2018-11-13T14:13:16-06:00 2017-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2017-01-01 141731786 ADIRONDACK MEDICAL CENTER ADIR 5188914141 PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 ROBERT LABA INTERIM CFO 5188914141 2018-11-13 1 KELLY A REDMOND P00443718 3154463600 2018-11-13 24.39.85.114 2018-11-13 09:00:25 ES P D099D794138F3BB4C0F509DA94FDCE5AD5515DDD 78F987A6F9B841F8A92EE1C31D8D96B0F16799DC 2017 2019-02-21 02:37:17Z ROBERT LABA PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 113501069 0 X WWW.ADIRONDACKHEALTH.ORG X 1991 NY THE MEDICAL CENTER PROVIDES ACUTE, SKILLED NURSING AND OUTPATIENT SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHIC REGION. 17 14 990 60 0 0 949836 1018768 100818078 104876651 41627 485535 2298476 2251415 104108017 108632369 0 0 0 0 53595991 56691182 0 0 0 50810977 49515889 104406968 106207071 -298951 2425298 83373282 104036922 38541117 54766531 44832165 49270391 X THE MEDICAL CENTER PROVIDES ACUTE, SKILLED NURSING AND OUTPATIENT SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHICAL AREA. 0 0 24834476 33514655 ADIRONDACK MEDICAL CENTER IS A 95-BED ACUTE CARE FACILITY IN SARANAC LAKE. IT PROVIDES A FULL RANGE OF INPATIENT SERVICES(SURGICAL, MATERNITY AND PEDIATRIC) AS WELL AS MAINTAINS A 60 BED LONG-TERM CARE FACILITY. 60390874 71153704 REFERRED AMBULATORY, AMBULATORY SURGERY AND EMERGENCY SERVICES IN SARANAC LAKE, LAKE PLACID, TUPPER LAKE AND KEENE. 2001262 MISCELLANEOUS PROGRAM SERVICE REVENUE DERIVED FROM SUPPORT OF ADIRONDACK MEDICAL CENTER, INCLUDING: DIETARY REVENUE, REBATES AND REFUNDS, PURCHASE DISCOUNTS AND OTHER REVENUE. 2001262 85225350 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 296 0 1 990 1 0 0 0 0 0 0 0 0 0 0 X 17 14 0 0 1 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X TRISTAN GLANVILLE 5188914141 PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 JEANNIE CROSS CHAIR 4.00 X X 0 0 0 CHRISTOPHER ERICSON TRUSTEE 3.00 X 0 0 0 CHERYL MAID SECRETARY/TREASURER 4.00 X X 0 0 0 F RAYMOND AGNEW VICE CHAIR 4.00 X X 0 0 0 PETER G BEATTY PHD TRUSTEE 3.00 X 0 0 0 CHARLES CARROLL TRUSTEE 3.00 X 0 0 0 BETH LAWYER TRUSTEE 3.00 X 0 0 0 PATRICIA MONROE MD TRUSTEE 3.00 X 18720 0 21986 RANDY QUAYLE PHD TRUSTEE 3.00 X 0 0 0 CRAIG SHELDON CPA TRUSTEE 3.00 X 0 0 0 WAGUIH KIROLLOS MD EX-OFFICIO MEDICAL STAFF PRESIDENT 3.00 X 48943 0 0 KEVIN BRADY CFA EX-OFFICIO VICE CHAIR, AH FOUNDATION 3.00 X 0 0 0 GERALD GOLDMAN TRUSTEE 3.00 X 0 0 0 DOUGLAS L HOFFMAN CPA TRUSTEE 3.00 X 0 0 0 REBECCA LEAHY TRUSTEE 3.00 X 0 0 0 RICHARD M MOCCIA MD TRUSTEE 3.00 X 39872 0 37397 GLENN KEET TRUSTEE 3.00 X 0 0 0 CHARLES GLANVILLE C.F.O. 40.00 X 221647 0 17610 SYLVIA GETMAN EX-OFFICIO PRESIDENT/C.E.O. 40.00 X 400531 0 64164 DANA KELLERMAN COO/CHRO 40.00 X 203966 0 7732 LINDA MCCLARIGAN C.N.O. 40.00 X 183609 0 17173 DARCI BEIRAS C.M.O. ENDING 06/17 40.00 X 330437 0 45672 JOAHD TOURE C.M.O. BEGINNING 06/17 40.00 X 174098 0 5781 ANTHONY TRAMANTANO PHYSICIAN 40.00 X 521165 0 22591 JONATHAN KRANT PHYSICIAN 40.00 X 366886 0 24300 ANTHONY F LOMBARDI PHYSICIAN 40.00 X 306792 0 18902 MATTHEW L MORGAN PHYSICIAN 40.00 X 314206 0 13428 WILLIAM M VISCARDO JR PHYSICIAN 40.00 X 284622 0 18426 3415494 0 315162 77 0 1 0 PREMIER ANESTHESIA ON NEW YORKPC 2655 NORTHWINDS PARKWAY ALPHARETTA GA 30368 PHYSICIAN FEES 1241427 LAVALLEEBRENSINGER ASSOCIATION 155 DOW STREET SUITE 400 MANCHESTER NH 03101 ARCHITECTURE SERVICES 1018692 MATRIX HEALTH SYSTEMS 86 LAKE STREET BURLINGTON VT 05401 PHYSICIAN FEES 751549 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 642955 INSIGHT HEALTH SERVICES CORP PO BOX 847689 DALLAS TX 75284 MRI SERVICES 513045 35 577525 152445 288798 1018768 NET PATIENT SERVICE REVENUE 900099 104668359 104668359 UIHLEIN REVENUE- DISCONTINUED OPE 900099 208292 208292 104876651 352485 352485 458445 0 458445 458445 458445 5001750 4864181 4519 137569 -4519 133050 133050 DIETARY REVENUE 900099 376298 376298 PURCHASE DISCOUNTS 900099 174561 174561 REBATES & REFUNDS 900099 73637 73637 1168474 1168474 1792970 108632369 106669621 0 943980 X 1704201 599287 1104914 45937780 37808619 8129161 1199916 968963 230953 4472750 3631502 841248 3376535 2723816 652719 269545 269545 146719 146719 12953150 8238883 4714267 263742 7693 256049 1334700 699191 635509 1274439 1274439 331092 202828 128264 309377 309377 3818906 3818906 696367 696367 MEDICAL SUPPLIES 18633870 18612096 21774 BAD DEBT 3430483 3430483 LEASE EXPENSE 941967 825221 116746 MINOR EQUIPMENT 908862 523270 385592 4202670 2825215 1377455 106207071 85225350 20981721 0 8398677 333475 10021285 12700059 14051539 3007647 3564498 2623560 2866947 109220441 72732411 25486562 36488030 28770690 19862851 2386087 16848297 83373282 104036922 11805781 14625788 1003787 1274294 20375830 33856589 1172000 1172000 4183719 3837860 38541117 54766531 X 43841316 48276793 55787 58536 935062 935062 44832165 49270391 83373282 104036922 X 2425298 2072501 -59573 X X 0 1 X 1 0 X 990849 5798 3049 993598 999633 4486 13270 990849 995626 4007 999633 992079 3547 995626 991415 4116 3452 992079 0.94110 0.05890 0 0 328567 328567 45625527 29179767 16445760 47834814 42552066 5282748 15431533 1000578 14430955 36488030 OTHER RECEIVABLES 1125720 RESIDENT FUNDS 29411 OTHER ASSETS 14249396 DEFERRED COSTS 1443770 16848297 DEBT-CURRENT 643845 RESIDENT FUNDS LIABILITY 29411 ASSET RETIREMENT AND OTHER LT 1061533 ESTIMATED THIRD PARTY LIABILITY 2103071 3837860 X PART V, LINE 4: THE SYSTEM'S ENDOWMENTS CONSIST OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. ITS ENDOWMENTS INCLUDE DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS AN ENDOWMENT. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. TEMPORARILY RESTRICTED FUNDS ARE AVAILABLE FOR NURSING EDUCATION & OTHER PROGRAMS. PERMANENTLY RESTRICTED FUNDS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE FOR VARIOUS HEALTHCARE SERVICES. PART X, LINE 2: ADIRONDACK HEALTH (PREVIOUSLY DEFINED AS THE COLLECTIVE ENTITY, WHICH WOULD INCLUDE THE FOUNDATION) AND THE FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND ARE EXEMPT ORGANIZATIONS QUALIFIED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ADIRONDACK HEALTH AND THE FOUNDATION HAVE BEEN CLASSIFIED BY THE INTERNAL REVENUE SERVICE (IRS) AS ENTITIES THAT ARE NOT PRIVATE FOUNDATIONS. AS OF DECEMBER 31, 2017 AND 2016, ADIRONDACK HEALTH DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR LIABILITIES OR ANY RELATED ACCRUED INTEREST OR PENALTIES. ADIRONDACK HEALTH DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES WILL CHANGE IN THE NEXT TWELVE MONTHS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL STATE TAXING AUTHORITIES ARE 2014 THROUGH 2017. 1 1 X 1 X 1 X 1 1 1 0 1 1 149081 12066 137015 0.00130 21233436 18456360 2777076 0.02700 21382517 18468426 2914091 0.02830 43497 0 43497 0.00040 455601 0 455601 0.00440 5243436 2934131 2309305 0.02250 22757 0 22757 0.00020 5765291 2934131 2831160 0.02750 27147808 21402557 5745251 0.05580 69 69 0.00000 1122 1122 0.00000 1497 1497 0.00000 215 215 0.00000 2903 2903 0.00000 1 1368763 526690 25260162 30046134 -4785972 X 1 1 2 1 ADIRONDACK MEDICAL CENTER 2233 STATE ROUTE 86-PO BOX 471 SARANAC LAKE NY 12983 X X 95 ACUTE BEDS; NURSING HOME WITH 60 BEDS; NURSING HOME WITH 157 BEDS A 2 ADIRONDACK MEDICAL CENTER-LAKE PLACID 29 CHURCH STREET LAKE PLACID NY 12946 X X OUTPATIENT SERIVCES, EMERGENCY ROOM A FACILITY REPORTING GROUP - A 0 0 1 X X X X X X X X X 16 1 1 1 1 X WWW.ADIRONDACKHEALTH.ORG X 1 16 1 WWW.ADIRONDACKHEALTH.ORG 0 1 X 150.000000000000 400.000000000000 X X 1 1 X X X 1 X WWW.ADIRONDACKHEALTH.ORG X WWW.ADIRONDACKHEALTH.ORG X WWW.ADIRONDACKHEALTH.ORG X X X X X X 1 X 0 X X X X 1 X 0 0 PART V, SECTION B FACILITY REPORTING GROUP A FACILITY REPORTING GROUP A CONSISTS OF: - FACILITY 1: ADIRONDACK MEDICAL CENTER, - FACILITY 2: ADIRONDACK MEDICAL CENTER-LAKE PLACID GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 5: ADIRONDACK MEDICAL CENTER AND OUR COLLABORATING PARTNERS, COUNTY PUBLIC HEALTH DEPARTMENTS AND REGIONAL HOSPITALS, WORKED THROUGH THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY THAT GAVE US INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY WE SERVE. ARHN ENGAGED THE CENTER FOR HEALTH WORKFORCE STUDIES (CHWS) AT THE UNIVERSITY AT ALBANY SCHOOL OF PUBLIC HEALTH FOR QUANTITATIVE AND QUALITATIVE DATA COLLECTION.THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO A REGIONAL EMAIL CONTACT LIST OF 658. ULTIMATELY, 217 SURVEYS WERE COMPLETED DURING THE SIX-WEEK SURVEY PERIOD, A RESPONSE RATE OF 33 PERCENT. OF ALL 217 RESPONSES, 79 INDICATED THAT ESSEX COUNTY WAS PART OF THEIR SERVICE AREA AND 56 INDICATED THAT FRANKLIN COUNTY WAS PART OF THEIR SERVICE AREA; HOWEVER, IT SHOULD BE NOTED THAT MANY OF THE RESPONDING HEALTH CARE STAKEHOLDERS SERVICE MULTIPLE COUNTIES WITHIN THE LARGER ARHN REGION.SURVEY PARTICIPANTS REPRESENTED A DIVERSE ARRAY OF DIFFERENT AGENCIES, POPULATION GROUPS, AND SERVICE-AREAS WITHIN THE OVERALL EIGHT-COUNTY ARHN REGION. BELOW, TABLE A.1 SHOWS THE PRIMARY FUNCTIONS SELECTED BY RESPONDENTS AND TABLE A.2 SHOWS THE POPULATIONS THAT THEIR AGENCIES SERVE. HEALTH CARE AND EDUCATIONAL AGENCIES ARE WELL REPRESENTED, AND THEMAJORITY PROVIDES SERVICES TO CHILDREN AND ADOLESCENTS, AS WELL AS PEOPLE LIVING AT OR NEAR THE POVERTY LEVEL.TABLE A.1. PRIMARY FUNCTIONS INDICATED BY SURVEY RESPONDENTS ORGANIZATION PRIMARY FUNCTION / PERCENT OF ALL APPLICANTSEDUCATION / 56.2PREVENTION/WELLNESS SERVICES / 53.0HEALTH CARE SERVICES / 44.2OTHER SERVICES / 31.8HEALTHY ENVIRONMENT / 30.0SOCIAL SERVICES / 24.4EMPLOYMENT & TRAINING / 23.0HOUSING/RESIDENTIAL SERVICES / 15.7DAY PROGRAM SERVICES / 13.4NOTE: RESPONDENTS COULD SELECT MORE THAN ONE PRIMARY FUNCTION.TABLE A.2. POPULATIONS SERVED BY SURVEY RESPONDENT AGENCIES POPULATION SERVED / PERCENT OF ALL RESPONDENTSSCHOOL AGED CHILDREN/ADOLESCENTS / 75.1INDIVIDUALS LIVING AT OR NEAR THE FEDERAL POVERTY LEVEL / 68.7ADULTS / 67.3INDIVIDUALS WITH BEHAVIORAL HEALTH ISSUES / 56.7INDIVIDUALS WHO ARE SENIOR CITIZENS/ELDERLY / 56.2INDIVIDUALS WITH DEVELOPMENT DISABILITIES / 55.8PRE-SCHOOL CHILDREN / 53.9INDIVIDUALS WITH SUBSTANCE ABUSE ISSUE / 47.9WOMEN OF REPRODUCTIVE AGE / 46.5BABIES / 40.1FARMERS / 33.6MIGRANT WORKERS / 27.2SPECIFIC RACIAL/ETHNIC MINORITIES / 23OTHER / 21.2NOTE: RESPONDENTS COULD SELECT MULTIPLE POPULATIONS GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 6A: OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH OUR PARTNERS ESSEX COUNTY PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UVM HEALTH NETWORK-ALICE HYDE MEDICAL CENTER, ELIZABETHTOWN COMMUNITY HOSPITAL, MOSES LUDINGTON HOSPITAL, AND ADIRONDACK RURAL HEALTH NETWORK. GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 6B: SEE QUESTION 6A ABOVE GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 11: ADIRONDACK HEALTH STRIVES TO MEET AS MANY OF THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS AS POSSIBLE. IN MANY CASES, WE PARTNER WITH APPROPRIATE ORGANIZATIONS AND AGENCIES TO ADDRESS NEEDS THATADIRONDACK HEALTH DOES NOT. ON INITIATIVES THAT ARE NOT HOSPITAL-LED, ADIRONDACK HEALTH PARTNERS AND WORKS WITH THE LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, SUBSTANCE ABUSE PREVENTION AND TREATMENT PROVIDERS, HOME CARE, AND MANY OTHERS TO ENSURE THAT THE NEEDS OF OUR COMMUNITY MEMBERS ARE MET.THE FOLLOWING ARE THE NYS PREVENTION AGENDA ITEMS THAT ADIRONDACK HEALTH DOES NOT DIRECTLY ADDRESS IN OUR IMPLEMENTATION STRATEGY:PROMOTE A HEALTHY AND SAFE ENVIRONMENTFOCUS AREA: INJURIES, VIOLENCE AND OCCUPATIONAL HEALTH THE RATE OF CRIME AND ASSAULT ARE LOW IN ADIRONDACK HEALTH'S SERVICE AREA. FALLS IN THE HOME AND OCCUPATIONAL HEALTH ARE ISSUES THAT COMMUNITY PARTNERS ARE BETTER POSITIONED TO ADDRESS.FOCUS AREA: OUTDOOR AIR AND WATER QUALITYTHE AIR AND WATER QUALITY INDICATORS ARE GOOD. DATA INDICATES THAT IT IS ONLY A FEW DAYS EACH YEAR THAT OUTDOOR AIR QUALITY IS POOR, AND THE LIKELY CAUSE OF THIS IS INDUSTRIAL POLLUTION FROM THE MID-WEST CARRIED HERE ON THE JET STREAM. ADIRONDACK HEALTH DOES NOT HAVE A STRATEGY TO DIRECTLY ADDRESS THIS AT THIS TIME, BUT NATIONAL GROUPS HAVE MADE PROGRESS AND ARE STILL WORKING TO IMPROVE OUTPUTS FROM THESE INDUSTRIAL AREAS.FOCUS AREA: BUILT ENVIRONMENTIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD PASSING COMPLETE STREETS POLICIES, IMPROVING PARKS AND OTHER RECREATIONAL AREAS, PASSING TOBACCO FREE GROUNDS POLICIES, IMPROVING ACCESS TO FRESH FRUITS AND VEGETABLES IN STORES AND RESTAURANTS, AND OTHER PROJECTS THAT IMPROVE ACCESS TO HEALTHY FOODS AND IMPROVE THE BUILT ENVIRONMENT SO COMMUNITY MEMBERS OF ALL LEVELS OF MOBILITY CAN FEEL SAFE AS PEDESTRIANS AND USINGALTERNATIVE FORMS OF TRANSPORTATION.PREVENT HIV/STDS, VACCINE-PREVENTABLE DISEASE AND HEALTHCARE ASSOCIATED INFECTIONSFOCUS AREA: PREVENT HIV AND STDS THE RATE OF HIV IS EXTREMELY LOW IN ADIRONDACK HEALTH'S SERVICE AREA. ADIRONDACK HEALTH'S PROVIDERS CONTINUE TO WORK WITH PUBLIC HEALTH AND OTHER PROVIDERS TO DELIVER THE HIGHEST LEVEL OF CARE TO PATIENTS WITH HIV. GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 16J: AN INTERPRETER IS AVAILABLE TO ASSIST LEP POPULATIONS AND STAFF IS AVAILABLE TO HELP PATIENTS FILL OUT DOCUMENTATION AND ANSWER ANY QUESTIONS. GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 5: ADIRONDACK MEDICAL CENTER AND OUR COLLABORATING PARTNERS, COUNTY PUBLIC HEALTH DEPARTMENTS AND REGIONAL HOSPITALS, WORKED THROUGH THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY THAT GAVE US INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY WE SERVE. ARHN ENGAGED THE CENTER FOR HEALTH WORKFORCE STUDIES (CHWS) AT THE UNIVERSITY AT ALBANY SCHOOL OF PUBLIC HEALTH FOR QUANTITATIVE AND QUALITATIVE DATA COLLECTION.THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO A REGIONAL EMAIL CONTACT LIST OF 658. ULTIMATELY, 217 SURVEYS WERE COMPLETED DURING THE SIX-WEEK SURVEY PERIOD, A RESPONSE RATE OF 33 PERCENT. OF ALL 217 RESPONSES, 79 INDICATED THAT ESSEX COUNTY WAS PART OF THEIR SERVICE AREA AND 56 INDICATED THAT FRANKLIN COUNTY WAS PART OF THEIR SERVICE AREA; HOWEVER, IT SHOULD BE NOTED THAT MANY OF THE RESPONDING HEALTH CARE STAKEHOLDERS SERVICE MULTIPLE COUNTIES WITHIN THE LARGER ARHN REGION.SURVEY PARTICIPANTS REPRESENTED A DIVERSE ARRAY OF DIFFERENT AGENCIES, POPULATION GROUPS, AND SERVICE-AREAS WITHIN THE OVERALL EIGHT-COUNTY ARHN REGION. BELOW, TABLE A.1 SHOWS THE PRIMARY FUNCTIONS SELECTED BY RESPONDENTS AND TABLE A.2 SHOWS THE POPULATIONS THAT THEIR AGENCIES SERVE. HEALTH CARE AND EDUCATIONAL AGENCIES ARE WELL REPRESENTED, AND THEMAJORITY PROVIDES SERVICES TO CHILDREN AND ADOLESCENTS, AS WELL AS PEOPLE LIVING AT OR NEAR THE POVERTY LEVEL.TABLE A.1. PRIMARY FUNCTIONS INDICATED BY SURVEY RESPONDENTS ORGANIZATION PRIMARY FUNCTION / PERCENT OF ALL APPLICANTSEDUCATION / 56.2PREVENTION/WELLNESS SERVICES / 53.0HEALTH CARE SERVICES / 44.2OTHER SERVICES / 31.8HEALTHY ENVIRONMENT / 30.0SOCIAL SERVICES / 24.4EMPLOYMENT & TRAINING / 23.0HOUSING/RESIDENTIAL SERVICES / 15.7DAY PROGRAM SERVICES / 13.4NOTE: RESPONDENTS COULD SELECT MORE THAN ONE PRIMARY FUNCTION.TABLE A.2. POPULATIONS SERVED BY SURVEY RESPONDENT AGENCIES POPULATION SERVED / PERCENT OF ALL RESPONDENTSSCHOOL AGED CHILDREN/ADOLESCENTS / 75.1INDIVIDUALS LIVING AT OR NEAR THE FEDERAL POVERTY LEVEL / 68.7ADULTS / 67.3INDIVIDUALS WITH BEHAVIORAL HEALTH ISSUES / 56.7INDIVIDUALS WHO ARE SENIOR CITIZENS/ELDERLY / 56.2INDIVIDUALS WITH DEVELOPMENT DISABILITIES / 55.8PRE-SCHOOL CHILDREN / 53.9INDIVIDUALS WITH SUBSTANCE ABUSE ISSUE / 47.9WOMEN OF REPRODUCTIVE AGE / 46.5BABIES / 40.1FARMERS / 33.6MIGRANT WORKERS / 27.2SPECIFIC RACIAL/ETHNIC MINORITIES / 23OTHER / 21.2NOTE: RESPONDENTS COULD SELECT MULTIPLE POPULATIONS GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 6A: OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH OUR PARTNERS ESSEX COUNTY PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, UVM HEALTH NETWORK-ALICE HYDE MEDICAL CENTER, ELIZABETHTOWN COMMUNITY HOSPITAL, MOSES LUDINGTON HOSPITAL, AND ADIRONDACK RURAL HEALTH NETWORK. GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 6B: SEE QUESTION 6A ABOVE GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 11: ADIRONDACK HEALTH STRIVES TO MEET AS MANY OF THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS AS POSSIBLE. IN MANY CASES, WE PARTNER WITH APPROPRIATE ORGANIZATIONS AND AGENCIES TO ADDRESS NEEDS THATADIRONDACK HEALTH DOES NOT. ON INITIATIVES THAT ARE NOT HOSPITAL-LED, ADIRONDACK HEALTH PARTNERS AND WORKS WITH THE LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, SUBSTANCE ABUSE PREVENTION AND TREATMENT PROVIDERS, HOME CARE, AND MANY OTHERS TO ENSURE THAT THE NEEDS OF OUR COMMUNITY MEMBERS ARE MET.THE FOLLOWING ARE THE NYS PREVENTION AGENDA ITEMS THAT ADIRONDACK HEALTH DOES NOT DIRECTLY ADDRESS IN OUR IMPLEMENTATION STRATEGY:PROMOTE A HEALTHY AND SAFE ENVIRONMENTFOCUS AREA: INJURIES, VIOLENCE AND OCCUPATIONAL HEALTH THE RATE OF CRIME AND ASSAULT ARE LOW IN ADIRONDACK HEALTH'S SERVICE AREA. FALLS IN THE HOME AND OCCUPATIONAL HEALTH ARE ISSUES THAT COMMUNITY PARTNERS ARE BETTER POSITIONED TO ADDRESS.FOCUS AREA: OUTDOOR AIR AND WATER QUALITYTHE AIR AND WATER QUALITY INDICATORS ARE GOOD. DATA INDICATES THAT IT IS ONLY A FEW DAYS EACH YEAR THAT OUTDOOR AIR QUALITY IS POOR, AND THE LIKELY CAUSE OF THIS IS INDUSTRIAL POLLUTION FROM THE MID-WEST CARRIED HERE ON THE JET STREAM. ADIRONDACK HEALTH DOES NOT HAVE A STRATEGY TO DIRECTLY ADDRESS THIS AT THIS TIME, BUT NATIONAL GROUPS HAVE MADE PROGRESS AND ARE STILL WORKING TO IMPROVE OUTPUTS FROM THESE INDUSTRIAL AREAS.FOCUS AREA: BUILT ENVIRONMENTIN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD PASSING COMPLETE STREETS POLICIES, IMPROVING PARKS AND OTHER RECREATIONAL AREAS, PASSING TOBACCO FREE GROUNDS POLICIES, IMPROVING ACCESS TO FRESH FRUITS AND VEGETABLES IN STORES AND RESTAURANTS, AND OTHER PROJECTS THAT IMPROVE ACCESS TO HEALTHY FOODS AND IMPROVE THE BUILT ENVIRONMENT SO COMMUNITY MEMBERS OF ALL LEVELS OF MOBILITY CAN FEEL SAFE AS PEDESTRIANS AND USINGALTERNATIVE FORMS OF TRANSPORTATION.PREVENT HIV/STDS, VACCINE-PREVENTABLE DISEASE AND HEALTHCARE ASSOCIATED INFECTIONSFOCUS AREA: PREVENT HIV AND STDS THE RATE OF HIV IS EXTREMELY LOW IN ADIRONDACK HEALTH'S SERVICE AREA. ADIRONDACK HEALTH'S PROVIDERS CONTINUE TO WORK WITH PUBLIC HEALTH AND OTHER PROVIDERS TO DELIVER THE HIGHEST LEVEL OF CARE TO PATIENTS WITH HIV. GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 16J: AN INTERPRETER IS AVAILABLE TO ASSIST LEP POPULATIONS AND STAFF IS AVAILABLE TO HELP PATIENTS FILL OUT DOCUMENTATION AND ANSWER ANY QUESTIONS. 5 1 - TUPPER LAKE MEDICAL OFFICE BUILDING 7 STETSON ROAD TUPPER LAKE NY 12986 CLINIC; LABORATORY; RADIOLOGY 2 - MOUNTAIN HEALTH CENTER 2841 NYS ROUTE 73 KEENE NY 12942 CLINIC 4 - MERCY LIVING CENTER 114 WAWBEEK AVENUE TUPPER LAKE NY 12986 NURSING HOME WITH 60 BEDS; DIALYSIS, REHABILITATION 5 - LAKE PLACID HEALTH CENTER 29 CHURCH STREET LAKE PLACID NY 12946 CLINIC 6 - WOUND CARE MEDICAL OFFICE BUILDING 285 COUNTY ROUTE 47 SARANAC LAKE NY 12983 CLINIC, PRIMARY CARE HEALTH CENTER PART I, LINE 7: AMOUNTS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 (TOTAL OPERATING EXPENSE MINUS MEDICAID/PROVIDER TAXES, TOTAL COMMUNITY BENEFIT EXPENSE, AND TOTAL COMMUNITY BUILDING EXPENSE DIVIDED BY GROSS PATIENT CHARGES), AND ADDRESSES ALL PATIENT SEGMENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,430,483. PART II, COMMUNITY BUILDING ACTIVITIES: THE CEO ATTENDED ADIRONDACK HEALTH INSTITUTE MEETINGS. AHI IS A REGIONAL ORGANIZATION THAT INCLUDES THE TRI-LAKES, PLATTSBURGH, AND GLENS FALLS COMMUNITIES WHOSE PURPOSE IS TO IMPROVE THE OVERALL HEALTH OF THESE ADIRONDACK COMMUNITIES BY WORKING TOGETHER ON A REGIONAL BASIS. THE INFECTION PREVENTIONIST PREPARED AND CONDUCTED A BLOOD BORN PATHOGENS PROGRAM FOR THE GABRIELS FIRE DEPARTMENT, AND ALSO SERVES AS A COMMUNITY MEMBER FOR THE TRUDEAU INSTITUTE BIOSAFETY COMMITTEE. PART III, LINE 2: THE ORGANIZATION'S BAD DEBT EXPENSE OF $1,368,763 IS CALCULATED USING THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND BAD DEBT EXPENSE. PART III, LINE 3: THE ORGANIZATION'S BAD DEBT EXPENSE IS CALCULATED USING A PERCENTAGE OF BAD DEBT THAT CONTAINS POSSIBLE CHARITY CARE CASES AND APPLYING IT TO LINE 2. RATIONALE FOR WHAT PORTION OF BAD DEBT SHOULD CONSTITUTE COMMUNITY BENEFIT: THE PROVISION OF HEALTH CARE IS DIFFERENT FROM PROVIDING OTHER SERVICES, IN THAT HOSPITALS, ALTHOUGH THEY MAY ATTEMPT TO OBTAIN FINANCIAL INFORMATION BEFORE SERVICE IS PROVIDED, FOCUS ON PROVIDING THE PATIENT WITH NEEDED HEALTH CARE AND LATER TRY TO OBTAIN PAYMENT. IN OTHER INDUSTRIES, THE SERVICE PROVIDER CAN CHECK THE CUSTOMER'S CREDIT RATING, ASK FOR PAYMENT IN ADVANCE, ETC AND IS USUALLY ASKING THIS INFORMATION WHEN THE CONSUMER IS NOT IN A HEALTH CRISIS AND UNDER GREAT STRESS AND WORRY. AT A LATER TIME, WHEN THE PROVIDER ATTEMPTS TO COLLECT PAYMENT AND FINDS THE PATIENT UNWILLING TO PAY, THEIR OPTIONS ARE AGAIN LIMITED GIVEN THE NATURE OF THE SERVICE PROVIDED AND THE INABILITY TO REPOSSESS THESERVICE. PART III, LINE 4: IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, ADIRONDACK HEALTH ANALYZES PAST PAYMENT HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, ADIRONDACK HEALTH ANALYZES CONTRACTUALY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), ADIRONDACK HEALTH RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNT RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. PART III, LINE 8: CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND APPLYING IT TO GROSS MEDICARE CHARGES. SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE PATIENT SERVICES ARE PROVIDED AT A COST THAT IS GREATER THAN REIMBURSEMENT. PART III, LINE 9B: ACCORDING TO OUR CHARITY CARE POLICY, THE LARGEST NUMBER OF OUR FAP-ELIGIBLE PATIENTS ARE WRITTEN-OFF AT 100% SO NO COLLECTION EFFORTS ARE NECESSARY. PART VI, LINE 2: ADIRONDACK MEDICAL CENTER USES A NUMBER OF ASSESSMENT METHODS TO DETERMINE HOW WELL WE ARE MEETING COMMUNITY NEEDS AND WHAT ADDITIONAL SERVICES WE CAN OFFER OUR COMMUNITY MEMBERS.AMC USES THE PRESS-GANEY PATIENT SATISFACTION SURVEY FOR CONTINUAL PATIENT FEEDBACK. THE SURVEYS ARE MAILED TO RANDOMLY SELECTED PATIENTS BY PRESS-GANEY, A NATIONALLY RECOGNIZED PATIENT SURVEY FIRM, AND PRESS-GANEY PROCESSES THE RESULTS. THEY GIVE AMC THE RESULTS BENCHMARKED AGAINST OTHER HOSPITALS TO HELP US UNDERSTAND HOW WELL WE ARE SERVING OUR COMMUNITY.THE MAJORITY OF AMC'S STRATEGIC INITIATIVES ARE DRIVEN BY A THREE-YEAR STRATEGIC PLAN, WHICH IS DEVELOPED THROUGH THE COLLABORATION OF THE BOARD, MEDICAL STAFF, AMC STAFF AND COMMUNITY MEMBERS. THE GOALS THAT ARE SET FORTH EVERY THREE YEARS IN THE STRATEGIC PLAN ARE INCORPORATED INTO AMC'S MANAGEMENT ACTION PLAN (MAP), WHICH IS REVIEWED AND REVISED EACH YEAR. AT THE BEGINNING OF EACH YEAR EVERY DEPARTMENT CREATES A MAP THAT OUTLINES THE CONCRETE STEPS THAT THE DEPARTMENT WILL ACCOMPLISH IN MOVING THE HOSPITAL CLOSER TO COMPLETING THE STRATEGIC PLAN GOALS. THE SUCCESS OF AMC, EACH DEPARTMENT, AND EACH EMPLOYEE IS MEASURED BY THE MAP AND THE PROGRESS MADE TOWARD ACCOMPLISHING THE GOALS SET OUT IN THE STRATEGIC PLAN.FOR NEW SERVICES, AMC STAFF DEVELOPS A NEEDS ASSESSMENT USING A VARIETY OF DATA INCLUDING REGIONAL DEMAND FOR THE SPECIFIC SERVICE, DEMOGRAPHICS, AND FINANCIAL ANALYSIS. THE BOARD OF TRUSTEES CAREFULLY REVIEWS THE ANALYSIS AND EITHER SUPPORTS THE RECOMMENDATION OR ASKS FOR FURTHER INFORMATION. PART VI, LINE 3: ANY PATIENT THAT CONTACTS SCHEDULING OR PRESENTS TO ANY AMC DEPARTMENT (INCLUDING ADMITTING, EMERGENCY ROOM, ETC.) THAT DOES NOT IDENTIFY AN INSURANCE COMPANY OR IDENTIFIES THEMSELVES AS SELF-PAY ARE INFORMED OF OUR SELF-PAY PROCESS. THIS PROCESS INCLUDES INFORMATION ABOUT AMC'S CHARITY CARE POLICY AND THE BENEFITS OF VISITING WITH A CERTIFIED FACILITATED ENROLLER WHO CAN CHECK THE PATIENT'S ELIGIBILITY FOR STATE AND FEDERAL HEALTH INSURANCE PROGRAMS. PART VI, LINE 4: AMC IS LOCATED IN THE HEART OF THE ADIRONDACK PARK IN RURAL, UPSTATE NEW YORK. THE ADIRONDACK PARK IS A UNIQUE, SIX-(6)-MILLION-ACRE PATCHWORK OF PUBLIC AND PRIVATE LANDS. THE ADIRONDACK PARK CREATES A UNIQUE SETTING WHERE SMALL POPULATION CENTERS ARE SURROUNDED BY SUBSTANTIAL AREAS OF STATE-OWNED WILDERNESS AREAS. IT IS BEST KNOWN FOR ITS MOUNTAINS, THE HIGHEST IN NEW YORK STATE, AND ITS LAKES. THERE ARE EXPANSIVE AREAS OF BACKCOUNTRY INTERSPERSED WITH VILLAGES, PRIVATE HOMES, AND FARMS. AMC'S SERVICE AREA IS MAINLY COMPRISED OF TOWNS IN SOUTHERN FRANKLIN AND NORTHERN ESSEX COUNTIES, BUT ALSO INCLUDES PORTIONS OF SOUTHWESTERN CLINTON, NORTHERN HAMILTON, AND SOUTHEASTERN ST. LAWRENCE COUNTIES. THIS SERVICE AREA COVERS OVER 1,200 SQUARE MILES WITH AN AVERAGE OF JUST OVER 30 PEOPLE PER SQUARE MILE. AMC IS THE PRINCIPAL PROVIDER OF ACUTE CARE FOR 70.7% OF THE 22,595 RESIDENTS IN THE PRIMARY SERVICE AREA AND CARES FOR APPROXIMATELY 25.1% OF THE 12,455 RESIDENTS IN THE SECONDARY SERVICE AREA. THE TOTAL NUMBER OF RESIDENTS HAS REMAINED STABLE OVER THE LAST TEN YEARS, HOWEVER, THE PERCENTAGE OF THE POPULATION THAT ARE 55-64 YEARS OF AGE, IS INCREASING, WITH A CORRESPONDING DECREASE IN YOUNGER AGE GROUPS. IN THE SERVICE AREA THE PERCENTAGE OF PEOPLE FALLING INTO THE 55-64 AND 65+ AGE GROUPS IS 28.9 % OF THE TOTAL POPULATION COMPARED TO 24.3% OF THE U.S. THE NUMBER OF WOMEN OF CHILD BEARING AGE IN THE SERVICE AREA IS EXPECTED TO DECREASE BY 3.1%. WHILE THE PERCENT OF RESIDENTS WITH HEALTH INSURANCE HAS BEEN INCREASING, RESIDENTS CONTINUE TO BE AT A HEALTHCARE PROVIDER ACCESS DISADVANTAGE AS DESCRIBED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. OF PARTICULAR NOTE IS THAT THE NUMBER OF PRIMARY CARE PROVIDERS ARE CONSIDERABLY LESS THAN THE REGION AND NEW YORK AND THERE ARE HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS) FOR PRIMARY CARE, DENTAL CARE AND MENTAL HEALTH IN THE SERVICE AREA. DATA SHOWS ADDITIONAL HEALTH RISKS FOR LOWER INCOME POPULATIONS SUCH AS THOSE ELIGIBLE FOR MEDICAID OR WIC. RESIDENTS CONTINUE TO EXPERIENCE LOWER MEAN HOUSEHOLD INCOMES AND PER-CAPITA INCOMES THAN NEW YORK. THE HIGHEST PERCENT OF SUB-POPULATIONS LIVING IN POVERTY ARE CHILDREN AT 16.1%. AN INCREASING PERCENT OF CHILDREN ARE ELIGIBLE FOR FREE AND REDUCED LUNCHES (40.8% IN 2005 TO 53.5% IN 2016). WHILE THERE ARE NOT SIGNIFICANT HEALTH DISPARITIES BASED ON RACE AND ETHNICITY IN FRANKLIN COUNTY, THERE ARE, HOWEVER, ACCESS TO CARE ISSUES. ONLY 77% OF THE FRANKLIN COUNTY POPULATION HAVE A REGULAR SOURCE OF CARE, WHICH IS LOWER THAN UPSTATE NEW YORK (84.6%), THE STATE AS A WHOLE (84.4%), AND THE PREVENTION AGENDA BENCHMARK OF 90.8%. FRANKLIN COUNTY ALSO HAS HIGHER PERCENTAGES OF ADULTS WHO DID NOT RECEIVE HEALTH CARE DUE TO COSTS (17.6%) - HIGHER THAN THE ARHN REGION (11.4%), UPSTATE NEW YORK (11.2%), AND NEW YORK STATE (13.1%). ADDITIONALLY, FRANKLIN COUNTY HAS A HIGH PERCENTAGE OF ADULTS WHO REPORT 14 DAYS OR MORE IN A MONTH OF POOR PHYSICAL HEALTH AND A HIGHER PERCENTAGE OF ADULTS WITH DISABILITIES COMPARED TO THEIR RESPECTIVE UPSTATE NEW YORK BENCHMARKS. THE RATE OF ED VISITS PER 10,000 POPULATION IS HIGHER IN FRANKLIN COUNTY (4,658.3) THAN IN THE ARHN REGION (4,418.4), UPSTATE NEW YORK (3,752.5), AND THE STATE AS A WHOLE (4,086.4). THE RATE OF AVOIDABLE HOSPITALIZATIONS IN FRANKLIN COUNTY (118.8) IS HIGHER THAN IN UPSTATE NEW YORK (107.3) BUT LOWER THAN THE PREVENTION AGENDA BENCHMARK OF 122.0. PART VI, LINE 5: AMC IS A SOLE COMMUNITY HOSPITAL AND ALTHOUGH NOT AFFILIATED WITH A LARGER MEDICAL NETWORK, IS PART OF THE ADIRONDACK ACCOUNTABLE CARE ORGANIZATION, WHICH IS COMPRISED OF 450 PRIMARY AND SPECIALTY CLINICIANS THROUGH NEW YORK AND VERMONT. AMC IS A PARTNER IN THE ADIRONDACK HEALTH INSTITUTE PPS FOR DSRIP AND COLLABORATES CLOSELY WITH MANY COMMUNITY-BASED ORGANIZATIONS IN THE REGION, INCLUDING PUBLIC HEALTH AGENCIES IN BOTH FRANKLIN AND ESSEX COUNTIES AND BEHAVIORAL HEALTH AGENCIES TO FURTHER THE GOALS OF THE COMMUNITY SERVICE PLAN. EFFORTS INCLUDE:- COLLABORATION WITH THE HEART HEALTHY NETWORK TO PROVIDE CHRONIC DISEASE COACHING THAT FOCUSES ON COACHING PATIENTS WHO HAVE CHRONIC DISEASES OR ARE AT RISK FOR THEM LIKE COPD, HYPERTENSION, HEART DISEASE AND DIABETES.- ENGAGED IN QUALITY IMPROVEMENT INITIATIVES AIMED AT REDUCING HOSPITAL READMISSIONS FOR PATIENTS WITH HEART FAILURE BY INITIATING A GUIDELINE BASED INPATIENT HEART FAILURE EDUCATION PROGRAM CALLED "HEART FAILURE ZONES." THIS PROGRAM EDUCATES THE PATIENT AND CAREGIVERS ALONG WITH CONTINUOUS FOLLOW UP POST DISCHARGE TO DETERMINE PATIENT'S PROGRESS. - CREATED PEER NAVIGATORS IN THE ED TO ACT AS A GATEKEEPER FOR PATIENTS BEING EVALUATED FOR ADMISSIONS/OBSERVATION INTO THE HOSPITAL SETTING BY WORKING WITH PATIENTS TO ACT AS AN ADVOCATE AND LIAISON BETWEEN THE PATIENT, FAMILY/CAREGIVER, THEIR CLINICAL TEAM AND PROVIDERS, AND THIRD-PAYORS. - NEW YORK STATE PREVENTION AGENDA PRIORITY OF PROMOTING HEALTHY WOMEN, INFANT AND CHILDREN WITH A PERINATAL QUALITY COLLABORATIVE SAFE SLEEP PROJECT TO REDUCE SUDDEN INFANT DEATH SYNDROME AND INCREASE BREASTFEEDING IN OUR REGION. - SPONSOR OF ADIRONDACK HEALTH PROGRAMS AND EMPLOYEE WELLNESS PROGRAMS WHICH INCLUDED FREE PHYSICAL ACTIVITY EVENTS FOR THE COMMUNITY WITH CHAIR YOGA, 5K EVENTS/HALF MARATHON EVENTS, CHAIR MASSAGE, CROSS COUNTRY SKIING, FAMILY SWIM PROGRAMS AND SNOWSHOE CLASSES.- PARTICIPATION IN DSRIP (DELIVERY SYSTEM REFORM INCENTIVE PAYMENT) WITH SEVEN PROJECTS ALL OF WHICH ARE PART OF A COMPREHENSIVE MEDICAID REFORM PROGRAM TO REDUCE AVOIDABLE HOSPITAL ADMISSIONS AND EMERGENCY DEPARTMENT ADMISSIONS BY 25% OVER 5 YEARS. THESE PROJECTS INCLUDE HOME TELEMONITORING EQUIPMENT, FACILITATOR TRAINING WITH RESPECTING CHOICES (A PALLIATIVE CARE INITIATIVE), CHRONIC DISEASE PREVENTION, INTEGRATING BEHAVIORAL HEALTH INTO PRIMARY CARE, HEALTH CENTER CERTIFICATION UNDER NCQA AND MANY OTHER POPULATION HEALTH EFFORTS. PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES NY X 0 1 X X X X X 0 1 0 0 0 0 0 0 0 CHARLES GLANVILLE C.F.O. 221647 0 0 0 0 0 8837 0 8773 0 239257 0 0 0 SYLVIA GETMAN EX-OFFICIO PRESIDENT/C.E.O. 358356 0 42175 0 0 0 51869 0 12295 0 464695 0 0 0 DANA KELLERMAN COO/CHRO 203966 0 0 0 0 0 242 0 7490 0 211698 0 0 0 LINDA MCCLARIGAN C.N.O. 183609 0 0 0 0 0 7302 0 9871 0 200782 0 0 0 DARCI BEIRAS C.M.O. ENDING 06/17 330437 0 0 0 0 0 33198 0 12474 0 376109 0 0 0 JOAHD TOURE C.M.O. BEGINNING 06/17 174098 0 0 0 0 0 0 0 5781 0 179879 0 0 0 ANTHONY TRAMANTANO PHYSICIAN 521165 0 0 0 0 0 10800 0 11791 0 543756 0 0 0 JONATHAN KRANT PHYSICIAN 366886 0 0 0 0 0 10800 0 13500 0 391186 0 0 0 ANTHONY F LOMBARDI PHYSICIAN 306792 0 0 0 0 0 10800 0 8102 0 325694 0 0 0 MATTHEW L MORGAN PHYSICIAN 314206 0 0 0 0 0 5428 0 8000 0 327634 0 0 0 WILLIAM M VISCARDO JR PHYSICIAN 284622 0 0 0 0 0 5700 0 12726 0 303048 0 0 0 PART I, LINE 1A TAX GROSS-UP PAID ON A PERFORMANCE BONUS AWARDED TO SYLVIA GETMAN. IT WAS TREATED AS TAXABLE COMPENSATION AND REPORTED ON HER W-2. PART I, LINE 1B THE ORGANIZATION HAS AN EXECUTIVE COMPENSATION POLICY WHICH WAS FOLLOWED IN DETERMINING THE BONUS, BUT THE POLICY DOES NOT ADDRESS GROSS-UPS. PART 1, LINE 4B THE HOSPITAL HAS A DEFERRED COMPENSATION PLAN FOR PARTICIPATING PHYSICIANS WHO PROVIDE SERVICES THROUGH THE HOSPITAL'S "ON-CALL" PROGRAM. PATRICIA MONROE, MD RECEIVED $18,720 FROM THIS DEFERRED COMPENSATION PLAN AND $21,986 WAS CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HIS/HER BEHALF IN 2017. RICHARD MOCCIA, MD RECEIVED $39,872 FROM THIS DEFERRED COMPENSATION PLAN AND $37,397 WAS CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HIS/HER BEHALF IN 2017. DARCI BEIRAS, MD HAD $22,397 CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HIS/HER BEHALF IN 2017. WAGUIH KIROLLOS, MD RECEIVED $43,942 FROM THIS DEFERRED COMPENSATION PLAN AND AN ADDITIONAL $5,000 OF MEDICAL STAFF STIPENDS ON HIS/HER BEHALF IN 2017. A FRANKLIN COUNTY CIVIC DEVELOPMENT CORPORATION 800627350 2016-10-18 24455000 MULTI-MODE REVENUE BONDS FOR CAPITAL PROJECTS- REFINANCE 0 0 0 B ESSEX COUNTY CAPITAL RESOURCE CORPORATION 274698218 2017-10-05 9500000 MULTI-MODE REVENUE BONDS FOR CAPITAL PROJECTS 0 0 0 A 110000 24455000 479474 14335658 349674 2019 1 0 0 1 B 9500000 190000 9238750 71250 2018 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 B 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 B 0 1 0 0 0 0 0 0 1 A 1 B 1 FORM 990, PART VI, SECTION A, LINE 4 CHANGES IN THE CURRENT BY-LAWS INCLUDE ELIMINATING THE CHIEF SENIOR SERVICES OFFICER AND REPLACING WITH AMC-MERCY NURSING HOME ADMINISTRATOR, ADDING ADIRONDACK HEALTH FOUNDATION TREASURER TO FINANCE COMMITTEE, QIC VICE CHAIR WILL SERVE AS A LIAISON TO MEDICAL STAFF CREDENTIALS COMMITTEE AS WELL AS ASSURANCE COMMITTEE, JOINT CONFERENCE COMMITTEE WILL PROVIDE INPUT INTO MEDICAL STAFF STRATEGIC DEVELOPMENT PLAN AND THE THREE-YEAR STRATEGIC PLANNING PROCESS, ELIMINATION OF HOLDING THE MEDICAL STAFF RESPONSIBLE FOR PERIODIC REVIEW OF MEDICAL STAFF BYLAWS. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PRESENTED AND REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING THE 990. FORM 990, PART VI, SECTION B, LINE 12C ALL MEMBERS OF THE BOARD OF TRUSTEES ARE REQUIRED TO COMPLETE AND SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY. THESE ARE THEN REVIEWED BY THE AUDIT AND COMPLIANCE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION DECISIONS ARE DEVELOPED BASED ON THE USE OF NATIONAL AND REGIONAL SALARY SURVEY DATA WHICH IS ANALYZED BY THE COMPENSATION COMMITTEE AND THEN APPROVED BY THE FULL BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER FEES: PROGRAM SERVICE EXPENSES 8,238,883. MANAGEMENT AND GENERAL EXPENSES 4,714,267. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,953,150. FORM 990, PART XI, LINE 9: EXPENSES ELIMINATED DURING CONSOLIDATION -59,573. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. ADIRONDACK MEDICAL CENTER FOUNDATION PO BOX 120 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 161528554 SUPPORT AND ASSIST ADIRONDACK MEDICAL CENTER NY 501(C)3 BOX 11 ADIRONDACK MEDICAL CENTER 0 ADIRONDACK HEALTH REGIONAL MEDICAL PC PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 475676016 SUPPORT AND ASSIST ADIRONDACK MEDICAL CENTER NY 501(C)3 BOX 11 ADIRONDACK MEDICAL CENTER 0 TRUDEAU HEALTH SYSTEMS LLC PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 141788211 CONTRACTING - HEALTH SERVICES NY AMC AND TRUDEAU HEALTH SYSTEMS C 16972 0.50000 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 1 0 0