BLYTHEDALE CHILDRENS HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- BLYTHEDALE CHILDRENS HOSPITAL (EIN 13-1739922)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202243199349313359
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T12:42:24-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO JERICHO PLAZA | AddressLine1Txt |
| City | JERICHO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11753 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 131739922 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLYTHEDALE CHILDREN'S HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BLYT | BusinessNameControlTxt |
| Phone | 9145927555 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 BRADHURST AVE | AddressLine1Txt |
| City | VALHALLA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10595 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN CANNING | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9148312412 | PhoneNum |
| Signature | 2022-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOHN | PersonFirstNm |
| Person Last | CANNING | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRISTINE KAWECKI | PreparerPersonNm |
| PTIN | P00743140 | PTIN |
| Phone | 5169187000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LARRY L LEVINE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 BRADHURST AVE | AddressLine1Txt |
| City | VALHALLA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10595 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $245,646,179 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BLYTHEDALE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1891 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | BLYTHEDALE CHILDREN'S HOSPITAL IS DEDICATED TO IMPROVING THE HEALTH & WELL-BEING OF CHILDREN. | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 21 | VotingMembersIndependentCnt |
| Total Employee | 656 | TotalEmployeeCnt |
| Total Volunteers | 32 | TotalVolunteersCnt |
| Total Gross UBI | $25,946 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $23,834 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $11,475,558 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,870,589 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $72,083,602 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $85,869,006 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,513,835 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,380,157 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,536,755 | PYOtherRevenueAmt |
| CY Other Revenue | $4,291,706 | CYOtherRevenueAmt |
| PY Total Revenue | $90,609,750 | PYTotalRevenueAmt |
| CY Total Revenue | $102,411,458 | 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 | $56,778,834 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $57,665,546 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $779,244 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $28,620,793 | PYOtherExpensesAmt |
| CY Other Expenses | $30,875,465 | CYOtherExpensesAmt |
| PY Total Expenses | $85,399,627 | PYTotalExpensesAmt |
| CY Total Expenses | $88,541,011 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,210,123 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $13,870,447 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $255,207,206 | TotalAssetsBOYAmt |
| Total Assets EOY | $271,989,720 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $47,861,193 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $37,176,774 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $207,346,013 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $234,812,946 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BLYTHEDALE CHILDREN'S HOSPITAL IS DEDICATED TO IMPROVING THE HEALTH & WELL-BEING OF CHILDREN. BLYTHEDALE IS A LEADER IN THE DIAGNOSIS & TREATMENT OF CHILDREN WITH DISABLING AND COMPLEX MEDICAL CONDITIONS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $50,577,367 | ExpenseAmt |
| Revenue | $59,701,785 | RevenueAmt |
| Desc | INPATIENT SERVICES - BLYTHEDALE CHILDREN'S HOSPITAL, FOUNDED IN 1891, IS A LICENSED ACUTE CARE FREE-STANDING CHILDREN'S HOSPITAL THAT SPECIALIZES IN THE CARE OF CHILDREN REQUIRING REHABILITATIVE, RESPIRATORY AND COMPLEX MEDICAL CARE. BLYTHEDALE IS DESIGNATED BY CMS AS A PPS EXEMPT, FREESTANDING CHILDREN'S HOSPITAL. WITHIN BLYTHEDALE CHILDREN'S HOSPITAL, WE PROVIDE A COMPREHENSIVE RANGE OF SERVICES WHICH INCLUDE BUT ARE NOT LIMITED TO GENERAL PEDIATRICS, ADOLESCENT MEDICINE, PEDIATRIC PULMONOLOGY, CHILD NEUROLOGY, PSYCHIATRY, ORTHOPEDICS, PHYSICAL MEDICINE, REHABILITATION OF MULTIPLE PEDIATRIC SPECIALTIES (SUCH AS CARDIOLOGY, INFECTIOUS DISEASE, ENT, OPHTHALMOLOGY, ETC.) BLYTHEDALE MAINTAINS A CORE GROUP OF FULL-TIME SPECIALTY COVERAGE IN PEDIATRICS, PULMONOLOGY, ADOLESCENT MEDICINE, NEUROLOGY, AND PSYCHIATRY. OTHER SUBSPECIALTY COVERAGE IS MAINTAINED AND UTILIZED AS NEEDED THROUGH A VARIETY OF CONTRACTUAL RELATIONSHIPS WITH THE AREA'S LEADING ACADEMIC MEDICAL CENTERS. BLYTHEDALE ALSO PROVIDES OTHER VITAL CLINICAL SERVICES SUCH AS NURSING, RESPIRATORY THERAPY, PSYCHOLOGY, CHILD LIFE, RESPIRATORY, SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY, THERAPEUTIC RECREATION, SOCIAL WORK AND CASE MANAGEMENT. THE INPATIENT SERVICES ARE PRIMARILY COMPOSED OF 5 MAJOR PROGRAMS, PHYSICAL MEDICINE AND REHABILITATION SERVICES, VENTILATOR WEANING, TRAUMATIC BRAIN INJURY, FEEDING THERAPY, AND MEDICAL THERAPIES FOR COMPLEX AND CHRONIC HEALTH CONDITIONS.IN 2021, THE HOSPITAL OPERATED 94 LICENSED ACUTE BEDS, AND 24 PEDIATRIC LONG TERM CARE BEDS FOR A TOTAL OF 118 LICENSED BEDS. IN 2021 THE HOSPITAL ADDED 8 ACUTE TBI BEDS, MAKING BLYTHEDALE THE LARGEST INPATIENT POST-ACUTE TBI PROGRAM IN THE REGION. THE HOSPITAL PROVIDED CARE TO OVER 353 INPATIENTS THROUGHOUT 2021. THE HOSPITAL RAN AN AVERAGE DAILY CENSUS OF 80.3 IN 2021. BLYTHEDALE RECEIVED OVER 848 REGIONAL REFERRALS IN THE YEAR AND HAD 397 ADMISSIONS. OVER 79% OF OUR SERVICES WERE REIMBURSED THROUGH THE MEDICAID PROGRAM IN 2021. 100% OF BLYTHEDALE'S INPATIENT POPULATION IS REFERRED IN FROM OTHER ACUTE CARE HOSPITALS IN THE REGION, OF WHICH 56% ARE REFERRED DIRECTLY FROM INTENSIVE CARE UNITS (ICU'S). THIS SPEAKS TO THE HIGH ACUITY OF THE PATIENT POPULATION MANAGED AT BLYTHEDALE. IN 2021 ALMOST 71% OF PATIENTS TREATED WERE BELOW THE AGE OF 6 YEARS. THIS FACT PRESENTS MANY UNIQUE CHALLENGES TO THE DELIVERY OF CARE AS THE HOSPITAL PROVIDES HIGH QUALITY TO BOTH THE PATIENTS AND THE FAMILY. WE ARE PROUD THAT BLYTHEDALE DISCHARGES OVER 91% OF OUR KIDS BACK TO THEIR HOME AFTER ADMISSION. BLYTHEDALE CHILDREN'S HOSPITAL DOESN'T OPERATE PRIMARY CARE CLINICS, AN EMERGENCY DEPARTMENT OR OBSTETRICAL SERVICES. THESE SERVICES ARE OFTEN THE PRIMARY DRIVERS OF UNINSURED PATIENTS AT ACUTE CARE HOSPITALS. SECONDLY, CHILDREN, MORE SO THAN ADULTS HAVE GREATER ACCESS TO MEDICAID & CHILD HEALTH PLUS (CHP) REIMBURSEMENT AS A PAYER OF LAST RESORT IN NEW YORK STATE. THESE TWO FACTORS SIGNIFICANTLY IMPACT THE REPORTED AMOUNT OF CARE CLASSIFIED AS TRUE CHARITY CARE RELATIVE TO FULL SERVICE ACUTE CARE HOSPITALS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $14,969,706 | ExpenseAmt |
| Revenue | $13,828,914 | RevenueAmt |
| Desc | THE STEVEN AND ALEXANDRA COHEN PEDIATRIC LONG TERM CARE PAVILION, WHICH OPENED IN FALL 2016, IS A UNIQUE 24-BED FACILITY DEDICATED TO THE HIGHLY SPECIALIZED NEEDS OF INFANTS AND CHILDREN WHO REQUIRE EXTENDED MEDICAL CARE AND REHABILITATION. IN 2021, THE HOSPITAL CARED FOR 27 CHILDREN AND RAN AN AVERAGE OCCUPANCY OF 99%. 45% OF THE CHILDREN WERE UNDER THE AGE OF 6, 100% WERE REIMBURSED THROUGH THE MEDICAID PROGRAM AND 100% REQUIRED VENTILATOR-RESPIRATORY SUPPORT. THE PAVILION SERVES CHILDREN WITH COMPLEX MEDICAL NEEDS, INCLUDING THOSE WHO REQUIRE A LONGER PERIOD OF TIME TO BE WEANED FROM THE VENTILATOR, AND PREMATURE INFANTS WITH FEEDING DIFFICULTIES, CONGENITAL CONDITIONS OR NEUROLOGICAL DISORDERS. THE PAVILION IS STAFFED BY A FULL-TIME PEDIATRICIAN WHO WORKS IN CONSULTATION WITH A VARIETY OF PEDIATRIC SUBSPECIALISTS INCLUDING PEDIATRIC PULMONOLOGY, PEDIATRIC PHYSICAL MEDICINE AND REHABILITATION, AND PEDIATRIC NEUROLOGY. THE COMPREHENSIVE TEAM ALSO INCLUDE REGISTERED NURSES, CERTIFIED RESPIRATORY THERAPISTS, PHYSICAL/OCCUPATIONAL/SPEECH THERAPISTS, RECREATIONAL THERAPISTS, CHILD PSYCHOLOGISTS, CHILD LIFE SPECIALISTS AND A DEDICATED SOCIAL WORKER. FEATURES OF THE PAVILION INCLUDE 11 DOUBLE-BEDDED ROOMS AND TWO PRIVATE ROOMS, ALL WITH PIPED-IN OXYGEN, A SPACIOUS DINING AND RECREATION AREA, DEDICATED THERAPY SPACE, AN INFANT PLAYROOM AND TEEN LOUNGE. AN ATTRACTIVE COURTYARD INCLUDES PLAY AREAS, WALKING PATHS AND SITTING AREAS FOR RESIDENTS AND THEIR FAMILIES. CHILDREN IN THE PEDIATRIC LONG TERM CARE UNIT HAVE ACCESS TO EDUCATION THROUGH THE ON-SITE MT. PLEASANT-BLYTHEDALE SCHOOL AND EARLY CHILDHOOD CENTER, AND RECREATIONAL PROGRAMMING ON EVENINGS, WEEKENDS AND HOLIDAYS. FAMILY INVOLVEMENT IS A KEY COMPONENT OF CARE AT BLYTHEDALE, AND PROGRESS TOWARD GOALS (ESTABLISHED UPON ADMISSION) WILL BE REVIEWED DURING PERIODIC FAMILY CONFERENCES. AN INTERDISCIPLINARY APPROACH TO TREATMENT IS A HALLMARK OF BLYTHEDALE, AND EACH PATIENT'S CLINICAL CARE TEAM WILL MEET EVERY TWO WEEKS TO DISCUSS THE INDIVIDUALIZED PLAN FROM EVERY PERSPECTIVE: MEDICAL, SOCIAL, PSYCHOLOGICAL, AND EDUCATIONAL. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,772,178 | ExpenseAmt |
| Revenue | $10,238,178 | RevenueAmt |
| Desc | THE DAY HOSPITAL PROGRAM - BLYTHEDALE OFFERS A DAY HOSPITAL PROGRAM FOR THOSE CHILDREN WHO ARE ABLE TO LIVE AT HOME, BUT STILL REQUIRE A LEVEL OF MEDICAL AND REHABILITATIVE CARE THAT CANNOT BE MET BY THEIR SCHOOL OR OUTPATIENT PROGRAM. IN 2021, BLYTHEDALE TREATED 195 CHILDREN IN THE PROGRAM. THE PROGRAM CONTINUED TO BE IMPACTED BY COVID THROUGH 2021, BUT THE HOSPITAL MANAGED TO CONTINUE TREATING OUR MEDICALLY FRAGILE CHILDREN THROUGH A MIX OF ON-SITE THERAPY AND TELETHERAPY. ROUGHLY 30+ % OF THE PROGRAM COMES DIRECTLY FROM BLYTHEDALE'S INPATIENT SETTING, WHILE THE BALANCE COME DIRECTLY FROM REFERRALS IN THE COMMUNITY AND THROUGH THE EARLY INTERVENTION/CPSE PROGRAMS THROUGHOUT THE REGION. IN 2021, THE DAY HOSPITAL SERVED ON AVERAGE OF 94 PATIENTS PER SCHOOL DAY FOR A TOTAL OF 16,995 VISITS. OVER 80+% OF THESE PATIENTS WERE REIMBURSED BY THE MEDICAID PROGRAM. THE DAY HOSPITAL PROGRAM PROVIDES A NURTURING ENVIRONMENT WHERE CHILDREN WITH VARIOUS SPECIAL MEDICAL NEEDS CAN RECEIVE DAILY MEDICAL SUPERVISION, NURSING CARE, AND HAVE THEIR NEEDS FOR PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES MET, ALL WHILE RETURNING HOME AT THE END OF THE DAY. EACH CHILD'S PROGRAM IS INDIVIDUALIZED TO ADDRESS THEIR UNIQUE MEDICAL, PSYCHOLOGICAL AND THERAPEUTIC NEEDS. IN ADDITION, EVERY CHILD IS ASSIGNED A SOCIAL WORKER TO PROVIDE FAMILY SUPPORT AND CASE MANAGEMENT. AS NECESSARY, ONGOING PSYCHOSOCIAL SUPPORT AND COUNSELING, AND CASE MANAGEMENT ARE PROVIDED. SERVICES FOR SCHOOL-AGE CHILDREN ARE PROVIDED IN CONJUNCTION WITH A FULL ACADEMIC PROGRAM UNDER THE AUSPICES OF THE MOUNT PLEASANT-BLYTHEDALE UNION FREE SCHOOL DISTRICT.THE CPSE PROGRAM - COMMITTEE ON PRESCHOOL SPECIAL EDUCATION (CPSE PROGRAM): BLYTHEDALE CHILDREN'S HOSPITAL PROVIDES EVALUATION AND TREATMENT SERVICES FOR YOUNG CHILDREN BETWEEN THE AGES OF 3 TO 5 YEARS WHO ARE REFERRED THROUGH THEIR LOCAL COMMITTEE ON PRESCHOOL SPECIAL EDUCATION (CPSE). THESE PATIENTS ARE ELIGIBLE FOR ASSESSMENT AT NO COST TO THEIR FAMILIES. THE NEW YORK STATE EDUCATION DEPARTMENT OVERSEES A STATEWIDE PRESCHOOL SPECIAL EDUCATION PROGRAM WITH SCHOOL DISTRICTS, MUNICIPALITIES, APPROVED PROVIDERS, AND PARENTS. EVALUATIONS AND SERVICES ARE PROVIDED TO ELIGIBLE CHILDREN WHO HAVE A DISABILITY THAT AFFECTS THEIR LEARNING. FUNDING FOR EVALUATIONS AND SERVICES IS PROVIDED BY MUNICIPALITIES AND THE STATE. IN 2021, THE PROGRAM SERVED 34 PATIENTS FOR A TOTAL OF 3,449 VISITS. EVALUATION AND TREATMENT PLANNING ARE PERFORMED BY A MULTIDISCIPLINARY TEAM THAT MAY CONSIST OF THERAPISTS, SPECIAL EDUCATION TEACHERS, AUDIOLOGISTS, PHYSIATRISTS (REHABILITATION DOCTORS), NEUROLOGISTS, PSYCHIATRISTS, PSYCHOLOGISTS, SOCIAL WORKERS, NURSES, NUTRITIONISTS, AND OTHER SPECIALTY CONSULTANTS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,280,603 | ExpenseAmt |
| Revenue | $2,565,340 | RevenueAmt |
| Desc | IN 2021, THE HOSPITAL PROVIDED 4,328 OUTPATIENT THERAPY, TELETHERAPY, AND SPECIALTY CLINIC VISITS TO 869 CHILDREN IN THE REGION. BLYTHEDALE CHILDREN'S HOSPITAL IS WELL SUITED TO PROVIDE EVALUATION AND TREATMENT SERVICES FOR YOUNG CHILDREN. AS THE REGION'S PREMIERE HOSPITAL OFFERING REHABILITATIVE SERVICES TO CHILDREN, WE HAVE THE LARGEST DEPARTMENTS OF SPEECH THERAPY, OCCUPATIONAL THERAPY AND PHYSICAL THERAPY. THE EXPERTISE OF OUR HIGHLY SKILLED, MULTIDISCIPLINARY STAFF ENABLES US TO PROVIDE COORDINATED, COMPREHENSIVE, INDIVIDUALIZED PROGRAMS FOR THE CHILDREN AND FAMILIES WE SERVE. PARENTS AND STAFF WORK CLOSELY TOGETHER TO DEVELOP GOALS. EVALUATION AND TREATMENT PLANNING ARE PERFORMED BY A MULTI-DISCIPLINARY TEAM THAT MAY CONSIST OF THERAPISTS, PHYSIATRISTS (REHABILITATION DOCTORS), NEUROLOGISTS, PSYCHIATRISTS, PSYCHOLOGISTS, SPECIAL EDUCATION, TEACHERS, AUDIOLOGISTS, SOCIAL WORKERS, NURSES, NUTRITIONISTS, AND OTHER SPECIALTY CONSULTANTS. WHILE NOT LIMITED TO THE FOLLOWING, THE PROGRAM TREATS A WIDE ARRAY OF ISSUES AND DIAGNOSES INCLUDING DELAYS OR LAGS IN REACHING THEIR DEVELOPMENTAL MILESTONES, CONGENITAL OR ACQUIRED ABNORMALITIES SUCH AS VISION OR HEARING IMPAIRMENTS, DIAGNOSED MEDICAL CONDITIONS SUCH AS CEREBRAL PALSY, NEUROMUSCULAR OR OTHER NEUROLOGICAL DISORDERSBLYTHEDALE CHILDREN'S HOSPITAL IS A DOWNSTREAM CARE MANAGEMENT AGENCY FOR MEDICALLY FRAGILE CHILDREN UNDER THE UMBRELLA OF NEW YORK STATE'S HEALTH HOME SERVING CHILDREN PROGRAM. OUR PROACTIVE CARE COORDINATION MODEL PROVIDES MEMBERS AND THEIR FAMILIES WITH THE SUPPORT NEEDED TO PROMOTE MORE CONSISTENT MEDICAL CARE, A REDUCTION IN UNNECESSARY HOSPITALIZATIONS, AND THE ACHIEVEMENT OF MEDICAL AND THERAPEUTIC GOALS. THE MODEL INCLUDES MONTHLY IN-HOME VISITS WITH THE CHILD AND FAMILY, 24 HOUR/7 DAYS A WEEK ACCESS TO CARE MANAGEMENT SUPPORT, AND COORDINATION OF CARE AND SERVICES ACROSS THE MEDICAL, BEHAVIORAL HEALTH, EDUCATIONAL, AND SOCIAL SPECTRUM. SOCIAL DETERMINANTS OF HEALTH INCLUDING ACCESS TO TRANSPORTATION, FOOD SECURITY, AND HEALTH LITERACY ARE ALSO CONSIDERED BY THE CARE MANAGER. WE ARE CURRENTLY PARTNERED WITH MONTEFIORE HEALTH HOME TO PROVIDE SERVICES IN THE BRONX AND WITH SKYWARD HEALTH TO PROVIDE SERVICES IN WESTCHESTER COUNTY, 2 OF OUR LARGEST REGIONAL CATCHMENT AREAS. MEMBER CAPACITY IS CURRENTLY BETWEEN 40 AND 45 MEMBERS BUT WILL INCREASE TO AT LEAST 65-70 BY 2023. OUR CARE MANAGERS ARE BILINGUAL TO ALLOW FOR BETTER SERVICE FOR OUR SPANISH-SPEAKING MEMBERS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,280,603 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $2,565,340 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $75,599,854 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | 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 | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | 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 | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 137 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 656 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 21 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | 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
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN CANNING | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9145927555 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 BRADHURST AVE | AddressLine1Txt |
| City | VALHALLA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10595 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (35 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| LUCY SCHMOLKA | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PETER D RITTMASTER | |||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SCOTT R LEVY | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TIM EVNIN | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ABBY POPPER | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALAN GERSTEIN | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CINDY MUSOFF | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| COUGHLIN SCOTT | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID R PEDOWITZ | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DEAN CURNUTT | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| FARREL STARKER | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| HOWARD ADLER | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN L FURTH | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JUDITH R WIENER GOODHUE | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KIM MOTOLA | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LANCE WACHENHEIM | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LARRY W COHEN | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| OWEN GUTFREUND | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PERRY C HOFFMEISTER | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| VIRGINIA FURTH WEISMAN | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM G LEVY | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEVINE LAWRENCE | |||||||
| PRESIDENT AND CEO | 40.00 | Yes (X) | $940,962 | $0 | $173,513 | ||
| KLEIN SCOTT M | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $599,664 | $0 | $129,571 | ||
| CANNING JOHN EDWARD | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $526,804 | $0 | $153,895 | ||
| WEGENER JILL MARIE | |||||||
| CHIEF NURSING OFFICER | 40.00 | Yes (X) | $333,180 | $0 | $13,832 | ||
| FLANAGAN JOHN J | |||||||
| VICE PRESIDENT OF OPERATIONS | 40.00 | Yes (X) | $300,429 | $0 | $27,387 | ||
| KOCH CAPOBIANCO LISA | |||||||
| VICE PRESIDENT OF DEVELOPMENT | 40.00 | Yes (X) | $259,803 | $0 | $52,630 | ||
| GOODBODY MURRAY SUSAN | |||||||
| CHIEF ENGAGEMENT & EXPERIENCE | 40.00 | Yes (X) | $231,511 | $0 | $41,706 | ||
| CORNELL CONSTANCE T | |||||||
| VICE PRESIDENT OF STRATEGIC CO | 40.00 | Yes (X) | $189,265 | $0 | $49,623 | ||
| DE MURO CINDY L | |||||||
| DIRECTOR OF HUMAN RESOURCES | 40.00 | Yes (X) | $191,487 | $0 | $36,874 | ||
| FERNANDEZ BYRON | |||||||
| CLINICAL/UNIT CHIEF | 40.00 | $341,152 | $0 | $92,634 | Yes (X) | ||
| SILVERMAN KATHY | |||||||
| CLINICAL/UNIT CHIEF | 40.00 | $267,905 | $0 | $55,915 | Yes (X) | ||
| ALEJANDRO RUTH ESTHER | |||||||
| ATTENDING PHYSIATRIST | 40.00 | $224,115 | $0 | $90,176 | Yes (X) | ||
| ASHE DAVID | |||||||
| ATTENDING PEDIATRICIAN | 40.00 | $244,388 | $0 | $30,041 | Yes (X) | ||
| DIDIE MARY MARGARET | |||||||
| CLINICAL/UNIT CHIEF | 40.00 | $225,477 | $0 | $28,628 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,876,142 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $976,425 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 169 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LEND LEASE | |||||
| 200 PARK AVE | NEW YORK | NY | 10166 | CONSTRUCTION | $8,348,025 |
| SODEXO INC AFFILIATES | |||||
| 500 ROSS ST | PITTSBURGH | PA | 152620001 | FACILITY SERVICES | $3,919,050 |
| OMNICELL INC | |||||
| PO BOX 204650 | DALLAS | TX | 753204650 | PHARMACY SYSTEMS | $947,724 |
| SSC INC | |||||
| 25 CONTROLS DR | SHELTON | CT | 06484 | SECURITY | $910,997 |
| PRESIDIO NETWORKED SOLUTIONS | |||||
| PO BOX 822169 | PHILADELPHIA | PA | 191822169 | IT NETWORK CONSULTANTS | $619,001 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $1,665,526 | FundraisingAmt |
| Government Grants | $665,163 | GovernmentGrantsAmt |
| All Other Contributions | $2,539,900 | AllOtherContributionsAmt |
| Noncash Contributions | $274,342 | NoncashContributionsAmt |
| Total Contributions | $4,870,589 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INPATIENT CARE | 622110 | $59,701,785 | $59,701,785 |
| RHCF LONG TERM CARE | 622110 | $13,828,914 | $13,828,914 |
| DAY HOSPITAL | 622110 | $10,238,178 | $10,238,178 |
| SCHOOL PROGRAM | 621400 | $1,144,090 | $1,144,090 |
| OUTPATIENT | 611710 | $956,039 | $956,039 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $85,869,006 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,314,569 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $25,946 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,288,623 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $147,090,956 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $143,025,368 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,065,588 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,065,588 | TotalRevenueColumnAmt |
| Exclusion | $4,065,588 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $158,280 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $1,665,526 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $209,353 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$51,073 | TotalRevenueColumnAmt |
| Exclusion | -$51,073 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| SPENDING POLICY | 900099 | $3,630,214 | $0 | $3,630,214 |
| CAFETERIA | 722514 | $247,354 | $0 | $247,354 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $465,211 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $465,211 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,342,779 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $102,411,458 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $86,334,217 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $25,946 | UnrelatedBusinessRevenueAmt |
| Exclusion | $11,180,706 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,568,104 | TotalAmt |
| Program Services | $1,163,647 | ProgramServicesAmt |
| Management And General | $2,145,537 | ManagementAndGeneralAmt |
| Fundraising | $258,920 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,596,092 | TotalAmt |
| Program Services | $35,886,523 | ProgramServicesAmt |
| Management And General | $4,583,391 | ManagementAndGeneralAmt |
| Fundraising | $126,178 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,701,835 | TotalAmt |
| Program Services | $3,074,744 | ProgramServicesAmt |
| Management And General | $564,160 | ManagementAndGeneralAmt |
| Fundraising | $62,931 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,666,158 | TotalAmt |
| Program Services | $5,595,796 | ProgramServicesAmt |
| Management And General | $1,005,686 | ManagementAndGeneralAmt |
| Fundraising | $64,676 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,133,357 | TotalAmt |
| Program Services | $2,602,566 | ProgramServicesAmt |
| Management And General | $477,524 | ManagementAndGeneralAmt |
| Fundraising | $53,267 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,300,899 | TotalAmt |
| Program Services | $4,041,965 | ProgramServicesAmt |
| Management And General | $243,870 | ManagementAndGeneralAmt |
| Fundraising | $15,064 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $654,278 | TotalAmt |
| Program Services | $527,498 | ProgramServicesAmt |
| Management And General | $96,698 | ManagementAndGeneralAmt |
| Fundraising | $30,082 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $189,996 | TotalAmt |
| Program Services | $157,279 | ProgramServicesAmt |
| Management And General | $27,815 | ManagementAndGeneralAmt |
| Fundraising | $4,902 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,201 | TotalAmt |
| Program Services | $55,112 | ProgramServicesAmt |
| Management And General | $11,128 | ManagementAndGeneralAmt |
| Fundraising | $1,961 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $574,764 | TotalAmt |
| Management And General | $574,764 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,372 | TotalAmt |
| Program Services | $52,387 | ProgramServicesAmt |
| Management And General | $8,985 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,008 | TotalAmt |
| Program Services | $106,103 | ProgramServicesAmt |
| Management And General | $7,675 | ManagementAndGeneralAmt |
| Fundraising | $4,230 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,778,678 | TotalAmt |
| Program Services | $1,273,386 | ProgramServicesAmt |
| Management And General | $391,309 | ManagementAndGeneralAmt |
| Fundraising | $113,983 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,584,814 | TotalAmt |
| Program Services | $9,584,228 | ProgramServicesAmt |
| Fundraising | $586 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,481 | TotalAmt |
| Program Services | $5,922 | ProgramServicesAmt |
| Management And General | $553 | ManagementAndGeneralAmt |
| Fundraising | $6 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,518 | TotalAmt |
| Program Services | $15,515 | ProgramServicesAmt |
| Management And General | $800 | ManagementAndGeneralAmt |
| Fundraising | $203 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,374 | TotalAmt |
| Program Services | $86,374 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,701,689 | TotalAmt |
| Program Services | $5,418,316 | ProgramServicesAmt |
| Management And General | $1,251,205 | ManagementAndGeneralAmt |
| Fundraising | $32,168 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $801,885 | TotalAmt |
| Program Services | $684,489 | ProgramServicesAmt |
| Management And General | $117,396 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACT LABOR | $3,360,303 | $3,078,095 | $276,992 | $5,216 |
| TAXES/ASSESSMENTS | $1,254,466 | $1,065,941 | $183,654 | $4,871 |
| UTILITIES | $931,489 | $795,119 | $136,370 | $0 |
| DEBT EXPENSES | $385,250 | $328,849 | $56,401 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,541,011 | TotalAmt |
| Program Services | $75,599,854 | ProgramServicesAmt |
| Management And General | $12,161,913 | ManagementAndGeneralAmt |
| Fundraising | $779,244 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,260,729 | BOYAmt |
| EOY | $29,068,754 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,483,450 | BOYAmt |
| EOY | $1,002,923 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,483,024 | BOYAmt |
| EOY | $12,032,990 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,027,661 | BOYAmt |
| EOY | $3,006,424 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $672,452 | BOYAmt |
| EOY | $807,503 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $939,376 | BOYAmt |
| EOY | $1,307,346 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $142,559,487 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $75,155,677 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,310,695 | BOYAmt |
| EOY | $67,403,810 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,294,842 | BOYAmt |
| EOY | $84,128,250 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,605,458 | BOYAmt |
| EOY | $71,960,719 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,129,519 | BOYAmt |
| EOY | $1,271,001 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $255,207,206 | BOYAmt |
| EOY | $271,989,720 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,301,014 | BOYAmt |
| EOY | $4,949,833 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $580,856 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,944,939 | BOYAmt |
| EOY | $18,104,174 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,479,278 | BOYAmt |
| EOY | $2,434,020 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,555,106 | BOYAmt |
| EOY | $11,688,747 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,861,193 | BOYAmt |
| EOY | $37,176,774 | 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 | $188,884,189 | BOYAmt |
| EOY | $214,699,280 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,461,824 | BOYAmt |
| EOY | $20,113,666 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,346,013 | BOYAmt |
| EOY | $234,812,946 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $255,207,206 | BOYAmt |
| EOY | $271,989,720 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $13,870,447 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,757,591 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $8,838,895 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $49,991 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $18,210 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $68,201 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | IN 2021 THE HOSPITAL MET WITH GOVERNMENT OFFICIALS TO PROMOTE A HEALTH LAW AMENDMENT THAT WOULD CLOSE LOOP HOLES IN INSURANCE COVERAGE FOR MEDICALLY FRAGILE CHILDREN. A PERCENTAGE OF ANNUAL MEMBERSHIP DUES PAID TO SEVERAL HOSPITAL ORGANIZATIONS IS ATTRIBUTABLE TO LOBBYING EXPENSE. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $18,461,824 | BeginningYearBalanceAmt |
| Contributions | $3,787,709 | ContributionsAmt |
| Investment Earnings Or Losses | $2,760,074 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $4,895,941 | OtherExpendituresAmt |
| End Year Balance | $20,113,666 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $14,963,763 | BeginningYearBalanceAmt |
| Contributions | $5,079,552 | ContributionsAmt |
| Investment Earnings Or Losses | $1,756,082 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,337,573 | OtherExpendituresAmt |
| End Year Balance | $18,461,824 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $13,082,617 | BeginningYearBalanceAmt |
| Contributions | $2,957,030 | ContributionsAmt |
| Investment Earnings Or Losses | $3,042,821 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $4,118,705 | OtherExpendituresAmt |
| End Year Balance | $14,963,763 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,056,311 | BeginningYearBalanceAmt |
| Contributions | $4,270,912 | ContributionsAmt |
| Investment Earnings Or Losses | -$659,699 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $5,584,906 | OtherExpendituresAmt |
| End Year Balance | $13,082,618 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $15,662,160 | BeginningYearBalanceAmt |
| Contributions | $2,796,440 | ContributionsAmt |
| Investment Earnings Or Losses | $2,173,245 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,575,534 | OtherExpendituresAmt |
| End Year Balance | $15,056,311 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.93300 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.06700 | TermEndowmentBalanceEOYPct |
| 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 | $1,383,879 | OtherCostOrOtherBasisAmt |
| Book Value | $1,383,879 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $60,654,249 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,345,365 | DepreciationAmt |
| Book Value | $34,308,884 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,855,674 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,102,823 | DepreciationAmt |
| Book Value | $752,851 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $71,688,338 | OtherCostOrOtherBasisAmt |
| Depreciation | $45,001,789 | DepreciationAmt |
| Book Value | $26,686,549 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,977,347 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,705,700 | DepreciationAmt |
| Book Value | $4,271,647 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $67,403,810 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS- OTHER SECURITIES | Desc |
| Book Value | $71,960,719 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $71,960,719 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| EST. INSURANCE RECOVERIES | $2,031,000 |
| ASSET RETIREMENT OBLIGATION | $178,801 |
| ACCRUED PENSION | $9,478,946 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,688,747 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $107,294,264 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $4,757,591 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $699,979 | OtherRevenueAmt |
| Revenue Not Reported | $5,457,570 | RevenueNotReportedAmt |
| Revenue Subtotal | $101,836,694 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $574,764 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $574,764 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $102,411,458 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $88,175,600 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $88,175,600 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $574,764 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | -$209,353 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $365,411 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $88,541,011 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | BLYTHEDALE MAINTAINS A VARIETY OF DONOR FUNDS RESTRICTED BY PURPOSE THAT COVER A VARIETY OF PROGRAM ACTIVITIES INCLUDING THE PROVISION OF TRANSPORTATION TO PARENT FAMILIES, SUPPORT FOR ASSISTIVE TECHNOLOGY, AND FUNDS THAT SUPPORT THE SALARIES OF THERAPISTS AMONG OTHERS. IN ADDITION, BLYTHEDALE MAINTAINS A NUMBER OF PERMANENT ENDOWMENTS, THE INCOME FROM WHICH IS PRIMARILY USED TO SUPPORT GENERAL OPERATIONS. NET ASSETS WITH DONOR RESTRICTIONS CONSIST OF ASSETS WHOSE USE IS LIMITED BY DONOR IMPOSED, TIME AND/OR PURPOSE RESTRICTIONS. THE HOSPITAL REPORTS GIFTS OF CASH AND OTHER ASSETS AS REVENUE WITH DONOR RESTRICTIONS IF THEY ARE RECEIVED WITH DONOR STIPULATIONS THAT LIMIT THE USE OF THE DONATED ASSETS. WHEN A DONOR RESTRICTION EXPIRES, THAT IS, WHEN A STIPULATED TIME RESTRICTION ENDS OR PURPOSE RESTRICTION IS ACCOMPLISHED, THE NET ASSETS WITH DONOR RESTRICTION ARE RECLASSIFIED TO NET ASSETS WITHOUT DONOR RESTRICTION AND REPORTED IN THE STATEMENTS OF OPERATIONS AND CHANGES IN NET ASSETS AS NET ASSETS RELEASED FROM RESTRICTIONS. AT DECEMBER 31, 2021 THE HOSPITAL HAD ENDOWMENTS INCLUDED IN NET ASSETS WITH DONOR RESTRICTIONS PLEDGE RECEIVABLES : $ 1,002,923 BENEFICIAL INTEREST IN TRUST : $1,271,001 DONOR RESTRICTED INVESTMENTS : $17,839,742 BLYTHEDALE CHILDREN'S HOSPITAL HAS A CHARITABLE REMAINDER TRUST HELD BY TRUSTEES CITIBANK, CALLED THE HENRY STERN TRUST. THE CORPUS IS RESTRICTED. |
| PART X, LINE 2: | THE HOSPITAL RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY WHEN THE TAX POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE HOSPITAL HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE HOSPITAL IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO 2018. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES TO SCHEDULE G 209,353. PENSION NPBC TRANSFER FROM NON OPERATING 490,626. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES TO SCHEDULE G -209,353. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)
| RegionRegionTxt | Type Of Activities ConductedTypeOfActivitiesConductedTxt | Region Total ExpendituresRegionTotalExpendituresAmt |
|---|---|---|
| CENTRAL AMERICA AND THE CARIBBEAN | INVESTMENTS | $31,752,233 |
| EUROPE (INCLUDING ICELAND & GREENLAND) | INVESTMENTS | $3,268,124 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continuation Total Office | 0 | ContinuationTotalOfficeCnt |
| Continuation Total Employee | 0 | ContinuationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $35,020,357 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $35,020,357 | TotalSpentAmt |
| Transfer To Foreign Corp | Yes (1) | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (1) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | Yes (1) | PassiveForeignInvestmestCoInd |
| Foreign Partnership | Yes (1) | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III ACCOUNTING METHOD: | FormAndLineReferenceDesc |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | STUART DIX GOLF | Event1Nm |
| Gross Receipts Event1 | $792,307 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $792,307 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $32,762 | OtherDirectExpensesEvent1Amt |
| Event2 | FALL GALA | Event2Nm |
| Gross Receipts Event2 | $592,465 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $502,165 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $90,300 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $78,072 | RentFacilityCostsEvent2Amt |
| Other Direct Expenses Event2 | $22,687 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $439,034 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $371,054 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $67,980 | GrossRevenueOtherEventsAmt |
| Rent Fclty Costs Other Events | $57,784 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $294 | FoodAndBeverageOtherEventsAmt |
| Oth Direct Expnss Other Events | $17,754 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $1,823,806 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $1,665,526 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $158,280 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $135,856 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $294 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $73,203 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $209,353 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$51,073 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 400.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,464 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,464 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66,353,727 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $66,049,714 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $304,013 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00340 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $66,366,191 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $66,049,714 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $316,477 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00350 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $197,853 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $50,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $147,853 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $505,135 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $42,858 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $462,277 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00520 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $600,497 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $392,643 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $207,854 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $148,376 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $148,376 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00170 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,451,861 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $485,501 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $966,360 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01090 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $67,818,052 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $66,535,215 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,282,837 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01440 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $507,717 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $191,142 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $316,575 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00360 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $165,000 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $165,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $672,717 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $191,142 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $481,575 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00550 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $0 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $0 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $0 | CostOfCareReimbursedByMedcrAmt |
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 | BLYTHEDALE CHILDREN'S HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 BRADHURST AVE | AddressLine1Txt |
| City | VALHALLA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10595 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.BLYTHEDALE.ORG | WebsiteAddressTxt |
| State License | 5957000H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Childrens Hospital | Yes (X) | ChildrensHospitalInd |
| Other | THE STEVEN & ALEXANDRA COHEN PEDIATRIC LONG TERM CARE FACILITY | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLYTHEDALE CHILDREN'S HOSPITAL | 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 | 0 | 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 | WWW.BLYTHEDALE.ORG | OwnWebsiteURLTxt |
| 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 | WWW.BLYTHEDALE.ORG | 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 | 400.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.BLYTHEDALE.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.BLYTHEDALE.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.BLYTHEDALE.ORG | 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 Translated | Yes (X) | FAPTranslatedInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Other Reason | Yes (X) | OtherReasonInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BLYTHEDALE CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 5: THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH (DOH) CONVENED A WORKGROUP OF LOCAL HOSPITALS TO SELECT PRIORITIES FROM THE STATE'S PREVENTION AGENDA AND COLLABORATIVELY DEVELOP PLANS TO ADDRESS THESE PRIORITIES AS PART OF WESTCHESTER COUNTY DEPARTMENT OF HEALTH (DOH)'S COMMUNITY HEALTH ASSESSMENT. THE WESTCHESTER COUNTY WORKGROUP DISTRIBUTED COMMUNITY AND PROVIDER SURVEYS TO COLLECT EXTENSIVE DATA ABOUT THE PARAMOUNT HEALTH CARE NEEDS WITHIN THE COMMUNITY AND COMPARED THAT DATE WITH THE CURRENT STATE OF AFFAIRS WITHIN THE COUNTY TO DESIGNATE SPECIFIC AGENDA ITEMS. IN ADDITION TO ITS REFERRING HOSPITALS, BLYTHEDALE WORKS CLOSELY WITH THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH (DOH) TO IDENTIFY COMMUNITY HEALTH PRIORITIES RELEVANT TO BLYTHEDALE'S MISSION AND SERVICES.THE PURPOSE OF THIS COMMUNITY HEALTH NEEDS ASSESSMENT AND COMMUNITY SERVICE PLAN IS THREEFOLD:1. ASSIST IN IDENTIFYING PRIORITY HEALTH NEEDS OF THE AREA SERVED BY BLYTHEDALE CHILDREN'S HOSPITAL;2. COMPLY WITH THE REQUIREMENTS AND GUIDELINES OF THE NYS DEPARTMENT OF HEALTH FOR A COMMUNITY SERVICE PLAN; AND3. COMPLY WITH THE REQUIREMENTS PROMULGATED BY THE INTERNAL REVENUE SERVICE (IRS) BASED ON THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT ENACTED MARCH 23, 2010 THAT ALL 501(C)(3) HOSPITAL ORGANIZATIONS CONDUCT A "COMMUNITY HEALTH NEEDS ASSESSMENT AND PREPARE A CORRESPONDING IMPLEMENTATION STRATEGY ONCE EVERY THREE TAXABLE YEARS."AS DIRECTED BY THE STATE HEALTH DEPARTMENT, BLYTHEDALE'S 2019-2021 COMMUNITY SERVICE PLAN ADDRESSES HEALTH IMPROVEMENT PRIORITIES FROM THE STATE'S PREVENTION AGENDA, INCLUDING THOSE SELECTED BY A COALITION OF LOCAL COMMUNITY HOSPITALS AND OTHER COMMUNITY REPRESENTATIVES CONVENED BY THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH. AS A SPECIALTY HOSPITAL SERVING ONLY CHILDREN AND ADOLESCENTS, BLYTHEDALE HAS SELECTED PRIORITIES FROM THE STATE'S PREVENTION AGENDA WHICH ADDRESS ISSUES OF CONCERN TO BLYTHEDALE'S LOCAL COMMUNITY AND ITS COMMUNITY OF REFERRING HOSPITALS IN THE NEW YORK CITY METROPOLITAN AREA. IT ALSO IDENTIFIED TARGET OBJECTIVES FOR MEASURING FUTURE ACHIEVEMENTS MADE IN ADDRESSING THE SELECTED PRIORITIES. |
| BLYTHEDALE CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 6B: WESTCHESTER COUNTY DEPARTMENT OF HEALTHREGIONAL BEHAVIORAL HEALTH WORKGROUPA LARGE COLLECTION OF AGENCIES AND HOSPITALS FROM ACROSS THE MID-HUDSON REGION HAVE JOINED TOGETHER TO CREATE A MONTHLY BEHAVIORAL HEALTH WORKGROUP THAT EVALUATES THE MENTAL AND BEHAVIORAL HEALTH NEEDS OF THE COMMUNITY. COMMUNITY PARTNERS OF OSSINING, CENTERS FOR DISEASE CONTROL/NHSN, AND WESTCHESTER MEDICAL CENTER |
| BLYTHEDALE CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 11: BLYTHEDALE'S COMMUNITY SERVICE PLAN FOR 2019-2021 IDENTIFIED A NUMBER OF HEALTH INDICATORS AS A BASIS FOR SELECTING PRIORITIES. AS NOTED ABOVE, IN ADDITION TO PUBLIC INPUT, A VARIETY OF DATA FROM THE NYS DEPARTMENT OF HEALTH, WESTCHESTER COUNTY COMMUNITY HEALTH ASSESSMENTS, AND OTHER SOURCES WERE USED TO IDENTIFY THE HEALTH PRIORITIES. THE FOLLOWING GOALS WERE SELECTED AS STATE AND COUNTY-WIDE PRIORITIES: PREVENT COMMUNICABLE DISEASES PREVENT CHRONIC DISEASES PROMOTE A HEALTHY AND SAFE ENVIRONMENT PROMOTE ACCESS FOR PHYSICAL ACTIVITY PROMOTE HEALTHY WOMEN, INFANTS AND CHILDREN PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE ABUSE DISORDERSAS NOTED ABOVE, SEVERAL OF THE PRIORITY INITIATIVES IDENTIFIED BY THE COUNTY WERE NOT WITHIN BLYTHEDALE'S SCOPE OF PRACTICE. THEREFORE, IT HAD FOCUSED ON THOSE PRIORITIES THAT FELL WITHIN THE HOSPITAL'S MISSION.THE PURPOSE OF BLYTHEDALE'S ANTIMICROBIAL STEWARDSHIP PROGRAM (ASP) IS TO ADVANCE THE HOSPITAL'S ANTIMICROBIAL PRESCRIBING PRACTICES THAT ASSIST IN REDUCING THE RISK OF ANTIMICROBIAL RESISTANCE IN THE COMMUNITY ONCE A PATIENT IS DISCHARGED.BY 2021, BLYTHEDALE WILL MEET THE FOLLOWING OBJECTIVES:1. REDUCE THE STANDARDIZED ANTIMICROBIAL ADMINISTRATION RATIO (SAAR) BY 5%. THE SAAR FOR 2021 IS 0.29. AN SAAR OF LESS THAN ONE IS CONSIDERED TO BE OPTIMUM.2. MONITOR ANTIMICROBIAL PRESCRIBING PRACTICES IN THE HOSPITAL AND REPORT TO THE PRESCRIBERS AND THE CHIEF MEDICAL OFFICER.3. MONITOR CHANGING PATTERNS OF ANTIMICROBIAL RESISTANCE BASED ON THE HOSPITAL'S ANTIBIOGRAM AND REPORT TREATMENT RECOMMENDATIONS TO THE PRESCRIBERS.BLYTHEDALE INCREASED THE PERCENTAGE OF SCHOOL STAFF MEMBERS EDUCATED ON TRAUMA-INFORMED, RESILIENCE FOCUSED PRACTICES TO ADDRESS ACES. THE WELLNESS PROGRAM WILL ALSO IMPLEMENT SCHOOL-BASED PROGRAMS, PARTICIPATE IN COMMUNITY EVENTS AND FORM COMMUNITY PARTNERSHIPS AIMED TO IMPROVE CHILDREN'S MENTAL HEALTH.INTERVENTIONS AND ACTIVITIES1. INFORM AND IMPROVE SCHOOL WELLNESS PROGRAMS & PROTOCOLS:SCHOOLS ARE IN A UNIQUE POSITION TO IMPROVE BOTH THE DETRIMENTAL IMPACTS OF ADVERSE CHILDHOOD EXPERIENCES (ACES) AND THE HEALTH STATUS OF YOUNG PEOPLE ACROSS THE NATION. WE WILL SUPPORT SCHOOLS IN CUSTOMIZING AN APPROACH TO HEALTH BASED ON A MULTIDIMENSIONAL- MODEL WELLNESS PROGRAM, THE FOCUS OF WHICH WOULD BE COORDINATING POLICY, STRATEGIES AND CURRICULUM RELATED TO SIX KEY COMPONENTS (NUTRITION AND HEALTHY EATING, PHYSICAL EDUCATION AND PHYSICAL ACTIVITY, HEALTH EDUCATION, HEALTH SERVICES, PSYCHOLOGICAL AND SOCIAL SERVICES, AND EMPLOYEE WELLNESS). THESE COMPONENTS SERVE THE DIRECT HEALTH NEEDS OF THE STUDENTS AND STAFF, WHICH RESULTS IN IMPROVED HEALTH OUTCOMES AND LEARNING. OUR MISSION IS TO INSPIRE AND GUIDE SCHOOLS TO EVALUATE THEIR CURRENT STATUS, OFFER EDUCATION TO THE KEY STAKEHOLDERS, ENCOURAGE SHORT AND LONG-TERM GOAL-SETTING, INFORM ON ENDORSED POLICY AND STRATEGIES; AND SERVE AS A RESOURCE FOR EVIDENCE-BASED HEALTH EDUCATION AND PREVENTION-BASED PROGRAMS.BLYTHEDALE HAS PROVIDED A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT PROGRAMS, AS EVIDENCED THROUGH A VARIETY OF PROGRAMS AND SERVICES, INCLUDING:CARE MANAGEMENT: BLYTHEDALE BEGAN WORKING WITH HUDSON RIVER HEALTHCARE'S COMMUNITY CARE COLLABORATIVE HEALTH HOME SERVING CHILDREN PROGRAM AS A CMA (CARE MANAGEMENT AGENCY) FOR MEDICALLY FRAGILE CHILDREN. OUR CARE MANAGER SERVES AN AVERAGE OF 15 MEDICALLY FRAGILE CHILDREN AND THEIR FAMILIES IN WESTCHESTER COUNTY THROUGH THIS IMPORTANT NYSDOH INITIATIVE.CPR TRAINING CENTER: BLYTHEDALE HAS BEEN A COMMUNITY TRAINING CENTER FOR THE AMERICAN HEART ASSOCIATION, PROVIDING TRAINING IN HEARTSAVER CPR (CARDIO-PULMONARY RESUSCITATION), HEARTSAVER AED (AUTOMATED EXTERNAL DEFIBRILLATOR) AND HEARTSAVER FIRST AID. IN ADDITION TO BLYTHEDALE STAFF, THOSE TRAINED INCLUDE HEALTH CARE PROFESSIONALS, MEMBERS OF LOCAL POLICE AND FIRE DEPARTMENTS, STUDENTS AT AREA SCHOOLS AND STAFF FROM VARIOUS COMMUNITY AGENCIES. BLYTHEDALE HAS ALSO OFFERED PEDIATRIC CPR TRAINING FOR THE COMMUNITY AND HEALTH CARE PROFESSIONALS, AND IS A CERTIFIED PEDIATRIC ADVANCED LIFE SUPPORT (PALS) TRAINING CENTER.FIRST RESPONDER TRAINING PROGRAM: BLYTHEDALE, IN COORDINATION WITH THE WESTCHESTER REGIONAL EMS OFFICE, WESTCHESTER COUNTY DEPARTMENT OF ENVIRONMENTAL SERVICES, AND THE NYS EMS FOR CHILDREN PROGRAM, HAS DEVELOPED A SPECIAL PEDIATRIC CONTINUING MEDICAL EDUCATION SERIES FOR FIRST RESPONDERS OF THE WESTCHESTER EMS REGION. THE SERIES COVERS SUBJECTS VITAL TO FIRST RESPONDERS, INCLUDING TRAUMATIC BRAIN INJURY, AUTISM, TECHNOLOGY AND CARE OF THE INFANT OR CHILD, CHILD ABUSE/NEGLECT AND CHILD/INFANT SAFETY DURING TRANSFER. THE COURSES ARE PRESENTED BY BLYTHEDALE CLINICAL EXPERTS, INCLUDING PHYSICIANS, NURSES, AND THERAPISTS. |
| BLYTHEDALE CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 16J: BLYTHEDALE CHILDREN'S HOSPITAL IS A LONG-TERM, REFERRAL-BASED, CHILDREN'S HOSPITAL. ALL PATIENTS ARE PROVIDED INFORMATION REGARDING BLYTHEDALE'S POLICIES UPON THEIR REFERRAL TO THE HOSPITAL. |
| BLYTHEDALE CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 21D: HOSPITAL IS A REGIONAL SPECIALTY CHILDREN'S HOSPITAL, AND DOES NOT HAVE AN EMERGENCY ROOM. |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | NA |
| PART I, LINE 7: | NYS ICR EXHIBIT 46 / 53 ALLOWABLE COST TO CHARGES SCHEDULES. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | AS A RESULT OF THE COVID-19 CONTINUATION IN 2021, THE ORGANIZATION'S ABILITY TO PHYSICALLY INTERACT WITH MANY COMPONENTS OF THE COMMUNITY AT PREVIOUS REPORTED SERVICE LEVELS WAS HAMPERED. BLYTHEDALE STILL PROVIDED A SIGNIFICANT AMOUNT OF COMMUNITY BENEFIT PROGRAMS, AS EVIDENCED THROUGH A VARIETY OF PROGRAMS AND SERVICES, INCLUDING:BLYTHEDALE HOSPITAL, BECAUSE OF THE UNIQUE NATURE OF OUR PATIENT POPULATION & MISSION, PROVIDES OUTPATIENT SERVICES TO MEDICAL FRAGILE CHILDREN UNDER THE EARLY INTERVENTION PROGRAM. THE HOSPITAL ALSO PROVIDES OUTPATIENT TELETHERAPY SERVICES TO PATIENTS UNABLE TO ATTEND THE BLYTHEDALE SCHOOL AS A RESULT OF COVID19 OR OTHER HEALTH RELATED ISSUES PREVENTING THEM FROM ATTENDING IN PERSON. THE COST TO PROVIDE THESE SERVICES IS HISTORICALLY UNDER/UNREIMBURSED.BLYTHEDALE HOSPITAL, BECAUSE OF THE UNIQUE NATURE OF OUR PATIENT POPULATION & MISSION, PROVIDES SIGNIFICANT TRAINING TO MEDICAL PROFESSIONALS THROUGHOUT THE REGION THROUGH COLLABORATIONS WITH SEVERAL INSTITUTIONS OF HIGHER EDUCATION. BLYTHEDALE HOSPITAL PROVIDED ON-SITE TRAINING FOR STUDENTS FREE OF CHARGE ACROSS THE MULTIPLE SPECIALTIES INCLUDING; NURSING, PHARMACY, SOCIAL WORK, ASSISTIVE TECHNOLOGY, INFORMATION TECHNOLOGY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY AND SPEECH THERAPY. IN 2021, BLYTHEDALE COLLABORATED WITH 10 SCHOOLS OF NURSING, PROVIDING ALMOST 30,000 HOURS OF TRAINING AND PRECEPTORSHIP TO THE NEXT GENERATION OF PEDIATRIC NURSES IN THE REGION. OUR CHILD LIFE DEPARTMENT PROVIDED OVER 740 HOURS OF EXPERIENCE THROUGH VARIOUS INTERNSHIPS PROVIDING STUDENTS WITH BED-SIDE EXPERIENCE. SOCIAL WORK PROVIDED OVER 800 HOURS OF INTERNSHIP EXPERIENCE IN 2021.OUR PHARMACY DEPARTMENT COLLABORATED WITH 2 COLLEGES AND PROVIDED ROUGHLY 900 HOURS OF TRAINING TO STUDENTS IN 2021. THE STUDENTS LEARNED TO LOOK UP RESEARCH FOR NEW DRUG THERAPIES, HELP COUNSEL PATIENTS BEING DISCHARGED (IN CONJUNCTION WITH A PHARMACIST), PERFORM ORAL LIQUID COMPOUNDING, CALL MANUFACTURERS FOR DRUG QUESTIONS, CALL VENDORS TO FIND REPLACEMENTS FOR DRUG SHORTAGES, AND TO GO ON DELIVERIES WITH OUR TECHNICIANS.BLYTHEDALE HAS THE LARGEST STAFF OF PEDIATRIC THERAPISTS IN THE REGION AND CONSIDERS IT A PART OF THEIR MISSION TO TRAIN THE NEXT GENERATION OF THERAPIST WHO WILL PROVIDE THE CARE TO OUR MEDICALLY FRAGILE POPULATION. WE PROVIDED OVER 1,100 HOURS OF CLINICAL PRECEPTORSHIP ACROSS ALL OUR THERAPY DEPARTMENTS INCLUDING PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES.BLYTHEDALE HAS PARTNERED WITH THE NEW YORK LEGAL ASSISTANCE GROUP (NYLAG) TO CREATE A FREE LEGAL CLINIC OPEN TO ALL BLYTHEDALE PATIENTS, RESIDENTS, HEALTH HOME SERVING CHILDREN MEMBERS, AND THEIR FAMILIES. THE CLINIC IS HELD TWICE EACH MONTH IN A VIRTUAL FORMAT AND THE ATTORNEY ASSISTS FAMILIES WITH ISSUES INCLUDING ENTITLEMENTS, HOUSING, IMMIGRATION, LEGAL GUARDIANSHIP, AND EDUCATIONAL CONCERNS. THESE SOCIAL DETERMINANTS OF HEALTH CAN HAVE A GREAT IMPACT ON A MEDICALLY FRAGILE CHILD'S STABILITY AND THE ABILITY OF A FAMILY TO PROVIDE TIMELY CARE AND SUPPORT, SO THIS CLINIC IS AN INVALUABLE WAY TO PROVIDE ASSISTANCE AND SUPPORT TO THOSE MOST IN NEED. THE CLINIC SERVED NEARLY 50 FAMILIES IN 2021. CARE MANAGEMENT: BLYTHEDALE BEGAN WORKING WITH HUDSON RIVER HEALTHCARE'S COMMUNITY CARE COLLABORATIVE HEALTH HOME SERVING CHILDREN PROGRAM AS A CMA (CARE MANAGEMENT AGENCY) FOR MEDICALLY FRAGILE CHILDREN. OUR CARE MANAGER SERVES AN AVERAGE OF 15 MEDICALLY FRAGILE CHILDREN AND THEIR FAMILIES IN WESTCHESTER COUNTY THROUGH THIS IMPORTANT NYSDOH INITIATIVE.CPR TRAINING CENTER: BLYTHEDALE HAS BEEN A COMMUNITY TRAINING CENTER FOR THE AMERICAN HEART ASSOCIATION, PROVIDING TRAINING IN HEARTSAVER CPR (CARDIO-PULMONARY RESUSCITATION), HEARTSAVER AED (AUTOMATED EXTERNAL DEFIBRILLATOR) AND HEARTSAVER FIRST AID. IN ADDITION TO BLYTHEDALE STAFF, THOSE TRAINED INCLUDE HEALTH CARE PROFESSIONALS, MEMBERS OF LOCAL POLICE AND FIRE DEPARTMENTS, STUDENTS AT AREA SCHOOLS AND STAFF FROM VARIOUS COMMUNITY AGENCIES. BLYTHEDALE HAS ALSO OFFERED PEDIATRIC CPR TRAINING FOR THE COMMUNITY AND HEALTH CARE PROFESSIONALS AND IS A CERTIFIED PEDIATRIC ADVANCED LIFE SUPPORT (PALS) TRAINING CENTER.FIRST RESPONDER TRAINING PROGRAM: BLYTHEDALE, IN COORDINATION WITH THE WESTCHESTER REGIONAL EMS OFFICE, WESTCHESTER COUNTY DEPARTMENT OF ENVIRONMENTAL SERVICES, AND THE NYS EMS FOR CHILDREN PROGRAM, HAS DEVELOPED A SPECIAL PEDIATRIC CONTINUING MEDICAL EDUCATION SERIES FOR FIRST RESPONDERS OF THE WESTCHESTER EMS REGION. THE SERIES COVERS SUBJECTS VITAL TO FIRST RESPONDERS, INCLUDING TRAUMATIC BRAIN INJURY, AUTISM, TECHNOLOGY AND CARE OF THE INFANT OR CHILD, CHILD ABUSE/NEGLECT AND CHILD/INFANT SAFETY DURING TRANSFER. THE COURSES ARE PRESENTED BY BLYTHEDALE CLINICAL EXPERTS, INCLUDING PHYSICIANS, NURSES, AND THERAPISTS. |
| PART III, LINE 2: | IN 2021 THE HOSPITAL RECORDED $0 IN THE BAD DEBT EXPENSE ON THE IRS 990. THIS WAS A RESULT OF THE HOSPITAL ADOPTING NEW ACCOUNTING STANDARD ASU 2014-09 WHICH NEGATES THE WAY BAD DEBT WAS DISCLOSED IN PRIOR YEARS. THE HOSPITAL DID RECOGNIZE $535,730 OF IMPLICIT PRICE CONCESSIONS IN 2021 RELATED TO DENIED REIMBURSEMENT FROM THIRD PARTY INSURERS WHERE CARE WAS PROVIDED. |
| PART III, LINE 3: | AS A RESULT OF IMPLEMENTING ASU 2014-09, CERTAIN PATIENT ACTIVITY WHERE COLLECTION IS UNCERTAIN PREVIOUSLY REPORTED AS NET PATIENT SERVICE REVENUE AND BAD DEBT EXPENSE IN THE HOSPITAL'S CONSOLIDATED STATEMENTS OF OPERATIONS NO LONGER MEETS THE CRITERIA FOR REVENUE RECOGNITION AND, ACCORDINGLY, BAD DEBT EXPENSE AFTER THE ADOPTION DATE IS SIGNIFICANTLY REDUCED WITH A CORRESPONDING REDUCTION TO NET PATIENT SERVICE REVENUE. FOR THE YEAR ENDED DECEMBER 31, 2021, THE HOSPITAL RECORDED $535,730 OF IMPLICIT PRICE CONCESSIONS AS A DIRECT REDUCTION TO NET PATIENT SERVICE REVENUE THAT WOULD HAVE BEEN RECORDED AS BAD DEBT EXPENSE PRIOR TO THE ADOPTION OF ASU 2014-09. ADDITIONALLY, BAD DEBT EXPENSE AFTER DECEMBER 31, 2019 IS NOW PRESENTED AS AN EXPENSE ITEM (INCLUDED AS A COMPONENT OF SUPPLIES AND OTHER EXPENSES) RATHER THAN A REDUCTION TO NET PATIENT SERVICE REVENUE.THE HOSPITAL ALSO PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. BECAUSE THE COLLECTIONS OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE IS NOT PURSUED, THEY ARE NOT REPORTED AS REVENUE. THE AMOUNT OF IDENTIFIED CHARITY CARE PROVIDED AT COST NET OF ANY REIMBURSEMENTS DURING THE YEARS ENDED DECEMBER 31, 2021 AND 2020, WAS $12,464 AND $131,669, RESPECTIVELY. THE ESTIMATED COST OF THESE CHARITY CARE SERVICES WAS DETERMINED USING A RATIO OF COST TO GROSS CHARGES AND APPLYING THAT RATIO TO THE GROSS CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS FOR THE PERIOD. |
| PART III, LINE 4: | ACCOUNTS RECEIVABLE FOR SERVICES TO PATIENTS AND PATIENT SERVICE REVENUE ACCOUNTS RECEIVABLE ARE STATED AT ESTIMATED NET REALIZABLE AMOUNTS FROM PATIENTS, THIRD-PARTY PAYERS, AND OTHER INSURERS TO WHICH THE HOSPITAL EXPECTS TO BE ENTITLED IN EXCHANGE FOR PROVIDING PATIENT CARE. MANAGEMENT PERIODICALLY REVIEWS THE ADEQUACY OF THE IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL EXPERIENCE, TRENDS IN HEALTH CARE COVERAGE, AND OTHER COLLECTION INDICATORS.SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE (DETERMINED ON A PORTFOLIO BASIS WHEN APPLICABLE) ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. FOR THE YEAR ENDED DECEMBER 31, 2021, CHANGES IN THE HOSPITAL'S ESTIMATES OF EXPECTED PAYMENTS FOR PERFORMANCE OBLIGATIONS SATISFIED IN PRIOR YEARS WERE NOT SIGNIFICANT. PORTFOLIO COLLECTION ESTIMATES ARE UPDATED BASED ON COLLECTION TRENDS. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY (DETERMINED ON A PORTFOLIO BASIS WHEN APPLICABLE) ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEAR ENDED DECEMBER 31, 2021, WAS NOT SIGNIFICANT. |
| PART III, LINE 8: | BLYTHEDALE IS A CHILDREN'S HOSPITAL AND SERVES A PEDIATRIC POPULATION TYPICALLY NOT ELIGIBLE FOR THE MEDICARE PROGRAM.BLYTHEDALE, AS A CHILDREN'S HOSPITAL RECEIVED IMMATERIAL AMOUNTS OF MEDICARE REIMBURSEMENT. IN 2021 THE HOSPITAL FILED A LOW/NO COST UTILIZATION REPORT WITH CMS. |
| PART III, LINE 9B: | 1. BLYTHEDALE WILL SEEK PAYMENT ON ACCOUNTS WITH BALANCES IN SELF-PAY (I.E., PATIENT LIABILITY). BLYTHEDALE DOES NOT TAKE PART IN EXTRAORDINARY COLLECTION ACTIONS (ECA) BEFORE MAKING REASONABLE EFFORTS TO DECIDE WHETHER FINANCIAL ASSISTANCE IS AVAILABLE AND/OR COLLECTION EFFORTS HAVE BEEN PURSUED. ANY ITEMIZED STATEMENT REQUESTED BY A GUARANTOR WILL BE GIVEN WITHIN TEN (10) DAYS OF SUCH REQUEST, IN COMPLIANCE WITH NEW YORK LAW.2. BLYTHEDALE WILL MAKE REASONABLE EFFORTS TO NOTIFY PATIENTS AND FAMILIES ABOUT THE FAP THROUGH THE FOLLOWING METHODS:A. ORALLY NOTIFY INDIVIDUALS ABOUT THE FAP AND HOW TO OBTAIN ASSISTANCE WITH THE APPLICATION PROCESS.B. BLYTHEDALE WILL REFRAIN FROM INITIATING ECAS UNLESS AUTHORIZED BY THE CFO.C. BLYTHEDALE WILL SEND AT LEAST THREE MONTHLY BILLING NOTICES IN A THIRTY (30) DAY PERIOD, FOR AT LEAST 3 MONTHS OR CYCLES, TO THE GUARANTOR OF AN ACCOUNT INFORMING OF A BALANCE DUE.1) FIRST NOTICE INFORMS THE GUARANTOR THAT THERE IS AN UNPAID BALANCE DUE ON AN ACCOUNT;2) SECOND NOTICE REMINDS THE GUARANTOR OF CONTINUED UNPAID BALANCE;3) FINAL NOTICE OF THE PAST DUE ACCOUNT NOTIFIES THE GUARANTOR THAT HE/SHE HAS THIRTY (30) DAYS TO RESOLVE THE DEBT, OR ECAS MAY BE TAKEN ON THE DEBT AND WILL SPECIFY THE ECAS THAT BLYTHEDALE INTENDS TO TAKE AND INCLUDE A COPY OF THE PLAIN LANGUAGE SUMMARY.NOTE: THE ACCOUNT CAN EITHER BE PAID IN FULL, SET UP ON A PAYMENT PLAN, REFERRED TO FINANCIAL COUNSELING, OR MORE INSURANCE INFORMATION OBTAINED DURING THIS TIMELINE. A PLAIN LANGUAGE NOTICE OF BLYTHEDALE'S FAP IS PROVIDED IN BOTH ENGLISH AND SPANISH ON EVERY BILLING STATEMENT.D. AFTER THREE (3) BILLING NOTICES HAVE BEEN SENT AND NO PAYMENT HAS BEEN RECEIVED WITHIN SIXTY (60) DAYS OF THE FINAL NOTICE, THE ACCOUNT MAY BE CONSIDERED BAD DEBT AND ECAS MAY BE TAKEN.1) ACCOUNTS QUALIFY FOR BAD DEBT WHEN PATIENT BALANCES (I.E., SELF-PAY) HAVE NOT BEEN PAID AND THE HOSPITAL HAS MADE REASONABLE EFFORTS, THAT INCLUDE BUT ARE NOT LIMITED TO PHONE CALLS, STATEMENTS OR LETTERS, TO DECIDE WHETHER THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE.2) THE BAD DEBT AGENCY WILL REPORT TO THE CREDIT BUREAU SIXTY (60) DAYS AFTER AN ACCOUNT IS PLACED WITH SUCH BAD DEBT AGENCY IF NO ACTION IS TAKEN BY THE GUARANTOR TO RESOLVE THE BALANCE EITHER BY MAKING A PAYMENT OR BY SUBMITTING ADDITIONAL DISPUTE INFORMATION.3) IF ALL OTHER OPTIONS TO COLLECT PAYMENT HAVE BEEN TAKEN AND AN ACCOUNT IN BAD DEBT HAS AGED MORE THAN SIXTY (60) DAYS WITHOUT CONTACT FROM THE GUARANTOR OR THE GUARANTOR REFUSES TO RESOLVE THE BALANCE, LEGAL ACTION MAY BE TAKEN.E. INITIATION OF A FINANCIAL ASSISTANCE APPLICATION1) THE APPLICATION PERIOD FOR FINANCIAL ASSISTANCE WILL END NO EARLIER THAN 240 DAYS FROM THE FIRST POST-VISIT BILL.F. ALL PARTIES ENGAGED IN COLLECTION ACTIONS FOR BLYTHEDALE WILL FOLLOW TO THIS POLICY. |
| PART VI, LINE 2: | SINCE THE VAST MAJORITY OF ADMISSIONS TO BLYTHEDALE COME BY REFERRAL FROM OTHER HOSPITALS, PARTICULARLY THE LARGE MEDICAL CENTERS IN THE METROPOLITAN NEW YORK AND HUDSON VALLEY AREA, BLYTHEDALE'S SENSE OF NEED FOR CLINICAL SERVICES LARGELY EMANATES FROM REFERRING HOSPITALS AND THEIR PHYSICIANS. BLYTHEDALE CONTINUOUSLY REVIEWS WITH REFERRING HOSPITALS AND PHYSICIANS THEIR NEEDS FOR SERVICES.HOWEVER, IN ADDITION TO ITS REFERRAL HOSPITALS, BLYTHEDALE ALSO WORKS CLOSELY WITH A VARIETY OF LOCAL AGENCIES, NOTABLY THE WESTCHESTER, ROCKLAND AND PUTNAM COUNTY DEPARTMENTS OF HEALTH TO IDENTIFY COMMUNITY HEALTH PRIORITIES THAT ARE RELEVANT TO BLYTHEDALE'S MISSION AND SERVICES. PARTICIPANTS IN THESE COALITIONS INCLUDE THE MAJOR CHILD AND ADOLESCENT HEALTH-FOCUSED COMMUNITY-BASED ORGANIZATIONS IN WESTCHESTER. BLYTHEDALE ALSO HAS CLOSE WORKING RELATIONSHIPS WITH MANY OF THE SCHOOL DISTRICTS IN WESTCHESTER COUNTY, THROUGH ITS NUTRITION EDUCATION ACTIVITIES, AND THROUGH ARRANGEMENTS WHEREBY BLYTHEDALE STAFF ARE CONTRACTED TO PROVIDE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES TO CHILDREN IN THE SCHOOLS. |
| PART VI, LINE 3: | CONSISTENT WITH ITS MISSION AND STATE REQUIREMENTS (NEW YORK STATE PUBLICHEALTH LAW 2807(K) (9-A), BLYTHEDALE HAS DEVELOPED GUIDELINES THAT DELINEATE THE CIRCUMSTANCES AND PROCEDURES UNDER WHICH FREE OR REDUCED COST CARE IS AVAILABLE. THESE GUIDELINES ARE MADE AVAILABLE TO ALL FAMILIES UPON REGISTRATION, AND HOSPITAL STAFF PROVIDE COUNSELING AS NECESSARY. INTERPRETATION SERVICES ARE AVAILABLE FOR PATIENTS NEEDING INFORMATION IN LANGUAGES OTHER THAN ENGLISH. PATIENTS ARE ALSO NOTIFIED OF BLYTHEDALE'S CHARITY CARE FINANCIAL ASSISTANCE POLICIES THROUGH NOTICES IN ENGLISH AND SPANISH POSTED IN THE HOSPITAL'S LOBBY AND IN PATIENT REGISTRATION AND WAITING AREAS. IN ADDITION, BLYTHEDALE'S PATIENT ASSISTANCE FUNDS HELPS PROVIDE CHILDREN WITH VARIOUS ITEMS (I.E., EQUIPMENT, CLOTHING, ETC.) WHERE FAMILY RESOURCES ARE LIMITED AND INSURANCE DOES NOT COVER. |
| PART VI, LINE 4: | AS A SPECIALTY CHILDREN'S HOSPITAL SERVING CHILDREN WITH A BROAD RANGE OF DIAGNOSES, BLYTHEDALE'S SERVICE AREA IS WIDESPREAD, WITH INPATIENT POPULATIONS COMING FROM THE ENTIRE SOUTHERN PORTION OF NEW YORK STATE AS WELL AS ADJACENT AREAS OF CONNECTICUT, NEW JERSEY AND UPSTATE NEW YORK. NEW YORK CITY (54%), WESTCHESTER & THE HUDSON VALLEY (35%), AND 11% FROM OUT OF STATE AND UPSTATE NEW YORK. BLYTHEDALE ATTRACTS 87% OF ITS OUTPATIENT PROGRAMS FROM BRONX, WESTCHESTER-HUDSON VALLEY REGION. THE HOSPITAL IS LOCATED IN SUBURBAN WESTCHESTER COUNTY THAT IS PART OF THE GREATER NEW YORK METROPOLITAN AREA. BLYTHEDALE'S PATIENT POPULATION REFLECTS THE ETHNIC AND RACIAL DIVERSITY OF ITS LARGE SERVICE AREA, AS ILLUSTRATED BY ITS PATIENT POPULATION THAT SELF-IDENTIFIES AS 81% MINORITIES AND PEOPLE OF COLOR. TO ADDRESS THIS DIVERSITY, THE HOSPITAL PROVIDES STAFF TRAINING IN CULTURAL DIVERSITY, INTERPRETER SERVICES, DIETARY VARIETY AND OTHER ACCOMMODATIONS TO SUPPORT FAMILIES FROM DIFFERENT CULTURAL BACKGROUNDS WHILE THEIR CHILDREN ARE PATIENTS AT BLYTHEDALE. |
| PART VI, LINE 5: | AS A MEANS TO ADDRESS THE COLLECTIVE TRAUMA AND STRESSES THE COVID-19 CRISIS HAS CAUSED CHILDREN AND FAMILIES IN OUR COMMUNITY, BLYTHEDALE CHILDREN'S HOSPITAL SERVED AS THE CLINICAL LEADER AND SPONSOR OF WESTCHESTER COUNTY'S FIRST-EVER TRAUMA-INFORMED SYSTEMS' CHANGE LEARNING COLLABORATIVE, FACILITATED BY UNIVERSITY AT BUFFALO'S INSTITUTE ON TRAUMA & TRAUMA-INFORMED CARE (ITTIC). THIS TRAINING WAS MADE POSSIBLE THROUGH A GRANT FROM KOHL'S DEPARTMENT STORES AND ITS KOHL'S CARES PROGRAM. THE BLYTHEDALE/ITTIC TRAINING PROGRAM TOOK PLACE OVER SIX MONTHS (MARCH TO AUGUST) AND INCLUDED 37 PARTICIPANTS, COMPRISING SENIOR-LEVEL LEADERSHIP AT 24 DIFFERENT ORGANIZATIONS IN WESTCHESTER AND ROCKLAND COUNTIES, INCLUDING BLYTHEDALE CHILDREN'S HOSPITAL, WESTCHESTER COUNTY DEPARTMENT OF COMMUNITY MENTAL HEALTH, WESTCHESTER COUNTY DEPARTMENT OF SOCIAL SERVICES, MHA OF WESTCHESTER, WESTCHESTER LIBRARY SYSTEM, MY SISTER'S PLACE, SISTER TO SISTER INTERNATIONAL, INC., WJCS GREENBURGH ELEVEN UFSD, HENDRICK HUDSON SCHOOL DISTRICT, OSSINING SCHOOL DISTRICT, PUBLIC SCHOOLS OF THE TARRYTOWNS, NYACK PUBLIC SCHOOLS, SLEEPY HOLLOW MIDDLE SCHOOL, ST. VINCENT'S WESTCHESTER, WESTCHESTER INSTITUTE FOR HUMAN DEVELOPMENT, WHITE PLAINS YOUTH BUREAU, YWCA WHITE PLAINS & CENTRAL WESTCHESTER, FAMILY TIES OF WESTCHESTER, INC., GUIDANCE CENTER OF WESTCHESTER, INC., HUMAN DEVELOPMENT SERVICES OF WESTCHESTER, MOUNT PLEASANT COTTAGE SCHOOL, OPEN DOOR FAMILY MEDICAL CENTER, AND STUDENT ASSISTANCE SERVICES CORPORATION.TIBBETTS BROOK PARK IS A 161-ACRE COUNTY PARK LOCATED IN THE LINCOLN PARK SECTION OF YONKERS IN WESTCHESTER COUNTY, NEW YORK THAT GETS MORE THAN 80,000 VISITORS EACH YEAR. BLYTHEDALE PARTNERS WITH KOHL'S DEPARTMENT STORES AND WESTCHESTER COUNTY OPENED A NEW OUTDOOR FITNESS PARK IN YONKERS. THE COMPLETION AND OPENING OF THE SEVEN-STATION FITNESS CENTER AT TIBBETTS BROOK PARK WAS CELEBRATED WITH AN OFFICIAL RIBBON CUTTING CEREMONY IN 2021. THE PROJECT WAS THE CULMINATION OF TWO YEARS OF PLANNING, DEVELOPMENT AND CONSTRUCTION. THE NEW FITNESS PARK, DESIGNED FOR INDIVIDUALS AGED 14 AND UP, INCLUDES A ROWING MACHINE, A LOWER BODY COMBO STATION, A LAT PULL-DOWN AND VERTICAL PRESS STATION, BACK AND ARMS STATION, AND OTHER EQUIPMENT. EACH STATION HAS A QR CODE THAT PEOPLE CAN SCAN WITH THEIR SMARTPHONES TO ACCESS A VIDEO THAT SHOWCASES A VARIETY OF EXERCISES THAT CAN BE PERFORMED, THE MUSCLES BEING USED AND DETAILED INSTRUCTIONS ON HOW TO UTILIZE THE EQUIPMENT PROPERLY. THE PURCHASE AND GIFTING OF THE FITNESS EQUIPMENT WAS MADE POSSIBLE BY A GENEROUS GRANT FROM KOHL'S DEPARTMENT STORES AND ITS KOHL'S CARES PROGRAM. SITE CONSTRUCTION AND EQUIPMENT INSTALLATION WAS COORDINATED WITH THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH, DEPARTMENT OF PARKS, RECREATION AND CONSERVATION AND THE DEPARTMENT OF PUBLIC WORKS AND FUNDED BY THE COUNTY. GREENFIELDS OUTDOOR FITNESS, INC., THE CALIFORNIA CORPORATION AND MANUFACTURER OF THE EQUIPMENT, ALSO MADE A DONATIONS TOWARDS THE PROJECT.BLYTHEDALE OFFERS A NUMBER OF COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND SPECIAL PROGRAMS FOR DEVELOPMENT OF THE PEDIATRIC PROFESSIONAL COMMUNITY: NUTRITION EDUCATION: IN A MAJOR INITIATIVE TO HELP REDUCE THE PREVALENCE OF CHILDHOOD OBESITY AND PREVENT ITS LONG TERM NEGATIVE HEALTH EFFECTS, BLYTHEDALE IS REACHING OUT TO SCHOOL DISTRICTS THROUGHOUT WESTCHESTER AND SURROUNDING COUNTIES WITH ITS EAT WELL BE WELL SCHOOL BASED NUTRITION EDUCATION PROGRAM. THE EAT WELL, BE WELL PROGRAM, WITH SUPPORT FROM KOHLS DEPARTMENT STORES, IS DESIGNED TO PROVIDE SCHOOL STAFF AND STUDENTS WITH THE TOOLS NECESSARY TO HELP CHILDREN DEVELOP HEALTHY EATING HABITS THROUGH A COMPREHENSIVE CURRICULUM DEVELOPED BY BLYTHEDALE'S REGISTERED DIETICIANS. AS OF 2020, THIS PROGRAM HAS REACHED MORE THAN 125,000 STUDENTS, AS WELL AS OVER 6,000 PARENTS AND SCHOOL STAFF IN SCHOOLS THROUGHOUT WESTCHESTER, ROCKLAND AND PUTNAM COUNTIES, WITH INFORMATION ON HOW TO MAKE FOOD AND LIFESTYLE CHOICES THAT WILL PROMOTE HEALTHY LIVING FOR A LIFETIME. THE PROGRAM FOCUSED ON AT-RISK SCHOOL DISTRICTS IN WESTCHESTER COUNTY, INCLUDING OSSINING AND YONKERS. A COLLABORATION WITH FEEDING WESTCHESTER ENABLED US TO REACH FAMILIES WITH DIETARY INFORMATION TRANSLATED IN SPANISH, RELATED TO FOOD PANTRY OFFERINGS. IN ADDITION TO OUR OFF-SITE PROGRAMMING, WE HAVE AN EXTENSIVE PAID SOCIAL MEDIA CAMPAIGN PROMOTING OUR EAT WELL, BE WELL PROGRAM, AND A RADIO CAMPAIGN ON WCBS. AS OF 2021, THIS PROGRAM HAS REACHED MORE THAN 125,000 STUDENTS, AS WELL AS OVER 6,000 PARENTS AND SCHOOL STAFF IN SCHOOLS THROUGHOUT WESTCHESTER, ROCKLAND AND PUTNAM COUNTIES, WITH INFORMATION ON HOW TO MAKE FOOD AND LIFESTYLE CHOICES THAT WILL PROMOTE HEALTHY LIVING FOR A LIFETIME. |
| 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 |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| 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 (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LEVINE LAWRENCE | ||||||||||||||
| PRESIDENT AND CEO | $712,419 | $0 | $214,929 | $0 | $13,614 | $0 | $142,483 | $0 | $31,030 | $0 | $1,114,475 | $0 | $0 | $0 |
| KLEIN SCOTT M | ||||||||||||||
| CHIEF MEDICAL OFFICER | $484,975 | $0 | $112,200 | $0 | $2,489 | $0 | $87,192 | $0 | $42,379 | $0 | $729,235 | $0 | $0 | $0 |
| CANNING JOHN EDWARD | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $415,578 | $0 | $100,000 | $0 | $11,226 | $0 | $111,663 | $0 | $42,232 | $0 | $680,699 | $0 | $0 | $0 |
| FERNANDEZ BYRON | ||||||||||||||
| CLINICAL/UNIT CHIEF | $335,152 | $0 | $6,000 | $0 | $0 | $0 | $50,402 | $0 | $42,232 | $0 | $433,786 | $0 | $0 | $0 |
| WEGENER JILL MARIE | ||||||||||||||
| CHIEF NURSING OFFICER | $275,791 | $0 | $54,900 | $0 | $2,489 | $0 | $13,832 | $0 | $0 | $0 | $347,012 | $0 | $0 | $0 |
| FLANAGAN JOHN J | ||||||||||||||
| VICE PRESIDENT OF OPERATIONS | $263,740 | $0 | $34,200 | $0 | $2,489 | $0 | $13,313 | $0 | $14,074 | $0 | $327,816 | $0 | $0 | $0 |
| SILVERMAN KATHY | ||||||||||||||
| CLINICAL/UNIT CHIEF | $261,905 | $0 | $6,000 | $0 | $0 | $0 | $40,551 | $0 | $15,364 | $0 | $323,820 | $0 | $0 | $0 |
| ALEJANDRO RUTH ESTHER | ||||||||||||||
| ATTENDING PHYSIATRIST | $222,115 | $0 | $2,000 | $0 | $0 | $0 | $44,072 | $0 | $46,104 | $0 | $314,291 | $0 | $0 | $0 |
| KOCH CAPOBIANCO LISA | ||||||||||||||
| VICE PRESIDENT OF DEVELOPMENT | $224,314 | $0 | $33,000 | $0 | $2,489 | $0 | $10,398 | $0 | $42,232 | $0 | $312,433 | $0 | $0 | $0 |
| ASHE DAVID | ||||||||||||||
| ATTENDING PEDIATRICIAN | $241,888 | $0 | $2,500 | $0 | $0 | $0 | $4,134 | $0 | $25,907 | $0 | $274,429 | $0 | $0 | $0 |
| GOODBODY MURRAY SUSAN | ||||||||||||||
| CHIEF ENGAGEMENT & EXPERIENCE | $207,522 | $0 | $21,500 | $0 | $2,489 | $0 | $40,465 | $0 | $1,241 | $0 | $273,217 | $0 | $0 | $0 |
| DIDIE MARY MARGARET | ||||||||||||||
| CLINICAL/UNIT CHIEF | $222,977 | $0 | $2,500 | $0 | $0 | $0 | $0 | $0 | $28,628 | $0 | $254,105 | $0 | $0 | $0 |
| CORNELL CONSTANCE T | ||||||||||||||
| VICE PRESIDENT OF STRATEGIC CO | $164,511 | $0 | $22,500 | $0 | $2,254 | $0 | $7,391 | $0 | $42,232 | $0 | $238,888 | $0 | $0 | $0 |
| DE MURO CINDY L | ||||||||||||||
| DIRECTOR OF HUMAN RESOURCES | $184,723 | $0 | $5,600 | $0 | $1,164 | $0 | $8,246 | $0 | $28,628 | $0 | $228,361 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PROVIDES NON-QUALIFIED DEFERRED COMPENSATION IN THE FORM OF A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO MEMBERS OF A SELECT GROUP OF MANAGEMENT THAT INCLUDES LAWRENCE LEVINE-CEO, SCOTT KLEIN-CMO, AND JOHN CANNING-CFO. THE PLANS ARE UNFUNDED DEFINED CONTRIBUTION PLANS THAT ARE AT-RISK OF SIGNIFICANT FORFEITURE AND HAVE VESTING PERIODS RANGING FROM 5 TO 12 YEARS. FOR EACH PLAN YEAR THE HOSPITAL MAKES QUARTERLY CONTRIBUTIONS ON BEHALF OF THE PARTICIPANTS IN AN AMOUNT EQUAL TO TWENTY (20%), AND FIFTEEN PERCENT (15%) RESEPECTIVELY FOR THE CEO, COO, AND CFO. IN 2021, THE HOSPITAL CONTRIBUTED THE FOLLOWING AMOUNTS LARRY LEVINE - CEO $142,282 SCOTT KLEIN - CMO $72,746 JOHN CANNING - CFO $62,337 | 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 | DORMITORY AUTHORITY OF NY (DASNY) | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 146000293 | BondIssuerEIN |
| CUSIP | 649905DG8 | CUSIPNum |
| Bond Issued | 2009-06-19 | BondIssuedDt |
| Issue Price | $27,000,000 | IssuePriceAmt |
| Purpose | CONSTRUCTION | 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 | $7,860,000 | RetiredAmt |
| Total Proceeds | $26,748,127 | TotalProceedsAmt |
| In Reserve Fund | $118,441 | InReserveFundAmt |
| Issuance Costs From Proceeds | $540,000 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $820,868 | CreditEnhancementAmt |
| Capital Expenditures | $25,387,259 | CapitalExpendituresAmt |
| Substantial Completion | 2011 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | 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 | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | 0 | EngageBondCounselContractsInd |
| 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 | Yes (1) | 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 | Yes (1) | 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 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, COLUMN (E) & PART II, LINE 3: | THE DIFFERENCE BETWEEN THE ISSUE PRICE (PART I, COLUMN (E)) AND TOTAL PROCEEDS (PART II, LINE 3) IS DUE TO (A) AN INCREASE FOR INVESTMENT EARNINGS OF $227,835, AND (B) A DECREASE DUE TO SALE PROCEEDS OF $479,707 THAT WERE USED TO CALL AND RETIRE OUTSTANDING BONDS. |
| PART II, LINE 4: | THE AMOUNT ENTERED HERE IS A DEBT SERVICE FUND BALANCE. |
| PART IV, LINE 2C: | THE DATE OF THE COMPUTATION IS NOT KNOWN BY BLYTHEDALE CHILDREN'S HOSPITAL. ARBITRAGE REPORTING IS HANDLED BY THE ACTUAL ISSUER OF THE BONDS, AND BLYTHEDALE CHILDREN'S HOSPITAL DOES NOT HAVE A COPY OF THE ACTUAL REBATE REPORT. |
| PART IV, LINE 6: | SUCH AMOUNTS WERE APPROPRIATELY YIELD RESTRICTED. |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 19 | ContributionCnt |
| Noncash Contributions Rpt F990 | $274,342 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING PRICE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | 19 REPRESENTS THE NUMBER OF CONTRIBUTIONS RECEIVED IN 2021. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | JOHN FURTH AND OWEN GUTFREUND (BOARD MEMBERS) HAVE A FAMILY RELATIONSHIP. DAVID PEDOWITZ HAS A BUSINESS RELATIONSHIP WITH PATRICIA STANLEY (BOARD MEMBERS, AND FORMER BOARD MEMBER, RESPECTIVELY), LARRY COHEN, AND PEGGY TANNER (BOARD MEMBERS, AND FORMER BOARD MEMBER, RESPECTIVELY). |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BLYTHEDALE CHILDREN'S HOSPITAL'S BOARD OF TRUSTEES PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 IS REVIEWED BY THE BLYTHEDALE FINANCE DEPARTMENT AS WELL AS BY DELOITTE TAX, LLP, BEFORE IT IS PRESENTED TO THE BOARD'S AUDIT & COMPLIANCE COMMITTEE. THE COMMITTEE AUTHORIZES DELOITTE TO FILE ON OUR BEHALF AND THEN PROVIDES AN OVERVIEW OF THE FORM 990 TO THE FULL BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS, SENIOR MANAGEMENT AND KEY EMPLOYEES OF BLYTHEDALE CHILDREN'S HOSPITAL MUST COMPLETE A STATEMENT ANNUALLY AND WHENEVER NEW INFORMATION ARISES, WHICH DISCLOSES ANY POTENTIAL CONFLICT OF INTEREST, AS REQUIRED BY THE HOSPITAL'S CONFLICT OF INTEREST POLICY. THESE STATEMENTS ARE REVIEWED BY THE HOSPITAL'S COMPLIANCE OFFICER WHO PREPARES A REPORT ON DISCLOSURES FOR THE BOARD'S AUDIT & COMPLIANCE COMMITTEE. HOSPITAL BOARD MEMBERS AND STAFF ARE TRAINED AND EDUCATED ON THEIR OBLIGATIONS UNDER THIS POLICY, INCLUDING ITS GIFT AND GRATUITIES PROVISIONS. ONCE A YEAR, THE HOSPITAL DISTRIBUTES A CERTIFICATION AND DISCLOSURE FORM TO ITS OFFICERS, DIRECTORS AND KEY EMPLOYEES, IN WHICH EACH RESPONDENT CERTIFIES THAT HE OR SHE: (I) HAS RECEIVED A COPY OF THE CONFLICT OF-INTEREST POLICY; (II) HAS READ AND UNDERSTANDS THE POLICY; (III) HAS AGREED TO COMPLY WITH THE POLICY; AND (IV) UNDERSTANDS THAT THE HOSPITAL IS CHARITABLE AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION IT MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS EXEMPT PURPOSES AND NOT ENGAGE IN ACTIVITIES AND TRANSACTIONS THAT PROVIDE IMPERMISSIBLE BENEFITS TO INDIVIDUALS OR ENTITIES. IN ADDITION, THE CERTIFICATION AND DISCLOSURE FORM ALSO REQUIRE EACH PERSON TO EITHER: (I) CERTIFY THAT HE OR SHE HAS NO ACTUAL OR POSSIBLE CONFLICT OF INTEREST TO REPORT, OR (II) DESCRIBE ANY RELATIONSHIPS, TRANSACTIONS, OR OTHER CIRCUMSTANCES, INCLUDING THOSE OF AN IMMEDIATE FAMILY MEMBER, THAT COULD RESULT IN A CONFLICT BETWEEN THE HOSPITAL'S INTERESTS AND HIS OR HER PERSONAL, FINANCIAL OR OTHER INTERESTS. AS PART OF THE ANNUAL PROCESS, THE HOSPITAL PROVIDES EACH PERSON COVERED BY THE CONFLICT-OF-INTEREST POLICY WITH A COPY OF THE POLICY AND OFFERS INDIVIDUALS THE OPPORTUNITY TO ASK QUESTIONS ABOUT THE POLICY. THE COVERED PERSONS SHOULD THEN BE REQUIRED TO COMPLETE AND SIGN THE CERTIFICATION AND DISCLOSURE FORM, WHICH SHOULD BE RETAINED IN THE HOSPITAL'S FILES. TO PROPERLY MONITOR AND ENFORCE A CONFLICT-OF-INTEREST POLICY, THE HOSPITAL IS DILIGENT IN REVIEWING THE ANNUAL DISCLOSURE FORMS SUBMITTED BY COVERED PERSONS, AND IN COMPILING AND MAINTAINING A LIST OF POTENTIALLY CONFLICTED ENTITIES AND INDIVIDUALS. PROPOSED TRANSACTIONS CAN THEN BE MATCHED AGAINST THE LIST AS A MEANS OF IDENTIFYING POSSIBLE CONFLICTS. THE HOSPITAL HAS IDENTIFIED THE CHIEF COMPLIANCE OFFICER AS THE PERSON ULTIMATELY RESPONSIBLE FOR MAINTAINING THE LIST AND SCREENING FOR POSSIBLE CONFLICTS OF INTEREST. WHEN DEALING WITH MAJOR VENDORS AND SERVICE PROVIDERS, THE HOSPITAL ASKS THE VENDOR OR SERVICE PROVIDER TO DISCLOSE ANY RELATIONSHIP - PERSONAL, FINANCIAL, OR OTHERWISE - THAT THE VENDOR OR SERVICE PROVIDER HAS WITH ANY OF THE HOSPITAL'S DIRECTORS, OFFICERS, EMPLOYEES, OR VOLUNTEERS. IN ADDITION, THE HOSPITAL UNDERTAKES PERIODIC REVIEWS OF TRANSACTIONS INVOLVING ANY SIGNIFICANT EXPENDITURE OF ORGANIZATIONAL FUNDS TO ENSURE ANY COMPENSATION PAID CONTINUES TO BE REASONABLE. IF A POSSIBLE CONFLICT IS IDENTIFIED WITH RESPECT TO A PROPOSED TRANSACTION, THE HOSPITAL IS COMMITTED TO FOLLOWING THE PROCEDURES SET OUT IN ITS CONFLICT-OF INTEREST POLICY FOR DETERMINING WHETHER AN ACTUAL CONFLICT OF INTEREST EXISTS, AND THE PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST. AMONG THE STEPS THE HOSPITAL TAKES ARE THE FOLLOWING: (I) THE PERSON WITH THE POTENTIAL CONFLICT WITH RESPECT TO A TRANSACTION SHOULD DISCLOSE SUCH CONFLICT (II) THE PERSON DOES NOT PARTICIPATE OR BE PRESENT AT ANY MEETING DURING WHICH THE DISCUSSION OF THE POSSIBLE CONFLICT OF INTEREST TAKES PLACE (III) THE CHAIR OF THE BOARD, IF APPROPRIATE, APPOINT A COMMITTEE OF THE BOARD MADE UP OF DISINTERESTED DIRECTORS TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION (IV) IF THERE IS A MORE ADVANTAGEOUS TRANSACTION IS NOT REASONABLY AVAILABLE, THE GOVERNING BOARD OR COMMITTEE DETERMINES WHETHER THE TRANSACTION IS IN THE ORGANIZATION'S BEST INTEREST AND IS FAIR AND REASONABLE. |
| FORM 990, PART VI, SECTION B, LINE 15 | BLYTHEDALE CHILDREN'S HOSPITAL MAINTAINS A DILIGENT, THOROUGH, AND TRANSPARENT PROCESS TO EVALUATE EXECUTIVE COMPENSATION. ON AN ANNUAL BASIS, BLYTHEDALE FORMALLY ENGAGES SULLIVAN, COTTER AND ASSOCIATES (SCA) TO PROVIDE THE COMPENSATION COMMITTEE WITH A COMPLETE TOTAL COMPENSATION STUDY OF ALL ELEMENTS OF EXECUTIVE COMPENSATION. THIS IS DONE TO ENSURE THE OVERALL REASONABLENESS OF THE TOTAL COMPENSATION PROVIDED TO ITS CHIEF EXECUTIVE OFFICER (CEO) AND ALL OTHER EXECUTIVES. IN ADDITION, BLYTHEDALE ALSO ENGAGES SCA TO REVIEW BOTH THE NATIONAL AND REGIONAL HEALTHCARE MARKETPLACE TO DETERMINE ANNUAL BASE PAY INCREASE PROJECTIONS FOR ALL MAIN EMPLOYEE CATEGORIES INCLUDING EXECUTIVES. SULLIVAN, COTTER AND ASSOCIATES IS A WELL-REGARDED COMPENSATION CONSULTING FIRM WITH REGIONAL AND NATIONAL EXPERTISE. THE FIRM COMPARES BLYTHEDALE'S EXECUTIVE COMPENSATION TO A PRIMARY COMPARATOR MARKET OF SIMILARLY SITUATED ORGANIZATIONS THAT INCLUDES REGIONAL CHILDREN'S AND REHABILITATION NOT-FOR-PROFIT HOSPITALS; NOT-FOR-PROFIT HOSPITALS IN THE METROPOLITAN NEW YORK AREA; AND NOT-FOR-PROFIT HOSPITALS IN THE HUDSON VALLEY REGION. THE PRIMARY COMPARATOR MARKET REFLECTS THE ORGANIZATION'S EXECUTIVE RECRUITMENT AND RETENTION MARKET AND COMPLIES WITH THE DEFINITION OF "COMPARABLE ORGANIZATIONS AS SET FORTH IN THE IRS INTERMEDIATE SANCTIONS REGULATIONS. IN 2021, SCA PROVIDED TO THE BOARD'S COMPENSATION COMMITTEE AN ASSESSMENT OF THE COMPETITIVENESS OF THE TOTAL COMPENSATION PROVIDED TO BLYTHEDALE'S EXECUTIVES RELATIVE TO PREVALENT AND COMPARABLE MARKETPLACE PRACTICES. FURTHERMORE, SCA ASSISTED THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES IN REVIEWING BLYTHEDALE'S EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT AND REVIEWED THE RANGES FOR INCENTIVE COMPENSATION AWARDS FOR THE CEO AND OTHER EXECUTIVES. IN ADDITION TO ANALYZING THE DATA PROVIDED BY SCA, THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES CONSIDERS A NUMBER OF FACTORS WHEN REVIEWING AND ESTABLISHING COMPENSATION FOR THE CEO AND ALL OTHER EXECUTIVES INCLUDING BUT NOT LIMITED TO THE FOLLOWING: DEVELOPMENT OF NEW PROGRAMS; MOBILIZING THE HOSPITAL TO STRIVE FOR EXCELLENT RESULTS IN PATIENT CARE; MANAGEMENT PERFORMANCE AND COMPLIANCE WITH ALL PROFESSIONAL AND REGULATORY STANDARDS; AND INITIATIVES AND FACILITIES TO SUPPORT AND ADVANCE BLYTHEDALE'S MISSION WHILE EFFECTIVELY ALLOCATING AND MANAGING THE HOSPITAL'S RESOURCES. BY REVIEWING THE COMPENSATION DATA FROM INDEPENDENT SOURCES FOR FUNCTIONALLY COMPARABLE POSITIONS IN ORGANIZATIONS COMPARABLE TO BLYTHEDALE AND BY ANALYZING THE INTERNAL PERFORMANCE DATA, THE COMPENSATION COMMITTEE DETERMINES THAT IT PROVIDES A "REBUTTABLE PRESUMPTION OF REASONABLENESS" THAT THE TOTAL COMPENSATION PROVIDED TO BLYTHEDALE EXECUTIVES IS REASONABLE AND CONSISTENT WITH MARKET PRACTICES. |
| FORM 990, PART VI, SECTION C, LINE 19 | BLYTHEDALE CHILDREN'S HOSPITAL MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC BY RETAINING A COPY OF EACH AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. THE ORGANIZATION' S FORM 990 IS ALSO AVAILABLE FOR PUBLIC INSPECTION ON WWW.GUIDESTAR.ORG. THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION. |
| FORM 990, PART XI, LINE 9: | CHANGE IN PENSION LIABILITY 8,348,269. PENSION NPBC TRANSFER FROM NON OPERATING 490,626. |