2011-11-15T08:57:06-05:00 2010-12-31 PricewaterhouseCoopers LLP 677 BROADWAY ALBANY NY 12207 990 2010-01-01 160960470 CROUSE HEALTH HOSPITAL INC D/B/A CROUSE HOSPITAL CROU 3154707376 736 IRVING AVENUE SYRACUSE NY 132101687 Kimberly Boynton 2011-11-14 Jeffrey C Hamilton 5184622030 2010 2016-03-07 17:11:31Z Paul Kronenberg MD CEO 736 Irving Avenue Syracuse NY 13210 351341349 false X WWW.CROUSE.ORG X 1913 NY THE MISSION OF CROUSE HEALTH HOSPITAL, INC. IS TO PROVIDE THE BEST IN PATIENT CARE AND TO PROMOTE COMMUNITY HEALTH. 13 9 3014 456 345400 154268 193009 321655505 341709445 2086268 2090566 8024684 7342271 331920725 351335291 0 0 0 0 172491701 182975885 0 0 0 152985909 163680577 325477610 346656462 6443115 4678829 243582247 252383318 229926788 232430104 13655459 19953214 THE MISSION OF CROUSE HEALTH HOSPITAL, INC. IS TO PROVIDE THE BEST IN PATIENT CARE AND TO PROMOTE COMMUNITY HEALTH. false false 221783313 341709445 PROVISION OF HEALTHCARE SERVICES. CROUSE HEALTH HOSPITAL, INC. PROVIDES A VARIETY OF HEALTHCARE SERVICES TO A 15-COUNTY AREA IN CENTRAL NEW YORK. THE HOSPITAL OPERATES 506 ACUTE-CARE BEDS and 57 BASSINETS. crouse hospital serves more than 23,000 inpatients, 66,000 emergency service patients, and more than 250,000 outpatients annually. CROUSE HOSPITAL PROVIDED APPROXIMATELY $7.6 million IN CHARITY CARE IN 2010. Additional details on crouse hospital exempt purpose achievements are found in the "2010 community servie report" which can be accessed on the hospital website: www.crouse.org. 221783313 true true false true false false false false false true true false false true true true false true false false false false false false false false true true false false true true false false false false false false false true true true false false false false false true true true false false true 209 0 true 3014 true true true false false false false false false false false false X 13 9 true false false false true true true true true false false true true true true true true true true true true NY X KIMBERLY BOYNTON 3154707376 736 IRVING AVENUE SYRACUSE NY 13210 X Elizabeth Hartnett Esq 1.0 X X 0 0 0 Patrick Mannion 1.0 X X 0 0 0 PAUL KRONENBERG MD 38.0 X X X 630109 20414 28587 JAMES HUGHES 1.0 X 0 0 0 JOHN FRANTZ JR 1.0 X 0 0 0 MARY COTTER 1.0 X 0 0 0 RUBEN P COWART DDS 1.0 X 0 0 0 LOUIS GREEN MD 1.0 X 0 78078 0 ALBERT WERTHEIMER 1.0 X 0 0 0 Ellen Bifano MD 1.0 X 0 0 0 James Carrick 1.0 X 0 0 0 Michele Johnson 1.0 X 0 0 0 Melvin Stith PhD 1.0 X 0 0 0 RICHARD RUSSELL CPA 1.0 X 0 0 0 James Mills MD 40.0 X 305234 0 50266 hadley falk md 1.0 X 0 0 29500 pamela reilly 1.0 X 0 0 0 Derrick Suehs 40.0 X X 206921 0 29267 KIMBERLY BOYNTON 38.0 X X 333783 10868 42576 Mary Agnew 40.0 X 180312 0 22006 Ronald Stahl MD 40.0 X 293426 0 22993 Michael Dupuis 40.0 X 165140 0 24568 Richard Steinmann MD 40.0 X 368273 0 53249 Lawrence Moloff MD 40.0 X 345522 0 49538 Mark Barasz MD 40.0 X 315417 0 26773 Cristina Topor MD 40.0 X 292227 0 26159 Michael Jorolemon MD 40.0 X 319157 0 43302 3755521 109360 448784 167 false true false CROUSE MEDICAL GROUP PC 401 N SALINA STREET SUITE 400 SYRACUSE NY 13203 Professional Medical 2008963 MAGNETIC DIAGNOSTIC RESOURCES 4567 CROSSROADS PARK DRIVE LIVERPOOL NY 13088 medical testing 1408980 CNY Anesthesia Group PC 736 IRVING AVE SYRACUSE NY 13210 Professional medical 2353075 southern ny neurosurgial group pc 46 harrison street JOHNSON CITY NY 13790 professional medical 1134845 aramark corporation 12483 collections center drive CHICAGO IL 60693 biomed engineers 1460588 39 52780 140229 193009 PATIENT SER. REV 623000 175166189 175166189 MEDICARE/MEDICAID PAYMENTS 623000 161691867 161691867 PARKING 812930 1914869 1914869 PROPERTY MGT REV FROM AFFILIATE 531310 1008207 1008207 RENT 532000 503061 503061 1425252 1425252 341709445 2035997 2035997 0 0 60627 6058 54569 54569 54569 0 0 0 OTHER INVESTMENT INCOME 525990 1500416 345400 1155016 CAFETERIA 721110 1653935 1653935 COLLEGE OF NURSING 611600 1504355 1504355 2683565 2683565 7342271 351335291 341709445 345400 9087437 0 0 0 0 2374110 359611 2014499 0 0 143091537 89951131 53140406 0 1761959 1118086 643873 0 25220115 15740100 9480015 0 10528164 6543254 3984910 0 0 757858 757858 0 295600 295600 0 127200 127200 0 0 0 15866744 9864002 6002742 0 1281940 796726 485214 0 1685137 1047313 637824 0 2548229 1583724 964505 0 0 10891657 6769165 4122492 0 129954 80766 49188 0 0 305815 190064 115751 0 2625772 2625772 0 3680 3680 0 13328087 8283406 5044681 0 2713775 1680919 1032856 0 PENSION EXPENSE 11247272 6990180 4257092 PROVISION FOR BAD DEBTS 13503386 13479277 24109 SUPPLIES 50868382 31614699 19253683 PURCHASED SERVICES 17964306 11414308 6549998 DRUGS 8897994 8897994 8637789 5378588 3259201 346656462 221783313 124873149 0 8025 8175 26348346 21895184 35089932 40480420 2219927 3150822 6293849 5655230 5681300 4598922 251380215 127668833 102831005 123711382 208027 208027 64901836 52675156 243582247 252383318 23570910 21789360 75405000 71330000 10148046 10017809 120802832 129292935 229926788 232430104 X -8684798 -3612949 11303796 12378153 11036461 11188010 13655459 19953214 243582247 252383318 X 4678829 1618926 X false true true X true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false true false false false false true 148802 false false 148802 false ORG. EXEMPT UNDER SEC. 501(c)(3) - DIRECT CONTACT WITH LEGISLATORS PART II-B LINE 1G Crouse Health Hospital, Inc. contracted with the firm of Wilson, Elser, Moskowitz, Edelman & Dicker, LLP effective 2/11/10 to 2/10/11 to serve as legislative counsel to the Hospital. The fee for these services is $120,000 annually plus expenses. As of December 31, 2010, Crouse Hospital has paid the firm $120,000 in professional service fees and $7,200 in administrative expense reimbursement. Professional services include: legislative advocacy encompassing presentation of Hospital views to the legislative and executive branches of New York state government. Review and analysis of all proposed New York state legislation of potential impact. Preparation of affirmative legislation. Preparation of memoranda supporting or opposing legislation. Attendance at public health hearings, committee meeting, and other related activities to insure that legislators are aware of Hospital views and informed of the impact of the legislation affecting Hospital interests. Preparation of regular reports advising the current status of pending legislation. Discussions and recommendations regarding an affirmative legislation program. Conferences with the Hospital or its representatives as necessary. Administrative expense reimbursement includes: telephone, faxes and all other wireless forms of communications, postage and delivery services, reproduction and presentation materials, in-house computer services, research and database interfaces. Paid staff of Crouse Health Hospital, Inc. had direct contact with legislators, their staffs, government officials and legislative bodies. The cost of these activities is $21,602. Crouse Health Hospital, Inc. belongs to professional organizations that provide lobbying on behalf of its members. These organizations are: Greater New York Hospital Association, Hospital Association of New York State, and Centerstate CEO. 19569523 57126 2430827 28500 770515 38108 21220353 16978156 63493 3388889 28750 797265 35000 19569523 24198431 129183 -6351133 34000 929075 35250 16978156 0.42000 0.46000 0.12000 false true true 285832 285832 154528915 64425220 90103695 16367877 13143348 3224529 75786038 50100265 25685773 4411553 4411553 123711382 CROUSE HEALTH FOUNDATION 22084481 ASSETS WHOSE USE IS LIMITED 25937011 FUNDS HELD IN TRUST BY OTHERS 1481682 BOND ISSUANCE/CLOSING COSTS 3148275 410 S CROUSE CLOSING COSTS-NET 23707 52675156 0 SELF INSURED PROFESS. LIAB. 16290762 ACCRUED PENSION LIABILITY 79335989 POSTRETIREMENT OBLIGATION 16306971 ASSET RETIREMENT OBLIGATION 2563911 DUE TO/FROM RELATED PARTIES (NET) 1631724 FUNDS HELD IN TRUST 246611 LIABILITIES TO THIRD PARTY PAY 12916967 129292935 351335291 346656462 4678829 -193572 1812498 1618926 6297755 349720306 349720306 1614985 1614985 351335291 346656462 346656462 346656462 Reconciliation of Revenue Per Audited FS with Revenue Per Return Part XII, Line 2d & Line 4b net income from equity investments 1,500,416 investment income 60,000 net gain on sale of assets other than inventory 54,569 _________ total 1,614,985 ========= Reconciliation of Change in Net Assets from Form 990 to FS Part XI Line 8 contributions for property acquisitions 2,940,455 pension & post retirement charges other than periodic (2,353,863) costs net increase in interest in net assets of crouse Health 1,131,571 foundation, inc. increase in funds held in trust by others 94,335 _________ total 1,812,498 ========= Endowment Fund Part V, Line 4 endowment funds: crouse health foundation, inc., a related organization, is in possession of endowment funds to support crouse health hospital, inc. these endowment funds are valued at approximately $21 million at december 31, 2010. the principal, with an approximate value of $12 million, remains untouched; while the investment income is used to fund equipment and programs required for hospital services and initatives. true true true X true X true true true false true true 6597622 3083952 3513670 0.01060 73113728 55116167 17997561 0.05420 79711350 58200119 21511231 0.06480 415491 72681 342810 0.00100 9894203 5495175 4399028 0.01320 3829971 3466836 363135 0.00110 95871 95871 0.00030 14235536 9034692 5200844 0.01560 93946886 67234811 26712075 0.08040 true 9887446 930477 88290202 86627943 1662259 X true true lacny inc laboratory services 0.33300 0.00000 mdr llc magnetic resonance imaging 0.25000 0.75000 sea llc endoscopy services 0.40000 0.60000 3 1 Crouse Health Hospital Inc

736 Irving Ave Syracuse NY 13210

X X X X 2 Crouse Hospital - Commonwealth Division

6010 East Molloy Rd Syracuse NY 13211

Residential Chemical dependency rehabilitation 3 Crouse East Hand Clinic

5823 Widewaters Pkwy East Syracuse NY 13057

Outpatient Clinic Physical THERAPY Crouse Health Hospital Inc 1 true true 100 true 300. true X X X true true X X X X X X true X X X X true X X X X X X X X true X false true Crouse Hospital - Commonwealth Division 2 true true 100 true 300. true X X X true true X X X X X X true X X X X true X X X X X X X X true X false true Crouse East Hand Clinic 3 true true 100 true 300. true X X X true true X X X X X X true X X X X true X X X X X X X X true X false true 5 madison irving surgery center

475 irving avenue syracuse NY 13210

outpatient ambulatory surgery center pob surgery center

723 irving avenue syracuse NY 13210

outpatient ambulatory surgery center cny promptcare

739 irving avenue syracuse NY 13210

urgent care center cny medical imaging center

739 irving avenue syracuse NY 13210

medical imaging testing center crouse endoscopy

739 irving avenue syracuse NY 13210

endoscopy testing center part vi : charity care and certain other community benefits at cost 1. required description part i, lines 6a & 7 A copy of the Community Service Report is posted on Crouse Hospital's website - www.crouse.org. A notice of the Community Service Report's availability is posted on the Hospital's website, Facebook and Twitter accounts. A shorter summary of the CSP will be included in the hospital's community publication, YourCare, along with an offer to have the complete report mailed to individuals upon request. That same offer is presented in a news release sent to local media for inclusion in their publications and broadcasts. Additional distribution to the public is made in a brochure format that highlights key information regarding the hospital's public health programs, including Prevention Agenda priorities and non-Prevention Agenda programs. Forms of distribution occur as follows: - Mailing and e-mailing the report to public libraries, community organizations, local officials, businesses and media, hospital employees, volunteers and physicians, the hospital's board of directors and Crouse Health Foundation trustees and donors. - Posting copies of the report in public areas of the hospital and its off-site locations. - Copies made available at community health fairs/screenings and other educational events - Providing copies to prospective Crouse Hospital College of Nursing students and prospective employees at recruitment fairs - Mailed to residents and community groups upon request part ii Describe how our community building activities promoted the health of the community we serve. In 2009, three of the 10 priority areas outlined in the New York Prevention Agenda were identified by the Onondaga County Health Department and its partner hospitals, including Crouse, as focus areas for collaborative interventions in Onondaga County. Those areas are: - Tobacco Use; - Healthy Mothers, Healthy Babies, Healthy Children; and - Access to Quality Health Care. The scope of the plan for the priority areas remains steadfast, and is described below. The goals of our Tobacco Use prevention priority are to eliminate exposure to secondhand smoke; decrease social acceptability of tobacco use; promote tobacco cessation; prevent initiation of tobacco use among youth and young adults; and contribute to the science of tobacco control. The Syracuse hospitals and Onondaga County Health Department have committed to working closely with the local New York State Department of Health-designated Tobacco Smoking Cessation Center. The goals for the Healthy Mothers, Healthy Babies, Healthy Children priority area include developing a systematic approach to the provision of care to refugee populations of all ages, with a particular focus on the maternal and child health services system. This project is a practice-based strategy that lends itself to the identification of collaborative relationships, building on existing programs, as well as the development of a model for refugee care that may be exported to other communities. Ideally the new approach will provide a route of care that will allow Onondaga County refugees to enter the healthcare system with a primary care provider no longer than two months after their arrival (without the barriers of transportation and /or language and cultural sensitivity) and to provide a method for accurate record keeping that can follow the refugee patients. Onondaga County has been host to a number of refugee populations in recent years. Access to healthcare for the refugee population, particularly maternal and child health services, has been challenging. Refugees are brought into the community and screened for health issues, but are not connected to a regular source of care in a systematic manner. The collaborative work group continues to find solutions to this problem. The goals for the Access to Quality Health Care priority area include addressing disparities through access to healthcare, including an asthma education program for parents, students and staff of the Syracuse City School District, ensuring that eligible children are enrolled in public health insurance and by fostering an environment that encourages higher education. Additionally, there will be a strengthening of local collaborative processes as well as the design of community-action models that could improve health status through a range of initiatives, recognizing that good health status does not depend on healthcare alone. Further, the design of such an initiative should be informed by the experiences of other communities that have developed collaborative strategies that bring hospitals and public health systems together in a broad-based approach to improvement in health status for a specific population. While many health status indicators in Onondaga County suggest that the overall community health is comparable to the rest of New York State, discussion by local healthcare partners and review of these indicators on a more specific level (geographic and/or socioeconomic) reveal disparities. There is focused data collection that identifies a subset of the population as bearing a disproportionate burden of disease. This subset can be the target of an initiative to improve health status. v, section b, line 13g The policy is described in the hospital's annual NYS Community part Service Plan. part vi supplemental information 2. needs assessment Describe how the organization assessed the health care needs of the communities it serves, in addition to any needs assessments reported in Part V, Section B. Crouse Hospital is actively engaged with a variety of community partners in the discussion, planning and implementation of our various community health initiatives. Administrative and patient care staffs routinely gather and share information about issues related to our community's health. We solicit information via the following methods: - Focus groups with patients for feedback on specific services - Satisfaction surveys distributed to Crouse Hospital inpatient and outpatient groups - Community, educational, health-related and corporate organizations that partner with Crouse Hospital - Board of Directors' meetings - Monthly Medical Staff Executive Committee meetings - Administrative planning meetings - Feedback from Crouse Hospital's Speakers Bureau presentations - One-on-one conversations with individuals attending health fairs/screenings - Crouse Hospital School of Nursing Community Advisory Committee - Surveys distributed at community educational events and seminars - Get Health Connected Consortium - Transcending Boundaries Planning Committee - Cancer Services Partnership - Anecdotal input from patients, physicians, staff, visitors and opinion leaders from a variety of settings. 3. patient education of eligibility for assistance Describe how the 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 the organization's financial assistance policy. Crouse Hospital cares for 37 percent of all Medicaid patients in our service area, the largest percentage seen by any of the Syracuse hospitals. In 2010, we assisted 2,839 families in applying for financial assistance programs (up from 2,334 in 2009). Of patients applying for charity care 71% received free or significantly reduced cost of care in 2010 (up from 65% in 2009). Nearly all of the remaining 29% received a discount on their hospital bill based on economic need and circumstances. In total, the amount of charity care Crouse Hospital provided in 2010 was $7,567,733 (up from $5,928,500 in 2009). One reason for these statistics increasing over 2009 is because there is now a much larger pool of people in our service area without insurance coverage or without adequate insurance coverage. Traditional charity care was for the poor and indigent; today it is needed more and more by working families and individuals. Many people with health insurance are now being asked to assume much larger deductible payments, instead of higher premiums. This leads to situations where a once $500 deductible is now $1,200 or $1,500. As a result, Crouse is receiving many more requests for sliding scale adjustments to unpaid bills. In 2010, Crouse provided bad debt service totaling $7,567,733. We view meeting increased charity costs as a challenge and a success. Knowing our community's financial struggles has allowed Crouse Hospital financial assistance staff become much more proactive in identifying individuals who need help. It has become our practice to communicate the availability of our financial assistance policy and staff at every possible opportunity, including intake calls, registration paperwork, bills sent to patients' homes, the hospital's web site and printed materials. For the last year, the registrar's office has been asking patients about their financial needs long before their procedures are performed, eliminating the need for patients having to discuss their finances during a hospital stay and eliminating the need for patients to receive bills at home they weren't aware would arrive. We attribute a portion of our increased charity dollars to enhanced communication alone. Also, to handle increased requests, Crouse has increased staff time for inpatient needs by utilizing external facilitated enrollers at our outpatient facilities three times a week, which increases customer satisfaction. Another convenience for patients has been allowing them access to our financial assistance forms online through recent improvements made to the Crouse Hospital web site (for some it is less intimidating to present staff with completed forms printed from the web site, than to ask for the forms in person). 4. community information Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves. Crouse Hospital serves a 15-county region in New York that extends south to Binghamton and north to Malone. Its primary service area is Onondaga County and the contiguous surrounding counties. Seventy-five percent of inpatient and outpatient admissions are from Onondaga County; 25 percent are from outside Onondaga County. A major contributor to out-of-county admissions is the fact that Crouse is the New York State-designated regional referral center for perinatal and neonatal intensive care services (60% of NICU admissions at Crouse come from outside Onondaga County). Onondaga County is included in the Syracuse, NY Metropolitan Statistical Area (MSA). The county's 2010 population is estimated at 467,026, with approximately 140,658 residing in Syracuse. 5. promotion of community health Provide any other information important to describing how the organization's hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc Crouse Hospital has a dedicated manager of community health outreach who works closely with hospital departments to maximize efforts to improve community health. This focused area remains the second component of Crouse Hospital's mission to provide the best in patient care and to promote community health. Below are outlined current activities Crouse Hospital independently supports to address our three NYS Prevention Agenda focus areas and following that is a list of additional community health-related activities that the hospital continues to maintain and enhance on an annual basis. Current Crouse Hospital Programs Addressing NYS Prevention Agenda Items Tobacco Use The following existing Crouse Hospital programs directly relate to Tobacco Use and are planned to continue through 2013. As a smoke-free hospital, Crouse provides ongoing smoking cessation programs for patients, employees, volunteers and school of nursing students. All patients who identify themselves as smokers are counseled about quitting smoking before they leave the hospital. Smoking cessation counselors provide necessary education to all patients in our outpatient diabetes program and to the nearly 2,000 individuals who annually participate in free community heart-health and pulmonary function screenings, as well as health fairs sponsored by the hospital. Crouse staff members provide annual on-site smoking prevention/avoidance programs for all fourth grade students at Hughes Magnet Elementary School, a Syracuse city school located in an economically disadvantaged area. Healthy Mothers, Healthy Babies, Healthy Children The following Crouse Hospital programs directly relate to this priority prevention area and are planned to continue through 2013. Crouse Hospital, in partnership with SUNY Upstate Medical University, serves as the only New York State-designated Regional Perinatal Center / Program in Central New York, caring for the highest risk and most complicated obstetrical and neonatal (NICU) patients in the 15-county region. Annually, Crouse experiences 4,000 births and 900 NICU admissions. The region averages 19,000 births per year, with 1,582 of those births receiving NICU care. - Crouse Hospital's Walter R.G. Baker Neonatal Intensive Care Unit annually admits more than 900 premature and critically ill infants, with an on-site, round-the-clock staff of neonatologists, neonatal nurse practitioners and highly skilled registered nurses. - Unique pediatric care services at Crouse include extracorporeal membrane oxygenation for infants and the region's only pediatric cardiac catheterization program. - Crouse staff members facilitate a monthly infant-loss support group for parents and their families throughout the region. The infant-loss bereavement staff also provides training for medical residents and other OB/GYN staff. - Preventive healthcare offerings include a pediatric first-aid program and comprehensive childbirth education programs that promote the maternal/child benefits of waiting until 39 weeks for any scheduled birth, and breastfeeding, plus lactation consultant services for any mother needing assistance during and/or after her hospital stay. - Crouse continues working with Every Person Influences Children (EPIC) and the Children's Consortium of Central New York to offer parents the Ready, Set, Parent education program to help reduce the risk of child abuse and increase parenting skills for those with children from infancy to age 3. There is no charge for this program. - Since 1976 Crouse Hospital has been educating first-grade students throughout Onondaga County (3,956 in the 2010 school year) with our free Visit to Hospital-Land community service program. The program is designed to lessen the fears and confusion of young children who may have to visit a loved one in the hospital, or stay in a hospital themselves. Crouse offers Babysitters Training Course for sixth grade students in several elementary schools across Onondaga County. Annually we equip nearly 400 students with the skills and tools needed to provide safe care for younger children, as well as for staying home alone. Crouse Hospital also continues its partnership with Hughes Magnet School in Syracuse and is launching a new nutrition education/cooking instruction program through a grant from a local foundation. In addition, Crouse works with the Syracuse City School District to serve as wellness advisors and provide support for their health and wellness initiatives. The hospital provides: - health speakers for each grade; - free continuing medical education training for school nurses; - free heart health screenings for staff; and - placement of Crouse Hospital College of Nursing students in schools to assist school nurses. The Crouse Hospital Chemical Dependency Treatment Services provides comprehensive care that improves the health of our community's mothers, babies and children. - Staff provides substance abuse prevention education for parents, teachers and students in the Syracuse City School District and other rural school districts where substance abuse rates are highest. - Crouse Hospital provides a continuum of care for pregnant and post-partum mothers with alcohol and other substance abuse issues. Pregnant women can enter our residential treatment program at any time before delivery; continue to receive pre-natal care and then deliver at Crouse Hospital. Mothers also may return to treatment at any time following delivery. - Crouse Hospital's Chemical Dependency Treatment Services program serves teens between the ages of 13 and 17 with substance abuse disorders using gender-specific group training. - In collaboration with the Elmcrest Children's Center in Syracuse, Crouse Hospital supports an on-site chemical dependency treatment unit addressing the recovery needs of the children. We are integrating addiction treatment for children to provide them with a comprehensive system of support while they are residing at Elmcrest and when they move on to after-care in their community. Access to Quality Health Care The following Crouse Hospital programs directly relate to this priority prevention area and are planned to continue through 2013. Crouse Hospital staff work closely with many local heath and social service agencies to provide free screenings for blood pressure, cholesterol and blood glucose levels to more than 2,000 individuals annually, most of whom are from underserved or underinsured groups. We also support dozens of community education health fairs and other events annually. As a member of the Onondaga County Get Health Connected Consortium, Crouse annually plans and participates in an inner-city free health screening fair promoted to underinsured and uninsured individuals. For 2010 Crouse Hospital served as the event organizer. Serving as a sponsor of Syracuse's annual Juneteenth Health Pavilion, Crouse nursing staff are on site providing free blood pressure checks, healthcare proxy cards, medication records and a wide variety of helpful health-related information. In 2010, more than 300 people had their blood pressure checked and reviewed. Working with the Syracuse Say Yes to Education staff and volunteers, Crouse provides leadership support and healthcare expertise for the program. Syracuse University and the Syracuse City School District have joined forces to develop and launch this first district-wide program that will promote lifelong success for Syracuse school district students and their families by increasing both high school and college graduation rates. Crouse Hospital's Chemical Dependency Treatment Services Program provides several services that focus on access to care, including: a hospital intervention service for patients identified with addictive complications in their primary care that provides in-hospital clinical intervention and access to treatment after discharge; - the region's only medical detoxification unit; - the region's only opioid maintenance treatment program; - the region's only service for older adults suffering with addiction - and serving as the area's largest provider of addiction treatment to the Hispanic community in the patients' primary language and with cultural enhanced understanding of the Hispanic community. As the only Central New York hospital designated as a NICHE organization (Nurses Improving Care for Healthcare Elders), Crouse continues a newly expanded Care Transitions program for patients with a variety of cardiac conditions (CHF, AFib, MI), COPD patients and patients with complex transition. Utilizing a registered nurse as a Transition Coach, the program enables patients to successfully manage their chronic conditions at home. The primary outcomes of this program a 7. state filing of community benefit report If applicable, identify all states with which the organization, or a related organization, files. New York part v Lines 15 & 16 - Other Actions - Wage garnishments and liens on bank accounts Line 19 - Other - Uninsured patients who receive emergency or other medically necessary care are informed of a range of financial assistance options that include assistance in applying for Medicaid and for charity care discounts. The hospital charges consistently across all payors. Therefore, the bill for uninsured patients who receive emergency or other medically necessary care is at gross charges. The uninsured individual adjustment to gross charges is based on the hospitals income guidelines adjusted against our lowest commercial insurance rate. Line 21 - Other - The hospital makes every attempt to work with patients to secure financial assistance to allow the charge to be reduced to a lower rate for payment. schedule H part VI PART III, Line 4: The costs are equal to the bad debt expense as presented in the audited financial statements. To estimate the bad debt costs of those who are eligible for charity care but whose applications are denied or incomplete was calculated by determining the average cost of an approved charity care application times the number of denied or incomplete applications for 2010. PART III, Line 8: The costing methodology used is the Medicare cost report for 2010. Outpatient costs are represented on Medicare Cost Report Worksheet D, Parts V & VI. Inpatient costs are on Worksheet D-4. Line 7 shows a surplus of revenue over expenses due directly to DSH revenue which is directly correlated to the large population of Medicaid patients served. PART III, Line 9B: The financial assistance policy contains provisions for installment payment and payment plans. part iv management companies and joint ventures Name of entity: Laboratory Alliance of CNY, Inc. Primary activity of entity: Laboratory services Organization's profit % or stock ownership %: 33.30 Officers, directors, trustee, profit % or stock ownership %: 0.00 Physician's profit % or stock ownership %: 0.00 Name of entity: Magnetic Diagostics Resources of CNY, LLC. Primary activity of entity: Magnetic resonance imaging Organization's profit % or stock ownership %: 25.00 Officers, directors, trustee, profit % or stock ownership %: 0.00 Physician's profit % or stock ownership %: 75.00 Name of entity: Syracuse Endoscopy Associates, LLC. Primary activity of entity: Endoscopy services Organization's profit % or stock ownership %: 40.00 Officers, directors, trustee, profit % or stock ownership %: 0.00 Physician's profit % or stock ownership %: 60.00 Part VI Line 8 - All states which organization files a community benefit report: New York X true true X X X false false false false false false false true false PAUL KRONENBERG MD 507943 20414 119990 0 2176 0 8620 1686 22259 5051 660988 27151 0 0 Derrick Suehs 206921 0 0 0 0 0 10986 0 23505 0 241412 0 0 0 KIMBERLY BOYNTON 266507 10868 67276 0 0 0 13044 898 29679 2689 376506 14455 0 0 James Mills MD 297985 0 7249 0 0 0 16946 0 40582 0 362762 0 0 0 Mary Agnew 180312 0 0 0 0 0 3725 0 25591 0 209628 0 0 0 Richard Steinmann MD 359149 0 9124 0 0 0 19929 0 44486 0 432688 0 0 0 Lawrence Moloff MD 334523 0 10999 0 0 0 16218 0 44050 0 405790 0 0 0 Mark Barasz MD 303820 0 10999 0 598 0 8784 0 24689 0 348890 0 0 0 Cristina Topor MD 247550 0 0 0 44677 0 7878 0 35276 0 335381 0 0 0 Ronald Stahl MD 293426 0 0 0 0 0 4712 0 24598 0 322736 0 0 0 Michael Dupuis 162390 0 0 0 2750 0 6287 0 29761 0 201188 0 0 0 Michael Jorolemon MD 311908 0 7249 0 0 0 9482 0 50682 0 379321 0 0 0 Continuation of Officers, Directors, Trustees, Key Employees, & Highest Part I 1a Health of social club dues: Paul Kronenberg was reimbursed for his social club dues. officers, directors, trustees, key employees & highest compensated employe Part II All individuals listed are employees of and compensated by Crouse Health Hospital, Inc. Compensation is disclosed for services provided to the Hospital or its related organizations. All members of the Board of Directors of the Hospital except the Ex-Officio members are voluntary. No compensation, employee benefits or expense account allowances are received for Board services. CHIEF EXECUTIVE OFFICER PART I, QUESTION 7 As stipulated by employment contract, the Hospital CEO receives incentive compensation in an amount determined by the Board of Directors, not to exceed 25% of base salary. The incentive is based upon the Executive's achievement of objectives that are mutually agreed upon by the Executive and the Board of Directors or a committee thereof. The objectives are established annually. The Board of Directors determines the amount of incentive compensation. Incentive compensation received in 2010 was based on achievement of 2009 objectives. CHIEF FINANCIAL OFFICER PART I, QUESTION 7 As stipulated by employment contract, the Hospital CFO receives incentive compensation in an amount to be determined by the Board of Directors, not to exceed 25% of base salary, based upon the CFO's achievement of reasonable objectives that are mutually agreed upon by the CFO and by the CEO and the Board or a committee thereof. The objectives are established annually and are not based upon the Hospital's financial performance. The Board in consultation with the CEO determines the amount of incentive compensation. Incentive compensation received in 2010 was based upon achievement of 2009 objectives. emergency department physicians part 1, question 7 In 2010 the emergency department physician received incentive compensation . This compensation was based on productivity benchmarks, successful outcomes of patient satisfaction survey conducted during 2009 and achievement of clinical/operational incentive goals for 2009. 2003a onondaga county industrial development agenc 161093714 682747ea4 2003-09-25 7510000 Refund Portion of O/S Series 1 false false false 2003a syracuse industrial development agency 521380308 871720bt4 2003-09-25 20000000 Refund Portion of O/S Series 1 false false false 2007a onondaga county industrial development agenc 161093714 682747gp9 2007-06-25 9000000 Capital Improvement Project at false false false 2007a syracuse industrial development agency 521380308 871720bw7 2007-12-14 20000000 Capital Improvement Project at false false false 0 0 0 0 0 0 0 0 0 0 0 0 2003 true false true true 0 0 0 0 0 0 0 0 0 0 0 0 2003 true false true true 0 0 0 0 25126 0 0 0 0 670747 0 0 2009 false false true true 0 0 0 0 613750 0 0 0 0 19646952 0 0 2010 false false true true false false false false false 0.00000 0.00000 0.00000 true false false false false false 0.00000 0.00000 0.00000 true false false false false false 0.00000 0.00000 0.00000 true false false false false false 0.00000 0.00000 0.00000 true false true false false false false false true false true false false false false false true false true false false false false false true false true false false false false false true ELLEN BIFANO MD SEE PART V EXPLANATION 323829 SEE PART V EXPLANATION false JOHN FRANTZ Jr SEE PART V EXPLANATION 458379 SEE PART V EXPLANATION false PAUL KRONENBERG MD SEE PART V EXPLANATION SEE PART V EXPLANATION false SCHEDULE L, PART IV LINE 1: Ellen Bifano, MD holds a research grant from which the Hospital receives a 10% payment covering overhead expenses in the amount of $11,892 in 2010. Dr. Bifano is a partner in Neonatal Associates of CNY which provides neonatal services to the Hospital and for which it received $311,937 in 2010. LINE 2: John Frantz is an owner of the managing member of, and a member of, Crouse Physicians Office Building, LLC, which leases space (at Fair market value) to the Hospital for rent totaling approximately $458,379 in 2010. LINE 3: PAUL KRONENBERG MD IS THE PHYSICIAN CEO AND SOLE MEMBER OF CROUSE MEDICAL PRACTICE PLLC. PLEASE SEE A MORE DETAILED EXPLANATION OF CROUSE MEDICAL PRACTICE, PLCC AND THE HOSPITAL'S TRANSACTIONS WITH THIS ENTITY, PLEASE REFER TO SCHEDULE 0 AND SCHEDULE R. FORM 990, PART VI QUESTION 2: Elizabeth Hartnett, a Director, is a partner in a law firm which provides legal services to James Carrick, who is also a Director. Question 2: Richard Russell, a Director provides accounting and tax advice to Albert Wertheimer, who is also a Director. QUESTION 6: CROUSE HEALTH SYSTEM, INC. IS THE SOLE MEMBER OF CROUSE HEALTH HOSPITAL, INC. QUESTION 7A: CROUSE HEALTH SYSTEM, INC. APPROVES AND ELECTS THE BOARD OF DIRECTORS OF CROUSE HEALTH HOSPITAL, INC. QUESTION 7B: CERTAIN DECISIONS OF THE BOARD OF DIRECTORS OF CROUSE HEALTH HOSPITAL, INC., SUCH AS APPOINTMENT OF THE HOSPITAL PRESIDENT, ARE SUBJECT TO APPROVAL BY CROUSE HEALTH SYSTEM, INC. QUESTION 11b: HOSPITAL ACCOUNTING STAFF PROVIDES DATA TO AN INDEPENDENT ACCOUNTING FIRM (PRICEWATERHOUSECOOPERS, LLP) THAT PREPARES THE FORM 990 AND ALL REQUIRED SCHEDULES. IT IS REVIEWED BY LEGAL COUNSEL AND THE HOSPITAL CFO. THE REVIEWED FORM IS THEN PRESENTED TO THE FINANCE AND AUDIT COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR REVIEW AND APPROVAL. COPIES OF FORM 990 AND ALL REQUIRED SCHEDULES ARE MADE AVAILABLE TO OTHER MEMBERS OF THE BOARD OF DIRECTORS, UPON THEIR REQUEST, PRIOR TO FILING. QUESTION 12C CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE COMPLETED ANNUALLY BY THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES OF CROUSE HEALTH HOSPITAL, INC. ONCE COLLECTED, THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY MEMBERS OF THE CORPORATE COMPLIANCE OFFICE. ALL REPORTED POTENTIAL CONFLICTS OF INTEREST ARE EVALUATED AND DISCUSSED AMONG THE PARTIES. A REPORT IS PROVIDED TO THE BOARD OF DIRECTORS UPON COMPLETION OF THE COMPLIANCE REVIEW. QUESTIONS 15A & 15B: THE COMPENSATION FOR ALL KEY EMPLOYEES, OFFICERS, CEO THROUGH THE REST OF SENIOR MANAGEMENT IS DONE BASED ON ANNUAL BOARD OF DIRECTOR REVIEW IN CONJUNCTION WITH HUMAN RESOURCES. CURRENT COMPENSATION IS COMPARED TO THE NATIONAL SALARY SURVEY AND ANY NECESSARY ADJUSTMENTS ARE DETERMINED BY THE FINANCE AND AUDIT COMMITTEE OF THE BOARD. Question 19; The conflict of interest policy of Crouse Hospital can be found on the Hospital's website www.crouse.org under "Corporate Compliance Handbook". Audited financial statements are available upon request. The governing documents of Crouse Hospital are not made available to the public. PART VII, SECTION A, COLUMN B Paul Kronenberg averages 2.0 hours per week for related organization Crouse Medical Practice, PLLC Kimberly Boynton averages 2.0 hours per week for related organization Crouse Medical Practice, PLLC Louis Green is an employee of related organization Crouse Medical Practice, PLLC effective October 1, 2010. Dr. Green averages 40.0 hours per week for services provided to Crouse Medical Practice, PLLC. GENERAL DISCLOSURE, CROUSE MEDICAL PRACTICE, PLLC On February 9, 2010 the Hospital, through its physician CEO as sole member, formed Crouse Medical Practice, PLLC ("PLLC"). The PLLC was formed to further the Hospital's charitable purposes through the acquisition of physician practices and the employment of physicians. In March 2010, the PLLC leased the services of a robotic urology surgeon to expand the scope of urology services available in the community and that lease expired on October 31, 2010. On September 30, 2010 the PLLC purchased the assets of Internist Associates of Central New York, PC ("IACNY"), a primary care practice and hired its physician employees. Effective November 22, 2010, The PLLC entered into another lease arrangement for the employment of two neurosurgeons to ensure neurosurgical coverage for the Hospital's Stroke Center This arrangement expires October 31, 2011. The PLLC borrowed its start-up capital on a fair market note from the Hospital, which accrues interest daily. Because the Hospital effectively controls the PLLC through contractual arrangements and maintains significant financial support of the PLLC, the PLLC's financial statements are consolidated with the System for financial statement purposes. The son of Paul Kronenberg, MD, Hospital CEO and non-voting member of the Hospital Board of Directors, is a partner in IACNY (which is no longer providing medical services) and is employed as a physician by the PLLC. Louis Green, MD is a voting member of the Board of Directors of Crouse Health Hospital, Inc. Dr. Green was an employee of Internist Associates of Central New York when the IACNY was purchased by Crouse Medical Practice, PLLC on September 30, 2010, thereby becoming an employee of the PLLC. As a result, Dr. Green is considered as not independent as a voting member of the Hospital's Board of Directors. All members of the Hospital's Board of Directors, including Dr. Green, complete annual conflict of interest disclosures. The Board's conflict of interest policy would prevent Dr. Green from using his voting powers on the Crouse Board of Directors from operating to his advantage as an employee of Crouse Medical Practice, PLLC. Part XI Reconciliation of net assets part xi line 5 Contributions for property acquisitions 2,940,455 Decrease in unrealized gains/losses (193,572) Pension & post retirement changes other than periodic costs (2,353,863) Net increase in interest in net assets of Crouse Health Foundation, Inc. 1,131,571 Increase in funds held in trust by others 94,335 _________ TOTAL 1,618,926 ========= PART VII, LINE 2 All members of the Board of Directors of the Hospital except ex-officio members Paul Kronenberg and James Mills (January - June 2010)/Hadley Falk (July - December 2010) are voluntary. No compensation, employee benefits or expense account allowances are received for Board services. Compensation is disclosed for employee services provided to the Hospital or its related organizations. CROUSE HEALTH SYSTEM INC 736 IRVING AVENUE SYRACUSE NY 13210 161560473 SEE PART VII NY 501(c)(3) 11A NA CROUSE HEALTH FOUNDATION INC 736 IRVING AVENUE SYRACUSE NY 13210 161035427 SEE PART VII NY 501(c)(3) 7 NA crouse medical practice pllc 730 s crouse avenue suite 204 syracuse NY 13210 800548096 SEE PART VII NY seepartvii 7 SEE PART VII false false true true true false false false false true false true false true false true false false CROUSE HEALTH FOUNDATION INC C 1886531 CROUSE HEALTH FOUNDATION INC e 2877711 crouse health foundation inc l 1715684 crouse health foundation inc n 417871 crouse health foundation inc p 303701 crouse health system inc j 3199995 crouse health system inc p 1008207 crouse medical practice pllc d 5192629 crouse medical practice pllc n 98000 SCHEDULE R, PART II LINE 2 - CROUSE HEALTH SYSTEM, INC. COLUMN B - PRIMARY ACTIVITY CROUSE HEALTH SYSTEM, INC.'S pRIMARY ACTIVITY IS TO PROVIDE OFf-SITE SPACE AND SECURE CAPITAL FOR CROUSE HEALTH HOSPITAL, INC. LINE 3 - CROUSE HEALTH FOUNDATION, INC. COLUMN B - PRIMARY ACTIVITY CROUSE HEALTH FOUNDATION, INC.'S PRIMARY ACTIVITY IS FUNDRAISING FOR CROUSE HEALTH HOSPITAL, INC. LINE 3 - CROUSE MEDICAL PRACTICE, PLLC COLUMN B - PRIMARY ACTIVITY CROUSE MEDICAL PRACTICE, PLLC WAS FORMED TO FURTHER THE HOSPITAL'S CHARITABLE PURPOSES THROUGH THE ACQUISITION OF PHYSICIAn PRACTICES AND THE EMPLOYMENT OF PHYSICIANS. column d exempt code section: crouse medical practice, pllc intends to file form 1023 "application for tax exempt status" as a 501(c)(3) corporation. COLUMN F - DIRECT CONTROLLING ENTITY CROUSE HEALTH HOSPITAL, INC. part v line 2(1)(d): monies transferred to crouse health hospital, inc. pursuant to crouse health foundation, inc.'s purpose. part v line 2(3)(d): monies raised on behalf of crouse health hospital, inc. pursuant to crouse health foundation, inc.'s purpose.