BLYTHEDALE CHILDRENS HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
BLYTHEDALE CHILDRENS HOSPITAL (EIN 13-1739922)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-08
IRS object ID
201133129349302363
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)
Timestamp2011-11-08T15:37:41-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1TWO JERICHO PLAZAAddressLine1
CityJERICHOCity
StateNYState
ZIP Code11753ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN131739922EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BLYTHEDALE CHILDREN'S HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBLYTNameControl
Phone9145927555Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line195 BRADHURST AVEAddressLine1
CityVALHALLACity
StateNYState
ZIP Code10595ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN CANNINGName
TitleCFOTitle
Phone9145927555Phone
Date Signed2011-11-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone5169187000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLAWRENCE LEVINENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line195 BRADHURST AVEAddressLine1
CityVALHALLACity
StateNYState
ZIP Code10595ZIPCode
FieldValueIRS element (for citing)
Gross Receipts175192249GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BLYTHEDALE.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1891YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionSEE SCHEDULE OActivityOrMissionDescription
Nbr Voting Members Governing Body35NbrVotingMembersGoverningBody
Nbr Independent Voting Members35NbrIndependentVotingMembers
Total Nbr Employees457TotalNbrEmployees
Total Nbr Volunteers241TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2825746ContributionsGrantsPriorYear
Contributions Grants Current Year1986785ContributionsGrantsCurrentYear
Program Service Revenue Prior Year47661794ProgramServiceRevenuePriorYear
Program Service Revenue CY56457526ProgramServiceRevenueCY
Investment Income Prior Year407584InvestmentIncomePriorYear
Investment Income Current Year7855281InvestmentIncomeCurrentYear
Other Revenue Prior Year1893443OtherRevenuePriorYear
Other Revenue Current Year2081355OtherRevenueCurrentYear
Total Revenue Prior Year52788567TotalRevenuePriorYear
Total Revenue Current Year68380947TotalRevenueCurrentYear
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 Year32607432SalariesEtcPriorYear
Salaries Etc Current Year34146677SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year695245TotalFundrsngExpCurrentYear
Other Expense Prior Year12901609OtherExpensePriorYear
Other Expenses Current Year14190915OtherExpensesCurrentYear
Total Expenses Prior Year45509041TotalExpensesPriorYear
Total Expenses Current Year48337592TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7279526RevenuesLessExpensesPriorYear
Revenues Less Expenses CY20043355RevenuesLessExpensesCY
Total Assets BOY170714534TotalAssetsBOY
Total Assets EOY189805578TotalAssetsEOY
Total Liabilities BOY52185934TotalLiabilitiesBOY
Total Liabilities EOY48818723TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY118528600NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY140986855NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSEE SCHEDULE OMissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense29149942Expense
Revenue45833857Revenue
DescriptionSEE SCHEDULE ODescription

Activity2 Activity2

FieldValueIRS element (for citing)
Expense5496094Expense
Revenue9751353Revenue
DescriptionSEE SCHEDULE ODescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense950426Expense
Revenue872316Revenue
DescriptionSEE SCHEDULE ODescription

Activity Other ActivityOther

FieldValueIRS element (for citing)
DescriptionCOMMITTEE ON PRESCHOOL SPECIAL EDUCATION (CPSE PROGRAM) - BLYTHEDALECHILDREN'S HOSPITAL PROVIDES EVALUATION AND TREATMENT SERVICES FOR YOUNG CHILDREN BETWEEN THE AGES OF 3 TO 5 YEARS WHO ARE REFERRED THROUGH THEIR LOCAL COMMITTEE ON PRESCHOOL SPECIAL EDUCATION (CPSE). THESE PATIENTS ARE ELIGIBLE FOR ASSESSMENT AT NO COST TO THEIR FAMILIES. THE NEW YORK STATE EDUCATION DEPARTMENT OVERSEES A STATEWIDE PRESCHOOL SPECIAL EDUCATION PROGRAM WITH SCHOOL DISTRICTS, MUNICIPALITIES, APPROVED PROVIDERS, AND PARENTS. EVALUATIONS AND SERVICES ARE PROVIDED TO ELIGIBLE CHILDREN WHO HAVE A DISABILITY THAT AFFECTS THEIR LEARNING. FUNDING FOR EVALUATIONS AND SERVICES IS PROVIDED BY MUNICIPALITIES AND THE STATE. IN 2010, THE PROGRAM SERVED ON AVERAGE OF 15 PATIENTS PER SCHOOL DAY FOR A TOTAL OF 3,529 VISITS. EVALUATION AND TREATMENT PLANNING ARE PERFORMED BY A MULTIDISCIPLINARY TEAM THAT MAY CONSIST OF THERAPISTS, SPECIAL EDUCATION TEACHERS, AUDIOLOGISTS, PHYSIATRISTS (REHABILITATION DOCTORS), NEUROLOGISTS, PSYCHIATRISTS, PSYCHOLOGISTS, SOCIAL WORKERS, NURSES, NUTRITIONISTS, AND OTHER SPECIALTY CONSULTANTS. AT BLYTHEDALE, WE PROVIDE INDIVIDUALIZED RELATED SERVICES TO ELIGIBLE CHILDREN AGE'S THREE TO FIVE THROUGH OUR OUTPATIENT DEPARTMENT. WE SERVE CHILDREN WITH A WIDE RANGE OF NEEDS INCLUDING DIFFICULTIES THAT MAY INTERFERE WITH THEIR LEARNING AND FUNCTIONING IN PRESCHOOL. CHILDREN WITH THE FOLLOWING DIFFICULTIES ARE MOST COMMON IN THE PROGRAM:- DELAYS OR LAGS IN COGNITIVE, LANGUAGE, MOTOR OR SOCIAL EMOTIONALDEVELOPMENT- CONGENITAL OR ACQUIRED ABNORMALITIES- DIAGNOSED MEDICAL CONDITIONS SUCH AS CEREBRAL PALSY, NEUROMUSCULAR OROTHER NEUROLOGICAL DISORDERSDescription
FieldValueIRS element (for citing)
Total Program Service Expense35596462TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities1ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached0FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
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 Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109634NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees457NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account1ForeignFinancialAccount
Name Of Foreign CountryOCNameOfForeignCountry
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members35NbrVotingGoverningBodyMembers
Number Independent Voting Members35NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
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 Line1JOHN CANNINGBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9145927555TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line195 BRADHURST AVEAddressLine1
CityVALHALLACity
StateNYState
ZIP Code10595ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (57 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
HOWARD ADLER
TRUSTEE1.00X000
JOHN BARKER
TRUSTEE1.00X000
JEAN HOFMEIMER BENNETT
TRUSTEE1.00X000
THOMAS BROCK
TRUSTEE1.00X000
JOHN BURNHAM
TRUSTEE1.00X000
WILLIAM CAHN
TRUSTEE1.00X000
LAURENCE COHEN
TRUSTEE1.00X000
EDWARD DAVIDOWITZ
TRUSTEE1.00X000
PEGGY EPSTEIN TANNER
VICE-CHAIRMAN1.00X000
TIM EVNIN
TREASURER1.00X000
MATTHEW FELDMAN
TRUSTEE1.00X000
DARREN FOGEL
TRUSTEE1.00X000
JOHN FURTH
TRUSTEE1.00X000
JUDITH GOODHUE
VICE-CHAIRMAN1.00X000
LOUISE GRAYER
TRUSTEE1.00X000
OWEN GUTFREUND
CHAIR OF THE BOARD1.00X000
MERWIN HASKEL
TRUSTEE1.00X000
SCOTT KARR
TRUSTEE1.00X000
PHYLLIS LASHINS
TRUSTEE1.00X000
MARION LEVY
TRUSTEE1.00X000
WILLIAM LEVY
TRUSTEE1.00X000
GEORGE LUSK
TRUSTEE1.00X000
MICHAEL MARGULIES
TRUSTEE1.00X000
DAVID OSBORN
TRUSTEE1.00X000
DAVID PEDOWITZ
VICE-CHAIRMAN1.00X000
ELIZABETH PFORZHEIMER
TRUSTEE1.00X000
ABBEY POPPER
TRUSTEE1.00X000
NANCY PUNDYK
TRUSTEE1.00X000
SONDRA RAPPAPORT
TRUSTEE1.00X000
PETER RITTMASTER
TRUSTEE1.00X000
JEANNE SAVITT
SECRETARY1.00X000
LUCY SCHMOLKA
TRUSTEE1.00X000
HEIDI SCHWARTZ
TRUSTEE1.00X000
STEVEN SOLOMON
TRUSTEE1.00X000
PATRICIA STANLEY
TRUSTEE1.00X000
FRANK STERN
TRUSTEE1.00X000
CHARLES WEINBERG
TRUSTEE1.00X000
LESLIE WEISSMAN
TRUSTEE1.00X000
JOAN BERNHARD
TRUSTEE1.00X000
JOSEPHINE BIRNBAUM
TRUSTEE1.00X000
PEG MICHELMAN
TRUSTEE1.00X000
LINDA MILLER
TRUSTEE1.00X000
DAVID STEIN
TRUSTEE1.00X000
LAWRENCE LEVINE
PRESIDENT & CEO37.505795030175412X
JOHN CANNING
CHIEF FINANCIAL OFFICER37.50341006030817X
JOELLE MAST
CHIEF MEDICAL OFFICER37.50290295061538X
MAUREEN DESIMONE
CHIEF OPERATING OFFICER37.50273692079891X
REGINA KELLY
CHIEF PLANNING OFFICER37.50159171043711X
LINDA HURWITZ
CHIEF NURSING OFFICER37.50200458039183X
LOIS ALLEN
DIRECTOR OF QUALITY37.50192945035791X
RONALD GALLO
DIRECTOR OF HUMAN RESOURCES37.50192958034628X
ELIZABETH BOWMAN
CHIEF DEVELOPMENT OFFICER37.50191666019013X
MILICENT MITCHELL
CHIEF OF PULMONOLOGY37.50237486058294X
BYRON FERNANDEZ
PEDIATRICIAN37.50210583023239X
KATHY SILVERMAN
PEDIATRICIAN37.50175069021241X
MARY DIDIE
PEDIATRICIAN37.50168761046507X
LAURA MIRKINSON
CHIEF OF PEDIATRICS37.50205262012736X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3418855TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation682001TotalOtherCompensation
Number Individuals GT100 K14NumberIndividualsGT100K
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
MORRIS SWITZER
185 TALCOTT ROADWILLISTONVT05495ARCHITECTS658559
NEW PROVIDENCE ASSET MANAGEMENT
570 LEXINGTON AVENEW YORKNY10022ASSET MANAGEMENT326943
NEW YORK PRESBYTERIAN HOSPITAL
PO BOX 6635NEW YORKNY102496635MEDICAL RESIDENTS218052
NAVIN HAFFY & ASSOCIATES LLC
200 CORDWAINER DRIVENORWELLMA02061MEDITECH CONSULTANTS150879
GARFUNKEL WILD PC
111 GREAT NECK ROADGREAT NECKNY11021LEGAL146715
FieldValueIRS element (for citing)
Number Of Contractors GT100 K16NumberOfContractorsGT100K
Fundraising Events544798FundraisingEvents
All Other Contributions1441987AllOtherContributions
Noncash Contributions79549NoncashContributions
Total Contributions1986785TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
INPATIENT9000994583385745833857
DAY HOSPITAL90009997513539751353
OUTPATIENT900099872316872316
FieldValueIRS element (for citing)
Total Program Service Revenue56457526TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column361763TotalRevenueColumn
Exclusion$361,763ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities114202076Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities106708558Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities7493518Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column7493518TotalRevenueColumn
Exclusion$7,493,518ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events166137GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events544798CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses102744FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column63393TotalRevenueColumn
Exclusion$63,393ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
SCHOOL CONTRACT900099825000$825,000
OFFSITE THERAPIES900099776080$776,080
CAFETERIA REVENUE900099195485$195,485

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column221397TotalRevenueColumn
Exclusion$221,397ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2017962TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column68380947TotalRevenueColumn
Related Or Exempt Function Income56457526RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$9,936,636ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2841818Total
Program Services2281340ProgramServices
Management And General507866ManagementAndGeneral
Fundraising52612Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23855634Total
Program Services19150702ProgramServices
Management And General4263278ManagementAndGeneral
Fundraising441654Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2234535Total
Program Services1793829ProgramServices
Management And General399337ManagementAndGeneral
Fundraising41369Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3153107Total
Program Services2531235ProgramServices
Management And General563497ManagementAndGeneral
Fundraising58375Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2061583Total
Program Services1654987ProgramServices
Management And General368429ManagementAndGeneral
Fundraising38167Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total70154Total
Management And General70154ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total202500Total
Management And General202500ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total907785Total
Program Services503555ProgramServices
Management And General404230ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total2000Total
Fundraising2000Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total494599Total
Program Services93945ProgramServices
Management And General397329ManagementAndGeneral
Fundraising3325Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total580214Total
Management And General580214ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3054778Total
Program Services1802319ProgramServices
Management And General1243295ManagementAndGeneral
Fundraising9164Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total23010Total
Program Services9120ProgramServices
Management And General11022ManagementAndGeneral
Fundraising2868Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total12308Total
Program Services3483ProgramServices
Management And General8825ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2000416Total
Program Services1180245ProgramServices
Management And General814170ManagementAndGeneral
Fundraising6001Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total598221Total
Program Services380412ProgramServices
Management And General217809ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PURCHASED SERVICES1328204188663110773331808
MEDICAL SUPPLIES993021993021
CONTRACTED LABOR884121884121
DRUGS766048766048
BAD DEBT EXPENSE563428563428

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1710108Total
Program Services816009ProgramServices
Management And General886197ManagementAndGeneral
Fundraising7902Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total48337592Total
Program Services35596462ProgramServices
Management And General12045885ManagementAndGeneral
Fundraising695245Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY15001501BOY
EOY9744707EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY54665360BOY
EOY11631837EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY2076819BOY
EOY1461216EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY5704174BOY
EOY8485147EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY220082BOY
EOY292718EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY327256BOY
EOY255905EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis67334858LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec13176170LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY24940401BOY
EOY54158688EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY59718704BOY
EOY43212904EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4787761BOY
EOY52835261EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3272476BOY
EOY7727195EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY170714534BOY
EOY189805578EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY7720974BOY
EOY7663657EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY27000000BOY
EOY27000000EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY549928BOY
EOY383043EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY16915032BOY
EOY13772023EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY52185934BOY
EOY48818723EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY97911388BOY
EOY126477863EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY17017038BOY
EOY10538526EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3600174BOY
EOY3970466EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY118528600BOY
EOY140986855EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY170714534BOY
EOY189805578EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses20043355ReconcilationRevenueExpenses
Reconcilation Other Changes2414900ReconcilationOtherChanges
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)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$33,192DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB33192TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPART IV, SUPPLEMENTAL INFORMATION:Identifier
ExplanationFORM 990, SCHEDULE C, PART II-B, LINE 1G: BLYTHEDALE CHILDREN'S HOSPITAL, AS A MEMBER OF STATE-WIDE HOSPITAL ORGANIZATIONS, HAS A PORTION OF ITS DUES USED FOR LOBBYING. IN ADDITION, BLYTHEDALE HAS ENGAGED AN OUTSIDE LOBBYIST TO LOBBY ON ITS BEHALF ON ISSUES RELATING TO THE STATE BUDGET.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance20617212BeginningOfYearBalance
Contributions430633Contributions
Investment Earnings Or Losses1098917InvestmentEarningsOrLosses
Other Expenditures-7637770OtherExpenditures
End Of Year Balance14508992EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance19230372BeginningOfYearBalance
Contributions1619160Contributions
Investment Earnings Or Losses372366InvestmentEarningsOrLosses
Other Expenditures-604686OtherExpenditures
End Of Year Balance20617212EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance28286047BeginningOfYearBalance
Contributions1671350Contributions
Investment Earnings Or Losses-2147297InvestmentEarningsOrLosses
Other Expenditures-8579728OtherExpenditures
End Of Year Balance19230372EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.73000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.27000TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs1EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis96449OtherCostOrOtherBasis
Book Value96449BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6556026OtherCostOrOtherBasis
Depreciation5471494Depreciation
Book Value1084532BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis13158533OtherCostOrOtherBasis
Depreciation5872548Depreciation
Book Value7285985BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis47523850OtherCostOrOtherBasis
Depreciation1832128Depreciation
Book Value45691722BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings54158688TotalOfBookValueLandBuildings

Other Securities OtherSecurities

FieldValueIRS element (for citing)
DescriptionLIMITED LIABILITY PARTNERSHIP (HEDGE FUNDS)Description
Book Value52835261BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities52835261TotalOfBookValueSecurities

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ACCRUED PENSION LIABILITY$10,311,147
ASSET RETIREMENT OBLIGATION$1,047,789
DUE TO THIRD PARTY PAYORS$2,413,087
FieldValueIRS element (for citing)
Total Of Amounts13772023TotalOfAmounts
Total Revenue68380947TotalRevenue
Total Expenses48337592TotalExpenses
Excess Or Deficit For Year20043355ExcessOrDeficitForYear
Net Unrealized GL On Investments1452207NetUnrealizedGLOnInvestments
Other$962,693OtherAmount
Total Adjustments2414900TotalAdjustments
Excess Or Deficit Per FS22458255ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt70795847TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1452207NetUnrealizedGainsInvestments
Other Revenues962693OtherRevenues
Revenue Not Rptd F9902414900RevenueNotRptdF990
Revenue Subtotal68380947RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99068380947TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt48337592TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal48337592ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99048337592TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY BLYTHEDALE CHILDREN'S HOSPITAL (THE "HOSPITAL") HAS BEEN LIMITED BY DONORS TO A SPECIFIC PERIOD OR PURPOSE. PERMANENTLY RESTRICTED NET ASSETS HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED BY THE HOSPITAL IN PERPETUITY. THE HOSPITAL'S ENDOWMENT CONSISTS OF APPROXIMATELY 20 INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE HOSPITAL BECAME SUBJECT TO NYPMIFA (THE NEW YORK PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT) WHICH WAS ENACTED IN SEPTEMBER 2010. THE BOARD OF TRUSTEES INTERPRETED NYPMIFA AS (A) REQUIRING THE PRESERVATION OF THE ORIGINAL GIFT AS OF THE GIFT DATE OF THE DONOR-RESTRICTED ENDOWMENT FUNDS ABSENT EXPLICIT DONOR STIPULATIONS TO THE CONTRARY. AS A RESULT OF THIS INTERPRETATION, THE HOSPITAL CLASSIFIES AS PERMANENTLY RESTRICTED NET ASSETS: (A) THE ORIGINAL VALUE OF GIFTS DONATED TO THE PERMANENT ENDOWMENT, (B) THE ORIGINAL VALUE OF SUBSEQUENT GIFTS TO THE PERMANENT ENDOWMENT, AND (C) ACCUMULATIONS OF INCOME ARE ADDED TO THE FUND IN ACCORDANCE WITH THE DIRECTION OF THE APPLICABLE DONOR GIFT INSTRUMENT AT THE TIME THE ACCUMULATION IS ADDED TO THE FUND. THE REMAINING PORTION OF THE DONOR-RESTRICTED ENDOWMENT FUND THAT IS NOT CLASSIFIED IN PERMANENTLY RESTRICTED NET ASSETS IS CLASSIFIED AS TEMPORARILY RESTRICTED UNTIL THOSE AMOUNTS ARE APPROPRIATED FOR EXPENDITURE BY THE ORGANIZATION. IN ACCORDANCE WITH NYPMIFA THE ORGANIZATION CONSIDERS THE FOLLOWING FACTORS IN MAKING A DETERMINATION TO APPROPRIATE OR ACCUMULATE DONOR-RESTRICTED ENDOWMENT FUNDS: (A) THE DURATION AND PRESERVATION OF THE FUND (B) THE PURPOSES OF THE ORGANIZATION AND THE DONOR-RESTRICTED ENDOWMENT FUND (C) GENERAL ECONOMIC CONDITIONS (D) THE POSSIBLE EFFECT OF INFLATION AND DEFLATION (E) THE EXPECTED TOTAL RETURN FROM INCOME AND THE APPRECIATION OF INVESTMENTS (F) OTHER RESOURCES OF THE ORGANIZATION (G) THE INVESTMENT POLICIES OF THE ORGANIZATION TEMPORARILY RESTRICTED NET ASSETS AS OF DECEMBER 31, 2010 AND 2009, ARE AVAILABLE FOR THE FOLLOWING PURPOSES: 2010 2009 PLANT REPLACEMENT $6,747,300 $14,819,291 TEMPORARILY RECTRICTED PORTION OF ENDOWMENT FUND 2,452,254 1,254,666 MEDICAL EQUIPMENT 268,585 804,786 OTHER 1,070,387 138,295 TOTALS $10,538,526 $17,017,038 PERMANENTLY RESTRICTED NET ASSETS AS OF DECEMBER 31, 2010 AND 2009, ARE RESTRICTED TO THE FOLLOWING: 2010 2009 INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES $3,970,466 $3,600,174
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:IN JUNE 2006, THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ISSUED ASC 740-10-65, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTERPRISE'S FINANCIAL STATEMENTS IN ACCORDANCE WITH ASC 740, ACCOUNTING FOR INCOME TAXES. THIS INTERPRETATION PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THIS INTERPRETATION ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION. THE HOSPITAL ADOPTED THE PROVISIONS OF ASC 740-10-65 ON JANUARY 1, 2009. THE ADOPTION HAD NO IMPACT UPON THE FINANCIAL STATEMENTS.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN PENSION LIABILITY 962,693.
PART XII, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN PENSION LIABILITY 962,693.
PART V, LINE 3A(I): BLYTHEDALE CHILDREN'S HOSPITAL HAS A CHARITABLE REMAINDER TRUST HELD BY TRUSTEES CITIBANK, CALLED THE HENRY STERN TRUST. THE PRINCIPLE IS PERMANENTLY RESTRICTED.

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCENTRAL AMERICA AND THE CARIBBEANRegion
Type Of Activities ConductedINVESTMENTTypeOfActivitiesConducted
Total Expenditures43781519TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent43781519SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent43781519TotalAmountSpent
Transfer To Foreign Corp1TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp1OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1SPRING EVENTNameOfEvent1
Gross Receipts Event1290324GrossReceiptsEvent1
Charitable Contributions Event1228573CharitableContributionsEvent1
Gross Revenue Event161751GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event11649NonCashPrizesEvent1
Rent Facility Costs Event16450RentFacilityCostsEvent1
Food And Beverage Event113450FoodAndBeverageEvent1
Entertainment Event112750EntertainmentEvent1
Other Direct Expenses Event110390OtherDirectExpensesEvent1
Name Of Event2GOLF EVENTNameOfEvent2
Gross Receipts Event2188309GrossReceiptsEvent2
Charitable Contributions Event2124425CharitableContributionsEvent2
Gross Revenue Event263884GrossRevenueEvent2
Cash Prizes Event20CashPrizesEvent2
Non Cash Prizes Event21552NonCashPrizesEvent2
Rent Facility Costs Event219525RentFacilityCostsEvent2
Food And Beverage Event215015FoodAndBeverageEvent2
Entertainment Event2690EntertainmentEvent2
Other Direct Expenses Event28510OtherDirectExpensesEvent2
Total Number Of Other Events2TotalNumberOfOtherEvents
Gross Receipts Other Events232302GrossReceiptsOtherEvents
Charitable Contrib Other Events191800CharitableContribOtherEvents
Gross Revenue Other Events40502GrossRevenueOtherEvents
Cash Prizes Other Events0CashPrizesOtherEvents
Non Cash Prizes Other Events366NonCashPrizesOtherEvents
Rent Facility Costs Other Events0RentFacilityCostsOtherEvents
Food And Beverage Other Events0FoodAndBeverageOtherEvents
Entertainment Other Events8520EntertainmentOtherEvents
Other Direct Expenses Other Events3877OtherDirectExpensesOtherEvents
Gross Receipts Total710935GrossReceiptsTotal
Charitable Contributions Total544798CharitableContributionsTotal
Gross Revenue Total Events166137GrossRevenueTotalEvents
Non Cash Prizes Total Events3567NonCashPrizesTotalEvents
Rent Facility Costs Total Events25975RentFacilityCostsTotalEvents
Food And Beverage Total Events28465FoodAndBeverageTotalEvents
Entertainment Total Events21960EntertainmentTotalEvents
Other Direct Expenses Total Events22777OtherDirectExpensesTotalEvents
Direct Expense Summary Events102744DirectExpenseSummaryEvents
Net Income Summary63393NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage400.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense64117TotalCommunityBenefitExpense
Net Community Benefit Expense64117NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense564579TotalCommunityBenefitExpense
Net Community Benefit Expense564579NetCommunityBenefitExpense
Percent Of Total Expense0.01180PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense628696TotalCommunityBenefitExpense
Net Community Benefit Expense628696NetCommunityBenefitExpense
Percent Of Total Expense0.01310PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense674629TotalCommunityBenefitExpense
Direct Offsetting Revenue310748DirectOffsettingRevenue
Net Community Benefit Expense363881NetCommunityBenefitExpense
Percent Of Total Expense0.00760PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense617786TotalCommunityBenefitExpense
Direct Offsetting Revenue90124DirectOffsettingRevenue
Net Community Benefit Expense527662NetCommunityBenefitExpense
Percent Of Total Expense0.01100PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense192501TotalCommunityBenefitExpense
Direct Offsetting Revenue106464DirectOffsettingRevenue
Net Community Benefit Expense86037NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1484916TotalCommunityBenefitExpense
Direct Offsetting Revenue507336DirectOffsettingRevenue
Net Community Benefit Expense977580NetCommunityBenefitExpense
Percent Of Total Expense0.02040PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2113612TotalCommunityBenefitExpense
Direct Offsetting Revenue507336DirectOffsettingRevenue
Net Community Benefit Expense1606276NetCommunityBenefitExpense
Percent Of Total Expense0.03350PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense2534871TotalCommunityBuildingExpense
Direct Offsetting Revenue1062946DirectOffsettingRevenue
Net Community Building Expense1471925NetCommunityBuildingExpense
Percent Of Total Expense0.03080PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense117119TotalCommunityBuildingExpense
Direct Offsetting Revenue31654DirectOffsettingRevenue
Net Community Building Expense85465NetCommunityBuildingExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense2651990TotalCommunityBuildingExpense
Direct Offsetting Revenue1094600DirectOffsettingRevenue
Net Community Building Expense1557390NetCommunityBuildingExpense
Percent Of Total Expense0.03260PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$563,428BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare0AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare0CostOfCareReimbursedByMedicare
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1BLYTHEDALE CHILDREN'S HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line195 BRADHURST AVEAddressLine1
CityVALHALLACity
StateNYState
ZIP Code10595ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
Childrens HospitalXChildrensHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)

ExplanationExplanation
PART I, L7 COL(F): BAD DEBTS WILL BE RECORDED AND RECOGNIZED IN THE PERIOD IN WHICH IT IS DETERMINED THE DEBT IS UNCOLLECTIBLE. BAD DEBT IS RECOGNIZED AS THE AMOUNT CONTRACTUALLY OBLIGATED AND RECOGNIZED AS REVENUE FOR WHICH ALL AVENUES OF COLLECTION HAVE BEEN EXHAUSTED. REVENUE IS RECOGNIZED WHEN THE CLAIM HAS (1) PERVASIVE EVIDENCE OF A PAYMENT AGREEMENT / AUTHORIZATION, RATE SHEET OR CONTRACT (2) SERVICES HAVE BEEN RENDERED (3) PRICE IS FIXED AND DETERMINABLE (4) COLLECTABILITY IS REASONABLE ASSURED. BAD DEBT IS RECOGNIZED IF MANAGEMENT IS UNABLE TO COLLECT THE DEBT AFTER THESE CRITERIA HAVE BEEN MET. BAD DEBTS DO NOT INCLUDE CHARITY CARE, COURTESY DISCOUNTS, SELF PAY ALLOWANCES, OR ALLOWANCES FOR OUTPATIENT SERVICES PROVIDED THAT ARE NOT AUTHORIZED.
PART II: BLYTHEDALE IS INVLOVED IN NUMEROUS COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES. NUMEROUS COMMUNITY CONCERNS ARE ADDRESSED, INCLUDING HEALTH IMPROVEMENT (SEE DETAILS UNDER LINE 6 BELOW) AND ACCESS TO CARE. BLYTHEDALE ACTIVELY PARTICIPATES IN THE WESTCHESTER CHILDREN'S ASSOCIATION'S CHILD HEALTH TASK FORCE, WHOSE PRINCIPAL GOAL IS TO MAXIMIZE ENROLLMENT OF ELIGIBLE CHILDREN IN NEW YORK STATE'S MEDICAID AND CHILD HEALTH PLUS PROGRAMS. ADDITIONALLY, UNDER THE AEGIS OF THE NEW YORK COALITION OF MEDICALLY FRAGILE CHILDREN, BLYTHEDALE HAS WORKED TO ADVOCATE FOR SERVICES TO SUPPORT FAMILIES CARING FOR MEDICALLY FRAGILE CHILDREN AT HOME.
PART III, LINE 9B: COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. ALL PATIENTS HAVING DIFFICULTY PAYING THEIR BILLS ARE DIRECTED TO HOSPITAL STAFF WHO ASSIST THE FAMILY IN COMPLETING A FINANCIAL ASSESSMENT AND TRY TO QUALIFY THE PATIENT FOR ASSISTANCE. ONCE A LEVEL OF FINANCIAL ASSISTANCE IS DETERMINED, THE ACCOUNT BALANCE IS PRORATED FOR CONTRACTUAL ADJUSTMENTS AND THEN PRO RATED TO COST. FROM COSTS, THE LEVEL OF FINANCIAL ASSISTANCE IS THEN APPLIED, ANY REMAINING BALANCE IS COLLECTABLE AS PATIENT RESPONSIBILITY. PATIENTS ARE SCREENED FOR ELIGIBILTY FOR FINANCIAL ASSISTANCE BEFORE COLLECTION PROCEDURE BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS, DOCUMENTATION IS RECEIVED THAT INDICATES THAT THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, THE ACCOUNT IS REFERRED BACK FOR A FINANCIAL ASSISTANCE REVIEW. BLYTHEDALE DOES NOT PURSUE COLLECTION OF AMOUNTS FROM PATIENTS DETERMINED TO QUALIFY FOR CHARITY CARE. IF A PATIENT HAS REQUESTED AND/OR FILLED OUT A FINANCIAL ASSISTANCE APPLICATION, ALL DEBT COLLECTION ACTIVITIES STOP UNTIL ELIGIBILTY FOR FINANCIAL ASSISTANCE CAN BE DETERMINED. BLYTHEDALE'S POLICY PROVIDES THAT WE WILL NOT REFER ANY ACCOUNTS FOR COLLECTION UNTIL IT IS DETERMINED WHETHER THE INDIVIDUAL IS INSURED AND NOT ELIGIBLE FOR FINANCIAL ASSISTANCE.
PART VI, LINE 2: SINCE THE VAST MAJORITY OF ADMISSIONS TO BLYTHEDALE COME BY REFERRAL FROM OTHER HOSPITALS, PARTICULARLY THE LARGE MEDICAL CENTERS IN THE METROPOLITAN NEW YORK AND HUDSON VALLEY AREA, BLYTHEDALE'S SENSE OF NEED FOR CLINICAL SERVICES LARGELY EMANATES FROM REFERRING HOSPITALS AND THEIR PHYSICIANS. HOWEVER, IN ADDITION TO ITS REFERRAL HOSPITALS, BLYTHEDALE ALSO WORKS CLOSELY WITH A VARIETY OF LOCAL AGENCIES, NOTABLY THE WESTCHESTER, ROCKLAND AND PUTNAM COUNTY DEPARTMENTS OF HEALTH, THE WESTCHESTER CHILD HEALTH ADVOCACY NETWORK AND THE WESTCHESTER SAFE KIDS COALITION, TO IDENTIFY COMMUNITY HEALTH PRIORITIES THAT ARE RELEVANT TO BLYTHEDALE'S MISSION AND SERVICES. PARTICIPANTS IN THESE COALITIONS INCLUDE THE MAJOR CHILD AND ADOLESCENT HEALTH-FOCUSED COMMUNITY-BASED ORGANIZATIONS IN WESTCHESTER. BLYTHEDALE ALSO HAS CLOSE WORKING RELATIONSHIPS WITH MANY OF THE SCHOOL DISTRICTS IN WESTCHESTER COUNTY, THROUGH ITS NUTRITION EDUCATION AND INJURY AND DISEASE PREVENTION ACTIVITIES AND THROUGH ARRANGEMENTS WHEREBY BLYTHEDALE STAFF ARE CONTRACTED TO PROVIDE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES TO CHILDREN IN THE SCHOOLS.
PART VI, LINE 3: CONSISTENT WITH ITS MISSION AND STATE REQUIREMENTS (NEW YORK STATE PUBLIC HEALTH LAW 2807(K) (9-A), BLYTHEDALE HAS DEVELOPED GUIDELINES THAT DELINEATE THE CIRCUMSTANCES AND PROCEDURES UNDER WHICH FREE OR REDUCED COST CARE IS AVAILABLE. THESE GUIDELINES ARE MADE AVAILABLE TO ALL FAMILIES UPON REGISTRATION, AND HOSPITAL STAFF PROVIDE COUNSELING AS NECESSARY. INTERPRETATION SERVICES ARE AVAILABLE FOR PATIENTS NEEDING INFORMATION IN LANGUAGES OTHER THAN ENGLISH. PATIENTS ARE ALSO NOTIFIED OF BLYTHEDALE'S CHARITY CARE FINANCIAL ASSISTANCE POLICIES THROUGH NOTICES IN ENGLISH AND SPANISH POSTED IN THE HOSPITAL'S LOBBY AND IN PATIENT REGISTRATION AND WAITING AREAS. IN ADDITION, BLYTHEDAL'S PATIENT ASSISTANCE FUNDS HELPS PROVIDE CHILDREN WITH VARIOUS ITEMS (I.E. EQUIPMENT, CLOTHING, ETC.) WHERE FAMILY RESOURCES ARE LIMITED AND INSURANCE DOES NOT COVER.
PART VI, LINE 4: AS A SPECIALTY CHILDREN'S HOSPITAL SERVING CHILDREN WITH A BROAD RANGE OF DIAGNOSES, BLYTHEDALE'S SERVICE AREA IS WIDESPREAD, WITH PATIENTS COMING FROM THE ENTIRE SOUTHERN PORTION OF NEW YORK STATE AS WELL AS ADJACENT AREAS OF NEW JERSEY AND CONNECTICUT. THE HOSPITAL IS LOCATED IN A SUBURBAN COUNTY (WESTCHESTER) THAT IS PART OF THE GREATER NEW YORK METROPOLITAN AREA, WHICH HAS AN EXTREMELY DIVERSE POPULATION. THE HOSPITAL'S PATIENT ARE BROADLY REPRESENTATIVE OF THIS POPULATION.
PART VI, LINE 6: BLYTHEDALE OFFERS A NUMBER OF COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND SPECIAL PROGRAMS FOR DEVELOPMENT OF THE PEDIATRIC PROFESSIONAL COMMUNITY: NUTRITION EDUCATION: IN A MAJOR INITIATIVE TO HELP REDUCE THE PREVALENCE OF CHILDHOOD OBESITY AND PREVENT ITS LONG-TERM NEGATIVE HEALTH EFFECTS, BLYTHEDALE CHILDREN'S HOSPITAL IS REACHING OUT TO SCHOOL DISTRICTS THROUGHOUT WESTCHESTER COUNTY WITH ITS EAT WELL, BE WELL SCHOOL-BASED NUTRITION EDUCATION PROGRAM. THE EAT WELL, BE WELL PROGRAM, WITH SUPPORT FROM KOHL'S DEPARTMENT STORES, IS DESIGNED TO PROVIDE SCHOOL STAFF AND STUDENTS WITH THE TOOLS NECESSARY TO HELP CHILDREN DEVELOP HEALTHY EATING HABITS THROUGH A COMPREHENSIVE CURRICULUM DEVELOPED BY BLYTHEDALE'S REGISTERED DIETICIANS. TO DATE THIS PROGRAM HAS REACHED MORE THAN 55,000 STUDENTS IN SCHOOLS THROUGHOUT WESTCHESTER AND PUTNAM, AS WELL AS THEIR PARENTS AND TEACHERS, WITH INFORMATION ON HOW TO MAKE FOOD AND LIFESTYLE CHOICES THAT WILL PROMOTE HEALTHY LIVING FOR A LIFETIME.A RELATED BLYTHEDALE UNDERTAKING IN THE AREA OF HEALTHY EATING FOR CHILDREN AND ADOLESCENTS IS A COMMUNITY LECTURE SERIES ORGANIZED BY BLYTHEDALE AND SUPPORTED BY THE DANNON CORPORATION. THIS SERIES HAS INCLUDED SESSIONS FOCUSING ON BUILDING BLOCKS FOR NUTRITION FOR VARIOUS AGE GROUPS. IN 2010 OVER 200 PARENTS AND CHILDREN ATTENDED THESE SESSIONS.INJURY PREVENTION: BLYTHEDALE IS COMMITTED TO KEEPING CHILDREN SAFE AND INJURY FREE. IN ORDER TO PROVIDE CHILDREN WITH LESSONS THAT WILL HELP ESTABLISH GOOD SAFETY HABITS, BLYTHEDALE HAS DEVELOPED A SCHOOL-BASED INJURY PROGRAM. WITH THE SUPPORT OF KOHL'S DEPARTMENT STORES, THIS PROGRAM IS DESIGNED TO PROMOTE THE SAFE PRACTICES AND THE CONSISTENT USE OF PROTECTIVE QUIPMENT TO CHILDREN IN THE THIRD, FOURTH AND FIFTH GRADES. IN TWO YEARS THIS PROGRAM HAS REACHED OVER 15,000 CHILDREN. THE INJURY PREVENTION PROGRAM PROVIDES CLASSROOM INSTRUCTIONS TO CHILDREN FROM GRADES K-5. THE THREE AREAS ADDRESSED BY THE PROGRAM ARE: BICYCLE SAFETY, FIRE AND WATER SAFETY. THIS YEAR THE PROGRAM HAS BEEN PRESENTED IN 17 SCHOOLS THROUGHOUT WESTCHESTER, ROCKLAND AND PUNTAM COUNTIES AND HAS REACHED OVER 4,633 STUDENTS. HOSPITAL STAFF ALSO PARTICIPATED IN SEVERAL HEALTH FAIRS AND SAFETY DAYS. IN ADDITION TO THIS SPECIAL INJURY PREVENTION EDUCATION PROGRAM, BLYTHEDALE HAS FOR MANY YEARS COORDINATED THE WESTCHESTER SAFE KIDS COALITION, THE LOCAL AFFILIATE OF THE NATIONAL SAFE KIDS CAMPAIGN. SAFE KIDS IS DEDICATED TO PREVENTING UNINTENTIONAL CHILDHOOD INJURY FROM ACCIDENTS SUCH AS MOTOR VEHICLE CRASHES, FIRES, DROWNING, POISONING AND FALLS, BY PROMOTING CHANGE IN BEHAVIORS, LAWS AND THE ENVIRONMENT. AS PART OF ITS SAFE KIDS ACTIVITIES, BLYTHEDALE SPONSORS FITTING AND INSTALLATION CHECKS FOR BOTH REGULAR AND SPECIAL-NEED CAR SEATS ON SITE AT THE HOSPITAL. HOSPITAL STAFF ALSO ARE INSTRUCTORS IN CAR SEAT TECHNOLOGIST TRAINING COURSES IN THE LOWER HUDSON VALLEY. CPR TRAINING CENTER: BLYTHEDALE IS A COMMUNITY TRAINING CENTER FOR THE AMERICAN HEART ASSOCIATION, PROVIDING TRAINING IN HEARTSAVER CPR, HEARTSAVER AED AND HEARTSAVER FIRST AID. THOSE TRAINED INCLUDE HEALTH CARE PROFESSIONALS, MEMBER OF LOCAL POLICE AND FIRE DEPARTMENTS, STUDENTS AT AREA SCHOOLS AND STAFF FROM VARIOUS COMMUNITY AGENCIES. BLYTHEDALE ALSO OFFERS PEDIATRIC CPR TRAINING FOR THE COMMUNITY AND HEALTH CARE PROFESSIONALS, AND IS A CERTIFIED PEDIATRIC ADVANCED LIFE SUPPORT TRAINING CENTER. SERVICES TO THE PROFESSIONAL COMMUNITY: BLYTHEDALE ALSO PROVIDES CLINICAL TRAINING FOR SCORES OF PROFESSIONAL STUDENTS IN A WIDE RANGE OF FIELDS, INCLUDING MEDICINE, NURSING, RESPIRATORY THERAPY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY AND SOCIAL WORK. BLYTHEDALE ALSO SPONSORS SPECIALIZED COURSES ON PEDIATRIC ISSUES FOR AREA PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS. BLYTHEDALE IS THE SPONSOR OF THE REGIONAL CHAPTER OF THE SOCIETY FOR PEDIATRIC NURSING (SPN) WHICH PROMOTES EXCELLENCE IN NURSING CARE OF CHILDREN AND THEIR FAMILIES THROUGH SUPPORT OF ITS MEMBERS' CLINICAL PRACTICE, EDUCATION, RESEARCH AND ADVOCACY. SPN HOSTS BI-ANNUAL CONFERENCES WHICH HAVE COVERED TOPICS RANGING FROM PREVENTING THE SPREAD OF INFECTION TO ETHICS AND LEGAL ISSUES IN PREDIATRIC PRACTICE. THE SPN ALSO SPONSORS A REVIEW COURSE AND ON-SITE EXAM FOR NATIONAL PEDIATRIC CERTIFICATION BOARD FOR PEDIATRICS NURSES FROM THE SURROUNDING COMMUNITY.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
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 Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 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
LAWRENCE LEVINE
48028103224806697401492610261510754915000
JOHN CANNING
278883020188041935040030268140371823000
JOELLE MAST
250465079900318400293870321510351833000
MAUREEN DESIMONE
2217080138430381410531410267500353583000
REGINA KELLY
140581030630155270197540239570202882000
LINDA HURWITZ
174728040000217300205950185880239641000
LOIS ALLEN
157831016110019004030238055530228736000
RONALD GALLO
1590990108000230590174660171620227586000
ELIZABETH BOWMAN
1750970358401298509763092500210679000
MILICENT MITCHELL
211068044280219900346370236570295780000
BYRON FERNANDEZ
19223500018348040300192090233822000
KATHY SILVERMAN
15957400015495012951082900196310000
MARY DIDIE
150314000184470285820179250215268000
LAURA MIRKINSON
195092069360323404684080520217998000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 4BTHE PURPOSE OF BLYTHEDALE CHILDREN'S HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (THE "PLAN") IS TO PROVIDE DEFERRED COMPENSATION FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. THERE IS ONE PARTICIPANT IN THE PLAN. BLYTHEDALE CHILDREN'S HOSPITAL IS A TAX-EXEMPT ENTITY UNDER THE INTERNAL REVENUE CODE OF 1986. THE PLAN IS TAXED UNDER CODE SECTION 457(F) AND IS INTENDED TO BE A "TOP-HAT PLAN" PURSUANT TO SECTIONS 201(2), 301(A)(3) AND 401(A)(1) OF THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). THE PLAN IS ALSO INTENDED TO COMPLY WITH THE REQUIREMENTS OF SECTION 409A OF THE CODE, AS ADDED BY THE AMERICAN JOBS CREATION ACT OF 2004, AND THE TREASURY REGULATIONS OR ANY OTHER AUTHORITATIVE GUIDANCE ISSUED THERE UNDER ("SECTION 409A"). THE SECRETARY OF LABOR WAS PROVIDED WRITTEN NOTICE OF THE PLAN IN JULY OF 2008 AND THAT BLYTHEDALE CHILDREN'S HOSPITAL WOULD UTILIZE THE ALTERNATIVE FORM OF COMPLIANCE WITH REPORTING AND DISCLOSURE REQUIREMENTS OF PART 1 OF TITLE 1 OF ERISA.
PART I, LINE 7BLYTHEDALE ENGAGED SULLIVAN COTTER IN 2010 TO DEVELOP AND PROVIDE RECOMMENDATIONS TO THE COMPENSATION COMMITTEE OF THE BOARD REGARDING PAYMENT OF AN ANNUAL PERFORMANCE INCENTIVE PLAN FOR EMPLOYEES WITH MANAGEMENT RESPONSIBILITIES. THIS INCENTIVE PLAN CONDITIONS PAYMENTS BASED UPON THE ACHIEVEMENT OF MULTIPLE INDIVIDUAL AND ORGANIZATIONAL MEASURES. FUNDING FOR THE PLAN IS DEPENDENT UPON ANNUAL BOARD OF TRUSTEES APPROVAL. BASED UPON THE FINANCIAL CONDITIONS TOWARD THE END OF EACH FISCAL YEAR, THE BOARD WILL EVALUATE THE APPROPRIATENESS OF ESTABLISHING A LUMP SUM POOLED AMOUNT. EVEN IF ALL RELEVANT PERFORMANCE MEASURES ARE ACHIEVED, THE BOARD OF TRUSTEES RETAINS FULL DISCRETION TO MAKE, NOT MAKE OR REDUCE THE AMOUNT OF ANY INCENTIVE AWARDS.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1DORMITORY AUTHORITY OF THE STATE OF NEW YORKBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN146000293IssuerEIN
CUSIP Number649905DG8CUSIPNumber
Date Issued2009-06-19DateIssued
Issue Price27000000IssuePrice
Description Of PurposeCONSTRUCTIONDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds27176275TotalProceeds
Amount In Reserve Fund10423AmountInReserveFund
Issuance Costs From Proceeds540000IssuanceCostsFromProceeds
Credit Enhancement820868CreditEnhancement
Capital Expenditures15717346CapitalExpenditures
Amount Unspent10098060AmountUnspent
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

IdentifierIdentifierExplanationExplanation
PART I, COLUMN (E) & PART II, LINE 3THE DIFFERENCES BETWEEN THE ISSUE PRICE (PART I, COLUMN (E)) AND TOTAL PROCEEDS (PART II, LINE 3) ARE DUE TO INVESTMENT EARNINGS.
PART II, LINE 4THE AMOUNT ENTERED HERE IS A DEBT SERVICE FUND BALANCE.

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions5NumberOfContributions
Noncash Contribs Rptd F99079549NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION MISSION STATEMENTFORM 990, PART I, LINE 1BLYTHEDALE CHILDREN'S HOSPITAL IS DEDICATED TO IMPROVING THE HEALTH & WELL-BEING OF CHILDREN. BLYTHEDALE IS A LEADER IN THE DIAGNOSIS & TREATMENT OF CHILDREN WITH DISABLING AND COMPLEX MEDICAL CONDITIONS.
ORGANIZATION MISSION STATEMENTFORM 990, PART III, LINE 1BLYTHEDALE CHILDREN'S HOSPITAL IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF CHILDREN. WE ACT TO SERVE AS THE PRE-EMINENT SPECIALTY CHILDREN'S HOSPITAL IN THE NORTHEAST. WE SERVE HIGHER ACUITY PATIENTS WITH A VARIETY OF SPECIAL HEALTHCARE NEEDS, THROUGH SUPERB MEDICAL, PSYCHOSOCIAL, TEACHING, RESEARCH AND ADVOCACY PROGRAMS. WE SERVE CHILDREN WITHOUT REGARD TO RELIGION, RACE, OR ABILITY TO PAY.
PROGRAM SERVICE STATEMENTFORM 990, PART III, LINE 4AINPATIENT SERVICES - BLYTHEDALE CHILDREN'S HOSPITAL, FOUNDED IN 1891, IS A LICENSED ACUTE CARE FREE-STANDING CHILDREN'S HOSPITAL THAT SPECIALIZES IN THE CARE OF CHILDREN REQUIRING REHABILITATIVE, REPIRATORY AND COMPLEX MEDICAL CARE. BLYTHEDALE IS DESIGNATED BY CMS AS A PPS EXEMPT, FREESTANDING CHILDREN'S HOSPITAL. WITHIN BLYTHEDALE CHILDREN'S HOSPITAL, WE PROVIDE A COMPREHENSIVE RANGE OF SERVICES WHICH INCLUDE BUT ARE NOT LIMITED TO GENERAL PEDIATRICS, ADOLESCENT MEDICINE, PEDIATRIC PULMONOLOGY, CHILD NEUROLOGY, PSYCHIATRY, ORTHOPEDICS, PHYSICAL MEDICINE, AND REHABILITATION OF MULTIPLE PEDIATRIC SPECIALITIES (SUCH AS CARDIOLOGY, INFECTIOUS DISEASE, ENT, OPHTHALMOLOGY, ETC.) BLYTHEDALE MAINTAINS A CORE GROUP OF FULL TIME SPECIALTY COVERAGE IN PEDIATRICS, PULMONOLOGY, ADOLESCENT MEDICINE, NEUROLOGY, AND PSYCHIATRY. OTHER SUBSPECIALTY COVERAGE IS MAINTAINED AND UTILIZED AS NEEDED THROUGH A VARIETY OF CONTRACTUAL RELATIONSHIPS WITH THE AREA'S LEADING ACADEMIC MEDICAL CENTERS. BLYTHEDALE ALSO PROVIDES OTHER VITAL CLINICAL SERVICES SUCH AS NURSING, RESPIRATORY THERAPY, PSYCHOLOGY, CHILD LIFE, REPIRATORY, SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY, THERAPEUTIC RECREATION, SOCIAL WORK AND CASE MANAGEMENT. THE INPATIENT SERVICES ARE PRIMARLY COMPOSED OF 4 MAJOR PROGRAMS, PHYSICAL MEDICINE AND REHABILITATION SERVICES, VENTILATOR WEANING, TRAUMATIC BRAIN INJURY AND MEDICAL THERAPIES FOR COMPLEX AND CHRONIC HEALTH CONDITIONS. THE HOSPITAL OPERATES 92 LICENSED BEDS AND PROVIDED CARE TO OVER 63 PATIENTS PER DAY ON AVERAGE IN 2010. OVER 65.5% OF OUR INPATIENT POPULATION WAS REIMBURSED THROUGH THE MEDICAID PROGRAM IN 2010. WHILE 100% OF THE HOSPITALS INPATIENT POPULATION IS REFERRED IN FROM OTHER ACUTE CARE HOSPITALS IN THE REGION, OVER 55% COME DIRECTLY FROM INTENSIVE CARE UNITS (ICU'S). THIS SPEAKS TO THE HIGH ACUITY OF THE PATIENT POPULATION BEING MANAGED AT BLYTHEDALE. IN 2010 OVER 54% OF PATIENTS TREATED WERE BELOW THE AGES OF 5 YEARS. THIS FACT PRESENTS MANY UNIQUE CHALLENGES TO THE DELIVERY OF CARE AS THE HOSPITAL PROVIDES HIGH QUALITY TO BOTH THE PATIENTS AND THE FAMILY. BLYTHEDALE CHILDREN'S HOSPITAL DOESN'T OPERATE PRIMARY CARE CLINICS, OR AN EMERGENCY DEPARTMENT OR OBSTETRICAL SERVICES. THESE SERVICES ARE OFTEN THE PRIMARY DRIVERS OF UNINSURED PATIENTS AT ACUTE CARE HOSPITALS. SECONDLY, CHILDREN, MORE SO THAN ADULTS HAVE GREATER ACCESS TO MEDICAID REIMBURSEMENT AS A PAYER OF LAST RESORT BECAUSE OF STATE CHILD HEALTH PLUS LAWS. THESE TWO FACTORS SIGNIFICANTLY IMPACT THE REPORTED AMOUNT OF CARE CLASSIFIED AS TRUE CHARITY CARE RELATIVE TO FULL SERVICE ACUTE CARE HOSPITALS.
PROGRAM SERVICE STATEMENTFORM 990, PART III, LINE 4BDAY HOSPITAL PROGRAM - BLYTHEDALE OFFERS A DAY HOSPITAL PROGRAM FOR THOSE CHILDREN WHO ARE ABLE TO LIVE AT HOME, BUT STILL REQUIRE A LEVEL OF MEDICAL AND REHABILITATIVE CARE THAT CANNOT BE MET BY THEIR SCHOOL OR OUTPATIENT PROGRAM. IN 2010, 50% OF THE PROGRAM CAME DIRECTLY FROM THE INPATIENT SETTING, 40% CAME DIRECTLY FROM REFERRALS IN THE COMMUNITY AND 10% THROUGH THE EARLY INTERVENTION/CPSE PROGRAMS. IN 2010, THE PROGRAM SERVED ON AVERAGE OF 78 PATIENTS PER SCHOOL DAY FOR A TOTAL OF 18,524 VISITS. OVER 77% OF THESE PATIENTS WERE REIMBURSED BY THE MEDICAID PROGRAM. THE DAY HOSPITAL PROGRAM PROVIDES A NURTURING ENVIRONMENT WHERE CHILDREN WITH VARIOUS SPECIAL MEDICAL NEEDS CAN RECEIVE DAILY MEDICAL SUPERVISION, NURSING CARE, AND HAVE THEIR NEEDS FOR PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES MET, ALL WHILE RETURNING HOME AT THE END OF THE DAY. EACH CHILD'S PROGRAM IS INDIVIDUALIZED TO ADDRESS THEIR UNIQUE MEDICAL, PSYCHOLOGICAL AND THERAPEUTIC NEEDS. IN ADDITION, EVERY CHILD IS ASSIGNED A SOCIAL WORKER TO PROVIDE FAMILY SUPPORT AND CASE MANAGEMENT. AS NECESSARY, ONGOING PSYCHOSOCIAL SUPPORT AND COUNSELING, AND CASE MANAGEMENT ARE PROVIDED. SERVICES FOR SCHOOL-AGE CHILDREN ARE PROVIDED IN CONJUCTION WITH A FULL ACADEMIC PROGRAM UNDER THE AUSPICES OF THE MOUNT PLEASANT-BLYTHEDALE UNION FREE SCHOOL DISTRICT.
PROGRAM SERVICE STATEMENTFORM 990, PART III, LINE 4CEARLY INTERVENTION - THE EARLY INTERVENTION PROGRAM IS A STATEWIDE PROGRAM THAT PROVIDES MANY DIFFERENT TYPES OF EARLY INTERVENTION SERVICES TO CHILDREN BETWEEN THE AGES OF BIRTH TO THREE YEARS WITH DEVELOPMENT DELAY OR DIAGNOSED DISABILITIES AND TO THEIR FAMILIES. IN NEW YORK STATE, THE DEPARTMENT OF HEALTH IS THE LEAD STATE AGENCY REPONSIBLE FOR THE EARLY INTERVENTION PROGRAM. IN 2010, THE PROGRAM SERVED ON AVERAGE OF 27 PATIENTS PER SCHOOL DAY FOR A TOTAL OF 6,501 VISITS. BLYTHEDALE CHILDREN'S HOSPITAL IS WELL SUITED TO PROVIDE EVALUATION AND TREATMENT SERVICES FOR YOUNG CHILDREN. AS THE REGION'S PREMIERE HOSPITAL OFFERING REHABILITATIVE SERVICES TO CHILDREN, WE HAVE THE LARGEST DEPARTMENTS OF SPEECH THERAPY, OCCUPATIONAL THERAPY AND PHYSICAL THERAPY. THE EXPERTISE OF OUR HIGHLY SKILLED, MULTIDISCIPLINARY STAFF ENABLES US TO PROVIDE COORDINATED, COMPREHENSIVE, INDIVIDUALIZED PROGRAMS FOR THE CHILDREN AND FAMILIES WE SERVE. PARENTS AND STAFF WORK CLOSELY TOGETHER TO DEVELOP GOALS AND IMPATIENT PLANS. EVALUATION AND TREATMENT PLANNING ARE PERFORMED BY A MULTI-DISCIPLINARY TEAM THAT MAY CONSIST OF THERAPISTS, PHYSIATRISTS (REHABILITATION DOCTORS), NEUROLOGISTS, PSYCHIATRISTS, PSYCHOLOGISTS, SPECIAL EDUCATION, TEACHERS, AUDIOLOGISTS, SOCIAL WORKERS, NURSES, NUTRITIONISTS, AND OTHER SPECIALTY CONSULTANTS. WHILE NOT LIMITED TO THE FOLLOWING, THE PROGRAM TREATS A WIDE ARRAY OF ISSUES AND DIAGNOSES: - DELAYS OR LAGS IN REACHING THEIR DEVELOPMENTAL MILESTONES - CONGENITAL OR AQUIRED ABNORMALITIES SUCH AS VISION OR HEARING IMPAIREMENTS - DIAGNOSED MEDICAL CONDTIONS SUCH AS CEREBRAL PALSY, NEUROMUSCULAR OR OTHER NEUROLOGICAL DISORDERS
FORM 990, PART VI, SECTION A, LINE 2JOHN FURTH AND OWEN GUTFREUND (BOARD MEMBERS) HAVE A FAMILY RELATIONSHIP. DAVID PEDOWITZ HAS BUSINESS RELATIONSHIPS WITH PEGGY EPSTEIN TANNER, PATRICIA STANLEY AND LARRY COHEN (BOARD MEMBERS). STEPHEN GOODHUE (SPOUSE OF BOARD MEMBER JUDY GOODHUE) AND NANCY ADLER (SPOUSE OF BOARD MEMBER HOWARD ADLER) HAVE BUSINESS RELATIONSHIPS WITH JOHN FURTH. FRANK STERN AND JOHN BARKER (BOARD MEMBERS) HAVE A BUSINESS RELATIONSHIP. JOHN BARKER, DAVID PEDOWITZ AND DARREN FOGEL ARE EMPLOYEES OF NEUBERGER BERMAN, WHICH MANAGES SOME ASSET AND PENSION PORTFOLIOS FOR THE HOSPITAL. THESE MEMBERS RECUSE THEMSELVES FROM ALL ISSUES RELATED TO THESE INVESTMENTS.
FORM 990, PART VI, SECTION B, LINE 11A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BLYTHEDALE CHILDREN'S HOSPITAL'S BOARD OF TRUSTEES PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 IS REVIEWED BY THE BLYTHEDALE FINANCE DEPARTMENT AS WELL AS BY DELOITTE TAX, LLP, BEFORE IT IS PRESENTED TO THE BOARD'S EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE THEN PROVIDES AN OVERVIEW OF THE FORM 990 TO THE FULL BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS, SENIOR MANAGEMENT AND KEY EMPLOYEES OF BLYTHEDALE CHILDREN'S HOSPITAL MUST COMPLETE A STATEMENT ANNUALLY AND WHENEVER NEW INFORMATION ARISES, WHICH DISCLOSES ANY POTENTIAL CONFLICT OF INTEREST, AS REQUIRED BY THE HOSPITAL'S CONFLICT OF INTEREST POLICY. THESE STATEMENTS ARE REVIEWED BY THE HOSPITAL'S COMPLIANCE OFFICER WHO PREPARES A REPORT ON DISCLOSURES FOR THE BOARD'S EXECUTIVE COMMITTEE. HOSPITAL BOARD MEMBERS AND STAFF ARE TRAINED AND EDUCATED ON THEIR OBLIGATIONS UNDER THIS POLICY, INCLUDING ITS GIFT AND GRATUITIES PROVISIONS.
FORM 990, PART VI, SECTION B, LINE 15IN NOVEMBER 2008 SULLIVAN, COTTER AND ASSOCIATES, INC ASSISTED THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES IN DEVELOPING AND FORMALLY APPROVING AN EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT AND A COMPENSATION COMMITTEE CHARTER STATEMENT. ADDITIONALLY, SULLIVAN COTTER PROVIDED TO THE BOARD'S COMPENSATION COMMITTEE AN ASSESSMENT OF THE COMPETITIVENESS OF THE TOTAL COMPENSATION PROVIDED TO BLYTHEDALE'S EXECUTIVES RELATIVE TO PREVALENT AND COMPARABLE MARKETPLACE PRACTICES. COMPENSATION INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVES, ALL EMPLOYEE/STANDARD BENEFITS, SUPPLEMENTAL BENEFITS (I.E., THOSE FOR EXECUTIVES OR HIGHLY-COMPENSATED EMPLOYEES ONLY) AND PERQUISITES. SINCE ITS FOUNDING IN 1992, SULLIVAN COTTER'S EFFORTS HAVE BEEN DEVOTED TO ASSISTING HEALTHCARE ORGANIZATIONS WITH THE DESIGN AND IMPLEMENTATION OF COMPENSATION SYSTEMS AND PROGRAMS. THE FIRM HAS WORKED WITH OVER 700 HEALTHCARE ORGANIZATIONS INCLUDING MANY PEDIATRIC HOSPITALS/HEALTH SYSTEMS. SULLIVAN COTTER MAINTAINS A LIBRARY CONTAINING NEARLY ALL OF THE MAJOR HEALTHCARE EXECUTIVE COMPENSATION SURVEYS AS WELL AS THE RESULTS OF ITS OWN CUSTOM SURVEYS. IN ORDER FOR BLYTHEDALE TO ESTABLISH A "REBUTTABLE PRESUMPTION OF REASONABLENESS" ACCORDING TO INTERMEDIATE SANCTIONS REGULATIONS, ALL ELEMENTS OF EXECUTIVES'COMPENSATION WERE REVIEWED TO ENSURE THE OVERALL REASONABLENESS OF THE "TOTAL" PACKAGE PROVIDED. THUS, SULLIVAN COTTER PREPARED AN ANALYSIS OF COMPPLUS360 TOTAL COMPENSATION (DOLLAR VALUE OF CASH PLUS BENEFITS) RELATIVE TO MARKET PRACTICE, WHICH WILL SATISFY REQUIREMENTS TO ESTABLISH A "REBUTTABLE PRESUMPTION OF REASONABLENESS." THE ANALYSIS ENABLED THE COMPENSATION COMMITTEE TO REVIEW COMPENSATION DATA FROM INDEPENDENT SOURCES FOR FUNCTIONALLY COMPARABLE POSITIONS IN ORGANIZATIONS COMPARABLE TO BLYTHEDALE TO ENSURE THAT COMPENSATION PROVIDED TO BLYTHEDALE EXECUTIVES IS REASONABLE AND CONSISTENT WITH THESE MARKET PRACTICES. THE ANALYSIS WAS SUBMITTED IN ACCORDANCE WITH THE PROVISIONS OF TREASURY REGULATION SECTION 53.4958-6(C)(2) AND IS ALSO INTENDED TO SATISFY THE PROFESSIONAL ADVICE REQUIREMENTS OF TREASURY REGULATION SECTION 53.4958-1(0)(III). IN LIGHT OF THESE PROVISIONS, THE COMPENSATION COMMITTEE ENSURED FULL DISCLOSURE AND TRANSPARENCY OF EXECUTIVE COMPENSATION. IN DECEMBER OF 2009 THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES APPROVED ALL 2010 EXECUTIVE COMPENSATION. IN DECEMBER OF 2010 THE COMPENSATION COMMITTEE APPROVED INCENTIVE COMPENSATION AWARDS FOR THE EXECUTIVE MANAGEMENT TEAM.
FORM 990, PART VI, SECTION C, LINE 19BLYTHEDALE CHILDREN'S HOSPITAL MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC BY RETAINING A COPY OF EACH AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. THE ORGANIZATION'S FORM 990 IS ALSO AVAILABLE FOR PUBLIC INSPECTION ON WWW.GUIDESTAR.ORG. THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION.
CHANGES IN NET ASSETS OR FUND BALANCES:FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 1,452,207. CHANGE IN PENSION LIABILITY 962,693. TOTAL TO FORM 990, PART XI, LINE 5: 2,414,900.
FORM 990, PART V, LINE 4BINVESTMENT NAME FOREIGN COUNTRY YORK CREDIT OPPORTUNITIES UNIT TRUST CAYMAN ISLANDS NEW PROVIDENCE FUND LTD. BAHAMAS DAVIDSON KEMPNER INTERNATIONAL BRITISH VIRGIN ISLANDS AMICI FUND INTERNATIONAL BRITISH VIRGIN ISLANDS NEW GENERATION TURNAROUND FUND (BERMUDA) L.P. BERMUDA PENNANT CREDIT OPPORTUNITIES OFFSHORE FUND LTD. CAYMAN ISLANDS PENNANT WINDWARD FUND CAYMAN ISLANDS OVERSEAS CAP PARTNERS CAYMAN ISLANDS SAB OVERSEAS FUND BRITISH WEST INDIES SCOUT CAPITAL, LTD. CAYMAN ISLANDS CONVEXITY CAPITAL OFFSHORE L.P. CAYMAN ISLANDS ELLIOTT INTERNATIONAL LIMITED BRITISH WEST INDIES CITADEL KENSINGTON GLOBAL STRATEGIES FUND LTD. BERMUDA

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