NATHAN LITTAUER HOSPITAL ASSOCIATION: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization: NATHAN LITTAUER HOSPITAL ASSOCIATION (EIN 14-1338465)
Tax period: 2018-01-01 to 2018-12-31
Filed: 2019-11-14
IRS object ID: 201913189349305811
Schema version: 2018v3.0
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule O
Schedule R
Reasonable Cause Explanation

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2019-11-14T10:26:50-07:00	ReturnTs
Tax Period End	2018-12-31	TaxPeriodEndDt
Return Type	990	ReturnTypeCd
Tax Period Begin	2018-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	141338465	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	NATHAN LITTAUER HOSPITAL ASSOCIATION	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	NATH	BusinessNameControlTxt
Phone	5187258621	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	99 East State Street	AddressLine1Txt
City	Gloversville	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12078	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Mike Ostrander	PersonNm
Person Title	Vice President of Finance & CFO	PersonTitleTxt
Phone	5187735480	PhoneNum
Signature	2019-11-08	SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	208.125.81.163	IPv4AddressTxt

Field	Value	IRS element (for citing)
Tax	2018	TaxYr
Build TS	2020-03-31 21:24:44Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	Nathan Littauer Hospital and Nursing Home	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	Laurence E Kelly	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	99 East State Street	AddressLine1Txt
City	Gloversville	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12078	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$129,424,832	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.nlh.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1894	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	Nathan Littauer Hospital & Nursing Home and its family of health services is committed to providing safe high quality health and wellness services and improving the health of our communities in a caring, contemporary environment.	ActivityOrMissionDesc
Voting Members Governing Body	15	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	1168	TotalEmployeeCnt
Total Volunteers	129	TotalVolunteersCnt
Total Gross UBI	$547,762	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$784,916	PYContributionsGrantsAmt
CY Contributions Grants	$696,752	CYContributionsGrantsAmt
PY Program Service Revenue	$101,508,219	PYProgramServiceRevenueAmt
CY Program Service Revenue	$103,521,436	CYProgramServiceRevenueAmt
PY Investment Income	$1,786,353	PYInvestmentIncomeAmt
CY Investment Income	$4,171,972	CYInvestmentIncomeAmt
PY Other Revenue	$4,075,642	PYOtherRevenueAmt
CY Other Revenue	$9,611,163	CYOtherRevenueAmt
PY Total Revenue	$108,155,130	PYTotalRevenueAmt
CY Total Revenue	$118,001,323	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	$66,440,347	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$68,078,851	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$276,211	CYTotalFundraisingExpenseAmt
PY Other Expenses	$35,967,252	PYOtherExpensesAmt
CY Other Expenses	$37,560,000	CYOtherExpensesAmt
PY Total Expenses	$102,407,599	PYTotalExpensesAmt
CY Total Expenses	$105,638,851	CYTotalExpensesAmt
PY Revenues Less Expenses	$5,747,531	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$12,362,472	CYRevenuesLessExpensesAmt
Total Assets BOY	$94,577,042	TotalAssetsBOYAmt
Total Assets EOY	$105,410,056	TotalAssetsEOYAmt
Total Liabilities BOY	$26,019,521	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$28,403,031	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$68,557,521	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$77,007,025	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	Nathan Littauer Hospital & Nursing Home and its family of health services is committed to providing safe high quality health and wellness services and improving the health of our communities in a caring, contemporary environment.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$58,522,416	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$75,724,775	RevenueAmt
Desc	74 bed general medical surgical hospital providing inpatient and outpatient services with the following service statistics for 2018; 7,692 inpatient days, 900 observation visits, 815 new born days, 2,393 admissions, 365 nursery admissions, 23,868 emergency room visits, 93,135 outpatient visits and 5,525 day surgery visits.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$29,750,771	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$18,938,199	RevenueAmt
Desc	The Nathan Littauer Hospital and Specialty Care Centers provide care for the whole family. Our nine conveniently located centers offer a range of services and specialties that include urology, obstetrics, gynecology, podiatry, pulmonology, gastroenterology, pediatrics, and neurology along with direct access to state-of-the-art technology available at Nathan Littauer Hospital. Several Centers are located in remote rural parts of our service area. The Centers employ 38 physicians and over 27 other healthcare professionals. During 2018, the Centers collectively incurred 141,444 patient visits.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$9,514,803	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$8,669,856	RevenueAmt
Desc	The Nathan Littauer Nursing Home located on the Nathan Littauer Hospital campus is a short and long-term residential healthcare facility that provides a wide range of medical services with 84 beds. In 2018, the facility had a total of 30,067 patient days.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$664,067	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$9,347,979	RevenueAmt
Desc	HealthLink is Nathan Littauer Hospital's Wellness Education Center located in downtown Johnstown. HealthLink's role is to promote wellness by promoting prevention and providing resources to promote healthy lifestyle choices. Since its launch in 1989, HealthLink has served 9,014 area residents with 277,454 free or low-cost education programs and health screenings. Our wide varieties of programs are chosen based on the interests and the health needs of the community. Program categories: include Health & Wellness, Mind & Body, Childbirth & Parenting, Health Screenings, Support Groups, Chronic Disease Self-Management Workshops, and Fitness Classes. Programs and presentations on a variety of topics are offered throughout our service area at places such as local businesses, schools, churches and other organizations in order to better serve this rural community. HealthLink's resources include: fair and festival activities, trained employees and contracted staff, numerous brochures on a wide variety of health & wellness related topics available at no cost, as well as an array of health magazines, books and DVDs for loan. The Hospital also offers a Lifeline Program. Lifeline is a personal emergency response system providing immediate assistance 24 hours a day 7 days a week. A total of 430 subscribers are members of NLHs Lifeline Program. Other community services include community health fairs, speakers bureau, organ donation program and New Visions Program for high school students. Health Insurance Counseling: Nathan Littauer Hospital was awarded and continues to be the Lead Agency for the grant entitled: "Consumer Assistant for the NYS of Health Benefit Exchange" covering Fulton and Montgomery County. During the year of 2018 Nathan Littauer Hospital as Lead Agency the program's was able to enroll a total of 4,544 individuals with the following breakdown: Children's Medicaid - 1,217, Child Health Plus Program - 463, Adult Medicaid - 1,893, Adult Quality Health Plan - 337, Essential Plans - 634. Also included here is other operating revenue of $8,668,365.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$664,067	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$0	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$9,347,979	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$98,452,057	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
Temp Or Permanent Endowments	Yes (1)	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	Yes (1)	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	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	0	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	0	BusinessRlnWithOfficerEntInd
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	Yes (1)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	34	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	1168	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (1)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (1)	Form990TFiledInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind	0	Form8899Filedind
Form1098 C Filed	0	Form1098CFiledInd
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	15	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (1)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	0	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	Michael Redcross	PersonNm
Phone	5187735481	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	99 East State Street	AddressLine1Txt
City	Gloversville	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12078	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Gregory Truckenmiller PhD
Chair	0.5	0.25	Yes (X)	$0	$0	$0
Stephen Tomlinson
Vice Chair	0.5	0.25	Yes (X)	$0	$0	$0
Susan Johnson Esq
Treasurer	0.5	0.25	Yes (X)	$0	$0	$0
Holly Chamberlin Esq
Secrerary	0.5	0.25	Yes (X)	$0	$0	$0
Thomas Ciaccio
Member	0.5	0.25	Yes (X)	$0	$0	$0
Paul Connelie
Member	0.5	0.25	Yes (X)	$0	$0	$0
John Fox DDS
Member	0.5	0.25	Yes (X)	$0	$0	$0
Brian Hanaburgh
Member	0.5	0.25	Yes (X)	$0	$0	$0
Laurence Horowitz MD
Member/Employed Physician	0.5	0.25	Yes (X)	$155,336	$0	$6,046
John Mastrangelo MD
Member	0.5	0.25	Yes (X)	$0	$0	$0
Amy Pedrick
Member	0.5	0	Yes (X)	$0	$0	$0
G Jeremiah Ryan PhD
Member	0.5	0.25	Yes (X)	$0	$0	$0
David Seward Esq
Member	0.5	0.25	Yes (X)	$0	$0	$0
Shriraj Shah
Member/Employed Physician	40	0	Yes (X)	$233,788	$0	$28,324
Laurence E Kelly
President and CEO	40	0.25	Yes (X)	$728,740	$0	$88,512	Yes (X)
Mike Ostrander
Vice President of Finance and CFO	40	0.25		$294,969	$0	$22,833	Yes (X)
Kamini Ramani MD
Physician	40	0		$752,145	$0	$31,296		Yes (X)
Luz Alvarez MD
Physician	40	0		$568,938	$0	$17,854		Yes (X)
Paul Husson MD
Physician	40	0		$532,299	$0	$29,198		Yes (X)
Verma Shri MD
Physician	40	0		$653,128	$0	$27,379		Yes (X)
Wasiczko Robert MD
Physician	40	0		$427,025	$0	$17,926		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$4,346,368	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$269,368	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	101	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
Sodexo Operations
PO Box 905374	Charlotte	NC	28290	Dietary Services	$2,257,272
Gloversville Physician Medicine PC
PO Box 82368	Lafayette	LA	70598	Physician Services	$1,248,179
Alliance Healthcare Services
PO Box 964485	Chicago	IL	60693	MRI Imaging	$1,216,800
MLB Construction Services LLC
1 Stone Break Road	Malta	NY	12020	Construction Services	$902,735
Quest Diagnostics
1 Malcolm Avenue	Teterboro	NJ	07608	Diagnostic Services	$875,834

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	19	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$200,000	RelatedOrganizationsAmt
Government Grants	$491,008	GovernmentGrantsAmt
All Other Contributions	$5,744	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$696,752	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Inpatient and Outpatient Services	622110	$75,724,775	$75,593,350	$131,425	$0
Primary Care Centers	621400	$18,938,199	$18,938,199	$0	$0
Nursing Home	623000	$8,669,856	$8,669,856	$0	$0
Lifeline	621990	$164,612	$164,612	$0	$0
Healthlink	611710	$23,994	$23,994	$0	$0

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$103,521,436	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$3,950,946	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$3,586	UnrelatedBusinessRevenueAmt
Exclusion	$3,947,360	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$11,642,341	SecuritiesAmt
Other	$2,194	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$11,423,509	SecuritiesAmt
Other	$0	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$218,832	SecuritiesAmt
Other	$2,194	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$221,026	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$221,026	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$0	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$0	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Gaming Gross Income	$0	GamingGrossIncomeAmt
Gaming Direct Expenses	$0	GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
Retail Pharmacy	446110	$412,751	$0	$412,751	$0
340b Program	900099	$3,858,117	$3,858,117	$0	$0
Cafeteria Sales	722212	$419,416	$419,416	$0	$0

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,920,879	TotalRevenueColumnAmt
Related Or Exempt Func Income	$4,881,840	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$39,039	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$9,611,163	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$118,001,323	TotalRevenueColumnAmt
Related Or Exempt Func Income	$112,549,384	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$547,762	UnrelatedBusinessRevenueAmt
Exclusion	$4,207,425	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$1,023,709	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$1,023,709	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$53,027,976	TotalAmt
Program Services	$50,295,654	ProgramServicesAmt
Management And General	$2,520,747	ManagementAndGeneralAmt
Fundraising	$211,575	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$3,048,368	TotalAmt
Program Services	$2,881,577	ProgramServicesAmt
Management And General	$158,328	ManagementAndGeneralAmt
Fundraising	$8,463	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$7,368,223	TotalAmt
Program Services	$7,001,631	ProgramServicesAmt
Management And General	$337,715	ManagementAndGeneralAmt
Fundraising	$28,877	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$3,610,575	TotalAmt
Program Services	$3,417,738	ProgramServicesAmt
Management And General	$176,652	ManagementAndGeneralAmt
Fundraising	$16,185	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$553,791	TotalAmt
Program Services	$553,791	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$74,950	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$74,950	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$140,916	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$140,916	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$29,111	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$29,111	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,190,318	TotalAmt
Program Services	$2,073,630	ProgramServicesAmt
Management And General	$116,688	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$217,364	TotalAmt
Program Services	$576	ProgramServicesAmt
Management And General	$216,788	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,454,909	TotalAmt
Program Services	$4,053,080	ProgramServicesAmt
Management And General	$401,829	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$818,376	TotalAmt
Program Services	$764,642	ProgramServicesAmt
Management And General	$53,734	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,086,000	TotalAmt
Program Services	$1,084,937	ProgramServicesAmt
Management And General	$1,063	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$321,509	TotalAmt
Program Services	$287,927	ProgramServicesAmt
Management And General	$33,582	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$152,472	TotalAmt
Program Services	$152,472	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,836,817	TotalAmt
Program Services	$3,678,922	ProgramServicesAmt
Management And General	$157,895	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$1,660,050	TotalAmt
Program Services	$1,660,050	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Medical Supplies	$11,449,243	$11,448,968	$275	$0
Non-Medical Expenses	$1,365,693	$1,357,462	$8,231	$0
Purchased Services	$5,821,916	$5,000,758	$821,158	$0
Food	$987,932	$987,932	$0	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$2,398,633	TotalAmt
Program Services	$1,750,310	ProgramServicesAmt
Management And General	$637,212	ManagementAndGeneralAmt
Fundraising	$11,111	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$105,638,851	TotalAmt
Program Services	$98,452,057	ProgramServicesAmt
Management And General	$6,910,583	ManagementAndGeneralAmt
Fundraising	$276,211	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$4,953,457	BOYAmt
EOY	$5,946,653	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$4,114,904	BOYAmt
EOY	$4,491,685	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$71,360	BOYAmt
EOY	$71,360	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$12,001,398	BOYAmt
EOY	$11,614,731	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$630,442	BOYAmt
EOY	$792,191	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$959,133	BOYAmt
EOY	$953,378	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$94,158,355	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$67,775,695	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$26,332,671	BOYAmt
EOY	$26,382,660	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$38,796,691	BOYAmt
EOY	$49,734,077	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$6,716,986	BOYAmt
EOY	$5,423,321	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$94,577,042	BOYAmt
EOY	$105,410,056	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$7,064,979	BOYAmt
EOY	$7,810,531	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$362,363	BOYAmt
EOY	$362,363	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$18,592,179	BOYAmt
EOY	$20,230,137	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$26,019,521	BOYAmt
EOY	$28,403,031	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$68,203,661	BOYAmt
EOY	$76,653,165	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$71,360	BOYAmt
EOY	$71,360	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$282,500	BOYAmt
EOY	$282,500	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$68,557,521	BOYAmt
EOY	$77,007,025	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$94,577,042	BOYAmt
EOY	$105,410,056	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$12,362,472	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$4,119,239	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Investment Expense	$0	InvestmentExpenseAmt
Prior Period Adjustments	$0	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$206,271	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Separate Basis Fincl Stmt	Yes (X)	SeparateBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (1)	AuditCommitteeInd
Federal Grant Audit Required	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	0	PaidStaffOrManagementInd
Media Advertisements	0	MediaAdvertisementsInd
Mailings Members	0	MailingsMembersInd
Publications Or Broadcast	0	PublicationsOrBroadcastInd
Grants Other Organizations	0	GrantsOtherOrganizationsInd
Direct Contact Legislators	0	DirectContactLegislatorsInd
Rallies Demonstrations	0	RalliesDemonstrationsInd
Other Activities	Yes (1)	OtherActivitiesInd
Other Activities	$29,111	OtherActivitiesAmt
Total Lobbying Expenditures	$29,111	TotalLobbyingExpendituresAmt
Not Described Section501c3	0	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1	FormAndLineReferenceDesc
Explanation	A portion of the organizations dues for the American Hospital Association, Healthcare Association of New York State and the Iroquois Healthcare Consortium is used for Lobbying purposes. Also the organization engaged a law firm to seek an extension of the Medicare Dependent Hospital Designation as part of a group effort with other rural Hospitals.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$438,438	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	-$42,336	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$999	AdministrativeExpensesAmt
End Year Balance	$395,103	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$374,009	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$66,039	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$1,610	AdministrativeExpensesAmt
End Year Balance	$438,438	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$328,971	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$46,558	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$1,520	AdministrativeExpensesAmt
End Year Balance	$374,009	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$347,080	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	-$16,633	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$0	OtherExpendituresAmt
Administrative Expenses	$1,476	AdministrativeExpensesAmt
End Year Balance	$328,971	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$416,864	BeginningYearBalanceAmt
Contributions	$0	ContributionsAmt
Investment Earnings Or Losses	$31,838	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$0	GrantsOrScholarshipsAmt
Other Expenditures	$100,000	OtherExpendituresAmt
Administrative Expenses	$1,622	AdministrativeExpensesAmt
End Year Balance	$347,080	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	1	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	0	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$853,543	OtherCostOrOtherBasisAmt
Book Value	$853,543	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$44,622,515	OtherCostOrOtherBasisAmt
Depreciation	$29,500,457	DepreciationAmt
Book Value	$15,122,058	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$2,106,131	OtherCostOrOtherBasisAmt
Depreciation	$1,494,995	DepreciationAmt
Book Value	$611,136	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$41,545,925	OtherCostOrOtherBasisAmt
Depreciation	$34,507,173	DepreciationAmt
Book Value	$7,038,752	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$5,030,241	OtherCostOrOtherBasisAmt
Depreciation	$2,273,070	DepreciationAmt
Book Value	$2,757,171	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$26,382,660	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (7 entries)

DescDesc	Book ValueBookValueAmt
AWUIL by Board Designation	$648,569
Agency Fund	$52,462
Miscellaneous Receivable	$74,809
Other Assets	$352,102
Deferred Asset - 1199	$434,342
Deferred Asset - 457 plans	$3,304,293
Software License	$556,744

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$5,423,321	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)

DescDesc	AmtAmt
Due to Third Parties	$4,674,839
Asset Retirement Obligation	$393,394
Long-Term Pension Obligation	$5,761,669
Section 457 Plans	$3,706,789
Due to 1199	$434,342
EHR Reserve	$503,711
Promissory Notes	$4,755,393

Field	Value	IRS element (for citing)
Total Liability	$20,230,137	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$114,088,355	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$4,119,239	NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Recoveries Prior Year Grants	$0	RecoveriesPriorYearGrantsAmt
Other Revenue	$206,271	OtherRevenueAmt
Revenue Not Reported	-$3,912,968	RevenueNotReportedAmt
Revenue Subtotal	$118,001,323	RevenueSubtotalAmt
Investment Expenses Not Incld	$0	InvestmentExpensesNotIncldAmt
Other Revenues Not Included	$0	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$118,001,323	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$105,638,851	TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts	$0	DonatedServicesUseFcltsAmt
Prior Year Adjustments	$0	PriorYearAdjustmentsAmt
Losses Reported	$0	LossesReportedAmt
Other Expenses Included	$0	OtherExpensesIncludedAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$105,638,851	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$0	InvestmentExpensesNotIncld2Amt
Other Expenses Not Included	$0	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$105,638,851	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule D, Part V, Line 4	The principle donation is permanently restricted, income generated by the fund can be used toward operations of the hospital.
Schedule D, Part X, Line 2	The Hospital is a not-for-profit organization, as described in Section 501c 3 of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501 (a) of the Code. The Hospital recognizes income tax positions when its more-likely than not that position will be sustainable based on the merits of the position. Recognized tax liabilities are not material to the financial statements as of December 31, 2018 or 2017.
Schedule D, Part XI, Line 2d	Pension related changes other than periodic pension cost ($206,271).

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (1)	FinancialAssistancePolicyInd
Written Policy	Yes (1)	WrittenPolicyInd
FPG Reference Free Care	Yes (1)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
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	0	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (1)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (1)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	645	PersonsServedCnt
Total Community Benefit Expns	$287,251	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$38,581	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$248,670	NetCommunityBenefitExpnsAmt
Total Expense	0.0024	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	72920	PersonsServedCnt
Total Community Benefit Expns	$24,026,396	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,054,799	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$7,971,597	NetCommunityBenefitExpnsAmt
Total Expense	0.0755	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	73565	PersonsServedCnt
Total Community Benefit Expns	$24,313,647	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,093,380	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$8,220,267	NetCommunityBenefitExpnsAmt
Total Expense	0.0779	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	32	ActivitiesOrProgramsCnt
Persons Served	42637	PersonsServedCnt
Total Community Benefit Expns	$798,939	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$473,233	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$325,706	NetCommunityBenefitExpnsAmt
Total Expense	0.0031	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	152	PersonsServedCnt
Total Community Benefit Expns	$154,430	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$154,430	NetCommunityBenefitExpnsAmt
Total Expense	0.0015	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Activities Or Programs	1	ActivitiesOrProgramsCnt
Persons Served	141444	PersonsServedCnt
Total Community Benefit Expns	$22,284,114	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$15,859,184	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,424,930	NetCommunityBenefitExpnsAmt
Total Expense	0.0608	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	3	ActivitiesOrProgramsCnt
Persons Served	380	PersonsServedCnt
Total Community Benefit Expns	$19,479	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$19,479	NetCommunityBenefitExpnsAmt
Total Expense	0.0002	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	37	ActivitiesOrProgramsCnt
Persons Served	184613	PersonsServedCnt
Total Community Benefit Expns	$23,256,962	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,332,417	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$6,924,545	NetCommunityBenefitExpnsAmt
Total Expense	0.0656	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	37	ActivitiesOrProgramsCnt
Persons Served	258178	PersonsServedCnt
Total Community Benefit Expns	$47,570,609	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$32,425,797	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$15,144,812	NetCommunityBenefitExpnsAmt
Total Expense	0.1435	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (1)	BadDebtExpenseReportedInd
Bad Debt Expense	$5,517,125	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$11,401,323	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$13,119,596	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,718,273	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	Nathan Littauer Hospital Association	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	99 East State Street	AddressLine1Txt
City	Gloversville	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12078	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.nlh.org	WebsiteAddressTxt
State License	1701000H	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Nathan Littauer Hospital Association	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	0	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	0	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (1)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	16	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	www.nlh.org	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (1)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (1)	StrategyPostedWebsiteInd
Strategy Website URL	www.nlh.org	StrategyWebsiteURLTxt
Strategy Attached	0	StrategyAttachedInd
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	100	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300	FPGFamilyIncmLmtDscntCarePct
Explained Basis	Yes (1)	ExplainedBasisInd
App Financial Asst Expln	Yes (1)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Provided Nonprofit Contact	Yes (X)	ProvidedNonprofitContactInd
Includes Publicity Measures	Yes (1)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	www.nlh.org	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	www.nlh.org	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	www.nlh.org	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (1)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	0	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
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 (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5-Nathan Littauer Hospital Association	In conducting the CHNA, non-profit hospitals are required to take into account input from persons who represent the broad interests of the community served, including those with special knowledge or expertise in public health. In addition, member, leaders or representatives of medically underserved, low-income, minority populations should be consulted. In March and April of 2016, NLH coordinated with Fulton, Essex, Hamilton, Franklin, Clinton, Warren and Washington County Public Health, in addition to Adirondack Health, Inter-Lakes Health and Moses Ludington Hospital, Glens Falls Hospital, UVM Health Network-Alice Hyde Medical Center, UVM Health Network- Champlain Valley Physician Hospital, UVM Health Network-Elizabethtown Community Hospital to conduct a survey of selected stakeholders representing health care and service-providing agencies within the region. Respondents to the survey indicated they represent a wide array of sectors including: Day Program Services, Education, Employment, Training, Health Care Services, Prevention/Wellness Services, Healthy Environment, Housing/Residential and Social Services. The results of the survey provided an overview of regional needs and priorities, to inform planning and the development of a regional health care agenda. The survey results were presented at both the county and regional levels. We also were able to use the data from our membership on the Mohawk Valley Population Health Improvement Program. That data and partnership allows us to share data including, outcome, claims and utilization data and identifying appropriate, available sources, that include public health, regional health information organizations and other qualified entities. Mohawk Valley PHIP Bassett Research Institute staff and Healthy Communities Institute gather data on everything from unemployment rates, poverty levels, and smoking rates to targeted disease related emergency room visits and hospitalizations. De-identified electronic medical records and insurance claims will enable the data team to track how health care services are utilized and develop regional capability for hospitals to use their existing data for improvement. In order to promote standardization, this data plan also addresses development of metrics for performance evaluation and outcome measurement that are consistent with, to the tracks the metrics the Mohawk Valley PHIP has prioritized. Additionally, we met at a local level to review local priorities. Members of that extent possible, the Delivery System Reform Incentive Payment (DSRIP) metrics. Interrupted time series analysis meeting included AHI, Fulton County Public Health, Hamilton County Public Health, the data collection firm, Healthlink Littauer and Nathan Littauer Hospital. Nathan Littauer's Board of Directors also reviewed the data and findings in October of 2016. After reviewing the data, we were able to focus upon the areas of greatest need and our role in prevention.
Schedule H, Part V, Section B, Line 6a-Nathan Littauer Hospital Association	We coordinated with Adirondack Health, Inter-Lakes Health and Moses Ludington Hospital, Glens Falls Hospital, UVM Health Network-Alice Hyde Medical Center, UVM Health Network-Champlain Valley Physicians Hospital, UVM Health Network-Elizabethtown Community Hospital. Other entities included: Fulton, Essex, Hamilton, Franklin, Clinton, Warren and Washington County Public Health and Adirondack Health Institute.
Schedule H, Part V, Section B, Line 6b-Nathan Littauer Hospital Association	AHI and ARHN Center for Health and Workforce Studies, Fulton County Public Health, NYSDOH and Hamilton County Public Health.
Schedule H, Part V, Section B, Line 11-Nathan Littauer Hospital Association	We did not choose to focus on substance abuse, smoking cessation and mental health issues, although these needs were identified, we have partners who are addressing those health disparities. That is not to say that we do not address the above issues in a clinical setting, we simply did not choose to focus upon those health disparities as part of our CHNA. Priority #1 - Prevention of Chronic Disease by addressing colorectal cancer. To increase the percentage of adults 18 years and older who are screened for colorectal cancer. By improving colorectal awareness and screening, for more people we will be addressing an identified disparity: Access to Health Care. Colorectal cancer is the second leading cancer killer in the United States. Data collected by Adirondack Rural Health Network shows that the death rate from colorectal cancer is higher in Fulton County than in other counties across New York State. We are identifying community members age 50-75 years old and anyone who is at an increased risk and anyone that presents with symptoms or symptoms indicating a risk. Screening can find precancerous polyps-abnormal growth in the colon or rectum-so that they can be removed before turning in cancer. Screenings find cancer at an early stage, when treatment often leads to a cure. We are hoping to achieve, an increase Colorectal Cancer Screens, improved Community Education (date, topic, attendance), and targeted media campaigns. Our outcomes will include: Increased awareness of Colorectal Cancer prevention a 5% increase in Cancer Screenings for Colorectal cancer and ultimately, a decrease in the death rate from Colorectal Cancer since earlier detection will provide improved outcomes. Priority #2-Prevention of Chronic Disease through Promoting Breastfeeding. Fulton County has an obesity rate, asthma disease rate, ovarian cancer rate and death from ovarian cancer rate that is higher than that of other counties in New York State. There is a direct linkage to lowering these risks in addition to other benefits for breastfed children and their mothers. Infants who are breastfed are less likely to be obese, develop respiratory and G.I. infections, childhood cancers, asthma, and SIDS. Mothers who breastfeed have a decreased risk of breast and ovarian cancer, osteoporosis, postpartum depression and are more likely to return to their pre-pregnancy weight. We will be addressing this priority by obtaining a baseline number of infants who are exclusively breastfed during hospitalization. We will provide structured, comprehensive breastfeeding education and professional lactation counseling, including the use of Internal Board Certified Lactation Consultants (IBCLCs) during pregnancy, in the hospital and in the community. We will offer support groups that promote peer counselors, in Johnstown and Gloversville to increase access to care. We will recruit, train and support breastfeeding peer counselors, including WIC, La Leche League and community health workers, and explore ways to reimburse peer educators for breastfeeding education. Nathan Littauer Hospital Primary Care Centers will refer any pregnant woman to the Breastfeeding Specialist upon conception. We will also increase the areas for our own employees to breastfeed and pump, along with offering insurance options that promote breastfeeding. We will continue to partner with Albany Medical Center for perinatal outsource and best practices for breastfeeding and continue to partner with Community Health Center (CHC) in regards to Breastfeeding Bill of Rights. We hope to achieve the following: Increase the number of breastfed infants in our hospital by 10%. Increase the number of breastfed infants at 3 months of age. Increase the number of breastfed infants at 6 months of age.
Schedule H, Part V, Section B, Line 20d-Nathan Littauer Hospital Association	The hospital does not utilize a presumptive eligibility model to make determinations for its financial assistance program.

Field	Value	IRS element (for citing)
Facility	10	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (11 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
Nathan Littauer Hospital Nursing Home
99 East State Street	Gloverville	NY	12078	84 Bed Nursing Home.
Nathan Littauer Hospital Primary Care
99 East State Street	Gloversville	NY	12078	Primary/Specialty Care Center (Clinic)
Perth Primary Care Center
4100 State Highway 30	Amsterdam	NY	12110	Primary/Specialty Care Center (Clinic).
Johnstown Primary Care Center
23 South Perry Street	Johnstown	NY	12095	Primary/Specialty Care Center (Clinic).
Mayfield Primary Care Center
2497 State Highway 30	Mayfield	NY	12117	Primary/Specialty Care Center (Clinic).
Kingsboro GI Center
434 South Kingsboro Ave Extension	Johnstown	NY	12095	Primary/Specialty Care Center (Clinic).
Decker Drive Primary Care Center
9 Decker Drive	Johnstown	NY	12095	Primary/Specialty Care Center (Clinic).
Steele Avenue Primary Care Center
182 Steele Avenue	Gloversville	NY	12078	Primary/Specialty Care Center (Clinic).
Speculator Primary Care Center
Route 8	Speculator	NY	12164	Primary/Specialty Care Center (Clinic).
Caroga Lake Primary Care Center
1840 State Highway 10	Caroga Lake	NY	12032	Primary/Specialty Care Center (Clinic).
Fonda Primary Care Center
46 East Main Street	Fonda	NY	12068	Primary/Specialty Care Center (Clinic).

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 7	The costing methodology used to calculate the amounts reported in the Table for Lin 7 is the ratio of patient cost to patient care charges.
Schedule H, Part I, Line 7, Column f	Bad Debt Expense was not included in Form 990, Part IX, line 25, column (A), and not subtracted for purposes of calculating the percentage in Schedule H Part I, Line 7, column (f).
Schedule H, Part I, Line 7g	Subsidized health series reported included details from the Primary/Specialty Care Centers and licensed clinics. The Centers operate despite financial losses to the Organization for at least the last fifteen years. The Hospital is committed to operate the Centers as a benefit to the community in order to address an identified need and to improve access to healthcare, including our remote rural communities.
Schedule H, Part III, Section A, Line 2	In evaluating the collectability of patient accounts receivable, the Hospital analyzes its past collection history, business and economic conditions, trends in governmental and employee health care coverage and other collection indicators for each of its major categories of revenue by payor to estimate the appropriate allowance for estimated uncollectible accounts.
Schedule H, Part III, Section A, Line 4	In evaluating the collectability of patient accounts receivable, the Hospital analyzes its past collection history, business and economic conditions, trends in governmental and employee health care coverage and other collection indicators for each of its major categories of revenue by payor to estimate the appropriate allowance for estimated uncollectible accounts. Patient accounts receivables are reflected net of an allowance for estimated uncollectible accounts. In evaluating the collectability of patient accounts receivable, the Hospital analyzes its past collection history, business and economic conditions, trends in governmental and employee health care coverage and other collection indicators for each of its major categories of revenue by payer to estimate the appropriate allowance for estimated uncollectible accounts. Management regularly reviews data about these major categories of revenue in evaluating the sufficiency of the allowance for estimated uncollectible accounts. Throughout the year, the Hospital, after all reasonable collection efforts have been exhausted, will write off the difference between the standard rates (or discounted rates if applicable) and the amounts actually collected against the allowance for estimated uncollectible accounts. In addition to the review of the categories of revenue, management monitors the write offs against established allowances to determine the appropriateness of the underlying assumptions used in estimating the allowance for estimated uncollectible accounts.
Schedule H, Part III, Section B, Line 8	Medicare allowable costs were calculated using a cost to charge ratio based upon the cost finding methodology in the Medicare 2252-10 Cost Report. Community Benefit rationale: The Medicare shortfall should be considered a community benefit because our mission is to promote health in the community and we do not limit the care available to any patient, including those covered by Medicare. We are relieving a government burden by providing care to Medicare patients even though costs exceed reimbursements by $1,718,273. Tax exempt hospital are expected to participate in the Medicare program. For many of the medical services provided by the Hospital, Medicare does not provide sufficient reimbursement to cover the cost of providing care to our patients, forcing the Hospital to use other funds to cover the deficit. Medicare Cost Reports that hospitals are required to file do not include the costs required to treat all Medicare patients. Therefore, the amount reflected on the Medicare Cost Report differs from actual losses. In 2018 the Hospital realized an additional shortfall of $2,601,359 resulting from Medicare Advantage and non-PPS Medicare patients. The total shortfall for all types of Medicare patients was $4,319,632.
Schedule H, Part III, Section C, Line 9b	Requests for Financial Assistance may be made at any point before, during or after the provision of care. Anyone seeking Financial Assistance will be given an application. Financial Assistance requests may be proposed by sources other than the patient, such as patient's physician, family members, social services or hospital personnel. Pending final eligibility determination, Nathan Littauer Hospital will not initiate collection efforts or requests for deposits provided that the responsible party is cooperative with Nathan Littauer Hospital's efforts to get payment from other sources. If initial screening does not disqualify someone for Financial Assistance they will be given an application, which includes instructions on how to apply.
Schedule H, Part VI, Line 2	Assessment of Public Health Priorities with AHI facilitating the process the Community Health Planning Committee (the Committee) was formed with representation from all six of the hospitals and all six of local health departments in the region Members of the Committee participated in a collaborative approach to community health assessment and planning, relying on regional information gathered and analyzed by AHI as well as information specific to each hospital's service area, each AHI hospital prepared a Community Service Plan in collaboration with the other participating hospitals and local health departments.
Schedule H, Part VI, Line 3	NLH educates our patient population for our Financial Assistance policy in the following ways: NLH has provided a "Frequently Asked Question" section on our website (www.nlh.org) to answer questions our patients may have. We have posted the complete Charity/Financial assistance policy on our website (www.nlh.org). NLH posts in their registration areas the availability of Financial Assistance and the appropriate contact information to obtain and complete the application process. NLH also provides pamphlets in all of our inpatient and outpatient registration areas literature providing information on insurances and again, providing information on our Financial Assistance program and contact information. NLH has four facilitated enrollers available to assist patients with their application for Medicaid, Quality Health Plan and Child Health Plus. They will also assist patients in completing our charity care application. Our staff has been trained in assisting our patients with obtaining application and providing direction and contact information for the completion of same. Our in-patient statements and our billing agency provides information advising patients to contact our offices to request the application and assistance in its completion.
Schedule H, Part VI, Line 4	Nathan Littauer Hospital and Nursing Home is located in a rural area in Upstate New York. Our primary service area is Fulton County with additional services in neighboring Hamilton and Montgomery counties. Within our main service area, Fulton County, 2018 data shows a population of 53,591 a 3.5% decrease since 2010. Of those reporting one race, 95.2% of those residents identified themselves as white. 50.2% of our population are women. Over 19.6% of the population has a median age of 65 or older. The median household income in Fulton County is $48,033. Our county has 15.9% of its residents living below the poverty level. 87.0% of the population has a high school degree or higher. The leading industries remain Educational services, health care and social assistance org employing 26% of the workforce followed by manufacturing employing 15%. Unemployment rates for 2018 are about 5.8%. Major health issues for our region remain, respiratory diseases/childhood asthma, cancers of the lung and colon, lack of physical fitness and nutrition, unintentional injuries, tobacco use, lead poisoning and chronic diseases of the lung and the heart. Of particular note is our aging population and poverty levels, which are much higher than the state average. Our mission is in keeping with the community need as we strive to provide care that is effective, clinically astute, safe and accessible.
Schedule H, Part VI, Line 5	The Board of Directors of Nathan Littauer Hospital and Nursing Home is made up of medical and business professionals, all of whom reside in our primary service area. These volunteers give countless hours to the organization in their oversight role. They are involved in the community needs assessment process, in fundraising and in general stewardship. Littauer utilizes excess funds to reinvest in our technology, computerization and facilities to keep our organization safe, efficient and accessible as well as to ensure quality patient care. For example, we used excess funds to support free and low cost education programs offered by Healthlink Littauer. Built a new a Primary Care Center in Fonda NY, added a new Interventional Radiology department among other capital equipment acquisitions and projects in 2017. Most of the funds needed for these projects and purchases were made with operational gains.
Schedule H, Part VI, Line 7	New York State

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (1)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (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
Laurence E Kelly
President and CEO	$728,740	$0	$0	$0	$0	$0	$65,961	$0	$22,551	$0	$817,252	$0	$0	$0
Mike Ostrander
Vice President of Finance and CFO	$294,969	$0	$0	$0	$0	$0	$22,833	$0	$0	$0	$317,802	$0	$0	$0
Kamini Ramani MD
Physician	$752,145	$0	$0	$0	$0	$0	$11,000	$0	$20,296	$0	$783,441	$0	$0	$0
Luz Alvarez MD
Physician	$568,938	$0	$0	$0	$0	$0	$11,000	$0	$6,854	$0	$586,792	$0	$0	$0
Paul Husson MD
Physician	$532,299	$0	$0	$0	$0	$0	$11,000	$0	$18,198	$0	$561,497	$0	$0	$0
Verma Shri MD
Physician	$653,128	$0	$0	$0	$0	$0	$11,000	$0	$16,379	$0	$680,507	$0	$0	$0
Wasiczko Robert MD
Physician	$427,025	$0	$0	$0	$0	$0	$11,000	$0	$6,926	$0	$444,951	$0	$0	$0
Laurence Horowitz MD
Member/Employed Physician	$155,336	$0	$0	$0	$0	$0	$6,046	$0	$0	$0	$161,382	$0	$0	$0
Shriraj Shah
Member/Employed Physician	$233,788	$0	$0	$0	$0	$0	$9,600	$0	$18,724	$0	$262,112	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule J, Part I, Line 4	FormAndLineReferenceDesc
Explanation	Payments of $54,961 were made on behalf of the CEO, Laurence E. Kelly to a 457(f) plan in 2018.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part I, Line 6	Total volunteer hours for 2018 were 10,92 based upon the annual report of the Nathan Littauer Hospital Auxiliary. This included Auxilians, Candy Stripers and Junior Volunteers.
Form 990, Part I, Line 7b	The Hospital's unrelated business taxable income for 2018 included $37,606 in expenses incurred to maintain employee parking spaces. Under Section 512(a)(7), such expenses are included in unrelated business taxable income as amounts paid for disallowed fringes and are therefore reflected in Part I, Line 7b.
Form 990, Part III, Line 4d	HealthLink is Nathan Littauer Hospital's Wellness Education Center located in downtown Johnstown. HealthLink's role is to promote wellness by promoting prevention and providing resources to promote healthy lifestyle choices. Since its launch in 1989, HealthLink has served 9,014 area residents with 277,454 free or low-cost education programs and health screenings. Our wide variety of programs are chosen based on the interests and the health needs of the community. Program categories: include Health & Wellness, Mind & Body, Childbirth & Parenting, Health Screenings, Support Groups, Chronic Disease Self-Management Workshops, and Fitness Classes. Programs and presentations on a variety of topics are offered throughout our service area at places such as local businesses, schools, churches and other organizations in order to better serve this rural community. HealthLink's resources include: fair and festival activities, trained employees and contracted staff, numerous brochures on a wide variety of health & wellness related topics available at no cost, as well as an array of health magazines, books and DVDs for loan. The Hospital also offers a Lifeline Program. Lifeline is a personal emergency response system providing immediate assistance 24 hours a day 7 days a week. A total of 430 subscribers are members of NLHs Lifeline Program. Other community services include community health fairs, speakers bureau, organ donation program and New Visions Program for high school students. Health Insurance Counseling: Nathan Littauer Hospital was awarded and continues to be the Lead Agency for the grant entitled: "Consumer Assistant for the NYS of Health Benefit Exchange" covering Fulton and Montgomery County. During the year of 2018 Nathan Littauer Hospital as Lead Agency the program's was able to enroll a total of 4,544 individuals with the following breakdown: Children's Medicaid - 1,217, Child Health Plus Program - 463, Adult Medicaid - 1,893, Adult Quality Health Plan - 337, Essential Plans - 634. Also included here is other operating revenue of $8,668,365.
Form 990, Part VI, Section A, Line 6	The sole member of the Nathan Littauer Hospital Association is Colonial Healthcare Corp. which shall be represented at all meetings of the Association by the President of the Board of Directors of Colonial Healthcare Corp. or such person designated by the President in writing.
Form 990, Part VI, Section A, Line 7b	Colonial Healthcare Corp. the sole member of the Nathan Littauer Hospital Association must consent to any changes to the Hospital's bylaws.
Form 990, Part VI, Section B, Line 11b	The draft form 990 was presented at a regular meeting of the Board of Directors on October 22, 2019 by Mike Ostrander, Vice President of Finance and CFO and Laurence Kelly, President and CEO prior to the filing of the form.
Form 990, Part VI, Section B, Line 12c	The Hospital's Conflict of Interest policy requires the filing of an annual disclosure statement by covered persons. Covered persons are defined as "Any director, officer, member of a committee with governing board delegated powers, or any member of the Capital Acquisition Committee, Pharmacy & Therapeutics Committee. Value Analysis Committee and Hospital employees who have a position which involves the acquisition of equipment and supplies or who authorize payments for such material. The Board or Committee is informed annually of any possible conflicts. The covered person has a duty to disclose the possible conflict when a matter is brought before or the Board or Committee and Board or Committee makes the determination if a conflict actually exists. The conflicted party will not participate in the discussion of the matter at hand and will leave the meeting which a vote of the disinterested parties takes place. The Corporate Compliance Officer and the Chairman of the Board or Committee are responsible for compliance with policy.
Form 990, Part VI, Section B, Line 15	The Hospital's Compensation Committee is composed of the Chairman, Vice Chairman and immediate past Chairman of the Board of Directors. All members are independent directors. The Committee utilizes comparable compensation data in its determinations. The compensation of the President (CEO) of the hospital is in the form of a recommendation to the full Board of Directors in an Executive Session of the meeting. Only independent directors are present at the meeting. The Compensation committee also advises and assists the President (CEO) in determining the compensation for senior management of the Hospital using comparative compensation data.
Form 990, Part VI, Section C, Line 19	The Hospital publishes an annual report distributed by mail and made available for distribution through a number of public outlets such as civic and social organizations. The report includes condensed financial statements and various statistical data relative to services provided to the community including free clinics, education programs, health fairs, ect. The form 990 is available to the public upon request. The Hospital's governing documents, conflict of interest policy and internal financial statements are not available to the public.
Form 990, Part XI, Line 9	Pension related changes other than periodic pension expense.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 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	Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt	Controlled OrganizationControlledOrganizationInd	Direct Controlling NADirectControllingNACd
Gloversville Extended Care & Nursing Home Co Inc
99 East State Street	Gloversville	NY	12078	237065255	Leasing a 84 bed Skilled Nursing Facility	NY	501(c)3	Schedule A Line 3	Nathan Littauer Hospital	Association	Yes (1)
NLH Realty Corp
99 East State Street	Gloversville	NY	12078	141641020	Realty Holding Company	NY	501(c)2		Nathan Littauer Foundation		0
Nathan Littauer Foundation
99 East State Street	Gloversville	NY	12078	141638991	Support the Hospital and promote healthcare	NY	501(c)3	Schedule A Line 7	Colonial Healthcare Corporation		0
Nathan Littauer Hospital Auxiliary
99 East State Street	Gloversville	NY	12078	146086641	Assisting Hospital in promoting healthcare	NY	501(c)3	Schedule A Line 12			0	N/A
Colonial Healthcare Corportation
PO Box 586	Gloversville	NY	12078	141670605	Support & Supplement the activities and goals	NY	501(c)3	Schedule A Line 7			0	N/A

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	0	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	0	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	0	DivRelatedOrganizationInd
Asset Sale To Other Org	0	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	0	AssetPurchaseFromOtherOrgInd
Asset Exchange	0	AssetExchangeInd
Rental Of Facilities To Oth Org	0	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	0	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	0	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	0	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	0	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (1)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	0	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	0	TransferToOtherOrgInd
Transfer From Other Org	0	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	Nathan Littauer Foundation	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Transaction Type	c	TransactionTypeTxt
Involved	$200,000	InvolvedAmt
Method Of Amount Determination	Payment to Hospital.	MethodOfAmountDeterminationTxt

Reasonable Cause Explanation ReasonableCauseExplanation

Field	Value	IRS element (for citing)
Explanation	N/A	ExplanationTxt