CARTHAGE AREA HOSPITAL INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CARTHAGE AREA HOSPITAL INC (EIN 15-0622079)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-10-27
- IRS object ID
- 202133009349300928
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-10-27T09:36:46-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161131146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BONADIO & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 171 SULLYS TRAIL | AddressLine1Txt |
| City | PITTSFORD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14534 | 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 | 150622079 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARTHAGE AREA HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CART | BusinessNameControlTxt |
| Phone | 3154931000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 WEST STREET | AddressLine1Txt |
| City | CARTHAGE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13619 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROB BLOOM | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 3154931000 | PhoneNum |
| Signature | 2021-10-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ROB | 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 | JONATHAN MILLER | PreparerPersonNm |
| PTIN | P01322027 | PTIN |
| Phone | 5853811000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RICHARD DUVALL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 WEST STREET | AddressLine1Txt |
| City | CARTHAGE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13619 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $50,147,243 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.CARTHAGEHOSPITAL.COM/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1921 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE QUALITY, COMPREHENSIVE HEALTHCARE SERVICES, IN A COMMUNITY SETTING. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 572 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,930,687 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,232,353 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $50,144,340 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $44,075,140 | CYProgramServiceRevenueAmt |
| PY Investment Income | $150,349 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,029,537 | PYOtherRevenueAmt |
| CY Other Revenue | $839,750 | CYOtherRevenueAmt |
| PY Total Revenue | $55,254,913 | PYTotalRevenueAmt |
| CY Total Revenue | $50,147,243 | 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 | $34,816,041 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $36,628,909 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $10,177 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $18,895,882 | PYOtherExpensesAmt |
| CY Other Expenses | $19,466,606 | CYOtherExpensesAmt |
| PY Total Expenses | $53,711,923 | PYTotalExpensesAmt |
| CY Total Expenses | $56,095,515 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,542,990 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$5,948,272 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $30,976,159 | TotalAssetsBOYAmt |
| Total Assets EOY | $37,020,576 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $22,625,611 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $34,198,986 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,350,548 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,821,590 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CARTHAGE AREA HOSPITAL PROVIDES QUALITY COMPREHENSIVE HEALTHCARE SERVICES, PRIMARILY IN JEFFERSON COUNTY, PERSONALIZING QUALITY HEALTHCARE IN PARTNERSHIP WITH VARIOUS COMMUNITIES THROUGHOUT THE AREA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $50,725,826 | ExpenseAmt |
| Revenue | $44,667,211 | RevenueAmt |
| Desc | CARTHAGE AREA HOSPITAL IS A NOT-FOR-PROFIT, CRITICAL ACCESS HOSPITAL, LOCATED IN CARTHAGE, NEW YORK. THE HOSPITAL PROVIDES QUALITY INPATIENT AND OUTPATIENT HEALTHCARE SERVICES. THE HOSPITAL HAS 25 CERTIFIED BEDS, COMPRISED OF 10 MEDICAL/SURGICAL, 4 INTENSIVE CARE, 3 PEDIATRIC, AND 8 MATERNITY. THE HOSPITAL PROVIDES OUTPATIENT ANCILLARY SERVICES SUCH AS GENERAL AND ORTHOPEDIC SURGERIES, LAB TESTS, MEDICAL IMAGING, EMERGENCY ROOM SERVICES, AND RESPIRATORY SERVICES. THE HOSPITAL HAD 127,541 OUTPATIENT VISITS AND 4,112 PATIENT DAYS OF CARE IN 2020. THE HOSPITAL ALSO HAS AN EXTENSIVE NETWORK OF PRIMARY CARE, SPECIALTY CARE, AND SCHOOL-BASED CLINICS AND HOME HEALTH SERVICES LOCATED PRIMARILY IN JEFFERSON COUNTY. | Desc |
| Total Program Service Expenses | $50,725,826 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 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 | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 45 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 572 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROB BLOOM | PersonNm |
| Phone | 3154931000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 WEST STREET | AddressLine1Txt |
| City | CARTHAGE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13619 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| GARY ROWE | |||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| DALE KLOCK | |||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| TIM STURICK | |||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| LAWRENCE HASSELER | |||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JAMIE VANDERVEEKEN | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DR MIRZA ASHRAF | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DR KENNETH FISH | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| PETER TURNER | |||||||||
| DIRECTOR UNTIL JANUARY 2020 | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ADAM FULLER | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ANNE ROHR | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| PATTIE EARL | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | |||
| JENNIFER PREMO | |||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD DUVALL | |||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $0 | $0 | $0 | ||||
| ROB BLOOM | |||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $487,316 | $0 | $18,711 | ||||
| MICHAEL GORDON | |||||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $1,208,953 | $0 | $22,200 | ||||
| NATALIE BURNHAM | |||||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $190,785 | $0 | $19,862 | ||||
| NATA PARNES | |||||||||
| MEDICAL STAFF REPRESENTATI | 40.00 | $900,226 | $0 | $22,200 | Yes (X) | ||||
| BRYAN VENERUS | |||||||||
| PHYSICIAN | 40.00 | $417,758 | $0 | $8,898 | Yes (X) | ||||
| KINGSLEY MALCOLM | |||||||||
| CRNA | 40.00 | $459,845 | $0 | $20,049 | Yes (X) | ||||
| FELIX OBEN | |||||||||
| CLINICAL PROVIDER | 40.00 | $713,581 | $0 | $2,924 | Yes (X) | ||||
| REBECCA TAN ALBERTO | |||||||||
| MD-ANESTHESIA | 40.00 | $475,353 | $0 | $22,200 | Yes (X) | ||||
| RICCARDO TURRIN | |||||||||
| PHYSICIAN | 40.00 | $711,866 | $0 | $19,587 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,565,683 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $156,631 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 58 | 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 |
|---|---|---|---|---|---|
| DELPHI HOSPITALIST SERVICES | |||||
| 7785 N STATE STREET | LOWVILLE | NY | 13367 | STAFFING | $1,323,706 |
| LABCORP OF AMERICA HOLDINGS | |||||
| 600 E GENESEE ST 305 | SYRACUSE | NY | 13202 | LABORATORY SERVICES | $757,418 |
| MEDICAL SOLUTIONS LLC | |||||
| 1010 N 102ND STREET SUITE 300 | OMAHA | NE | 68114 | STAFFING | $728,995 |
| SURGICALIST OF NEW YORK PC | |||||
| 1001 WEST STREET | CARTHAGE | NY | 13619 | MEDICAL SERVICES | $397,718 |
| BARTON AND ASSOCIATES INC | |||||
| 300 JUBILEE DRIVE | PEABODY | MA | 01960 | ENGINEERING CONSULTANT | $375,268 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 27 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $10,000 | RelatedOrganizationsAmt |
| Government Grants | $5,192,230 | GovernmentGrantsAmt |
| All Other Contributions | $30,123 | AllOtherContributionsAmt |
| Noncash Contributions | $8,612 | NoncashContributionsAmt |
| Total Contributions | $5,232,353 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $44,035,091 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,035,091 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,049 | TotalRevenueColumnAmt |
| Exclusion | $40,049 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $44,075,140 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $207,630 | 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 | $207,630 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $207,630 | TotalRevenueColumnAmt |
| Exclusion | $207,630 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $632,120 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $632,120 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $632,120 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $50,147,243 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,667,211 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $247,679 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,869,376 | TotalAmt |
| Program Services | $2,185,103 | ProgramServicesAmt |
| Management And General | $684,273 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,480,304 | TotalAmt |
| Program Services | $25,306,991 | ProgramServicesAmt |
| Management And General | $1,163,313 | ManagementAndGeneralAmt |
| Fundraising | $10,000 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,730,740 | TotalAmt |
| Program Services | $1,639,095 | ProgramServicesAmt |
| Management And General | $91,645 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,568,927 | TotalAmt |
| Program Services | $2,967,997 | ProgramServicesAmt |
| Management And General | $600,930 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,979,562 | TotalAmt |
| Program Services | $1,857,161 | ProgramServicesAmt |
| Management And General | $122,401 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $432,778 | TotalAmt |
| Management And General | $432,778 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $323,511 | TotalAmt |
| Management And General | $323,511 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,877,985 | TotalAmt |
| Program Services | $4,498,025 | ProgramServicesAmt |
| Management And General | $379,960 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,516 | TotalAmt |
| Program Services | $12,566 | ProgramServicesAmt |
| Management And General | $207,950 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,292,984 | TotalAmt |
| Program Services | $6,077,072 | ProgramServicesAmt |
| Management And General | $215,738 | ManagementAndGeneralAmt |
| Fundraising | $174 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,682,321 | TotalAmt |
| Program Services | $3,979,011 | ProgramServicesAmt |
| Management And General | $703,310 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,697 | TotalAmt |
| Program Services | $38,317 | ProgramServicesAmt |
| Management And General | $24,377 | ManagementAndGeneralAmt |
| Fundraising | $3 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,239 | TotalAmt |
| Program Services | $51,239 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,305,216 | TotalAmt |
| Program Services | $1,305,216 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $830,109 | TotalAmt |
| Program Services | $575,737 | ProgramServicesAmt |
| Management And General | $254,372 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DUES AND LICENSES | $301,360 | $202,452 | $98,908 |
| MISCELLANEOUS EXPENSES | $85,890 | $29,844 | $56,046 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,095,515 | TotalAmt |
| Program Services | $50,725,826 | ProgramServicesAmt |
| Management And General | $5,359,512 | ManagementAndGeneralAmt |
| Fundraising | $10,177 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,845,001 | BOYAmt |
| EOY | $1,898,707 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,828,542 | BOYAmt |
| EOY | $16,571,614 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,798,278 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,046,396 | BOYAmt |
| EOY | $2,938,238 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,265,011 | BOYAmt |
| EOY | $1,419,371 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $898,957 | BOYAmt |
| EOY | $879,895 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $46,832,421 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $35,167,350 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,545,167 | BOYAmt |
| EOY | $11,665,071 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,748,807 | BOYAmt |
| EOY | $1,647,680 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,976,159 | BOYAmt |
| EOY | $37,020,576 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,460,466 | BOYAmt |
| EOY | $17,629,610 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,044,615 | BOYAmt |
| EOY | $863,809 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,120,530 | BOYAmt |
| EOY | $15,705,567 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,625,611 | BOYAmt |
| EOY | $34,198,986 | 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 | $8,350,548 | BOYAmt |
| EOY | $2,821,590 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,350,548 | BOYAmt |
| EOY | $2,821,590 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,976,159 | BOYAmt |
| EOY | $37,020,576 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$5,948,272 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $419,314 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Direct Contact Legislators | $3,321 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $16,467 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $19,788 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | MEMBERS OF MANAGEMENT MET WITH VARIOUS STATE AND FEDERAL LEGISLATORS IN ORDER TO ADVOCATE FOR LEGISLATION FOR THE BENEFIT OF THE HEALTHCARE INDUSTRY. ADDITIONALLY, A PORTION OF MEMBERSHIP DUES PAID TO THE HEALTHCARE ASSOCIATION OF NEW YORK STATE, THE AMERICAN HOSPITAL ASSOCIATION, AND IROQUOIS HEALTHCARE ASSOCIATION ARE USED BY THOSE ASSOCIATIONS SPECIFICALLY FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | 0 | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $343,688 | OtherCostOrOtherBasisAmt |
| Book Value | $343,688 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,373,781 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,755,659 | DepreciationAmt |
| Book Value | $8,618,122 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,229,779 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,411,691 | DepreciationAmt |
| Book Value | $1,818,088 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $885,173 | OtherCostOrOtherBasisAmt |
| Book Value | $885,173 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,665,071 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED AMOUNTS DUE TO THIRD PARTY PAYORS | $8,415,264 |
| ACCRUED PENSION LIABILITY | $2,446,783 |
| INSURANCE CLAIMS LIABILITY | $4,843,520 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $15,705,567 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $686,716 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $307,257 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $379,459 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00680 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,057,280 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,609,031 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,448,249 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09710 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $13,743,996 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,916,288 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,827,708 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10390 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,699,481 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,375,883 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,323,598 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09490 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $35,699,481 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $30,375,883 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,323,598 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09490 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $49,443,477 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $38,292,171 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $11,151,306 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.19880 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,490 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $91,490 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $50 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $50 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $91,540 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $91,540 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,961,815 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $1,997,904 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $11,293,363 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,186,420 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $106,943 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARTHAGE AREA HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1001 WEST STREET | AddressLine1Txt |
| City | CARTHAGE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13619 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://WWW.CARTHAGEHOSPITAL.COM/ | WebsiteAddressTxt |
| State License | 2238700C | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARTHAGE AREA HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | HTTP://WWW.CARTHAGEHOSPITAL.COM/ABOUT/COMMUNITY-SERVICE-PLAN/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | HTTP://WWW.CARTHAGEHOSPITAL.COM/ABOUT/COMMUNITY-SERVICE-PLAN/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTP://WWW.CARTHAGEHOSPITAL.COM/PATIENTS-VISITORS/BILLING-INSURANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTP://WWW.CARTHAGEHOSPITAL.COM/PATIENTS-VISITORS/BILLING-INSURANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTP://WWW.CARTHAGEHOSPITAL.COM/PATIENTS-VISITORS/BILLING-INSURANCE/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CARTHAGE AREA HOSPITAL | PART V, SECTION B, LINE 5: CARTHAGE AREA HOSPITAL UTILIZES OTHER DATA SOURCES AS NECESSARY INCLUDING PATIENT SATISFACTION SURVEYS, COMMUNITY WORKSHOP EVELUATIONS, AND COMMUNITY EVENT SURVEYS. |
| CARTHAGE AREA HOSPITAL | PART V, SECTION B, LINE 6A: THE 2019-2021 JEFFERSON COUNTY COMMUNITY HEALTH ASSESSMENT WAS PERFORMED IN COOPERATION WITH RIVER HOSPITAL AND SAMARITAN MEDICAL CENTER. |
| CARTHAGE AREA HOSPITAL | PART V, SECTION B, LINE 6B: CARTHAGE AREA HOSPITAL'S SERVICE LOCATION IS WITHIN JEFFERSON COUNTY. THE 2019-2021 JEFFERSON COUNTY COMMUNITY HEALTH ASSESSMENT PREPARED BY FORT DRUM REGIONAL HEALTH PLANNING ORGANIZATION WAS PERFORMED IN COOPERATION WITH JEFFERSON COUNTY PUBLIC HEATH SERVICES AND NORTH COUNTRY HEALTH COMPASS PARTNERS. |
| CARTHAGE AREA HOSPITAL | PART V, SECTION B, LINE 11: CARTHAGE AREA HOSPITAL DEVELOPED AND IMPLEMENTED A COMMUNITY SERVICE PLAN WHICH ALIGNED WITH THE MOST RECENT CHNA. CARTHAGE ARE HOSPITAL FOCUSED ON TWO PRIORITIES ADDRESSING COMMUNITY NEEDS. 1) PREVENTING CHRONIC DISEASE; REDUCE OBESITY: OUR EMPLOYEES MADE REFERRALS TO NUTRITIONAL COUNSELING WITH A REGISTERED DIETITION FOR STUDENTS WHO WERE IDENTIFIED AS AT-RISK DURING THEIR ANNUAL PHYSICALS CONDUCTED THROUGH THE SCHOOL-BASED HEALTH CLINICS. THE HOSPITAL PARTNERED WITH A LOCAL FARMER TO USE LOCAL PRODUCE, AS AVAILABLE, IN THE HOSPITAL CAFETERIA AND ALSO OFFERED COOKING CLASSES ON HOW TO PREPARE HEALTHY FOODS AT HOME. THE HOSPITAL OFFERED COMMUNITY EDUCATION ON WEIGHT MANAGEMENT AND HEALTHY LIFESTYLES IN A "WEIGHT OF LIFE" EDUCATION SERIES. IN ADDITION TO THE COOKING CLASSES THE HOSPITAL INTRODUCED THE OPTION TO PURCHASE HEALTHY MEALS READY TO BE MADE IN SIMILAR STYLE OF "BLUE APRON AND "HELLO FRESH." OTHER PREVENTION AND WEIGHT MANAGEMENT PROGRAMS INCLUDED AN ANNUAL COMMUNITY HEALTH DAY AT A LOCAL PARK FOR ALL AGE GROUPS. 2) PROMOTE MENTAL HEALTH AND PREVENT SUBSTANCE ABUSE; STRENGTHEN INFRASTRUCTURE ACROSS SYSTEMS: THE HOSPITAL BEGAN TO INTEGRATE SCREENINGS FOR DEPRESSION DURING PRIMARY CARE VISITS AND REFERRING QUALIFYING HIGH RISK PATIENTS TO DEPRESSION CARE MANAGER. PROMOTE AWARENESS AND ACCESS TO MENTAL HEALTH TREATMENT AT COMMUNITY EVENTS AND CONTINUE TO RAISE AWARENESS REGARDING AVAILABLE SCHOOL-BASED MENTAL HEALTH PROGRAMS AS WELL AS BEHAVIORAL HEALTH CLINIC SERVICES. CARTHAGE AREA HOSPITAL ALSO PARTICIPATES IN THE DSRIP PROJECT WHICH ALIGNS WITH THESE NEEDS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 13 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - CAH FAMILY MEDICAL CENTER | ||||
| 117 NORTH MECHANIC STREET | CARTHAGE | NY | 13619 | PRIMARY CARE CLINIC |
| 2 - WOMEN'S WAY TO WELLNESS | ||||
| 117 NORTH MECHANIC STREET | CARTHAGE | NY | 13619 | OB/GYNO OUTPATIENT CLINIC |
| 3 - TRI-COUNTY ORTHOPEDIC CENTER | ||||
| 3 BRIDGE STREET | CARTHAGE | NY | 13619 | OUTPATIENT ORTHOPEDIC CENTER |
| 4 - CAH SURGERY CENTER | ||||
| 3 BRIDGE STREET | CARTHAGE | NY | 13619 | OUTPATIENT SURGERY CLINIC |
| 5 - CAH BEHAVIORAL HEALTH CENTER | ||||
| 3 BRIDGE STREET | CARTHAGE | NY | 13619 | OUTPATIENT BEHAVIORAL HEALTH CLINIC |
| 6 - PHILADELPHIA PHYSICAL THERAPY | ||||
| US ROUTE 11 | PHILADELPHIA | NY | 13673 | REHABILITATION CLINIC |
| 7 - CARTHAGE HIGH SCHOOL CLINIC | ||||
| 36500 ROUTE 26 | CARTHAGE | NY | 13619 | OUTPATIENT SCHOOL CLINIC |
| 8 - CARTHAGE MIDDLE SCHOOL CLINIC | ||||
| 21986 COLE ROAD | CARTHAGE | NY | 13619 | OUTPATIENT SCHOOL CLINIC |
| 9 - BEAVER RIVER SCHOOL CLINIC | ||||
| 9508 ARTZ ROAD | BEAVER FALLS | NY | 13305 | OUTPATIENT SCHOOL CLINIC |
| 10 - CAH THERAPHY SERVICES | ||||
| 3 BRIDGE STREET | CARTHAGE | NY | 13619 | REHABILITATION CLINIC |
| 11 - COMPREHENSIVE WOMEN'S HEALTH SERVICES | ||||
| 622 WASHINGTON STREET | WATERTOWN | NY | 13601 | OB/GYNO OUTPATIENT CLINIC |
| 12 - PHILADELPHIA MEDICAL CENTER | ||||
| 32787 US ROUTE 11 | PHILADELPHIA | NY | 13673 | RURAL HEALTH CLINIC |
| 13 - LAFARGEVILLE SCHOOL-BASED HEALTH CLINIC | ||||
| 20414 SUNRISE AVE | LAFARGEVILLE | NY | 13656 | SCHOOL-BASED HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | CARTHAGE AREA HOSPITAL ROUTINELY PROVIDES THE COMMUNITY WITH INFORMATION ON THE COMMUNITY BENEFIT ACTIVITIES AND UTILIZATION OF CARTHAGE AREA HOSPITAL. THIS IS OFTEN IN THE FORM OF NEWSLETTERS AVAILABLE AND DISTRIBUTED TO THE COMMUNITY. |
| PART I, LINE 7: | THE 2020 COST REPORT PREPARED BY M.S. HALL & ASSOCIATES LLC WAS UTILIZED IN COMPLETION OF SCHEDULE H. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND CARTHAGE AREA HOSPITAL'S COMMUNITY ACTION PLAN WAS ALSO USED TO COMPLETE SCHEDULE H. |
| PART I, LINE 7G: | CARTHAGE AREA HOSPITAL'S SUBSIDIZED HEALTH SERVICES INCLUDE ITS PRIMARY CARE CLINIC, REFERRED AMBULATORY SERVICE, EMERGENCY ROOM, AND OBSERVATION BEDS. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | CARTHAGE AREA HOSPITAL HOSTS AND PARTICIPATES IN MANY COMMUNITY BUILDING ACTIVITIES. THERE ARE MANY ACTIVITIES HOSTED BY CARTHAGE WHICH ARE POINTED AT EDUCATING THE COMMUNITY ON THEIR HEALTH. EXAMPLES INCLUDE BREAST CANCER AWARENESS LUNCHEONS, HEALTH FAIRS AND COMMIT TO BE FIT PROGRAMS. INCREASING THE EDUCATION OF THE COMMUNITY IS BELIEVED TO AID IN PREVENTION OF AILMENTS AND THEREFORE ARE AN INTERVENTION METHOD. ADDITIONALLY CARTHAGE PARTICIPATES IN ACTIVITIES THAT BUILD THE GENERAL WELL BEING AND COHESIVENESS OF THE COMMUNITY. SUCH EVENTS INCLUDE UNITED WAY, COMMUNITY PARADES AND SPONSORSHIP OF COMMUNITY ACTIVITIES. |
| PART III, LINE 2: | BAD DEBT EXPENSE INFORMATION WAS OBTAINED FROM THE 2020 MEDICAID COST REPORT. THE COST REPORT IS COMPLETED BY INDEPENDENT CONSULTANTS UTILIZING PATIENT CHARGE DATA. |
| PART III, LINE 3: | THE AMOUNT OF BAD DEBT EXPENSE RELATED TO PATIENTS ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY WAS DETERMINED BY UTILIZING THE MEDICARE COST TO CHARGE RATIO APPLIED TO BAD DEBT EXPENSE. THIS INFORMATION WAS OBTAINED BY UTILIZING COST REPORTS PREPARED BY INDEPENDENT CONSULTANTS. |
| PART III, LINE 4: | THE HOSPITAL IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL BY MEDICARE AND MEDICAID. AS A CRITICAL ACCESS HOSPITAL, MEDICARE AND TRICARE REIMBURSES THE HOSPITAL ON A COST BASIS, AND MEDICAID REIMBURSES THE HOSPITAL USING A TRENDED BASE YEAR COST PER DISCHARGE HELD TO 110% OF THE STATEWIDE AVERAGE OF ALL CRITICAL ACCESS HOSPITALS PLUS CAPITAL AND ON A PROSPECTIVE PAYMENT SYSTEM FOR OUTPATIENT VISISTS. THE COMPANY ALSO HAS AGREEMENTS WITH OTHER THIRD-PARTY PAYORS WITH PAYMENT ARRANGEMENTS WHICH INCLUDE PROSPECTIVELY DETERMINED RATES PER DISCHARGE OR VISIT, COST-BASED REIMBURSEMENT, DISCOUNTED CHARGES, PER DIEM PAYMENTS AND FEE-FOR-SERVICE PAYMENTS. THE COMPANY RECOGNIZES PATIENT AND RESIDENT SERVICE REVENUE ASSOCIATED WITH SERVICES OR HOUSING PROVIDED TO PATIENTS AND RESIDENTS WHO HAVE THIRD-PARTY COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES OR HOUSING PROVIDED, INCLUDING ESTIMATED RETROACTIVE ADJUSTMENTS DUE TO FUTURE AUDITS, REVIEWS AND INVESTIGATIONS. RETROACTIVE ADJUSTMENTS ARE INCLUDED IN THE RECOGNITION OF PATIENT AND RESIDENT SERVICE REVENUE ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ADJUSTED IN FUTURE PERIODS AS ADJUSTMENTS BECOME KNOWN OR AS YEARS ARE NO LONGER SUBJECT TO SUCH AUDITS, REVIEWS AND INVESTIGATIONS.FOR UNINSURED PATIENTS AND RESIDENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE COMPANY RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES OR HOUSING PROVIDED. HISTORICALLY, A SIGNIFICANT PORTION OF THE COMPANY'S UNINSURED PATIENTS AND RESIDENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES OR HOUSING PROVIDED. THUS, THE COMPANY RECORDS A PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS AND RESIDENTS IN THE PERIOD THE SERVICES OR HOUSING ARE PROVIDED. THE COMPANY ESTIMATES THE AMOUNT TO BE RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR DOUBTFUL ACCOUNTS BY ANALYZING PATIENT AND RESIDENT ACCOUNTS FOR COLLECTABILITY, CONSIDERING PREVAILING ECONOMIC CONDITIONS, AND APPLYING HISTORICALLY ESTABLISHED PERCENTAGES FOR SELF-PAY AND VARIOUS THIRD-PARTY PAYORS TO THE AGING CATEGORIES IN THE ACCOUNTS RECEIVABLE AGING AND REVIEWING SPECIFIC OUTSTANDING BALANCES. ACCOUNTS FOR WHICH NO PAYMENTS HAVE BEEN RECEIVED FOR A SIGNIFICANT AMOUNT OF TIME ARE CONSIDERED DELINQUENT AND THE ACCOUNTS ARE WRITTEN-OFF WHEN CUSTOMARY COLLECTION EFFORTS ARE EXHAUSTED.THE COMPANY'S ACCOUNTING POLICY WITH RESPECT TO THE CONSOLIDATED FINANCIAL STATEMENTS IS TO REPORT THE CONSOLIDATED BAD DEBT EXPENSE AS A DEDUCTION FROM NET PATIENT SERVICE REVENUE. |
| PART III, LINE 8: | THE 2020 COST REPORT WAS UTILIZED WITHIN THE COMPLETION OF SCHEDULE H. CARTHAGE AREA HOSPITAL HAS A REMOTE LOCATION. THE HOSPITAL OFFERS A FULL RANGE OF SERVICES FROM LAB WORK, IMAGING, EMERGENCY ROOM AND PRIMARY CARE DESPITE LOW UTILIZATION AT TIMES. SURPLUSES AND SHORTFALLS OCCUR DUE TO THE WIDE SPREAD OF SERVICES OFFERED WITH A LIMITED AMOUNT OF PATIENTS WITHIN THE REMOTE AREA. HOWEVER, THESE SERVICES ARE CONTINUALLY OFFERED TO PATIENTS INCREASING THE AVAILABILITY TO HEALTHCARE SERVICES. THE HOSPITAL OFFERS SERVICES TO MANY LOW INCOME PATIENTS AS WELL, WHOM OFTEN WOULD CHOOSE NOT TO OBTAIN ANY HEALTH INTERVENTION IF THEY WERE REQURED TO SPEND FUNDS TO TRAVEL TO CARE. |
| PART III, LINE 9B: | THE COLLECTION POLICY REFERS TO CHARITY CARE. THE POLICY STATES "ANY PATIENT RECEIVING SERVICES FOR WHICH THERE IS NO INSURANCE COVERAGE WILL BE REGISTERED AS SELF PAY AND ALL BALANCES WILL BE DUE FROM THE PATIENT EXCEPT CHARIY CARE ADJUSTMENTS AS DETERMINED BY THE FINANCIAL COUNSELOR IN ACCORDANCE WITH CARTHAGE AREA HOSPITAL'S CHARITY CARE POLICY." CARTHAGE AREA HOSPITAL'S COLLECTION POLICY DOES STATE HOW TO APPLY FOR FINANCIAL ASSISTANCE. THERE ARE NO PROVISIONS WRITTEN INTO THE COLLECTION POLICY FOR THOSE ACCOUNTS WHICH ARE DEEMED ELIGIBLE FOR FINANCIAL ASSISTANCE. CARTHAGE HAS NOT WRITTEN THIS INTO THE POLICY AS THOSE WHO RECEIVE FINANCIAL ASSISTANCE TYPICALLY DO NOT HAVE A BALANCE TO SEND TO COLLECTION AFTER THE FINANCIAL ASSISTANCE IS APPLIED. |
| PART VI, LINE 2: | CARTHAGE AREA HOSPITAL UTILIZES OTHER DATA SOURCES AS NECESSARY INCLUDING PATIENT SATISFACTION SURVEYS, COMMUNITY WORKSHOP EVALUATIONS, AND COMMUNITY EVENT SURVEYS. |
| PART VI, LINE 3: | THE HOSPITAL POSTS ITS CHARITY CARE POLICY INCLUDING CONTACT INFORMATION FOR THE FINANCIAL COUNSELOR IN THE ADMISSION AREA. ADDITIONALLY THIS INFORMATION CAN BE FOUND ON THE HOSPITAL'S WEBSITE. IF A PATIENT DOES NOT MEET WITH A FINANCIAL COUNSELOR ANOTHER HOSPITAL EMPLOYEE INFORMS THE PATIENT OF OTHER STATE AND FEDERAL ASSISTANCE OPTIONS. |
| PART VI, LINE 4: | THE HOSPITAL'S SERVICE AREA CONSISTS OF SOCIO-ECONOMICALLY RURAL DEPRIVED POPULATION WITHIN A LARGE GEOGRAPHIC REGION. THE REGION IS SERVED BY THREE HOSPITALS. DUE TO THE PROXIMITY OF FORT DRUM, THE NEEDS OF THE POPULATION ARE UNIQUE. THIS AREA IS MORE ETHNICALLY DIVERSE COMPARED TO OTHER COUNTIES IN THE REGION. WHILE FERTILITY AND BIRTH RATES ARE ABOVE AVERAGE DUE TO THE PROXIMITY TO THE MILITARY BASE, THE POVERTY RATE IS HIGH AND HAS CAUSED A LOWER MEDIAN INCOME THAN THE NATIONAL AVERAGE. THE GROWTH OF FORT DRUM AND RAPID NEEDS OF SOLDIERS WHEN THEY REDEPLOY HEAVILY IMPACTS THE UTILIZATION EXPERIENCED AT THE HOSPITAL. THEREFORE OFTEN SERVICE NEEDS REVOLVE AROUND THE ACTIVITY OF THE BASE AND THE HOSPITAL MAY EXPERIENCE TIMES OF SLOW UTILIZATION DESPITE CONTINUED COMMUNITY NEED FOR THAT SERIVCE. THESE FACTORS HAVE CREATED A REGION WHERE THE POPULATION IS OFTEN MEDICALLY INDIGENT. |
| PART VI, LINE 5: | CARTHAGE AREA HOSPITAL PROMOTED THE IMPORTANCE OF GOOD COMMUNITY HEALTH DURING SEVERAL EVENTS. HEALTHCARE PROVIDERS, PHYSICAL THERAPISTS AND REGISTERED DIETITIANS MADE THEMSELVES AVAILABLE DURING COMMUNITY EVENTS, SPOKE AT LOCAL EVENTS AND OUTREACH EVENTS ON THE HOSPITAL CAMPUS. EVENTS INCLUDED MEDICAL IMAGING OPEN HOUSE EVENT, HOLIDAY PARADE, COOKING CLASSES FOR CHILDREN AND CARE SEAT SAFETY CHECKS.OTHER ORGANIZATIONS THE HOSPITAL SUPPORTED WERE THE AMERICAN HEART ASSOCIATION, TOYS FOR TOTS, UNITED WAY, AND MARCH OF DIMES. THE HOSPITAL PARTICIPATED IN WALKS, FOOD DRIVES AND OTHER EVENTS THROUGHOUT THE YEAR, AN EVEN HELPED TO RAISE MONEY FOR THE UNITED WAY OF NORTHERN NEW YORK, AMERICAN HEART ASSOCIATION AND MARCH OF DIMES. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 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 (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL GORDON | ||||||||||||||
| CHIEF MEDICAL OFFICER | $1,208,953 | $0 | $0 | $0 | $0 | $0 | $9,750 | $0 | $12,450 | $0 | $1,231,153 | $0 | $0 | $0 |
| NATA PARNES | ||||||||||||||
| MEDICAL STAFF REPRESENTATI | $900,226 | $0 | $0 | $0 | $0 | $0 | $9,750 | $0 | $12,450 | $0 | $922,426 | $0 | $0 | $0 |
| RICCARDO TURRIN | ||||||||||||||
| PHYSICIAN | $711,866 | $0 | $0 | $0 | $0 | $0 | $9,750 | $0 | $9,837 | $0 | $731,453 | $0 | $0 | $0 |
| FELIX OBEN | ||||||||||||||
| CLINICAL PROVIDER | $703,581 | $0 | $10,000 | $0 | $0 | $0 | $0 | $0 | $2,924 | $0 | $716,505 | $0 | $0 | $0 |
| ROB BLOOM | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $436,466 | $0 | $50,850 | $0 | $0 | $0 | $8,100 | $0 | $10,611 | $0 | $506,027 | $0 | $0 | $0 |
| REBECCA TAN ALBERTO | ||||||||||||||
| MD-ANESTHESIA | $475,353 | $0 | $0 | $0 | $0 | $0 | $9,750 | $0 | $12,450 | $0 | $497,553 | $0 | $0 | $0 |
| KINGSLEY MALCOLM | ||||||||||||||
| CRNA | $459,845 | $0 | $0 | $0 | $0 | $0 | $9,750 | $0 | $10,299 | $0 | $479,894 | $0 | $0 | $0 |
| BRYAN VENERUS | ||||||||||||||
| PHYSICIAN | $417,758 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $8,898 | $0 | $426,656 | $0 | $0 | $0 |
| NATALIE BURNHAM | ||||||||||||||
| CHIEF OPERATING OFFICER | $176,795 | $0 | $13,990 | $0 | $0 | $0 | $9,569 | $0 | $10,293 | $0 | $210,647 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | CARTHAGE AREA HOSPITAL'S COMPENSATION COMMITTEE BENCHMARKS SALARIES BY USING FORM 990 FROM OTHER NOT-FOR-PROFIT ORGANIZATIONS AS WELL AS SALARY REPORTS PROVIDED BY REGIONAL HOSPITAL-SPECIFIC VENDORS. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KRISTEN BLOOM | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER OF ROB BLOOM, OFFICER | RelationshipDescriptionTxt |
| Transaction | $41,260 | TransactionAmt |
| Transaction | EMPLOYEE COMPENSATION | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE HOSPITAL ENTERED INTO A LEASED EMPLOYEE AGREEMENT WITH CLAXTON-HEPBURN MEDICAL CENTER FOR SHARED SERVICES OF THE CHIEF EXECUTIVE OFFICER. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE COMPLETED FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. THE FORM 990 IS REVIEWED AND APPROVDED BY BOTH THE BOARD OF DIRECTORS AND THE CHIEF FINANCIAL OFFICER PRIOR TO BEING SUBMITTED. IN ADDITION, AN EMAIL IS SENT TO EACH BOARD MEMBER INFORMING THEM THAT THE ADMINISTRATION WILL PROVIDE A COPY OF THE FORM 990 UPON REQUEST. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS COMPLETE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE FORM. THE AUDIT AND FINANCE COMMITTEE OVERSEES THE ANNUAL COMPLETION OF THE CONFLICT OF INTEREST DISCLOSURES. THE EXECUTIVE SECRETARY IS RESPONSIBLE FOR OBTAINING THE SIGNED AND COMPLETED FORMS, THE CHIEF COMPLIANCE OFFICER REVIEWS ALL DISCLOSURE FORMS. DURING A BOARD VOTE, WHEN A MEMBER IS CONFLICTED, THEY ARE ASKED TO LEAVE THE ROOM DURING VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF THE CHIEF EXECUTIVE OFFICER, OFFICERS, AND KEY EMPLOYEES IS REVIEWED AND APPROVED ANNUALLY BY THE BOARD, COMPENSATION COMMITTEE, AS WELL AS THE FINANCE COMMITTEE. THE COMPENSATION COMMITTEE USES BENCH-MARKING DATA PROVIDED BY FORM 990 OF OTHER NOT-FOR-PROFIT ORGANIZATIONS IN ITS REVIEW OF OFFICER COMPENSATION. TO PROVIDE AN ADDITIONAL LEVEL OF COMPENSATION REVIEW, THE FINANCE COMMITTEE ALSO REVIEWS COMPENSATION OVER $115,000 ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE PROVIDED UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 419,314. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CARTHAGE AREA HOSPITAL FOUNDATION INC | ||||||||||
| 3 BRIDGE STREET | CARTHAGE | NY | 13619 | 161467023 | FUNDRAISING | NY | 501(C)(3) | LINE 7 | CARTHAGE AREA HOSPITAL INC | Yes (1) |
| MEADOWBROOK TERRACE INC | ||||||||||
| 21957 COLE ROAD | CARTHAGE | NY | 13619 | 454102458 | ASSISTED LIVING | NY | 501(C)(3) | LINE 10 | CARTHAGE AREA HOSPITAL INC | Yes (1) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMPREHENSIVE WOMEN'S HEALTH SERVICES PLLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 622 WASHINGTON STREET | AddressLine1Txt |
| City | WATERTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562394825 | EIN |
| Primary Activities | OBSTETRICS AND GYNECOLOGY | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CARTHAGE AREA HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$1 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $382,587 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 1.00000 | OwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt |
|---|---|
| COMPREHENSIVE WOMEN'S HEALTH SERVICES PLLC | |
| L | $80,020 |
| COMPREHENSIVE WOMEN'S HEALTH SERVICES PLLC | |
| D | $109,175 |
| MEADOWBROOK TERRACE INC | |
| D | $598,139 |