among smaller cities, villages, suburbs and rural areas.Albany and Rensselaer counties have a fairly consistent demographic profile based on income, poverty and health insurance measures as illustrated below:Demographic Albany Rensselaer2010 Population 302,162 156,6022020 Population 307,201 158,579% Change 1.7% 1.3%2010 Households 125,729 62,3852020 Households 129,568 64,442% Change 3.1% 3.3%2009 Median Household Income $53,317 $52,232Persons Below Poverty Level (2007 Estimate) 33,254 (11.7%) 15,898 (10.6%)Number of Medicaid Enrollees 2008 37,659 (12.5%) 21,767 (13.9%)Number of Uninsured (2007 Estimate) 33,550 (11.1%) 17,098 (10.9%)On a percentage basis, the communities are very similar for median income, poverty, Medicaid enrollees and the uninsured.Other HospitalsThere are four other hospitals in the two county area. Albany Medical Center Hospital (Albany) is a 600-bed tertiary care facility. St. Peter's Hospital (Albany) is a 450-bed tertiary care facility. Albany Memorial Hospital (Albany) is a 160-bed acute care general hospital, also part of the Northeast Health network. Seton Health System/St. Mary's Hospital (Troy), is a 190-bed acute care facility.Medically Underserved Areas / PopulationsEach of these counties has areas that are designated as medically underserved. In Rensselaer County, those parts of the City of Troy which border the Hudson River are designated as medically underserved populations (MUP). The City of Albany areas adjacent to the river are designated as a medically underserved area (MUA) Samaritan Hospital is located adjacent to the MUP and delivers services to that population through the Emergency Room and a Primary Care practice located within the MUP designated area. |
| Part VI - Patient Education of Eligibility for Assistance | In addition to posting Samaritan Hospital's financial assistance policy on the hospital's website, Samaritan Hospital physically posts the policy at almost all inpatient and outpatient intake desks. All registration personnel are trained to know the procedures for assisting patients who have no insurance. Samaritan Hospital has also contracted with a firm that supplies the services of a Medicaid enroller "on-site". |
| Part VI - Needs Assessment | The organization, as a component of the Northeast Health system, has been a participant in the Healthy Capital District Initiative ("HCDI") since 1999. Other participants include all hospitals, county health departments and payers in the Albany, Rensselaer and Schenectady counties. Recently, HCDI undertook a three-pronged initiative to engage the public and assess community need. The three efforts consisted of:1. The collection and analysis of data in the Community Health Profile;2. The production of a Community Health Forum broadcast by the local PBS affiliate; and3. The collection of data using an online Community Health Survey to assess respondents' opinions on the health of the Capital District.Through the HCDI process, consideration of the New York State Commissioner of Health's ten public health priorities, and through other local efforts to obtain additional community input, Northeast Health developed health services priorities contained in its Community Service Plan. |
| Part III, Line 9b - Provisions On Collection Practices For Qualified Patients | If a patient qualifies for financial assistance, their account will not be subject to the usual collection practices during this process. If the patient does not submit the necessary documentation within 90 days, then their account could be forwarded to collections. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
| Rebuttable Presumption Procedure | false | RebuttablePresumptionProcedure |
Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Vinita Singh | |||||||||||
| 309245 | 214 | 4900 | 11738 | 326097 | |||||||
| Sergio Biguzzi | |||||||||||
| 349455 | 1188 | 4900 | 1698 | 357241 | |||||||
| Robert Smith | |||||||||||
| 126023 | 14013 | 5734 | 6657 | 154509 | 2082 | ||||||
| Robert C Davenport | |||||||||||
| 96364 | 934 | 9975 | 4278 | 3022 | 114573 | ||||||
| Norman Dascher | |||||||||||
| 310980 | 28476 | 9800 | 13131 | 370693 | 8306 | ||||||
| Naveen Achar | |||||||||||
| 193836 | 270 | 9800 | 1698 | 265686 | 60082 | ||||||
| Lori Santos | |||||||||||
| 187468 | 3046 | 16770 | 8375 | 3198 | 218857 | ||||||
| Karen Tassey | |||||||||||
| 208314 | 3075 | 414 | 8394 | 841 | 221038 | ||||||
| John Collins MD | |||||||||||
| 279185 | 7052 | 5080 | 10789 | 14418 | 316524 | ||||||
| James K Reed MD | |||||||||||
| 460797 | 14190 | 33086 | 14827 | 13681 | 536581 | ||||||
| Indra Singh | |||||||||||
| 182721 | 16770 | 9800 | 841 | 258197 | 48065 | ||||||
| Gregory Field | |||||||||||
| 291551 | 180 | 9800 | 14995 | 316526 | |||||||
| Daniel Silverman MD | |||||||||||
| 198330 | 1290 | 4222 | 16781 | 223743 | 3120 | ||||||
| Craig Duncan | |||||||||||
| 402637 | 402637 | ||||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Sch J, Part I, Line 7 | Part I, Line 7: Non-Fixed payments not listed above | Bonuses based on objective, non-financial performance measures were paid to Norman Dascher, Daniel Silverman and Robert Smith, the amounts of which are included in Schedule J, Part II, column B(ii) and/or Part VII, Section A, Line 1a, column (D).Drs. Achar and Singh received bonuses base on a combination of work units personally performed by them,and based on certain quality measures. |
| Sch J, Part I, Line 1a | Part I, Line 1a: Relevant information in regards to selections on 1a. | Samaritan Hospital pays for the dues associated with CEO Norman Dascher's membership to a country club. All invoices are received by Samaritan Hospital. Mr. Dascher reimburses the organization for the personal use charges that are unrelated to dues, so that only the dues payments represent additional compensation to Mr. Dascher. The organization pays for business-related charges. Reimbursement for this benefit is covered by Samaritan Hospital's general expense reimbursement policy. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part III Form990ScheduleLPartIII (3 entries)
| Relationship With OrganizationRelationshipWithOrganization | Name Of Interested PersonNameOfInterestedPerson |
|---|---|
| See note in Schedule O | |
| Officer or Key Employee | |
| Current or Former Director, | 6 unnamed individuals |
Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)
| RelationshipRelationship | Sharing Of RevenuesSharingOfRevenues | Description Of TransactionDescriptionOfTransaction | Amount Of TransactionAmountOfTransaction |
|---|---|---|---|
| (no name) | |||
| board | false | ||
| Insurance Co | |||
| Reed, M.D. on its | false | gen/prof liability ins | |
| Medical Liability Mutual | |||
| Director James K | false | Aggregate premiums for | 1596061 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (15 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part VII, Section A, Line 1a. | Form 990 Part VII, Section A, Line 1a.The following officers, directors, key employees and highest compensated employees devoted the indicated average number of weekly hours to related organizations:James Reed, M.D. (37.6)John Collins, M.D. (37.1)Norman Dascher (20)Lori Santos (20)Karen Tassey (20)Robert Smith (20) | |
| The combined financial statements for Northeast Health, Inc. and Affiliates (which include Samaritan Hospital), contain the following note regarding bad debt expense:"Charity Care and Provision for Bad Debts* * *"The Affiliates grant credit without collateral to patients, most of whom are local residents and are insured under third-party agreements. Additions to the allowance for estimated uncollectible accounts are made by means of the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in Federal and state governmental health care coverage and other collection indicators. Services rendered to individuals when payment is expected and ultimately not received are written off to the allowance for estimated uncollectible accounts."III.8 - Samaritan Hospital used its internal cost accounting system to calculate the amounts used in the table. The Hospital's cost accounting system includes all operations and service lines the hospital offers and includes all payor groups with detail for Medicare, Medicaid, Commerical Insurers, HMO's, Managed Care Plans, Private Insurance, Self Pay, etc. | ||
| Schedule L, Part III: Items described in this part of schedule L are courtesy discounts for hospital services provided by the organization to interested persons. The names of such persons are not provided in order to protect their health information privacy, consistent with the privacy provisions of the federal Health Insurance Portability and Accountability Act of 1996, and implementing regulations, popularly known as HIPAA. The courtesy discounts are provided under two established hospital policies, one that provides a hospital services discount benefit to all employees of the organization and their dependents, and one that provides the same discount benefit to all current and former board members of the organization, and their dependents. In 2010, 6 interested persons listed on Form 990, Part VII received such benefits, none of whom received more than $600 in aggregate discounts. | ||
| Schedule H Part VI Line 1 I.3c: Samaritan Hospital's financial assistance policy uses the Federal Poverty Guidelines to determine eligibility, and does not use an asset test." I.6a: The community benefit report, in the form of a document entitled "Community Service Plan - Comprehensive Three-Year Plan," was prepared by Northeast Health, Inc., a related organization that controls Samaritan Hospital. I.7g: Samaritan Hospital reported costs of $1,055,713 for the operation of primary care clinics. These costs are net of Medicaid and other means-tested government programs, charity care and bad debt. I.7 column (f): Samaritan Hospital had bad debt expense of $7,082.670 reported on Form 990 Part IX, Line 25, but subtracted this amount for purposes of calculating line 7 column (f). I.7 line a - Samaritan Hospital utilized the same methodology required by the NYS Institutional Cost Report. This methodology requires the Hospital to use a cost to charge ratio (from the annual Medicare Cost Report) to calculate (at cost) uncollected amounts attributable to services provided to uninsured patients found to be eligible for financial aid as well as uncollected co-insurance and deductibles for insured patients found to be eligible for financial aid. I.7 line f - Samaritan Hospital used the step-down costs as reported in our 2010 Medicare Cost Report to calculate the costs for the School of Nursing program costs reported on line 7f. I.7 (Remaining Lines) - Samaritan Hospital used its internal cost accounting system to calculate the amounts used in the table. The Hospital's cost accounting system includes all operations and service lines the hospital offers and includes all payor groups with detail for Medicare, Medicaid, Commercial Insurers, HMO's, Managed Care Plans, Private Insurance, Self Pay etc. | ||
| III.4 - The Hospital's bad debt expense is calculated on an allowance/reserve basis. Each month, account balances, net of payments, discounts and contractual allowances, are sorted by the age of the receivable and payor group. Each payor and aging group is assigned a percentage that will be used to calculate a reserve/allowance for bad debt. This allowance for doubtful account total is combined with our bad debt account receivable balance to arrive at a total estimated allowance for doubtful accounts. This total is compared to our total allowance for doubtful accounts recorded in the Hospital's general ledger. The difference is recorded as bad debt expense.Account balances on patient accounts are transferred to bad debt accounts receivable once they are determined to be uncollectible. The balances are net of discounts, adjustments and payments that have been applied to these accounts.In order to determine the Hospital's bad debt expense at cost for Part III, line 2, we first identified what portion of the bad debt was inpatient and what portion was outpatient. We then applied the appropriate cost to charge ratio (I/P or O/P) as reported in our 2010 Medicare Cost Report to the bad debt expense amounts (I/P and O/P) to determine bad debt expense at cost. The Hospital's estimate of bad debt expense at cost attributable to patients that may have been eligible under organization's charity care policy, but for whom sufficient information was unable to be obtained in order to make a determination, is based on the following: - We then took the number of incomplete and denied applications for 2010 and researched each account to see what amount was transferred to bad debt and multplied that amount by the appropriate RCC to calculate the bad debt at cost - Accounts are denied or incomplete due to insufficient information or refusal to provide information. We only selected accounts that then actually had balance transferred to bad debt with our rationale being that these patients would have qualified for charity care had they completed the process since they didn't have the means to pay and the balances were transferred to bad debt. | ||
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | In 2010, Northeast Health and its affiliates did not make the above-named documents available to the public, although certificates of incorporation were available from the NYS Secretary of State. | Form 990, Part VI, Line 19 |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | The executive compensation policy described in the note for Line 15a also applies to other officers and key employees of the organization | Form 990, Part VI, Line 15b |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Northeast Health, the health system to which Samaritan Hospital belongs, has two system-wide conflict of interest policies, one applicable to the board of directors of each system affiliate and one applicable to administrative staff and select employees and medical staff. Together, the two policies require annual disclosure of conflicts of interest by all directors, officers and key employees, and prescribe various responses to such conflicts applying customary conflicts of interest principles. Employee disclosure forms are reviewed annually by the system compliance officer for a determination of any conflicts impact on the integrity of the disclosing individuals acts and decisions. Violation of the policy subjects an employee to potential disciplinary action. Board of directors conflict of interest disclosure forms are reviewed and summarized by the system compliance officer, and the summary is reviewed by the board corporate compliance and audit committee and any necessary action taken by such committee. Customary procedures are followed, including non-participation by affected individuals in the deliberation and vote on any matters that potentially conflict with the individuals outside interests. Appropriate corrective action is taken by the Board in the event of a directors failure to disclose a conflict of interest or other violation of the policy. | Form 990, Part VI, Line 12c |
| Form 990, Part VI, Line 11: Form 990 Review Process | First, Form 990 was presented to the Board Audit/Compliance Committee for review at a special meeting, to which all other Board members were invited to attend. The 990 was then made available on the Board website for all Board members to review. | Form 990, Part VI, Line 11 |
| Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing Body | Northeast Health elects the members of the organization's governing body. | Form 990, Part VI, Line 7a |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | Northeast Health, Inc. | Form 990, Part VI, Line 6 |
| Form 990, Part VI, Line 4: Description of Significant Changes to Organizational Documents | The organization amended its bylaws to extend the date until which the number of directors is set at no less than 17 nor more than 27, to January 2012, and to provide that directors whose final term expires in January 2011 may be re-elected and serve for an additional year, until January 2012 | Form 990, Part VI, Line 4 |
| Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company | The organization delegated control over certain duties of key employees to a related exempt organization. | Form 990, Part VI, Line 3 |
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | Directors Robert Johnson and James Prout have a business relationship. Directors James H. Puleo, M.D. and James V. Puleo, M.D. have a family relationship. | Form 990, Part VI, Line 2 |
| Form 990, Part III, Line 4d : Other Program Services Description | OTHER PROGRAM SERVICES 4: Surgical servcies including operating room, anesthesiology and post anesthesia care provided to patients on both an inpatient and outpatient basis. | Form 990, Part III, Line 4d |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (16 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Empire Home Infusion Service Inc | ||||||||||
| 10 Blacksmith Drive 2 | Malta | NY | 12020 | 141795732 | Home Care | NY | 501(c)(3) | 9 | N/A | false |
| Sunnyview Hospital Rehabilitation Center | ||||||||||
| 1270 Belmont Ave | Schenectady | NY | 12308 | 141338386 | Rehab Hospital | NY | 501(c)(3) | 3 | N/A | false |
| Shaker Properties Inc | ||||||||||
| 63 Shaker Road | Albany | NY | 12204 | 223119822 | Real Estate Holding | NY | 501(c)(2) | N/A | N/A | false |
| Northeast Health Inc | ||||||||||
| 2212 Burdett Ave | Troy | NY | 12180 | 042450756 | Health System | NY | 501(c)(3) | 11, II | N/A | false |
| Majorie Doyle Rockwell Center Inc | ||||||||||
| 421 West Columbia Street | Cohoes | NY | 12047 | 141793885 | Adult Home/Alzheimer | NY | 501(c)(3) | 9 | N/A | false |
| LTC Eddy Inc | ||||||||||
| 2212 Burdett Ave | Troy | NY | 12180 | 222564710 | Elderly Health/Housing | NY | 501(c)(3) | 11, II | N/A | false |
| James A Eddy Memorial Geriatric Center | ||||||||||
| 2256 Burdett Ave | Troy | NY | 12180 | 222570478 | Nursing Home | NY | 501(c)(3) | 9 | N/A | false |
| Home Aide Services of Eastern NY Inc | ||||||||||
| 433 River Street | Troy | NY | 12180 | 141514867 | Home Care | NY | 501(c)(3) | 9 | N/A | false |
| Heritage House Nursing Center Inc | ||||||||||
| 2920 Tibbits Ave | Troy | NY | 12180 | 141725101 | Nursing Home | NY | 501(c)(3) | 9 | N/A | false |
| Hawthorne Ridge Inc | ||||||||||
| 30 Community Way | East Greenbush | NY | 12061 | 800102840 | Independent/Assisted Living | NY | 501(c)(3) | 9 | N/A | false |
| Glen Eddy Inc | ||||||||||
| 1 Glen Eddy Drive | Niskayuna | NY | 12309 | 141794150 | Independent/Assisted Living | NY | 501(c)(3) | 9 | N/A | false |
| Senior Care connection Inc | ||||||||||
| 504 State Street | Schenectady | NY | 12305 | 141708754 | PACE program | NY | 501(c)(3) | 9 | N/A | false |
| Capital Region Geriatric Center Inc | ||||||||||
| 421 West Columbia Street | Cohoes | NY | 12047 | 141701597 | Nursing Home | NY | 501(c)(3) | 9 | N/A | false |
| Beverwyck Inc | ||||||||||
| 40 Autumn Drive | Slingerlands | NY | 12159 | 141717028 | Independent/Assisted Living | NY | 501(c)(3) | 9 | N/A | false |
| Beechwood Inc | ||||||||||
| 2218 Burdett Ave | Troy | NY | 12180 | 141651563 | Real Estate Holding | NY | 501(c)(2) | N/A | N/A | false |
| Albany Memorial Hospital | ||||||||||
| 600 Northern Blvd | Albany | NY | 12204 | 141338547 | General Hospital | NY | 501(c)(3) | 3 | N/A | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Samaritan Medical Office Building | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2231 Burdett Avenue | AddressLine1 |
| City | Troy | City |
| State | NY | State |
| ZIP Code | 12180 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141607244 | EIN |
| Primary Activity | Real Estate Holding/Mgmt | PrimaryActivity |
| Legal Domicile State | NY | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C corp | TypeOfEntity |
| Percentage Ownership | 0.15000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |