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ALICE HYDE MEDICAL CENTER: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
ALICE HYDE MEDICAL CENTER (EIN 15-0346515)
Tax period
2023-10-01 to 2024-09-30
Filed
2025-08-12
IRS object ID
202522249349301542
Schema version
2023v6.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-08-12T14:39:14-05:00ReturnTs
Tax Period End2024-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161226221PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FUSTCHARLES LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 S WARREN STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN150346515EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ALICE HYDE MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlALICBusinessNameControlTxt
Phone5184833000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PARK STREETAddressLine1Txt
CityMALONECityNm
State AbbreviationNYStateAbbreviationCd
ZIP12953ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMATEJ KOLLARPersonNm
Person TitleVP/CFOPersonTitleTxt
Phone5184833000PhoneNum
Signature2025-08-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHOMAS J GIUFREPreparerPersonNm
PTINP00841958PTIN
Phone3154463600PhoneNum
Preparation2025-08-11PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMATEJ KOLLARPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PARK STREETAddressLine1Txt
CityMALONECityNm
State AbbreviationNYStateAbbreviationCd
ZIP12953ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$115,130,595GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ALICEHYDE.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1905FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTO SERVE THE COMMUNITY THROUGH ACUTE, LONG TERM AND PRIMARY HEALTHCARE.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee898TotalEmployeeCnt
Total Volunteers22TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,138,318PYContributionsGrantsAmt
CY Contributions Grants$3,131,647CYContributionsGrantsAmt
PY Program Service Revenue$89,624,346PYProgramServiceRevenueAmt
CY Program Service Revenue$108,194,275CYProgramServiceRevenueAmt
PY Investment Income-$58,579PYInvestmentIncomeAmt
CY Investment Income$96,170CYInvestmentIncomeAmt
PY Other Revenue$2,657,116PYOtherRevenueAmt
CY Other Revenue$3,030,673CYOtherRevenueAmt
PY Total Revenue$94,361,201PYTotalRevenueAmt
CY Total Revenue$114,452,765CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$70,829,693PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$72,472,230CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$34,491,678PYOtherExpensesAmt
CY Other Expenses$43,868,628CYOtherExpensesAmt
PY Total Expenses$105,321,371PYTotalExpensesAmt
CY Total Expenses$116,340,858CYTotalExpensesAmt
PY Revenues Less Expenses-$10,960,170PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,888,093CYRevenuesLessExpensesAmt
Total Assets BOY$59,902,936TotalAssetsBOYAmt
Total Assets EOY$67,372,089TotalAssetsEOYAmt
Total Liabilities BOY$56,241,267TotalLiabilitiesBOYAmt
Total Liabilities EOY$63,345,265TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,661,669NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,026,824NetAssetsOrFundBalancesEOYAmt
MissionALICE HYDE MEDICAL CENTER WILL DISTINGUISH ITSELF AS A TRUSTED AND RESPECTED HEALTH CARE LEADER AND PROVIDER OF CHOICE, EXCEEDING EXPECTATIONS THROUGH SERVICE EXCELLENCE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$93,585,078ExpenseAmt
Revenue$110,951,644RevenueAmt
DescALICE HYDE MEDICAL CENTER PROVIDES PATIENT CARE AS A CRITICAL ACCESS HOSPITAL, GENERAL MEDICAL/SURGICAL HOSPITAL AND SKILLED NURSING FACILITY. ALICE HYDE MEDICAL CENTER PROVIDED INPATIENT SERVICES FOR 856 PATIENTS, PROVIDED 412,350 OUTPATIENT ANCILLARY PROCEDURES, PROVIDED 77,575 PHYSICIAN OFFICE VISITS, AND PROVIDED 43,790 DAYS OF SKILLED NURSING FACILITY CARE, AND 10,704 DAYS OF ASSISTED LIVING FACILITY CARE DURING THE PERIOD.Desc
Total Program Service Expenses$93,585,078TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document63IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee898EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMATEJ KOLLAR CFOPersonNm
Phone5184833000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PARK STREETAddressLine1Txt
CityMALONECityNm
State AbbreviationNYStateAbbreviationCd
ZIP12953ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
ROBERT G MAIN JR
CHAIR2.000.00Yes (X)Yes (X)$0$0$0
KEVIN HART
SECRETARY2.002.00Yes (X)Yes (X)$0$0$0
THOMAS FITZPATRICK
VICE CHAIR2.000.00Yes (X)Yes (X)$0$0$0
CAROL MCKEE RN
BOARD MEMBER2.000.00Yes (X)$0$0$0
DONNA KISSANE
BOARD MEMBER2.000.00Yes (X)$0$0$0
JASON ELLIS
TREASURER2.000.00Yes (X)Yes (X)$0$0$0
PAUL KOEHLER
BOARD MEMBER2.000.00Yes (X)$0$0$0
BRIAN MONETTE
BOARD MEMBER2.000.00Yes (X)$0$0$0
BARBARA MONTOUR CPA
BOARD MEMBER2.000.00Yes (X)$0$0$0
CRAIG RICHARDS DO
BOARD MEMBER2.000.00Yes (X)$0$0$0
MARINA MEDVED
BOARD MEMBER2.0043.00Yes (X)$0$351,883$26,882
MICHELLE LEBEAU
PRESIDENT & COO10.0040.00Yes (X)$0$610,683$113,166
MATEJ KOLLAR
VP/CFO20.0030.00Yes (X)$0$323,937$53,305
DR LISA MARK
CHIEF MEDICAL OFFICER1.0044.00$0$462,496$50,610Yes (X)
SUSAN BIONDOLILLO
AVP OF LONG TERM CARE45.000.00$188,586$0$6,123Yes (X)
LISA L GOODRICH
VP MEDICAL GROUP NTWK DEPTS1.0049.00$0$416,444$74,035Yes (X)
DR JASON SANDERS
UVMMG PRESIDENT & CEO1.0049.00$0$508,675$95,551Yes (X)
MATT JONES
CVPH AVP/ FORMER AHMC COO0.0040.00$217,739$0$18,846Yes (X)
ROBERT STOUT
PHYSICIAN ASSISTANT (TIL 04/24)40.000.00$236,409$0$8,503Yes (X)
DUYEN NGUYEN
DENTIST40.000.00$229,534$0$17,278Yes (X)
DEBRA PIERCEY
ANESTHETIST NURSE40.000.00$252,407$0$11,557Yes (X)
JOHN REMILLARD
DEVELOPMENT CONSULTANT40.000.00$227,250$0$0Yes (X)
CHRISTOPHER HICKEY
FORMER SVP/CFO5.005.00$0$212,356$36,772Yes (X)
EMILE BENARDOT MD
FORMER DIRECTOR0.00$111,000$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,462,925TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,886,474TotReportableCompRltdOrgAmt
Total Other Compensation$512,628TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K113IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CROSS COUNTRY STAFFING INC
5201 CONGRESS AVENUE SUITE 100 - BBOCA RATONFL33487PHYSICIAN SERVICES$4,136,443
WEATHERBY LOCUMS INC
PO BOX 972633DALLASTX75397PHYSICIAN SERVICES$814,577
MEDICAL SVCS SUFFOLK CNTY PC
39 MAIN STREETTIBURONCA94920PHYSICIAN SERVICES$369,851
ANJNI BHAGAT
756 WEBSTER STREETMALONENY12953PHYSICIAN SERVICES$315,434
HEALTHCARE WORKFORCE LOGISTICS LLC
PO BOX 860573MINNEAPOLISMN55486PHYSICIAN SERVICES$204,601
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
Fundraising$13,860FundraisingAmt
Government Grants$2,051,115GovernmentGrantsAmt
All Other Contributions$1,066,672AllOtherContributionsAmt
Total Contributions$3,131,647TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT CARE622000$105,077,498$105,077,498
340B REVENUE900099$3,104,005$3,104,005
RETAIL PHARMACY REVENUE900099$12,772$12,772
FieldValueIRS element (for citing)
Total Program Service Revenue$108,194,275TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$88,601TotalRevenueColumnAmt
Exclusion$88,601ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$736,111RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$465,160RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$270,951RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$270,951TotalRevenueColumnAmt
Exclusion$270,951ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$215,721SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$208,152SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$7,569SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,569TotalRevenueColumnAmt
Exclusion$7,569ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$6,871FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$13,860ContriRptFundraisingEventAmt
Fundraising Direct Expenses$4,518FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,353TotalRevenueColumnAmt
Exclusion$2,353ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCAFETERIA REVENUEDesc
Business900099BusinessCd
Total Revenue Column$496,813TotalRevenueColumnAmt
Related Or Exempt Func Income$496,813RelatedOrExemptFuncIncomeAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,260,556TotalRevenueColumnAmt
Related Or Exempt Func Income$2,260,556RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,757,369OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$114,452,765TotalRevenueColumnAmt
Related Or Exempt Func Income$110,951,644RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$369,474ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$194,709TotalAmt
Management And General$194,709ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$212,723TotalAmt
Management And General$212,723ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$59,314,803TotalAmt
Program Services$50,902,474ProgramServicesAmt
Management And General$8,412,329ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,944,552TotalAmt
Program Services$1,690,933ProgramServicesAmt
Management And General$253,619ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,646,461TotalAmt
Program Services$5,713,687ProgramServicesAmt
Management And General$932,774ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,158,982TotalAmt
Program Services$3,564,922ProgramServicesAmt
Management And General$594,060ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$161,190TotalAmt
Management And General$161,190ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$31,818TotalAmt
Management And General$31,818ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$2,289TotalAmt
Management And General$2,289ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$13,748,989TotalAmt
Program Services$6,442,650ProgramServicesAmt
Management And General$7,306,339ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$251,336TotalAmt
Program Services$134,116ProgramServicesAmt
Management And General$117,220ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$211,443TotalAmt
Program Services$884ProgramServicesAmt
Management And General$210,559ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,424,488TotalAmt
Program Services$200,175ProgramServicesAmt
Management And General$1,224,313ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$407,921TotalAmt
Program Services$363,410ProgramServicesAmt
Management And General$44,511ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$957,004TotalAmt
Program Services$914,705ProgramServicesAmt
Management And General$42,299ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,491,006TotalAmt
Program Services$2,868,909ProgramServicesAmt
Management And General$622,097ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,281,746TotalAmt
Program Services$397,296ProgramServicesAmt
Management And General$884,450ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & PHAR$13,228,367$13,078,499$149,868
BAD DEBT EXPENSE$3,281,441$3,281,441
REPAIRS AND MAINTENANCE$2,503,372$1,796,201$707,171
PROVIDER TAX EXPENSE$1,127,826$1,127,826

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,758,392TotalAmt
Program Services$1,106,950ProgramServicesAmt
Management And General$651,442ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$116,340,858TotalAmt
Program Services$93,585,078ProgramServicesAmt
Management And General$22,755,780ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,363,354BOYAmt
EOY$5,531,921EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,869,180BOYAmt
EOY$2,551,049EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,853,008BOYAmt
EOY$11,036,176EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$93,923BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,170,888BOYAmt
EOY$1,198,516EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,599,183BOYAmt
EOY$3,665,468EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$64,275,789LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$33,542,041LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$32,848,327BOYAmt
EOY$30,733,748EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,605,330BOYAmt
EOY$4,492,282EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$16,283BOYAmt
EOY$16,283EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$4,483,460BOYAmt
EOY$8,146,646EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$59,902,936BOYAmt
EOY$67,372,089EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$10,886,995BOYAmt
EOY$8,060,339EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$27,628,545BOYAmt
EOY$25,732,848EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$17,725,727BOYAmt
EOY$29,552,078EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$56,241,267BOYAmt
EOY$63,345,265EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,484,263BOYAmt
EOY$3,202,812EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,177,406BOYAmt
EOY$824,012EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,661,669BOYAmt
EOY$4,026,824EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$59,902,936BOYAmt
EOY$67,372,089EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,888,093ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$380,848NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,872,400OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$995,509BeginningYearBalanceAmt
Investment Earnings Or Losses$244,720InvestmentEarningsOrLossesAmt
End Year Balance$1,240,229EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$897,940BeginningYearBalanceAmt
Investment Earnings Or Losses$97,569InvestmentEarningsOrLossesAmt
End Year Balance$995,509EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,122,767BeginningYearBalanceAmt
Investment Earnings Or Losses-$224,827InvestmentEarningsOrLossesAmt
End Year Balance$897,940EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$949,748BeginningYearBalanceAmt
Investment Earnings Or Losses$173,019InvestmentEarningsOrLossesAmt
End Year Balance$1,122,767EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$872,503BeginningYearBalanceAmt
Investment Earnings Or Losses$77,245InvestmentEarningsOrLossesAmt
End Year Balance$949,748EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.14832PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.85168TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,051,000OtherCostOrOtherBasisAmt
Book Value$2,051,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$43,350,304OtherCostOrOtherBasisAmt
Depreciation$20,224,626DepreciationAmt
Book Value$23,125,678BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,687,155OtherCostOrOtherBasisAmt
Depreciation$11,524,213DepreciationAmt
Book Value$4,162,942BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,187,330OtherCostOrOtherBasisAmt
Depreciation$1,793,202DepreciationAmt
Book Value$1,394,128BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$30,733,748TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
OTHER ASSETS$880,228
OPERATING LEASE RIGHT-OF-USE ASSETS, NET$455,968
ESTIMATED 3RD PARTY RECEIVABLE$6,540,056
SECURITY DEPOSITS AND RESIDENT FUNDS$270,394
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,146,646TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
DUE TO RELATED PARTIES$18,936,098
OTHER LIABILITIES$1,177,966
OPERATING LEASE RIGHT-OF-USE-OBLIGATIONS$455,968
ESTIMATED 3RD PARTY PAYOR SETTLEMENTS$8,024,720
ESTIMATED INCURRED BY UNREPORTED MEDICAL CLAIMS$957,326
FieldValueIRS element (for citing)
Total Liability$29,552,078TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE FUNDS, AND ALL NET EARNINGS IN ADDITION THERETO, ARE HELD TO BENEFIT CHARITY, EDUCATION, RESEARCH, AND CHILDREN'S PROGRAMS.
PART X, LINE 2:ALICE HYDE MEDICAL CENTER IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE UNIVERSITY OF VERMONT HEALTH NETWORK. PAGE 18 OF THE CONSOLIDATED FINANCIAL STATEMENTS CONTAIN A FOOTNOTE INDICATING THAT NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1SILENT VIRTUAL AUCTIONEvent1Nm
Gross Receipts Event1$6,423GrossReceiptsEvent1Amt
Charitable Contri Event1$1,250CharitableContriEvent1Amt
Gross Revenue Event1$5,173GrossRevenueEvent1Amt
Rent Facility Costs Event1$250RentFacilityCostsEvent1Amt
Other Direct Expenses Event1$1,311OtherDirectExpensesEvent1Amt
Event25K WALK/RUNEvent2Nm
Gross Receipts Event2$14,308GrossReceiptsEvent2Amt
Charitable Contri Event2$12,610CharitableContriEvent2Amt
Gross Revenue Event2$1,698GrossRevenueEvent2Amt
Cash Prizes Event2$400CashPrizesEvent2Amt
Non Cash Prizes Event2$389NonCashPrizesEvent2Amt
Rent Facility Costs Event2$250RentFacilityCostsEvent2Amt
Entertainment Event2$500EntertainmentEvent2Amt
Other Direct Expenses Event2$1,418OtherDirectExpensesEvent2Amt
Gross Receipts Total$20,731GrossReceiptsTotalAmt
Charitable Contributions Tot$13,860CharitableContributionsTotAmt
Gross Revenue Total Events$6,871GrossRevenueTotalEventsAmt
Cash Prizes Total Events$400CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$389NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$500RentFcltyCostsTotalEventsAmt
Entertainment Total Events$500EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$2,729OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$4,518DirectExpenseSummaryEventsAmt
Net Income Summary$2,353NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other250.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,904,290TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$426,776DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,477,514NetCommunityBenefitExpnsAmt
Total Expense0.01310TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,570,707TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,181,002DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,389,705NetCommunityBenefitExpnsAmt
Total Expense0.15380TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$28,474,997TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,607,778DirectOffsettingRevenueAmt
Net Community Benefit Expns$18,867,219NetCommunityBenefitExpnsAmt
Total Expense0.16690TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$197,993TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$197,993NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$197,993TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$197,993NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$28,672,990TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$9,607,778DirectOffsettingRevenueAmt
Net Community Benefit Expns$19,065,212NetCommunityBenefitExpnsAmt
Total Expense0.16870TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$3,281,441BadDebtExpenseAmt
Bad Debt Expense Attributable$116,124BadDebtExpenseAttributableAmt
Reimbursed By Medicare$16,524,145ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$25,037,604CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$8,513,459MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ALICE HYDE MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1133 PARK STREETAddressLine1Txt
CityMALONECityNm
State AbbreviationNYStateAbbreviationCd
ZIP12953ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.ALICEHYDE.COMWebsiteAddressTxt
State License1624000HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ALICE HYDE MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, SECTION COwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART V, SECTION COtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, SECTION CStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care250.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSEE PART V, SECTION CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSEE PART V, SECTION CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSEE PART V, SECTION CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
ALICE HYDE MEDICAL CENTERPART V, SECTION B, LINE 5: TO HELP INFORM A COLLABORATIVE APPROACH TO IMPROVING COMMUNITY HEALTH, THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) SOUGHT TO IDENTIFY PRIORITIES, FACTORS AND RESOURCES THAT INFLUENCE THE HEALTH OF RESIDENTS OF THE ADIRONDACK REGION (CLINTON, ESSEX, FRANKLIN, FULTON, HAMILTON, WARREN AND WASHINGTON COUNTIES). ARHN SURVEYED STAKEHOLDERS IN THE SEVEN-COUNTY SERVICE AREA, TO PROVIDE THE CHA COMMITTEE WITH INPUT ON REGIONAL HEALTH CARE NEEDS AND PRIORITIES. STAKEHOLDERS INCLUDED PROFESSIONALS FROM HEALTH CARE, SOCIAL SERVICES, EDUCATIONAL, AND GOVERNMENTAL INSTITUTIONS AS WELL AS COMMUNITY MEMBERS. ALICE HYDE MEDICAL CENTER ENGAGED ESSENTIAL CLINICAL STAFF AS PART OF AN INTERNAL PRIORITIZATION COMMITTEE TO ASSESS AND IDENTIFY THE KEY CRITICAL AREAS FOR TARGETED FOCUS AS DETERMINED BY THE 2022 COMMUNITY STAKEHOLDER SURVEY, AND IN SUPPORT OF THE NEW YORK STATE PREVENTION AGENDA. IN ADDITION TO THE VARIETY OF COMMUNITY AND REGIONAL RESOURCES AVAILABLE, ALICE HYDE MEDICAL CENTER (15-0346515) ASSESSED DATA AND PROGRAMS FROM ITS OUTPATIENT PRIMARY CARE PRACTICES, THE EMERGENCY DEPARTMENT AND OTHER KEY HOSPITAL DEPARTMENTS TO FURTHER IDENTIFY AREAS OF FOCUS AND AVAILABLE ASSETS. LEAD STAFF FROM FRANKLIN COUNTY PUBLIC HEALTH, THE UNIVERSITY OF VERMONT HEALTH NETWORK ALICE HYDE MEDICAL CENTER AND ADIRONDACK HEALTH WORKED WITH PARTNERS TO COLLECT ACTIVITIES AND INTERVENTIONS IN SUPPORT OF THE NEW YORK STATE PREVENTION AGENDA. DETERMINATION OF SPECIFIC INTERVENTIONS RELATED TO EACH PRIORITY AREA WAS BASED ON ALIGNMENT WITH THE SPECIFIC GOALS AND OBJECTIVES EACH AGENCY IS COMMITTED TO; OTHER POPULATION HEALTH BASED INITIATIVES OCCURRING WITHIN THE ORGANIZATION; AND ORGANIZATIONAL ABILITY TO MAKE A SUSTAINED IMPACT WITH THE INTERVENTION.
ALICE HYDE MEDICAL CENTERPART V, SECTION B, LINE 6A: ADIRONDACK HEALTH - ADIRONDACK MEDICAL CENTER
ALICE HYDE MEDICAL CENTERPART V, SECTION B, LINE 6B: FRANKLIN COUNTY HEALTH DEPARTMENT - PUBLIC HEALTH UNIT
ALICE HYDE MEDICAL CENTERPART V, SECTION B, LINE 11: ALICE HYDE MEDICAL CENTER IDENTIFIED TWO NYS PREVENTION AGENDA PRIORITY AREAS FOR THE 2022-2024 COMMUNITY SERVICE PLAN CYCLE: (1) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AND (2) PREVENT CHRONIC DISEASE. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO ALICE HYDE MEDICAL CENTER.THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS:PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: PROMOTE WELL BEINGACTION PLAN:INVESTIGATE AND IMPLEMENT COMMUNITY PARTNERSHIPS FOR EXPANDED PRIMARY CARE OFFERINGS IN THE MALONE COMMUNITY TO IMPROVE ACCESS TO CARE. ACHIEVE GERIATRIC EMERGENCY DEPARTMENT (GEDA) ACCREDITATION IN 2022 TO SUPPORT THE NEEDS OF OUR AGING POPULATION. DEVELOP AND PLAN FOR AN ENHANCED/MODERNIZED/REIMAGINED HOSPITAL CAMPUS THROUGH NYS TRANSFORMATION IV GRANT FUNDING. CONTINUE THE ED PEER NAVIGATOR PROGRAM IMPLEMENTED IN AHMC EMERGENCY DEPARTMENT TO PROVIDE ACCESS TO AND COORDINATION OF COMMUNITY BASED RESOURCES FOR PATIENTS FREQUENTING THE ED, WHO NEED ADDITIONAL SERVICES TO MANAGE THEIR HEALTH AND WELL-BEING.PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: MENTAL AND SUBSTANCE USE DISORDER PREVENTIONACTION PLAN:BUILD SUPPORT SYSTEMS TO CARE FOR OPIOID USERS OR AT RISK OF AN OVERDOSE. INTEGRATE TRAUMA INFORMED APPROACHES IN TRAINING STAFF AND IMPLEMENTING PROGRAM AND POLICY. STRENGTHENING RESOURCES FOR FAMILIES AND CAREGIVERS. CONTINUED COORDINATION/COLLABORATION BETWEEN AHMC ED AND THE CITIZEN ADVOCATES' CRISIS INTERVENTION CENTER TO ENSURE PATIENTS PRESENTING TO THE AHMC ED RECEIVE THE APPROPRIATE LEVEL OF CARE. CREATION OF FULLY TRAINED AHMC CISM TEAM (CRITICAL INCIDENT STRESS MANAGEMENT TEAM) IN 2022 TO SUPPORT STAFF, PATIENTS AND FAMILIES EXPERIENCING CRISIS EVENTS. UTILIZE THE EXPERTISE OF THE UVMHN COMMUNICATIONS AND ENGAGEMENT STRATEGIES TEAM TO EDUCATE PROVIDERS, STAFF AND THE BROADER COMMUNITY ON MENTAL AND SUBSTANCE USE DISORDERS AND PREVENTION/EARLY INTERVENTION STRATEGIES. PREVENT CHRONIC DISEASE: HEALTHY EATING AND FOOD SECURITYACTION PLAN:ESTABLISHMENT AND CONTINUED ENHANCEMENT OF EMPLOYEE WELLNESS COMMITTEE (EWC) TO PROMOTE HEALTH AND WELL-BEING FOR ALL EMPLOYEES. COLLABORATE WITH JCEO FOR ONSITE MOBILE FOOD MARKET PROVIDING ACCESS TO HEALTHY FRUITS AND VEGETABLES WEEKLY DURING THE GROWING SEASON. PARTNER WITH LOCAL ORCHARD FOR ONSITE ACCESS TO LOCAL APPLES, HONEY, AND OTHER NATURALLY GROWN PRODUCTS. UTILIZE THE EXPERTISE OF THE UMVHN COMMUNICATION AND ENGAGEMENT STRATEGIES TO CREATE AND PROMOTE MEDIA PIECES SPOTLIGHTING AND EDUCATING STAFF, PATIENTS AND THE COMMUNITY ABOUT THE HEALTH BENEFITS ASSOCIATED WITH HEALTHY EATING.PREVENT CHRONIC DISEASE: PHYSICAL ACTIVITYACTION PLAN:IMPLEMENT A COMBINATION OF WORKSITE-BASED PHYSICAL ACTIVITY POLICIES, PROGRAMS, OR BEST PRACTICES THROUGH MULTI-COMPONENT WORKSITE PHYSICAL ACTIVITY AND/OR NUTRITION PROGRAMS; ENVIRONMENTAL SUPPORTS OR PROMPTS TO ENCOURAGE WALKING AND/OR TAKING THE STAIRS; OR STRUCTURED WALKING-BASED PROGRAMS FOCUSING ON OVERALL PHYSICAL ACTIVITY THAT INCLUDE GOAL-SETTING, ACTIVITY MONITORING, SOCIAL SUPPORT, COUNSELING, AND HEALTH PROMOTION AND INFORMATION MESSAGING. IMPLEMENT AND/OR PROMOTE A COMBINATION OF COMMUNITY WALKING, WHEELING, OR BIKING PROGRAMS.AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR. INVESTIGATE THE ABILITY TO CREATE EMPLOYEE FITNESS CENTER ON CAMPUS. PREVENT CHRONIC DISEASE: TOBACCO PREVENTIONACTION PLAN:IMPLEMENT WORKFLOW TO ENSURE ALL PRIMARY CARE PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE (ALL FORMS) AND REFERRED FOR INTERVENTION SERVICES WITH ONSITE CTCS OR NYS QUITLINE.UTILIZE AHMC COMMUNICATIONS AND ENGAGEMENT STRATEGIES DIVISION TO CREATE CONTENT TO PROMOTE AND EDUCATE SMOKERS ABOUT THE BENEFITS OF EVIDENCE-BASED QUITTING APPROACHES PROMOTE THE GREAT AMERICAN SMOKEOUT INITIATIVE WORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS. WORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS, INCLUDING ACCESS TO CERTIFIED TOBACCO CESSATION SPECIALISTS AS NEEDED AND ALSO COLLABORATE WITH NORTH COUNTRY HEALTHY HEART NETWORK TO CREATE AND PROVIDE EDUCATION OPPORTUNITIES AND TOBACCO CESSATION INTERVENTION MATERIALS FOR HEALTH CARE PROVIDERS AND PATIENTS.PREVENT CHRONIC DISEASE - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT ACTION PLAN:WORK WITH HEALTH CARE PROVIDERS/CLINICS TO PUT SYSTEMS IN PLACE FOR PATIENT AND PROVIDER SCREENING REMINDERS (E.G., LETTER, POSTCARDS, EMAILS, RECORDED PHONE MESSAGES, ELECTRONIC HEALTH RECORDS [EHR] ALERTS). PROMOTE THE USE OF HEALTH INFORMATION TECHNOLOGY FOR: MEASUREMENT, REGISTRY DEVELOPMENT, PATIENT ALERTS, BI-DIRECTIONAL REFERRALS, REPORTING. EXPAND ACCESS TO EVIDENCE-BASED SELF-MANAGEMENT INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC DISEASE (ARTHRITIS, ASTHMA, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES, AND OBESITY) WHOSE CONDITION(S) IS NOT WELL-CONTROLLED WITH GUIDELINES-BASED MEDICAL MANAGEMENT ALONE.CONTINUE TO OPTIMIZE THE EPIC EMR SYSTEM TO ENHANCE PATIENT CARE DELIVERY, MEASUREMENT AND REPORTING. UTILIZE THE EPIC EMR REMINDER SYSTEM IN PRIMARY CARE TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS, INCLUDING MANAGEMENT OF PATIENT ALERTS AND REMINDERS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. CONTINUE TO DELIVER THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM TO EXISTING PATIENTS (INPATIENTS AS IDENTIFIED) TO EDUCATE PATIENTS ON BEST PRACTICE STRATEGIES FOR MANAGING THEIR CHRONIC CONDITION SPECIFICALLY WITH THE FOCUS ON CHF, COPD AND DIABETES, WITH THE GOAL OF REDUCING AVOIDABLE READMISSIONS AND IMPROVING THE HEALTH OF OUR PATIENT POPULATION LIVING WITH CHRONIC DISEASE.ALICE HYDE MEDICAL CENTER'S PRIMARY SERVICE AREA IS IDENTIFIED AS THE THIRTEEN NORTHERN NEW YORK TOWNSHIPS OF: BOMBAY 12914, BRUSHTON 12916, BURKE 12917, CHATEAUGAY 12920, CHURUBUSCO 12923, CONSTABLE 12926, DICKINSON CENTER 12930, LYON MOUNTAIN 12955, MALONE 12953, MOIRA 12957, NORTH BANGOR 12966, OWLS HEAD 12969, AND ST. REGIS FALLS 12980. ALICE HYDE MEDICAL CENTER'S SECONDARY SERVICE AREA IS IDENTIFIED AS THE EIGHT TOWNSHIPS IN THE NORTHWEST PORTION OF THE FRANKLIN COUNTY BORDER INTO ST. LAWRENCE COUNTY, INCLUDING BRASHER FALLS 13613, CHASE MILLS 13621, HOGANSBURG 13655, MADRID 13660, MASSENA 13662, NORFOLK 13667, NORTH LAWRENCE 12967, AND WINTHROP 13697. THESE TWO SERVICE AREAS COMPRISE 95% OF AHMC'S PATIENT ORIGIN AS OF THE LATEST AVAILABLE DATA.
PART V, LINE 7A, HOSPITAL FACILITY'S WEBSITE:HTTPS://WWW.ALICEHYDE.COM/ABOUT-US/COMMUNITY-SERVICE-PLANPROGRESS REPORTS AVAILABLE FOR 2023 AND 2024 AT THIS WEBSITE
PART V, LINE 7B, OTHER WEBSITES FOR CHNA REPORT:HTTPS://AHIHEALTH.ORG/ARHN/ HTTPS://COUNTYFRANKLIN.DIGITALTOWPATH.ORG:1007
PART V, LINE 10A, MOST RECENTLY ADOPTED IMPLEMENTATION STARTEGY'S WEBSITE:HTTPS://WWW.ALICEHYDE.COM/ABOUT-US/COMMUNITY-SERVICE-PLANRESULTS: FOCUS AREAS: PROMOTE WELL-BEING AND PREVENT MENTAL HEALTH AND SUBSTANCE USE DISORDERS PROMOTE WELL-BEING MENTAL AND SUBSTANCE USE DISORDERS PREVENTIONPREVENT CHRONIC DISEASE HEALTH EATING AND FOOD SECURITY PHYSICAL ACTIVITY TOBACCO PREVENTION PREVENTION AND CARE MANAGEMENT2023: (1) BEGAN PARTNERSHIP WITH HUDSON HEADWATERS TO EXPAND ACCESS TO NEEDED PRIMARY CARE SERVICES IN THE GREATER MALONE SERVICE AREA(2) OPENED HOSPITAL FITNESS CENTER FOR EMPLOYEES, WITH 47% ENROLLMENT TO DATE(3) COLLABORATED WITH COMMUNITY CONNECTIONS OF FRANKLIN COUNTY TO HELP CONNECT ED VISITORS WITH VITAL COMMUNITY RESOURCES ADDRESSING SOCIAL DETERMINANTS OF HEALTH NEEDS FOR AHMC PATIENTS(4) EARNED BRONZE STATUS AS GERIATRIC EMERGENCY DEPARTMENT ACCREDIATION (GEDA); THE GOAL IS GOLD STATUS BY 2026(5) SIMULATOR TRAINING OF EMPLOYEES IN OUR MANNEQUIN LAB (MALE, PREGNANT FEMALE, BABY) (6) MENTAL HEALTH INTERVENTION TEAM COMPRISED OF MULTIPLE PROFESSIONAL DISCIPLINES (7) ALICE HYDE PROVIDED COMMUNITY BENEFIT INVESTMENTS IN THE GREATER MALONE COMMUNITY, SPECIFICALLY TO INCREASE OPPORTUNITIES FOR NAVIGATION TO SOCIAL SUPPORTIVE SERVICES PROVIDED BY COMMUNITY CONNECTIONS OF FRANKLIN COUNTY, FRANKLIN COUNTY OFFICE FOR THE AGING, AND NORTH COUNTRY HEALTHY HEART NETWORK2024: (1) HUDSON HEADWATERS HEALTH NETWORK BEGAN SEEING PATIENTS IN RENTED SPACE FROM ALICE HYDE UNTIL THEIR 15,000 SQ FT BUILDING ON OUR CAMPUS IS COMPLETE, WHICH IS PROJECTED FOR DECEMBER 2025(2) CONTINUED WORK WITH OUR ED PEER NAVIGATOR PROGRAM TO PROVIDE SOCIAL SUPPORT SERVICES TO PATIENTS ENTERING THE EMERGENCY DEPARTMENT AS IDENTIFIED THROUGH SDOH SCREENING MECHANISMS (TRANSPORTATION, FOOD, HOUSING, HEAT, HEALTH INSURANCE ENROLLMENT, ETC). A CRISIS CLINICIAN HAS BEEN ADDED TO THE ED STAFFING MODEL TO CONNECT PATIENTS IN NEED WITH CRITICALLY IMPORTANT SERVICES.(3) 28 TRAININGS FOR A TOTAL OF 615 INDIVIDUALS WERE COMPLETED IN THE SIMULATION LAB FOR ACLS, EKG TRAINING, PATIENT ROUNDING, IMMINENT BIRTH SITUATION, MOCK CODE AND EMS SKILLS. THE TRAININGS WERE AVAILABLE TO COMMUNITY HEALTH AGENCY STAFF AND INTERNAL HOSPITAL STAFF.(4) IN RESPONSE TO THE UPTICK IN VIOLENT SITUATIONS IN THE HEALTHCARE ENVIRONMENT, MENTAL HEALTH TRAINING CONTINUES TO BE A PRIORITY FOR STAFF AT ALICE HYDE. AHMC HAS IMPLEMENTED THE RIES TRAINING PROGRAM (RESPONDING TO INTENSE EMOTIONAL SITUATIONS) TO PROVIDE A SAFER ENVIRONMENT FOR EMPLOYEES, PATIENTS AND FAMILIES. 123 EMPLOYEES (17.7%) WERE TRAINED IN DE-ESCALATION TECHNIQUES AND PROVIDED NECESSARY SKILLS FOR RESPONDING TO NON-VIOLENT AND VIOLENT HEALTHCARE INCIDENCES.(5) AHMC BECOMES CRITICAL ACCESS HOSPITAL WITH SWING BED PROGRAM, PROVIDING AN AVENUE FOR PATIENTS TO TRANSITION FROM ACUTE INPATIENT CARE TO SKILLED NURSING AND/OR REHABILITATIVE CARE WITHOUT LEAVING THE HOSPITAL TO ENSURE A SEAMLESS RECOVERY AND TRANSITION HOME.(6) ALL PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE AND REFERRED FOR INTERVENTION SERVICES DURING ANNUAL PHYSICAL APPOINTMENT(7) AHMC IS CURRENTLY IMPLEMENTING A NUMBER OF HIGH VALUE CARE INITIATIVES IN THE PRIMARY CARE PRACTICES. TRACKING AND TRENDING OF DIABETES HBA1C POOR CONTROL, INCREASING COLORECTAL SCREENING RATES AND BREAST CANCER SCREENING RATES, HYPERTENSION BLOOD PRESSURE CONTROL, DEPRESSION SCREENING AND FOLLOW UP, AND MEDICARE ANNUAL WELLNESS VISITS. SUBSTANTIAL PROGRESS IS BEING MADE WITH THESE MEASURES, AND THE GOAL IS TO IDENTIFY CARE GAPS AND IMPROVE THE HEALTH AND WELL-BEING OF OUR PATIENTS.FUTURE PLANS: ALICE HYDE WILL CONTINUE TO PARTNER WITH THE ADIRONDACK RURAL HEALTH NETWORK OF THE ADIRONDACK HEALTH INSTITUTE (AHI-ARHN) AND FRANKLIN COUNTY PARTNERS TO IMPLEMENT THE 2025-2027 CHNA AND CHIP. OUR PATH FORWARD WILL ALIGN WITH THE NEW YORK STATE PREVENTION AGENDA, AND ADDRESS RESULTS OF COUNTY HEALTH INDICATORS FOR FRANKLIN COUNTY RESIDENTS IN ORDER TO IMPROVE HEALTH STATUS AND ADDRESS DISPARITIES IDENTIFIED. THIS WORK IS SET TO KICK OFF MARCH 1, 2025. AHMC WILL FINALIZE ITS PARTNERSHIP WITH HUDSON HEADWATERS AS THEY COMPLETE CONSTRUCTION OF THEIR NEW BUILDING NEAR ALICE HYDE'S CAMPUS. ALICE HYDE WILL CONTINUE TO WORK ON AGE FRIENDLY STRATEGIES OF CARE AND CONTINUE PARTNERING WITH THE CHRONIC DISEASE CARE COORDINATION NETWORK TO ENHANCE CHRONIC DISEASE PREVENTION STRATEGIES AND PROVIDE FREE HEALTH IMPROVEMENT PROGRAMS FOR OUR PATIENTS AND COMMUNITY. AHMC WILL WORK TO MEET AND/OR EXCEED BENCHMARKS IDENTIFIED FOR CANCER SCREENING RATES, ANNUAL WELLNESS VISITS AND A1C THRESHOLD RATES OF THE PATIENTS IN AHMC PRIMARY CARE PANELS IN 2025. A NUMBER OF HIGH VALUE CARE INITIATIVES WILL BE IMPLEMENTED IN 2025-2027 WITH THE GOAL OF IDENTIFYING CARE GAPS TO IMPROVE THE HEALTH AND WELLBEING OF OUR PATIENTS. AHMC WILL PARTNER WITH COMMUNITY AGENCIES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH OF OUR PATIENT POPULATION, WITH A FOCUS ON HEALTH EQUITY, INCREASING CHRONIC DISEASE SELF-MANAGEMENT, REDUCING HEALTH DISPARITIES AND INCREASING OUR APTITUDE IN YOUTH AND ADULT MENTAL HEALTH INTERVENTION STRATEGIES AND WELLBEING TRAINING.
PART V, LINE 16A, FAP WEBSITEHTTPS://WWW.ALICEHYDE.COM/PATIENTS-AND-VISITORS/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE-PROGRAM
PART V, LINE 16B, FAP APPLICATION WEBSITE:HTTPS://WWW.ALICEHYDE.COM/PATIENTS-AND-VISITORS/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE-PROGRAM
PART V, SECTION B, LINE 20A:ALICE HYDE MEDICAL CENTER DOES NOT PURSUE LEGAL ACTION IN ORDER TO COLLECT A DEBT, INCLUDING NOT SELLING DEBT INFORMATION TO ANOTHER PARTY FOR COLLECTIONS, REPORTING TO INDIVIDUAL CREDIT AGENCIES REGARDING PAYMENT STATUS, NOR DOES ALICE HYDE MEDICAL CENTER REFUSE TREATMENT FORPAST DEBT OBLIGATIONS.
FieldValueIRS element (for citing)
Facility9FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - THE ALICE CENTER
45 SIXTH STREETMALONENY12953SKILLED NURSING FACILITY
2 - REDDY CANCER TREATMENT CENTER
23 FOURTH STREET STE 1 2MALONENY12953ONCOLOGY TREATMENT
3 - HASTINGS HEMODIALYSIS UNIT
20 FOURTH STREETMALONENY12901OUTPATIENT DIALYSIS
4 - BESSETT HEALTH CENTER
6087 STATE ROUTE 11CHATEAUGAYNY12920PRIMARY CARE CLINIC
5 - DWYER HEALTH CENTER
969 STATE ROUTE 11MORIANY12957PRIMARY CARE CLINIC
6 - THE MARTIN J LEROUX HEALTH CENTER
577 COUNTY ROUTE 1FORT COVINGTONNY12937PRIMARY CARE CLINIC
7 - TOWER HEALTH CENTER
76 NORTH MAIN STREETSAINT REGIS FALLSNY12980PRIMARY CARE CLINIC
8 - ALICE HYDE WALK-IN CLINIC
134 PARK STREETMALONENY12953URGENT CARE
9 - DENTAL CARE CENTER
134 PARK STREETMALONENY12953DENTAL CARE

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:UTILIZED IS WORKSHEETS FOR SCHEDULE H AND RATIO OF COST TO CHARGES.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,281,441.
PART III, LINE 2:OUR BAD DEBT METHODOLOGY IS BASED ON HISTORICAL AMOUNTS WHICH WERE TYPICALLY, 3.2% OF NET REVENUE.
PART III, LINE 3:WE USE THE BAD DEBT EXPENSE AND ALLOCATE BASED ON THE ACTUAL WRITE-OFFS. FY2043 MARKS THE SECOND FULL YEAR OF A NEW ELECTRONIC HEALTH RECORD THAT HELPED REFINE THE METHODOLOGY.
PART III, LINE 4:SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED SEPTEMBER 30, 2024, AND 2023, WAS NOT SIGNIFICANT. THE ORGANIZATION'S BAD DEBT EXPENSE IS ADDRESSED ON PAGE 22IN FOOTNOTE 4 OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:THE MEDICARE BENEFICIARIES WHO ALICE HYDE PROVIDES SERVICES TO ARE PART OF OUR COMMUNITY OF MALONE, NEW YORK, AND THEREFORE, SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE SOURCE FOR THE COST METHODOLOGY IS THE 2024 MEDICARE COST REPORT.THE MEDICAL CENTER EXPERIENCED A SHORTFALL IN MEDICARE REVENUE OVER COSTS. DESPITE THIS SHORTFALL, THE MEDICAL CENTER CONTINUES TO PROVIDE QUALITY CARE TO THE COMMUNITY OF MALONE, NEW YORK.
PART III, LINE 9B:THE CENTER PROVIDES CARE TO CLIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CENTER'S POLICY IS NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE, THESE AMOUNTS ARE NOT REPORTED IN NET OPERATING REVENUES OR IN PROVISIONS FOR DOUBTFUL ACCOUNTS.
PART VI, LINE 3:THE ALICE HYDE MEDICAL CENTER (AHMC) BELIEVES THAT FEAR OF A MEDICAL BILL SHOULD NOT PRECLUDE A RESIDENT OF ITS COMMUNITY FROM SEEKING OR OBTAINING ESSENTIAL HEALTH CARE SERVICES. TO HELP THOSE WHO ARE UNINSURED, AHMC PARTNERS WITH VARIOUS ORGANIZATIONS, INCLUDING THE FRANKLIN COUNTY DEPARTMENT OF SOCIAL SERVICES, PUBLIC HEALTH, FIDELIS, AND EXCELLUS, TO ENSURE ACCURATE INFORMATION AND RESOURCES ARE AVAILABLE THROUGHOUT THE COMMUNITY, INCLUDING A FACILITATED ENROLLMENT PROGRAM FOR ITS UNINSURED.THIS PROGRAM ASSISTS THE INDIVIDUAL IN APPLYING FOR STATE SPONSORED HEALTH INSURANCE, INCLUDING MEDICAID AND CHILD HEALTH PLUS. THE GOAL OF THIS INITIATIVE IS TO PROVIDE CONVENIENT LOCATION FOR PATIENTS AND COMMUNITY MEMBERS TO ACCESS THE PROGRAM AND TO PROVIDE ASSISTANCE IN COMPLETING HEALTH INSURANCE APPLICATIONS. THESE GOALS ARE MET THROUGH A PARTNERSHIP BETWEEN AHMC AND ADIRONDACK HEALTH INSTITUTE. AHMC HAS AN EMPLOYEE DEDICATED TO FINANCIAL COUNSELING AND ASSISTANCE.
PART VI, LINE 4:ALICE HYDE MEDICAL CENTER (AHMC) PRIMARILY SERVES TOWNS, VILLAGES, AND THE NATIVE AMERICAN RESERVATION IN FRANKLIN COUNTY. AHMC'S PRIMARY SERVICE AREA COVERS THE FOLLOWING TOWNS (BY ZIP CODE) - MALONE (12953), NORTH BANGOR (12966), CHATEAUGAY (12920), CONSTABLE (12926), BRUSHTON (12916), MOIRA (12957), BURKE (12917), FORT COVINGTON (12937), HOGANSBURG (13655), SAINT REGIS FALLS (12980), BOMBAY (12914), OWLS HEAD (12969), DICKINSON CENTER (12930). THE SECONDARY SERVICE AREAS SERVED BY AHMC INCLUDE CHURUBUSCO (12923), ELLENBURG CENTER (12934), NORTH LAWRENCE (12967), LYON MOUNTAIN (12955), NICHOLVILLE (12965). IN ADDITION, AHMC PROVIDES SERVICESTO THE INMATE POPULATION FOR THE FRANKLIN COUNTY JAIL AND THE CLINTON, FRANKLIN, UPSTATE, BAREHILL AND ALTONA CORRECTIONAL FACILITIES.
PART VI, LINE 5:ALICE HYDE MEDICAL CENTER IDENTIFIED TWO NYS PREVENTION AGENDA PRIORITY AREAS FOR THE 2022-2024 COMMUNITY SERVICE PLAN CYCLE: (1) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AND (2) PREVENT CHRONIC DISEASE. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO ALICE HYDE MEDICALCENTER.THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS:PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: PROMOTE WELL BEINGACTION PLAN:INVESTIGATE AND IMPLEMENT COMMUNITY PARTNERSHIPS FOR EXPANDED PRIMARY CARE OFFERINGS IN THE MALONE COMMUNITY TO IMPROVE ACCESS TO CARE. ACHIEVE GERIATRIC EMERGENCY DEPARTMENT (GEDA) ACCREDITATION IN 2022 TO SUPPORT THE NEEDS OF OUR AGING POPULATION. DEVELOP AND PLAN FOR AN ENHANCED/MODERNIZED/REIMAGINED HOSPITAL CAMPUS THROUGH NYS TRANSFORMATION IV GRANT FUNDING. CONTINUE THE ED PEER NAVIGATOR PROGRAM IMPLEMENTED IN AHMC EMERGENCY DEPARTMENT TO PROVIDE ACCESS TO AND COORDINATION OF COMMUNITY BASED RESOURCES FOR PATIENTS FREQUENTING THE ED, WHO NEED ADDITIONAL SERVICES TO MANAGE THEIR HEALTH AND WELL-BEING.PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: MENTAL AND SUBSTANCE USE DISORDER PREVENTIONACTION PLAN:BUILD SUPPORT SYSTEMS TO CARE FOR OPIOID USERS OR AT RISK OF AN OVERDOSE. INTEGRATE TRAUMA INFORMED APPROACHES IN TRAINING STAFF AND IMPLEMENTING PROGRAM AND POLICY. STRENGTHENING RESOURCES FOR FAMILIES AND CAREGIVERS. CONTINUED COORDINATION/COLLABORATION BETWEEN AHMC ED AND THE CITIZEN ADVOCATES' CRISIS INTERVENTION CENTER TO ENSURE PATIENTS PRESENTING TO THEAHMC ED RECEIVE THE APPROPRIATE LEVEL OF CARE. CREATION OF FULLY TRAINED AHMC CISM TEAM (CRITICAL INCIDENT STRESS MANAGEMENT TEAM) IN 2022 TO SUPPORT STAFF, PATIENTS AND FAMILIES EXPERIENCING CRISIS EVENTS. UTILIZE THE EXPERTISE OF THE UVMHN COMMUNICATIONS AND ENGAGEMENT STRATEGIES TEAM TO EDUCATE PROVIDERS, STAFF AND THE BROADER COMMUNITY ON MENTAL AND SUBSTANCE USE DISORDERS AND PREVENTION/EARLY INTERVENTION STRATEGIES. PREVENT CHRONIC DISEASE: HEALTHY EATING AND FOOD SECURITYACTION PLAN:ESTABLISHMENT AND CONTINUED ENHANCEMENT OF EMPLOYEE WELLNESS COMMITTEE (EWC) TO PROMOTE HEALTH AND WELL-BEING FOR ALL EMPLOYEES. COLLABORATE WITH JCEO FOR ONSITE MOBILE FOOD MARKET PROVIDING ACCESS TO HEALTHY FRUITS AND VEGETABLES WEEKLY DURING THE GROWING SEASON.PARTNER WITH LOCAL ORCHARD FOR ONSITE ACCESS TO LOCAL APPLES, HONEY, AND OTHER NATURALLY GROWN PRODUCTSUTILIZE THE EXPERTISE OF THE UMVHN COMMUNICATION AND ENGAGEMENT STRATEGIES TO CREATE AND PROMOTE MEDIA PIECES SPOTLIGHTING AND EDUCATING STAFF, PATIENTS AND THE COMMUNITY ABOUT THE HEALTH BENEFITS ASSOCIATED WITH HEALTHY EATING.PREVENT CHRONIC DISEASE PHYSICAL ACTIVITYACTION PLAN:IMPLEMENT A COMBINATION OF WORKSITE-BASED PHYSICAL ACTIVITY POLICIES, PROGRAMS, OR BEST PRACTICES THROUGH MULTI-COMPONENT WORKSITE PHYSICAL ACTIVITY AND/OR NUTRITION PROGRAMS; ENVIRONMENTAL SUPPORTS OR PROMPTS TO ENCOURAGE WALKING AND/OR TAKING THE STAIRS; OR STRUCTURED WALKING-BASED PROGRAMS FOCUSING ON OVERALL PHYSICAL ACTIVITY THAT INCLUDE GOAL-SETTING, ACTIVITY MONITORING, SOCIAL SUPPORT, COUNSELING, AND HEALTH PROMOTION ANDINFORMATION MESSAGING. IMPLEMENT AND/OR PROMOTE A COMBINATION OF COMMUNITY WALKING, WHEELING, OR BIKING PROGRAMS.AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR. INVESTIGATE THE ABILITY TO CREATE EMPLOYEE FITNESS CENTER ON CAMPUS.PREVENT CHRONIC DISEASE TOBACCO PREVENTIONACTION PLAN:IMPLEMENT WORKFLOW TO ENSURE ALL PRIMARY CARE PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE (ALL FORMS) AND REFERRED FOR INTERVENTION SERVICES WITH ONSITE CTCS OR NYS QUITLINE.UTILIZE AHMC COMMUNICATIONS AND ENGAGEMENT STRATEGIES DIVISION TO CREATE CONTENT TO PROMOTE AND EDUCATE SMOKERS ABOUT THE BENEFITS OF EVIDENCE-BASED QUITTING APPROACHESPROMOTE THE GREAT AMERICAN SMOKEOUT INITIATIVEWORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS, INCLUDING ACCESS TO CERTIFIED TOBACCO CESSATION SPECIALISTS AS NEEDED AND ALSO COLLABORATE WITH NORTH COUNTRY HEALTHY HEART NETWORK TO CREATE AND PROVIDE EDUCATION OPPORTUNITIES AND TOBACCO CESSATION INTERVENTION MATERIALS FOR HEALTH CARE PROVIDERS AND PATIENTS.PREVENT CHRONIC DISEASE - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENTACTION PLAN:WORK WITH HEALTH CARE PROVIDERS/CLINICS TO PUT SYSTEMS IN PLACE FOR PATIENT AND PROVIDER SCREENING REMINDERS (E.G., LETTER, POSTCARDS, EMAILS, RECORDED PHONE MESSAGES, ELECTRONIC HEALTH RECORDS [EHR] ALERTS). PROMOTE THE USE OF HEALTH INFORMATION TECHNOLOGY FOR: MEASUREMENT, REGISTRY DEVELOPMENT, PATIENT ALERTS, BI-DIRECTIONAL REFERRALS, REPORTING. EXPAND ACCESS TO EVIDENCE-BASED SELF-MANAGEMENT INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC DISEASE (ARTHRITIS, ASTHMA, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES, AND OBESITY) WHOSE CONDITION(S) IS NOT WELL-CONTROLLED WITH GUIDELINES-BASED MEDICAL MANAGEMENT ALONE.CONTINUE TO OPTIMIZE THE EPIC EMR SYSTEM TO ENHANCE PATIENT CARE DELIVERY, MEASUREMENT AND REPORTING. UTILIZE THE EPIC EMR REMINDER SYSTEM IN PRIMARY CARE TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS, INCLUDING MANAGEMENT OF PATIENT ALERTS AND REMINDERS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. CONTINUE TODELIVER THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM TO EXISTING PATIENTS (INPATIENTS AS IDENTIFIED) TO EDUCATE PATIENTS ON BEST PRACTICE STRATEGIES FOR MANAGING THEIR CHRONIC CONDITION SPECIFICALLY WITH THE FOCUS ON CHF, COPD AND DIABETES, WITH THE GOAL OF REDUCING AVOIDABLE READMISSIONS AND IMPROVING THE HEALTH OF OUR PATIENT POPULATION LIVING WITH CHRONIC DISEASE.ALICE HYDE MEDICAL CENTER'S PRIMARY SERVICE AREA IS IDENTIFIED AS THE THIRTEEN NORTHERN NEW YORK TOWNSHIPS OF: BOMBAY 12914, BRUSHTON 12916, BURKE 12917, CHATEAUGAY 12920, CHURUBUSCO 12923, CONSTABLE 12926, DICKINSON CENTER 12930, LYON MOUNTAIN 12955, MALONE 12953, MOIRA 12957, NORTH BANGOR 12966, OWLS HEAD 12969, AND ST. REGIS FALLS 12980. ALICE HYDE MEDICAL CENTER'S SECONDARY SERVICE AREA IS IDENTIFIED AS THE EIGHT TOWNSHIPS IN THE NORTHWEST PORTION OF THE FRANKLIN COUNTY BORDER INTO ST. LAWRENCE COUNTY, INCLUDING BRASHER FALLS 13613, CHASE MILLS 13621, HOGANSBURG 13655, MADRID 13660, MASSENA 13662, NORFOLK 13667, NORTH LAWRENCE 12967, AND WINTHROP 13697. THESE TWO SERVICE AREAS COMPRISE 95% OF AHMC'S PATIENT ORIGIN AS OF THE LATEST AVAILABLE DATA.
PART VI, LINE 7, REPORTS FILED WITH STATESNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract ExceptionYes (1)InitialContractExceptionInd
Rebuttable Presumption ProcYes (1)RebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MICHELLE LEBEAU
PRESIDENT & COO$0$503,752$0$64,499$0$42,432$0$84,670$0$28,496$0$723,849$0$0
DR JASON SANDERS
UVMMG PRESIDENT & CEO$0$407,420$0$89,269$0$11,986$0$58,037$0$37,514$0$604,226$0$0
DR LISA MARK
CHIEF MEDICAL OFFICER$0$428,756$0$32,267$0$1,473$0$19,800$0$30,810$0$513,106$0$0
LISA L GOODRICH
VP MEDICAL GROUP NTWK DEPTS$0$379,299$0$28,723$0$8,422$0$39,600$0$34,435$0$490,479$0$0
MARINA MEDVED
BOARD MEMBER$0$325,124$0$0$0$26,759$0$19,800$0$7,082$0$378,765$0$0
MATEJ KOLLAR
VP/CFO$0$277,133$0$23,695$0$23,109$0$19,737$0$33,568$0$377,242$0$0
DEBRA PIERCEY
ANESTHETIST NURSE$248,827$0$0$0$3,580$0$0$0$11,557$0$263,964$0$0$0
CHRISTOPHER HICKEY
FORMER SVP/CFO$0$201,211$0$0$0$11,145$0$11,124$0$25,648$0$249,128$0$0
DUYEN NGUYEN
DENTIST$228,579$0$0$0$955$0$6,752$0$10,526$0$246,812$0$0$0
ROBERT STOUT
PHYSICIAN ASSISTANT (TIL 04/24)$235,443$0$0$0$966$0$6,905$0$1,598$0$244,912$0$0$0
MATT JONES
CVPH AVP/ FORMER AHMC COO$204,794$0$12,508$0$437$0$6,208$0$12,638$0$236,585$0$0$0
JOHN REMILLARD
DEVELOPMENT CONSULTANT$227,250$0$0$0$0$0$0$0$0$0$227,250$0$0$0
SUSAN BIONDOLILLO
AVP OF LONG TERM CARE$176,613$0$9,934$0$2,039$0$5,299$0$824$0$194,709$0$0$0
EMILE BENARDOT MD
FORMER DIRECTOR$111,000$0$0$0$0$0$0$0$0$0$111,000$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3ALICE HYDE MEDICAL CENTER RELIED ON THE UNIVERSITY OF VERMONT HEALTH NETWORK ("UVM HEALTH NETWORK"), THE PARENT ORGANIZATION, TO ESTABLISH SENIOR EXECUTIVE COMPENSATION. UVM HEALTH NETWORK UTILIZED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4BTHE UNIVERSITY OF VERMONT HEALTH NETWORK, BY AND THROUGH ITS AFFILIATED SUBSIDIARIES, MAINTAINS A SUPPLEMENTAL RETIREMENT BENEFIT PLAN (SRP) UNDER CONTRACTUAL ARRANGEMENTS WITH SEVERAL PERSONS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A. PURSUANT TO THE TERMS OF THE SRP, ANNUAL CREDITS WERE MADE EQUAL TO A FIXED PERCENTAGE OF BASE SALARY. THE FOLLOWING PERSONS PARTICIPATED IN THE SRP IN CALENDAR YEAR 2023, AND THEIR RESPECTIVE FIXED PERCENTAGE IS DESIGNATED IN PARENTHESES: JASON SANDERS (8.68); MICHELLE LEBEAU (10.04%). DEFERRED AMOUNTS VEST ON THE EARLIER OF: (I) JANUARY 1 OF THE THIRD PLAN YEAR AFTER THE PLAN YEAR FOR WHICH THE ACCOUNT WAS CREATED; OR (II) THE PARTICIPANT'S 65TH BIRTHDAY. SRP DISTRIBUTIONS REFLECTED IN SCH J, PART II, COLS (B)(III) AND (F). FOR THE PLANS NOTED ABOVE, AMOUNTS DEFERRED DURING CALENDAR YEAR 2023 ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. AMOUNTS DEFERRED REMAIN SUBJECT TO FORFEITURE IF CERTAIN CONDITIONS ARE NOT MET.
PART I, LINE 7ALICE HYDE MEDICAL CENTER PAID AWARDS TO CERTAIN MEMBERS OF UPPER MANAGEMENT (DIRECTORS, VICE PRESIDENTS, PHYSICIAN CHAIRS AND SENIOR EXECUTIVES) THROUGH ITS ANNUAL VARIABLE PAY PLAN AS THE PLAN'S PERFORMANCE MEASURES WERE MET. THE MEASURES WERE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THESE MEASURES INCLUDED FINANCIAL, POPULATION HEALTH & QUALITY, AND OPERATIONAL RELATED METRICS.
PART I, LINE 8SALARIES AND OTHER FIXED AMOUNTS PAYABLE TO EXECUTIVES SUCH AS OFFICERS AND CERTAIN KEY EMPLOYEES ARE SET BY CONTRACTS THAT ARE NEGOTIATED AND ENTERED INTO PRIOR TO THE COMMENCEMENT OF EACH EXECUTIVES' EMPLOYMENT. THE TERMS OF SUCH CONTRACTS ARE APPROVED IN ADVANCE BY THE APPROPRIATE COMPENSATION COMMITTEE OR OTHER BOARD-AUTHORIZED BODY, WHICH OBTAINS AND RELIES ON APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING SUCH OFFER, AND CONCURRENTLY DOCUMENTS ITS BASIS FOR DETERMINATION.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonKRISTIN ELLIS-WOODPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionSIBLING OF BOARD MEMBERRelationshipDescriptionTxt
Transaction$212,724TransactionAmt
TransactionKRISTIN ELLIS-WOOD, SISTER TO BOARD MEMBER JASON ELLIS, IS THE AVP OF SUPPORT & PROFESSIONAL SERVICESTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2MICHELLE LEBEAU, DR. LISA MARK, AND MATEJ KOLLAR WERE EMPLOYED BY CHAMPLAIN VALLEY PHYSICIAN'S HOSPITAL MEDICAL CENTER, A RELATED ORGANIZATION AT WHICH THESE INDIVIDUALS ALSO SERVED AS OFFICERS.
FORM 990, PART VI, SECTION A, LINE 4EFFECTIVE JANUARY 1, 2024, THE BYLAWS FOR THE ALICE HYDE MEDICAL CENTER ("AHMC") WERE AMENDED IN CONNECTION WITH A NETWORK-WIDE EFFORT TO PROMOTE EFFICIENCY AND STANDARDIZATION IN THE DELIVERY OF MEDICAL SERVICES THROUGH THE CREATION OF A SINGLE, UNIFIED MEDICAL STAFF (THE "MEDICAL STAFF"). THE AMENDMENTS REMOVE PROVISIONS IN THE BYLAWS RELATING TO THE ADMINISTRATION OF A SEPARATE MEDICAL STAFF, INCLUDING PROVISIONS GRANTING THE BOARD OF TRUSTEES AUTHORITY TO APPROVE MEDICAL STAFF AND CREDENTIALS. IN THE PLACE OF THESE PROVISIONS, ADDITIONAL PROVISIONS WERE ADDED RELATING TO THE ADMINISTRATION OF A CAMPUS ADVISORY COMMITTEE OF THE MEDICAL STAFF. THE CHAIR OF THE CAMPUS ADVISORY COMMITTEE SHALL SERVE EX OFFICIO, WITHOUT VOTE, ON THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 6THE UNIVERSITY OF VERMONT HEALTH NETWORK, INC. (UVMHN) IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7AUVM HEALTH NETWORK HAS POWERS TO ELECT ALICE HYDE MEDICAL CENTER'S BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7BUVM HEALTH NETWORK HAS THE POWER TO APPROVE SIGNIFICANT CORPORATE ACTIONS, INCLUDING ANNUAL OPERATING AND CAPITAL BUDGETS, STRATEGIC PLANS, THE APPOINTMENT OF THE CEO, THE INCURRENCE OF LONG-TERM INDEBTEDNESS, AMENDMENTS TO ALICE HYDE MEDICAL CENTER'S BYLAWS AND ARTICLES OF THE ORGANIZATION, AND APPROVAL OF MAJOR FINANCIAL DECISIONS INCLUDING MERGERS, BANKRUPTCIES, AND THE DEVELOPMENT OR TERMINATION OF PROGRAM SERVICES. UVM HEALTH NETWORK IS A NON-PROFIT CORPORATION WHICH HAS BEEN RECOGNIZED BY THE IRS AS A 501(C)(3) ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN INDEPENDENT OUTSIDE ACCOUNTING FIRM. IT IS PROVIDED TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH THE UVM HEALTH NETWORK'S CONFLICT OF INTEREST POLICY, WHICH IT HAS ADOPTED. IN ACCORDANCE WITH THE POLICY, TRUSTEES, OFFICERS, KEY EMPLOYEES AND PHYSICIANS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE AND CERTIFICATION UPON HIRING, AT LEAST ANNUALLY, PRIOR TO PARTICIPATING IN ANY DECISION THAT MAY BE AFFECTED BY A PERSONAL INTEREST, AND WHENEVER A POTENTIALLY CONFLICTING INTEREST FIRST ARISES. CONFLICT OF INTEREST DISCLOSURES AND CERTIFICATIONS MAY BE MADE ONLINE OR IN WRITING AND ARE REGULARLY REVIEWED BY THE GENERAL COUNSEL. THE CONFLICT OF INTEREST POLICY IS ENFORCED BY THE OFFICE OF GENERAL COUNSEL AND OVERSEEN BY A FIVE-PERSON CONFLICT OF INTEREST COMMITTEE. THE GENERAL COUNSEL REPORTS AT LEAST QUARTERLY ON CONFLICT OF INTEREST ISSUES TO THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES. CONFLICTS OF INTEREST ARE MANAGED IN ACCORDANCE WITH THE POLICY, WHICH PROVIDES FOR A VARIETY OF REMEDIES TO ADDRESS CONFLICTS OF INTEREST. IN ADDITION, "DISQUALIFIED PERSONS", CONSISTING OF TRUSTEES, OFFICERS AND KEY EMPLOYEES ARE SUBJECT TO SPECIAL PROCEDURES TO COMPLY WITH THE INTERMEDIATE SANCTION RULES, AS OUTLINED IN THE CONFLICT OF INTEREST POLICY. REMEDIES TO ADDRESS CONFLICTS OF INTEREST MAY INCLUDE THE FOLLOWING: RECUSAL FROM DECISION MAKING, DISCLOSURE TO APPROPRIATE PARTIES, COMMITTEE PARTICIPATION LIMITS AND REQUESTED DIVESTITURE. AN APPEALS PROCESS EXISTS SHOULD THE INDIVIDUAL REQUEST A SECONDARY REVIEW BE PERFORMED.
FORM 990, PART VI, SECTION B, LINE 15ALICE HYDE MEDICAL CENTER DELEGATES THE SETTING OF EXECUTIVE COMPENSATION TO THE UVM HEALTH NETWORK COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE, UNDER PRINCIPLES DESCRIBED IN ITS CHARTER. THE HEALTH NETWORK HAS ADOPTED A COMPENSATION PHILOSOPHY WHICH PROVIDES A FRAMEWORK FOR SETTING COMPENSATION FOR THE EXECUTIVES OF UVM HEALTH NETWORK, ITS AFFILIATED HOSPITALS, AND ITS MEDICAL GROUP. THE PARAMETERS OF THIS PHILOSOPHY INCLUDE UTILIZING APPROPRIATE NATIONAL AND REGIONAL PEER GROUPS. SALARIES ARE TARGETED AT THE 50TH PERCENTILE OF THE NATIONAL PEER GROUP, WITH PERFORMANCE BASED VARIABLE PAY OPPORTUNITIES TO ACHIEVE UP TO THE 65TH PERCENTILE, DEPENDING ON ORGANIZATION AND INDIVIDUAL RESULTS. COMPENSATION LEVELS ARE APPROVED BY THE NETWORK COMPENSATION COMMITTEE FOR THE UVM HEALTH NETWORK/DIRECT REPORTS AND THE AFFILIATE HOSPITAL CEOS. CALCULATIONS ARE PERFORMED USING THE SAME PHILOSPHY FOR THE THIRD TIER OF LEADERSHIP. ALL ACTIONS TAKEN REGARDING EXECUTIVE COMPENSATION ARE CONTEMPORANEOUSLY DOCUMENTED BY THE APPROPRIATE ORGANIZATION. THIS REVIEW IS PERFORMED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 18THE COMPLETED FORMS 1023, 990, AND 5500 FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GPURCHASED SERVICES : PROGRAM SERVICE EXPENSES 2,947,279. MANAGEMENT AND GENERAL EXPENSES 6,723,868. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,671,147. TRAVELER/AGENCY FEES: PROGRAM SERVICE EXPENSES 3,495,371. MANAGEMENT AND GENERAL EXPENSES 582,471. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,077,842.
FORM 990, PART XI, LINE 9:TRANSFER OF NET ASSETS 1,872,400.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (19 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
UVM HEALTH NETWORK MEDICAL GROUP
111 COLCHESTER AVEBURLINGTONVT05401030225105PHYSICIAN SERVICESVT501(C)(3)LINE 12B, IIUVMHNYes (1)
UNIV OF VT MED CTR FOUNDATION INC
111 COLCHESTER AVEBURLINGTONVT05401263159849FUNDRAISINGVT501(C)(3)LINE 12B, IIUVMMCYes (1)
UNIV OF VT MED CTR AUXILLIARY INC
111 COLCHESTER AVEBURLINGTONVT05401208022004SERVICEVT501(C)(3)LINE 12D, III-O0N/A
UNIV OF VT HEALTH NETWORK
111 COLCHESTER AVEBURLINGTONVT05401452880726HOLDING COMPANYVT501(C)(3)LINE 12B, II0N/A
CENTRAL VT MEDICAL CENTER
111 COLCHESTER AVEBURLINGTONVT05401222547186HOSPITALVT501(C)(3)LINE 3UVMHNYes (1)
UNIVERSITY HEALTH CENTER
111 COLCHESTER AVEBURLINGTONVT05401030229931HOSPITALVT501(C)(3)LINE 12D, III-OUVMHNMGYes (1)
COMMUNITY PROVIDERS INC
75 BEEKMAN STREETPLATTSBURGHNY12901222544844HLTH SVC COORDNY501(C)(3)LINE 12B, IIUVMHNYes (1)
CHAMPLAIN VALLEY PHYSICIANS HOSPITAL
75 BEEKMAN STREETPLATTSBURGHNY12901141338471HOSPITALNY501(C)(3)LINE 3UVMHNYes (1)
ELIZABETHTOWN COMMUNITY HOSPITAL
75 PARK STREETELIZABETHTOWNNY12901141364513HOSPITALNY501(C)(3)LINE 3UVMHNYes (1)
EMERGENCY MEDICAL TRANSPORT OF CVPH INC
75 BEEKMAN STREETPLATTSBURGHNY12901061718419AMBULANCE SVCNY501(C)(3)LINE 12C, III-FIUVMHNYes (1)
CVPH MEDICAL CENTER FOUNDATION
75 BEEKMAN STREETPLATTSBURGHNY12901141727048HLTH SVC COORDNY501(C)(3)LINE 12C, III-FICVPHYes (1)
LAKE CHAMPLAIN PHYSICIAN SERVICES PC
75 BEEKMAN STREETPLATTSBURGHNY12901273785445PHYSICIAN SERVICESNY501(C)(3)LINE 12B, IICVPHYes (1)
UNIVERSITY MEDICAL EDUCATION ASSOCIATES
89 BEAUMONT AVENUEBURLINGTONVT05401237107832EDUCATIONALVT501(C)(3)LINE 11UVMHNMGYes (1)
PORTER MEDICAL CENTER INC
115 PORTER DRIVEMIDDLEBURYVT05753030310862SUPPORTING ORGVT501(C)(3)LINE 12B, IIUVMHNYes (1)
HELEN PORTER NURSING HOME
37 PORTER DRIVEMIDDLEBURYVT05753030306549NURSING HOMEVT501(C)(3)LINE 3PMCYes (1)
AUXILIARY OF PORTER MEDICAL CENTER
37 PORTER DRIVEMIDDLEBURYVT05753237363227SUPPORTING ORGVT501(C)(3)LINE 12B, IIPMCYes (1)
PORTER HOSPITAL INC
37 PORTER DRIVEMIDDLEBURYVT05753030181058HOSPITALVT501(C)(3)LINE 3PMCYes (1)
VMC INDEMNITY COMPANY INC
95 ST PAUL STBURLINGTONVT05401831102018INSURANCEVT501(C)(3)LINE 12B, IIUVMHNYes (1)
UVMHN HOME HEALTH AND HOSPICE
1110 PRIM ROADCOLCHESTERVT05446030179603HOME HEALTHCAREVT501(C)(3)LINE 11UVMHNYes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
UVM HEALTH VENTURES INC
111 COLCHESTER AVEBURLINGTONVT05401043380045HOLDING COMPANYVTUVMHNC0
UVMHN NETWORK CREDENTIALING & ENROLLMENT
111 COLCHESTER AVEBURLINGTONVT05401030333056ADMIN SVCVTUVMHN VENTURESC0
CHARITABLE REMAINDER TRUST (6)
SUPPORTVTUVMMCCVMCT0
PERPETUAL TRUST (10)
SUPPORTVTUVMMCT0
CHARITABLE IRREVOCABLE TRUST (8)
SUPPORTVTUVMMCCVMCT0
CHAMPLAIN VALLEY HEALTH NETWORK
75 BEEKMAN STREETPLATTSBURGHNY12901161586102ADMIN SVCNYC0N/A
MEDIQUEST INC
PO BOX 1656PLATTSBURGHNY12901141663061MED OFFICE LEASENYC0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset ExchangeYes (1)AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
THE UNIVERSITY OF VERMONT MEDICAL CENTER INC
P$25,795,917FMV
THE UNIVERSITY OF VERMONT HEALTH NETWORK
P$3,211,457FMV
VMCIC INC
M$787,456FMV
CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER
Q$1,858,088FMV
THE UNIVERSITY OF VERMONT MEDICAL CENTER INC
I$73,881FMV
THE UNIVERSITY OF VERMONT MEDICAL CENTER INC
Q$1,851,239FMV