CAYUGA MEDICAL ASSOCIATES PC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CAYUGA MEDICAL ASSOCIATES PC (EIN 20-4356115)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-03
IRS object ID
201123079349301407
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-03T14:59:09-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1SCIARABBA WALKER & CO LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1200 E BUFFALO ST SUITE 402AddressLine1
CityITHACACity
StateNYState
ZIP Code14850ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN204356115EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CAYUGA MEDICAL ASSOCIATES PCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCAYUNameControl
Phone6072772365Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 DATES DRIVEAddressLine1
CityITHACACity
StateNYState
ZIP Code14850ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARTY STALLONEName
TitleSECRETARY/TREASURERTitle
Phone6072772365Phone
Date Signed2011-11-03DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone6072725550Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDANIEL ROB MCKENZIENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1101 DATES DRIVEAddressLine1
CityITHACACity
StateNYState
ZIP Code14850ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14784878GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2006YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE ACCESS TO PRIMARY CARE AND MEDICAL SPECIALTIES TO THE RESIDENTS OF TOMPKINS COUNTY.ActivityOrMissionDescription
Nbr Voting Members Governing Body2NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees101TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3647914ContributionsGrantsPriorYear
Contributions Grants Current Year5991261ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6415537ProgramServiceRevenuePriorYear
Program Service Revenue CY8732302ProgramServiceRevenueCY
Investment Income Prior Year1488InvestmentIncomePriorYear
Investment Income Current Year-2565InvestmentIncomeCurrentYear
Other Revenue Prior Year23973OtherRevenuePriorYear
Other Revenue Current Year60697OtherRevenueCurrentYear
Total Revenue Prior Year10088912TotalRevenuePriorYear
Total Revenue Current Year14781695TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year6473552SalariesEtcPriorYear
Salaries Etc Current Year10067277SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3965652OtherExpensePriorYear
Other Expenses Current Year5093641OtherExpensesCurrentYear
Total Expenses Prior Year10439204TotalExpensesPriorYear
Total Expenses Current Year15160918TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-350292RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-379223RevenuesLessExpensesCY
Total Assets BOY2193621TotalAssetsBOY
Total Assets EOY2308958TotalAssetsEOY
Total Liabilities BOY610444TotalLiabilitiesBOY
Total Liabilities EOY1111855TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY1583177NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1197103NetAssetsOrFundBalancesEOY
Mission DescriptionCAYUGA MEDICAL ASSOCIATES, PC WAS FORMED EXCLUSIVELY FOR THE CHARITABLE PURPOSE OF SERVING THE HEALTH CARE NEEDS OF THE RESIDENTS OF TOMPKINS COUNTY AND SURROUNDING AREAS, AND EXISTS TO FURTHER THE CHARITABLE MISSION OF CAYUGA MEDICAL CENTER AT ITHACA.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense14028514Expense
Revenue8732302Revenue
DescriptionIN 2010, THE ORGANIZATION PROVIDED MEDICAL SERVICES TO 14,836 PATIENTS IN THE COURSE OF CONDUCTING 58,825 PATIENT VISITS. THE ORGANIZATION PROVIDES MEDICAL CARE TO ALL PATIENTS, REGARDLESS OF ABILITY TO PAY. THE ORGANIZATION ALSO OFFERS A FINANCIAL ASSISTANCE PROGRAM THAT, BASED ON FEDERAL POVERTY GUIDELINES, PROVIDES FREE OR REDUCED FEE CARE TO QUALIFYING INDIVIDUALS. IN 2010, THE ORGANIZATIONS PHYSICIANS CONDUCTED OVER 5,261 VISITS WITH MEDICAID AND LOW INCOME PATIENTS. THE ORGANIZATION CONTINUES WITH THE COMMITMENT TO ACCEPT PATIENTS FROM THE LOCAL PHYSICIANS REFERRAL CENTER, REGARDLESS OF ABILITY TO PAY.Description
Total Program Service Expense14028514TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109628NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees101NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members2NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1CAYUGA MEDICAL ASSOCIATES PC ADMINBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6072772365TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1821 CLIFF STAddressLine1
CityITHACACity
StateNYState
ZIP Code14850ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
DANIEL ROB MACKENZIE MD
PRESIDENT2.00XX041794921524
DAVID GEORGE EVELYN MD
VICE PRESIDENT2.00XX029567918524
TONY VOTAW
SECRETARY2.00X01754222972
JOHN B RUDD
TREASURER2.00X029567921524
QUTAYBEH MAGHAYDAH MD
PHYSICIAN40.00474040023601X
JONATHAN MAUSER MD
PHYSICIAN40.00444030023601X
BARRY POLLACK MD
PHYSICIAN40.00423645023601X
GERALD ZUPRUK MD
PHYSICIAN40.00423473023601X
DIRK DUGAN MD
PHYSICIAN40.00415376025915X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2180564TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1184729TotalReportableCompFrmRltdOrgs
Total Other Compensation184863TotalOtherCompensation
Number Individuals GT100 K26NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WEATHERBY LOCUMS
6451 NORTH FEDERAL HIGHWAY SUITE 8FORT LAUDERDALEFL33308STAFFING552170
PRACTICE RESOURCES LLC
1001 WEST LAFAYETTE STREET STE 400SYRACUSENY132042856MEDICAL BILLING SERVICE416605
CAYUGA ENT
2 ASCOT PLACEITHACANY14850PROFESSIONAL MEDICAL SERVICES203820
SAMPSON & ASSOCIATES LLC
301 S GENEVA STREET SUITE 107ITHACANY14850PRACTICE CONSULTING & BOOKKEEPING189887
MED-CARE ADMINISTRATORS LLC
587 MAIN STNEW YORK MILLSNY13417PRACTICE MANAGEMENT166609
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations5991261RelatedOrganizations
Total Contributions5991261TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT FEES62111070115237011523
HOSPITALIST REVENUE62111015600001560000
SERVICE FEES621110153506153506
MISCELLANEOUS90009972737273
FieldValueIRS element (for citing)
Total Program Service Revenue8732302TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column618TotalRevenueColumn
Exclusion$618ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real60697Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real60697Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column60697TotalRevenueColumn
Exclusion$60,697ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other3183Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-3183Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-3183TotalRevenueColumn
Related Or Exempt Function Income-3183RelatedOrExemptFunctionIncome

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14781695TotalRevenueColumn
Related Or Exempt Function Income8729119RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$61,315ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total8820144Total
Program Services8820144ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total247383Total
Program Services247383ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total535265Total
Program Services535265ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total464485Total
Program Services464485ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total130333Total
Management And General130333ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total26503Total
Management And General26503ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total118990Total
Management And General118990ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total935783Total
Program Services79205ProgramServices
Management And General856578ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total191639Total
Program Services191639ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total42097Total
Program Services42097ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total84743Total
Program Services84743ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1269858Total
Program Services1269858ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total54305Total
Program Services54305ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total220109Total
Program Services220109ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total623312Total
Program Services623312ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
LEASED MD'S666536666536
MEDICAL SUPPLIES184465184465
BAD DEBT EXPENSE165637165637
RECRUITING6834368343
COMMUNICATIONS6534865348

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total245640Total
Program Services245640ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total15160918Total
Program Services14028514ProgramServices
Management And General1132404ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY434917BOY
EOY94817EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY65595BOY
EOY6402EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY588364BOY
EOY767207EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY39294BOY
EOY73007EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1927747LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec565622LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1055884BOY
EOY1362125EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY4167BOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5400BOY
EOY5400EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY2193621BOY
EOY2308958EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY76974BOY
EOY379782EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY533470BOY
EOY732073EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY610444BOY
EOY1111855EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY1583177BOY
EOY1197103EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1583177BOY
EOY1197103EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2193621BOY
EOY2308958EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-379223ReconcilationRevenueExpenses
Reconcilation Other Changes-6851ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years6356795CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3647914CurrentTaxYearMinus1Year
Current Tax Year5991261CurrentTaxYear
Total15995970Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1075285CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2844218CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3712629CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6415537CurrentTaxYearMinus1Year
Current Tax Year8732302CurrentTaxYear
Total22779971Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1075285CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2844218CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10069424CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10063451CurrentTaxYearMinus1Year
Current Tax Year14723563CurrentTaxYear
Total38775941Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50938775941PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years471CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years387CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7599CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year25461CurrentTaxYearMinus1Year
Current Tax Year61315CurrentTaxYear
Total95233Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years471CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years387CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7599CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year25461CurrentTaxYearMinus1Year
Current Tax Year61315CurrentTaxYear
Total95233Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1075756CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2844605CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10077023CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10088912CurrentTaxYearMinus1Year
Current Tax Year14784878CurrentTaxYear
Total38871174Total
FieldValueIRS element (for citing)
First5 Years509XFirst5Years509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis618272OtherCostOrOtherBasis
Depreciation78146Depreciation
Book Value540126BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1302349OtherCostOrOtherBasis
Depreciation483328Depreciation
Book Value819021BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7126OtherCostOrOtherBasis
Depreciation4148Depreciation
Book Value2978BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1362125TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ACCRUED PAYROLL LIABILITIES$32,337
ACCRUED PAYROLL$218,158
ACCRUED EXPENSES$481,578
FieldValueIRS element (for citing)
Total Of Amounts732073TotalOfAmounts
Total Revenue14781695TotalRevenue
Total Expenses15160918TotalExpenses
Excess Or Deficit For Year-379223ExcessOrDeficitForYear
Other-$6,851OtherAmount
Total Adjustments-6851TotalAdjustments
Excess Or Deficit Per FS-386074ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt14778027TotRevenueEtcAuditedFinclStmt
Other Revenues3183OtherRevenues
Revenue Not Rptd F9903183RevenueNotRptdF990
Revenue Subtotal14774844RevenueSubtotal
Other Revenues Not Included6851OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt6851RevenueNotRptdOnFinStmt
Total Revenue Per Form99014781695TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt15164101TotExpensesEtcAuditedFinclStmt
Other Expenses Included3183OtherExpensesIncluded
Expenses Not Rptd F9903183ExpensesNotRptdF990
Expenses Subtotal15160918ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99015160918TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierExplanationExplanation
PART XII, LINE 2D - OTHER ADJUSTMENTS:LOSS ON DISPOSAL OF ASSETS 3,183.
PART XII, LINE 4B - OTHER ADJUSTMENTS:SECTION 481(A) ADJUSTMENT- YEAR 3 6,851.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:LOSS ON DISPOSAL OF ASSETS 3,183.
PART XI, LINE 8 AND PART XII, LINE 4B - SECTION 481(A) ADJUSTMENT. IN 2008, THE ORGANIZATION CHANGED ITS ACCOUNTING METHOD FROM CASH TO ACCRUAL FOR ITS AUDITED FINANCIAL STATEMENTS AND FOR FORM 990 REPORTING. AS A RESULT OF THE CHANGE IN ACCOUNTING METHOD, 2008 BEGINNING BALANCES WERE RESTATED ON THE ACCRUAL BASIS, RESULTING IN AN INCREASE TO NET ASSETS OF $27,401. FOR TAX PURPOSES THIS ADJUSTMENT IS RECOGNIZED OVER A FOUR YEAR PERIOD. FOR 2009, CMA HAS RECOGNIZED THE 3RD YEAR OF THE SECTION 481(A) INCOME ADJUSTMENT TOTALING $6,851, AS SHOWN ABOVE IN PART XI, LINE 8 AND PART XII, LINE 4B.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DANIEL ROB MACKENZIE MD
03482910696580004900016624043947300
DAVID GEORGE EVELYN MD
02548960407830001900016624031420300
TONY VOTAW
0151226024196000297200017839400
JOHN B RUDD
02548960407830004900016624031720300
QUTAYBEH MAGHAYDAH MD
4740400000073500162510497641000
JONATHAN MAUSER MD
4440300000073500162510467631000
BARRY POLLACK MD
4236450000073500162510447246000
GERALD ZUPRUK MD
4234730000073500162510447074000
DIRK DUGAN MD
41537600000124900134250441291000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3IN 2010, CAYUGA MEDICAL ASSOCIATES DELEGATED CONTROL OF ITS ACCOUNTING DUTIES TO AN EMPLOYEE OF ITS RELATED PARTY, CAYUGA MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS ONE SHAREHOLDER WHO OWNS TWENTY COMMON SHARES.
FORM 990, PART VI, SECTION A, LINE 7ACMAS RELATIONSHIP WITH THE MEDICAL CENTER IS ESTABLISHED THROUGH THE CORPORATE DOCUMENTS, NAMELY THE BYLAWS AND A SHAREHOLDER AGREEMENT. THROUGH THESE DOCUMENTS, THE SOLE SHAREHOLDER AND PRESIDENT OF THE CORPORATION WILL BE THE PRESIDENT/CEO OR THE VICE PRESIDENT FOR MEDICAL AFFAIRS OF MEDICAL CENTER. NEW YORK LAW REQUIRES THAT ALL THE SHAREHOLDERS AND MEMBERS OF THE BOARD, EXCEPT THE SECRETARY, MUST BE PHYSICIANS. IN ORDER TO KEEP THE LINK TO MEDICAL CENTER, THE BYLAWS PROVIDE THAT THE SECRETARY WILL BE A VICE-PRESIDENT OF MEDICAL CENTER. OTHER BOARD MEMBERS MAY BE OTHER PHYSICIANS WHO MAY BE EMPLOYEES OF THE CORPORATION, BUT THEIR APPOINTMENT IS SUBJECT TO THE APPROVAL OF MEDICAL CENTER. THE SHAREHOLDER AGREEMENT CONTROLS THE ACTIONS OF THE INDIVIDUAL MEDICAL CENTER EMPLOYEE WHO SERVES AS THE PRESIDENT AND SOLE SHAREHOLDER OF THE CORPORATION. IF THAT PERSON EVER LEAVES THEIR POSITION AT MEDICAL CENTER, THE SHARES MUST BE TENDERED TO ANOTHER PERSON WHO MEETS THE FOLLOWING QUALIFICATIONS: IS A PHYSICIAN, HOLDS THE TITLE PRESIDENT/CEO OR VICE PRESIDENT FOR MEDICAL AFFAIRS AND IS APPROVED BY MEDICAL CENTER. SO THAT THERE IS NO CONFUSION, THE SHAREHOLDER AGREEMENT MAKES CLEAR THAT THE SHAREHOLDER DESIGNATES ALL RIGHTS TO ANY DIVIDENDS TO MEDICAL CENTER. HOWEVER, UNDER THE BYLAWS, THERE WILL BE NO DIVIDENDS PAID. THEREFORE, CAYUGA MEDICAL ASSOCIATES SHALL BE ORGANIZED AND OPERATED EXCLUSIVELY FOR THE CHARITABLE PURPOSE OF SERVING THE HEALTH CARE NEEDS OF THE RESIDENTS OF TOMPKINS COUNTY AND ITS SURROUNDING AREA.
FORM 990, PART VI, SECTION A, LINE 7BSEE ABOVE ANSWER TO 7A FOR COMPLETE EXPLANATION OF MEMBERSHIP STRUCTURE AND DECISION MAKING AUTHORITY.
FORM 990, PART VI, SECTION B, LINE 11FORM 990 IS PROVIDED TO AND REVIEWED BY ITS BOARD OF DIRECTORS BEFORE FILING.
CAYUGA MEDICAL ASSOCIATES HAS ADOPTED A CONFLICT OF INTEREST POLICY IN 2011, WHICH BOARD MEMBERS ARE REQUIRED TO REVIEW AND SIGN ANNUALLY. THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE POLICY BY REVIEWING STATEMENTS ANNUALLY FOR CONFLICTS, IDENTIFYING ANY DISQUALIFIED PERSONS, AND RECORDING ALL PROCEEDING RELATED TO A CONFLICT OF INTEREST TRANSACTIONS.FORM 990, PART VI, SECTION B, LINE 12C
IT IS THE POLICY AND PRACTICE OF CAYUGA MEDICAL ASSOCIATES, PC (CMA) TO COMPENSATE STAFF AT MARKET DRIVEN WAGES COMMENSURATE WITH INDIVIDUAL PERFORMANCE. OUTSIDE SOURCES ARE USED TO DETERMINE APPROPRIATE PAY RANGES FOR ALL ROLES, INCLUDING ANY EXECUTIVE COMPENSATION. PHYSICIAN AND KEY EMPLOYEE COMPENSATION IS DETERMINED BASED ON MEDICAL GROUP MANAGEMENT ASSOCIATION (MGMA) NATIONAL SURVEY DATA AND OTHER REGIONAL AND LOCAL COMPENSATION DATA. IT IS THE INTENT THAT PHYSICIANS ARE COMPENSATED APPROPRIATELY BASED ON THEIR INDIVIDUAL PRODUCTIVITY AS MEASURED IN COLLECTIONS, RVUS, WORK HOURS, DUTIES, ETC.FORM 990, PART VI, SECTION B, LINE 15
THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:SECTION 481(A) ADJUSTMENT- YEAR 3 -6,851. TOTAL TO FORM 990, PART XI, LINE 5: -6,851.FORM 990, PART XI, LINE 5:
NO CHANGES FROM PRIOR YEAR.FORM 990, PART XI, LINE 2C

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1CAYUGA MEDICAL CENTERBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1101 DATES DRIVEAddressLine1
CityITHACACity
StateNYState
ZIP Code14850ZIPCode
FieldValueIRS element (for citing)
EIN222325405EIN
Primary ActivitiesHOSPITALPrimaryActivities
Legal Domicile StateNYLegalDomicileState
Exempt Code Section501 C(3)ExemptCodeSection
Public Charity Status170(B)(1)(A)(III)PublicCharityStatus
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CAYUGA MEDICAL CENTER
C5991261ACKNOWLEDGMENT LETTER
CAYUGA MEDICAL CENTER
J21260LEASE AGREEMENT

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