REGIONAL MEDICAL PRACTICE PC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- REGIONAL MEDICAL PRACTICE PC (EIN 20-4848729)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-12
- IRS object ID
- 202103169349308195
- Schema version
- 2020v4.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-12T14:12:40-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161226221 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUST CHARLES CHAMBERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5784 WIDEWATERS PARKWAY | AddressLine1Txt |
| City | SYRACUSE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204848729 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REGIONAL MEDICAL PRACTICE PC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | REGI | BusinessNameControlTxt |
| Phone | 3157563500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 134 HOMER AVENUE | AddressLine1Txt |
| City | CORTLAND | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 130450960 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FREDERICK BLOOM | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3157563500 | PhoneNum |
| Signature | 2021-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | FREDERICK | PersonFirstNm |
| Person Last | BLOOM | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA M FRANCO | PreparerPersonNm |
| PTIN | P00589741 | PTIN |
| Phone | 3154463600 | PhoneNum |
| Preparation | 2021-11-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | FREDERICK BLOOM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 134 HOMER AVENUE | AddressLine1Txt |
| City | CORTLAND | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13045 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,388,520 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.REGIONALMEDICALPRACTICE.COM/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | ENGAGE IN THE PRACTICE OF MEDICINE AND PROVIDE PHYSICIAN SERVICES THAT IMPROVE THE STANDARDS AND QUALITY OF HEALTH CARE AVAILABLE TO THE RESIDENTS OF CORTLAND COUNTY AND OTHER AREAS SERVED BY THE CORPORATION. IN ADDITION, PARTICIPATING IN ACTIVITIES TO PROMOTE AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 0 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,568,906 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,849,370 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$8,644 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,887 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,882,348 | PYOtherRevenueAmt |
| CY Other Revenue | $537,263 | CYOtherRevenueAmt |
| PY Total Revenue | $13,442,610 | PYTotalRevenueAmt |
| CY Total Revenue | $3,388,520 | 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 | $12,846,367 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,719,219 | PYOtherExpensesAmt |
| CY Other Expenses | $5,569,012 | CYOtherExpensesAmt |
| PY Total Expenses | $22,565,586 | PYTotalExpensesAmt |
| CY Total Expenses | $5,569,012 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$9,122,976 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,180,492 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,293,577 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,154,316 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,898,715 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,355,011 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$2,605,138 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$8,200,695 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | REGIONAL MEDICAL PRACTICE, P.C.'S PURPOSE IS TO ENGAGE IN THE PRACTICE OF MEDICINE AND PROVIDE PHYSICIAN SERVICES THAT IMPROVE THE STANDARDS AND QUALITY OF HEALTH CARE AVAILABLE TO THE RESIDENTS OF CORTLAND COUNTY AND OTHER AREAS SERVED BY THE CORPORATION. IN ADDITION, PARTICIPATING IN ACTIVITIES TO PROMOTE AND IMPROVE THE OVERALL HEALTH OF THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,081,908 | ExpenseAmt |
| Revenue | $3,384,293 | RevenueAmt |
| Desc | PROVIDING ORTHOPEDIC, CARDIOLOGY, SURGERY, PHYSIATRY, HOSPITALISTS, MEDICAL ONCOLOGY, PSYCHIATRY, PULMONOLOGY, UROLOGY, FAMILY PRACTICE, OPHTHALMOLOGY, PODIATRY, INFECTIOUS DISEASE, GASTROENTEROLOGY, MID-WIVES, AND INTERNAL MEDICINE SERVICES THROUGH ITS PHYSICIAN OFFICES. | Desc |
| Total Program Service Expenses | $5,081,908 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 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 | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 23 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 0 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 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 | DENISE WRINN - CORTLAND REGIONAL MED | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6077563501 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 134 HOMER AVENUE | AddressLine1Txt |
| City | CORTLAND | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13045 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (2 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt |
|---|---|---|---|---|---|---|---|
| FREDERICK BLOOM | |||||||
| PRESIDENT | 37.50 | Yes (X) | Yes (X) | $0 | $483,467 | $86,919 | |
| JENNIFER YARTYM | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $268,317 | $17,413 | 39.00 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $751,784 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $104,332 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | 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 |
|---|---|---|---|---|---|
| UPSTATE UROLOGY INC | |||||
| 750 E ADAMS ST | SYRACUSE | NY | 13210 | PHYSICIAN | $487,687 |
| MCKESSON MEDICAL SURGICAL | |||||
| 9954 MAYLAND DR | RICHMOND | VA | 23233 | MEDICAL SUPPLIES | $315,511 |
| BRUCE SLAGLE MD | |||||
| 8779 STATE ROUTE 13 | CANASTOTA | NY | 13032 | PHYSICIAN | $250,061 |
| HASAN ZAKARIYYA | |||||
| 946 S 1ST STREET | FULTON | NY | 13069 | PHYSICIAN | $245,404 |
| TALI REEIS MARTIN MD PC | |||||
| 2220 VESTAL PARKWAY EAST 2 | VESTAL | NY | 13850 | PHYSICIAN | $228,150 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICE REVENU | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $2,849,370 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,849,370 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,849,370 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,887 | TotalRevenueColumnAmt |
| Exclusion | $1,887 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,340 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,340 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,340 | TotalRevenueColumnAmt |
| Exclusion | $2,340 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $534,923 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $534,923 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $534,923 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,388,520 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,384,293 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,227 | ExclusionAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,000 | TotalAmt |
| Management And General | $15,000 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,947 | TotalAmt |
| Program Services | $30,947 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,008 | TotalAmt |
| Program Services | $102,579 | ProgramServicesAmt |
| Management And General | $69,429 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,921 | TotalAmt |
| Program Services | $224,532 | ProgramServicesAmt |
| Management And General | $4,389 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,996 | TotalAmt |
| Program Services | $147,321 | ProgramServicesAmt |
| Management And General | $2,675 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,027 | TotalAmt |
| Program Services | $5,826 | ProgramServicesAmt |
| Management And General | $201 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49 | TotalAmt |
| Management And General | $49 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,821 | TotalAmt |
| Program Services | $46,113 | ProgramServicesAmt |
| Management And General | $25,708 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHYSICIAN FEES | $3,522,056 | $3,522,056 | |
| CONTRACT LABOR | $1,247,089 | $948,767 | $298,322 |
| BAD DEBT EXPENSE | $37,200 | $37,200 | |
| TAXES AND ASSESSMENTS | $18,676 | $10,833 | $7,843 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,222 | TotalAmt |
| Program Services | $5,734 | ProgramServicesAmt |
| Management And General | $63,488 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,569,012 | TotalAmt |
| Program Services | $5,081,908 | ProgramServicesAmt |
| Management And General | $487,104 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $425,105 | BOYAmt |
| EOY | $1,687,659 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $849,375 | BOYAmt |
| EOY | $456,437 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,690 | BOYAmt |
| EOY | $2,743 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,477 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,821,407 | BOYAmt |
| EOY | $7,477 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,293,577 | BOYAmt |
| EOY | $2,154,316 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,148,715 | BOYAmt |
| EOY | $10,355,011 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,750,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,898,715 | BOYAmt |
| EOY | $10,355,011 | 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 | -$2,605,138 | BOYAmt |
| EOY | -$8,200,695 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$2,605,138 | BOYAmt |
| EOY | -$8,200,695 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,293,577 | BOYAmt |
| EOY | $2,154,316 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,180,492 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$3,415,065 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,477 | OtherCostOrOtherBasisAmt |
| Book Value | $7,477 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,477 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FREDERICK BLOOM | ||||||||||||||
| PRESIDENT | $0 | $477,527 | $0 | $0 | $0 | $5,940 | $0 | $65,873 | $0 | $21,046 | $0 | $570,386 | $0 | $0 |
| JENNIFER YARTYM | ||||||||||||||
| SECRETARY | $0 | $249,617 | $0 | $13,000 | $0 | $5,700 | $0 | $13,787 | $0 | $3,626 | $0 | $285,730 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | FRED BLOOM IS THE SOLE SHAREHOLDER OF REGIONAL MEDICAL PRACTICE, P.C. |
| FORM 990, PART VI, SECTION B, LINE 11B | BEFORE THE 990 IS SUBMITTED, IT IS MADE AVAILABLE TO THE BOARD OF DIRECTORS FOR THEIR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | REGIONAL MEDICAL PRACTICE, P.C. ENFORCES ITS CONFLICT OF INTEREST POLICY REQUIRING OFFICERS AND DIRECTORS TO SUBMIT ANNUAL CONFLICT OF INTEREST STATEMENTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | CORTLAND REGIONAL MEDICAL CENTER, INC. (THE HOSPITAL) HAS A COMPENSATION COMMITTEE AND THEY REVIEW THE STANDARDS OF PERFORMANCE FOR THE KEY OBJECTIVES AND MEASURE RESULTS. THEY ALSO DO THE FOLLOWING: -CONSIDER FACTORS INVOLVED IN MANAGERIAL EFFECTIVENESS -CONSIDER ANY UNANTICIPATED RESPONSIBILITIES OR SPECIAL ACCOMPLISHMENTS -SOLICIT PERFORMANCE EVALUATION FROM ALL BOARD MEMBERS -CONDUCT A PERFORMANCE REVIEW OF THE CEO -DETERMINE THE OVERALL EVALUATION AND AWARD LEVEL -RECEIVE A PERFORMANCE REVIEW FROM THE CEO FOR ALL OTHER MEMBERS OF THE EXECUTIVE MANAGEMENT TEAM AND A SUMMARY OF PROPOSED SALARY AND INCENTIVE AWARDS SALARIES FOR REGIONAL MEDICAL PRACTICE P.C.'S PHYSICIANS AND MID-LEVEL PROVIDERS ARE SET BASED ON NATIONAL MGMA SPECIALTY GUIDELINES BETWEEN THE 25TH AND 50TH PERCENTILES. |
| FORM 990, PART VI, SECTION C, LINE 18 | REGIONAL MEDICAL PRACTICE, P.C.'S 990 IS AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | REGIONAL MEDICAL PRACTICE, P.C.'S GOVERNING DOCUMENTS, FINANCIAL STATEMENT AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | ADJUSTMENT DUE TO GUTHRIE AFFILIATION -3,415,065. |
| SCHEDULE A LINE 3 | REGIONAL MEDICAL PRACTICE, PC IS A CAPTIVE PHYSICIAN PRACTICE WHICH HAS AS ITS MAIN PURPOSE THE PROVISION OF MEDICAL SERVICES, IT APPROPRIATELY NOTED ON FORM 1023 THAT IT IS A HOSPITAL. THE STATE OF NEW YORK DOES NOT REQUIRE CAPTIVE PHYSICIAN PRACTICES TO BE LICENSED AS A HOSPITAL. AS A CAPTIVE PHYSICIAN PRACTICE, REGIONAL MEDICAL PRACTICE, PC HAS AS ITS PRINCIPAL PURPOSE THE PROVISION OF MEDICAL CARE. ACCORDINGLY, IT WAS (I) PROPERLY IDENTIFIED AS A "HOSPITAL" ON FORM 1023; (II) PROPERLY IDENTIFIED AS A "HOSPITAL" ON FORM 990 SCHEDULE A; AND (III) SHOULD NOT BE DESIGNATED AS A "HOSPITAL/HOSPITAL FACILITY" ON FORM 990 SCHEDULE H. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| GUTHRIE CORTLAND MEDICAL CENTER | |||||||||||
| 134 HOMER AVENUE | CORTLAND | NY | 13045 | 150532079 | NOT-FOR-PROFIT ACUTE CARE | NY | 501(C)(3) | 3 | N/A | 0 | |
| TROY COMMUNITY HOSPITAL INC | |||||||||||
| 275 GUTHRIE DRIVE | TROY | PA | 16947 | 240800337 | HEALTH CARE | PA | 501(C)(3) | 3 | 0 | TGC | |
| CORNING HOSPITAL | |||||||||||
| ONE GUTHRIE DRIVE | CORNING | NY | 14830 | 160393490 | HEALTH CARE | NY | 501(C)(3) | 3 | 0 | TGC | |
| DONALD GUTHRIE FOUNDATION | |||||||||||
| ONE GUTHRIE SQUARE | SAYRE | PA | 18840 | 246022957 | MEDICAL RESEARCH | PA | 501(C)(3) | 4 | 0 | TGC | |
| GUTHRIE HOME CARE | |||||||||||
| 421 TOMAHAWK ROAD | TOWANDA | PA | 18848 | 232394345 | HOME HEALTH | PA | 501(C)(3) | 10 | 0 | TGC | |
| GUTHRIE MEDICAL GROUP PC | |||||||||||
| ONE GUTHRIE SQUARE | SAYRE | PA | 18840 | 250815795 | HEALTH CARE | PA | 501(C)(3) | 3 | 0 | TGC | |
| GUTHRIE RISK RETENTION GROUP | |||||||||||
| 151 MEETING STREET | CHARLESTON | SC | 29401 | 201090801 | SUPPORTING | SC | 501(C)(3) | 12A, I | 0 | TGC | |
| THE GUTHRIE CLINIC | |||||||||||
| ONE GUTHRIE DRIVE | SAYRE | PA | 18840 | 233055017 | SUPPORTING | PA | 501(C)(3) | 3 | N/A | 0 | |
| SAYRE HOUSE OF HOPE | |||||||||||
| ONE GUTHRIE DRIVE | SAYRE | PA | 18840 | 203979472 | HEALTH CARE | PA | 501(C)(3) | 3 | 0 | TGC | |
| GUTHRIE TOWANDA MEMORIAL HOSPITAL | |||||||||||
| 91 HOSPITAL DRIVE | TOWANDA | PA | 18848 | 240786657 | HEALTH CARE | PA | 501(C)(3) | 3 | 0 | TGC | |
| CORTLAND MEMORIAL FOUNDATION INC | |||||||||||
| 134 HOMER AVENUE | CORTLAND | NY | 13045 | 222230692 | SUPPORTING | NY | 501(C)(3) | 12B, 13 | 0 | GCMC | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| GUTHRIE CORTLAND MEDICAL CENTER | ||
| A | $247,041 | FMV |
| GUTHRIE CORTLAND MEDICAL CENTER | ||
| Q | $3,469,796 | FMV |
| GUTHRIE CORTLAND MEDICAL CENTER | ||
| P | $1,726,353 | FMV |
| GUTHRIE CORTLAND MEDICAL CENTER | ||
| S | $1,750,000 | FMV |