ALICE HYDE MEDICAL CENTER: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: ALICE HYDE MEDICAL CENTER (EIN 15-0346515)
Tax period: 2020-10-01 to 2021-09-30
Filed: 2022-08-11
IRS object ID: 202232239349300418
Schema version: 2020v4.2
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 K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2022-08-11T12:20:10-05:00	ReturnTs
Tax Period End	2021-09-30	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	FUST CHARLES CHAMBERS LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	5784 WIDEWATERS PARKWAY	AddressLine1Txt
City	SYRACUSE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	13214	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-10-01	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	CHRISTOPHER HICKEY	PersonNm
Person Title	SVP/CFO	PersonTitleTxt
Phone	5184833000	PhoneNum
Signature	2022-08-10	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	CHRISTOPHER	PersonFirstNm
Person Last	HICKEY	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	2022-08-10	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	CHRISTOPHER HICKEY	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	$102,169,059	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	11	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	934	TotalEmployeeCnt
Total Volunteers	3	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$11,454,304	PYContributionsGrantsAmt
CY Contributions Grants	$3,584,173	CYContributionsGrantsAmt
PY Program Service Revenue	$78,564,107	PYProgramServiceRevenueAmt
CY Program Service Revenue	$88,387,739	CYProgramServiceRevenueAmt
PY Investment Income	$128,961	PYInvestmentIncomeAmt
CY Investment Income	$28,594	CYInvestmentIncomeAmt
PY Other Revenue	$9,235,109	PYOtherRevenueAmt
CY Other Revenue	$10,158,497	CYOtherRevenueAmt
PY Total Revenue	$99,382,481	PYTotalRevenueAmt
CY Total Revenue	$102,159,003	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	$61,392,080	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$61,678,177	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$37,270,166	PYOtherExpensesAmt
CY Other Expenses	$40,846,844	CYOtherExpensesAmt
PY Total Expenses	$98,662,246	PYTotalExpensesAmt
CY Total Expenses	$102,525,021	CYTotalExpensesAmt
PY Revenues Less Expenses	$720,235	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$366,018	CYRevenuesLessExpensesAmt
Total Assets BOY	$86,331,725	TotalAssetsBOYAmt
Total Assets EOY	$84,353,502	TotalAssetsEOYAmt
Total Liabilities BOY	$59,567,017	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$57,326,608	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$26,764,708	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$27,026,894	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	$82,708,678	ExpenseAmt
Revenue	$98,143,545	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 1,054 PATIENTS ADMITTED. PROVIDED 490,579 OUTPATIENT ANCILLARY PROCEDURES, PROVIDED 93,443 PHYSICIAN OFFICE VISITS, AND PROVIDED 43,962 DAYS OF SKILLED NURSING FACILITY CARE. 9,972 DAYS OF ASSISTED LIVING FACILITY CARE WAS ALSO PROVIDED DURING THE PERIOD.	Desc
Total Program Service Expenses	$82,708,678	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	Yes (1)	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	Yes (1)	TaxExemptBondsInd
Invest Tax Exempt Bonds	0	InvestTaxExemptBondsInd
Escrow Account	0	EscrowAccountInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
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	Yes (1)	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	83	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	934	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	11	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	CHRISTOPHER HICKEY SVPCFO	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 (20 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
BRIAN MONETTE
CHAIRMAN	10.00	Yes (X)	Yes (X)	$0	$0	$0
KEVIN HART
SECRETARY	10.00	Yes (X)	Yes (X)	$0	$0	$0
ROBERT G MAIN JR
VICE CHAIR	10.00	Yes (X)	Yes (X)	$0	$0	$0
EMILE BENARDOT MD
BOARD MEMBER	10.00	Yes (X)		$0	$0	$0
NICHOLAS EELLS CPA
BOARD MEMBER	10.00	Yes (X)		$0	$0	$0
PAUL KOEHLER
BOARD MEMBER	10.00	Yes (X)		$0	$0	$0
CAROL MCKEE
BOARD MEMBER	10.00	Yes (X)		$0	$0	$0
MARINA MEDVED DO
BOARD MEMBER	10.00	Yes (X)		$0	$0	$0
THOMAS FITZPATRICK
TREASURER	10.00	Yes (X)	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
MATT JONES
COO	50.00		Yes (X)	$223,595	$0	$27,288
MICHELLE LEBEAU
CEO	2.00		Yes (X)	$0	$558,456	$33,449	48.00
CHRISTOPHER HICKEY
SVP/CFO	8.00		Yes (X)	$0	$405,322	$17,462	42.00
DR LISA MARK
CHIEF MEDICAL OFFICER	8.00		Yes (X)	$0	$320,611	$26,253	40.00
RITA NGUYEN DDS
DENTIST	40.00			$185,764	$0	$13,961		Yes (X)
THOMAS SCMANIA
CRNA	40.00			$200,001	$0	$15,966		Yes (X)
JULIE MARSHALL
AVP	40.00			$180,646	$0	$15,819		Yes (X)
DEBRA PIERCEY
CRNA	10.00			$210,001	$0	$8,547		Yes (X)
JOSEPH ROBINSON
PHYSICIAN	40.00			$181,098	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,181,105	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$1,284,389	TotReportableCompRltdOrgAmt
Total Other Compensation	$158,745	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	78	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
NORTH COUNTRY HEALTHCARE
183 PARK STREET	MALONE	NY	12953	PHYSICIAN FEES	$219,625
MEDICAL SOLUTIONS LLC
PO BOX 850737	MINNEAPOLIS	MN	554850737	PHYSICIAN FEES	$158,888
GERALD CAHILL
81 CONSTABLE STREET	MALONE	NY	12953	PHYSICIAN FEES	$140,800
EMILE BENARDOT
58 ELM STREET	MALONE	NY	12953	PHYSICIAN FEES	$125,500

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	4	CntrctRcvdGreaterThan100KCnt
Fundraising	$39,750	FundraisingAmt
Government Grants	$3,378,274	GovernmentGrantsAmt
All Other Contributions	$166,149	AllOtherContributionsAmt
Total Contributions	$3,584,173	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PATIENT CARE	Desc
Business	622000	BusinessCd
Total Revenue Column	$88,387,739	TotalRevenueColumnAmt
Related Or Exempt Func Income	$88,387,739	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$88,387,739	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$28,594	TotalRevenueColumnAmt
Exclusion	$28,594	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$363,452	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$1,319	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$362,133	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$362,133	TotalRevenueColumnAmt
Exclusion	$362,133	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$49,295	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$39,750	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$8,737	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$40,558	TotalRevenueColumnAmt
Exclusion	$40,558	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
340B REVENUE	900099	$5,501,924	$5,501,924
DSRIP REVENUE	900099	$1,845,429	$1,845,429

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,408,453	TotalRevenueColumnAmt
Related Or Exempt Func Income	$2,408,453	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$9,755,806	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$102,159,003	TotalRevenueColumnAmt
Related Or Exempt Func Income	$98,143,545	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$431,285	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$250,883	TotalAmt
Management And General	$250,883	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$50,723,830	TotalAmt
Program Services	$43,618,280	ProgramServicesAmt
Management And General	$7,105,550	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$1,671,321	TotalAmt
Program Services	$1,402,415	ProgramServicesAmt
Management And General	$268,906	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$5,607,118	TotalAmt
Program Services	$4,713,939	ProgramServicesAmt
Management And General	$893,179	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,425,025	TotalAmt
Program Services	$2,867,431	ProgramServicesAmt
Management And General	$557,594	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$124,548	TotalAmt
Management And General	$124,548	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$95,077	TotalAmt
Management And General	$95,077	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,688,678	TotalAmt
Program Services	$2,164,117	ProgramServicesAmt
Management And General	$524,561	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$112,517	TotalAmt
Management And General	$112,517	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$293,641	TotalAmt
Program Services	$187,901	ProgramServicesAmt
Management And General	$105,740	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,290,357	TotalAmt
Program Services	$825,699	ProgramServicesAmt
Management And General	$464,658	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$138,067	TotalAmt
Program Services	$88,349	ProgramServicesAmt
Management And General	$49,718	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$532,168	TotalAmt
Program Services	$508,668	ProgramServicesAmt
Management And General	$23,500	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,877,245	TotalAmt
Program Services	$3,186,274	ProgramServicesAmt
Management And General	$690,971	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES AND PH	$11,542,602	$7,386,111	$4,156,491
PHYSICIANS	$6,858,044	$5,520,040	$1,338,004
PURCHASED SERVICES	$6,283,453	$6,025,931	$257,522
BAD DEBT EXPENSE	$2,505,180	$2,505,180

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,505,267	TotalAmt
Program Services	$1,708,343	ProgramServicesAmt
Management And General	$2,796,924	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$102,525,021	TotalAmt
Program Services	$82,708,678	ProgramServicesAmt
Management And General	$19,816,343	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$7,733,540	BOYAmt
EOY	$5,567,628	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$23,812,025	BOYAmt
EOY	$22,803,463	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$6,489,078	BOYAmt
EOY	$9,020,323	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$116,693	BOYAmt
EOY	$108,695	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$873,454	BOYAmt
EOY	$1,044,798	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$2,125,014	BOYAmt
EOY	$1,735,101	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$62,435,111	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$23,887,819	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$39,992,037	BOYAmt
EOY	$38,547,292	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$3,441,278	BOYAmt
EOY	$4,069,482	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$15,029	BOYAmt
EOY	$16,283	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$1,733,577	BOYAmt
EOY	$1,440,437	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$86,331,725	BOYAmt
EOY	$84,353,502	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$12,099,607	BOYAmt
EOY	$11,011,978	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$31,643,884	BOYAmt
EOY	$30,802,906	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$15,823,526	BOYAmt
EOY	$15,511,724	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$59,567,017	BOYAmt
EOY	$57,326,608	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	$25,814,960	BOYAmt
EOY	$25,904,127	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$949,748	BOYAmt
EOY	$1,122,767	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$26,764,708	BOYAmt
EOY	$27,026,894	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$86,331,725	BOYAmt
EOY	$84,353,502	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$366,018	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$628,204	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)
Consol And Sep Basis Fincl Stmt	Yes (X)	ConsolAndSepBasisFinclStmtInd

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	$949,748	BeginningYearBalanceAmt
Investment Earnings Or Losses	$173,019	InvestmentEarningsOrLossesAmt
End Year Balance	$1,122,767	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

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 Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

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

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$183,946	BeginningYearBalanceAmt
End Year Balance	$183,946	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	$42,839,591	OtherCostOrOtherBasisAmt
Depreciation	$14,250,961	DepreciationAmt
Book Value	$28,588,630	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$14,492,295	OtherCostOrOtherBasisAmt
Depreciation	$8,759,748	DepreciationAmt
Book Value	$5,732,547	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,052,225	OtherCostOrOtherBasisAmt
Depreciation	$877,110	DepreciationAmt
Book Value	$2,175,115	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$38,547,292	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDesc	AmtAmt
DUE TO RELATED PARTIES	$4,182,011
OTHER LIABILITIES	$1,507,942
THIRD PARTY PAYABLES	$1,874,552
OPERATING LEASE RIGHT-OF-USE-OBLIGATIONS	$549,012
CONTRACT LIABILITY - MEDICARE ACCELERATED PAYMENTS	$7,269,315
FINANCE LEASE	$128,892

Field	Value	IRS element (for citing)
Total Liability	$15,511,724	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$99,662,560	TotalRevEtcAuditedFinclStmtAmt
Other Revenue	$8,737	OtherRevenueAmt
Revenue Not Reported	$8,737	RevenueNotReportedAmt
Revenue Subtotal	$99,653,823	RevenueSubtotalAmt
Other Revenues Not Included	$2,505,180	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$2,505,180	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$102,159,003	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$100,028,578	TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included	$8,737	OtherExpensesIncludedAmt
Expenses Not Reported	$8,737	ExpensesNotReportedAmt
Expenses Subtotal	$100,019,841	ExpensesSubtotalAmt
Other Expenses Not Included	$2,505,180	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$2,505,180	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$102,525,021	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART X, LINE 2:	THE MEDICAL CENTER IS 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 THE MEDICAL CENTER IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE MEDICAL CENTER ACCOUNTS FOR RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC 740, INCOME TAXES, WHICH ADDRESSES HOW TO ACCOUNT FOR AND REPORT THE EFFECTS OF TAXES BASED ON INCOME. NO PROVISION FOR UNCERTAIN TAX POSITIONS HAS BEEN RECORDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2018 THROUGH 2021.
PART XI, LINE 2D - OTHER ADJUSTMENTS:	FUNDRAISING EXPENSE 8,737.
PART XI, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBTS 2,505,180.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	FUNDRAISING EXPENSE 8,737.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BAD DEBTS 2,505,180.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	DECEMBER ONLINE AUCTION	Event1Nm
Gross Receipts Event1	$24,325	GrossReceiptsEvent1Amt
Charitable Contri Event1	$11,750	CharitableContriEvent1Amt
Gross Revenue Event1	$12,575	GrossRevenueEvent1Amt
Other Direct Expenses Event1	$1,216	OtherDirectExpensesEvent1Amt
Event2	SPRING ONLINE AUCTION	Event2Nm
Gross Receipts Event2	$28,220	GrossReceiptsEvent2Amt
Charitable Contri Event2	$12,500	CharitableContriEvent2Amt
Gross Revenue Event2	$15,720	GrossRevenueEvent2Amt
Other Direct Expenses Event2	$710	OtherDirectExpensesEvent2Amt
Other Events Total	1	OtherEventsTotalCnt
Gross Receipts Other Events	$36,500	GrossReceiptsOtherEventsAmt
Charitable Contri Other Events	$15,500	CharitableContriOtherEventsAmt
Gross Revenue Other Events	$21,000	GrossRevenueOtherEventsAmt
Oth Direct Expnss Other Events	$6,811	OthDirectExpnssOtherEventsAmt
Gross Receipts Total	$89,045	GrossReceiptsTotalAmt
Charitable Contributions Tot	$39,750	CharitableContributionsTotAmt
Gross Revenue Total Events	$49,295	GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events	$8,737	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$8,737	DirectExpenseSummaryEventsAmt
Net Income Summary	$40,558	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	$1,491,893	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$379,698	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,112,195	NetCommunityBenefitExpnsAmt
Total Expense	0.01110	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$24,095,281	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$8,660,262	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,435,019	NetCommunityBenefitExpnsAmt
Total Expense	0.15430	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,587,174	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,039,960	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,547,214	NetCommunityBenefitExpnsAmt
Total Expense	0.16540	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$145,188	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$145,188	NetCommunityBenefitExpnsAmt
Total Expense	0.00150	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$145,188	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$145,188	NetCommunityBenefitExpnsAmt
Total Expense	0.00150	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,732,362	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,039,960	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$16,692,402	NetCommunityBenefitExpnsAmt
Total Expense	0.16690	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$2,505,180	BadDebtExpenseAmt
Bad Debt Expense Attributable	$16,012	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$18,076,823	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$23,669,108	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$5,592,285	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	19	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	19	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 (6 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 2019 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 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 2019-2021 COMMUNITY SERVICE PLAN CYCLE: (1) PREVENT CHRONIC DISEASE AND (2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS: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 PRODUCTSPREVENT CHRONIC DISEASE PHYSICAL ACTIVITYACTION PLAN AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR EMPLOYEE WALKING TRAILS - PROMOTE AND PROVIDE MAPS (INSIDE HOSPITAL AND AROUND CAMPUS) MALONE COMMUNITY FUN RUN PROGRAM SPONSORSHIP (SIX WEEKLY EVENTS DURING SUMMER MONTHS).PREVENT CHRONIC DISEASE TOBACCO PREVENTIONACTION PLAN CERTIFIED TOBACCO CESSATION SPECIALIST (CTCS) EMBEDDED IN AHMC PRIMARY CARE PRACTICES 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 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. 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 UTILIZE PRIMARY CARE EMR REMINDER SYSTEM TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. IMPLEMENT FIT-DNA TESTING PROGRAM FOR IMPROVED PATIENT ADHERENCE AND CONVENIENCE WITH COLORECTAL CANCER SCREENINGS. EXPANSION OF CLINIC HOURS BEING PILOTED AT RURAL HEALTH CLINIC IN MOIRA (DWYER HC) TO ENSURE ADDITIONAL ACCESS FOR PATIENTS NEEDING CARE, SCREENINGS, OR TESTING. MEDICAID/MEDICARE INSURANCE ENROLLMENT AGENTS ONSITE FOR PATIENT REFERRALS M-F FROM ED, PRIMARY CARE, AND WALK-IN CLINIC. UTILIZE HIXNY DATA ON PRE-DIABETIC NON-DIAGNOSED INDICATORS BY LAB RESULTS TO IDENTIFY AT-RISK PATIENTS. COLLABORATE WITH CVPH TO ACCESS AND IMPLEMENT DIABETES PREVENTION PROGRAM WITH ACCESS TO CERTIFIED DPP AND HEALTH COACH. PARTICIPATE IN THE ADIRONDACKS ACO POPULATION HEALTH COMMITTEE TO ENSURE A TEAM-BASED APPROACH TO CHRONIC DISEASE CARE MANAGEMENT FOR PATIENTS AT AHMC PRIMARY CARE PRACTICES. AHMC PRIMARY CARE EMR SYSTEM ESTABLISHED WITH EVIDENCE-BASED CLINICAL DECISION SUPPORT REFERENCE AND GUIDELINES FOR PATIENT TREATMENT. UTILIZE AHMC PRACTICE EMR TO EFFECTIVELY MANAGE PATIENT ALERTS, MEASUREMENT AND REPORTING TO IMPROVE CARE DELIVERY. IMPLEMENTATION OF INTEGRATED NETWORK-WIDE EHR (EPIC) AT AHMC IN 2021 TO ENHANCE CARE COORDINATION ACROSS THE ENTIRE CONTINUUM. INSTALLATION OF MEDICAL HOME COMMUNITY RESOURCE SPECIALIST WITHIN AHMC PRIMARY CARE TO TRACK AND REPORT FOLLOW- THROUGH WITH MEDICATION ADHERENCE (BY TARGET YEAR 2) AND PROVIDE PATIENT EDUCATION AND INTERVENTION AS NECESSARY. PARTICIPATE ON NORTH COUNTRY CHRONIC DISEASE PREVENTION COALITION TO IMPLEMENT THE NORTH COUNTRY HEALTHY HEART NETWORK'S (NC HHN) PRE-DIABETES PREVENTION PROGRAM THROUGH THE AHMC PRIMARY CARE SETTING. PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS PROMOTE WELL BEING ACTION PLAN INVESTIGATE THE OPPORTUNITY FOR INTEGRATION OF BEHAVIORAL HEALTH SERVICES INTO THE AHMC PRIMARY CARE RURAL HEALTH CLINIC PRACTICES. DEVELOP A PLAN TO CONSTRUCT A NEW AHMC PRIMARY CARE BUILDING ON CAMPUS, TO DEVELOP A COORDINATED, MULTI-DISCIPLINARY APPROACH TO CARE DELIVERY THAT INCLUDES BEHAVIORAL HEALTH. 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 CREATE EDUCATION SESSIONS FOR PRIMARY CARE PROVIDERS ON OPIOID PRESCRIBING ESTABLISHMENT OF PAIN MANAGEMENT PROGRAM WITH AHMC PAIN MANAGEMENT PROVIDER TO CREATE ACCESS TO SPECIALIZED AND APPROPRIATE CARE OF PATIENTS DEALING WITH CHRONIC PAIN. CONTINUED COORDINATION BETWEEN CRISIS INTERVENTION CENTER AND AHMC ED TO ENSURE PATIENTS RECEIVE THE APPROPRIATE LEVEL OF CARE. INVESTIGATE INCREASED OPPORTUNITIES TO COLLABORATE WITH ST. JOSEPH'S REHABILITATION CENTER. IMPLEMENTATION OF THE NYS PSYCKES SYSTEM IN THE AHMC EMERGENCY DEPARTMENT, PROVIDING ACCESS TO BEHAVIORAL AND MENTAL HEALTH INFORMATION AS WELL AS SUBSTANCE USE INFORMATION FOR MEDICAID PATIENTS WHO ARE TREATING IN THE ED, IN ORDER TO INFORM TREATMENT PLANS AND IMPROVE COORDINATION OF CARE. INVESTIGATE IMPLEMENTATION OF ADDITIONAL SAFE DISPOSAL BOXES ON AHMC CAMPUS OR IN OUTLYING HEALTH CENTER (S). CREATE MEDIA AND PROMOTION AROUND ORGANIZED TAKE BACK DAYS TO ENSURE PUBLIC IS EDUCATED.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 20B:	ON MARCH 23, 2020 THE ORGANIZATION SUSPENDED COLLECTION ACTIVITIES IN RESPONSE TO THE COVID-19 PANDEMIC, IN RECOGNITION OF THE FACT THAT MANY PATIENTS, STAFF AND MEMBERS OF THE WIDER COMMUNITY WOULD FACE FINANCIAL CHALLENGES IN ADDITION TO HEALTH CHALLENGES DURING THE PANDEMIC. COLLECTION ACTIVITIES RESUMED IN JULY 2020.
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 $ 2,505,180.
PART III, LINE 2:	OUR BAD DEBT METHODOLOGY IS BASED ON HISTORICAL AMOUNTS WHICH WERE TYPICALLY 3.5% 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:	ON OCTOBER 1, 2018, THE MEDICAL CENTER ADOPTED, USING THE FULL RETROSPECTIVE APPROACH, ASU 2014-09 AND ASU 2016-08, REVENUE FROM CONTRACTS WITH CUSTOMERS (TOPIC 606) AND REVENUE FROM CONTRACTS WITH CUSTOMERS: PRINCIPAL VERSUS AGENT CONSIDERATIONS (REPORTING REVENUE GROSS VERSUS NET), RESPECTIVELY, WHICH PROVIDES GUIDANCE FOR REVENUE RECOGNITION. THE STANDARD'S CORE PRINCIPLE IS THAT A COMPANY WILL RECOGNIZE REVENUE WHEN IT TRANSFERS PROMISED GOODS OR SERVICES TO CUSTOMERS IN AN AMOUNT THAT REFLECTS THE CONSIDERATION TO WHICH THE COMPANY EXPECTS TO BE ENTITLED IN EXCHANGE FOR THOSE GOODS OR SERVICES. THE MOST SIGNIFICANT CHANGE FROM THE ADOPTION OF THE NEW STANDARD RELATES TO THE ESTIMATION OF IMPLICIT PRICE CONCESSIONS. UNDER THE PREVIOUS STANDARDS, THE ESTIMATE FOR AMOUNTS NOT EXPECTED TO BE COLLECTED BASED UPON HISTORICAL EXPERIENCE, WERE REFLECTED AS PROVISION FOR DOUBTFUL ACCOUNTS, AND PRESENTED SEPARATELY AS AN OFFSET TO NET PATIENT SERVICE REVENUE. UNDER THE NEW STANDARD, THE ESTIMATE FOR AMOUNTS NOT EXPECTED TO BE COLLECTED BASED ON HISTORICAL EXPERIENCE WILL CONTINUE TO BE RECOGNIZED AS A REDUCTION TO NET PATIENT SERVICE REVENUE, HOWEVER, NOT REFLECTED SEPARATELY AS PROVISION FOR DOUBTFUL ACCOUNTS.UNDER THE NEW STANDARD, SUBSEQUENT CHANGES IN ESTIMATE OF COLLECTABILITY DUE TO A CHANGE IN THE FINANCIAL STATUS OF A PAYER, FOR EXAMPLE A BANKRUPTCY, WILL BE RECOGNIZED AS BAD DEBT EXPENSE AND PRESENTED AS AN OPERATING EXPENSE. THE ADOPTION OF THIS GUIDANCE IN 2019, AND AMOUNTS RECOGNIZED AS BAD DEBT EXPENSE AND INCLUDED IN SUPPLIES AND OTHER EXPENSES, DID NOT HAVE A MATERIAL IMPACT ON THE 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 2020 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. AS AN ACCOMMODATION TO PATIENTS AND FAMILIES, COLLECTION ACTIVITY WAS SUSPENDED IN MARCH 2020 IN RECOGNITION OF THE FINANCIAL CHALLENGES ASSOCIATED WITH THE COVID-19 PANDEMIC. COLLECTION ACTIVITIES RESUMED IN JULY 2020.
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 2019-2021 COMMUNITY SERVICE PLAN CYCLE: (1) PREVENT CHRONIC DISEASE AND (2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS: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 PRODUCTSPREVENT CHRONIC DISEASE PHYSICAL ACTIVITYACTION PLAN AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR EMPLOYEE WALKING TRAILS - PROMOTE AND PROVIDE MAPS (INSIDE HOSPITAL AND AROUND CAMPUS) MALONE COMMUNITY FUN RUN PROGRAM SPONSORSHIP (SIX WEEKLY EVENTS DURING SUMMER MONTHS).PREVENT CHRONIC DISEASE TOBACCO PREVENTIONACTION PLAN CERTIFIED TOBACCO CESSATION SPECIALIST (CTCS) EMBEDDED IN AHMC PRIMARY CARE PRACTICES 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 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. 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 UTILIZE PRIMARY CARE EMR REMINDER SYSTEM TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. IMPLEMENT FIT-DNA TESTING PROGRAM FOR IMPROVED PATIENT ADHERENCE AND CONVENIENCE WITH COLORECTAL CANCER SCREENINGS. EXPANSION OF CLINIC HOURS BEING PILOTED AT RURAL HEALTH CLINIC IN MOIRA (DWYER HC) TO ENSURE ADDITIONAL ACCESS FOR PATIENTS NEEDING CARE, SCREENINGS, OR TESTING. MEDICAID/MEDICARE INSURANCE ENROLLMENT AGENTS ONSITE FOR PATIENT REFERRALS M-F FROM ED, PRIMARY CARE, AND WALK-IN CLINIC. UTILIZE HIXNY DATA ON PRE-DIABETIC NON-DIAGNOSED INDICATORS BY LAB RESULTS TO IDENTIFY AT-RISK PATIENTS. COLLABORATE WITH CVPH TO ACCESS AND IMPLEMENT DIABETES PREVENTION PROGRAM WITH ACCESS TO CERTIFIED DPP AND HEALTH COACH. PARTICIPATE IN THE ADIRONDACKS ACO POPULATION HEALTH COMMITTEE TO ENSURE A TEAM-BASED APPROACH TO CHRONIC DISEASE CARE MANAGEMENT FOR PATIENTS AT AHMC PRIMARY CARE PRACTICES. AHMC PRIMARY CARE EMR SYSTEM ESTABLISHED WITH EVIDENCE-BASED CLINICAL DECISION SUPPORT REFERENCE AND GUIDELINES FOR PATIENT TREATMENT. UTILIZE AHMC PRACTICE EMR TO EFFECTIVELY MANAGE PATIENT ALERTS, MEASUREMENT AND REPORTING TO IMPROVE CARE DELIVERY. IMPLEMENTATION OF INTEGRATED NETWORK-WIDE EHR (EPIC) AT AHMC IN 2021 TO ENHANCE CARE COORDINATION ACROSS THE ENTIRE CONTINUUM. INSTALLATION OF MEDICAL HOME COMMUNITY RESOURCE SPECIALIST WITHIN AHMC PRIMARY CARE TO TRACK AND REPORT FOLLOW- THROUGH WITH MEDICATION ADHERENCE (BY TARGET YEAR 2) AND PROVIDE PATIENT EDUCATION AND INTERVENTION AS NECESSARY. PARTICIPATE ON NORTH COUNTRY CHRONIC DISEASE PREVENTION COALITION TO IMPLEMENT THE NORTH COUNTRY HEALTHY HEART NETWORK'S (NC HHN) PRE-DIABETES PREVENTION PROGRAM THROUGH THE AHMC PRIMARY CARE SETTING. PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS PROMOTE WELL BEING ACTION PLAN INVESTIGATE THE OPPORTUNITY FOR INTEGRATION OF BEHAVIORAL HEALTH SERVICES INTO THE AHMC PRIMARY CARE RURAL HEALTH CLINIC PRACTICES. DEVELOP A PLAN TO CONSTRUCT A NEW AHMC PRIMARY CARE BUILDING ON CAMPUS, TO DEVELOP A COORDINATED, MULTI-DISCIPLINARY APPROACH TO CARE DELIVERY THAT INCLUDES BEHAVIORAL HEALTH. 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 CREATE EDUCATION SESSIONS FOR PRIMARY CARE PROVIDERS ON OPIOID PRESCRIBING ESTABLISHMENT OF PAIN MANAGEMENT PROGRAM WITH AHMC PAIN MANAGEMENT PROVIDER TO CREATE ACCESS TO SPECIALIZED AND APPROPRIATE CARE OF PATIENTS DEALING WITH CHRONIC PAIN. CONTINUED COORDINATION BETWEEN CRISIS INTERVENTION CENTER AND AHMC ED TO ENSURE PATIENTS RECEIVE THE APPROPRIATE LEVEL OF CARE. INVESTIGATE INCREASED OPPORTUNITIES TO COLLABORATE WITH ST. JOSEPH'S REHABILITATION CENTER. IMPLEMENTATION OF THE NYS PSYCKES SYSTEM IN THE AHMC EMERGENCY DEPARTMENT, PROVIDING ACCESS TO BEHAVIORAL AND MENTAL HEALTH INFORMATION AS WELL AS SUBSTANCE USE INFORMATION FOR MEDICAID PATIENTS WHO ARE TREATING IN THE ED, IN ORDER TO INFORM TREATMENT PLANS AND IMPROVE COORDINATION OF CARE. INVESTIGATE IMPLEMENTATION OF ADDITIONAL SAFE DISPOSAL BOXES ON AHMC CAMPUS OR IN OUTLYING HEALTH CENTER (S). CREATE MEDIA AND PROMOTION AROUND ORGANIZED TAKE BACK DAYS TO ENSURE PUBLIC IS EDUCATED.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	0	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	$470,774	$0	$87,682	$0	$0	$0	$0	$0	$33,449	$0	$591,905	$0	$0
CHRISTOPHER HICKEY
SVP/CFO	$0	$379,788	$0	$25,534	$0	$0	$0	$0	$0	$17,462	$0	$422,784	$0	$0
DR LISA MARK
CHIEF MEDICAL OFFICER	$0	$320,611	$0	$0	$0	$0	$0	$0	$0	$26,253	$0	$346,864	$0	$0
MATT JONES
COO	$223,595	$0	$0	$0	$0	$0	$3,805	$0	$23,483	$0	$250,883	$0	$0	$0
DEBRA PIERCEY
CRNA	$200,001	$0	$10,000	$0	$0	$0	$0	$0	$8,547	$0	$218,548	$0	$0	$0
THOMAS SCMANIA
CRNA	$200,001	$0	$0	$0	$0	$0	$0	$0	$15,966	$0	$215,967	$0	$0	$0
RITA NGUYEN DDS
DENTIST	$185,764	$0	$0	$0	$0	$0	$5,116	$0	$8,845	$0	$199,725	$0	$0	$0
JULIE MARSHALL
AVP	$168,215	$0	$12,431	$0	$0	$0	$5,746	$0	$10,073	$0	$196,465	$0	$0	$0
JOSEPH ROBINSON
PHYSICIAN	$181,098	$0	$0	$0	$0	$0	$0	$0	$0	$0	$181,098	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 3	FormAndLineReferenceDesc
Explanation	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	ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	FRANKLIN COUNTY CIVIC DEVELOPMENT CORP	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	800627350	BondIssuerEIN
CUSIP	35313PAA0	CUSIPNum
Bond Issued	2013-10-31	BondIssuedDt
Issue Price	$27,375,000	IssuePriceAmt
Purpose	CONSTRUCTION OF 135 BED SKILLED NURSING FACILITY AND 30 BED ASSISTED LIVING	PurposeDesc
Defeased	0	DefeasedInd
On Behalf Of Issuer	0	OnBehalfOfIssuerInd
Pool Financing	0	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$5,830,000	RetiredAmt
Bond Defeased	$1,975,000	BondDefeasedAmt
Total Proceeds	$27,375,000	TotalProceedsAmt
Issuance Costs From Proceeds	$1,675,004	IssuanceCostsFromProceedsAmt
Capital Expenditures	$6,213,316	CapitalExpendituresAmt
Substantial Completion	2015	SubstantialCompletionYr
Refunding Tax Exempt Bonds	0	RefundingTaxExemptBondsInd
Refunding Taxable Bonds	0	RefundingTaxableBondsInd
Final Allocation Made	Yes (1)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (1)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedPropertyInd
Any Lease Arrangements	0	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	0	MgmtContractBondFincdPropInd
Any Research Agreements	0	AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test	0	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd	0	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiledInd
Rebate Not Due Yet	0	RebateNotDueYetInd
Exception To Rebate	0	ExceptionToRebateInd
No Rebate Due	0	NoRebateDueInd
Variable Rate Issue	Yes (1)	VariableRateIssueInd
Hedge Identified In Bks And Rec	0	HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGICInd
Gross Proceeds Invested	0	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	0	ProceduresCorrectiveActionInd

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	$108,695	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	$108,695	TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
MARINA MEDVED
BOARD MEMBER	$219,625	COMPANY CONTRACTED FOR PHYSICIAN SERVICES	0
KIM JONES
SPOUSE OF OFFICER	$88,788	CY 2020 SALARY	0

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 628,204.
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
$15,523,486	FMV
CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER
$1,111,184	FMV