CHENANGO MEMORIAL HOSPITAL INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CHENANGO MEMORIAL HOSPITAL INC (EIN 15-0532180)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-04
- IRS object ID
- 201133089349301558
- 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 G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-04T10:20:46-05:00 | 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 | 150532180 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHENANGO MEMORIAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHEN | NameControl |
| Phone | 6073374111 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 179 NORTH BROAD STREET | AddressLine1 |
| City | NORWICH | City |
| State | NY | State |
| ZIP Code | 13815 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DRAKE LAMEN MD | Name |
| Title | PRESIDENT/CEO | Title |
| Phone | 6073374111 | Phone |
| Date Signed | 2011-10-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANGELA M FRANCO | Name |
| 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 | DRAKE LAMEN MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 179 NORTH BROAD STREET | AddressLine1 |
| City | NORWICH | City |
| State | NY | State |
| ZIP Code | 13815 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 60906036 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.UHS.NET/CMH | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1910 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | CHENANGO MEMORIAL HOSPITAL, INC. (THE HOSPITAL) IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO OPERATE ACUTE AND SKILLED NURSING FACILITIES IN NORWICH, NEW YORK. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF CHENANGO COUNTY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 629 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 57334 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -63535 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1146764 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 909950 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 58477906 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 59351390 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 249971 | InvestmentIncomePriorYear |
| Investment Income Current Year | 267166 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1404164 | OtherRevenuePriorYear |
| Other Revenue Current Year | 377089 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 61278805 | TotalRevenuePriorYear |
| Total Revenue Current Year | 60905595 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 33000 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 50784 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 30894787 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 31995357 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 27135378 | OtherExpensePriorYear |
| Other Expenses Current Year | 27534909 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 58063165 | TotalExpensesPriorYear |
| Total Expenses Current Year | 59581050 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3215640 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1324545 | RevenuesLessExpensesCY |
| Total Assets BOY | 27811029 | TotalAssetsBOY |
| Total Assets EOY | 29550692 | TotalAssetsEOY |
| Total Liabilities BOY | 27947590 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 28576268 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -136561 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 974424 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | CHENANGO MEMORIAL HOSPITAL, INC. (THE HOSPITAL) IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO OPERATE ACUTE AND SKILLED NURSING FACILITIES IN NORWICH, NEW YORK. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF CHENANGO COUNTY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 22894517 | Expense |
| Revenue | 21179651 | Revenue |
| Description | INPATIENT, ACUTE AND LONG TERM SKILLED NURSING SERVICES- CHENANGO MEMORIAL HOSPITAL FULFILLS ITS MISSION BY WORKING TOGETHER WITH THE COMMUNITY, PHYSICIANS AND OTHER HEALTH CARE PROVIDERS TO CONTINUOUSLY IMPROVE THE AVAILABILITY AND QUALITY OF SERVICES AND THE ABILITY TO PROVIDE A COMPREHENSIVE RANGE OF SHORT-TERM INPATIENT ACUTE SERVICES AND LONG-TERM SKILLED NURSING CARE. CHENANGO MEMORIAL HOSPITAL PROVIDES A WIDE RANGE OF MEDICAL-SURGICAL SERVICES, INCLUDING: OPHTHALMOLOGY, EMERGENCY MEDICINE, MATERNITY CARE, PULMONARY MEDICINE, AND PEDIATRICS. TOTAL INPATIENT DAYS FOR THE YEAR ENDED DECEMBER 31, 2010 TOTALED 9,408. DISCHARGES WERE 2,309, AND AVERAGE LENGTH OF STAY WAS 4.07 DAYS. LONG TERM SKILLED NURSING DAYS WERE 26,079. THERE WERE 272 BIRTHS AND 468 INPATIENT SURGERIES PERFORMED AT CHENANGO MEMORIAL HOSPITAL IN 2010. IN 2010, CHENANGO MEMORIAL HOSPITAL GAVE FINANCIAL ASSISTANCE TO 68 INDIVIDUALS FOR WHICH $650,453 OF INPATIENT CARE (AT CHARGES) WAS PROVIDED. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 8045492 | Expense |
| Revenue | 29876128 | Revenue |
| Description | OUTPATIENT AND AMBULATORY SERVICES- CHENANGO MEMORIAL HOSPITAL ALSO PROVIDES A WIDE RANGE OF OUTPATIENT DIAGNOSTIC AND TREATMENT SERVICES, INCLUDING EMERGENCY DEPARTMENT, AMBULATORY SURGERY, FULL-SERVICE LABORATORY, COMPREHENSIVE IMAGING AND OTHER PROCEDURAL OUTPATIENT SERVICES. TOTAL PATIENT VISITS FOR OUTPATIENT SERVICES FOR YEAR-ENDED 2010 TOTALED 148,845. INCLUDED IN THE 148,845 VISITS WERE 14,774 EMERGENCY ROOM VISITS, 1,437 EMERGENCY ROOM TREATED AND ADMITTED AS ACUTE CARE PATIENTS, 2,476 VARIOUS OUTPATIENT SURGICAL CASES, AND 130,158 OTHER OUTPATIENT DEPARTMENT VISITS. IN 2010 CHENANGO MEMORIAL HOSPITAL GAVE FINANCIAL ASSISTANCE TO 427 INDIVIDUALS FOR WHICH $1,175,485 OF OUTPATIENT CARE (AT CHARGES) WAS PROVIDED. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 13858284 | Expense |
| Revenue | 8295611 | Revenue |
| Description | CLINICS- CHENANGO MEMORIAL HOSPITAL PROVIDES A WIDE RANGE OF PRIMARY CARE AND SPECIALTY CARE CLINICS. PRIMARY CARE SERVICES ARE THE FOUNDATION FOR SERVING THE COMMUNITY WITH A COORDINATED SYSTEM OF CARE, WITH SPECIAL ATTENTION TO UNDER-SERVED AREAS. CMH OFFERS SIX FAMILY HEALTH CENTERS LOCATED THROUGHOUT A MULTI-COUNTY SERVICE AREA: 1) NORWICH FAMILY HEALTH CENTER 2) INTERNAL MEDICINE 3) OXFORD FAMILY HEALTH CENTER 4) SHERBURNE FAMILY HEALTH CENTER 5) SIDNEY FAMILY HEALTH CENTER AND 6) WALK-IN CENTER. OTHER OUTPATIENT SERVICES INCLUDE: 6 SCHOOL BASED HEALTH CENTERS, DENTAL CLINIC, GERIATRICS, WOMEN'S HEALTH CENTER AND GENERAL SURGERY, ENT AND HEART CENTER. TOTAL PATIENT VISITS FOR THE CMH CLINICS AT YEAR-ENDED 2010 TOTALED 79,529. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenue | 319755 | Revenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Rev | 319755 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 44798293 | 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 | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | 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 | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 0 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | 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 | 54 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 629 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 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 | DRAKE LAMEN MD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6073374111 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 179 NORTH BROAD ST | AddressLine1 |
| City | NORWICH | City |
| State | NY | State |
| ZIP Code | 13815 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (30 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 |
|---|---|---|---|---|---|---|---|---|
| DRAKE LAMEN MD | ||||||||
| PRESIDENT/CEO | 40.00 | X | X | 288323 | 0 | 46761 | ||
| THOMAS C EMERSON | ||||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| ROBERT W NASSAR | ||||||||
| 1ST VICE CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | ||
| MATTHEW J SALANGER | ||||||||
| PRESIDENT & CEO - UHS,INC. | 1.00 | X | X | 0 | 1177438 | 38160 | ||
| ERIC G LARSEN | ||||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | ||
| CHRISTOPHER R CALHOUN | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| RAJESH DAVE MD | ||||||||
| TRUSTEE | 1.00 | X | 0 | 678610 | 33538 | |||
| MARTIN A DIETRICH | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| PETER J KWASNIK | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| MARILYN M QUINNEY | ||||||||
| PRESIDENT- AUXILLARY | 1.00 | X | X | 0 | 0 | 0 | ||
| AARON J VALENTINE | ||||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | ||
| SCOTT A COHEN MD | ||||||||
| PRESIDENT OF MEDICAL STAFF | 1.00 | X | X | 0 | 0 | 0 | ||
| MEREDITH B MCDOWELL MD | ||||||||
| VP OF MEDICAL STAFF | 40.00 | X | X | 230216 | 0 | 95891 | ||
| JOANNE RACE BORFITZ | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| ROBERT G GOMULKA | ||||||||
| TRUSTEE | 1.00 | X | 0 | 541830 | 33425 | |||
| CATHERINE M SCARLETT | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| MICHAEL TREVISANI | ||||||||
| VP MEDICAL AFFAIRS/CMO | 40.00 | X | 262038 | 0 | 45719 | |||
| ROBERT MCCARTHY | ||||||||
| VP/CFO | 40.00 | X | 0 | 140282 | 6872 | |||
| MARGARET SWARTWOOD | ||||||||
| CONTROLLER | 40.00 | X | 114588 | 0 | 27596 | |||
| RON CEROW | ||||||||
| ADMINISTRATOR | 40.00 | X | 107296 | 0 | 29766 | |||
| ANNE ENGLISH | ||||||||
| DIRECTOR OF HUMAN RESOURCE | 40.00 | X | 97450 | 0 | 20110 | |||
| DRU CAVANUAGH | ||||||||
| VP OF PATIENT CARE SERVICES | 40.00 | X | 132121 | 0 | 29444 | |||
| WENDY SURDOVAL | ||||||||
| VP OF QUALITY MGMT | 40.00 | X | 96853 | 0 | 25033 | |||
| TIMOTHY COREY MD | ||||||||
| PHYSICIAN | 40.00 | 297625 | 0 | 115442 | X | |||
| MICHAEL L WATERS MD | ||||||||
| PHYSICIAN | 40.00 | 196413 | 0 | 39859 | X | |||
| JOHN R BRERETON MD | ||||||||
| PHYSICIAN | 40.00 | 274530 | 0 | 104835 | X | |||
| WILLIAM J BOUDREAU MD | ||||||||
| PHYSICIAN | 40.00 | 254013 | 0 | 104160 | X | |||
| CHUNJIE YANG MD | ||||||||
| PHYSICIAN | 40.00 | 302374 | 0 | 117827 | X | |||
| FRANK C COLE III MD | ||||||||
| PHYSICIAN | 40.00 | 264208 | 0 | 103668 | X | |||
| PAUL M DOROGHAZI MD | ||||||||
| PHYSICIAN | 40.00 | 261083 | 0 | 105827 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3179131 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 2538160 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1123933 | TotalOtherCompensation |
| Number Individuals GT100 K | 30 | 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 |
|---|---|---|---|---|---|
| MORRISON | |||||
| PO BOX 102289 | ATLANTA | GA | 30368 | DIETARY FOOD SERVICES MANAGEMENT | 1461610 |
| DELF KING MD | |||||
| PO BOX 819 | NORWICH | NY | 13815 | ANESTHESIA SERVICES | 1348093 |
| CROTHALL | |||||
| 955 CHESTERBROOK BLVD | WAYNE | PA | 19087 | HOUSEKEEPING SERVICES | 1078495 |
| STAFFCARE | |||||
| PO BOX 281923 | ATLANTA | GA | 30384 | LOCUM PHYSICIANS | 418808 |
| CSU PHYSICIAN SERVICES | |||||
| PO BOX 200528 | HOUSTON | TX | 77216 | LOCUM PHYSICIANS | 340518 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
| Membership Dues | 3901 | MembershipDues |
| Fundraising Events | 18681 | FundraisingEvents |
| Government Grants | 518684 | GovernmentGrants |
| All Other Contributions | 368684 | AllOtherContributions |
| Total Contributions | 909950 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| OUTPATIENT AND AMBULAT | 623000 | 29876128 | 29876128 |
| INPATIENT, ACUTE AND L | 623000 | 21179651 | 21179651 |
| CLINICS | 623000 | 8295611 | 8295611 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 59351390 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 267166 | TotalRevenueColumn |
| Exclusion | $267,166 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 441 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 18681 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 441 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| CAFETERIA REVENUE | 623000 | 183916 | 183916 | |
| OTHER OPERATING REVENU | 623000 | 135839 | 135839 | |
| CONSULTING REVENUE | 623000 | 57334 | 57334 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 377089 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 60905595 | TotalRevenueColumn |
| Related Or Exempt Function Income | 59671145 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 57334 | UnrelatedBusinessRevenue |
| Exclusion | $267,166 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50784 | Total |
| Program Services | 50784 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2298544 | Total |
| Program Services | 2298544 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21884355 | Total |
| Program Services | 17744051 | ProgramServices |
| Management And General | 4140304 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1878972 | Total |
| Program Services | 1557277 | ProgramServices |
| Management And General | 321695 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5933486 | Total |
| Program Services | 4917626 | ProgramServices |
| Management And General | 1015860 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 329170 | Total |
| Management And General | 329170 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88463 | Total |
| Management And General | 88463 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 92376 | Total |
| Management And General | 92376 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38507 | Total |
| Management And General | 38507 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9622406 | Total |
| Program Services | 3996569 | ProgramServices |
| Management And General | 5625837 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4694 | Total |
| Management And General | 4694 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241174 | Total |
| Program Services | 125536 | ProgramServices |
| Management And General | 115638 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71286 | Total |
| Program Services | 31882 | ProgramServices |
| Management And General | 39404 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 75131 | Total |
| Program Services | 36224 | ProgramServices |
| Management And General | 38907 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 173140 | Total |
| Program Services | 173140 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2024351 | Total |
| Program Services | 2024351 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1052243 | Total |
| Program Services | 1052243 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 9650937 | 6719035 | 2931902 |
| BAD DEBTS | 3604598 | 3604598 | |
| NEW YORK STATE CASH REC | 448115 | 448115 | |
| MISCELLANEOUS AUXILLARY | 18318 | 18318 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59581050 | Total |
| Program Services | 44798293 | ProgramServices |
| Management And General | 14782757 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3175370 | BOY |
| EOY | 2611215 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6394361 | BOY |
| EOY | 6617724 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7041402 | BOY |
| EOY | 7814695 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 358185 | BOY |
| EOY | 429099 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 607959 | BOY |
| EOY | 538582 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 45336079 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 36762293 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8311878 | BOY |
| EOY | 8573786 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 85916 | BOY |
| EOY | 92871 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1835958 | BOY |
| EOY | 2872720 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27811029 | BOY |
| EOY | 29550692 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5034859 | BOY |
| EOY | 5749522 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2593700 | BOY |
| EOY | 1831520 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20319031 | BOY |
| EOY | 20995226 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27947590 | BOY |
| EOY | 28576268 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -6691587 | BOY |
| EOY | -5938566 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 456916 | BOY |
| EOY | 436068 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6098110 | BOY |
| EOY | 6476922 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -136561 | BOY |
| EOY | 974424 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27811029 | BOY |
| EOY | 29550692 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1324545 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -213560 | 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 Separate | X | FinancialStatementSeparate |
| 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 | $38,507 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 38507 | 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 | DUES PAID TO HEALTHCARE ASSOCIATION OF NYS AND IROQUOIS HEALTHCARE | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 6555026 | BeginningOfYearBalance |
| Contributions | 885911 | Contributions |
| Investment Earnings Or Losses | 177728 | InvestmentEarningsOrLosses |
| Other Expenditures | 705675 | OtherExpenditures |
| End Of Year Balance | 6912990 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5781660 | BeginningOfYearBalance |
| Contributions | 1128222 | Contributions |
| Investment Earnings Or Losses | 646828 | InvestmentEarningsOrLosses |
| Other Expenditures | 1001684 | OtherExpenditures |
| End Of Year Balance | 6555026 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7180804 | BeginningOfYearBalance |
| Contributions | 1315814 | Contributions |
| Investment Earnings Or Losses | -1251758 | InvestmentEarningsOrLosses |
| Other Expenditures | 1463200 | OtherExpenditures |
| End Of Year Balance | 5781660 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.93700 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.06300 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 167753 | OtherCostOrOtherBasis |
| Book Value | 167753 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 19998413 | OtherCostOrOtherBasis |
| Depreciation | 15843902 | Depreciation |
| Book Value | 4154511 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1111015 | OtherCostOrOtherBasis |
| Depreciation | 980075 | Depreciation |
| Book Value | 130940 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20312630 | OtherCostOrOtherBasis |
| Depreciation | 19063689 | Depreciation |
| Book Value | 1248941 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3746268 | OtherCostOrOtherBasis |
| Depreciation | 874627 | Depreciation |
| Book Value | 2871641 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8573786 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INTEREST IN CMH FOUNDATION | 2096117 |
| ASSETS LIMITED TO USE- RESTRICTED CASH FOR EQUIPMENT | 776603 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 2872720 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO THIRD-PARTY PAYORS | $3,564,088 |
| DUE TO AFFILIATE | $5,556,815 |
| LONG TERM PENSION LIABILITY | $9,765,104 |
| CAPITAL LEASE OBLIGATIONS | $969,687 |
| OTHER LIABILITIES | $1,139,532 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 20995226 | TotalOfAmounts |
| Total Revenue | 60905595 | TotalRevenue |
| Total Expenses | 59581050 | TotalExpenses |
| Excess Or Deficit For Year | 1324545 | ExcessOrDeficitForYear |
| Other | -$213,560 | OtherAmount |
| Total Adjustments | -213560 | TotalAdjustments |
| Excess Or Deficit Per FS | 1110985 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 60836668 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 60836668 | RevenueSubtotal |
| Other Revenues Not Included | 68927 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 68927 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 60905595 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 59511238 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 59511238 | ExpensesSubtotal |
| Other Expenses Not Included | 69812 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 69812 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 59581050 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE INTENDED USE OF ENDOWMENT FUNDS IS A COMBINATION OF DESIGNATED SPECIAL PURPOSES AND GENERAL USE BY THE HOSPITAL. |
| 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. THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN A HOSPITAL'S FINANCIAL STATEMENTS. THESE STANDARDS HAD NO IMPACT ON THE ACCOMPANYING FINANCIAL STATEMENTS. AS OF DECEMBER 31, 2010 AND 2009, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2007 THROUGH 2010. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | CHANGE IN NET UNREALIZED GAINS AND LOSSES ON INVESTMENTS 6,955. CUMULATIVE EFFECT OF AUXILIARY INCOME AND EXPENSE 885. CHANGE IN INTEREST IN CHENANGO MEMORIAL HOSPITAL FOUNDATION 356,364. PENSION CHANGES OTHER THAN NET PERIODIC BENEFIT COSTS -956,576. CHANGE IN INTEREST IN PERMANENTLY RESTRICTED NET ASSETS 378,812. | |
| PART XII, LINE 4B: AUXILIARY INCOME $68,926 PART XIII, LINE 4B: AUXILIARY EXPENSES $69,811 |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | FESTIVAL OF TREES | NameOfEvent1 |
| Gross Receipts Event1 | 15441 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 15000 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 441 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 441 | OtherDirectExpensesEvent1 |
| Name Of Event2 | UNIFORM SALE | NameOfEvent2 |
| Gross Receipts Event2 | 2868 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 2868 | CharitableContributionsEvent2 |
| Total Number Of Other Events | 1 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 813 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 813 | CharitableContribOtherEvents |
| Gross Receipts Total | 19122 | GrossReceiptsTotal |
| Charitable Contributions Total | 18681 | CharitableContributionsTotal |
| Gross Revenue Total Events | 441 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 441 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 441 | DirectExpenseSummaryEvents |
| Net Income Summary | 0 | NetIncomeSummary |
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 |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 0.0 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 730375 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 476431 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 285467 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00480 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 10792659 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10278490 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 514169 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00860 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 215738 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 168446 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 47292 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11738772 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10923367 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 846928 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01420 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11738772 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10923367 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 846928 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01420 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1075 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1075 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 12640 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 12640 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 1700 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 1700 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 15415 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 15415 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $1,441,839 | BadDebtExpenseAmount |
| Amount Attributable To | 919647 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 11205663 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 17237373 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -6031710 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 0 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 19 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (19 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | OtherOther | Address Line2Address/AddressLine2 | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Er24 HoursEr24Hours |
|---|---|---|---|---|---|---|---|---|---|
| CMH FAMILY HEALTH CENTER IN NORWICH | |||||||||
| 1 | 4 NEWTON AVENUE | NORWICH | NY | 13815 | FAMILY HEALTH CENTER | ||||
| CMH FAMILY HEALTH CENTER IN SHERBURNE | |||||||||
| 2 | 38A CLASSIC STREET | SHERBURNE | NY | 13460 | FAMILY HEALTH CENTER | ||||
| CMH DENTAL CENTER | |||||||||
| 3 | 32 CONKEY AVENUE | NORWICH | NY | 13815 | DENTAL HEALTH CENTER | ||||
| CV STRATTON CENTER FOR THERAPIES | |||||||||
| 4 | NORWICH SHOPPING PLAZA- ROUTE 12 | NORWICH | NY | 13815 | CENTER FOR THERAPIES | NORTH | |||
| CMH FAMILY HEALTH CENTER IN OXFORD | |||||||||
| 5 | 40 NORTH CANAL STREET | OXFORD | NY | 13830 | FAMILY HEALTH CENTER | ||||
| CMH FAMILY HEALTH CENTER IN SIDNEY | |||||||||
| 6 | 44 PEARL STREET | SIDNEY | NY | 13838 | FAMILY HEALTH CENTER | ||||
| CMH WALK-IN CENTER | |||||||||
| 7 | 4 NEWTON AVENUE | NORWICH | NY | 13815 | WALK IN CLINIC | ||||
| CMH ENT CENTER | |||||||||
| 8 | 32 CONKEY AVENUE | NORWICH | NY | 13815 | ENT CENTER | ||||
| NORWICH HIGH SCHOOL | |||||||||
| 9 | 49 MIDLAND DRIVE | NORWICH | NY | 13815 | CMH SCHOOL BASED HEALTH CENTER | ||||
| NORWICH MIDDLE SCHOOL | |||||||||
| 10 | 89 MIDLAND DRIVE | NORWICH | NY | 13815 | CMH SCHOOL BASED HEALTH CENTER | ||||
| STANDORD J GIBSON PRIMARY SCHOOL | |||||||||
| 11 | 8 RIDGELAND ROAD | NORWICH | NY | 13815 | CMH SCHOOL BASED HEALTH CENTER | ||||
| PERRY BROWNE INTERMEDIATE SCHOOL | |||||||||
| 12 | 31 BEEBE AVENUE | NORWICH | NY | 13815 | CMH SCHOOL BASED HEALTH CENTER | ||||
| GUILFORD ELEMENTARY | |||||||||
| 13 | 132 SCHOOL STREET | GUILFORD | NY | 13780 | CMH SCHOOL BASED HEALTH CENTER | ||||
| OXFORD PRIMARY & HIGH SCHOOL | |||||||||
| 14 | 50 SOUTH WASHINGTON AVENUE | OXFORD | NY | 13830 | CMH SCHOOL BASED HEALTH CENTER | ||||
| OXFORD MIDDLE SCHOOL | |||||||||
| 15 | 2 LAFAYETTE PARK | OXFORD | NY | 13830 | CMH SCHOOL BASED HEALTH CENTER | ||||
| UNADILLA VALLEY CENTRAL SCHOOLS | |||||||||
| 16 | 4238 STATE HIGHWAY 8 | NEW BERLIN | NY | 13411 | CMH SCHOOL BASED HEALTH CENTER | ||||
| BAINBRIDGEGUILFORD CENTRAL SCHOOL | |||||||||
| 17 | 18 JUILAND STREET | BAINBRIDGE | NY | 13733 | CMH SCHOOL BASED HEALTH CENTER | ||||
| GUILFORD GREENLAWN ELEMENTARY | |||||||||
| 18 | 43 GREENLAWN AVENUE | BAINBRIDGE | NY | 13733 | CMH SCHOOL BASED HEALTH CENTER | ||||
| CHENANGO MEMORIAL HOSPITAL INC | |||||||||
| 19 | 179 NORTH BROAD STREET | NORWICH | NY | 13815 | X | X | X | ||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHENANGO MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 0 | EligibilityCriteriaExplained |
| Uses FPG Free | 0 | UsesFPGFree |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 0 | ExplainsApplicationMethod |
| Includes Publicity Measures | 0 | IncludesPublicityMeasures |
| Actions On Nonpayment | 0 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 0 | NondiscrimEmergencyCarePolicy |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation |
|---|
| PART I, LINE 3C: PATIENTS WHO HAVE NO INSURANCE, OR HAVE A PATIENT BALANCE ON A SINGLE ACCOUNT GREATER THAN $2,000, HAVE COMPLETED THE APPLICATION PROCESS, INCLUDING APPLYING FOR GOVERNMENT ASSISTANCE (IF DEEMED ELIGIBLE), AND ARE DENIED FOR THE SLIDING FEE FOR EXCESS INCOME, WILL BE AWARDED THE 15% "PARTICIPATION" DISCOUNT. NO FURTHER PAPERWORK IS REQUIRED. UNDER NO CIRCUMSTANCES CAN A PERSON RECEIVE BOTH A SLIDING FEE AND A 15% PARTICIPATION DISCOUNT. |
| PART I, LINE 7: A COMBINATION OF IRS PROVIDED WORKSHEETS AND THE RATIO OF PATIENT CARE COST TO CHARGES WAS USED. |
| PART I, L7 COL(F): 100% OF THE ANNUAL BAD DEBT EXPENSE OF $3,604,598 WAS NOT INCLUDED IN THE CALCULATION OF NET BENEFIT EXPENSE. |
| PART II: THE HOSPITAL'S COMMUNITY BUILDING ACTIVITIES SUPPORT THE HOSPITAL'S MISSION TO DELIVER LOCAL, HIGH QUALITY HEALTHCARE, AND SERVE AS A GATEWAY TO CLINICALLY INTEGRATED SERVICES PROVIDED IN COLLABORATION WITH OTHER LOCAL, REGIONAL, AND NATIONAL CAREGIVERS. PARTICIPATION IN THE 2-YEAR MAPP PROCESS FUNDED BY A HEAL 9 GRANT TO DETERMINE HOW PUBLIC HEALTH IMPROVEMENTS COULD BE SHAPED IN THE FUTURE IS AN IMPORTANT COMPONENT OF LOCAL HEALTH PLANNING. BEING THE SOLE HOSPITAL IN THE COMMUNITY COMPELS OUR ORGANIZATION TO BE A MAJOR CONTRIBUTOR TO THAT PROCESS AND TO THE NECESSARY OUTREACH AND EDUCATION ACTIVITIES WHOSE QUALITY ONLY IMPROVES WHEN THE APPROPRIATE PARTNERS ARE COLLABORATING. THE NYSDOH PREVENTION AGENDA SHAPES THESE COLLABORATIONS, WHOSE GOALS ARE PREVENTION OF CHRONIC DISEASE, PROMOTION OF PHYSICAL ACTIVITY AND NUTRITION; ACCESS TO QUALITY HEALTH CARE, LIMITED TOBACCO USE AND EXPOSURE TO TOBACCO; AND ACHIEVING THE HEALTH AND WELL-BEING OF PRENATAL MOTHERS AND THEIR CHILDREN. |
| PART III, LINE 4: THE ORGANIZATON'S FINANCIAL STATEMENTS DO NOT SPECIFICALLY REFERENCE OR DESCRIBE BAD DEBT EXPENSE. THE ORGANIZATION'S COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON PART III, SECTION A. LINES 2 AND 3 IS THE RATIO OF PATIENT CARE COSTS TO CHARGES. |
| PART III, LINE 9B: THE ORGANIZATION'S COLLECTION POLICY PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE AS FOLLOWS:CHARITY CARE IS GIVEN FIRST, THE REMAINING BALANCE, IS THEN SUBJECT TO AN INTEREST FREE PAY PLAN. IF THE PATIENT/ GUARANTOR CHOOSES TO IGNORE ALL FURTHER ATTEMPTS TO MAKE ARRANGEMENTS FOR PAYMENTS, AFTER 180 DAYS THE ACCOUNT IS SENT TO A COLLECTION AGENCY AT THE DISCOUNTED LEVEL. |
| PART VI, LINE 2: CHENANGO MEMORIAL HOSPITAL USES COMMUNITY SPECIFIC DATA FROM MULTIPLE SOURCES TO UNDERSTAND THE HEALTH CARE NEEDS OF OUR AREA RESIDENTS. DURING 2010, WE CONTINUED TO FOCUS ON IMPROVING COMMUNITY HEALTH CARE BY LISTENING TO INPUT FROM CUSTOMERS AND RESPONDING TO THOSE NEEDS. CHENANGO MEMORIAL HOSPITAL CONTINUALLY INVITES THE PUBLIC TO PARTICIPATE IN ITS SELF-ASSESSMENT PROCESS BY MEANS OF SURVEYS, PRIMARY MARKET STUDIES, FOCUS GROUPS, AND E-MAIL COMMENTS SUBMITTED THROUGH OUR COMPREHENSIVE INTERNET SITE. THROUGHOUT THE YEAR, INPUT FROM STAFF, THE PUBLIC AND BOARD MEMBERS IS UTILIZED IN DETERMINING AND SHAPING THE HOSPITAL'S RESPONSE TO THE COMMUNITY'S HEALTH CARE NEEDS. RECENT STUDIES USED BY OUR ORGANIZATION FOR THE PURPOSE OF ASSESSING OUR MARKET'S HEALTH STATUS INCLUDE:- PRESS GANEY PATIENT SATISFACTION SURVEY SCORES AND COMMENTS (ONGOING)- UHS-SPONSORED PRIMARY MARKET RESEARCH STUDIES, INCLUDING AN ONGOING CONSUMER PERCEPTION SURVEY CONDUCTED BY NRC.- MARKET EXPERT SOFTWARE FROM THE HOSPITAL ASSOCIATION OF NEW YORK STATE (HANYS) WHICH CONTAINS A HEALTH STATUS PROFILER MODULE.- ADMINISTRATIVE AND BOARD STRATEGIC PLANNING COMMITTEES.- FEEDBACK FROM PHYSICIANS- PHYSICIAN AND EMPLOYEE SATISFACTION SURVEYS.- QUALITATIVE SURVEYS AND FOCUS GROUPS TO CAPTURE CONSUMER FEEDBACK- LOCAL AND NATIONAL HEALTH-RELATED NEWS REPORTS.- REPORTS FROM INDUSTRY PUBLICATIONS AND ORGANIZATIONS.CHENANGO MEMORIAL HOSPITAL'S COMMUNITY SERVICE PLANNING IS SHAPED BY ANNUAL STRATEGIC PLANNING WHICH INCLUDES A REVIEW OF ALL AVAILABLE HEALTH/COMMUNITY ASSESSMENT DOCUMENTS, INCLUDING:- COMMUNITY HEALTH ASSESSMENT 2005-2010, CHENANGO COUNTY HEALTH DEPARTMENT- HEALTHY PEOPLE 2010- ANNUAL ENVIRONMENTAL ASSESSMENT PREPARED BY UHS MARKET RESEARCH- UHS, INC. STRATEGIC PLAN 2008-2010IN 2008, NEW YORK STATE DEPARTMENT OF HEALTH DEVELOPED A PREVENTION AGENDA THAT ESTABLISHED 10 PRIORITY AREAS WITH 2010 GOALS AND MEASURABLE OBJECTIVES. AS PART OF A STATEWIDE EFFORT TO EMPHASIZE LOCAL HEALTH PLANNING, CHENANGO MEMORIAL HOSPITAL (CMH) COLLABORATED WITH THE CHENANGO COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY PARTNERS TO DETERMINE TWO PUBLIC HEALTH PRIORITIES WHICH FORM THE BASIS OF THE CMH 2010-2012 COMMUNITY SERVICE PLAN. CMH IS PROUD OF THE TRADITION OF PARTNERING WITH MANY COMMUNITY AGENCIES, BOTH FORMALLY AND INFORMALLY, TO HELP MEET THE HEALTH NEEDS OF THE COMMUNITY. IN ORDER TO ASSESS COMMUNITY HEALTH NEEDS FOR THIS PLAN, CHENANGO MEMORIAL HOSPITALS COLLABORATED WITH THE CHENANGO COUNTY HEALTH DEPARTMENT AND A TASK FORCE OF REPRESENTATIVES FROM COMMUNITY AGENCIES WHICH INCLUDED:-NORWICH SCHOOL DISTRICT-SOUTH CENTRAL NEW YORK PERINATAL NETWORK-CORNELL COOPERATIVE EXTENSION OF CHENANGO COUNTY-CHENANGO HEALTH NETWORK-HOSPICE OF CHENANGO COUNTY-OPPORTUNITIES FOR CHENANGO, INC.-NBT BANKCORP, INC.-CHENANGO COUNTY AREA AGENCY ON AGING-CATHOLIC CHARITIES-EXCELLUS BLUECROSS/BLUESHIELD-CENTRAL DIAGNOSTIC IMAGING-CHENANGO COUNTY DEPARTMENT OF SOCIAL SERVICES-CHENANGO COUNTY WIC-CHENANGO COUNTY HEALTH DEPARTMENT-MORRISVILLE STATE COLLEGE-GOLDEN ARTISTS COLORS-BARTLE'S PHARMACY-UNITED MEDICAL ASSOCIATES- GREENE-UNISON INDUSTRIES-COMMUNITY MENTAL HYGIENE SERVICES- CHENANGO COUNTY-THE FAMILY ENRICHMENT NETWORK-PLANNED PARENTHOOD OF SOUTH CENTRAL NEW YORK-UNITED HEALTH SERVICES HOSPITALS-DCMO BOCES-CHENANGO COUNTY HEALTHY HEART COALITIONTHE CHENANGO COUNTY COMMUNITY HEALTH ASSESSMENT IS THE RESULT OF THIS COLLABORATION AND THE BASIS FOR SELECTION OF THE PUBLIC HEALTH PRIORITIES FRAMING THIS PLAN. CMH CONTINUALLY INVITES THE PUBLIC TO PARTICIPATE IN ITS SELF-ASSESSMENT PROCESS BY MEANS OF SURVEYS, PRIMARY MARKET STUDIES, FOCUS GROUPS, AND E-MAIL COMMENTS SUBMITTED THROUGH OUR COMPREHENSIVE INTERNET SITE. THROUGHOUT THE YEAR, INPUT FROM STAFF, THE PUBLIC AND BOARD MEMBERS IS UTILIZED IN DETERMINING AND SHAPING THE HOSPITAL'S RESPONSE TO THE COMMUNITY'S HEALTH CARE NEEDS. THE UHS INC., STRATEGIC PLAN 2008-2010 WAS ALSO INTEGRAL TO ASSESSING COMMUNITY HEALTH NEEDS.CHENANGO MEMORIAL HOSPITAL (CMH) HAS BEEN AN ACTIVE MEMBER OF OUR COUNTY'S RURAL HEALTH NETWORK, CHENANGO HEALTH NETWORK (CHN), SINCE ITS INCEPTION TWENTY YEARS AGO, AND A CMH REPRESENTATIVE SITS ON THE CHN BOARD. THE NETWORK'S MEMBERSHIP INCLUDES BROAD-BASED REPRESENTATIVE OF LOCAL HEALTH AND HUMAN SERVICE PROVIDERS AND BUSINESSES. THE NETWORK'S QUARTERLY BOARD MEETINGS FOCUS ON HEALTH PRIORITY AREAS IN CHENANGO COUNTY, AND THEIR WORK PROVIDED PRELIMINARY INPUT INTO THE COMMUNITY SERVICE PLAN PRIORITIES. IN ADDITION, HOSPITAL STAFF, REPRESENTATIVES OF PUBLIC HEALTH, AND CHENANGO HEALTH NETWORK FORMED A PLANNING GROUP TO GUIDE THE PRIORITY SELECTION FOR THIS PLAN. IN ADDITION, CHENANGO COUNTY COMPLETED A 2 YEAR MAPP. THIS PROCESS ELICITED CONSUMER INPUT FROM OVER 20 FOCUS GROUPS CONDUCTED THROUGHOUT THE COUNTY DURING THE SPRING AND SUMMER OF 2009 AND INCLUDES A WIDE VARIETY OF DEMOGRAPHICS. INPUT FROM THIS PROCESS HAS BEEN FACTORED INTO THE PLANNING PROCESS OF CHENANGO MEMORIAL'S COMMUNITY SERVICE PLAN. |
| PART VI, LINE 3: OUR ORGANIZATION INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS OR UNDER OUR CHARITY CARE POLICY AS FOLLOWS:* EVERY CLINIC AND AREA OF PATIENT REGISTRATION HAS A NOTICE POSTED INFORMING THE PATIENT/S/PUBLIC OF THE AVAILABILITY OF FINANCIAL ASSISTANCE* BROCHURES DESCRIBING THE POLICY ARE AVAILABLE AT CLINICS, POINTS OF REGISTRATION, AND ARE MAILED TO SELF PAY PATIENTS ALONG WITH APPLICATIONS* INPATIENTS ARE VISITED BY THE PATIENT FINANCIAL ADVOCATE. THEY ARE MADE AWARE OF GOVERNMENT PROGRAMS AND IF NECESSARY, ARRANGEMENTS ARE MADE WITH THE DEPARTMENT OF SOCIAL SERVICES TO HAVE A WORKER COME IN AND TAKE THE APPLICATION FROM THE PATIENT. THE PATIENT IS GIVEN INFORMATION AND APPLICATION FOR FINANCIAL ASSISTANCE, AND APPLICATION CAN BE TAKEN RIGHT AT PATIENT BEDSIDE* THE WOMAN'S HEALTH CENTER INFORMS ALL SELF PAY PREGNANT WOMEN OF THE "PRESUMPTIVE ELIGIBILITY" PROCESS AND PATIENTS ARE DIRECTED TO PATIENT FINANCIAL SERVICES FOR COMPLETION OF THE APPLICATION AND COMPLETION OF A WIC APPLICATION IF PATIENT SO DESIRES* EVERY CMH EMPLOYEE IS MADE AWARE OF THE CHARITY CARE PROGRAM AT ORIENTATION AND ENCOURAGED TO MAKE PATIENTS AND THE PUBLIC AWARE OF THE PROGRAM. PERSONNEL WHO HAVE PATIENT CONTACT ARE ANNUALLY IN-SERVICED ON CHARITY CARE PROGRAM* EVERY BILL THAT IS SENT OUT IS MARKED "FOR INFORMATION REGARDING OUR "PATIENT FINANCIAL ASSISTANCE" PROGRAM" PLEASE CONTACT 607-337-4295 |
| PART VI, LINE 4: CHENANGO MEMORIAL HOSPITAL, A 138-BED HEALTH CARE FACILITY IN NORWICH, NEW YORK, IS THE ONLY HOSPITAL IN CHENANGO COUNTY. THE HOSPITAL'S SERVICE AREA IS CENTERED IN CHENANGO COUNTY, WITH NEARLY 88% OF PATIENTS COMING FROM CHENANGO COUNTY COMMUNITIES AND ANOTHER 10% FROM OTSEGO, DELAWARE, MADISON AND BROOME COUNTIES. CHENANGO MEMORIAL'S 90% ZIP CODE SERVICE AREA INCLUDES THE COMMUNITIES OF NORWICH, OXFORD, SHERBURNE, NEW BERLIN, MCDONOUGH, SOUTH NEW BERLIN, BAINBRIDGE, SOUTH PLYMOUTH, MOUNT UPTON, GUILFORD, PLYMOUTH, SIDNEY, SMYRNA, GREENE, UNADILLA, EARLVILLE, SOUTH OTSELIC AND GILBERTSVILLE. PER CAPITA INCOME AS REPORTED BY THE US CENSUS BUREAU (2005-2009) IS $22,496 WITH MEDIAN HOUSEHOLD INCOME OF $42,523 (2010). 15.5% OF RESIDENTS HAVE INCOME BELOW THE POVERTY LEVEL (2009). CHENANGO COUNTY ALSO HAS A DISPROPORTIONATE SHARE OF RESIDENTS AGE 65+ AT 16.8% COMPARED TO THE NATIONAL AVERAGE OF 13.2% (2010), LOWER THAN AVERAGE % OF COLLEGE GRADUATES AT 17.3%, COMPARED TO 27.5% NATIONALLY (2010); AND A LOWER THAN AVERAGE % OF HOUSEHOLDS EARNING $75K+ AT 10.4%, COMPARED TO 12.5% NATIONALLY (2010). |
| PART VI, LINE 6: THE UHS SYSTEMS MISSION IS TO SERVE THE PEOPLE OF OUR REGION, TO IMPROVE OR MAINTAIN THEIR HEALTH, AND TO PROVIDE THE PATIENT-CENTERED, CONTEMPORARY HEALTH SERVICES IN A CARING, COMPETENT, AND CONVENIENT MANNER. SERVICE WILL BE AFFORDABLE AND WELL ORGANIZED TO MEET THE NEEDS OF OUR PATIENTS AND THEIR FAMILIES. CMH SERVES THE COMMUNITY WITH AN OPEN MEDICAL STAFF AND A DIVERSE COMMUNITY BOARD OF DIRECTORS. ANY SURPLUS FUNDS GENERATED THROUGH OPERATIONS ARE USED SOLELY TO PURCHASE NEEDED MEDICAL EQUIPMENT AND TECHNOLOGY, UPGRADE FACILITIES AND PROVIDE FOR PROGRAM SERVICE ENHANCEMENTS. |
| PART VI, LINE 7: CMH 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 CMH IN 1910 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, CHENANGO MEMORIAL HOSPITAL'S SYSTEM ENGAGED IN A STRATEGIC PLANNING PROCESS FOR THE YEARS 2008-2011. CONSISTENT WITH THE MISSION AND VISION, THE PLAN IS FOCUSED ON CONTINUING TO STRENGTHEN THE HEALTH SYSTEM AND ITS SERVICES TO COMMUNITY. 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 CMH COMMUNITY SERVICE REPORT CAPTURES THE BENEFITS SPECIFIC TO CMH. THE OTHER HOSPITAL MEMBERS OF THE UHS SYSTEM, UHS WILSON MEDICAL CENTER, UHS BINGHAMTON GENERAL HOSPITAL, AND DELAWARE VALLEY HOSPITAL SUBMIT SEPARATE REPORTS.- CLINICAL EXCELLENCE: CMH HAS FOCUSED ITS RESOURCES AND ENERGY AROUND ACHIEVING DISTINCTION AS A HEALTH SYSTEM IN CLINICAL QUALITY, PATIENT SAFETY AND SERVICE. CMH 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 INITIATIVES 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. - FINANCIAL STRENGTH: TO ENSURE CMH 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.CHENANGO MEMORIAL HOSPITAL FILES THE COMMUNITY BENEFIT REPORT WITH NEW YORK STATE. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMH AUXILIARY TO CMH HOSPITAL | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 179 NORTH BROAD STREET | AddressLine1 |
| City | NORWICH | City |
| State | NY | State |
| ZIP Code | 13815 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 150532180 | EINOfRecipient |
| IRC Section | 501 (C) (3) | IRCSection |
| Amount Of Cash Grant | 50000 | AmountOfCashGrant |
| Method Of Valuation | CASH | MethodOfValuation |
| Purpose Of Grant | MATERNITY UNIT; FETAL MONITORING EQUIPMENT | PurposeOfGrant |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| 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 (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DRAKE LAMEN MD | |||||||||||||
| 288323 | 0 | 0 | 0 | 0 | 0 | 22489 | 0 | 24272 | 0 | 335084 | 0 | 0 | 0 |
| MATTHEW J SALANGER | |||||||||||||
| 0 | 679428 | 0 | 268838 | 0 | 229172 | 0 | 18870 | 0 | 19290 | 0 | 1215598 | 0 | 0 |
| RAJESH DAVE MD | |||||||||||||
| 0 | 424228 | 0 | 135271 | 0 | 119111 | 0 | 18870 | 0 | 14668 | 0 | 712148 | 0 | 0 |
| MEREDITH B MCDOWELL MD | |||||||||||||
| 230216 | 0 | 0 | 0 | 0 | 0 | 17957 | 0 | 77934 | 0 | 326107 | 0 | 0 | 0 |
| ROBERT G GOMULKA | |||||||||||||
| 0 | 330532 | 0 | 113271 | 0 | 98027 | 0 | 18870 | 0 | 14555 | 0 | 575255 | 0 | 0 |
| MICHAEL TREVISANI | |||||||||||||
| 262038 | 0 | 0 | 0 | 0 | 0 | 20439 | 0 | 25280 | 0 | 307757 | 0 | 0 | 0 |
| DRU CAVANUAGH | |||||||||||||
| 132121 | 0 | 0 | 0 | 0 | 0 | 10305 | 0 | 19139 | 0 | 161565 | 0 | 0 | 0 |
| TIMOTHY COREY MD | |||||||||||||
| 297625 | 0 | 0 | 0 | 0 | 0 | 23215 | 0 | 92227 | 0 | 413067 | 0 | 0 | 0 |
| MICHAEL L WATERS MD | |||||||||||||
| 196413 | 0 | 0 | 0 | 0 | 0 | 15320 | 0 | 24539 | 0 | 236272 | 0 | 0 | 0 |
| JOHN R BRERETON MD | |||||||||||||
| 274530 | 0 | 0 | 0 | 0 | 0 | 21413 | 0 | 83422 | 0 | 379365 | 0 | 0 | 0 |
| WILLIAM J BOUDREAU MD | |||||||||||||
| 254013 | 0 | 0 | 0 | 0 | 0 | 19813 | 0 | 84347 | 0 | 358173 | 0 | 0 | 0 |
| CHUNJIE YANG MD | |||||||||||||
| 302374 | 0 | 0 | 0 | 0 | 0 | 23585 | 0 | 94242 | 0 | 420201 | 0 | 0 | 0 |
| FRANK C COLE III MD | |||||||||||||
| 264208 | 0 | 0 | 0 | 0 | 0 | 20608 | 0 | 83060 | 0 | 367876 | 0 | 0 | 0 |
| PAUL M DOROGHAZI MD | |||||||||||||
| 261083 | 0 | 0 | 0 | 0 | 0 | 20364 | 0 | 85463 | 0 | 366910 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | UNITED HEALTH SERVICES, INC. IS THE SOLE MEMBER OF CHENANGO MEMORIAL HOSPITAL, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER, UNITED HEALTH SERVICES, INC, SHALL ELECT TRUSTEES AT THE ANNUAL MEETING OF THE ORGANIZATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 PREPARATION AND FILING IS THE RESPONSIBILITY OF THE HOSPITALS BOARD OF DIRECTORS WHO DELEGATES THE TIMELY AND ACCURATE COMPLETION OF THE 990 TO MANAGEMENT. THE HOSPITAL'S FINANCE DIVISION ASKED THE ORGANIZATION'S PUBLIC ACCOUNTANTS TO PREPARE FORM 990 WHICH IS THEN REVIEWED BY THE HOSPITAL'S CEO. | |
| DIRECTORS, OFFICERS AND KEY EMPLOYEES SUBMIT CONFLICT OF INTEREST STATEMENTS ANNUALLY WHICH ARE REVIEWED BY THE CEO, BOARD CHAIRMAN AND THE ORGANIZATION'S AUDIT COMMITTEE. | FORM 990, PART VI, SECTION B, LINE 12C | |
| IT IS THE PHILOSOPHY OF THE HOSPITAL THAT THE EXECUTIVE STAFF BE COMPENSATED FAIRLY FOR THEIR WORK. BASE SALARY LEVELS, INCENTIVE/BONUS PROGRAMS AND BENEFIT PLANS SHALL TAKE INTO ACCOUNT THE LOCAL, REGIONAL AND NATIONAL MARKETS TO ALLOW UHS HOSPITALS TO RECRUIT, MOTIVATE, REWARD, RECOGNIZE AND RETAIN HIGHLY TALENTED EXECUTIVES WITH THE SKILL SETS REQUIRED TO FULFILL ITS MISSION. THE EXECUTIVE COMPENSATION PROGRAM MUST FOCUS EXECUTIVES' ATTENTION ON UHS'S STRATEGIC INITIATIVES AND MISSION CRITICAL PERFORMANCE OBJECTIVES THAT WILL LEAD TO THE ORGANIZATION'S AND SYSTEM'S SUCCESS. TO CARRY OUT THIS COMPENSATION PHILOSOPHY, THE UHS HOSPITALS (WHICH INCLUDES CHENANGO MEMORIAL HOSPITAL) BOARD OF DIRECTORS' EXECUTIVE COMPENSATION COMMITTEE REVIEWS ANNUALLY A COMPREHENSIVE REPORT PREPARED BY AN EXTERNAL EXECUTIVE COMPENSATION CONSULTING FIRM, SULLIVAN COTTER ASSOCIATES TO DETERMINE THE APPROPRIATENESS OF THE BASE AND TOTAL COMPENSATION LEVELS FOR THE SENIOR MANAGEMENT STAFF. THIS ANNUAL REPORT FOCUSES ON TWO KEY AREAS; 1) THE COMPETITIVENESS OF THE SENIOR MANAGEMENT STAFF'S BASE AND TOTAL COMPENSATION (INCLUDING BENEFITS) VS. NATIONAL BENCHMARK DATA FOR COMPARABLY SIZED HEALTH CARE SYSTEMS AND HOSPITAL (BASED UPON 'TOTAL REVENUE' METRICS), AND 2) A 'REASONABLENESS ASSESSMENT' CONSISTENT WITH U.S. TREASURY DEPARTMENT REGULATIONS GOVERNING EXECUTIVE COMPENSATION FOR NOT-FOR-PROFIT ORGANIZATIONS. THE DATA FROM THIS REPORT ASSISTS THE EXECUTIVE COMPENSATION COMMITTEE IN DETERMINING THE APPROPRIATENESS OF THE SENIOR MANAGEMENTS' CURRENT BASE AND TOTAL COMPENSATION LEVELS AND THE NEED FOR ANY ADJUSTMENTS FOR THAT CALENDAR YEAR. | FORM 990, PART VI, SECTION B, LINE 15 | |
| THE ORGANIZATION PROVIDES FORM 1023, 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 NET UNREALIZED GAINS AND LOSSES ON INVESTMENTS 6,955. CUMULATIVE EFFECT OF AUXILIARY INCOME AND EXPENSE 885. CHANGE IN INTEREST IN CHENANGO MEMORIAL HOSPITAL FOUNDATION 356,364. PENSION CHANGES OTHER THAN NET PERIODIC BENEFIT COSTS -956,576. CHANGE IN INTEREST IN PERMANENTLY RESTRICTED NET ASSETS 378,812. TOTAL TO FORM 990, PART XI, LINE 5: -213,560. | FORM 990, PART XI, LINE 5: |
| THE UNITED HEALTH SERVICES HOSPITALS AUDIT COMMITTEE HAS RESPONSIBILITY FOR OVERSIGHT FOR THE ANNUAL ADUIT PERFORMED BY THE ORGANIZATIONS INDEPENDENT ACCOUNTANTS. THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. | FORM 990, PART XI, LINE 2C |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (11 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 HOSPITALS INC | ||||||||||
| 33-57 HARRISON STREET | JOHNSON CITY | NY | 13790 | 161165049 | HOSPITAL | NY | 501 (C) (3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| IDEAL SENIOR LIVING CENTER INC | ||||||||||
| 508 HIGH AVENUE | ENDICOTT | NY | 13760 | 222902896 | SENIOR LIVING CENTER | NY | 501 (C) (3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| IDEAL SENIOR LIVING CENTER HOUSING CO | ||||||||||
| 508 HIGH AVENUE | ENDICOTT | NY | 13760 | 222902899 | SENIOR HOUSING | NY | 501 (C) (3) | 9 | UNITED HEALTH SERVICES INC | 0 |
| TWIN TIER HOME HEALTH INC | ||||||||||
| 4401 VESTAL PARKWAY EAST | VESTAL | NY | 13850 | 222348211 | HOME HEALTH CARE | NY | 501 (C) (3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| UNITED HEALTH SERVICES INC | ||||||||||
| 20-42 MITCHELL AVENUE | BINGHAMTON | NY | 13903 | 222682421 | PARENT COMPANY | NY | 501 (C) (3) | 9 | BOARD OF DIRECTORS UHS INC | 0 |
| UNITED MEDMANAGEMENT | ||||||||||
| 601 RIVERSIDE DRIVE | JOHNSON CITY | NY | 13790 | 161396133 | PHYSICIAN PRACTICES | NY | 501 (C) (3) | 11B | UNITED HEALTH SERVICES INC | 0 |
| PROFESSIONAL HOME CARE INC | ||||||||||
| 4401 VESTAL PARKWAY EAST | VESTAL | NY | 138503556 | 161261977 | HOME HEALTH CARE | NY | 501 (C) (3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| DELAWARE VALLEY HOSPITAL INC | ||||||||||
| ONE TITUS PLACE | WALTON | NY | 13856 | 150524324 | HOSPITAL | NY | 501 (C) (3) | 3 | UNITED HEALTH SERVICES INC | 0 |
| ECKELBERGER TOWER INC | ||||||||||
| 156 CORLISS AVENUE | JOHNSON CITY | NY | 13790 | 237171440 | MEDICAL STUDENT HOUSING | NY | 501 (C) (3) | 9 | UNITED HEALTH SERVICES INC | 0 |
| CMH FUND | ||||||||||
| 179 NORTH BROAD STREET | NORWICH | NY | 13815 | 222985550 | INACTIVE | NY | 501 (C) (3) | 11B | CHENANGO MEMORIAL HOSPITAL INC | 0 |
| PROJECT HEAR INC | ||||||||||
| 4401 VESTAL PARKWAY EAST | VESTAL | NY | 13850 | 161462675 | HOME EMERGENCY ALARM SYSTEM | NY | 501 (C) (3) | 3 | TWIN TIER HOME HEALTH INC | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| PATHWAY HEALTH MANAGEMENT INC | ||||||||
| 20 MITCHELL AVENUE | BINGHAMTON | NY | 13903 | 161228654 | WINDING DOWN OF MANAGEMENT SERVICES TO SUSQUENHANA MEDICAL ASSOCIATES | NY | UNITED HEALTH SERVICES INC | C |
| CHENANGO MADA INC | ||||||||
| 179 N BROAD STREET | NORWICH | NY | 13915 | 161290726 | INACTIVE | NY | CMH FUND INC | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | 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 | 1 | 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 | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
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