ALICE HYDE MEDICAL CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ALICE HYDE MEDICAL CENTER (EIN 15-0346515)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-14
- IRS object ID
- 202322269349302722
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-14T16:08:01-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161226221 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUSTCHARLES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 S WARREN STREET | AddressLine1Txt |
| City | SYRACUSE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 150346515 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALICE HYDE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ALIC | BusinessNameControlTxt |
| Phone | 5184833000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MATEJ KOLLAR | PersonNm |
| Person Title | VP/CFO | PersonTitleTxt |
| Phone | 5184833000 | PhoneNum |
| Signature | 2023-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MATEJ | PersonFirstNm |
| Person Last | KOLLAR | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS J GIUFRE | PreparerPersonNm |
| PTIN | P00841958 | PTIN |
| Phone | 3154463600 | PhoneNum |
| Preparation | 2023-08-14 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MATEJ KOLLAR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $94,139,101 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ALICEHYDE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO SERVE THE COMMUNITY THROUGH ACUTE, LONG TERM AND PRIMARY HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 879 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,584,173 | PYContributionsGrantsAmt |
| CY Contributions Grants | $492,756 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $88,387,739 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $82,121,802 | CYProgramServiceRevenueAmt |
| PY Investment Income | $28,594 | PYInvestmentIncomeAmt |
| CY Investment Income | $11,156 | CYInvestmentIncomeAmt |
| PY Other Revenue | $10,158,497 | PYOtherRevenueAmt |
| CY Other Revenue | $10,964,101 | CYOtherRevenueAmt |
| PY Total Revenue | $102,159,003 | PYTotalRevenueAmt |
| CY Total Revenue | $93,589,815 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $61,678,177 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $68,841,621 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $40,846,844 | PYOtherExpensesAmt |
| CY Other Expenses | $36,734,898 | CYOtherExpensesAmt |
| PY Total Expenses | $102,525,021 | PYTotalExpensesAmt |
| CY Total Expenses | $105,576,519 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$366,018 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$11,986,704 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $84,353,502 | TotalAssetsBOYAmt |
| Total Assets EOY | $67,901,457 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $57,326,608 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $53,424,532 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $27,026,894 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,476,925 | NetAssetsOrFundBalancesEOYAmt |
| Mission | ALICE HYDE MEDICAL CENTER WILL DISTINGUISH ITSELF AS A TRUSTED AND RESPECTED HEALTH CARE LEADER AND PROVIDER OF CHOICE, EXCEEDING EXPECTATIONS THROUGH SERVICE EXCELLENCE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $85,814,983 | ExpenseAmt |
| Revenue | $92,750,821 | RevenueAmt |
| Desc | ALICE HYDE MEDICAL CENTER PROVIDES PATIENT CARE AS A GENERAL MEDICAL/SURGICAL HOSPITAL AND SKILLED NURSING FACILITY. ALICE HYDE MEDICAL CENTER PROVIDED INPATIENT SERVICES FOR 1,717 PATIENTS ADMITTED. PROVIDED 386,586 OUTPATIENT ANCILLARY PROCEDURES, PROVIDED 81,516 PHYSICIAN OFFICE VISITS, AND PROVIDED 43,809 DAYS OF SKILLED NURSING FACILITY CARE. 10,194 DAYS OF ASSISTED LIVING FACILITY CARE WAS ALSO PROVIDED DURING THE PERIOD. | Desc |
| Total Program Service Expenses | $85,814,983 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 85 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 879 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MATEJ KOLLAR CFO | PersonNm |
| Phone | 5184833000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ROBERT G MAIN JR | ||||||||
| CHAIRMAN | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KEVIN HART | ||||||||
| SECRETARY | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| THOMAS FITZPATRICK | ||||||||
| VICE CHAIRMAN/TREASURER | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CAROL MCKEE | ||||||||
| BOARD MEMBER | 10.00 | Yes (X) | $0 | $0 | $0 | |||
| DONNA KISSANE | ||||||||
| BOARD MEMBER | 10.00 | Yes (X) | $0 | $0 | $0 | |||
| JASON ELLIS | ||||||||
| BOARD MEMBER | 10.00 | Yes (X) | $0 | $0 | $0 | |||
| JOSHUA FRANK | ||||||||
| BOARD MEMBER | 10.00 | Yes (X) | $0 | $0 | $0 | |||
| PAUL KOEHLER | ||||||||
| BOARD MEMBER | 10.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN MONETTE | ||||||||
| BOARD MEMBER | 10.00 | Yes (X) | $0 | $0 | $0 | |||
| BARBARA MONTOUR | ||||||||
| BOARD MEMBER | 10.00 | Yes (X) | $0 | $0 | $0 | |||
| CRAIG RICHARDS | ||||||||
| BOARD MEMBER | 10.00 | Yes (X) | $0 | $0 | $0 | |||
| EMILE BENARDOT MD | ||||||||
| DIRECTOR THRU 12/13/2021 | 0.00 | Yes (X) | $121,000 | $0 | $0 | |||
| NICHOLAS EELLS | ||||||||
| DIRECTOR THRU 12/13/2021 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MARINA MEDVED | ||||||||
| DIRECTOR THRU 10/17/2021 | 0.00 | Yes (X) | $0 | $70,541 | $1,164 | 40.00 | ||
| MATT JONES | ||||||||
| COO | 50.00 | Yes (X) | $258,259 | $0 | $15,272 | |||
| MICHELLE LEBEAU | ||||||||
| CEO | 2.00 | Yes (X) | $0 | $613,736 | $34,524 | 48.00 | ||
| CHRISTOPHER HICKEY | ||||||||
| SVP/CFO | 8.00 | Yes (X) | $0 | $459,826 | $32,254 | 42.00 | ||
| DR LISA MARK | ||||||||
| CHIEF MEDICAL OFFICER | 8.00 | Yes (X) | $0 | $447,744 | $31,670 | 40.00 | ||
| WENDY FRANK | ||||||||
| FNP | 40.00 | $232,394 | $0 | $15,780 | Yes (X) | |||
| ROBERT STOUT | ||||||||
| CRNA | 40.00 | $250,664 | $0 | $7,697 | Yes (X) | |||
| DUYEN NGUYEN | ||||||||
| AVP | 40.00 | $224,083 | $0 | $15,932 | Yes (X) | |||
| DEBRA PIERCEY | ||||||||
| CRNA | 10.00 | $263,580 | $0 | $9,280 | Yes (X) | |||
| EMILY CAMPBELL | ||||||||
| HR DIRECTOR | 40.00 | $209,172 | $0 | $5,763 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,559,152 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,591,847 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $169,336 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CROSS COUNTRY STAFFING INC | |||||
| 5201 CONGRESS AVENUE SUITE 100-B | BOCA RATON | FL | 33487 | PHYSICIAN SERVICES | $2,104,972 |
| FASTAFF LLC | |||||
| 5700 S QUEBEC ST SUITE 300 | GREENWOOD VILLAGE | CO | 80111 | PHYSICIAN SERVICES | $2,002,856 |
| MEDICAL SVCS SUFFOLK CNTY PC | |||||
| 39 MAIN STREET | TRIBURON | CA | 94920 | PHYSICIAN SERVICES | $1,638,961 |
| SIGNATURE STAFF RESOURCES LLC | |||||
| 1460 T L TOWNSEND DR 104 | ROCKWALL | TX | 75032 | PHYSICIAN SERVICES | $1,076,014 |
| WEATHERBY LOCUMS INC | |||||
| 6451 NORTH FEDERAL HIGHWAY SUITE 7 | FORT LAUDERDALE | FL | 33308 | PHYSICIAN SERVICES | $433,053 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $40,039 | FundraisingAmt |
| Government Grants | $429,384 | GovernmentGrantsAmt |
| All Other Contributions | $23,333 | AllOtherContributionsAmt |
| Total Contributions | $492,756 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT CARE | Desc |
| Business | 622000 | BusinessCd |
| Total Revenue Column | $82,121,802 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,121,802 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $82,121,802 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,156 | TotalRevenueColumnAmt |
| Exclusion | $11,156 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $882,470 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $539,144 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $343,326 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $343,326 | TotalRevenueColumnAmt |
| Exclusion | $343,326 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $1,898 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $40,039 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $10,142 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$8,244 | TotalRevenueColumnAmt |
| Exclusion | -$8,244 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| 340B REVENUE | 900099 | $4,480,298 | $4,480,298 |
| PROVIDER RELIEF FUNDS | 900099 | $3,483,472 | $3,483,472 |
| CAFETERIA REVENUE | 900099 | $398,850 | $398,850 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,266,399 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,266,399 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $10,629,019 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $93,589,815 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $92,750,821 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $346,238 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $394,531 | TotalAmt |
| Management And General | $394,531 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,282,316 | TotalAmt |
| Program Services | $46,510,047 | ProgramServicesAmt |
| Management And General | $10,772,269 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,651,888 | TotalAmt |
| Program Services | $1,340,149 | ProgramServicesAmt |
| Management And General | $311,739 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,002,134 | TotalAmt |
| Program Services | $4,858,941 | ProgramServicesAmt |
| Management And General | $1,143,193 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,510,752 | TotalAmt |
| Program Services | $2,837,741 | ProgramServicesAmt |
| Management And General | $673,011 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,562 | TotalAmt |
| Program Services | $157,264 | ProgramServicesAmt |
| Management And General | $37,298 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,908 | TotalAmt |
| Program Services | $47,615 | ProgramServicesAmt |
| Management And General | $11,293 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,130,935 | TotalAmt |
| Program Services | $2,628,539 | ProgramServicesAmt |
| Management And General | $502,396 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,004 | TotalAmt |
| Program Services | $63,859 | ProgramServicesAmt |
| Management And General | $15,145 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,495 | TotalAmt |
| Program Services | $100,622 | ProgramServicesAmt |
| Management And General | $23,873 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,088,975 | TotalAmt |
| Program Services | $1,688,519 | ProgramServicesAmt |
| Management And General | $400,456 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,745,973 | TotalAmt |
| Program Services | $1,411,270 | ProgramServicesAmt |
| Management And General | $334,703 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,404 | TotalAmt |
| Program Services | $123,188 | ProgramServicesAmt |
| Management And General | $29,216 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $783,007 | TotalAmt |
| Program Services | $632,905 | ProgramServicesAmt |
| Management And General | $150,102 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,822,096 | TotalAmt |
| Program Services | $3,089,400 | ProgramServicesAmt |
| Management And General | $732,696 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES AND PH | $10,723,426 | $8,667,745 | $2,055,681 |
| ALL OTHER EXPENSES | $5,829,905 | $4,721,986 | $1,107,919 |
| PURCHASED SERVICES | $4,958,011 | $4,007,560 | $950,451 |
| BAD DEBT EXPENSE | $2,440,363 | $2,440,363 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $602,834 | TotalAmt |
| Program Services | $487,270 | ProgramServicesAmt |
| Management And General | $115,564 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,576,519 | TotalAmt |
| Program Services | $85,814,983 | ProgramServicesAmt |
| Management And General | $19,761,536 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,567,628 | BOYAmt |
| EOY | $3,048,184 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,803,463 | BOYAmt |
| EOY | $13,255,893 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,020,323 | BOYAmt |
| EOY | $7,587,878 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,695 | BOYAmt |
| EOY | $103,102 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,044,798 | BOYAmt |
| EOY | $1,227,735 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,735,101 | BOYAmt |
| EOY | $1,470,271 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $63,887,826 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $27,693,402 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,547,292 | BOYAmt |
| EOY | $36,194,424 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,069,482 | BOYAmt |
| EOY | $3,373,122 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,283 | BOYAmt |
| EOY | $16,283 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,440,437 | BOYAmt |
| EOY | $1,624,565 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,353,502 | BOYAmt |
| EOY | $67,901,457 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,011,978 | BOYAmt |
| EOY | $8,852,703 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,802,906 | BOYAmt |
| EOY | $29,140,996 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,511,724 | BOYAmt |
| EOY | $15,430,833 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,326,608 | BOYAmt |
| EOY | $53,424,532 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,904,127 | BOYAmt |
| EOY | $13,019,447 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,122,767 | BOYAmt |
| EOY | $1,457,478 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,026,894 | BOYAmt |
| EOY | $14,476,925 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,353,502 | BOYAmt |
| EOY | $67,901,457 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$11,986,704 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $332,689 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$895,954 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,122,767 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$224,827 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $897,940 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $949,748 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $173,019 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,122,767 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $872,503 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $77,245 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $949,748 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $829,056 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $43,447 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $872,503 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $183,946 | BeginningYearBalanceAmt |
| Contributions | $611,091 | ContributionsAmt |
| Investment Earnings Or Losses | $34,019 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $829,056 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,051,000 | OtherCostOrOtherBasisAmt |
| Book Value | $2,051,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,203,948 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,736,754 | DepreciationAmt |
| Book Value | $26,467,194 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,612,370 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,443,342 | DepreciationAmt |
| Book Value | $5,169,028 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,020,508 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,513,306 | DepreciationAmt |
| Book Value | $2,507,202 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $36,194,424 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTIES | $5,691,709 |
| OTHER LIABILITIES | $5,426,493 |
| OPERATING LEASE RIGHT-OF-USE-OBLIGATIONS | $549,012 |
| CONTRACT LIABILITY - MEDICARE ACCELERATED PAYMENTS | $3,634,727 |
| FINANCE LEASE | $128,892 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $15,430,833 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ENTITIES WITHIN UVM HEALTH NETWORK, WITH THE EXCEPTION OF ENTITIES SPECIFICALLY NAMED BELOW, ARE INCORPORATED AND RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). ACCORDINGLY, THE IRS HAS DETERMINED THAT THESE ORGANIZATIONS ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. HEALTH NETWORK VENTURES HOLDING, LLC, UNIVERSITY OF VERMONT HEALTH NETWORK SPECIALTY CARE TRANSPORT, LLC, UNIVERSITY OF VERMONT MEDICAL CENTER SKILLED NURSING, LLC, UNIVERSITY OF VERMONT MEDICAL CENTER EXECUTIVE SERVICES, LLC, VALCOUR IMAGING, INC., AND PORTER REAL ESTATE HOLDINGS, LLC, ARE SINGLE-MEMBER LIMITED LIABILITY CORPORATIONS. AS SUCH, FOR TAX PURPOSES, THESE ORGANIZATIONS ARE TREATED AS DIVISIONS OF THEIR SOLE MEMBER. EARNINGS AND LOSSES ARE PASSED THROUGH TO THE OWNERS, WHICH ARE TAX-EXEMPT, AND ARE TREATED IN THE SAME MANNER FOR TAX PURPOSES. NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS FOR THESE ORGANIZATIONS. UVM HEALTH NETWORK HEALTH VENTURES, INC., MEDICAL EDUCATION CENTER CONDOMINIUM ASSOCIATION, INC., MEDIQUEST CORP., EMERGENCY MEDICAL TRANSPORT OF CVPH, INC., AND CHAMPLAIN VALLEY HEALTH NETWORK, INC. ARE TAXABLE CORPORATIONS FOR WHICH THE PROVISION FOR INCOME TAXES IS IMMATERIAL TO THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ONLINE AUCTION | Event1Nm |
| Gross Receipts Event1 | $13,219 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $13,219 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $1,120 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF BENEFIT | Event2Nm |
| Gross Receipts Event2 | $28,718 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $26,820 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $1,898 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $9,022 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $41,937 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $40,039 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $1,898 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $10,142 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $10,142 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$8,244 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,482,969 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,105,714 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,029,626 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,183,442 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,846,184 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15360 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,512,595 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,289,156 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,846,184 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15360 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $145,176 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $145,176 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $145,176 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $145,176 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,657,771 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $11,289,156 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,991,360 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15500 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,440,363 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $396 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $17,565,257 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $26,366,459 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$8,801,202 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALICE HYDE MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 133 PARK STREET | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.ALICEHYDE.COM | WebsiteAddressTxt |
| State License | 1624000H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALICE HYDE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTPS://WWW.ALICEHYDE.COM/ABOUT-US/COMMUNITY-SERVICE-PLAN | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | HTTPS://AHIHEALTH.ORG/ARHN/ HTTPS://COUNTYFRANKLIN.DIGITALTOWPATH.ORG:1007 | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTPS://WWW.ALICEHYDE.COM/ABOUT-US/COMMUNITY-SERVICE-PLAN | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.ALICEHYDE.COM | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.ALICEHYDE.COM | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.ALICEHYDE.COM | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ALICE HYDE MEDICAL CENTER | PART V, SECTION B, LINE 5: TO HELP INFORM A COLLABORATIVE APPROACH TO IMPROVING COMMUNITY HEALTH, THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) SOUGHT TO IDENTIFY PRIORITIES, FACTORS AND RESOURCES THAT INFLUENCE THE HEALTH OF RESIDENTS OF THE ADIRONDACK REGION (CLINTON, ESSEX, FRANKLIN, FULTON, HAMILTON, WARREN AND WASHINGTON COUNTIES). ARHN SURVEYED STAKEHOLDERS IN THE SEVEN-COUNTY SERVICE AREA, TO PROVIDE THE CHA COMMITTEE WITH INPUT ON REGIONAL HEALTH CARE NEEDS AND PRIORITIES. STAKEHOLDERS INCLUDED PROFESSIONALS FROM HEALTH CARE, SOCIAL SERVICES, EDUCATIONAL, AND GOVERNMENTAL INSTITUTIONS AS WELL AS COMMUNITY MEMBERS. ALICE HYDE MEDICAL CENTER ENGAGED ESSENTIAL CLINICAL STAFF AS PART OF AN INTERNAL PRIORITIZATION COMMITTEE TO ASSESS AND IDENTIFY THE KEY CRITICAL AREAS FOR TARGETED FOCUS AS DETERMINED BY THE 2022 COMMUNITY STAKEHOLDER SURVEY, AND IN SUPPORT OF THE NEW YORK STATE PREVENTION AGENDA. IN ADDITION TO THE VARIETY OF COMMUNITY AND REGIONAL RESOURCES AVAILABLE, ALICE HYDE MEDICAL CENTER ASSESSED DATA AND PROGRAMS FROM ITS OUTPATIENT PRIMARY CARE PRACTICES, THE EMERGENCY DEPARTMENT AND OTHER KEY HOSPITAL ALICE HYDE MEDICAL CENTER 15-0346515 DEPARTMENTS TO FURTHER IDENTIFY AREAS OF FOCUS AND AVAILABLE ASSETS. LEAD STAFF FROM FRANKLIN COUNTY PUBLIC HEALTH, THE UNIVERSITY OF VERMONT HEALTH NETWORK ALICE HYDE MEDICAL CENTER AND ADIRONDACK HEALTH WORKED WITH PARTNERS TO COLLECT ACTIVITIES AND INTERVENTIONS IN SUPPORT OF THE NEW YORK STATE PREVENTION AGENDA. DETERMINATION OF SPECIFIC INTERVENTIONS RELATED TO EACH PRIORITY AREA WAS BASED ON ALIGNMENT WITH THE SPECIFIC GOALS AND OBJECTIVES EACH AGENCY IS COMMITTED TO; OTHER POPULATION HEALTH BASED INITIATIVES OCCURRING WITHIN THE ORGANIZATION; AND ORGANIZATIONAL ABILITY TO MAKE A SUSTAINED IMPACT WITH THE INTERVENTION. |
| ALICE HYDE MEDICAL CENTER | PART V, SECTION B, LINE 6A: ADIRONDACK HEALTH - ADIRONDACK MEDICAL CENTER |
| ALICE HYDE MEDICAL CENTER | PART V, SECTION B, LINE 6B: FRANKLIN COUNTY HEALTH DEPARTMENT - PUBLIC HEALTH UNIT |
| ALICE HYDE MEDICAL CENTER | PART V, SECTION B, LINE 11: ALICE HYDE MEDICAL CENTER IDENTIFIED TWO NYS PREVENTION AGENDA PRIORITY AREAS FOR THE 2022-2024 COMMUNITY SERVICE PLAN CYCLE: (1) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AND (2) PREVENT CHRONIC DISEASE. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO ALICE HYDE MEDICAL CENTER.THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS:PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: PROMOTE WELL BEINGACTION PLANINVESTIGATE AND IMPLEMENT COMMUNITY PARTNERSHIPS FOR EXPANDED PRIMARY CARE OFFERINGS IN THE MALONE COMMUNITY TO IMPROVE ACCESS TO CARE. ACHIEVE GERIATRIC EMERGENCY DEPARTMENT (GEDA) ACCREDITATION IN 2022 TO SUPPORT THE NEEDS OF OUR AGING POPULATION. DEVELOP AND PLAN FOR AN ENHANCED/MODERNIZED/REIMAGINED HOSPITAL CAMPUS THROUGH NYS TRANSFORMATION IV GRANT FUNDING. CONTINUE THE ED PEER NAVIGATOR PROGRAM IMPLEMENTED IN AHMC EMERGENCY DEPARTMENT TO PROVIDE ACCESS TO AND COORDINATION OF COMMUNITY BASED RESOURCES FOR PATIENTS FREQUENTING THE ED, WHO NEED ADDITIONAL SERVICES TO MANAGE THEIR HEALTH AND WELL-BEING.PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: MENTAL AND SUBSTANCE USE DISORDER PREVENTIONACTION PLANBUILD SUPPORT SYSTEMS TO CARE FOR OPIOID USERS OR AT RISK OF AN OVERDOSE. INTEGRATE TRAUMA INFORMED APPROACHES IN TRAINING STAFF AND IMPLEMENTING PROGRAM AND POLICY. STRENGTHENING RESOURCES FOR FAMILIES AND CAREGIVERS. CONTINUED COORDINATION/COLLABORATION BETWEEN AHMC ED AND THE CITIZEN ADVOCATES' CRISIS INTERVENTION CENTER TO ENSURE PATIENTS PRESENTING TO THE AHMC ED RECEIVE THE APPROPRIATE LEVEL OF CARE. CREATION OF FULLY TRAINED AHMC CISM TEAM (CRITICAL INCIDENT STRESS MANAGEMENT TEAM) IN 2022 TO SUPPORT STAFF, PATIENTS AND FAMILIES EXPERIENCING CRISIS EVENTS. UTILIZE THE EXPERTISE OF THE UVMHN COMMUNICATIONS AND ENGAGEMENT STRATEGIES TEAM TO EDUCATE PROVIDERS, STAFF AND THE BROADER COMMUNITY ON MENTAL AND SUBSTANCE USE DISORDERS AND PREVENTION/EARLY INTERVENTION STRATEGIES. PREVENT CHRONIC DISEASE: HEALTHY EATING AND FOOD SECURITYACTION PLAN ESTABLISHMENT AND CONTINUED ENHANCEMENT OF EMPLOYEE WELLNESS COMMITTEE (EWC) TO PROMOTE HEALTH AND WELL-BEING FOR ALL EMPLOYEES. COLLABORATE WITH JCEO FOR ONSITE MOBILE FOOD MARKET PROVIDING ACCESS TO HEALTHY FRUITS AND VEGETABLES WEEKLY DURING THE GROWING SEASON. PARTNER WITH LOCAL ORCHARD FOR ONSITE ACCESS TO LOCAL APPLES, HONEY, AND OTHER NATURALLY GROWN PRODUCTS. UTILIZE THE EXPERTISE OF THE UMVHN COMMUNICATION AND ENGAGEMENT STRATEGIES TO CREATE AND PROMOTE MEDIA PIECES SPOTLIGHTING AND EDUCATING STAFF, PATIENTS AND THE COMMUNITY ABOUT THE HEALTH BENEFITS ASSOCIATED WITH HEALTHY EATING.PREVENT CHRONIC DISEASE: PHYSICAL ACTIVITYACTION PLAN IMPLEMENT A COMBINATION OF WORKSITE-BASED PHYSICAL ACTIVITY POLICIES, PROGRAMS, OR BEST PRACTICES THROUGH MULTI-COMPONENT WORKSITE PHYSICAL ACTIVITY AND/OR NUTRITION PROGRAMS; ENVIRONMENTAL SUPPORTS OR PROMPTS TO ENCOURAGE WALKING AND/OR TAKING THE STAIRS; OR STRUCTURED WALKING-BASED PROGRAMS FOCUSING ON OVERALL PHYSICAL ACTIVITY THAT INCLUDE GOAL-SETTING, ACTIVITY MONITORING, SOCIAL SUPPORT, COUNSELING, AND HEALTH PROMOTION AND INFORMATION MESSAGING. IMPLEMENT AND/OR PROMOTE A COMBINATION OF COMMUNITY WALKING, WHEELING, OR BIKING PROGRAMS.AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR. INVESTIGATE THE ABILITY TO CREATE EMPLOYEE FITNESS CENTER ON CAMPUS. PREVENT CHRONIC DISEASE: TOBACCO PREVENTIONACTION PLAN IMPLEMENT WORKFLOW TO ENSURE ALL PRIMARY CARE PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE (ALL FORMS) AND REFERRED FOR INTERVENTION SERVICES WITH ONSITE CTCS OR NYS QUITLINEUTILIZE AHMC COMMUNICATIONS AND ENGAGEMENT STRATEGIES DIVISION TO CREATE CONTENT TO PROMOTE AND EDUCATE SMOKERS ABOUT THE BENEFITS OF EVIDENCE-BASED QUITTING APPROACHES PROMOTE THE GREAT AMERICAN SMOKEOUT INITIATIVE WORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS. WORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS, INCLUDING ACCESS TO CERTIFIED TOBACCO CESSATION SPECIALISTS AS NEEDED AND ALSO COLLABORATE WITH NORTH COUNTRY HEALTHY HEART NETWORK TO CREATE AND PROVIDE EDUCATION OPPORTUNITIES AND TOBACCO CESSATION INTERVENTION MATERIALS FOR HEALTH CARE PROVIDERS AND PATIENTS.PREVENT CHRONIC DISEASE - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT ACTION PLANWORK WITH HEALTH CARE PROVIDERS/CLINICS TO PUT SYSTEMS IN PLACE FOR PATIENT AND PROVIDER SCREENING REMINDERS (E.G., LETTER, POSTCARDS, EMAILS, RECORDED PHONE MESSAGES, ELECTRONIC HEALTH RECORDS [EHR] ALERTS). PROMOTE THE USE OF HEALTH INFORMATION TECHNOLOGY FOR: MEASUREMENT, REGISTRY DEVELOPMENT, PATIENT ALERTS, BI-DIRECTIONAL REFERRALS, REPORTING. EXPAND ACCESS TO EVIDENCE-BASED SELF-MANAGEMENT INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC DISEASE (ARTHRITIS, ASTHMA, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES, AND OBESITY) WHOSE CONDITION(S) IS NOT WELL-CONTROLLED WITH GUIDELINES-BASED MEDICAL MANAGEMENT ALONE.CONTINUE TO OPTIMIZE THE EPIC EMR SYSTEM TO ENHANCE PATIENT CARE DELIVERY, MEASUREMENT AND REPORTING. UTILIZE THE EPIC EMR REMINDER SYSTEM IN PRIMARY CARE TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS, INCLUDING MANAGEMENT OF PATIENT ALERTS AND REMINDERS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. CONTINUE TO DELIVER THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM TO EXISTING PATIENTS (INPATIENTS AS IDENTIFIED) TO EDUCATE PATIENTS ON BEST PRACTICE STRATEGIES FOR MANAGING THEIR CHRONIC CONDITION SPECIFICALLY WITH THE FOCUS ON CHF, COPD AND DIABETES, WITH THE GOAL OF REDUCING AVOIDABLE READMISSIONS AND IMPROVING THE HEALTH OF OUR PATIENT POPULATION LIVING WITH CHRONIC DISEASE.ALICE HYDE MEDICAL CENTER'S PRIMARY SERVICE AREA IS IDENTIFIED AS THE THIRTEEN NORTHERN NEW YORK TOWNSHIPS OF: BOMBAY 12914, BRUSHTON 12916, BURKE 12917, CHATEAUGAY 12920, CHURUBUSCO 12923, CONSTABLE 12926, DICKINSON CENTER 12930, LYON MOUNTAIN 12955, MALONE 12953, MOIRA 12957, NORTH BANGOR 12966, OWLS HEAD 12969, AND ST. REGIS FALLS 12980. ALICE HYDE MEDICAL CENTER'S SECONDARY SERVICE AREA IS IDENTIFIED AS THE EIGHT TOWNSHIPS IN THE NORTHWEST PORTION OF THE FRANKLIN COUNTY BORDER INTO ST. LAWRENCE COUNTY, INCLUDING BRASHER FALLS 13613, CHASE MILLS 13621, HOGANSBURG 13655, MADRID 13660, MASSENA 13662, NORFOLK 13667, NORTH LAWRENCE 12967, AND WINTHROP 13697. THESE TWO SERVICE AREAS COMPRISE 95% OF AHMC'S PATIENT ORIGIN AS OF THE LATEST AVAILABLE DATA. |
| PART V, SECTION B, LINE 20A: | ALICE HYDE MEDICAL CENTER DOES NOT PURSUE LEGAL ACTION IN ORDER TO COLLECT A DEBT, INCLUDING NOT SELLING DEBT INFORMATION TO ANOTHER PARTY FOR COLLECTIONS, REPORTING TO INDIVIDUAL CREDIT AGENCIES REGARDING PAYMENT STATUS, NOR DOES ALICE HYDE MEDICAL CENTER REFUSE TREATMENT FOR PAST DEBT OBLIGATIONS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - ALICE HYDE NURSING HOME | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 SIXTH STREET | AddressLine1Txt |
| City | MALONE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12953 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | SKILLED NURSING FACILITY | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | UTILIZED IS WORKSHEETS FOR SCHEDULE H AND RATIO OF COST TO CHARGES. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,440,363. |
| PART III, LINE 2: | OUR BAD DEBT METHODOLOGY IS BASED ON HISTORICAL AMOUNTS WHICH WERE TYPICALLY 3.0% OF NET REVENUE. |
| PART III, LINE 3: | WE USE THE BAD DEBT EXPENSE AND ALLOCATE BASED ON THE ACTUAL WRITE-OFFS. |
| PART III, LINE 4: | SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED SEPTEMBER 30, 2022 AND 2021, WAS NOT SIGNIFICANT. THE ORGANIZATION'S BAD DEBT EXPENSE IS ADDRESSED ON PAGE 26 IN FOOTNOTE 4 OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE MEDICARE BENEFICIARIES WHO ALICE HYDE PROVIDES SERVICES TO ARE PART OF OUR COMMUNITY OF MALONE, NEW YORK, AND THEREFORE, SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE SOURCE FOR THE COST METHODOLOGY IS THE 2022 MEDICARE COST REPORT. THE MEDICAL CENTER EXPERIENCED A SHORTFALL IN MEDICARE REVENUE OVER COSTS. DESPITE THIS SHORTFALL, THE MEDICAL CENTER CONTINUES TO PROVIDE QUALITY CARE TO THE COMMUNITY OF MALONE, NEW YORK. |
| PART III, LINE 9B: | THE CENTER PROVIDES CARE TO CLIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CENTER'S POLICY IS NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE THESE AMOUNTS ARE NOT REPORTED IN NET OPERATING REVENUES OR IN PROVISIONS FOR DOUBTFUL ACCOUNTS. |
| PART VI, LINE 3: | THE ALICE HYDE MEDICAL CENTER (AHMC) BELIEVES THAT FEAR OF A MEDICAL BILL SHOULD NOT PRECLUDE A RESIDENT OF ITS COMMUNITY FROM SEEKING OR OBTAINING ESSENTIAL HEALTH CARE SERVICES. TO HELP THOSE WHO ARE UNINSURED, AHMC PARTNERS WITH VARIOUS ORGANIZATIONS, INCLUDING THE FRANKLIN COUNTY DEPARTMENT OF SOCIAL SERVICES, PUBLIC HEALTH, FIDELIS, AND EXCELLUS, TO ENSURE ACCURATE INFORMATION AND RESOURCES ARE AVAILABLE THROUGHOUT THE COMMUNITY, INCLUDING A FACILITATED ENROLLMENT PROGRAM FOR ITS UNINSURED. THIS PROGRAM ASSISTS THE INDIVIDUAL IN APPLYING FOR STATE SPONSORED HEALTH INSURANCE, INCLUDING MEDICAID AND CHILD HEALTH PLUS. THE GOAL OF THIS INITIATIVE IS TO PROVIDE CONVENIENT LOCATION FOR PATIENTS AND COMMUNITY MEMBERS TO ACCESS THE PROGRAM AND TO PROVIDE ASSISTANCE IN COMPLETING HEALTH INSURANCE APPLICATIONS. THESE GOALS ARE MET THROUGH A PARTNERSHIP BETWEEN AHMC AND ADIRONDACK HEALTH INSTITUTE. AHMC HAS AN EMPLOYEE DEDICATED TO FINANCIAL COUNSELING AND ASSISTANCE. |
| PART VI, LINE 4: | ALICE HYDE MEDICAL CENTER (AHMC) PRIMARILY SERVES TOWNS, VILLAGES, AND THE NATIVE AMERICAN RESERVATION IN FRANKLIN COUNTY. AHMC'S PRIMARY SERVICE AREA COVERS THE FOLLOWING TOWNS (BY ZIP CODE) - MALONE (12953), NORTH BANGOR (12966), CHATEAUGAY (12920), CONSTABLE (12926), BRUSHTON (12916), MOIRA (12957), BURKE (12917), FORT COVINGTON (12937), HOGANSBURG (13655), SAINT REGIS FALLS (12980), BOMBAY (12914), OWLS HEAD (12969), DICKINSON CENTER (12930). THE SECONDARY SERVICE AREAS SERVED BY AHMC INCLUDE CHURUBUSCO (12923), ELLENBURG CENTER (12934), NORTH LAWRENCE (12967), LYON MOUNTAIN (12955), NICHOLVILLE (12965). IN ADDITION, AHMC PROVIDES SERVICES TO THE INMATE POPULATION FOR THE FRANKLIN COUNTY JAIL AND THE CLINTON, FRANKLIN, UPSTATE, BAREHILL AND ALTONA CORRECTIONAL FACILITIES. |
| PART VI, LINE 5: | ALICE HYDE MEDICAL CENTER IDENTIFIED TWO NYS PREVENTION AGENDA PRIORITY AREAS FOR THE 2022-2024 COMMUNITY SERVICE PLAN CYCLE: (1) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AND (2) PREVENT CHRONIC DISEASE. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO ALICE HYDE MEDICAL CENTER.THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS:PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: PROMOTE WELL BEINGACTION PLANINVESTIGATE AND IMPLEMENT COMMUNITY PARTNERSHIPS FOR EXPANDED PRIMARY CARE OFFERINGS IN THE MALONE COMMUNITY TO IMPROVE ACCESS TO CARE. ACHIEVE GERIATRIC EMERGENCY DEPARTMENT (GEDA) ACCREDITATION IN 2022 TO SUPPORT THE NEEDS OF OUR AGING POPULATION. DEVELOP AND PLAN FOR AN ENHANCED/MODERNIZED/REIMAGINED HOSPITAL CAMPUS THROUGH NYS TRANSFORMATION IV GRANT FUNDING. CONTINUE THE ED PEER NAVIGATOR PROGRAM IMPLEMENTED IN AHMC EMERGENCY DEPARTMENT TO PROVIDE ACCESS TO AND COORDINATION OF COMMUNITY BASED RESOURCES FOR PATIENTS FREQUENTING THE ED, WHO NEED ADDITIONAL SERVICES TO MANAGE THEIR HEALTH AND WELL-BEING.PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: MENTAL AND SUBSTANCE USE DISORDER PREVENTIONACTION PLAN BUILD SUPPORT SYSTEMS TO CARE FOR OPIOID USERS OR AT RISK OF AN OVERDOSE. INTEGRATE TRAUMA INFORMED APPROACHES IN TRAINING STAFF AND IMPLEMENTING PROGRAM AND POLICY. STRENGTHENING RESOURCES FOR FAMILIES AND CAREGIVERS. CONTINUED COORDINATION/COLLABORATION BETWEEN AHMC ED AND THE CITIZEN ADVOCATES' CRISIS INTERVENTION CENTER TO ENSURE PATIENTS PRESENTING TO THE AHMC ED RECEIVE THE APPROPRIATE LEVEL OF CARE. CREATION OF FULLY TRAINED AHMC CISM TEAM (CRITICAL INCIDENT STRESS MANAGEMENT TEAM) IN 2022 TO SUPPORT STAFF, PATIENTS AND FAMILIES EXPERIENCING CRISIS EVENTS. UTILIZE THE EXPERTISE OF THE UVMHN COMMUNICATIONS AND ENGAGEMENT STRATEGIES TEAM TO EDUCATE PROVIDERS, STAFF AND THE BROADER COMMUNITY ON MENTAL AND SUBSTANCE USE DISORDERS AND PREVENTION/EARLY INTERVENTION STRATEGIES. PREVENT CHRONIC DISEASE: HEALTHY EATING AND FOOD SECURITYACTION PLANESTABLISHMENT AND CONTINUED ENHANCEMENT OF EMPLOYEE WELLNESS COMMITTEE (EWC) TO PROMOTE HEALTH AND WELL-BEING FOR ALL EMPLOYEES.COLLABORATE WITH JCEO FOR ONSITE MOBILE FOOD MARKET PROVIDING ACCESS TO HEALTHY FRUITS AND VEGETABLES WEEKLY DURING THE GROWING SEASON.PARTNER WITH LOCAL ORCHARD FOR ONSITE ACCESS TO LOCAL APPLES, HONEY, AND OTHER NATURALLY GROWN PRODUCTSUTILIZE THE EXPERTISE OF THE UMVHN COMMUNICATION AND ENGAGEMENT STRATEGIES TO CREATE AND PROMOTE MEDIA PIECES SPOTLIGHTING AND EDUCATING STAFF, PATIENTS AND THE COMMUNITY ABOUT THE HEALTH BENEFITS ASSOCIATED WITH HEALTHY EATING.PREVENT CHRONIC DISEASE PHYSICAL ACTIVITYACTION PLAN IMPLEMENT A COMBINATION OF WORKSITE-BASED PHYSICAL ACTIVITY POLICIES, PROGRAMS, OR BEST PRACTICES THROUGH MULTI-COMPONENT WORKSITE PHYSICAL ACTIVITY AND/OR NUTRITION PROGRAMS; ENVIRONMENTAL SUPPORTS OR PROMPTS TO ENCOURAGE WALKING AND/OR TAKING THE STAIRS; OR STRUCTURED WALKING-BASED PROGRAMS FOCUSING ON OVERALL PHYSICAL ACTIVITY THAT INCLUDE GOAL-SETTING, ACTIVITY MONITORING, SOCIAL SUPPORT, COUNSELING, AND HEALTH PROMOTION AND INFORMATION MESSAGING. IMPLEMENT AND/OR PROMOTE A COMBINATION OF COMMUNITY WALKING, WHEELING, OR BIKING PROGRAMS.AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR. INVESTIGATE THE ABILITY TO CREATE EMPLOYEE FITNESS CENTER ON CAMPUS. PREVENT CHRONIC DISEASE TOBACCO PREVENTIONACTION PLAN IMPLEMENT WORKFLOW TO ENSURE ALL PRIMARY CARE PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE (ALL FORMS) AND REFERRED FOR INTERVENTION SERVICES WITH ONSITE CTCS OR NYS QUITLINE.UTILIZE AHMC COMMUNICATIONS AND ENGAGEMENT STRATEGIES DIVISION TO CREATE CONTENT TO PROMOTE AND EDUCATE SMOKERS ABOUT THE BENEFITS OF EVIDENCE-BASED QUITTING APPROACHESPROMOTE THE GREAT AMERICAN SMOKEOUT INITIATIVEWORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS,INCLUDING ACCESS TO CERTIFIED TOBACCO CESSATION SPECIALISTS AS NEEDED AND ALSO COLLABORATE WITH NORTH COUNTRY HEALTHY HEART NETWORK TO CREATE AND PROVIDE EDUCATION OPPORTUNITIES AND TOBACCO CESSATION INTERVENTION MATERIALS FOR HEALTH CARE PROVIDERS AND PATIENTS.PREVENT CHRONIC DISEASE - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENTACTION PLAN WORK WITH HEALTH CARE PROVIDERS/CLINICS TO PUT SYSTEMS IN PLACE FOR PATIENT AND PROVIDER SCREENING REMINDERS (E.G., LETTER, POSTCARDS, EMAILS, RECORDED PHONE MESSAGES, ELECTRONIC HEALTH RECORDS [EHR] ALERTS). PROMOTE THE USE OF HEALTH INFORMATION TECHNOLOGY FOR: MEASUREMENT, REGISTRY DEVELOPMENT, PATIENT ALERTS, BI-DIRECTIONAL REFERRALS, REPORTING. EXPAND ACCESS TO EVIDENCE-BASED SELF-MANAGEMENT INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC DISEASE (ARTHRITIS, ASTHMA, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES, AND OBESITY) WHOSE CONDITION(S) IS NOT WELL-CONTROLLED WITH GUIDELINES-BASED MEDICAL MANAGEMENT ALONE.CONTINUE TO OPTIMIZE THE EPIC EMR SYSTEM TO ENHANCE PATIENT CARE DELIVERY, MEASUREMENT AND REPORTING. UTILIZE THE EPIC EMR REMINDER SYSTEM IN PRIMARY CARE TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS, INCLUDING MANAGEMENT OF PATIENT ALERTS AND REMINDERS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. CONTINUE TO DELIVER THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM TO EXISTING PATIENTS (INPATIENTS AS IDENTIFIED) TO EDUCATE PATIENTS ON BEST PRACTICE STRATEGIES FOR MANAGING THEIR CHRONIC CONDITION SPECIFICALLY WITH THE FOCUS ON CHF, COPD AND DIABETES, WITH THE GOAL OF REDUCING AVOIDABLE READMISSIONS AND IMPROVING THE HEALTH OF OUR PATIENT POPULATION LIVING WITH CHRONIC DISEASE. ALICE HYDE MEDICAL CENTER'S PRIMARY SERVICE AREA IS IDENTIFIED AS THE THIRTEEN NORTHERN NEW YORK TOWNSHIPS OF: BOMBAY 12914, BRUSHTON 12916, BURKE 12917, CHATEAUGAY 12920, CHURUBUSCO 12923, CONSTABLE 12926, DICKINSON CENTER 12930, LYON MOUNTAIN 12955, MALONE 12953, MOIRA 12957, NORTH BANGOR 12966, OWLS HEAD 12969, AND ST. REGIS FALLS 12980. ALICE HYDE MEDICAL CENTER'S SECONDARY SERVICE AREA IS IDENTIFIED AS THE EIGHT TOWNSHIPS IN THE NORTHWEST PORTION OF THE FRANKLIN COUNTY BORDER INTO ST. LAWRENCE COUNTY, INCLUDING BRASHER FALLS 13613, CHASE MILLS 13621, HOGANSBURG 13655, MADRID 13660, MASSENA 13662, NORFOLK 13667, NORTH LAWRENCE 12967, AND WINTHROP 13697. THESE TWO SERVICE AREAS COMPRISE 95% OF AHMC'S PATIENT ORIGIN AS OF THE LATEST AVAILABLE DATA. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHELLE LEBEAU | ||||||||||||||
| CEO | $0 | $490,356 | $0 | $123,380 | $0 | $0 | $0 | $0 | $0 | $34,524 | $0 | $648,260 | $0 | $0 |
| CHRISTOPHER HICKEY | ||||||||||||||
| SVP/CFO | $0 | $389,224 | $0 | $70,602 | $0 | $0 | $0 | $0 | $0 | $32,254 | $0 | $492,080 | $0 | $0 |
| DR LISA MARK | ||||||||||||||
| CHIEF MEDICAL OFFICER | $0 | $378,367 | $0 | $69,377 | $0 | $0 | $0 | $0 | $0 | $31,670 | $0 | $479,414 | $0 | $0 |
| MATT JONES | ||||||||||||||
| COO | $217,736 | $0 | $40,523 | $0 | $0 | $0 | $6,097 | $0 | $9,175 | $0 | $273,531 | $0 | $0 | $0 |
| DEBRA PIERCEY | ||||||||||||||
| CRNA | $252,618 | $0 | $10,962 | $0 | $0 | $0 | $0 | $0 | $9,280 | $0 | $272,860 | $0 | $0 | $0 |
| ROBERT STOUT | ||||||||||||||
| CRNA | $242,926 | $0 | $7,738 | $0 | $0 | $0 | $7,275 | $0 | $422 | $0 | $258,361 | $0 | $0 | $0 |
| WENDY FRANK | ||||||||||||||
| FNP | $232,394 | $0 | $0 | $0 | $0 | $0 | $6,949 | $0 | $8,831 | $0 | $248,174 | $0 | $0 | $0 |
| DUYEN NGUYEN | ||||||||||||||
| AVP | $224,083 | $0 | $0 | $0 | $0 | $0 | $6,710 | $0 | $9,222 | $0 | $240,015 | $0 | $0 | $0 |
| EMILY CAMPBELL | ||||||||||||||
| HR DIRECTOR | $192,596 | $0 | $16,576 | $0 | $0 | $0 | $5,381 | $0 | $382 | $0 | $214,935 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | IN ADDITION TO THE TOOLS AND PROCESSES IDENTIFIED IN PART I, ALICE HYDE MEDICAL CENTER RECEIVES GUIDANCE REGARDING ITS PRESIDENT'S COMPENSATION FROM THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS THE SOLE MEMBER OF THE HOSPITAL. THAT NETWORK COMPENSATION COMMITTEE UTILIZES THE FOLLOWING METHODS TO ESTABLISH THAT GUIDANCE: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| PART I, LINE 7 | ALICE HYDE MEDICAL CENTER PAID AWARDS TO CERTAIN MEMBERS OF UPPER MANAGEMENT (DIRECTORS, VICE PRESIDENTS, PHYSICIAN CHAIRS AND SENIOR EXECUTIVES) THROUGH ITS ANNUAL VARIABLE PAY PLAN AS THE PLAN'S PERFORMANCE MEASURES WERE MET. THE MEASURES WERE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THESE MEASURES INCLUDED FINANCIAL, POPULATION HEALTH & QUALITY, AND OPERATIONAL RELATED METRICS. |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SEAN CURTIN | PersonNm |
| Relationship With Org | FORMER CEO | RelationshipWithOrgTxt |
| Loan Purpose | PART V | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $150,865 | OriginalPrincipalAmt |
| Balance Due | $103,102 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | Yes (1) | BoardOrCommitteeApprovalInd |
| Written Agreement | Yes (1) | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $103,102 | TotalBalanceDueAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LOANS TO AND FROM INTERESTED PERSONS: | FormAndLineReferenceDesc |
| Explanation | (C) PURPOSE OF LOAN:THE ORGANIZATION HAS AN AGREEMENT WITH AND HAS PROVIDED THE EXECUTIVE WITH A LOAN FOR EDUCATIONAL EXPENSES UP TO A MAXIMUM OF $185,000, FOR A 5 YEAR PERIOD WITH INTEREST ACCRUED AT A COMPETITIVE MARKET RATE. THE ANNUAL PAYMENT, INCLUDING INTEREST, WILL BE FORGIVEN IF THE EXECUTIVE REMAINS EMPLOYED WITH THE ORGANIZATION FOR FIVE YEARS. DURING FY2019, THE EXECUTIVE LEFT EMPLOYMENT. THE LOAN TERMS WERE RENEGOTIATED FOR A 15 YEAR REPAYMENT PERIOD AT A COMPETITIVE FAIR MARKET RATE OF INTEREST. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BOARD MEMBER BRIAN MONETTE HAS A FAMILY RELATIONSHIP. BOARD MEMBERS BRIAN MONETTE AND MARINA MEDVED HAVE A BUSINESS RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATIONS DID HAVE MEMBERS, AND UVMHN, INC., IS ALICE HYDE MEDICAL CENTER'S SOLE MEMBER. |
| FORM 990, PART VI, SECTION A, LINE 7A | UVMHN, INC., AS ALICE HYDE MEDICAL CENTER'S SOLE MEMBER HAS RESERVE POWERS THAT ALLOW THE UNIVERSITY OF VERMONT HEALTH NETWORK AND UVMHN, INC, TO REFUSE THE ACCEPTANCE OF NEW BOARD MEMBERS APPOINTED BY THE ALICE HYDE MEDICAL CENTER BOARD OF DIRECTORS IF UVMHN, INC., DOES NOT AGREE WITH THE CHOICE OF APPOINTMENTS. THE PROCESS OF APPOINTING MEMBERS TO THE GOVERNING BODY IS A COLLABORATION OF THE ALICE HYDE MEDICAL CENTER BOARD OF DIRECTORS AND UVMHN, INC., AS A RESULT. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE UNIVERSITY OF VERMONT HEALTH NETWORK THROUGH UVMHN, INC., HAS CERTAIN RESERVE POWERS THAT REQUIRE UVMHN, INC., TO APPROVE CERTAIN DECISIONS MADE BY THE ALICE HYDE MEDICAL CENTER BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT OUTSIDE ACCOUNTING FIRM. IT IS PROVIDED TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS MONITORED AND ENFORCED BY THE BOARD OF DIRECTORS. SPECIFICALLY, THE POLICY REQUIRES A DISCLOSURE OF ANY POTENTIAL CONFLICT TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS THEN REFERS THE POTENTIAL CONFLICT TO THE AUDIT AND COMPLIANCE COMMITTEE TO REVIEW THE MATTER. THE AUDIT AND COMPLIANCE COMMITTEE REVIEWS THE PROPOSED TRANSACTION OR ARRANGEMENT TO DETERMINE IF REASONABLE ALTERNATIVES TO THE PROPOSED TRANSACTION EXIST. BASED ON REVIEW, THE AUDIT AND COMPLIANCE COMMITTEE SHALL APPROVE OR DISAPPROVE THE TRANSACTION. ALL FINDINGS AND ACTIONS TAKEN BY THE AUDIT AND COMPLIANCE COMMITTEE ARE REPORTED TO THE BOARD AT THE NEXT REGULARLY SCHEDULED MEETING OF THE BOARD OF DIRECTORS. IN ADDITION, THE AUDIT AND COMPLIANCE OFFICER IS RESPONSIBLE FOR REVIEWING AND RETAINING ANNUAL DISCLOSURE STATEMENTS COMPLETED BY EACH DIRECTOR, OFFICER, COMMITTEE MEMBER AND KEY EMPLOYEE. |
| FORM 990, PART VI, SECTION B, LINE 15 | ALICE HYDE MEDICAL CENTER (AHMC) HAS A FORMAL PROCESS THAT IS USED TO DETERMINE THE COMPENSATION OF THE CEO ON AN ANNUAL BASIS. THIS PROCESS INCLUDES A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES, ENGAGING AN INDEPENDENT CONSULTANT, PERFORMANCE OF A COMPENSATION SURVEY OR STUDY, REVIEW OF OTHER ORGANIZATION'S 990 FORMS, AND APPROVAL BY THE BOARD OF COMPENSATION COMMITTEE. A WRITTEN EMPLOYMENT AGREEMENT IS ESTABLISHED SETTING FORTH THE COMPENSATION AND BENEFITS OF THE CEO. AHMC PAYS NON-FIXED EARNINGS BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA THAT ARE PROSPECTIVELY AGREED UPON AS GOALS FOR THE CEO. COMPENSATION FOR SENIOR LEADERS IS REVIEWED ANNUALLY, IN ACCORDANCE WITH NATIONAL BENCH MARKETING AND INTERNAL EQUITY WITHIN THE UVM HEALTH NETWORK. REVIEW IS CONDUCTED BY HUMAN RESOURCES, LOCALLY AND NETWORK-WIDE. NON-FIXED EARNINGS OF OTHER OFFICERS ARE BASED ON THE SUCCESS IN MEETING PERFORMANCE CRITERIA AND COMPARATIVE MARKET DATA. IN ADDITION TO THE TOOLS AND PROCESSES IDENTIFIED IN SCHEDULE J, PART I, ALICE HYDE MEDICAL CENTER RECEIVES GUIDANCE REGARDING ITS PRESIDENT'S COMPENSATION FROM THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES OF THE UNIVERSITY OF VERMONT HEALTH NETWORK, WHICH IS THE SOLE MEMBER OF THE HOSPITAL. THAT NETWORK COMPENSATION COMMITTEE UTILIZES THE FOLLOWING METHODS TO ESTABLISH THAT GUIDANCE: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
| FORM 990, PART VI, SECTION C, LINE 18 | THE COMPLETED FORMS 1023, 990, AND 5500 FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN INVESTMENT POOL -470,954. TRANSFER FROM AFFILIATE -425,000. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| UVM HEALTH NETWORK MEDICAL GROUP | |||||||||||
| 111 COLCHESTER AVE | BURLINGTON | VT | 05401 | 030225105 | PHYSICIAN SERVICES | VT | 501(C)(3) | LINE 12B, II | UVMHN | Yes (1) | |
| UNIV OF VT MEDICAL GROUP-NEW YORK | |||||||||||
| 183 PARK STREET | MALONE | NY | 12953 | 203905216 | PHYSICIAN SERVICES | NY | 501(C)(3) | LINE 3 | UVMHNMG | Yes (1) | |
| UNIV OF VT MED CTR FOUNDATION INC | |||||||||||
| 111 COLCHESTER AVE | BURLINGTON | VT | 05401 | 263159849 | FUNDRAISING | VT | 501(C)(3) | LINE 12B, II | UVMMC | Yes (1) | |
| UNIV OF VT MED CTR AUXILLIARY INC | |||||||||||
| 111 COLCHESTER AVE | BURLINGTON | VT | 05401 | 208022004 | SERVICE | VT | 501(C)(3) | LINE 12D, III-O | 0 | N/A | |
| UNIV OF VT HEALTH NETWORK | |||||||||||
| 111 COLCHESTER AVE | BURLINGTON | VT | 05401 | 452880726 | HOLDING COMPANY | VT | 501(C)(3) | LINE 12B, II | 0 | N/A | |
| CENTRAL VT MEDICAL CENTER | |||||||||||
| 111 COLCHESTER AVE | BURLINGTON | VT | 05401 | 222547186 | HOSPITAL | VT | 501(C)(3) | LINE 3 | UVMHN | Yes (1) | |
| UNIVERSITY HEALTH CENTER | |||||||||||
| 111 COLCHESTER AVE | BURLINGTON | VT | 05401 | 030229931 | HOSPITAL | VT | 501(C)(3) | LINE 12D, III-O | UVMHNMG | Yes (1) | |
| COMMUNITY PROVIDERS INC | |||||||||||
| 75 BEEKMAN STREET | PLATTSBURGH | NY | 12901 | 222544844 | HLTH SVC COORD | NY | 501(C)(3) | LINE 12B, II | UVMHN | Yes (1) | |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL | |||||||||||
| 75 BEEKMAN STREET | PLATTSBURGH | NY | 12901 | 141338471 | HOSPITAL | NY | 501(C)(3) | LINE 3 | UVMHN | Yes (1) | |
| ELIZABETHTOWN COMMUNITY HOSPITAL | |||||||||||
| 75 PARK STREET | ELIZABETHTOWN | NY | 12901 | 141364513 | HOSPITAL | NY | 501(C)(3) | LINE 3 | UVMHN | Yes (1) | |
| EMERGENCY MEDICAL TRANSPORT OF CVPH INC | |||||||||||
| 75 BEEKMAN STREET | PLATTSBURGH | NY | 12901 | 061718419 | AMBULANCE SVC | NY | 501(C)(3) | LINE 12C, III-FI | UVMHN | Yes (1) | |
| CVPH MEDICAL CENTER FOUNDATION | |||||||||||
| 75 BEEKMAN STREET | PLATTSBURGH | NY | 12901 | 141727048 | HLTH SVC COORD | NY | 501(C)(3) | LINE 12C, III-FI | CVPH | Yes (1) | |
| LAKE CHAMPLAIN PHYSICIAN SERVICES PC | |||||||||||
| 75 BEEKMAN STREET | PLATTSBURGH | NY | 12901 | 273785445 | PHYSICIAN SERVICES | NY | 501(C)(3) | LINE 12B, II | CVPH | Yes (1) | |
| UNIVERSITY MEDICAL EDUCATION ASSOCIATES | |||||||||||
| 89 BEAUMONT AVENUE | BURLINGTON | VT | 05401 | 237107832 | EDUCATIONAL | VT | 501(C)(3) | LINE 11 | UVMHNMG | Yes (1) | |
| PORTER MEDICAL CENTER INC | |||||||||||
| 115 PORTER DRIVE | MIDDLEBURY | VT | 05753 | 030310862 | SUPPORTING ORG | VT | 501(C)(3) | LINE 12B, II | UVMHN | Yes (1) | |
| HELEN PORTER NURSING HOME | |||||||||||
| 37 PORTER DRIVE | MIDDLEBURY | VT | 05753 | 030306549 | NURSING HOME | VT | 501(C)(3) | LINE 3 | PMC | Yes (1) | |
| AUXILIARY OF PORTER MEDICAL CENTER | |||||||||||
| 37 PORTER DRIVE | MIDDLEBURY | VT | 05753 | 237363227 | SUPPORTING ORG | VT | 501(C)(3) | LINE 12B, II | PMC | Yes (1) | |
| PORTER HOSPITAL INC | |||||||||||
| 37 PORTER DRIVE | MIDDLEBURY | VT | 05753 | 030181058 | HOSPITAL | VT | 501(C)(3) | LINE 3 | PMC | Yes (1) | |
| VMC INDEMNITY COMPANY INC | |||||||||||
| 95 ST PAUL ST | BURLINGTON | VT | 05401 | 831102018 | INSURANCE | VT | 501(C)(3) | LINE 12B, II | UVMHN | Yes (1) | |
| UVMHN HOME HEALTH AND HOSPICE | |||||||||||
| 1110 PRIM ROAD | COLCHESTER | VT | 05446 | 030179603 | HOME HEALTHCARE | VT | 501(C)(3) | LINE 11 | UVMHN | Yes (1) | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ONECARE VT ACCOUNTABLE CARE | ||||||||||
| 111 COLCHESTER AVE | BURLINGTON | VT | 05401 | 455399218 | ACCOUNTABLE CARE | VT | N/A | RELATED | 0 | 0 |
| ADIRONDACK ACO LLC | ||||||||||
| 75 BEEKMAN STREET | PLATTSBURGH | NY | 12901 | 462840926 | ACCOUNTABLE CARE | NY | N/A | NA | 0 | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| UVM HEALTH VENTURES INC | ||||||||||||||
| 111 COLCHESTER AVE | BURLINGTON | VT | 05401 | 043380045 | HOLDING COMPANY | VT | UVMHN | C | 0 | |||||
| VMC INDEMNITY COMPANY LTD | ||||||||||||||
| CAPTIVE INSURANCE | UVMMC | C | 0 | PO BOX HM 3103 | HAMILTON | BD | BD | |||||||
| UVMHN NETWORK CREDENTIALING & ENROLLMENT | ||||||||||||||
| 111 COLCHESTER AVE | BURLINGTON | VT | 05401 | 030333056 | ADMIN SVC | VT | UVMHN VENTURES | C | 0 | |||||
| CHARITABLE REMAINDER TRUST (5) | ||||||||||||||
| SUPPORT | VT | UVMMCCVMC | T | 0 | ||||||||||
| PERPETUAL TRUST (4) | ||||||||||||||
| SUPPORT | VT | UVMMC | T | 0 | ||||||||||
| CHARITABLE IRREVOCABLE TRUST (7) | ||||||||||||||
| SUPPORT | VT | UVMMCCVMC | T | 0 | ||||||||||
| CHAMPLAIN VALLEY HEALTH NETWORK | ||||||||||||||
| 75 BEEKMAN STREET | PLATTSBURGH | NY | 12901 | 161586102 | ADMIN SVC | NY | C | 0 | N/A | |||||
| MEDIQUEST INC | ||||||||||||||
| PO BOX 1656 | PLATTSBURGH | NY | 12901 | 141663061 | MED OFFICE LEASE | NY | C | 0 | N/A | |||||
| YANKEE MEDICAL INC | ||||||||||||||
| 276 NORTH AVENUE | BURLINGTON | VT | 05401 | 030225363 | HOME MEDICAL EQUIPMENT | VT | UVMHN | C | 0 | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (1) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|
| THE UNIVERSITY OF VERMONT MEDICAL CENTER INC | |
| $13,889,075 | FMV |
| CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER | |
| $593,099 | FMV |