2011-11-15T10:15:06-06:00 2010-12-31 KPMG LLP 60 South Street Boston MA 02111 990 2010-01-01 150532245 ST ELIZABETH MEDICAL CENTER STEL 3157988151 2209 GENESEE STREET UTICA NY 13501 LOU AIELLO 2011-11-15 6179881000 2010 2016-03-07 17:11:31Z RICHARD KETCHAM 2209 GENESEE STREET UTICA NY 13501 206509564 false 0928 X WWW.STEMC.ORG X 1861 NY ST. ELIZABETH MEDICAL CENTER COMMUNITY, INSPIRED BY ST. FRANCIS OF ASSISI AND FAITHFUL TO THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH, IS COMMITTED TO EXCELLENCE IN HEALTHCARE AND EDUCATION. 13 11 2306 172 619563 -84709 1534066 2609558 199113192 197921236 911308 961227 4383884 5017543 205942450 206509564 0 0 0 0 110654697 116961087 0 0 0 88573073 88530469 199227770 205491556 6714680 1018008 131351188 133682865 111314806 112978659 20036382 20704206 X ST. ELIZABETH MEDICAL CENTER COMMUNITY, INSPIRED BY ST. FRANCIS OF ASSISI AND FAITHFUL TO THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH, IS COMMITTED TO EXCELLENCE IN HEALTHCARE AND EDUCATION. false false 106032979 109135794 INPATIENT SERVICES - ST ELIZABETH MEDICAL CENTER IS A FULL SERVICE GENERAL HOSPITAL WITH 201 LICENSED BEDS. THE HOSPITAL PROVIDES A FULL RANGE OF ROUTINE AND ANCILLARY SERVICES, INCLUDING CARDIAC SURGERY AND ANGIOPLASTY. DISBURSEMENTS MADE BY THE HOSPITAL ARE EXCLUSIVELY FOR SERVICES AND MATERIALS USED IN PERFORMING THE HOSPITAL'S EXEMPT FUNCTIONS. ST. ELIZABETH MEDICAL CENTER PROVIDES CARE TO EVERYONE REGARDLESS OF RACE, RELIGION OR ABILITY TO PAY. 26107144 24745820 AMBULATORY SURGERY - ST. ELIZABETH MEDICAL CENTER HAS A FULL RANGE OF AMBULATORY SURGERY SERVICES ON ITS CAMPUS FOR PATIENTS THAT DO NOT REQUIRE OVERNIGHT OR LONG INPATIENT STAYS. ST. ELIZABETH MEDICAL CENTER PROVIDES SERVICES TO EVERYONE REGARDLESS OF RACE, RELIGION, OR ABILITY TO PAY. 14177292 13311267 COMMUNITY MEDICINE- THE MEDICAL CENTER, IN ADDITION TO HAVING OUTPATIENT VISITS ON SITE, HAS THIRTEEN OFF-SITE CLINICS THROUGHOUT THE COMMUNITY. THE CLINICS PROVIDE PATIENTS WITH CONVENIENT MEDICAL CARE AT A LOWER COST THAN A HOSPITAL SETTING. ST. ELIZABETH MEDICAL CENTER PROVIDES SERVICES TO EVERYONE, REGARDLESS OF RACE, RELIGION, OR ABILITY TO PAY. 13389531 14504569 Emergency Room 6675708 9665010 Referred Ambulatory 5786804 1515212 Clinics 6393585 6254174 Family Practice 483096 339177 Sports Medicine 4160093 1583309 College of Nursing 1386832 1218989 Home Health Agency 19499134 Other 38275649 54579574 184593064 true true false true false false false false true true false false true true false true false false false false false false false false false true true false false true true false false false false false false false false false true false false false false false true true true false false true 122 0 true 2306 true true true false false false false false false false false false X 13 11 false false false false true true true true true false false true true true true true true true true true true NY X ST ELIZABETH MEDICAL CENTER 3157988151 2209 GENESEE STREET UTICA NY 13501 SR DONNA MCGARTLAND 1.0 X 0 0 0 CATHERINE COMINSKY 1.0 X 0 0 0 GREGORY P EVANS 1.0 X 0 0 0 MARIANNE W GAIGE 1.0 X 0 0 0 HARRISON J HUMMEL III 1.0 X 0 0 0 FRED MATT 1.0 X 0 0 0 RAYMOND MEIER 1.0 X 0 0 0 HON NORMAN I SIEGEL 1.0 X 0 0 0 STEVEN WILLIAMS MD 1.0 X 0 0 0 ERIC YOSS MD 1.0 X 25950 0 0 RICHARD F ZWEIFEL 1.0 X 0 0 0 FRED TALERICO MD 1.0 X 0 0 0 M JOHANNA DELELYS 40.0 X X 0 0 0 ROBERT SCHOLEFIELD 40.0 X 228286 0 11960 RICHARD KETCHAM 40.0 X 127002 0 2719 LOU AIELLO 40.0 X 269927 0 12293 ALBERT D'ACCURZIO MD 40.0 X 283558 0 12362 OLEG DULKIN MD 40.0 X 347386 0 13593 PRABHAT AHLUWALIA MD 40.0 X 992982 0 13593 ERIC FRIEBERGER MD 40.0 X 359122 0 13593 SUNDAY ASAJU MD 40.0 X 351557 0 14033 FRANCIS CONSTANTINE MD 40.0 X 292278 0 13586 MATTHEW BABCOCK 0.0 X 100659 0 0 3378707 0 107732 73 true true false SODEXO OPERATIONS LLC PO BOX 81049 WOBURN MA 01813 CAFETERIA AND FOOD 1076286 UPTOWN ANESTHESIA ASSOC 2405 GENESEE STREET UTICA NY 13501 ANESTHETIST 1600583 ACUSIS PO BOX 951107 CLEVELAND OH 44193 TRANSCRIPTION SVCS 1236477 DIGESTIVE DISEASE MEDICINE 110 BUSINESS PARK DRIVE UTICA NY 13502 PERSONNEL COST 884287 MAYO COLLABORATIVE SERVICES PO BOX 9146 MINNEAPOLIS MN 55480 LAB SERVICES 851178 32 641395 1740076 228087 2609558 PATIENT SERVICE REVENUE 900099 83764037 83764037 NURSING HOME LAB TESTING 621500 469499 469499 CYTOLOGY LAB TESTING 621500 114061 114061 MEDICARE/MEDICAID PAYMENTS 900099 113573639 113573639 197921236 858657 858657 0 0 0 582764 0 582764 582764 36003 546761 102570 0 102570 0 102570 102570 0 0 0 0 0 TUITION: NURSING & X-RAY 900099 1583309 1583309 EMPLOYEE & VISITOR MEALS 900099 1230297 1230297 FAMILY PRACTICE SERVICES 900099 496771 496771 1124402 1124402 4434779 206509564 201772455 619563 1507988 0 0 0 0 807773 725622 82151 0 0 91860489 82518277 9342212 5921697 5319460 602237 11835592 10631912 1203680 6535536 5870872 664664 15443592 13872979 1570613 50541 45401 5140 187600 168521 19079 91084 81821 9263 0 0 0 361989 325175 36814 51344297 46122580 5221717 0 0 467884 420300 47584 47156 42360 4796 0 206902 185860 21042 1916191 1721314 194877 0 8350717 7501449 849268 1841866 1654548 187318 BAD DEBT 7574782 6804427 770355 JOINT VENTURE -115029 -103328 -11701 POSTAGE & SHIPPING 129123 115991 13132 DEBT ASSESSMENT 619647 556629 63018 PRINTING & PUBLICATIONS 12127 10894 1233 205491556 184593064 20898492 0 6271861 6221349 23971266 22615059 5597940 5811795 493919 523888 171984407 97085462 67186109 74898945 20593455 16917068 7236638 6694761 131351188 133682865 22635489 22709215 36446608 35327411 2905988 6916413 1960889 1830163 47365832 46195457 111314806 112978659 X 18772238 19793513 887830 533779 376314 376914 20036382 20704206 131351188 133682865 X 1018008 -350184 X false true true X true true X false false false RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 35000 false true 56084 91084 false false LOBBYING ACTIVITY BY NONELECTING PUBLIC CHARITIES PART II-B LOBBYING ACTIVITY WAS DONE DURING 2010 IN AN ATTEMPT TO SECURE FEDERAL AND STATE FUNDS FOR THE MEDICAL CENTER'S CAPITAL PROJECTS. OTHER ACTIVITIES INCLUDE THE ALLOCATED PORTION OF DUES PAID TO THE HOSPITAL ASSOCIATION OF NEW YORK STATE. 1264143 2090040 16876 32345 2428023 910691 1650930 976103 17145 18750 1361285 1264143 2723095 689098 20384 17850 1763797 1650930 0.00000 0.41390 0.58610 false true true 7078110 7078110 78680736 40766905 37913831 0 0 0 86225561 56318557 29907004 0 0 0 74898945 UNAMORTIZED DEBT FINANCING 1107787 OTHER RECEIVABLES 305964 BOND FUNDS 3584962 DEVELOPMENT FUND 1696048 6694761 0 ACCRUED PENSION LIABILITY 36865674 LIABILITY TO THIRD PARTY PAYORS 9329783 46195457 206509564 205491556 1018008 232889 -583073 -350184 667824 206159380 232889 -583073 -350184 206509564 206509564 205491556 205491556 205491556 ENDOWMENT FUNDS PART V THE INTENDED PURPOSE OF THE MEDICAL CENTER'S ENDOWMENT FUNDS ARE TO PROVIDE FUTURE SCHOLARSHIP AWARDS FOR STUDENTS IN THE COLLEGE OF NURSING PROGRAM. OTHER CHANGES IN NET ASSETS PART XI, LINE 8 PENSION RELATED CHANGES (260,324) NET DECREASE IN FOUNDATION ASSETS (322,749) TOTAL (583,073) REVENUE INCLUDED IN FINANCIAL STATEMENTS NOT ON RETURN PART XII, LINE 2D PENSION RELATED CHANGES (260,324) NET DECREASE IN FOUNDATION ASSETS (322,749) TOTAL (583,073) true true true X 230. true X 230. true true false true true 2885442 932870 1952572 0.00980 26891812 23761394 3130418 0.01570 4132714 2102376 2030338 0.01020 33909968 26796640 7113328 0.03570 250641 239485 11156 0.00010 7630952 5986642 1644310 0.00830 2217738 2090519 127219 0.00060 163837 57362 106475 0.00050 10263168 8374008 1889160 0.00950 44173136 35170648 9002488 0.04520 true 3696320 1131000 43369260 46808702 -3439442 X true true MVHI CARDIAC SERVICES 0.70000 0.00000 0.00000 1 1 ST ELIZABETH MEDICAL CENTER

2209 GENESEE STREET UTICA NY 13501

X ST ELIZABETH MEDICAL CENTER 1 16 SEMC AT FAMILY PRACTICE CENTER

120 HOBART STREET UTICA NY 13501

OUTPATIENT PHYSICIAN CLINIC WOMEN & CHILDREN'S FAMILY HEALTH CENTER

2212 GENESEE STREET UTICA NY 13502

OUTPATIENT PHYSICIAN CLINIC MARIAN MEDICAL IMAGING

2211 GENESEE STREET UTICA NY 13501

OUTPATIENT LAB/ XRAY CLINIC LITTLE FALLS FAMILY PRACTICE

500 MAIN STREET LITTLE FALLS NY 13365

OUTPATIENT PHYSICIAN CLINIC COMMUNITY MEDICINE-EAST UTICA

1256 CULVER AVE UTICA NY 13501

OUTPATIENT PHYSICIAN CLINIC WOUND CARE SERVICES

4401 MIDDLE SETTLEMENT ROAD NEW HARTFORD NY 13413

OUTPATIENT PHYSICIAN CLINIC ST ELIZABETH MEDICAL GROUP- NEW HARTFORD

86 GENESEE STREET NEW HARTFORD NY 13413

OUTPATIENT PHYSICIAN CLINIC NORTH UTICA COMMUNITY HEALTH CENTER

417 TRENTON ROAD UTICA NY 13502

OUTPATIENT PHYSICIAN CLINIC SAUQUOIT COMMUNITY MEDICINE

2888 ONEIDA STREET SAUQUOIT NY 13456

OUTPATIENT PHYSICIAN CLINIC CLINTON FAMILY HEALTH CENTER

101 COLLEGE STREET CLINTON NY 13323

OUTPATIENT PHYSICIAN CLINIC WATERVILLE FAMILY HEALTH CENTER

117 WEST MAIN STREET WATERVILLE NY 13480

OUTPATIENT PHYSICIAN CLINIC COMMUNITY MEDICAL SERVICES- MOHAWK

5 ANN STREET MOHAWK NY 13407

OUTPATIENT PHYSICIAN CLINIC COMMUNITY MEDICAL SERVICES- UTICA

6 HAMPDEN PLACE UTICA NY 13501

OUTPATIENT PHYSICIAN CLINIC ADIRONDACK SPORTS MEDICINE

4401 MIDDLE SETTLEMENT ROAD NEW HARTFORD NY 13413

OUTPATIENT REHAB SERVICES KERNAN ELEMENTARY SCHOOL

926 YORK STREET UTICA NY 13502

SCHOOL BASED HEALTH CENTER MOHAWK VALLEY HEART INSTITUTE (MVHI)

2209 GENESEE STREET UTICA NY 135015930

CARDIAC SERVICES COSTING METHODOLOGY - CHARITY CARE PART I, LINE 7 THE COST TO CHARGE RATIO THAT WAS USED TO COMPLETE THE CHART FOR LINE 7 WAS DERIVED FROM THE WORKSHEET 2 CALCULATION. BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25 PART I, LINE 7, COLUMN (F) BAD DEBT EXPENSE OF $7,574,782 IS INCLUDED ON FORM 990, PART IX, LINE 25 AND HAS BEEN REMOVED FOR CALCULATING THE PERCENTAGES IN COLUMN 7(F). COSTING METHODOLOGY - BAD DEBT EXPENSE PART III, LINE 2 & 3 THE MEDICAL CENTER DOES NOT DENY SERVICES TO A PERSON WHO NEEDS THEM BUT CANNOT PAY FOR THEM, AND IT MAINTAINS CERTAIN RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS RELATE PRIMARILY TO THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. THE TOTAL OF CHARGES FOREGONE, BASED ON ESTABLISHED CHARGES, WAS APPROXIMATELY $2,641,000 AND $2,689,000 IN 2010 AND 2009, RESPECTIVELY; THE ESTIMATED COST INCURRED TO PROVIDE SUCH CHARITY CARE WAS APPROXIMATELY $1,131,000 AND $1,199,000 IN 2010 AND 2009, RESPECTIVELY. THE MEDICAL CENTER GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY AGREEMENTS. ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR DOUBTFUL ACCOUNTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTABLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL EXPECTED NET COLLECTIONS. BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENT HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. SERVICES RENDERED TO INDIVIDUALS WHEN PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED ARE WRITTEN OFF TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. COSTING METHODOLOGY - MEDICARE PART III, LINE 8 THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS COST TO CHARGE RATIO. DEBT COLLECTION POLICY PART III, LINE 9B COLLECTION POLICY PROVISIONS PATIENTS THAT QUALIFY FOR THE MEDICAL CENTER'S CHARITY CARE PROGRAM HAVE THE CHARGES ON THEIR ACCOUNTS FORGIVEN AS THEY ARE PLACED IN CHARITY CARE AND THE BALANCES ARE WRITTEN OFF. THE MEDICAL CENTER'S CHARITY CARE PROGRAM USED THE FEDERAL POVERTY GUIDELINES (FPG) AS A GUIDE WITH HIGH-END LIMITS AT 230% OF THE FPG. IN THOSE SITUATIONS WHERE THE PATIENT'S INCOME IS BETWEEN 140% - 230% OF THE FPG, A SMALL COST SHARE WOULD BE THE ONLY AMOUNT NOT INCLUDED IN CHARITY CARE. ADDITIONALLY, THIS SMALL COST SHARE WOULD BE THE ONLY AMOUNT TURNED OVER TO COLLECTION WITH THE OPPORTUNITY OF EVENTUALLY BEING WRITTEN OFF TO BAD DEBT IF NOT PAID. HEALTH CARE NEEDS OF THE COMMUNITY PART VI, LINE 2 THE MEDICAL CENTER ASSESSES HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES BY COLLABORATING WITH ONEIDA AND HERKIMER COUNTIES' DEPARTMENTS OF HEALTH ON COMMUNITY HEALTH ASSESSMENTS. DATA WAS COLLECTED IN 2009 THROUGH A MAPP PROCESS, AROUND THE NYS PREVENTION AGENDA ISSUES. FIVE RESULTING PRIORITY WORK GROUPS THAT CONTAIN MEDICAL CENTER EMPLOYEES CONTINUE TO ASSESS CHANGES AND ADDRESS PRIORITY AREAS. THESE WORK GROUPS ALSO REPORT TO THE SEMC COMMUNITY DESIGN TEAM, WHICH REGULARLY HEARS ABOUT HEALTHCARE NEEDS THROUGH THOSE IN AREA COMMUNITIES. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI, LINE 3 THIS IS COMMUNICATED THROUGH SEMC'S FACILITATED ENROLLMENT PROGRAM AND THE MOTHER BERNARDINA CHARITY CARE PROGRAM. INFORMATION IS INCLUDED IN THE PATIENT INFORMATION GUIDES PRESENTED TO INPATIENTS AND OUTPATIENTS, AND IS BEING ADDED TO THE HOSPITAL'S NEWLY REDESIGNED WEBSITE. ST. ELIZABETH MEDICAL CENTER RECOGNIZES THAT PROVIDING EXCEPTIONAL HEALTHCARE SERVICE TO THE COMMUNITY IS A VITAL COMMUNITY RESOURCE. OUR ACHIEVEMENTS ARE NOT OURS ALONE, BUT ARE OBTAINED BY COLLABORATIVE EFFORTS WITH OUR COMMUNITY AND GOVERNMENT LEADERS WORKING TOGETHER TO IMPROVE THE "HEALTH" OF THE COMMUNITY. SEMC'S FACILITATED ENROLLMENT PROGRAM IN 2000, ST. ELIZABETH MEDICAL CENTER DEVELOPED AND IMPLEMENTED THE FACILITATED ENROLLMENT PROGRAM AS A RESULT OF THE UNIQUE COLLABORATION THAT WAS FORGED BETWEEN ST. ELIZABETH MEDICAL CENTER AND ONEIDA COUNTY SOCIAL SERVICE DEPARTMENT. THIS PROGRAM ALLOWS SEMC STAFF, PATIENT ACCOUNT REPRESENTATIVES, TO ACT AS AN AUTHORIZED REPRESENTATIVE OF THE PATIENT AT THE ONEIDA COUNTY DEPARTMENT OF SOCIAL SERVICES AND SUBMIT THE APPLICATION FOR BENEFITS. THIS SUCCESSFUL PROGRAM HAS EXPANDED THROUGHOUT THE PAST SEVEN YEARS TO INCLUDE OUTPATIENTS AND EMERGENCY DEPARTMENT PATIENTS. SEMC'S MOTHER BERNARDINA CHARITY CARE PROGRAM TO SUPPORT OUR MISSION, THE ST. ELIZABETH MEDICAL CENTER HAS DEVELOPED THE MOTHER BERNARDINA CHARITY CARE PROGRAM. THE MEDICAL CENTER WILL MAKE AVAILABLE A REASONABLE AMOUNT OF UNCOMPENSATED SERVICES TO ELIGIBLE PERSONS. COMMUNITY PART VI, LINE 4 ST. ELIZABETH MEDICAL CENTER'S PRIMARY SERVICE AREA (PSA) CONSISTS OF THE ZIP CODES IN WHICH 80% OF ITS PATIENTS LIVE (MOSTLY ONEIDA COUNTY AND SOME WITHIN HERKIMER COUNTY). ITS SECONDARY SERVICE AREA (SSA) CONSISTS OF ZIP CODES IN WHICH THE REMAINING 10+% OF ITS PATIENTS LIVE (MOSTLY OUTLYING REGIONS OF ONEIDA AND HERKIMER COUNTIES, PLUS SOME ZIP CODES IN MADISON AND LEWIS COUNTIES.) METHODS USED TO DETERMINE THE SERVICE AREA ARE ANALYSIS OF PATIENT ORIGIN, BASED ON HOME ZIP CODE. IT IS AN ETHNICALLY AND ECONOMICALLY DIVERSE REGION, WITH MANY IMMIGRANTS AND AN OLDER POPULATION THAN THE NATIONAL AVERAGE. PROMOTION OF COMMUNITY HEALTH PART VI, LINE 5 THESE ACTIONS REPRESENT THE MEDICAL CENTER'S EMPLOYEE OUTREACH BEYOND THE HOSPITAL AND MEDICAL GROUP OFFICES INTO AREA COMMUNITIES, AND THEY SPAN A WIDE REACH OF EVENTS AND SITES. ALONG WITH HOSPITALS ACROSS THE STATE AND NATION, ST. ELIZABETH NOW MONITORS HOW OUR FAITHFULNESS TO THE REGIONAL POPULATION MEETS OUR LOCAL COMMUNITIES' UNIQUE HEALTH NEEDS. THEREFORE, COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. OUR CATHOLIC TRADITION AND MEDICAL CENTER MISSION TEACH US TO PUT THE NEEDS OF THE POOR AND VULNERABLE FIRST. AMONG OUR COMMUNITY BENEFIT ACTIVITIES ARE: - CHARITY CARE FOR PEOPLE UNABLE TO AFFORD SERVICES - HEALTH EDUCATION AND ILLNESS PREVENTION - HEALTHCARE INITIATIVES FOR AT-RISK YOUTHS - FREE OR LOW-COST CLINICS AND - INITIATIVES TO RAISE AWARENESS AND RECEIVE PUBLIC INPUT. MANY OF THESE ACTIVITIES ARE ADVANCED IN COLLABORATION WITH COMMUNITY MEMBERS AND OTHER ORGANIZATIONS TO IMPROVE HEALTH AND QUALITY OF LIFE. THE MEDICAL CENTER FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH AN OPEN MEDICAL STAFF AND A COMMUNITY BOARD. SEMC FURTHER PROMOTES THE HEALTH OF THE COMMUNITY BY USING ITS SURPLUS FOR TRAINING AND EDUCATION OF ITS EMPLOYEES AND BY INVESTING IN HEALTHCARE TECHNOLOGY. STATE FILING OF COMMUNITY BENEFIT REPORT 990 SCHEDULE H, PART VI NY, X true true X X X X X X true false false false false false false false false ROBERT SCHOLEFIELD 228286 0 0 0 0 0 475 0 11485 0 240246 0 0 0 LOU AIELLO 269927 0 0 0 0 0 475 0 11818 0 282220 0 0 0 OLEG DULKIN MD 314167 0 33219 0 0 0 0 0 13593 0 360979 0 0 0 PRABHAT AHLUWALIA MD 992982 0 0 0 0 0 0 0 13593 0 1006575 0 0 0 ERIC FRIEBERGER MD 333769 0 25353 0 0 0 0 0 13593 0 372715 0 0 0 SUNDAY ASAJU MD 300258 0 51299 0 0 0 0 0 14033 0 365590 0 0 0 FRANCIS CONSTANTINE MD 226101 0 66177 0 0 0 0 0 13586 0 305864 0 0 0 ALBERT D'ACCURZIO MD 283558 0 0 0 0 0 475 0 11887 0 295920 0 0 0 MATTHEW BABCOCK 0 0 0 0 100659 0 0 0 0 0 100659 0 0 0 BENEFITS PART I, LINE 1A THE CEO WAS PROVIDED A TEMPORARY HOUSING ALLOWANCE THAT WAS PART OF A RELOCATION CONTRACT, WHICH WAS INCLUDED IN TAXABLE COMPENSATION FOR 2010. SEVERANCE PAYMENT PART I, LINE 4A IN 2010, MATTHEW BABCOCK RECEIVED OTHER REPORTABLE COMPENSATION OF $100,659 PAID UNDER A SEVERANCE AGREEMENT RELATED TO A SEPARATION OF SERVICE. ONEIDA COUNTRY IDA 166158201 682465AA7 2006-06-22 14000000 EMERGENCY ROOM & CAFETERIA PROJECT false false false 14000000 280000 70817 13649183 2007 false false true true false false false false true 0.00000 0.00000 0.00000 true false true false false false false false false PULMONARYCRITICAL CARE ASSOCIATES ERIC YOSS MD - TRUSTEE 244854 PULMONARY CARE - INTENSIVIST false ORGANIZATION MEMBER PART VI, SECTION A, LINE 6-7B RESERVED POWERS TO THE MOTHERHOUSE OF THE SISTERS OF THE THIRD FRANCISCAN ORDER THE FOLLOWING POWERS SHALL BE RESERVED TO THE CORPORATE MEMBER TO EXERCISE AND SHALL BE REFERRED TO AS RESERVED POWERS: A. TO CHANGE THE PHILOSOPHY, MISSION, AND PURPOSE OF THE CORPORATION. B. TO ADOPT AND/OR AMEND THE CERTIFICATE OF INCORPORATION. C. TO ADOPT AND/OR AMEND THE BYLAWS. D. TO ELECT THE BOARD OF TRUSTEES AND TO REMOVE BOARD MEMBERS WITH OR WITHOUT CAUSE. E. TO APPOINT THE PRESIDENT AND THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION. F. TO APPROVE THE PURCHASE, SALE, LEASE, MORTGAGE OF REAL PROPERTY; TO APPROVE THE PURCHASE, SALE, OR GIFT OF CAPITAL ASSETS. G. TO APPROVE THE MERGER, CONSOLIDATION, OR AFFILIATION OF THE CORPORATION WITH ANOTHER CORPORATION, ORGANIZATION, OR PROGRAM. H. TO APPROVE THE DISSOLUTION OF THE CORPORATION AND DISPOSITION OF ASSETS. FORM 990 REVIEW PROCESS PART VI, SECTION B, LINE 11 INFORMATION IS GATHERED FROM THE ACCOUNTING AND PAYROLL DEPARTMENTS, WHICH IS USED BY THE STAFF ACCOUNTANT TO PREPARE WORKSHEETS USED TO POPULATE THE FORM 990. MEMBERS OF AN EXTERNAL AUDIT AND TAX FIRM (CURRENTLY KPMG LLP) INITIALLY DISCUSS, PREPARE AND REVIEW THE RETURN WITH THE STAFF ACCOUNTANT. THE SEMC MANAGEMENT TEAM REVIEWS THE DRAFT AND HAS THE OPPORTUNITY TO ASK QUESTIONS AND DISCUSS THE RETURN WITH KPMG TAX STAFF. AFTER THE MANAGEMENT TEAM'S APPROVAL, THE FORM 990 IS DISTRIBUTED TO THE GOVERNING BODY FOR THEIR REVIEW AND COMMENT PRIOR TO THE FILING OF THE FORM. CONFLICT OF INTEREST POLICY PART VI, SECTION B, LINE 12C FIRST, EACH BOARD OF TRUSTEE MEMBER, THE PRESIDENT/CEO, CHIEF OPERATING OF OFFICER, AND EACH VICE PRESIDENT COMPLETE AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. THE RESULTS OF THE QUESTIONNAIRE ARE REVIEWED BY THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES WHICH IDENTIFIES ANY POTENTIAL CONFLICTS. AS PART OF THE POLICY, BOARD MEMBERS THAT HAVE A CONFLICT ARE UNABLE TO VOTE WHEN A SUBJECT THAT THEY HAVE A CONFLICT OF INTEREST IN COMES UP FOR A VOTE AT A BOARD MEETING. BOARD MEMBERS ARE NOT ALLOWED TO BE INVOLVED IN THE DISCUSSIONS RELATED TO THE ISSUE OTHER THAN TO MAKE A BRIEF COMMENT. STARTING IN SEPTEMBER OF 2010, THE MEDICAL CENTER BEGAN TO REQUIRE ALL DEPARTMENT MANAGERS TO COMPLETE A ONE PAGE CONFLICT OF INTEREST QUESTIONNAIRE ON AN ANNUAL BASIS. ALSO STARTING IN SEPTEMBER OF 2010, ALL MEMBERS OF THE MEDICAL STAFF ARE REQUIRED TO COMPLETE A ONE PAGE CONFLICT OF INTEREST QUESTIONNAIRE ONCE EVERY TWO YEARS, AS PART OF THE CREDENTIALING PROCESS. FOR ALL OTHER EMPLOYEES, A POLICY IS IN PLACE AS PART OF THE COMPLIANCE PLAN THAT REQUIRES EMPLOYEES TO DISCLOSE ANY CONFLICT OF INTEREST TO THEIR SUPERVISOR. THE SUPERVISOR IS THEN REQUIRED TO DISCLOSE THE INFORMATION TO THE COMPLIANCE OFFICER. BOARD MEMBERS OF SUBSIDIARIES ARE ALSO REQUIRED TO COMPLETE CONFLICT OF INTEREST QUESTIONNAIRES. COMPENSATION POLICY PART VI, SECTION B, LINE 15 ST. ELIZABETH MEDICAL CENTER (SEMC) RECOGNIZES THAT STRONG AND EFFECTIVE EXECUTIVE LEADERSHIP IS NEEDED TO ACHIEVE ITS MISSION AND TO SERVE ITS COMMUNITY EFFECTIVELY. 1. THE CHAIRMAN OF THE BOARD OF TRUSTEES WILL APPOINT AN EXECUTIVE COMPENSATION COMMITTEE WHICH IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF ALL FORMS OF COMPENSATION BENEFITS PROVIDED TO THE PRESIDENT AND CEO OF THE MEDICAL CENTER. 2. IN ORDER TO RECRUIT AND RETAIN THE QUALITY OF LEADERSHIP NECESSARY IN A PRESIDENT AND CEO, SEMC WILL TARGET ITS TOTAL COMPENSATION PROGRAM FOR THE PRESIDENT AND CEO BY COMPARING SAME WITH SIMILARLY SIZED COMMUNITY HOSPITALS IN THE NORTHEASTERN UNITED STATES. 3. THE CEO SALARY RANGE WILL BE SET WITHIN THE RANGE FROM THOSE COMPARABLES. THE RANGE WILL BE REVIEWED PERIODICALLY AND ADJUSTMENTS WILL BE MADE WHEN MARKET CONDITIONS WARRANT AND WHEN FINANCIAL PERFORMANCE OF THE MEDICAL CENTER ALLOWS. ANY ADJUSTMENT IN CEO SALARY WILL BE BASED ON THE PARTICULAR EXECUTIVE'S EXPERIENCE, PERFORMANCE, AND CONTRIBUTION TO SEMC, AS WELL AS ON THE COMPETITIVENESS OF THE EXECUTIVE'S SALARY WITHIN THE PEER GROUP. 4. SEMC'S CEO TOTAL COMPENSATION PROGRAM ALSO EMPHASIZES AND REWARDS OUTSTANDING PERFORMANCE THROUGH INCENTIVE AWARD OPPORTUNITIES. 5. THE EXECUTIVE COMPENSATION COMMITTEE WILL ANNUALLY REVIEW THE PRESIDENT AND CEO'S PERFORMANCE BASED UPON OBJECTIVE CRITERIA AND SUBJECTIVE CRITERIA IN AWARDING ANY ANNUAL INCENTIVE. THE COMMITTEE WILL CONSIDER VARIOUS FACTORS INCLUDING, BUT NOT LIMITED TO MEETING PREVIOUSLY APPROVED ANNUAL GOALS, THE OVERALL FINANCIAL PERFORMANCE OF THE MEDICAL CENTER, PATIENT SATISFACTION, QUALITY CARE INDICATORS, BOTH PUBLISHED AND NON-PUBLISHED, AND RESPONSE TO ANY OTHER UNUSUAL OR EXTRAORDINARY CIRCUMSTANCES OCCURRING DURING THE YEAR. THE PAYMENT OF THE INCENTIVE AWARD TO THE EXECUTIVE IS COMPLETELY CONTINGENT ON THE JUDGMENT OF THE COMPENSATION COMMITTEE AS TO THE EXECUTIVE ACHIEVING PRE-ESTABLISHED GOALS AND TARGETS. IN ADDITION, THE POOL OF MONEY AVAILABLE FOR THE INCENTIVE IS ALSO CONTINGENT AND CONDITIONAL ON THE FINANCIAL PERFORMANCE OF THE MEDICAL CENTER. 6. THE EXECUTIVE COMPENSATION COMMITTEE MAY ALSO ESTABLISH AN ANNUAL INCENTIVE COMPENSATION POOL FOR THE VICE PRESIDENTS. WHEN THIS OCCURS, IT IS EXPECTED THAT THE CEO WILL INCLUDE A TEAM COMPONENT, AS WELL AS AN INDIVIDUAL COMPONENT, TO BE CONSIDERED WHEN DISTRIBUTING THIS POOL TO THE SENIOR LEADERSHIP TEAM. 7. THE COMPENSATION COMMITTEE SHALL ALSO REVIEW THE CEO'S PARTICIPATION AND LEADERSHIP IN COMMUNITY AND PROFESSIONAL ORGANIZATIONS ON WHICH THE EXECUTIVE SERVES. SEMC VALUES THE EXECUTIVE'S PARTICIPATING IN COMMUNITY AND PROFESSIONAL ORGANIZATIONS BUT ALSO RECOGNIZES THAT THE RESPONSIBILITIES TO SEMC MUST BE HIS/HER FIRST PRIORITY. 8. SEMC RECOGNIZES ITS RESPONSIBILITY TO ENSURE THAT ITS EXECUTIVE COMPENSATION PROGRAM IS APPROPRIATE IN VIEW OF ITS STATUS AS A NOT-FOR-PROFIT COMMUNITY HOSPITAL AND IN ACCORDANCE WITH ITS TAX-EXEMPT STATUS, AND THAT ITS COMPENSATION AND BENEFITS ARE REASONABLE AND NOT EXCESSIVE. TO THAT END, SEMC AND THE COMMITTEE WILL REVIEW AND APPROVE ALL FORMS OF EXECUTIVE COMPENSATION AND BENEFITS IN A MANNER NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTION RULES OF SECTION 4958 OF THE INTERNAL REVENUE CODE. 9. THE COMPENSATION COMMITTEE SHALL ENSURE THAT ALL ELEMENTS OF COMPENSATION AND BENEFITS PROVIDED TO EXECUTIVES OF SEMC ARE DISCLOSED A) TO THE FULL BOARD ON A REGULAR BASIS, AND B) ON IRS FORM 990 TO THE EXTENT REQUIRED BY LAW. PUBLIC DISCLOSURE PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE ORGANIZATION'S FORM 990 IS POSTED ON WWW.GUIDESTAR.ORG. BOARD MEMBER COMPENSATION PART VII, SECTION A, LINE 1A ST. ELIZABETH MEDICAL CENTER DOES NOT COMPENSATE THE BOARD OF TRUSTEES FOR THEIR SERVICES AS BOARD MEMBERS. THE COMPENSATION PAID TO ERIC YOSS, MD WAS FOR PHYSICIAN SERVICES RENDERED. OTHER CHANGES IN NET ASSETS PART XI, LINE 5 PENSION RELATED CHANGES (260,324) NET DECREASE IN FOUNDATION ASSETS (322,749) UNREALIZED GAIN 232,889 TOTAL (350,184) ST ELIZABETH MEDICAL CENTER FOUNDATION 2209 GENESEE STREET UTICA NY 13501 222562170 HEALTHCARE NY 501(C)(3) 12 NA SRS OF ST FRANCIS OF THE NEUMANN COMM 2500 GRANT BLVD SYRACUSE NY 13208 HEALTHCARE NY 501(C)(3) 5 NA true false false false true false false true false false false true true true true false false false ST ELIZABETH MEDICAL CENTER FOUNDATION INC A 81540 ST ELIZABETH MEDICAL CENTER FOUNDATION INC N 252072 ST ELIZABETH MEDICAL CENTER FOUNDATION INC L 509133