STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

COMMUNITY MEMORIAL HOSPITAL INC: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY MEMORIAL HOSPITAL INC (EIN 15-0548010)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-11-07
IRS object ID
202533119349302443
Schema version
2024v5.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-11-07T13:19:17-06:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161226221PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FUSTCHARLES LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1220 S WARREN STREETAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13202ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN150548010EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone3158246550PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 BROAD STREETAddressLine1Txt
CityHAMILTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13346ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTRACY FRANKPersonNm
Person TitleCFOPersonTitleTxt
Phone3158246550PhoneNum
Signature2025-11-05SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTHOMAS J GIUFREPreparerPersonNm
PTINP00841958PTIN
Phone3154463600PhoneNum
Preparation2025-11-05PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTRACY FRANKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 BROAD STREETAddressLine1Txt
CityHAMILTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13346ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$67,627,567GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressCOMMUNITYMEMORIAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1949FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionCOMMUNITY MEMORIAL HOSPITAL'S MISSION-TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE FOR ALL.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee644TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,171,973PYContributionsGrantsAmt
CY Contributions Grants$544,569CYContributionsGrantsAmt
PY Program Service Revenue$57,612,419PYProgramServiceRevenueAmt
CY Program Service Revenue$66,686,587CYProgramServiceRevenueAmt
PY Investment Income$149,686PYInvestmentIncomeAmt
CY Investment Income$179,233CYInvestmentIncomeAmt
PY Other Revenue$655,554PYOtherRevenueAmt
CY Other Revenue$194,165CYOtherRevenueAmt
PY Total Revenue$61,589,632PYTotalRevenueAmt
CY Total Revenue$67,604,554CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$33,090,367PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$39,672,252CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$29,634,705PYOtherExpensesAmt
CY Other Expenses$29,022,766CYOtherExpensesAmt
PY Total Expenses$62,725,072PYTotalExpensesAmt
CY Total Expenses$68,695,018CYTotalExpensesAmt
PY Revenues Less Expenses-$1,135,440PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,090,464CYRevenuesLessExpensesAmt
Total Assets BOY$35,595,283TotalAssetsBOYAmt
Total Assets EOY$44,137,714TotalAssetsEOYAmt
Total Liabilities BOY$15,531,104TotalLiabilitiesBOYAmt
Total Liabilities EOY$28,845,183TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$20,064,179NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$15,292,531NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCOMMUNITY MEMORIAL HOSPITAL'S MISSION IS TO PROVIDE THE HIGHEST QUALITY, COMPASSIONATE CARE FOR ALL.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$17,456,305ExpenseAmt
Revenue$12,317,526RevenueAmt
DescOPERATION OF A CRITICAL ACCESS HOSPITALBEDS 25PATIENT DAYS OF CARE 7,751ADMISSIONS 1,550COMMUNITY MEMORIAL HOSPITAL HAS RECEIVED MANY AWARDS FOR OUTSTANDING CARE TO INCLUDE: 1) RATED AS AN OUTSTANDING LEADER IN PATIENT CARE AND PATIENT SAFETY BY BOTH STATE AND FEDERAL SURVEYORS. IT IS A 4 TO 5 STAR RATED HOSPITAL FOR CMS PATIENT SATISFACTION RATING, WHICH VARIES BY QUARTER.2) HEALTHGRADES MULTI-YEAR 5 STAR RATING IN ORTHOPEDIC SURGERY FOR KNEE REPLACEMENTS. 3) EXCELLUS AWARD FOR COMBINED CLINICAL PROCESS AND SURGICAL CARE IMPROVEMENT.4) JOINT COMMISSION RECOGNITION AS TOP PERFORMER IN QUALITY MEASURES.COMMUNITY MEMORIAL HOSPITAL STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITY BY:1) PARTICIPATING IN LOCAL HEALTH FAIRS.2) IMPROVING ACCESS TO PRIMARY CARE.3) IMPROVING THE CARE OF CHRONIC ILLNESSES SUCH AS DIABETES.4) IMPROVING MENTAL HEALTH SERVICES THROUGH THE INTEGRATION OF BEHAVIORAL HEALTH SERVICES IN THE CLINICS.5) INCREASING ACCESS TO SPECIALTY SERVICES SUCH AS WOMEN'S HEALTH, ORTHOPEDICS, CARDIOLOGY AND PULMONOLOGY.6) COUNSELING ON THERAPEUTIC DIETS AND WEIGHT RELATED ISSUES.7) OFFERING A PRE-DIABETIC COACHING COURSE ON DIET, EXERCISE AND OTHER WAYS TO REDUCE RISK OF PATIENTS BECOMING TYPE II DIABETIC.8) PROMOTING HEALTH SCREENING SERVICES SUCH AS COLONOSCOPY'S FOR MEN'S HEALTH AND MAMMOGRAPHY IMAGING FOR WOMEN'S HEALTH MONTH.9) CMH PROMOTES BACK TO SCHOOL AND SPORTS SCREENINGS TO THE COMMUNITY THROUGH EDUCATIONAL MAILINGS AND SOCIAL MEDIA REMINDERS FOR PARENTS.COMMUNITY MEMORIAL HOSPITAL HAS A CHARITY CARE PROGRAM FOR PATIENTS WHO CANNOT AFFORD TO PAY HOSPITAL BILLS AND FALL WITHIN THE NATIONAL POVERTY GUIDELINES, UP TO 400% OF THE POVERTY GUIDELINES. IN 2024 COMMUNITY MEMORIAL HOSPITAL PROVIDED CHARITY CARE IN THE AMOUNT OF $247,185 TO APPROXIMATELY 221 PATIENTS.)Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$15,879,885ExpenseAmt
Revenue$26,150,617RevenueAmt
DescOPERATION OF EMERGENCY SERVICES AND OUTPATIENT REFERRED AMBULATORY TESTINGEMERGENCY ROOM VISITS 12,461REFERRED AMBULATORY VISITS 41,981Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$15,488,205ExpenseAmt
Revenue$13,095,692RevenueAmt
DescOPERATION OF PRIMARY CARE CLINICSTOTAL VISITS 68,585Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$11,892,240ExpenseAmt
Revenue$15,122,752RevenueAmt
DescOPERATION OF AN AMBULATORY SURGERY UNITTOTAL VISITS 2,947Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$11,892,240TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$15,122,752TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$60,716,635TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document44IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee644EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3158246550PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 BROAD STREETAddressLine1Txt
CityHAMILTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13346ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
RICHARD RUSSELL
TREASURER1.00Yes (X)Yes (X)$0$0$0
MARY BRUNDAGE
TRUSTEE1.00Yes (X)$0$0$0
RICHARD COHEN MD
TRUSTEE1.00Yes (X)$0$0$0
HAZEL L JACK
SECRETARY1.00Yes (X)Yes (X)$0$0$0
ROBERT TYBURSKI
VICE CHAIRPERSON1.00Yes (X)Yes (X)$0$0$0
SUNNY NELSON MD
TRUSTEE40.00Yes (X)$0$0$0
RAYMOND MEEKS MD
TRUSTEE1.00Yes (X)$0$0$0
ANNE CLAUSS
TRUSTEE1.00Yes (X)$0$0$0
ELLEN P KRALY
CHAIRPERSON1.00Yes (X)Yes (X)$0$0$0
BRADFORD WHELER
TRUSTEE1.00Yes (X)$0$0$0
MICHAEL LATREILLE
TRUSTEE1.00Yes (X)$0$0$0
EVE ANN SCHWARTZ
TRUSTEE1.00Yes (X)$0$0$0
SAMANTHI MARTINEZ
TRUSTEE1.00Yes (X)$0$0$0
AVNEET SINGH MD
VP, MEDICAL STAFF40.00Yes (X)Yes (X)$620,046$0$20,051
JOANN BORFITZ
TRUSTEE1.00Yes (X)$0$0$0
ELLEN LARSON
TRUSTEE1.00Yes (X)$0$0$0
ROBERT TENNEY
TRUSTEE1.00Yes (X)$0$0$0
JEFFERY COAKLEY
PRESIDENT40.00Yes (X)Yes (X)$459,090$0$48,620
LEIGH BALDWIN
TRUSTEE1.00Yes (X)$0$0$0
SUSAN BARRETT
TRUSTEE1.00Yes (X)$0$0$0
WILLIAM GETMAN
TRUSTEE1.00Yes (X)$0$0$0
SETH KRONENBERG MD
TRUSTEE1.00Yes (X)$0$0$0
RUTH ANN LOVELESS
TRUSTEE1.00Yes (X)$0$0$0
DAVID ROGERS
TRUSTEE1.00Yes (X)$0$0$0
JEFF RUBENSTEIN
TRUSTEE1.00Yes (X)$0$0$0
JENNIFER MEYERS MD
PRESIDENT, MEDICAL STAFF40.00Yes (X)Yes (X)$221,933$0$11,823
TRACY FRANK
CFO40.00Yes (X)$195,581$0$933
MICHAEL WALSH
PHYSICIAN40.00$339,757$0$15,738Yes (X)
DAVE REBUCK MD
PHYSICIAN40.00$546,949$0$44,092Yes (X)
RICHELLE TAKEMOTO MD
PHYSICIAN40.00$797,086$0$32,408Yes (X)
GREGORY RIPICH MD
PHYSICIAN40.00$528,721$0$36,217Yes (X)
KAMALJEET BANGA
PHYSICIAN40.00$729,627$0$31,968Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,438,790TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$241,850TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K88IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
THE HAYNER HOYT CORPORATION
625 ERIE BLVD WESTSYRACUSENY13204CONSTRUCTION SERVICES$2,868,668
CROUSE HEALTH HOSPITAL INC
736 IRVING AVESYRACUSENY13210MGMT, CLINICAL, & IT$1,318,081
LABCORP
PO BOX 12140BURLINGTONNC27216LABORATORY SERVICES$1,154,228
RICH & GARDNER CONSTRUCTION
206 PLUM STREETSYRACUSENY13204CONSTRUCTION SERVICES$869,500
HEALTHCARE WORKFORCE LOGISTICS
PO BOX 860573MINNEAPOLISMN55486STAFFING RESOURCES$808,776
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K22CntrctRcvdGreaterThan100KCnt
Government Grants$472,038GovernmentGrantsAmt
All Other Contributions$72,531AllOtherContributionsAmt
Total Contributions$544,569TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
REFERRED AMBULATORY621990$26,150,617$26,150,617
AMBULATORY SURGERY621990$15,122,752$15,122,752
INPATIENT621110$12,317,526$12,317,526
CLINIC621110$11,010,955$11,010,955
340B REVENUE900099$2,084,737$2,084,737
FieldValueIRS element (for citing)
Total Program Service Revenue$66,686,587TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$182,669TotalRevenueColumnAmt
Exclusion$182,669ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$37,638RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$8,308RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$29,330RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,330TotalRevenueColumnAmt
Exclusion$29,330ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$2,078SecuritiesAmt
Other$9,191OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$14,705OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,078SecuritiesAmt
Other-$5,514OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$3,436TotalRevenueColumnAmt
Exclusion-$3,436ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescCAFETERIA SALESDesc
Business900099BusinessCd
Total Revenue Column$102,219TotalRevenueColumnAmt
Exclusion$102,219ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$62,616TotalRevenueColumnAmt
Exclusion$62,616ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$164,835OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$67,604,554TotalRevenueColumnAmt
Related Or Exempt Func Income$66,686,587RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$373,398ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,578,077TotalAmt
Program Services$873,852ProgramServicesAmt
Management And General$704,225ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$30,128,911TotalAmt
Program Services$27,365,982ProgramServicesAmt
Management And General$2,762,929ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$778,684TotalAmt
Program Services$697,458ProgramServicesAmt
Management And General$81,226ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,987,254TotalAmt
Program Services$4,530,508ProgramServicesAmt
Management And General$456,746ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,199,326TotalAmt
Program Services$1,964,487ProgramServicesAmt
Management And General$234,839ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$222,960TotalAmt
Management And General$222,960ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$208,607TotalAmt
Management And General$208,607ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$10,525TotalAmt
Management And General$10,525ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$8,213TotalAmt
Management And General$8,213ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$11,071,774TotalAmt
Program Services$10,114,432ProgramServicesAmt
Management And General$957,342ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$453,450TotalAmt
Program Services$100,824ProgramServicesAmt
Management And General$352,626ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$640,707TotalAmt
Program Services$100,645ProgramServicesAmt
Management And General$540,062ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,737,485TotalAmt
Program Services$742,315ProgramServicesAmt
Management And General$995,170ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$669,011TotalAmt
Program Services$650,223ProgramServicesAmt
Management And General$18,788ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$76,249TotalAmt
Program Services$27,938ProgramServicesAmt
Management And General$48,311ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$75,729TotalAmt
Program Services$75,729ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,719,411TotalAmt
Program Services$2,586,542ProgramServicesAmt
Management And General$132,869ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$835,672TotalAmt
Program Services$835,672ProgramServicesAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$9,133,837$9,133,837$0
PROVISION FOR BAD DEBTS$612,122$612,122$0
NYS ASSESSMENT$212,663$212,663$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$334,351TotalAmt
Program Services$91,406ProgramServicesAmt
Management And General$242,945ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$68,695,018TotalAmt
Program Services$60,716,635ProgramServicesAmt
Management And General$7,978,383ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$7,952,364BOYAmt
EOY$9,286,837EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,060,716BOYAmt
EOY$8,294,188EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$574,994BOYAmt
EOY$885,892EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,552,086BOYAmt
EOY$1,551,050EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$60,543,353LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$37,544,127LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$19,481,825BOYAmt
EOY$22,999,226EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$973,298BOYAmt
EOY$1,120,521EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$35,595,283BOYAmt
EOY$44,137,714EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$9,498,594BOYAmt
EOY$13,353,150EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,100,543BOYAmt
EOY$8,588,812EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,931,967BOYAmt
EOY$6,903,221EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,531,104BOYAmt
EOY$28,845,183EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$19,314,179BOYAmt
EOY$15,292,531EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$750,000BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,064,179BOYAmt
EOY$15,292,531EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$35,595,283BOYAmt
EOY$44,137,714EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,090,464ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$25,505NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$3,655,679OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings MembersYes (1)MailingsMembersInd
Mailings Members$10,525MailingsMembersAmt
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$10,525TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART 11-B, LINE 1, LOBBYING ACTIVITIES:FormAndLineReferenceDesc
ExplanationCOMMUNITY MEMORIAL HOSPITAL HAS LIMITED LOBBYING ACTIVITIES. SEVERAL ACTIVITIES ARE CONDUCTED ON BEHALF OF THE ORGANIZATION THROUGH MEMBERSHIP IN THE IROQUOIS HEALTHCARE ALLIANCE AND HEALTHCARE ASSOCIATION OF NYS. THESE ACTIVITIES INCLUDE ADVETISEMENTS AND CONTACT WITH LEGISLATORS ON VARIOUS HEALTHCARE ISSUES. IROQUOIS HEALTHCARE ALLIANCE - MEMBERHSIP DUES OF $11,448 OF WHICH $5,724 WAS FOR LOBBYING. HEALTHCARE ASSOCIATION OF NYS - MEMBERSHIP DUES OF $26,379 OF WHICH $2,659 WAS FOR LOBBYING. AHA-MEMBERHSIP DUES OF $21,251 OF WHICH $2,142 WAS FOR LOBBYING.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,855,233BeginningYearBalanceAmt
Contributions$629,034ContributionsAmt
Investment Earnings Or Losses$270,631InvestmentEarningsOrLossesAmt
Grants Or Scholarships$4,386GrantsOrScholarshipsAmt
Other Expenditures$835,167OtherExpendituresAmt
End Year Balance$3,915,345EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,166,252BeginningYearBalanceAmt
Contributions$444,441ContributionsAmt
Investment Earnings Or Losses$328,177InvestmentEarningsOrLossesAmt
Grants Or Scholarships$23,220GrantsOrScholarshipsAmt
Other Expenditures$60,417OtherExpendituresAmt
End Year Balance$3,855,233EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$3,063,566BeginningYearBalanceAmt
Contributions$479,697ContributionsAmt
Investment Earnings Or Losses-$310,239InvestmentEarningsOrLossesAmt
Grants Or Scholarships$725GrantsOrScholarshipsAmt
Other Expenditures$66,047OtherExpendituresAmt
End Year Balance$3,166,252EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,380,696BeginningYearBalanceAmt
Contributions$1,534,889ContributionsAmt
Investment Earnings Or Losses$178,761InvestmentEarningsOrLossesAmt
Grants Or Scholarships$593GrantsOrScholarshipsAmt
Other Expenditures$30,187OtherExpendituresAmt
End Year Balance$3,063,566EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$654,422BeginningYearBalanceAmt
Contributions$739,279ContributionsAmt
Investment Earnings Or Losses$100,604InvestmentEarningsOrLossesAmt
Grants Or Scholarships$65,769GrantsOrScholarshipsAmt
Other Expenditures$47,840OtherExpendituresAmt
End Year Balance$1,380,696EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.14700PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.85300TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$62,115OtherCostOrOtherBasisAmt
Book Value$62,115BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$37,603,132OtherCostOrOtherBasisAmt
Depreciation$20,211,864DepreciationAmt
Book Value$17,391,268BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$39,694OtherCostOrOtherBasisAmt
Depreciation$31,917DepreciationAmt
Book Value$7,777BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,670,531OtherCostOrOtherBasisAmt
Depreciation$16,015,804DepreciationAmt
Book Value$4,654,727BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,167,881OtherCostOrOtherBasisAmt
Depreciation$1,284,542DepreciationAmt
Book Value$883,339BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$22,999,226TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
ACCRUED RETIREMENT OBLIGATIONS, NET$2,431,223
OTHER LONG-TERM LIABILITIES$352,736
ESTIMATED 3RD PARTY PAYABLE, NET$4,119,262
FieldValueIRS element (for citing)
Total Liability$6,903,221TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:ENDOWMENT FUNDS ARE USED TO FURTHUR THE HOSPITAL'S TAX EXEMPT PURPOSE, SUCH AS FOR THE PURCHASE OF CAPITAL ASSETS.
PART X, LINE 2:THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2024 AND 2023, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2021 THROUGH 2024. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically Indigent0FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft Report0AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$367,449TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$75,985DirectOffsettingRevenueAmt
Net Community Benefit Expns$291,464NetCommunityBenefitExpnsAmt
Total Expense0.00420TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,437,496TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,316,328DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,121,168NetCommunityBenefitExpnsAmt
Total Expense0.06000TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,804,945TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,392,313DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,412,632NetCommunityBenefitExpnsAmt
Total Expense0.06420TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$118,332TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$78,449DirectOffsettingRevenueAmt
Net Community Benefit Expns$39,883NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$118,332TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$78,449DirectOffsettingRevenueAmt
Net Community Benefit Expns$39,883NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$9,923,277TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,470,762DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,452,515NetCommunityBenefitExpnsAmt
Total Expense0.06480TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$612,121BadDebtExpenseAmt
Bad Debt Expense Attributable$575,641BadDebtExpenseAttributableAmt
Reimbursed By Medicare$8,637,885ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$11,298,519CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$2,660,634MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEMORIAL HOSPITAL INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 BROAD STAddressLine1Txt
CityHAMILTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13346ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.COMMUNITYMEMORIAL.ORGWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted22CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (1)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, PAGE 8OwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLSEE PART V, PAGE 8OtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, PAGE 8StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://COMMUNITYMEMORIAL.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://COMMUNITYMEMORIAL.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://COMMUNITYMEMORIAL.ORG/PATIENT-VISITOR-INFO/FINANCIAL-ASSISTANCE/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicaid Medcr PrvtYes (X)LookBackMedicaidMedcrPrvtInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
COMMUNITY MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 5: COMMUNITY MEMORIAL HOSPITAL PARTNERED WITH MADISON COUNTY DEPARTMENT OF HEALTH (MCDOH), ONEIDA HEALTH, AND THE MADISON COUNTY RURAL HEALTH COUNCIL, INC. TO COMPLETE THE COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLAN PROCESS. REPRESENTATIVES FROM THE FOUR AGENCIES COMPRISED THE 2022-2024 STEERING COMMITTEE. THE COMMUNITY HEALTH ASSESSMENT AND IMPROVEMENT PLAN OUTLINES THE CURRENT HEALTH STATUS OF RESIDENTS AND IDENTIFIES A COMPREHENSIVE PLAN FOR ADDRESSING HEALTH CHALLENGES. THE PROCESS WAS UNDERTAKEN IN ALIGNMENT WITH THE 2019-2024 NEW YORK STATE PREVENTION AGENDA1, WHICH IDENTIFIES FIVE PRIORITY AREAS FOR HEALTH IMPROVEMENT: PREVENT CHRONIC DISEASES PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS PROMOTE A HEALTHY AND SAFE ENVIRONMENT PROMOTE HEALTHY WOMEN, INFANTS, AND CHILDREN PREVENT COMMUNICABLE DISEASES
COMMUNITY MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 6A: THE OTHER HOSPITAL THAT PARTICIPATED WAS ONEIDA HEALTHCARE.
COMMUNITY MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 6B: PLEASE SEE LINE 5 EXPLANATION.
COMMUNITY MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 11: THE 2022 CHA INTEGRATED RESULTS FROM THE PREVIOUS ASSESSMENTS WITH AN UPDATED COMMUNITY HEALTH STATUS ASSESSMENT. RESULTS OF THE REVISED CHA WERE PRESENTED TO THE STEERING COMMITTEE MEMBERS IN APRIL 2022 FOR THE SELECTION OF PRIORITY AREAS. A FACILITATED DISCUSSION LED TO THE DECISION TO FOCUS ON THE FOLLOWING PRIORITY AREAS: 1. PREVENT CHRONIC DISEASES 2. PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS TO PROMOTE ACTIVE COLLABORATION WITH COMMUNITY ORGANIZATIONS, THE STEERING COMMITTEE CONVENED PRIORITY AREA WORKGROUPS WITH REPRESENTATIVES FROM LOCAL ORGANIZATIONS. WORKGROUPS SELECTED GOALS, OBJECTIVES, AND EVIDENCE-BASED STRATEGIES TO ADDRESS PRIORITY AREAS. COMMUNITY MEMORIAL HOSPITAL WORKED CLOSELY WITH THE MADISON COUNTY PUBLIC HEALTH DEPARTMENT, AND ONEIDA HEALTHCARE. WE SELECTED PRIORITIES THAT COULD REACH THE MOST PEOPLE AND COULD HAVE THE MOST IMPACT, IDENTIFYING TWO PRIORITIES: PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AND PREVENTION OF CHRONIC DISEASETHE IDENTIFIED GOALS RELATED TO SUBSTANCE ABUSE INCLUDE 1) ESTABLISH COLLABORATIVE CARE MODEL IN PRIMARY CARE SETTINGS COMMUNITY MEMORIAL HOSPITAL IS DEVELOPING AND IMPLEMENTING A NETWORK OF LOCAL HEALTHCARE PROVIDERS, PUBLIC HEALTH ENTITIES, AND COMMUNITY NONPROFIT ORGANIZATIONS TO ENHANCE AND SUSTAIN THE DELIVERY OF COMMUNITY-BASED, BEHAVIORAL HEALTH CARE SERVICES TO RURAL AND UNDERSERVED POPULATIONS IN CENTRAL NEW YORK. PARTNER AGENCIES: MADISON COUNTY MENTAL HEALTH DEPARTMENT, FAMILY COUNSELING SERVICES OF CORTLAND COUNTY AND THE MADISON COUNTY COUNCIL ON ALCOHOLISM AND SUBSTANCE ABUSE, INC. (BRIDGES). 2) EXPAND COMMUNITY ACCESS TO NALOXONE COMMUNITY MEMORIAL HOSPITAL IS PARTNERING WITH BRIDGES TO ENSURE THAT WE HAVE NALOXONE TO PROVIDE TO PATIENTS PRESCRIBED NARCOTICS IN PRIMARY CARE, THOSE DISCHARGED FROM THE HOSPITAL, AND THOSE PATIENTS WHO VISIT THE EMERGENCY DEPARTMENT. IDENTIFIED GOALS RELATED TO PREVENTION OF CHRONIC DISEASE INCLUDE 1) IMPROVING ACCESS TO CARE COMMUNITY MEMORIAL HOSPITAL IS ACTIVELY RECRUITING FAMILY PRACTICE PROVIDERS TO INCREASE ACCESS TO CARE.
COMMUNITY MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 16J: A MESSAGE IS PRINTED ON PATIENTS' BILLS THAT STATES "COMMUNITY MEMORIAL HOSPITAL OFFERS A FINANCIAL ASSISTANCE PROGRAM. FOR MORE INFO PLEASE CALL 315-824-6552 OR 315-824-6553 OR GO TO WWW.COMMUNITYMEMORIAL.ORG"
COMMUNITY MEMORIAL HOSPITAL, INCPART V, SECTION B, LINE 20E: PATIENTS THAT ARE SELFPAY ON ADMISSION ARE SEEN BY THE FINANCIAL COUNSELING DEPARTMENT AND THE FINANCIAL ASSISTANCE PROGRAM IS DISCUSSED AND AN APPLICATION IS GIVEN. SELF PAY PATIENTS RECEIVING OUTPATIENT SERVICES ARE CALLED TO ADVISE THEM OF OUR POLICY BEFORE SERVICE IS SCHEDULED OR AFTER SERVICE IS RENDERED.
PART V, SECTION B, LINE 7A:HOSPITAL FACILITY'S WEBSITE:HTTPS://COMMUNITYMEMORIAL.ORG/ABOUT/COMMUNITY-SERVICE-PLAN/
PART V, SECTION B, LINE 7B:OTHER WEBSITE:HTTPS://WWW.MADISONCOUNTY.NY.GOV/2482/COMMUNITY-HEALTH-ASSESSMENT-IMPROVEMENT
PART V, SECTION B, LINE 10A:IMPLEMENTATION STRATEGY WEBSITE:HTTPS://COMMUNITYMEMORIAL.ORG/ABOUT/COMMUNITY-SERVICE-PLAN/
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - COMMUNITY MEMORIAL HOSPITAL FHC
164 BROAD STHAMILTONNY13346PRIMARY AND SPECIALTY CARE
2 - COMMUNITY MEMORIAL HOSPITAL FHC
3460 SOUTH STMORRISVILLENY13408PRIMARY CARE PHYSICIAN OFFICE
3 - COMMUNITY MEMORIAL HOSPITAL FHC
117 WEST MAIN STWATERVILLENY13480PRIMARY CARE PHYSICIAN OFFICE
4 - COMMUNITY MEMORIAL HOSPITAL FHC
5180 SOUTH MAIN STMUNNSVILLENY13409PRIMARY CARE PHYSICIAN OFFICE
5 - COMMUNITY MEMORIAL HOSPITAL FHC
3045 JOHN TRUSH BLVDCAZENOVIANY13035PRIMARY CARE PHYSICIAN OFFICE

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:LINE 7A - A COST-TO-CHARGE RATIO WAS USED, DERIVED FROM WORKSHEET 2LINE 7B - A COST-TO-CHARGE RATIO WAS USED, DERIVED FROM WORKSHEET 2.LINE 7E - WE USED OUR ACTUAL EXPENSES AND ACTUAL REVENUE FROM OUR WELLNESS CENTER AND HEALTHY LIVING PROGRAM, EXPENSES ASSOCIATED WITH NURSING TIME SPENT FOR CERTAIN PROGRAMS, AND EXPENSES FOR DIETARY COUNSELING.
PART I, LN 7 COL(F):BAD DEBT EXPENSE OF $612,121 WAS SUBTRACTED FROM FORM 990, PART IX, LINE 25, COLUMN A.
PART III, LINE 2:LINE 2 METHODOLOGY- THE HOSPITAL ESTIMATES BAD DEBT EXPENSE BASED ON HISTORICAL EXPERIENCE EXPRESSED AS A PERCENTAGE OF CURRENT YEAR GROSS REVENUE.
PART III, LINE 3:LINE 3 METHODOLOGY- THE APPROVAL PERCENTAGE OF 94.04% ON ALL PATIENTS WHO APPLIED FOR CHARITY CARE IN 2024 WAS MULTIPLIED BY THE AMOUNT ON LINE 2. THE RATIONAL BEING THAT THAT % WOULD HOLD ACROSS ALL OF OUR BAD DEBTS EXPENSE IF THOSE PATIENTS HAD APPLIED FOR CHARITY CARE. WE DID NOT INCLUDE BAD DEBT AMOUNTS IN COMMUNITY BENEFITS. BAD DEBTS EXPENSE IS NET OF DISCOUNTS AND PAYMENTS.
PART III, LINE 4:SEE PAGE 14 OF ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:FOR LINE 6 - THE HOSPITAL DETERMINED MEDICARE ALLOWABLE COSTS BY MULTIPLYING THE RATIO OF PATIENT CARE COST TO CHARGES DERIVED FROM WORKSHEET 2 BY THE TOTAL MEDICARE CHARGES REPORTED IN THE 2024 MEDICARE COST REPORT.THE SHORTFALL OF $2,660,634 ON LINE 7 REPRESENTS UNRECOGNIZED COMMUNITY BENEFIT INHERENT IN PROVIDING MEDICAL CARE TO THE COMMUNITY. OUR UNREIMBURSED COSTS FROM MEDICARE ARE INCURRED BY PROVIDING SERVICES TO OUR RURAL COMMUNITIES THAT HAVE A HIGHER THAN AVERAGE MEDICARE POPULATION, MANY OF WHOM ARE INDIGENT.
PART III, LINE 9B:LINE 9B -IN THE COLLECTION POLICY FOR COMMUNITY MEMORIAL HOSPITAL IT STATES THAT APPROVED APPLICATIONS WILL BE HONORED FOR A PERIOD OF TIME IF THE PATIENT RETURNS NEEDING MEDICAL SERVICES AND THE PATIENTS FINANCIAL STATUS HAS NOT CHANGED. PATIENTS WITHOUT INSURANCE ARE APPROVED FOR 3 MONTH COVERAGE PERIOD (MAY REAPPLY FOR COVERAGE IF ADDITIONAL MEDICAL SERVICES) AND PATIENTS WITH INSURANCE ARE APPROVED FOR ONE YEAR. PATIENTS WITH AN APPROVED APPLICATION ON FILE WILL BE IDENTIFIED UPON ADMISSION OR REGISTRATION IN THE HOSPITAL'S PATIENT ACCOUNTING SYSTEM BY PATIENT ACCESS STAFF. PATIENTS MAY ALSO CONTACT FINANCIAL COUNSELING TO NOTIFY THEM THAT AN APPROVED APPLICATION IS ON FILE IF THE APPROPRIATE DISCOUNT IS NOT TAKEN. ADDITIONAL DOCUMENTATION MAY BE REQUIRED TO DETERMINE IF INCOME LEVELS HAVE CHANGED. A NEW APPLICATION WILL BE REQUIRED AT THE END OF EACH COVERED PERIOD.
PART VI, LINE 2:COMMUNITY MEMORIAL WAS AN ACTIVE PARTNER WITH THE MADISON COUNTY HEALTH DEPARTMENT, OTHER HEALTH AND HUMAN SERVICE AGENCIES, AND AREA COMMUNITY AND INDUSTRY LEADERS IN PERFORMING AN EXTENSIVE ASSESSMENT OF THE HEALTH NEEDS OF OUR AREA. THE SHARED INFORMATION COLLECTED HAS BEEN USEFUL IN OUR EFFORTS TO PLAN FOR THE CHANGING NEEDS AND DEMOGRAPHICS OF OUR SERVICE AREA POPULATIONS. INFORMATION USED IN OUR PLANNING AND ASSESSMENT IS DERIVED FROM THE FOLLOWING SOURCES: 1) PRIMARY - PATIENT SATISFACTION SURVEYS, BOARD OF DIRECTORS, AUXILIARY MEMBERSHIP, MEDICAL STAFF, AND EMPLOYEES 2)PRIMARY - MADISON COUNTY DEPARTMENT OF HEALTH AND COMMUNITY NEEDS ASSESSMENT PLAN, SECONDARY - CHENANGO COUNTY COMMUNITY NEEDS ASSESSMENT, SPARCS, NYSDOH REPORTS AND DATA SOURCES, PHYSICIAN AND HEALTH SERVICES USAGE DATA BASES, MARKET SHARE AND DEMOGRAPHICS DATA BASES, HEALTHCARE ASSOCIATION OF NYS, AMERICAN HOSPITAL ASSOCIATION, IROQUOIS HEALTH ASSOCIATION, AND VOLUNTARY HOSPITALS OF AMERICA STATISTICAL REPORTS.
PART VI, LINE 3:LINE 3 - SIGNS ARE POSTED IN OUR ADMITTING/REGISTRATION AREAS REGARDING OUR POLICY OF PROVIDING SERVICES AT A REDUCED CHARGE OR NO CHARGE TO PATIENTS WHO HAVE FAMILY INCOME BELOW CERTAIN FEDERAL STANDARDS, INCLUDING A PHONE NUMBER TO CALL IN OUR FINANCIAL COUNSELING DEPARTMENT. A SUMMARY OF OUR FINANCIAL ASSISTANCE PROGRAM IS AVAILABLE FOR THEM TO TAKE. PATIENTS THAT ARE SELF PAY ON ADMISSION ARE SEEN BY THE FINANCIAL COUNSELING DEPARTMENT PERSONNEL AND THE FINANCIAL ASSISTANCE PROGRAM IS DISCUSSED AND AN APPLICATION IS GIVEN. PATIENTS THAT RECEIVE OUTPATIENT SERVICES ARE CALLED TO ADVISE THEM OF OUR POLICY BEFORE SERVICE IS SCHEDULED, OR AFTER SERVICE IS RENDERED. A MESSAGE IS AUTOMATICALLY PRINTED ON ALL PATIENT STATEMENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR THOSE WHO QUALIFY, WITH THE PHONE NUMBER TO CALL. OUR FINANCIAL ASSISTANCE PROGRAM POLICY, SUMMARY AND APPLICATION ARE AVAILABLE ON OUR HOSPITAL WEBSITE. PATIENTS ARE MADE AWARE THAT THEY MAY APPLY TO THE COUNTY IN WHICH THEY RESIDE FOR MEDICAID ASSISTANCE.
PART VI, LINE 4:COMMUNITY MEMORIAL HOSPITAL IN HAMILTON, NY, SERVES 45,000 PEOPLE IN 27 CENTRAL NEW YORK COMMUNITIES. THE REGION IS NOTED FOR ITS RICH AGRICULTURAL HISTORY AND A STRONG TRADITION OF HIGHER EDUCATION. COLGATE UNIVERSITY, MORRISVILLE STATE COLLEGE, AND CAZENOVIA COLLEGE OFFER CURRICULUMS THAT ARE RENOWNED NATIONWIDE. THE COMMUNITIES WE SERVE ALSO HAVE A SIGNIFICANT NUMBER OF FRAIL AND POOR ELDERLY, MEDICAID OF ALL AGES AND WORKING POOR. COMMUNITY MEMORIAL HOSPITAL PROVIDES CARE TO ALL OF THESE GROUPS REGARDLESS OF ABILITY TO PAY. THIS APPLIES TO ALL HOSPITAL AND OUTPATIENT SERVICES. COMMUNITY MEMORIAL HOSPITAL HAS A FINANCIAL ASSISTANCE PROGRAM FOR THOSE WHO CANNOT AFFORD TO PAY FOR THEIR MEDICAL BILLS.
PART VI, LINE 5:A MAJORITY OF COMMUNITY MEMORIAL HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE HOSPITAL, NOR FAMILY MEMBERS. COMMUNITY MEMORIAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE HOSPITAL USES SURPLUS FUNDS TO BUY STATE-OF-THE-ART CAPITAL EQUIPMENT, I.E. CARDIAC MONITOR FOR SPECIAL CARE UNIT, PHARMACY COMPUTER SYSTEM, SURGICAL EQUIPMENT, AND ADDITIONAL COMPUTERS/SERVERS.IN 1989, COMMUNITY MEMORIAL HOSPITAL EXPANDED ITS MISSION TO PROVIDE PRIMARY CARE IN THE RURAL COMMUNITIES OF ITS SERVICE AREA. SEVERAL PHYSICIANS HAD RETIRED OR WERE ABOUT TO CLOSE THEIR PRACTICES AND MANY SMALL TOWNS AND VILLAGES WERE LEFT WITHOUT ANY COVERAGE. THE HOSPITAL HAS A NETWORK OF SIX FAMILY HEALTH CENTERS (IN HAMILTON, CAZENOVIA, MORRISVILLE, MUNNSVILLE, SHERRILL AND WATERVILLE). THE HOSPITAL EMPLOYS FIVE FAMILY PRACTICE PHYSICIANS, ONE PEDIATRICIAN, ONE CARDIOLOGIST, ONE GENERAL SURGEON, TWO ORTHOPEDIC SURGEONS AND NURSE PRACTITIONERS/PHYSICIAN ASSISTANTS. WE CONTINUE TO ACTIVELY RECRUIT PRIMARY CARE PROVIDERS AND APPROPRIATE SPECIALISTS TO MEET THE NEEDS OF THE COMMUNITY. ALL PATIENTS WHO COME TO THE FAMILY HEALTH CENTERS ARE SERVED WITHOUT REGARD TO THEIR ABILITY TO PAY. THE HOSPITAL HAS DEVELOPED A SAFETY NET FOR LOW INCOME, UNINSURED AND/OR UNDERINSURED PATIENTS WHILE ENSURING PRIMARY CARE WILL REMAIN AVAILABLE IN RURAL CENTRAL NEW YORK.THE HOSPITAL PROMOTED CAREERS IN THE HEALTH CARE FIELD BY ATTENDING REGIONAL CAREER DAYS AT LOCAL HIGH SCHOOLS, COLLEGES AND LOCAL VENUES. THE HOSPITAL OFFERS A PRE-DIABETIC COACHING COURSE ON DIET, EXERCISE AND OTHER WAYS TO REDUCE THE LIKELIHOOD OF PATIENTS BECOMING DIABETIC. IN ADDITION, THE HOSPITAL DIETITIAN PROVIDES FREE COUNSELING TO THE COMMUNITY ON THERAPEUTIC DIETS AND WEIGHT RELATED ISSUES.
PART VI, LINE 6:COMMUNITY MEMORIAL HOSPITAL IS AN INDEPENDENT, CRITICAL ACCESS HOSPITAL (CAH). CMH HAS CLINICAL AFFILIATIONS WITH REGIONAL HOSPITALS, INCLUDING CROUSE HOSPITAL TO ENSURE CONTINUITY OF CARDIOLOGY SERVICES. CROUSE AND CMH ALSO MAINTAIN AN OPERATIONAL AFFILIATION WITH INFORMATION TECHNOLOGY SYSTEMS, INCLUDING EMR AND OTHER IT SYSTEMS.
PART VI, LINE 7, REPORTS FILED WITH STATESNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RICHELLE TAKEMOTO MD
PHYSICIAN$797,028$0$0$0$58$0$4,261$0$28,147$0$829,494$0$0$0
KAMALJEET BANGA
PHYSICIAN$729,538$0$0$0$89$0$250$0$31,718$0$761,595$0$0$0
AVNEET SINGH MD
VP, MEDICAL STAFF$534,616$0$85,396$0$34$0$13,454$0$6,597$0$640,097$0$0$0
DAVE REBUCK MD
PHYSICIAN$521,852$0$25,000$0$97$0$10,092$0$34,000$0$591,041$0$0$0
GREGORY RIPICH MD
PHYSICIAN$528,465$0$0$0$256$0$1,832$0$34,385$0$564,938$0$0$0
JEFFERY COAKLEY
PRESIDENT$428,852$0$30,000$0$238$0$15,197$0$33,423$0$507,710$0$0$0
MICHAEL WALSH
PHYSICIAN$317,644$0$21,875$0$238$0$9,141$0$6,597$0$355,495$0$0$0
JENNIFER MEYERS MD
PRESIDENT, MEDICAL STAFF$200,000$0$21,875$0$58$0$5,226$0$6,597$0$233,756$0$0$0
TRACY FRANK
CFO$185,215$0$10,000$0$366$0$0$0$933$0$196,514$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE CEO AND THE PRESIDENT OF THE BOARD OF DIRECTORS REVIEW THE CONFLICT OF INTEREST POLICIES ANNUALLY WITH THE FULL BOARD. ANY POSSIBLE CONFLICTS ARE REVIEWED AND APPROPRIATE ACTION TAKEN.
FORM 990, PART VI, SECTION B, LINE 15THE COMPENSATION OF THE CEO AND THE VP OF FINANCE IS DETERMINED BY THE BOARD OF DIRECTORS. THE BOARD REVIEWS COMPARATIVE DATA PROVIDED BY HOSPITAL TRADE ORGANIZATIONS SUCH AS HANYS. THE BOARD USES SALARY SURVEYS COMPLETED BY INDEPENDENT CONSULTANTS YAFFE & COMPANY. THE BOARD ALSO REVIEWS SALARIES FOR SIMILAR POSITIONS AT OTHER COMPARABLE HOSPITALS.
FORM 990, PART VI, SECTION C, LINE 19FINANCIAL STATEMENTS ARE FILED WITH THE CHARITIES BUREAU AND ARE PART OF THE PUBLIC RECORD. IN ADDITION, THE ORGANIZATION PROVIDES ALL DOCUMENTS REQUIRED BY THE INTERNAL REVENUE CODE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,943,564. MANAGEMENT AND GENERAL EXPENSES 111,259. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,054,823. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 7,170,868. MANAGEMENT AND GENERAL EXPENSES 846,083. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,016,951.
FORM 990, PART XI, LINE 9:RETIREMENT PLAN OBLIGATION CHANGES OTHER THAN NET PERIODIC BENEFIT COSTS 694,089. PAYMENT ON BEHALF OF RELATED ORGANIZATION -167,530. OTHER COMPONENTS OF NET PERIODIC BENEFIT COST -77,337. ALLOWANCE FOR HMS RECEIVABLE -4,104,901.
FORM 990, PART XII, LINE 2CTHERE WERE NO CHANGES TO THE OVERSIGHT PROCESS OR SELECTION PROCESS DURING THE CURRENT YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEMORIAL HOSPITAL FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 BROAD STAddressLine1Txt
CityHAMILTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13346ZIPCd
FieldValueIRS element (for citing)
EIN161603283EIN
Primary ActivitiesFUNDRAISINGPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Exempt Code Section501 C 3ExemptCodeSectionTxt
Public Charity Status11- TYPE IPublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HAMILTON MEDICAL SERVICES PLLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1150 BROAD STREETAddressLine1Txt
CityHAMILTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13346ZIPCd
FieldValueIRS element (for citing)
EIN463823973EIN
Primary ActivitiesPHYSICIAN SERVICESPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY MEMORIAL HOSPITAL INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd