DELAWARE VALLEY HOSPITAL INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- DELAWARE VALLEY HOSPITAL INC (EIN 15-0524324)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-04
- IRS object ID
- 201113089349301601
- Schema version
- 2010v3.4
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-04T10:11:51-05:00 | Timestamp |
| Tax Period End Date | 2010-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUST CHARLES CHAMBERS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5784 WIDEWATERS PARKWAY | AddressLine1 |
| City | SYRACUSE | City |
| State | NY | State |
| ZIP Code | 13214 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 150524324 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAWARE VALLEY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | DELA | NameControl |
| Phone | 6078652198 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 TITUS PLACE | AddressLine1 |
| City | WALTON | City |
| State | NY | State |
| ZIP Code | 138561457 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID POLGE | Name |
| Title | PRESIDENT/CEO | Title |
| Phone | 6078652160 | Phone |
| Date Signed | 2011-10-20 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3154463600 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DAVID POLGE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 TITUS PLACE | AddressLine1 |
| City | WALTON | City |
| State | NY | State |
| ZIP Code | 138561457 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 15727467 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.UHS.NET/ | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1950 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | TO SERVE OUR PATIENTS IN AN EFFICIENT AND PATIENT-FOCUSED MANNER AND OFFER A RANGE OF ACUTE, OUTPATIENT, DIAGNOSTIC, RAHABILITATIVE, PRIMARY CARE AND WELLNESS SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 238 | TotalNbrEmployees |
| Total Nbr Volunteers | 45 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 636420 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 443654 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 16261514 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 15178353 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 28440 | InvestmentIncomePriorYear |
| Investment Income Current Year | 26635 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 549832 | OtherRevenuePriorYear |
| Other Revenue Current Year | 78825 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 17476206 | TotalRevenuePriorYear |
| Total Revenue Current Year | 15727467 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9483934 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 9878570 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 20711 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 5622945 | OtherExpensePriorYear |
| Other Expenses Current Year | 5537932 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15106879 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15416502 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2369327 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 310965 | RevenuesLessExpensesCY |
| Total Assets BOY | 15856057 | TotalAssetsBOY |
| Total Assets EOY | 15422294 | TotalAssetsEOY |
| Total Liabilities BOY | 9567946 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 8830758 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6288111 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6591536 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE HIGH QUALITY HEALTH AND MEDICAL CARE SERVICES TO THE RESIDENTS OF IT'S RURAL SERVICE AREA. THE PRINCIPAL GEOGPRAPHIC AREAS SERVED INCLUDES THE MIDDLE AND SOUTHWESTERN PORTIONS OF DELAWARE COUNTY. IN ADDITION, A SIGNIFICANT NUMBER OF RESIDENTS LIVING IN NORTHERN SULLIVAN COUNTY UTILIZE THESE SERVICES. THE MAIN HOSPITAL CAMPUS IS LOCATED IN WALTON, WITH HEALTH CENTERS OPERATED IN DOWNSVILLE AND ROSCOE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4436644 | Expense |
| Revenue | 6684684 | Revenue |
| Description | INPATIENT AND ACUTE SERVICES: DELAWARE VALLEY HOSPITAL FULFILLS IT'S MISSION BY WORKING TOGETHER WITH THE COMMUNITY, PHYSICIANS, AND OTHER HEALTHCARE PROVIDERS TO CONTINUOUSLY IMPROVE THE AVAILABILITY AND QUALITY OF SERVICES. THIS INCLUDES THE ABILITY TO PROVIDE A COMPREHENSIVE RANGE OF SHORT-TERM (96 HRS. OR LESS) INPATIENT ACUTE, SWING BED, AND ADDICTION TREATMENT SERVICES VIA IT'S 25-BED HOSPITAL LOCATED ON THE MAIN CAMPUS IN WALTON IN DELAWARE COUNTY, NY. PATIENT DISCHARGES IN 2010 WERE COMPRISED OF 690 ACUTE, 136 SWING BED, AND 83 ADDICTION TREATMENT. ACUTE CARE REPRESENTED 2,202 PATIENT DAYS, IN ADDITION TO THE 1,324 PATIENT DAYS FOR SWING BED AND 1,527 PATIENT DAYS IN THE ADDICTION TREATMENT PROGRAM. INDICATIVE OF THE COMPREHENSIVE HEALTHCARE PROVIDED TO THESE PATIENTS, A TOTAL OF 10,787 LAB TESTS, 4,807 RESPIRATORY TREATMENTS, 670 X-RAYS, 720 PHYSICAL THERAPY SESSIONS, AND 615 EKG'S WERE ADMINISTERED. OTHER SERVICES INCLUDED OCCUPATIONAL THERAPY, ENDOSCOPIES, ECHO EXAMS, ULTRASOUNDS, CT EXAMS, AND MAMMOGRAPHIES. TO ENSURE OUR RURAL AREA RESIDENTS HAVE ACCESS TO HIGH QUALITY, EFFICIENT CARE IN A COMFORTABLE AND PRIVATE AREA, THE HOSPITALS NEW IMAGING CENTER IS EQUIPPED WITH A 16-SLICE CT SCANNER. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1696469 | Expense |
| Revenue | 1529704 | Revenue |
| Description | CLINICS: DELAWARE VALLEY HOSPITAL PROVIDES A WIDE RANGE OF PRIMARY AND PREVENTIVE CARE SERVICES THROUGH IT'S FAMILY HEALTH CENTERS LOCATED IN WALTON, DOWNSVILLE, AND ROSCOE. THESE HEALTH CENTERS FORM THE FOUNDATION NECESSARY TO SERVE OUR COMMUNITIES WITH A COORDINATED SYSTEM OF CARE WHILE PAYING SPECIAL ATTENTION TO UNDER-SERVED AREAS. IN 2010 OUR CLINICS PROVIDED CARE TO 9,762 PATIENTS IN WALTON, 2,408 IN ROSCOE, AND 1,240 IN DOWNSVILLE. WITH A FOCUS ON CONTINUOUS IMPROVEMENT, THE FAMILY HEALTH CENTERS OPERATE UNDER A NEW HEALTH INFORMATION MANAGEMENT SYSTEM AND CONTINUE TO BE SMOKE AND TOBACCO FREE. THEY HAVE ALSO BECOME A KEY TO THE IMPROVEMENT OF CHILDHOOD IMMUNIZATION LEVELS IN COORDINATION WITH DELAWARE COUNTY'S PUBLIC HEALTH NURSING SERVICES AND OTHER AREA HEALTHCARE PROVIDERS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 4622004 | Expense |
| Revenue | 6963965 | Revenue |
| Description | OUTPATIENT AND AMBULATORY SERVICES: DELAWARE VALLEY HOSPITAL PROVIDES A COMPREHENSIVE RANGE OF OUTPATIENT DIAGNOSTIC AND TREATMENT SERVICES AT IT'S WALTON CAMPUS. THESE INCLUDE A NEW 7-BED EMERGENCY DEPARTMENT WHICH SERVES THE COMMUNITY 24/7. OTHER TREATMENT SERVICES INCLUDE EMERGENCY CARE, REHABILITATIVE SERVICES, AMBULATORY PROCEDURES, AND ACCESS TO SPECIALTY SERVICES AND SURGERY. THE HOSPITAL ALSO CONDUCTS EXTENSIVE WELLNESS PROGRAMMING THAT INCLUDES CARDIOVASCULAR AWARENESS/CHOLESTEROL SCREENING, WEIGHT REDUCTION, CANCER EDUCATION AND SCREENING, AND DIABETES EDUCATION/GLUCOSE TESTING. THE PHYSCIAL THERAPY DEPARTMENT PROVIDES HOME VISITS IN COOPERATION WITH THE DELAWARE COUNTY PUBLIC HEALTH NURSING DEPARTMENT. A FREE PRESCRIPTION DELIVERY PROGRAM IS PROVIDED FOR ROSCOE AND DOWNSVILLE PATIENTS AS THESE COMMUNITIES LACK A PHARMACY. OCCUPATIONAL HEALTH PROGRAMMING MEETS THE NEEDS OF LOCAL BUSINESSES, FIRE DEPARTMENTS, AND EMERGENCY SQUADS BY PROVIDING PHYSICALS, DRUG TESTING, AND ERGONOMIC EDUCATION. IN 2010 THE EMERGENCY DEPARTMENT TREATED OR ADMITTED 5,397 RESIDENTS VIA ITS NEW 5,000+ SQ. FT. FACILITY, THE LAB PERFORMED 50,118 TESTS, AND 7,460 PHYSICAL/OCCUPATIONAL THERAPY SESSIONS WERE CONDUCTED. THE IMAGING CENTER PERFORMED 6,319 X-RAYS, CT SCANS, AND MAMMOGRAPHIES FOR OUTPATIENT SERVICES. EQUIPMENT UPGRADES FOR 2010 INCULDED A NEW HIGH PERFORMANCE BONE DENSITY MACHINE TO PROVIDE RELIABLE MEASUREMENTS TO AID IN DIAGNOSIS FOR PATIENTS. OTHER EQUIPMENT ADDITIONS INCLUDED A DEFIBRILLATOR UNIT AND PADDLES AND AN OLYMPUS PEDI-COLONSCOPE. BUILDING IMPROVEMENTS DURING 2010 INCLUDED NEW SECURE BADGE ACCESS TO THE HOSPITAL EMERGENCY AND ADDICTION TREATMENT FACILITIES AND SECURITY CAMERAS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 10755117 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 0 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 46 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 238 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 6 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicy |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN SAVELLI | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6078652198 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | DELAWARE VALLEY HOSPITAL 1 TITUS | AddressLine1 |
| City | WALTON | City |
| State | NY | State |
| ZIP Code | 138561457 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| DAVID POLGE | ||||||||
| PRESIDENT/CEO | 40.00 | X | X | 183224 | 0 | 10280 | ||
| DR MICHAEL FREEMAN | ||||||||
| MEDICAL STAFF PRESIDENT | 40.00 | X | X | 227374 | 0 | 18039 | ||
| DR RAJESH DAVE | ||||||||
| 2ND VICE CHAIR | 1.00 | X | X | 0 | 678610 | 52408 | ||
| HELEN JOHNSTON | ||||||||
| 1ST VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| EDWARD SNOW | ||||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | ||
| EDWARD SCHOTT | ||||||||
| BOARD CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| PAUL CARLSTROM | ||||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | ||
| REV LARRY LIGHT | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| BRIDGET DEMOTT | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DOTTIE KRUPPO | ||||||||
| V.P. COMMUNITY HLTH SVCS | 40.00 | X | 74765 | 0 | 6939 | |||
| JOAN GUARNIERI | ||||||||
| V.P. ANCILLARY SERVICES | 40.00 | X | 91195 | 0 | 7362 | |||
| PAUL SUMMERS | ||||||||
| V.P. FINANCE/CFO | 40.00 | X | 104070 | 0 | 8673 | |||
| DEBORAH HITT | ||||||||
| V.P. QUALITY/SUPPORT SVCS | 40.00 | X | 77547 | 0 | 11133 | |||
| VICTORIA CONKLING | ||||||||
| V.P. NURSING/CNO | 40.00 | X | 93197 | 0 | 1907 | |||
| DR VADIM DAVYDOV | ||||||||
| PHYSICIAN | 40.00 | 170514 | 0 | 9093 | X | |||
| DR VALENTINA DAVYDOV | ||||||||
| PHYSICIAN | 40.00 | 170800 | 0 | 0 | X | |||
| SUMAN CHOUDHURY | ||||||||
| ER PHYSICIAN | 63.00 | 170097 | 0 | 14833 | X | |||
| DEVELYN CORRIGAN | ||||||||
| ER PHYSICIAN | 63.00 | 111867 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1474650 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 678610 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 140667 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| MVP HEALTH PLAN INC | |||||
| PO BOX 26864 | NEW YORK | NY | 10087 | HEALTH CARE | 314416 |
| SECO PHYSICAL & OCCUPATIONAL THERAPY | |||||
| PO BOX 1046 | NORWICH | NY | 13815 | PHYSICAL AND OCCUPATIONAL THERAPY SERVIC | 310102 |
| HEALTHCARE MANAGEMENT SYSTEMS | |||||
| 2739 MOMENTUM PLACE | CHICAGO | IL | 60689 | INFORMATION TECHNOLOGY | 269872 |
| NATIONAL GOVERNMENT SERVICES | |||||
| PO BOX 13078 | NEWARK | NJ | 07188 | MEDICARE CONTRACTOR | 265953 |
| UNITED HEALTH SERVICES INC | |||||
| 20-40 MITCHELL AVE | BINGHAMTON | NY | 13903 | HEALTH CARE | 213436 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| Government Grants | 383234 | GovernmentGrants |
| All Other Contributions | 60420 | AllOtherContributions |
| Total Contributions | 443654 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 15178353 | TotalRevenueColumn |
| Related Or Exempt Function Income | 15178353 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 15178353 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 25301 | TotalRevenueColumn |
| Exclusion | $25,301 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1334 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 1334 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1334 | TotalRevenueColumn |
| Exclusion | $1,334 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| VENDING MACHINE | 722210 | 24364 | $24,364 | |
| PHYSICIAN OTHER REVENU | 621498 | 18949 | 18949 | |
| REBATES | 900099 | 18426 | 18426 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17086 | TotalRevenueColumn |
| Exclusion | $17,086 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 78825 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15727467 | TotalRevenueColumn |
| Related Or Exempt Function Income | 15215728 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $68,085 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1266112 | Total |
| Program Services | 871186 | ProgramServices |
| Management And General | 394926 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6736581 | Total |
| Program Services | 4811438 | ProgramServices |
| Management And General | 1911438 | ManagementAndGeneral |
| Fundraising | 13705 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 196793 | Total |
| Program Services | 121764 | ProgramServices |
| Management And General | 74397 | ManagementAndGeneral |
| Fundraising | 632 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1112775 | Total |
| Program Services | 688521 | ProgramServices |
| Management And General | 420683 | ManagementAndGeneral |
| Fundraising | 3571 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 566309 | Total |
| Program Services | 398446 | ProgramServices |
| Management And General | 166957 | ManagementAndGeneral |
| Fundraising | 906 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 187014 | Total |
| Management And General | 187014 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20993 | Total |
| Management And General | 20993 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75665 | Total |
| Management And General | 75665 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5429 | Total |
| Management And General | 5429 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2000 | Total |
| Management And General | 2000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 880276 | Total |
| Program Services | 768899 | ProgramServices |
| Management And General | 111377 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 942092 | Total |
| Program Services | 709622 | ProgramServices |
| Management And General | 230603 | ManagementAndGeneral |
| Fundraising | 1867 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 191159 | Total |
| Management And General | 191159 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 226692 | Total |
| Program Services | 55268 | ProgramServices |
| Management And General | 171424 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38390 | Total |
| Program Services | 26542 | ProgramServices |
| Management And General | 11818 | ManagementAndGeneral |
| Fundraising | 30 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34726 | Total |
| Program Services | 31322 | ProgramServices |
| Management And General | 3404 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 365366 | Total |
| Management And General | 365366 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 888824 | Total |
| Program Services | 877804 | ProgramServices |
| Management And General | 11020 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 181568 | Total |
| Program Services | 141153 | ProgramServices |
| Management And General | 40415 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT EXPENSE | 832370 | 832370 | |
| MISCELLANEOUS | 611643 | 367057 | 244586 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53725 | Total |
| Program Services | 53725 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15416502 | Total |
| Program Services | 10755117 | ProgramServices |
| Management And General | 4640674 | ManagementAndGeneral |
| Fundraising | 20711 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2557358 | BOY |
| EOY | 1867280 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 642603 | BOY |
| EOY | 654900 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 101752 | BOY |
| EOY | 2721 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1705146 | BOY |
| EOY | 1825175 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 113845 | BOY |
| EOY | 134131 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 464805 | BOY |
| EOY | 426743 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 18470672 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 10396019 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8270314 | BOY |
| EOY | 8074653 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 492978 | BOY |
| EOY | 531930 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1507256 | BOY |
| EOY | 1904761 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15856057 | BOY |
| EOY | 15422294 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 953288 | BOY |
| EOY | 824833 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5678593 | BOY |
| EOY | 5427574 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1060279 | BOY |
| EOY | 963096 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1326531 | BOY |
| EOY | 1134093 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 549255 | BOY |
| EOY | 481162 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9567946 | BOY |
| EOY | 8830758 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5863720 | BOY |
| EOY | 6248704 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106181 | BOY |
| EOY | 24622 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 318210 | BOY |
| EOY | 318210 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6288111 | BOY |
| EOY | 6591536 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15856057 | BOY |
| EOY | 15422294 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 310965 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -7540 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $5,429 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 5429 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF OTHER LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1I: | ReturnReference |
| Explanation | DELAWARE VALLEY HOSPITAL HAS LIMITED LOBBYING ACTIVITIES WHICH ARE CONDUCTED ON BEHALF OF THE ORGANIZATION THROUGH MEMBERSHIP IN IROQUOIS HEALTHCARE AND THE HEALTH CARE ASSOCIATION OF NEW YORK STATE (HANYS). THESE ACTIVITIES INCLUDE ADVERTISEMENTS AND CONTACTS WITH THE LEGISLATORS ON VARIOUS HEALTHCARE ISSUES. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 424391 | BeginningOfYearBalance |
| Contributions | 6550 | Contributions |
| Other Expenditures | 88109 | OtherExpenditures |
| End Of Year Balance | 342832 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 361680 | BeginningOfYearBalance |
| Contributions | 145420 | Contributions |
| Other Expenditures | 82709 | OtherExpenditures |
| End Of Year Balance | 424391 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 765743 | BeginningOfYearBalance |
| Contributions | 79512 | Contributions |
| Investment Earnings Or Losses | 299 | InvestmentEarningsOrLosses |
| Other Expenditures | 483874 | OtherExpenditures |
| End Of Year Balance | 361680 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.07000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.93000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 51202 | OtherCostOrOtherBasis |
| Book Value | 51202 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8484554 | OtherCostOrOtherBasis |
| Depreciation | 3096669 | Depreciation |
| Book Value | 5387885 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9100042 | OtherCostOrOtherBasis |
| Depreciation | 6947409 | Depreciation |
| Book Value | 2152633 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 834874 | OtherCostOrOtherBasis |
| Depreciation | 351941 | Depreciation |
| Book Value | 482933 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8074653 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| WELLS FARGO - PRINCIPAL PMTS. ON BOND | 158020 | F |
| TEMPORARILY RESTRICTED DONATIONS | 21520 | F |
| CAPITAL CONSTRUCTION (FUNDED DEPR.) | 1725221 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 1904761 | TotalOfBookValueProgramRelated |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE UNITED MED. ASSOC. NET CHENANGO MEM. | $3,500 |
| DUE UNITED HEALTH SERVICES HOSPITALS | $462,371 |
| DUE UNITED HEALTH SERVICES, INC. | $15,291 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 481162 | TotalOfAmounts |
| Total Revenue | 15727467 | TotalRevenue |
| Total Expenses | 15416502 | TotalExpenses |
| Excess Or Deficit For Year | 310965 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 36797 | NetUnrealizedGLOnInvestments |
| Other | -$44,337 | OtherAmount |
| Total Adjustments | -7540 | TotalAdjustments |
| Excess Or Deficit Per FS | 303425 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 15762930 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 36797 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 36797 | RevenueNotRptdF990 |
| Revenue Subtotal | 15726133 | RevenueSubtotal |
| Other Revenues Not Included | 1334 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 1334 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 15727467 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 15459505 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 44337 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 44337 | ExpensesNotRptdF990 |
| Expenses Subtotal | 15415168 | ExpensesSubtotal |
| Other Expenses Not Included | 1334 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1334 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 15416502 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | PURCHASE OF CAPITAL EQUIPMENT (MEDICAL) AND IMPROVEMENT OF FACILITIES. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. THE HOSPITAL IS SUBJECT TO FEDERAL INCOME TAXES ON UNRELATED BUSINESS INCOME UNDER SECTION 511 OF THE INTERNAL REVENUE CODE. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | GAIN ON DISPOSAL OF ASSETS 1,334. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 44,337. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | GAIN ON DISPOSAL OF ASSETS 1,334. | |
| PART XI, LINE 8 - CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 126486 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 41235 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 85251 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00550 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4579962 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3008705 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1571257 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10190 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4706448 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3049940 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1656508 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.10740 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 182931 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6940 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 175991 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01140 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 42979 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 42979 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00280 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1300 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1300 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 227210 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6940 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 220270 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01430 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4933658 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3056880 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1876778 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12170 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $416,185 | BadDebtExpenseAmount |
| Amount Attributable To | 35040 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 3445653 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 3647494 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -201841 | 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 | 0 | WrittenDebtCollectionPolicy |
| Number Of Hospital Facilities | 6 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (6 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | Critical Access HospitalCriticalAccessHospital | Er24 HoursEr24Hours | OtherOther |
|---|---|---|---|---|---|---|---|---|
| DELAWARE VALLEY HOSPITAL INC | ||||||||
| 1 | 1 TITUS PLACE | WALTON | NY | 13856 | X | X | X | |
| ROSCOE FAMILY HEALTH CENTER | ||||||||
| 2 | 1982 OLD ROUTE 17 | ROSCOE | NY | 12776 | OUTPATIENT PHYSICIAN CLINIC | |||
| DOWNSVILLE FAMILY HEALTH CENTER | ||||||||
| 3 | 15212 MAIN STREET | DOWNSVILLE | NY | 13755 | OUTPATIENT PHYSICIAN CLINIC | |||
| WALTON FAMILY HEALTH CENTER | ||||||||
| 4 | 2 TITUS PLACE | WALTON | NY | 13856 | OUTPATIENT PHYSICIAN CLINIC | |||
| PHYSICAL AND OCCUPATIONAL THERAPY | ||||||||
| 5 | 123 STOCKTON AVENUE | WALTON | NY | 13856 | REHABILITATION CLINIC | |||
| SPECIALTY CLINIC | ||||||||
| 6 | 121 STOCKTON AVENUE | WALTON | NY | 13856 | OUTPATIENT PHYSICIAN CLINIC | |||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELAWARE VALLEY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: DELAWARE VALLEY HOSPITAL IS A CRITICAL ACCESS HOSPITAL (CAH) AS DESIGNATED BY MEDICARE AND MEDICAID. UNLIKE NON-CAH'S THAT ARE REIMBURSED BASED ON A PROSPECTIVE REIMBURSEMENT METHODOLOGY, CAH'S ARE REIMBURSED THEIR ALLOWABLE COSTS FOR MEDICARE PURPOSES. THE MEDICARE COST REPORT (CMS 2552) AND THE MEDICAID INSTITUTIONAL COST REPORT (ICR) WAS UTILIZED FOR PURPOSES OF IDENTIFYING COSTS AND NET REVENUE. A. COSTS:I. FYE COSTS AS INDEPENDENTLY AUDITED. NON-ALLOWABLE COSTS (I.E.-PHYSICIANS, ETC.) ARE USED TO REDUCE COSTS TO ARRIVE AT ALLOWABLE COSTS.II. VARIOUS STATISTICAL BASIS ARE USED TO ALLOCATE GENERAL SERVICE COSTS (I.E.-ADMINISTRATION, PLANT OPERATIONS, HOUSEKEEPING, ETC.), VIA A "STEPDOWN" METHODOLOGY TO REVENUE PRODUCING COST CENTERS SUCH AS ANCILLARY COST CENTERS (I.E. - RADIOLOGY, LAB, PHYSICAL THERAPY, ETC.) ROUTINE COST CENTERS (MEDICAL SURGICAL, ETC.) AND OUTPATIENT COST CENTERS (EMERGENCY, CLINIC, ETC.). III. ROUTINE COSTS PER DAY ARE THEN CALCULATED BY DIVIDING DIRECT AND INDIRECT COSTS (STEPDOWN) BY TOTAL DAYS. THIS PER DAY COST CAN THEN BE MULTIPLIED BY PAYOR SPECIFIC DAYS TO ARRIVE AT ROUTINE PAYOR COSTS.IV. ANCILLARY AND OUTPATIENT COSTS RELATED TO SPECIFIC PAYORS CAN BE DETERMINED BASED ON THE RATIO OF COST TO CHARGES (RCC).1. THE RCC IS CALCULATED BY DIVIDING THE DIRECT AND INDIRECT COSTS (STEPDOWN COSTS)BY GROSS CHARGES. THE RCC CAN THEN BE MULTIPLIED BY PAYOR SPECIFIC GROSS CHARGES TO ARRIVE AT PAYOR SPECIFIC COSTS. B. REVENUE: I. MEDICARE: NET REVENUE IS BASED IN DVH'S ALLOWABLE COSTS (INPATIENT AND OUTPATIENT) ARE REIMBURSED WITH A 1% MARKUP. II. MEDICAID: NET REVENUE IS BASED ON THE FOLLOWING:A. INPATIENT - A BASE YEAR COST PER DAY TRENDED ANNUALLY FOR INFLATION.B. OUTPATIENT - MEDICAID PUBLISHED RATES.III. OTHER PAYORS: REVENUE IS BASED ON NEGOTIATED RATES OF PAYMENT. | ||
| PART I, L7 COL(F): DELAWARE VALLEY HOSPITAL REPORTED BAD DEBT EXPENSE IN THE AMOUNT OF $832,370 IN PART IX, LINE 24A. THE AFOREMENTIONED BAD DEBT EXPENSE WAS NOT USED IN THE CALCULATIONS OF SCHEDULE H, PART 1, LINES 7A THRU 7K. | ||
| PART II: ...THE CEO SERVES ON THE COUNTY RURAL HEALTH ALLIANCE WHICH BRINGS HEALTHCARE AND SERVICE AGENCIES TOGETHER TO RECOGNIZE AND ADDRESS HEALTHCARE NEEDS OF RESIDENTS. THE HOSPITALS DIETITIAN SERVES ON THE LOCAL SCHOOL COMMITTEE ON OBESITY TO HELP ADDRESS STUDENTS HEALTH. THE HUMAN RESOURCE COORDINATOR PARTICIPATES IN THE LOCAL SCHOOL CAREER DAY, MAKING STUDENTS AWARE OF HEALTHCARE CAREERS. THE HOSPITAL ALSO HOLDS A 2 DAY MASH CAMP FOR STUDENTS IN GRADES 7 - 12 TO OFFER THEM THE OPPORTUNITY TO HAVE HANDS ON EXPERIENCE IN VARIOUS HEALTHCARE CAREERS. NUMERIOUS JOB FARES ARE ATTENDED. FINALLY, THE CEO SERVES AS A BOARD MEMBER OF THE CATSKILL-HUDSON AREA HEALTH EDUCATION CENTER WHICH FOCUSES ON WORKFORCE DEVELOPMENT. COMMUNITY SUPPORT ACTIVITIES INCLUDE SERVICE ON A COMMITTEE TO ATTRACT AND RETAIN PROFESSIONALS TO OUR AREA IN THE FIELDS OF HEALTHCARE. | ||
| PART III, LINE 4: THE ORGANIZATION'S FINANCIAL STATEMENTS DO NOT SPECIFICALLY REFERENCE OR DESCRIBE BAD DEBT EXPENSE. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS RECEIVABLE IS ESTIMATED BY MANAGEMENT BASED ON PERIODIC REVIEWS OF THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE CONSIDERING HISTORICAL EXPERIENCE AND PREVAILING ECONOMIC CONDITIONS. | ||
| PART III, LINE 8: BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS NET PATIENT SERVICE REVENUE. THE HOSPITAL HAS A POLICY TO PROVIDE A COMMUNITY BENEFIT TO UNINSURED PATIENTS THAT CONSISTS OF FEE DISCOUNTS. CERTAIN PATIENTS THAT WERE PROVIDED FEE DISCOUNTS WOULD HAVE LIKELY QUALIFIED UNDER THE CHARITY CARE POLICY. | ||
| PART VI, LINE 2: DELAWARE VALLEY HOSPITAL (DVH) WORKS CLOSELY WITH OTHER HEALTHCARE ORGANIZATIONS AND SERVICE AGENCIES TO ADDRESS THE NEEDS OF AREA RESIDENTS. THE DELAWARE COUNTY PUBLIC HEALTH DEPARTMENT CONDUCTED IT'S MANDATED NEEDS ASSESSMENT IN 2008. DVH PARTICIPATED IN THE PROCESS. THE HOSPITAL ALSO SERVES AS A MEMBER OF THE DELAWARE COUNTY RURAL HEALTHCARE ALLIANCE; A COALITION OF SERVICE AND HEALTHCARE AGENCIES. THE CEO OF THE HOSPITAL SERVES ON THE CATSKILL-HUDSON AREA HEALTH EDUCATION CENTER. THESE RELATIONSHIPS ALLOW THE HOSPITAL TO RECOGNIZE THE NEEDS OF THE COMMUNITY AND ADDRESS THEM AS APPROPRIATE IN CONJUNCTION WITH OTHER STAKEHOLDERS. PATIENT SATISFACTION SURVEYS ARE COMPLETED ON AN ONGOING BASIS. ADMINISTRATIVE REPRESENTATIVES ALSO ATTEND ALL DELAWARE VALLEY HOSPITAL VOLUNTEERS MEETINGS, WHOSE MEMBERS ARE ABLE TO OFFER INSIGHT INTO THE NEEDS OF THE COMMUNITY MEMBERS. | ||
| PART VI, LINE 3: DELAWARE VALLEY HOSPITAL, INC. IS COMMITTED TO PROVIDING FINANCIAL ASSISTANCE TO ALL PATIENTS IN NEED AND TO COMMUNICATE THE AVAILABILITY OF ITS FINANCAIAL ASSISTANCE AND RELATED PROGRAMS TO ALL. PATIENT FINANCIAL ADVOCATES ARE AVAILABLE TO ASSIST PATIENTS AND PROVIDE ASSESSMENTS FOR ELIGIBILITY UNDER ANY STATE, FEDERAL, OR UHS SYSTEM HOSPITALS' FINANCIAL ASSISTANCE PROGRAM. BROCHURES AND SIGNAGE ARE POSTED IN MULTIPLE LANGUAGES IF REQUIRED BY NEW YORK STATE REGULATIONS AT EACH REGISTRATION/PATIENT ACCESS AREA. IF NEEDED, TRANSLATION SERVICES ARE AVAILABLE. DELAWARE VALLEY HOSPITAL, INC. ALSO MAINTAINS A FINANCIAL ASSISTANCE HELP LINE THAT IS ADVERTISED ON ALL (INPATIENT & OUTPATIENT) BILLS. | ||
| PART VI, LINE 4: DELAWARE VALLEY HOSPITAL (DVH) IS A 25-BED CRITICAL ACCESS HOSPITAL (CAH) FACILITY LOCATED IN WALTON IN DELAWARE COUNTY, NY. DVH PROVIDES HIGH QUALITY HEALTH AND MEDICAL CARE SERVICES TO A RURAL POPULATION OF APPROXIMATELY 31,000 PEOPLE LIVING IN SOUTHWESTERN DELAWARE AND NORTHEASTERN SULLIVAN COUNTIES. AS A CAH FACILITY, THE HOSPITAL GENERALLY SERVES PATIENTS WHOSE ACUTE STAY WILL BE 96 HOURS OR LESS; HOWEVER, DVH ALSO PROMOTES LONGER-TERM INPATIENT REHABILITATIVE AND ADDICTION TREATMENT CARE FOR PATIENTS. A NEW 7-BED EMERGENCY DEPARTMENT WAS CONSTRUCTED IN 2008 AND SERVES THE COMMUNITY 24/7. THE HOSPITAL ALSO OFFERS DIAGNOSTIC AND TREATMENT SERVICES WHICH INCLUDE A FULL SERVICE LABORATORY ON SITE, AMBULATORY SURGERY, ENDOSCOPY AND BLOOD TRANSFUSIONS AND PHLEBOTOMY. IT'S NEW IMAGING CENTER IS EQUIPPED WITH CT SCAN, MAMMOGRAPHY, AND BONE DENSITOMETRY TO NAME A FEW. CARDIOPULMONARY SERVICES INCLUDE EKG, PFT'S, EVENT MONITORING AND A CARDIAC REHABILITATION PROGRAM. SPEECH, PHYSICAL AND OCCUPATIONAL THERAPY ARE OFFERED BOTH ON AN INPATIENT AND OUTPATIENT BASIS. PRIMARY AND PREVENTIVE CARE FOR ALL AGES, AND OCCUPATIONAL HEALTH SERVICES ARE PROVIDED THROUGH THE THREE FAMILY HEALTH CENTER SITES IN WALTON, DOWNSVILLE AND ROSCOE, NY. AREA SPECIALISTS COME TO DELAWARE VALLEY HOSPITAL'S VISITING SPECIALIST CENTER ON A REGULAR BASIS TO SEE PATIENTS. THE SERVICE AREA WAS DETERMINED BY EXAMINING INPATIENT ORIGIN BY ZIP CODE AND BY COUNTY. BECAUSE THE MAJORITY OF THE SERVICE AREA FALLS INTO A SINGLE COUNTY, COLLABORATION TO IDENTIFY PUBLIC HEALTH PRIORITIES TOOK PLACE AT THE COUNTY LEVEL. DVH'S SERVICE AREA IS CENTERED IN DELAWARE COUNTY, WITH 81% OF PATIENTS COMING FROM MIDDLE AND SOUTHWESTERN DELAWARE COUNTY COMMUNITIES, AND ANOTHER 15% FROM NORTHERN SULLIVAN, BROOME, OTSEGO, AND CHENANGO COUNTIES. DVH'S 85% ZIP CODE SERVICE AREA INCLUDES THE COMMUNITIES OF: WALTON, DOWNSVILLE, SIDNEY CENTER, ROSCOE, HANCOCK, HAMDEN, DELHI, EAST BRANCH, DELANCEY, SIDNEY, UNADILLA, BAINBRIDGE, FRANKLIN, AND LONG EDDY. | ||
| PART VI, LINE 6: DURING 2010 THE DELAWARE VALLEY HOSPITAL PARTICIPATED IN SEVERAL PROGRAMS TO PROMOTE THE HEALTH AND WELLBEING OF THE LOCAL COMMUNITY WITHIN DELAWARE COUNTY. FOR EXAMPLE, THE HOSPITAL SUPPORTED THE DELAWARE COUNTY FAIR WITH A TOTAL OF 26 EMPLOYEES SPENDING 215 WORKING HOURS AT THE EVENT. THE HOSPITAL STAFF PROVIDED 373 BLOOD PRESSURE TESTS, 139 BLOOD SUGAR SCREENINGS AND OTHER HEALTH RELATED TESTS, FOR A TOTAL OF 656 SERVICES AT NO COST TO THE COMMUNITY. THE HOSPITAL ALSO PROVIDED VARIOUS SCREENING TESTS SUCH AS SERIES 2500, PSA, COLORECTAL, AND HGA1C TO A TOTAL OF 231 INDIVIDUALS WITHIN THE FIRE DEPARTENTS OF WALTON, STAMFORD, ANDES, HAMMOND, AND ROXBURY. OTHER EVENTS DURING THE YEAR INCLUDED A TEDDY BEAR CLINIC WHICH SERVED 96 CHILDREN IN THE LOCAL COMMUNITY AND PROVIDED THEM WITH AN INTRODUCTION AND BETTER UNDERSTANDING OF THE HOSPITAL'S EMERGENCY ROOM. THIS ALSO PROVIDED A CHANCE TO MEET THE STAFF THAT IS THERE TO TREAT THEM. OTHER COMMUNITY HEALTH IMPROVEMENT PROGRAMS INCLUDED DRUG SCREENS FOR THE DELAWARE VALLEY AND CHENANGO COUNTY DRUG COURT FOR CONVICTED (NON-VIOLENT) INDIVIDUALS. THIS PROGRAM PROVIDED DRUG TEST, COUNSELING, AND COMMUNITY SERVICE AS AN ALTERNATIVE TO INCARCERATION. THE HOSPITAL'S LIFESTEPS PROGRAM ADVOCATED WEIGHT LOSS AND HEALTHY EATING HABITS AND SOLUTIONS. THE HOSPITAL'S VICE-PRESIDENT OF COMMUNITY HEALTH SERVICES SERVES ON THE DELAWARE COUNTY RURAL HEALTH CARE ALLIANCE. THIS PROGRAM IS A COALITION OF HEALTH CARE PROVIDERS FROM DELAWARE COUNTY THAT STRESSES THE NEEDS OF VARIOUS ORGANIZATION IN THE COMMUNITY. ALSO TO NOTE, THE HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF BOTH STAFF AND MEMBERS OF THE LOCAL COMMUNITY. | ||
| PART VI, LINE 7: DELAWARE VALLEY HOSPITAL, INC. IS AN IMPORTANT PART OF A LARGER SYSTEM OF INTEGRATED DELIVERY OF CARE, WHICH PROVIDES ADDITIONAL BENEFITS TO THE COMMUNITY. AS A RESULT OF THE FORMATION OF UHS IN 1981 AND THE SUBSEQUENT TRANSFORMATION OF THE COMBINED ORGANIZATION INTO A HEALTH CARE SYSTEM, OUR REGION TODAY OFFERS MORE COMPLETE AND ADVANCED CARE THAN MANY COMMUNITIES FIVE TIMES OUR SIZE. IN 2007, THE UNITED HEALTH SERVICES SYSTEM ENGAGED IN A STRATEGIC PLANNING PROCESS FOR THE YEARS 2008-2011. CONSISTENT WITH THE MISSION AND VISION, THE PLAN FOCUSED ON CONTINUING TO STRENGTHEN THE HEALTH SYSTEM AND ITS SERVICES TO THE REGION. THE STRATEGIC PLAN IS ORGANIZED AROUND THREE GOALS: CLINICAL EXCELLENCE, GROWTH AND FINANCIAL STRENGTH. SPECIFIC DESTINATION METRICS OR MEASURES OF SUCCESS WERE DEVELOPED FOR EACH STRATEGIC GOAL. THE SPECIFIC INITIATIVES SUPPORTING ACHIEVEMENT OF THE GOALS ARE REVIEWED ON A REGULAR BASIS. EACH ENTITY CARRIES OUT INITIATIVES LOCALLY AND REGIONALLY. THE UHSH COMMUNITY SERVICE REPORT CAPTURES THE BENEFITS SPECIFIC TO UHSH, WITH THE OTHER AFFILIATES SUBMITTING SEPARATE REPORTS. -CLINICAL EXCELLENCE: UHS HAS FOCUSED ITS RESOURCES AND ENERGY AROUND ACHIEVING DISTINCTION AS A HEALTH SYSTEM IN CLINICAL QUALITY, PATIENT SAFETY AND SERVICE. UHS IS FOCUSED ON VIGOROUS ASSESSMENT AND IMPROVEMENT OF THE ORGANIZATION'S PERFORMANCE USING KEY PATIENT QUALITY, SAFETY AND SATISFACTION INDICATORS. THE PLAN PLACES A FOCUS IN PARTICULAR ON EMERGENCY ROOM PERFORMANCE, CLOSER INTEGRATION OF NON-ACUTE SERVICES WITH THE HOSPITALS, DEVELOPMENT AND IMPLEMENTATION OF STATE-OF-THE-ART INFORMATION TECHNOLOGY TO SUPPORT INITIATIVES IN PATIENT QUALITY AND SAFETY AND NEW INITATIVES IN THE RECRUITMENT AND RETENTION OF A QUALITY PHYSICIAN AND ALLIED HEALTH WORKFORCE. -SERVICE GROWTH: THIS GOAL AREA ADDRESSES THE KEY ASPECTS OF ALIGNING TECHNOLOGY, PHYSICIAN RESOURCES AND PROGRAMS AROUND THE CLINICAL NEEDS OF THE SERVICE AREA. THE PLAN FOCUSES ATTENTION ON KEY TERTIARY SERVICES AND THE ASSURANCE OF AN ADEQUATE SUPPLY OF PRIMARY CARE AND SPECIALIST PHYSICIANS FOR THE AREA. AT THE SAME TIME, UHS REMAINS COMMITTED TO MEETING THE COMMUNITY'S NEEDS IN BEHAVIORAL HEALTH SERVICES. -FINANCIAL STRENGTH: TO ENSURE UHS HAS THE FINANCIAL CAPACITY TO SUPPORT ITS SERVICE AND GROWTH GOALS, THE STRATEGIC PLAN CALLS THE ORGANIZATION TO DEMONSTRATE CONSISTENT PERFORMANCE WITH RESPECT TO BENCHMARKED OPERATING EFFICIENCIES. | ||
| NY | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID POLGE | |||||||||||||
| 177244 | 0 | 0 | 0 | 5980 | 0 | 5254 | 0 | 5026 | 0 | 193504 | 0 | 0 | 0 |
| DR MICHAEL FREEMAN | |||||||||||||
| 222374 | 0 | 0 | 0 | 5000 | 0 | 3647 | 0 | 14392 | 0 | 245413 | 0 | 0 | 0 |
| DR RAJESH DAVE | |||||||||||||
| 0 | 424228 | 0 | 135271 | 0 | 119111 | 0 | 18870 | 0 | 33538 | 0 | 731018 | 0 | 0 |
| DR VADIM DAVYDOV | |||||||||||||
| 160514 | 0 | 0 | 0 | 10000 | 0 | 0 | 0 | 9093 | 0 | 179607 | 0 | 0 | 0 |
| DR VALENTINA DAVYDOV | |||||||||||||
| 160800 | 0 | 0 | 0 | 10000 | 0 | 0 | 0 | 0 | 0 | 170800 | 0 | 0 | 0 |
| SUMAN CHOUDHURY | |||||||||||||
| 170097 | 0 | 0 | 0 | 0 | 0 | 4250 | 0 | 10583 | 0 | 184930 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF DELAWARE INDUSTRIAL DEVELOPMENT AGENCY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 161137407 | IssuerEIN |
| CUSIP Number | 245867AA4 | CUSIPNumber |
| Date Issued | 2007-06-29 | DateIssued |
| Issue Price | 5805000 | IssuePrice |
| Description Of Purpose | CONSTRUCTION OF NEW ER/IMAGING CENTER; REFINANCE HOSPITAL MORTGAGE | DescriptionOfPurpose |
| Defeased | 0 | Defeased |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Pool Financing | 0 | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 5805000 | TotalProceeds |
| Issuance Costs From Proceeds | 250826 | IssuanceCostsFromProceeds |
| Capital Expenditures | 5805000 | CapitalExpenditures |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | 0 | CurrentRefunding |
| Advance Refunding | 0 | AdvanceRefunding |
| Final Allocation Made | 1 | FinalAllocationMade |
| Adequate Books And Recds Maintaind | 1 | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | 0 | OwningBondFinancedProperty |
| Any Lease Arrangements | 0 | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | 0 | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | 0 | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | 1 | BondCounselRoutinelyEngaged |
| Prcntge Prvt Business Use By Others | 0.00000 | PrcntgePrvtBusinessUseByOthers |
| Percentage Of Prvt Business Re UBI | 0.00000 | PercentageOfPrvtBusinessReUBI |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUse |
| Post Issuance Compliance Procdrs | 1 | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | 1 | Form8038TFiled |
| Variable Rate Issue | 1 | VariableRateIssue |
| Hedge Identified In Books And Recds | 0 | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | 0 | GrossProceedsInvested |
| Exception To Rebate | 0 | ExceptionToRebate |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| MARIANNE SCHOTT | |||
| SPOUSE OF EDWARD SCHOTT, BOARD CHAIR | 22086 | EMPLOYEE WAGES | 0 |
| MICHAEL LAYTON | |||
| BROTHER-IN-LAW OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES | 45567 | EMPLOYEE WAGES | 0 |
| BONNIE CRAIG | |||
| SISTER OF DEBORAH HITT, V.P. QUALITY/SUPPORT SERVICES | 30699 | EMPLOYEE WAGES | 0 |
| NANCY VOLLKOMMER | |||
| SISTER-IN-LAW OF VICKI CONKLING, V.P. NURSING ADMIN./CNO | 27866 | EMPLOYEE WAGES | 0 |
| DR DENISE FREEMAN | |||
| SPOUSE OF MICHAEL FREEMAN, MEDICAL STAFF PRESIDENT | 72491 | EMPLOYEE WAGES | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBER OF THE ORGANIZATION IS UNITED HEALTH SERVICES, INC. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE DELAWARE VALLEY HOSPITAL CONTROLLER PREPARES THE FORM 990 AND THEN PRESENTS IT TO OUR V.P. FINANCE/CFO FOR REVIEW. IT IS THEN FORWARDED TO OUR EXTERNAL AUDITORS, FUST CHARLES CHAMBERS FOR THEIR REVIEW. ONCE THEY DETERMINE IT TO BE COMPLETE, IT IS THEN PRESENTED TO THE PRESIDENT/CEO FOR APPROVAL PRIOR TO FILING WITH THE IRS. | |
| PERFORMANCE REVIEW OF PRESIDENT/CEO IS COMPLETED BY BOARD CHAIR AND 2ND VICE CHAIR/UHS, INC. LIAISON ANNUALLY. RESULTS PRESENTED TO EXECUTIVE COMPENSATION COMMITTEE, COMPRISED OF CHAIR, LIAISON, AND THREE OTHER BOARD MEMBERS. COMMITTEE USES SULLIVAN-CARTER, A PAID CONSULTING FIRM, TO OBTAIN NATIONAL CEO COMPENSATION DATA BY HOSPITAL TYPE, SIZE, ETC. AS BASIS FOR ESTABLISHING ACCEPTABLE RANGE OF COMPENSATION TO ENSURE COMPLIANCE WITH TREASURY REGULATION 53.4958-1(D)(4)(3). THE COMMITTEE THEN DETERMINES AND APPROVES THE PRESIDENT/CEO COMPENSATION. | FORM 990, PART VI, SECTION B, LINE 15A | |
| THE ORGANIZATION PROVIDES FORM 990 AND OTHER INFORMATION REQUIRED UNDER INTERNAL REVENUE SERVICE REGULATIONS TO THE PUBLIC, UPON REQUEST. | FORM 990, PART VI, SECTION C, LINE 19 | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP & UNREALIZED GAINS/LOSSES. | FORM 990, PART XI, LINE 5: |
| THE DELAWARE VALLEY HOSPITAL HAS AN AUDIT COMMITTEE IN PLACE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF ITS ANNUAL FINANCIAL STATEMENT AUDIT AND THE SELECTION OF INDEPENDENT ACCOUNTANTS. | FORM 990, LINE 2C, PART XII |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| UNITED HEALTH SERVICES HOSPITAL INC | ||||||||||
| 10-42 MITCHELL AVENUE | BINGHAMTON | NY | 13903 | 161165049 | HOSPITAL | NY | 501(C)(3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| PROFESSIONAL HOME CARE | ||||||||||
| 4401 VESTAL PARKWAY EAST | VESTAL | NY | 13850 | 161261977 | HOME HEALTH CARE | NY | 501(C)(3) | 9 | UNITED HEALTH SERVICES INC | 0 |
| IDEAL SENIOR LIVING CENTER | ||||||||||
| 508 HIGH STREET | ENDICOTT | NY | 13760 | 222902896 | SENIOR LIVING CENTER | NY | 501(C)(3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| IDEAL SENIOR LIVING CENTER HOUSING | ||||||||||
| 508 HIGH STREET | ENDICOTT | NY | 13760 | 222902899 | SENIOR HOUSING | NY | 501(C)(3) | 9 | UNITED HEALTH SERVICES INC | 0 |
| CHENANGO MEMORIAL HOSPITAL | ||||||||||
| 179 NORTH BROAD STREET | NORWICH | NY | 13815 | 150532180 | HOSPITAL | NY | 501(C)(3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| UNITED MED MANAGEMENT | ||||||||||
| 601 RIVERSIDE DRIVE | JOHNSON CITY | NY | 13790 | 161396133 | PHYSICIAN PRACTICE | NY | 501(C)(3) | 11B | UNITED HEALTH SERVICES INC | 0 |
| UNITED HEALTH SERVICES HOSPITAL INC | ||||||||||
| 20-40 MITCHELL AVENUE | BINGHAMTON | NY | 13903 | PARENT COMPANY | NY | 501(C)(3) | 9 | UNITED HEALTH SERVICES INC BOARD OF DIRECTORS | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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