STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

BROOKS-TLC HOSPITAL SYSTEM INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
BROOKS-TLC HOSPITAL SYSTEM INC (EIN 16-0743301)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-09
IRS object ID
202333139349303748
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-09T14:16:47-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN160765486PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LUMSDEN & MCCORMICK LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1369 FRANKLIN STREETAddressLine1Txt
CityBUFFALOCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN160743301EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BROOKS-TLC HOSPITAL SYSTEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBROOBusinessNameControlTxt
Phone7163661111PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1529 CENTRAL AVEAddressLine1Txt
CityDUNKIRKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14048ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKENNETH MORRISPersonNm
Person TitlePRESIDENT AND CEOPersonTitleTxt
Phone7163661111PhoneNum
Signature2023-11-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstKENNETHPersonFirstNm
Person LastMORRISPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJILL M JOHNSON CPAPreparerPersonNm
PTINP01701478PTIN
Phone7168563300PhoneNum
Preparation2023-11-09PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKENNETH R MORRISPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1529 CENTRAL AVEAddressLine1Txt
CityDUNKIRKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14048ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$58,943,976GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.BROOKSHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1898FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionAN ACUTE CARE HOSPITAL SERVING PRIMARILY RESIDENTS OF NORTHWEST CHAUTAUQUA AND SOUTHERN ERIE COUNTIES.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee446TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$904,666TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,362,166PYContributionsGrantsAmt
CY Contributions Grants$6,044,659CYContributionsGrantsAmt
PY Program Service Revenue$37,930,080PYProgramServiceRevenueAmt
CY Program Service Revenue$33,541,995CYProgramServiceRevenueAmt
PY Investment Income$134,216PYInvestmentIncomeAmt
CY Investment Income$124,148CYInvestmentIncomeAmt
PY Other Revenue$7,928,233PYOtherRevenueAmt
CY Other Revenue$19,195,315CYOtherRevenueAmt
PY Total Revenue$50,354,695PYTotalRevenueAmt
CY Total Revenue$58,906,117CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$28,210,488PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$35,314,032CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$22,206,361PYOtherExpensesAmt
CY Other Expenses$23,377,719CYOtherExpensesAmt
PY Total Expenses$50,416,849PYTotalExpensesAmt
CY Total Expenses$58,691,751CYTotalExpensesAmt
PY Revenues Less Expenses-$62,154PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$214,366CYRevenuesLessExpensesAmt
Total Assets BOY$37,825,254TotalAssetsBOYAmt
Total Assets EOY$40,958,282TotalAssetsEOYAmt
Total Liabilities BOY$26,012,513TotalLiabilitiesBOYAmt
Total Liabilities EOY$25,648,135TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,812,741NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$15,310,147NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE O FOR FULL MISSION STATEMENT.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$48,704,671ExpenseAmt
Revenue$51,612,818RevenueAmt
DescNURSING SERVICES - PROVISION OF DAILY CARE INCLUDING INPATIENT AND OUTPATIENT SERVICES WITHIN THE SYSTEM. OTHER PROFESSIONAL SERVICES - ANCILLARY SERVICES PROVIDED WITHIN THE FACILITY INCLUDING LABORATORY, RADIOLOGY, INHALATION THERAPY, ETC.Desc
Total Program Service Expenses$48,704,671TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document117IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee446EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DAWN TURKBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7163637225PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1529 CENTRAL AVENUEAddressLine1Txt
CityDUNKIRKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14048ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
CHRISTOPHER LANSKI
CHAIRMAN2.001.00Yes (X)Yes (X)$0$0$0
JAMES WILD MD
CHAIRMAN ELECT2.001.00Yes (X)Yes (X)$0$0$0
LOUIS DIPALMA
TREASURER2.001.00Yes (X)Yes (X)$0$0$0
NATHAN ALDRICH
SECRETARY2.001.00Yes (X)Yes (X)$0$0$0
DANA ANDERSON MD
MEMBER2.001.00Yes (X)$0$0$0
ANDY BURR
MEMBER2.001.00Yes (X)$0$0$0
TIMOTHY COOPER
MEMBER2.001.00Yes (X)$0$0$0
CHRISTINA JIMERSON
MEMBER2.001.00Yes (X)$0$0$0
KEVIN KEARNS PHD
MEMBER2.001.00Yes (X)$0$0$0
STEPHEN KOLISON JR PHD
MEMBER2.001.00Yes (X)$0$0$0
KENNETH MORRIS
PRESIDENT/CEO40.001.00Yes (X)$172,834$0$12,850
JULIE MORTON
CHIEF NURSING OFFICER40.00Yes (X)$192,976$0$7,619
NAJMUL KHAN
PHYSICIAN40.00$293,713$0$27,577Yes (X)
KENNETH LONG
REGISTERED NURSE40.00$146,255$0$14,316Yes (X)
DAVID HALLASEY-ROBERTS
PHYSICIAN40.00$133,372$0$24,268Yes (X)
LISA BARONE
DIRECTOR OF INFECTION CONTROL40.00$128,681$0$21,345Yes (X)
CAROLINE FEARMAN
REGISTERED NURSE40.00$134,865$0$11,125Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,202,696TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$119,100TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K14IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
TRUSTED NURSE STAFFING LLC
BUFFALO STATIONBUFFALONY14240CONTRACT LABOR$2,247,158
PREMIER ANESTHESIA
2655 NORTHWINDS PARKWAYALPHARETTAGA30009ANESTHESIA SERVICE PROVIDERS$1,364,038
AYA HEALTHCARE INC
5930 CORNERSTONE COUTY WEST SUITESAN DIEGOCA92121CONTRACT LABOR$1,323,040
NASH PHARMACY SERVICES
4912 EAST SHOREWOOD DRIVEDUNKIRKNY14048PHARMACY SERVICES PROVIDER$1,160,945
CHAUTAUQUA PHYSICIANS PLLC
3184 DUTCH HOLLOW ROADBEMUS POINTNY14712HOSPITALIST PROVIDER$949,236
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K19CntrctRcvdGreaterThan100KCnt
Fundraising$45,300FundraisingAmt
Government Grants$5,753,786GovernmentGrantsAmt
All Other Contributions$245,573AllOtherContributionsAmt
Total Contributions$6,044,659TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business622110BusinessCd
Total Revenue Column$33,541,995TotalRevenueColumnAmt
Related Or Exempt Func Income$32,637,329RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$904,666UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$33,541,995TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$144,313TotalRevenueColumnAmt
Exclusion$144,313ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$4,000RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$4,000RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,000TotalRevenueColumnAmt
Exclusion$4,000ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$20,165OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$20,165OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$20,165TotalRevenueColumnAmt
Exclusion-$20,165ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$11,040FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$45,300ContriRptFundraisingEventAmt
Fundraising Direct Expenses$17,694FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$6,654TotalRevenueColumnAmt
Exclusion-$6,654ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
NEW YORK STATE OPERATING SUBSIDIE621990$18,975,489$18,975,489
CAFETERIA AND VENDING900099$135,393$135,393
MISCELLANEOUS900099$87,087$87,087
FieldValueIRS element (for citing)
Other Revenue Total$19,197,969OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$58,906,117TotalRevenueColumnAmt
Related Or Exempt Func Income$51,612,818RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$904,666UnrelatedBusinessRevenueAmt
Exclusion$343,974ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$386,279TotalAmt
Management And General$386,279ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$29,821,052TotalAmt
Program Services$25,658,833ProgramServicesAmt
Management And General$4,162,219ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,369,691TotalAmt
Program Services$938,335ProgramServicesAmt
Management And General$431,356ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,311,056TotalAmt
Program Services$1,563,687ProgramServicesAmt
Management And General$747,369ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,425,954TotalAmt
Program Services$1,212,061ProgramServicesAmt
Management And General$213,893ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$141,409TotalAmt
Program Services$127,268ProgramServicesAmt
Management And General$14,141ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$7,848,439TotalAmt
Program Services$5,769,114ProgramServicesAmt
Management And General$2,079,325ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$56,092TotalAmt
Program Services$50,483ProgramServicesAmt
Management And General$5,609ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$544,597TotalAmt
Program Services$506,062ProgramServicesAmt
Management And General$38,535ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,064,670TotalAmt
Program Services$958,203ProgramServicesAmt
Management And General$106,467ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$58,197TotalAmt
Program Services$52,377ProgramServicesAmt
Management And General$5,820ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$77,975TotalAmt
Program Services$77,975ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,200,369TotalAmt
Program Services$1,080,332ProgramServicesAmt
Management And General$120,037ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$799,606TotalAmt
Program Services$455,405ProgramServicesAmt
Management And General$344,201ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL AND OTHER SUPPL$6,653,780$5,839,913$813,867
PURCHASED SERVICES$3,431,849$3,088,664$343,185
MAINTENANCE AND REPAIRS$781,167$703,897$77,270
EQUIPMENT RENTAL AND LE$490,890$404,786$86,104

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$228,679TotalAmt
Program Services$217,276ProgramServicesAmt
Management And General$11,403ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$58,691,751TotalAmt
Program Services$48,704,671ProgramServicesAmt
Management And General$9,987,080ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,676,414BOYAmt
EOY$2,567,324EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$147,402BOYAmt
EOY$2,256,736EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,957,132BOYAmt
EOY$3,036,368EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,159,204BOYAmt
EOY$1,191,427EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$612,571BOYAmt
EOY$648,407EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$103,575,553LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$93,203,437LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$9,791,101BOYAmt
EOY$10,372,116EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$2,013,171BOYAmt
EOY$1,718,051EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$16,468,259BOYAmt
EOY$19,167,853EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$37,825,254BOYAmt
EOY$40,958,282EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,873,016BOYAmt
EOY$15,422,517EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,237,889BOYAmt
EOY$1,581,935EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,901,608BOYAmt
EOY$8,643,683EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,012,513BOYAmt
EOY$25,648,135EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,608,250BOYAmt
EOY$11,388,350EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,204,491BOYAmt
EOY$3,921,797EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,812,741BOYAmt
EOY$15,310,147EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$37,825,254BOYAmt
EOY$40,958,282EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$214,366ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$3,283,040OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,204,491BeginningYearBalanceAmt
Investment Earnings Or Losses-$774,085InvestmentEarningsOrLossesAmt
Other Expenditures$116,839OtherExpendituresAmt
End Year Balance$4,313,567EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,686,345BeginningYearBalanceAmt
Investment Earnings Or Losses$583,850InvestmentEarningsOrLossesAmt
Other Expenditures$65,704OtherExpendituresAmt
End Year Balance$5,204,491EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,388,422BeginningYearBalanceAmt
Investment Earnings Or Losses$383,900InvestmentEarningsOrLossesAmt
Other Expenditures$85,977OtherExpendituresAmt
End Year Balance$4,686,345EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,870,210BeginningYearBalanceAmt
Investment Earnings Or Losses$640,619InvestmentEarningsOrLossesAmt
Other Expenditures$122,407OtherExpendituresAmt
End Year Balance$4,388,422EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,239,939BeginningYearBalanceAmt
Investment Earnings Or Losses-$285,723InvestmentEarningsOrLossesAmt
Other Expenditures$84,006OtherExpendituresAmt
End Year Balance$3,870,210EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.64160PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.35840TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,041,949OtherCostOrOtherBasisAmt
Book Value$1,041,949BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$28,355,256OtherCostOrOtherBasisAmt
Depreciation$25,380,255DepreciationAmt
Book Value$2,975,001BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,920,664OtherCostOrOtherBasisAmt
Depreciation$2,802,537DepreciationAmt
Book Value$118,127BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$68,743,123OtherCostOrOtherBasisAmt
Depreciation$65,020,645DepreciationAmt
Book Value$3,722,478BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,514,561OtherCostOrOtherBasisAmt
Book Value$2,514,561BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$10,372,116TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
ADVANCES TO RELATED PARTIES$16,272,348
PERPETUAL TRUST ASSETS$2,203,746
OTHER ASSETS$171,915
RIGHT OF USE ASSETS$519,844
FieldValueIRS element (for citing)
Total Book Value Other Assets$19,167,853TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS$99,094
ACCRUED PENSION LIABILITY$8,023,472
LEASE LIABILITIES$521,117
FieldValueIRS element (for citing)
Total Liability$8,643,683TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART V, LINE 4:FormAndLineReferenceDesc
ExplanationTHE USE OF THE ENDOWMENT FUNDS IS FOR CAPITAL PURCHASES.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GOLF TOURNAMENTEvent1Nm
Gross Receipts Event1$56,340GrossReceiptsEvent1Amt
Charitable Contri Event1$45,300CharitableContriEvent1Amt
Gross Revenue Event1$11,040GrossRevenueEvent1Amt
Other Direct Expenses Event1$17,694OtherDirectExpensesEvent1Amt
Gross Receipts Total$56,340GrossReceiptsTotalAmt
Charitable Contributions Tot$45,300CharitableContributionsTotAmt
Gross Revenue Total Events$11,040GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$17,694OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$17,694DirectExpenseSummaryEventsAmt
Net Income Summary-$6,654NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$29,098TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$29,098NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,126,242TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,587,025DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,539,217NetCommunityBenefitExpnsAmt
Total Expense0.11140TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,155,340TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,587,025DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,568,315NetCommunityBenefitExpnsAmt
Total Expense0.11190TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$105,654TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$105,654NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,538TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$15,538NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$114,872TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$112,522DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,350NetCommunityBenefitExpnsAmt
Total Expense0.00000TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$236,064TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$112,522DirectOffsettingRevenueAmt
Net Community Benefit Expns$123,542NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$11,391,404TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,699,547DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,691,857NetCommunityBenefitExpnsAmt
Total Expense0.11400TotalExpensePct

Community Support CommunitySupportGrp

FieldValueIRS element (for citing)
Persons Served224PersonsServedCnt
Total Community Benefit Expns$105,654TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$105,654NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

FieldValueIRS element (for citing)
Persons Served224PersonsServedCnt
Total Community Benefit Expns$105,654TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$105,654NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReportedInd
Bad Debt Expense$1,610,166BadDebtExpenseAmt
Reimbursed By Medicare$6,178,235ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$7,351,843CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,173,608MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BROOKS-TLC HOSPITAL SYSTEM INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1529 CENTRAL AVENUEAddressLine1Txt
CityDUNKIRKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14048ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1BROOKS-TLC HOSPITAL SYSTEM INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTPS://BROOKSHOSPITAL.ORG/PATIENT-INFORMATION/COMMUNITY-HEALTH/OwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLHTTPS://CHQGOV.COMOtherWebsiteURLTxt
Implementation Strategy Adopt0ImplementationStrategyAdoptInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTP://WWW.BROOKSHOSPITAL.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross ChargesYes (1)GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
BROOKS-TLC HOSPITAL SYSTEM, INC.PART V, SECTION B, LINE 5: TO DETERMINE THE MOST RELEVANT HEALTH ISSUES IN CHAUTAUQUA COUNTY, THE CHAUTAUQUA COUNTY COMMUNITY HEALTH PLANNING TEAM (CCCHPT) UTILIZED THREE STRATEGIES: INPUT FROM COMMUNITY MEMBERS, SECONDARY DATA FROM NYSDOH AND OTHER HEALTH RESOURCES, AND INPUT FROM LOCAL CONTENT AREA EXPERTS ACROSS A BROAD RANGE OF AGENCIES AND ORGANIZATIONS INCLUDING THOSE PROVIDING DIRECT HEALTH SERVICES, ADDICTION SERVICES, AGING, SOCIAL SERVICES, AND EDUCATION.COMMUNITY MEMBERS:THE CHAUTAUQUA COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES (CCDHHS) CONDUCTED A COMMUNITY HEATLH SURVEY FROM JANUARY THROUGH APRIL, 2022 TO GATHER INFORMATION ABOUT CHAUTAUQUA COUNTY'S CURRENT HEALTH STATUS, NEEDS, AND ISSUES. THE INPUT PROVIDED BY RESIDENTS HAS INFORMED OUR COMMUNITY HEALTH ASSESSMENT AND COMMUNITY HEALTH IMPROVEMENT PLANS BY JUSTIFYING HOW AND WHERE RESOURCES SHOULD BE USED. ALL COUNTY RESIDENTS WERE ENCOURAGED TO PARTICIPATE IN THE PROCESS BY TAKING THE SURVEY, WHICH WAS AVAILABLE IN ENGLISH AND SPANISH, AND PAPER AND ELECTRONIC VERSIONS. THE SURVEY WAS PROMOTED IN A VARIETY OF WAYS INCLUDING BUT NOT LIMITED TO PRESS RELEASES, MEDIA NOTIFICATION, CHAUTAUQUA COUNTY WEBSITE, PARTNER AGENCY SHARING, AND DISTRIBUTION THROUGH SENIOR MEAL DELIVERIES, SOCIAL MEDIA, EMAIL BLASTS, AND MORE. THE SURVEY TOOK 5-10 MINUTES TO COMPLETE. ALL INDIVIDUAL RESPONSES WERE CONFIDENTIAL. SURVEY RESPONDENTS HAD THE OPPORTUNITY TO PROVIDE CONTACT INFORMATION (NOT LINKED TO SURVEY ANSWERS) TO BE ENTERED TO WIN ONE OF FIVE $40 AMAZON GIFT CARDS THAT WERE GIVEN AWAY BY RANDOM DRAWING.AFTER IDENTIFYING POTENTIAL HEALTH IMPROVEMENT STRATEGIES FOR THE PROPOSED COLLABORATIVE PRIORITY AREAS, THE CCDHHS REACHED OUT TO THE CCCHPT AND HEAD ONE-ON-ONE CONVERSATIONS WITH LOCAL CONTENT AREA EXPERTS TO ENSURE THAT THESE STRATEGIES WERE LOGICAL IN THE CONTEXT OF THE COMMUNITY AND CURRENT EFFORTS.EXPERTS CONSULTED:THE 2022-2024 COMMUNITY HEALTH ASSESSMENT PROCESS INVOLVED A GREAT DEAL OF COLLABORATION WITH LOCAL HOSPITALS AND COMMUNITY PARTNERS. CCCHPT FIRST CONVENED DURING THE 2020-2013 JOINT COMMUNITY HEALTH ASSESSMENT/COMMUNITY SERVICE PLAN PROCESS AND ONCE AGAIN JOINED FORCES TO PROVIDE IMPORTANT INPUT TO THIS PROCESS. INDIVIDUAL MEETINGS WERE HELD WITH ADDITIONAL PARTNERS TO IDENTIFY COMMUNITY NEEDS.THE CCCHPT CORE GROUP INCLUDED THE FOLLOWING ORGANIZATIONS AND REPRESENTATIVES:- BROOKS-TLC HOSPITAL SYSTEM, INC. - TRACEY STEVENS, DIRECTOR OF PRIMARY CARE- CHAUTAUQUA COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES - BREEANNE AGETT, EPIDEMIOLOGIST; SHELLY WELLS, PUBLIC HEALTH PLANNER; CHRISTINE SCHUYLER, DIRECTOR OF HEALTH AND HUMAN SERVICES- CHAUTAUQUA COUNTY DEPARTMENT OF MENTAL HYGIENE - CARMELO HERNANDEZ, DIRECTOR OF MENTAL HYGIENE; RACHEL MEMBER-LUDWIG, PROJECT COORDINATOR- CHAUTAUQUA COUNTY HEALTH NETWORK - JIM SHERRY, EXECUTIVE DIRECTOR- THE CHAUTAUQUA CENTER - MICHAEL PEASE, EXECUTIVE DIRECTOR- UPMC CHAUTAUQUA - CECIL MILLER, ADMINISTRATOR; TONI DEANGELO, DIRECTOR OF COMMUNITY WELLNESS- ALLEGHENY HEALTH NETWORK WESTFIELD MEMORIAL HOSPITAL - RODNEY BUCHANAN, HOSPITAL ADMINISTRATOR
BROOKS-TLC HOSPITAL SYSTEM, INC.PART V, SECTION B, LINE 6A: UPMC CHAUTAUQUAAHN WESTFIELD MEMORIAL HOSPITAL
BROOKS-TLC HOSPITAL SYSTEM, INC.PART V, SECTION B, LINE 6B: THE HEALTH FOUNDATION FOR WESTERN & CENTRAL NEW YORK'S 2022 REPORT COMMUNITY HEALTH NEEDS AND OPPORTUNITIES IN WNY'S SOUTHERN TIER; AND THE 2021 CHAUTAUQUA COUNTY COMMUNITY-LEVEL YOUTH DEVELOPMENT EVALUATION (CLYDE) SURVEY. NEW YORK STATE COMMUNITY HEALTH INDICATOR REPORTS ALSO INFORM OUR CHIP FOCUS AREA OF INTERVENTION.
BROOKS-TLC HOSPITAL SYSTEM, INC.PART V, SECTION B, LINE 11: NEEDS IDENTIFIED:1. PREVENT CHRONIC DISEASE; FOCUS - OBESITY IN ADULTS & CHILDREN.BROOKS-TLC HOSPITAL SYSTEM, INC.'S DIETITIAN PROVIDES A FULL ASSESSMENT/CONSULTATION TO INPATIENTS.2. PROMOTE HEALTH WOMEN, INFANTS & CHILDREN; FOCUS - PRECONCEPTION AND REPRODUCTIVE HEALTH, AND MATERNAL AND INFANT HEALTH. INPATIENT OBSTETRIC SERVIES HAVE BEEN TEMPORARILY SUSPENDED SINCE OCTOBER 4, 2021 DUE TO STAFFING CHALLENGES DESPITE ONGOING RECRUITMENT EFFORTS. PRECIPITOUS DELIVERS ARE MANAGED THROUGH THE EMERGENCY DEPARTMENT.3. PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE; FOCUS - STRENGTHEN INFRASTRUCTURE ACROSS SYSTEMS.BROOKS-TLC HOSPITAL SYSTEM, INC. HAS WORKED TO IMPROVE COMMUNICATION WITH CHAUTAUQUA SUBSTANCE ABUSE RESPONSE PARTNERSHIP TO TREAT SUBSTANCE ABUSE ON MENTAL HEALTH DIAGNOSES SEEN IN THE EMERGENCY ROOM. PATIENTS SEEN IN THE ER RECEIVE REFERRALS FOR FURTHER TREATMENT/COUNSELING TO MENTAL HEALTH AMERICA , PEER RECOVERY SUPPORT SERVICES, CHAUTAUQUA COUNTY MOBILE CRISIS TEAM, AND NY MATTERS.
BROOKS-TLC HOSPITAL SYSTEM, INC.PART V, SECTION B, LINE 24: PATIENTS WHO DO NOT APPLY FOR FINANCIAL ASSISTANCE OR REQUEST A REDUCTION TO THEIR BILL WILL BE CHARGED THE GROSS CHARGE FOR SERVICES PROVIDED.

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:RCC USED AS CALCULATED IN WORKSHEET 2.
PART II, COMMUNITY BUILDING ACTIVITIES:BROOKS-TLC HOSPITAL SYSTEM, INC. ACTIVELY PARTICIPATES IN LOCAL INITIATIVES INVOLVING CHAUTAUQUA COUNTY HEALTH NETWORK. AS A PARTICIPANT IN THESE ORGANIZATIONS THE HOSPITAL IS ABLE TO ASSESS NEED, IMPLEMENT PROGRAMS AND INTERVENTIONS AND FACILITATE COMMUNITY BUILDING AROUND EMERGING HEALTH RELATED ISSUES TO IMPROVE HEALTH OUTCOMES FOR LOCAL AND UNDERSERVED COMMUNITIES.
PART III, LINE 2:RCC USED AS CALCULATED IN WORKSHEET 2 FOR PART III, LINE 2 TO CALCULATE BAD DEBT COST. PATIENT PAYMENTS AND DISCOUNTS ARE NOT COUNTED TOWARD BAD DEBT IF POSTED PRIOR TO AN ACCOUNT BEING TRANSFERRED TO BAD DEBT. ONCE IN BAD DEBT, PATIENT PAYMENTS AND DISCOUNTS ARE USED TO REDUCE BAD DEBT.
PART III, LINE 3:THERE WERE NO PATIENTS TURNED OVER TO BAD DEBT WHO QUALIFIED FOR CHARITY CARE. PATIENTS ELIGIBLE FOR CHARITY CARE WHO OWED BALANCES WERE NOT TURNED OVER TO BAD DEBT EVEN THOUGH THEY DID NOT PAY THEIR BALANCES. BAD DEBTS ARE INCLUDED AS A COMMUNITY BENEFIT COST BECAUSE A HIGH PROPORTION OF BAD DEBT DERIVES FROM PATIENTS WHO ARE NOT ABLE TO PAY FOR SERVICES AND THAT THE PROVISION OF SUCH SERVICES AT A LOSS CONSTITUTES A FORM OF COMMUNITY BENEFIT. IT IS DIFFICULT FOR A HOSPITAL TO DISTINGUISH THESE PATIENTS WHO FAIL TO RESPOND TO ANY COMMUNICATION AND/OR EFFORT TO DETERMINE ELIGIBILITY FOR CHARITY CARE.
PART III, LINE 8:THE ALLOWABLE MEDICARE COSTS WERE TAKEN DIRECTLY FROM COST REPORT WORKSHEET D. IRS REV. RUL. 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT.IN THIS COMMUNITY, MEDICARE IS THE LARGEST PAYER, AND THE HOSPITAL MUST ACCEPT THESE PATIENTS REGARDLESS OF WHETHER THEY MAKE A SURPLUS OR DEFICIT FROM PROVIDING SUCH SERVICES. IF THE MEDICARE PARTICIPATION IS PREMISED ON THIS FACT, THEN PROVIDING MEDICARE SERVICES PROMOTES ACCESS TO HEALTHCARE SERVICES WHICH IS A COMMUNITY BENEFIT.THERE ARE A NUMBER OF LOW-INCOME CONSUMERS RECEIVING MEDICARE.THE ELDERLY ARE OFTEN AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE SERVICES, CMS WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY.MEDICARE PAYMENT ANOMALIES MAY BE PRESENT IN SOME STATES SO EVEN VERY EFFICIENT HOSPITALS ARE UNABLE TO AVOID LOSSES. THUS, LOSSES MAY NOT BE INDICATIVE OF INEFFICIENCY BUT RATHER PROVISION OF A COMMUNITY BENEFIT.
PART III, LINE 9B:PATIENTS THAT QUALIFY FOR THE FAP OUTSTANDING BALANCES ARE SUBJECT TO COLLECTION PRACTICES AS DEFINED IN THE FAP POLICY. IF AFTER COLLECTION ATTEMPTS, THE PATIENT CANNOT PAY THE BALANCE, THE HOSPITAL WILL WORK WITH THE PATIENT ON A PAYMENT PLAN.
PART VI, LINE 2:THE HOSPITAL PARTICIPATES WITH OTHER HEALTHCARE PROVIDERS AND INTERESTED PARTIES IN THE CHAUTAUQUA COUNTY COMMUNITY HEALTH PLANNING TEAM (CCCHPT), THE CHAUTAUQUA CENTER, THE RESOURCE CENTER, CHAUTAUQUA COUNTY OFFICE FOR THE AGING, PREVENTION WORKS, CHAUTAUQUA COUNTY MENTAL HYGIENE, CHAUTAUQUA HEALTH NETWORK, CHAUTAUQUA HOSPICE AND PALLIATIVE CARE, AND THE CHAUTAUQUA COUNTY TRANSPORTATION COALITION, TO ASSESS THE NEED REGIONALLY. IN 2021 AN EXTENSIVE COMMUNITY HEALTH NEEDS ASSESSMENT WAS PERFORMED. SEE SECTION V, PARTS B AND C FOR ADDITIONAL INFORMATION ON THE CHNA.THE HOSPITAL ALSO UTILIZES PATIENT SATISFACTION SURVEY TOOLS AND LOCAL PUBLIC INFORMATION PERTAINING TO POPULATION CHARACTERISTICS AND HEALTH STATUS.
PART VI, LINE 3:1. INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS PROVIDED UPON ADMISSION, IS POSTED ON THE HOSPITAL WEBSITE, THROUGHOUT THE HOSPITAL, AND PROVIDED THROUGH THE CHAUTAUQUA COUNTY HEALTH NETWORK. STAFF IN THE HOSPITAL HAVE ALSO BEEN IN-SERVICED ABOUT THE FINANCIAL ASSISTANCE PROGRAM SO THAT THEY CAN PROVIDE INFORMATION TO PATIENTS AS WELL.2. BROOKS-TLC HOSPITAL SYSTEM, INC. HAS ARRANGED WITH AN AGENCY TO FACILITATE ENROLLING IN THE MEDICAID PROGRAM. THE AGENCY WILL PROVIDE EDUCATION, ASSISTANCE IN COMPLETING THE APPLICATION, AND REPRESENTS THE PATIENT AT THE MEDICAID AGENCY. IN ADDITION, THE AGENCY ASSISTS WITH ENROLLMENT THROUGH THE STATE'S INSURANCE EXCHANGE SITE.3. FINANCIAL ASSISTANCE PROGRAM - BROOKS-TLC HOSPTIAL SYSTEM, INC. CONTINUES TO EDUCATE AND PROVIDE FINANCIAL ASSISTANCE OPTIONS FOR THOSE THAT ARE UNINSURED OR UNABLE TO PAY. IN ADDITION TO THE HOSPITAL'S OWN FINANCIAL ASSISTANCE POLICY BROCHURE, BUSINESS OFFICE PERSONNEL WILL CONTINUE TO DISTRIBUTE BROCHURES DEVELOPED BY CCHN TO ASSIST THE UNINSURED OR UNDERINSURED TO FIND AFFORDABLE HEALTHCARE. PATIENT FINANCIAL SERVICES STAFF WILL CONTINUE TO BE EDUCATED REGARDING ALL AVAILABLE ASSISTANCE IN OBTAINING HEALTH INSURANCE.
PART VI, LINE 4:THE HOSPITAL'S PRIMARY SERVICE AREA IS NORTHERN CHAUTAUQUA COUNTY IN NEW YORK AND INCLUDES THE CITY & TOWN OF DUNKIRK, VILLAGES OF FREDONIA, BROCTON, CASSADAGA, FORESTVILLE, AND THE TOWNS OF POMFRET, PORTLAND, STOCKTON, SHERIDAN, AND ARKWRIGHT. THE SECONDARY SERVICE AREA INCLUDES THE TOWNS OF HANOVER, CHERRY CREEK, VILLENOVA AND WESTFIELD.
PART VI, LINE 5:THE BOARD OF TRUSTEES IS A COMMUNITY BOARD, MADE UP ENTIRELY OF CIVIC AND COMMUNITY LEADERS, WHO SERVE VOLUNTARILY. THE BOARD APPOINTS THE CEO, APPROVES BUDGETS, DEVELOPS STRATEGIC PLANS AND PROVIDES OVERSIGHT FOR THE HOSPITAL IN GENERAL. POTENTIAL CONFLICT OF INTEREST BETWEEN BOARD MEMBERS AND THE HOSPITAL ARE REVIEWED ANNUALLY.THE HOSPITAL'S MEDICAL STAFF IS COMPRISED OF QUALIFIED PHYSICIANS FROM WITHIN THE COMMUNITY. THE HOSPITAL CONTRACTS DIRECTLY FOR EMERGENCY ROOM PHYSICIANS, A PATHOLOGIST, A RADIOLOGIST, AN ANESTHESIOLOGIST, AND HOSPITALIST PHYSICIANS, AND EMPLOYS PHYSICIANS FOR THE PRIMARY AND CD CLINICS AND THE HOSPITALIST PROGRAM.THE HOSPITAL OPERATES A FULL-TIME EMERGENCY ROOM OPEN TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY. PATIENTS COME TO THE EMERGENCY ROOM BY THEIR OWN TRANSPORTATION OR BY AMBULANCE FROM EITHER A LOCAL FIRE DEPARTMENT OR AN INDEPENDENT AMBULANCE BUSINESS THAT SERVES THE ENTIRE COUNTY. IN ORDER TO ENSURE 24 HOUR PHYSICIAN COVERAGE IN THE ER, THE HOSPITAL PROVIDES A SUBSIDY TO THE ER PHYSICIAN GROUP. NON EMERGENCY CARE IS PROVIDED BASED UPON PHYSICIAN ORDERS TO ALL PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY.SURPLUS FUNDS ARE INVESTED IN MEDICAL EQUIPMENT UPGRADES AND NEW TECHNOLOGIES THROUGH A CAPITAL BUDGET PROCESS. THERE ARE NO "OWNERS OR STOCKHOLDERS SO NO SURPLUS FUNDS ARE PAID OUT TO OWNERS OR STOCKHOLDERS.THE HOSPITAL WORKS TO ENSURE AN ADEQUATE BLOOD SUPPLY IN THE COMMUNITY AND SURROUNDING AREAS BY HOSTING PERIODIC BLOOD DRIVES IN COOPERATION WITH CONNECT LIFE. THE HOSPITAL STRIVES TO IMPROVE THE QUALITY OF PATIENT CARE BY A VARIETY OF ACCREDITATIONS, SURVEYS AND BENCHMARKS INCLUDING:THE HOSPITAL IS ACCREDITED THROUGH DNV, THE AMERICAN COLLEGE OF RADIOLOGY FOR MAMMOGRAPHY, MRI, CT SCAN, NUCLEAR MEDICINE AND ULTRASOUND, AND THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION FOR THE CARDIAC REHABILITATION DEPARTMENT. THE HOSPITAL TAKES A PROACTIVE APPROACH TO THE PREVENTION OF HOSPITAL-ACQUIRED INFECTIONS, INCLUDING:- INSTITUTION WIDE PROGRAM TO PROMOTE EFFECTIVE HAND WASHING- INSTITUTION WIDE PROGRAM TO REDUCE CATHETER RELATED URINARY TRACT INFECTIONS- INSTITUTION WIDE PROGRAM TO REDUCE CENTRAL LINE INFECTIONS- INSTITUTION WIDE PROGRAM TO REDUCE VENTILATOR-ASSOCIATED INFECTIONS THE HOSPITAL MEETS OR EXCEEDS NATIONAL AND STATE BENCHMARKS FOR THE USE OF ANTIBIOTICS RELATED TO SURGERY.THE HOSPITAL EXCEEDS NATIONAL AND STATE BENCHMARKS FOR THE PREVENTION OF BLOOD CLOTS AFTER SURGERY.THE HOSPITAL UTILIZES BAR CODE MEDICATION ADMINISTRATION TO REDUCE/ELIMINATE MEDICATION ERRORS.THE HOSPITAL USES PATIENT SURVEYS THROUGH BOTH PRESS GANEY AND HCAHPS. AREAS THAT MEASURED BELOW AVERAGE ARE REVIEWED WEEKLY AND BEING ADDRESSED THROUGH:- HOURLY ROUNDING- PRE-OPERATIVE JOINT EDUCATION CLASSES- SURGICAL AMBASSADOR PROGRAM- POST DISCHARGE CALLS TO ASSURE PATIENTS UNDERSTAND THEIR MEDICATION INSTRUCTIONS- CUSTOMER SERVICE TRAINING
PART VI, LINE 6:BROOKS-TLC HOSPITAL SYSTEM, INC. WORKS CLOSELY WITH COMMUNITY ORGANIZATIONS BOTH IN DETERMINING THE HEALTH NEEDS OF THE COMMUNITIES SERVED AS WELL AS DECIDING HOW BEST TO MEET THESE NEEDS. OFFICIALS FROM THE HOSPITAL HAVE BEEN SELECTED TO WORK ON VARIOUS PROJECTS TO FURTHER THIS CAUSE, INCLUDING RESEARCING COMMUNITY HEALTH NEEDS, WORKING WITH LOCAL HEALTH ORGANIZATIONS THROUGHOUT THE COUNTY AND BEYOND, DEVELOPING A FREE COMMUNITY WELLNESS PROGRAM CALLED HEALTHQUEST WNY, PROMOTING HEALTHQUEST WNY AND OTHER HEALTH RELATED EVENTS, DEVELOPING AND PROMOTING HEALTHY LIFESTYLE CLASSES AT OUR FACILITIES, REACHING OUT TO IDENTIFIED POPULATIONS OF NEED, AND MORE.
PART VI, LINE 7, REPORTS FILED WITH STATESNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KENNETH MORRIS
PRESIDENT/CEO$172,834$0$0$0$0$0$11,714$0$1,136$0$185,684$0$0$0
JULIE MORTON
CHIEF NURSING OFFICER$192,976$0$0$0$0$0$6,664$0$955$0$200,595$0$0$0
NAJMUL KHAN
PHYSICIAN$293,713$0$0$0$0$0$14,500$0$13,077$0$321,290$0$0$0
KENNETH LONG
REGISTERED NURSE$146,255$0$0$0$0$0$0$0$14,316$0$160,571$0$0$0
DAVID HALLASEY-ROBERTS
PHYSICIAN$133,372$0$0$0$0$0$6,816$0$17,452$0$157,640$0$0$0
LISA BARONE
DIRECTOR OF INFECTION CONTROL$128,681$0$0$0$0$0$6,404$0$14,941$0$150,026$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE IMISSION TO SERVE OUR COMMUNITIES BY PROVIDING ACCESS TO HIGH QUALITY PERSONALIZED HEALTHCARE VISION OUR VISION IS TO BE A MODEL HEALTH CENTER BY CONTINUALLY LEARNING AND PROVIDING EXTRAORDINARY CARE IN ALL ITS DIMENSIONS: CLINICAL EXCELLENCE: WE WILL DELIVER THE BEST CLINICAL CARE IN A CONSISTENT, INTEGRATED WAY. PATIENT ENGAGEMENT: WE WILL PROVIDE A COMPASSIONATE HEALING EXPERIENCE, AND WE WILL ENGAGE PATIENTS IN DECISIONS ABOUT THEIR HEALTH AND CARE. OPERATIONAL EFFECTIVENESS: WE WILL BE WISE AND CAREFUL STEWARDS OF OUR RESOURCES TO ENABLE EXTRAORDINARY CARE. PHYSICIAN ENGAGEMENT: WE WILL CREATE SYSTEMS AND PROCESSES THAT HELP OUR PHYSICIANS BEST SERVE THEIR PATIENTS. COMMUNITY STEWARDSHIP: WE ARE COMMITTED TO SERVING THE DIVERSE NEEDS OF THE REGION, AND TO PROVIDE GENERALLY AVAILABLE MEDICAL SERVICES TO ALL RESIDENTS, REGARDLESS OF ABILITY TO PAY. EMPLOYEE ENGAGEMENT: WE VALUE OUR EMPLOYEES AS OUR MOST IMPORTANT RESOURCE. VALUES - I CARE INTEGRITY OUR ACTIONS ARE GUIDED BY OUR ETHICAL COMMITMENTS - IN PUBLIC INTERACTIONS AND PRIVATE ACTIONS, WE DEDICATE OURSELVES TO SERVICE IN THE BEST INTERESTS OF OUR PATIENTS, THEIR FAMILIES, OUR HOSPITAL AND OUR COMMUNITY. - WE FOLLOW THROUGH ON OUR COMMITMENTS, HOLDING OURSELVES ACCOUNTABLE TO FULFILL OUR PROFESSIONAL OBLIGATIONS. - WHEN WE RECOGNIZE SOMETHING SEEMS WRONG, INAPPROPRIATE OR INCONSISTENT WITH OUR VALUES OR STANDARDS, WE PROACTIVELY SPEAK UP AND TAKE POSITIVE ACTION. - WE ACT WITH OPENNESS, HONESTY, TRANSPARENCY AND TRUSTWORTHINESS IN OUR COMMUNICATION. -AT ALL TIMES WE RESPECT THE DIGNITY, PRIVACY AND CONFIDENTIALITY OF THOSE WE SERVE. COMPASSION WE PROVIDE EXCELLENCE WITH PERSONAL KINDNESS - WITH UNDERSTANDING AND EMPATHY, WE ANTICIPATE THE NEEDS OF OTHERS AND ACT TO APPROPRIATELY AND MEANINGFULLY MEET THESE NEEDS. - BY ACTIVELY LISTENING TO THE PERSPECTIVES, VALUES AND NEEDS OF OTHERS, WE ACT TO BUILD BRIDGES TOWARD WHOLENESS. - OUR INTERACTIONS ARE CHARACTERIZED BY RESPECT, COURTESY, WARMTH AND PROFESSIONAL DIGNITY. - WE MAINTAIN AN ENGAGED, FOCUSED AND PERSONAL PRESENCE WHILE IN SERVICE TO OTHERS, CREATING AND SUSTAINING A THERAPEUTIC MILIEU. ACCOUNTABILITY WE TAKE RESPONSIBILITY FOR PERSONAL AND TEAM ACTIONS - WE FULLY ADOPT AND EMBRACE OUR CORE PROFESSIONAL IDENTITY AS THOSE WHOSE TALENTS ARE PLACED IN THE SERVICE OF OTHERS FOR THEIR BENEFIT. - IN ALL OUR INTERACTIONS WE DEMONSTRATE THE HIGHEST PROFESSIONAL STANDARDS OF ETHICS, KNOWLEDGE, SKILL AND COMPETENCE IN DECISION-MAKING AND WORK PERFORMANCE. - IN OUR APPEARANCE, DEMEANOR AND DEPORTMENT WE CONTINUOUSLY SEEK TO CONVEY A PROFESSIONAL IMAGE. - WE APPROACH CHALLENGES IN A MANNER THAT REFLECTS PROFESSIONAL MATURITY, CONFIDENCE AND RESPECT. RESPECT WE ADVOCATE FOR THE DIGNITY OF OTHERS - IN OUR BEHAVIOR TOWARD OTHERS, WE DEMONSTRATE RESPECT FOR THE PERSONAL AUTONOMY, INTRINSIC DIGNITY AND WORTH, AND INDIVIDUAL UNIQUENESS OF EACH PERSON WE SERVE, AND THOSE WITH WHOM WE SERVE. - WE VALUE THE RICH DIVERSITY OF PERSONAL EXPERIENCE, CULTURAL INSIGHT, PROFESSIONAL IDENTITY AND TRAINING IN ACHIEVING COLLABORATIVE GOALS. - WE DEMONSTRATE OUR CONSIDERATION FOR OTHERS BY REGARDING WITH EMPATHY THE FEELINGS AND NEEDS OF OTHERS, AND REGARDING WITH INSIGHT THE EFFECT ON OTHERS OF OUR OWN BEHAVIOR. - WE ACTIVELY SEEK OUT OPPORTUNITIES TO DEMONSTRATE OUR REGARD AND APPRECIATION FOR OTHERS. EXCELLENCE COMMITMENT TO QUALITY, INNOVATION AND CONTINUOUS IMPROVEMENTS - WE CONTINUOUSLY CHALLENGE THE STATUS QUO IN THE RELENTLESS PURSUIT OF EXCELLENCE. - WE UTILIZE QUANTITATIVE AND QUALITATIVE INFORMATION TO FORM THE BASIS FOR MEASURABLE AND DEMONSTRABLE IMPROVEMENTS IN OUTCOMES. - EACH OF US DEMONSTRATES A PERSONAL COMMITMENT TO THE HIGHEST STANDARDS OF SAFETY, QUALITY AND SERVICE. - INDIVIDUALLY, AND AS HIGH PERFORMING TEAMS, WE CONSCIENTIOUSLY WORK TO BETTER OUR BEST ON A DAILY BASIS. - WE ACTIVELY EMBRACE CHANGE IN THE CONTINUOUS PURSUIT OF INNOVATION AND SUPERIOR CARE.
FORM 990, PART VI, SECTION A, LINE 7BTHE DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO APPROVAL OF BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 IS PREPARED AND REVIEWED BY VARIOUS INDIVIDUALS WITHIN MANAGEMENT AND PROVIDED TO THE GOVERNING BODY PREVIOUS TO ITS FILING WHEN TIME ALLOWS OR AT ITS NEXT MEETING WHEN TIME DOES NOT PERMIT REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CDEPARTMENT MANAGERS, ADMINISTRATION, BOARD MEMBERS, AND MATERIAL MANAGEMENT EMPLOYEES SIGN A CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS.
FORM 990, PART VI, SECTION B, LINE 15THE PRESIDENT/CEO'S AND OTHER EXECUTIVES' COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD. WAGES AND INCREASES ARE COMPARED TO INDUSTRY STANDARDS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC ON THE HOSPITAL WEBSITE (WWW.BROOKSHOSPITAL.ORG) AND CERTAIN DOCUMENTS ARE AVAILABLE AT THE HOSPITAL AND AT PHYSICIANS' OFFICES.
FORM 990, PART IX, LINE 11GCOLLECTION FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 219,586. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 219,586. PHYSICIAN AND OTHER HEALTHCARE PROVIDER FEES: PROGRAM SERVICE EXPENSES 5,204,230. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,204,230. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 674,853. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 674,853. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 564,884. MANAGEMENT AND GENERAL EXPENSES 123,944. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 688,828. MAINTENANCE CONTRACTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,060,942. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,060,942.
FORM 990, PART XI, LINE 9:NET CHANGE IN FUNDS HELD IN TRUST -804,913. PENSION LIABILITY ADJUSTMENT 4,087,953.
FORM 990, PART XII, LINE 2CTHE BOARD OF DIRECTORS ASSUME RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
LAKE SHORE NURSING HOME INC
845 ROUTES 5 20IRVINGNY14081160976895SKILLED NURSING FACILITYNY501(C)(3)LINE 3BROOKS-TLC HEALTH SYSTEM INC0
LSP CORPORATION
845 ROUTES 5 20IRVINGNY14081222827314REAL ESTATE - MEDICAL AND ADMINISTRATIVE OFFICE FACILITYNY501(C)(3)LINE 3BROOKS-TLC HEALTH SYSTEM INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1LAKE ERIE MEDICAL SERVICES PCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1529 CENTRAL AVENUEAddressLine1Txt
CityDUNKIRKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP14048ZIPCd
FieldValueIRS element (for citing)
EIN452832259EIN
Primary ActivitiesPHYSICIAN GROUPPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd