BLYTHEDALE CHILDRENS HOSPITAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- BLYTHEDALE CHILDRENS HOSPITAL (EIN 13-1739922)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-08
- IRS object ID
- 201703129349300500
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule F
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-08T01:43:02-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO JERICHO PLAZA | AddressLine1Txt |
| City | JERICHO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11753 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 131739922 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLYTHEDALE CHILDREN'S HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BLYT | BusinessNameControlTxt |
| Phone | 9145927555 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 BRADHURST AVE | AddressLine1Txt |
| City | VALHALLA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10595 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN CANNING | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9145927555 | PhoneNum |
| Signature | 2017-11-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRISTINE KAWECKI | PreparerPersonNm |
| PTIN | P00743140 | PTIN |
| Phone | 5169187000 | PhoneNum |
| Preparation | 2017-11-06 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.219.88.214 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-07 | IPDt |
| IP Tm | 15:51:17 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D73626A0C70306D8F9DF5AF9012356B9233F38BE | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | D73626A0C70306D8F9DF5AF9012356B9233F38BE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN CANNING | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 BRADHURST AVE | AddressLine1Txt |
| City | VALHALLA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10595 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $84,956,961 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BLYTHEDALE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1891 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | BLYTHEDALE CHILDREN'S HOSPITAL IS DEDICATED TO IMPROVING THE HEALTH & WELL-BEING OF CHILDREN. | ActivityOrMissionDesc |
| Voting Members Governing Body | 29 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 29 | VotingMembersIndependentCnt |
| Total Employee | 571 | TotalEmployeeCnt |
| Total Volunteers | 274 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $11,361,061 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,428,187 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $61,164,787 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $62,952,704 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,052,589 | PYInvestmentIncomeAmt |
| CY Investment Income | -$3,111,474 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,788,721 | PYOtherRevenueAmt |
| CY Other Revenue | $3,963,671 | CYOtherRevenueAmt |
| PY Total Revenue | $82,367,158 | PYTotalRevenueAmt |
| CY Total Revenue | $67,233,088 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $42,609,552 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $45,348,987 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,203,076 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $21,696,322 | PYOtherExpensesAmt |
| CY Other Expenses | $22,890,818 | CYOtherExpensesAmt |
| PY Total Expenses | $64,305,874 | PYTotalExpensesAmt |
| CY Total Expenses | $68,239,805 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $18,061,284 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,006,717 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $217,643,442 | TotalAssetsBOYAmt |
| Total Assets EOY | $221,883,829 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $54,472,346 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $53,958,433 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $163,171,096 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $167,925,396 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BLYTHEDALE CHILDREN'S HOSPITAL IS DEDICATED TO IMPROVING THE HEALTH & WELL-BEING OF CHILDREN. BLYTHEDALE IS A LEADER IN THE DIAGNOSIS & TREATMENT OF CHILDREN WITH DISABLING AND COMPLEX MEDICAL CONDITIONS. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $40,143,051 | ExpenseAmt |
| Revenue | $48,432,073 | RevenueAmt |
| Desc | SEE SCHEDULE O. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,026,021 | ExpenseAmt |
| Revenue | $10,689,208 | RevenueAmt |
| Desc | SEE SCHEDULE O. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,480,866 | ExpenseAmt |
| Revenue | $1,077,802 | RevenueAmt |
| Desc | SEE SCHEDULE O. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,280,865 | ExpenseAmt |
| Revenue | $6,613,934 | RevenueAmt |
| Desc | EARLY INTERVENTION - THE EARLY INTERVENTION PROGRAM IS A STATEWIDE PROGRAM THAT PROVIDES MANY DIFFERENT TYPES OF EARLY INTERVENTION SERVICES TO CHILDREN BETWEEN THE AGES OF BIRTH TO THREE YEARS WITH DEVELOPMENT DELAY OR DIAGNOSED DISABILITIES AND TO THEIR FAMILIES. IN NEW YORK STATE, THE DEPARTMENT OF HEALTH IS THE LEAD STATE AGENCY RESPONSIBLE FOR THE EARLY INTERVENTION PROGRAM. IN 2016, THE PROGRAM SERVED ON AVERAGE OF 16 PATIENTS PER SCHOOL DAY FOR A TOTAL OF 4,054 VISITS. THE HOSPITAL ALSO PROVIDED 777 OUTPATIENT THERAPY AND CLINIC VISITS TO PATIENTS IN THE PROGRAM. BLYTHEDALE CHILDREN'S HOSPITAL IS WELL SUITED TO PROVIDE EVALUATION AND TREATMENT SERVICES FOR YOUNG CHILDREN. AS THE REGION'S PREMIERE HOSPITAL OFFERING REHABILITATIVE SERVICES TO CHILDREN, WE HAVE THE LARGEST DEPARTMENTS OF SPEECH THERAPY, OCCUPATIONAL THERAPY AND PHYSICAL THERAPY. THE EXPERTISE OF OUR HIGHLY SKILLED, MULTIDISCIPLINARY STAFF ENABLES US TO PROVIDE COORDINATED, COMPREHENSIVE, INDIVIDUALIZED PROGRAMS FOR THE CHILDREN AND FAMILIES WE SERVE. PARENTS AND STAFF WORK CLOSELY TOGETHER TO DEVELOP GOALS AND IMPATIENT PLANS. EVALUATION AND TREATMENT PLANNING ARE PERFORMED BY A MULTI-DISCIPLINARY TEAM THAT MAY CONSIST OF THERAPISTS, PHYSIATRISTS (REHABILITATION DOCTORS), NEUROLOGISTS, PSYCHIATRISTS, PSYCHOLOGISTS, SPECIAL EDUCATION, TEACHERS, AUDIOLOGISTS, SOCIAL WORKERS, NURSES, NUTRITIONISTS, AND OTHER SPECIALTY CONSULTANTS. WHILE NOT LIMITED TO THE FOLLOWING, THE PROGRAM TREATS A WIDE ARRAY OF ISSUES AND DIAGNOSES:- DELAYS OR LAGS IN REACHING THEIR DEVELOPMENTAL MILESTONES- CONGENITAL OR ACQUIRED ABNORMALITIES SUCH AS VISION OR HEARINGIMPAIRMENTS- DIAGNOSED MEDICAL CONDITIONS SUCH AS CEREBRAL PALSY, NEUROMUSCULAR OROTHER NEUROLOGICAL DISORDERSBLYTHEDALE CHILDREN'S HOSPITAL OFFERS VARIOUS OUTPATIENT THERAPY AND SUB SPECIALTY MEDICAL CLINICS TO SPECIAL NEEDS CHILDREN THROUGHOUT THE REGION. IN 2016 THE HOSPITAL PROVIDED OVER 2,192 ENCOUNTERS TO CHILDREN REQUIRING THESE SERVICES (THESE SERVICES INCLUDE AUDIOLOGY, NEUROLOGY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, BRACE AND EQUIPMENT MODIFICATION AND FITTING).BLYTHEDALE CHILDREN'S HOSPITAL IS A PARTICIPATING PEDIATRIC HEALTH HOME PROVIDER OF CARE, AND A LEAD CARE COORDINATION AGENCY FOR MEDICALLY FRAGILE CHILDREN. OUR PROACTIVE CARE COORDINATION MODEL PROVIDES THE FAMILIES OF MEDICALLY FRAGILE CHILDREN WITH THE SUPPORT THEY NEED, LEADING TO MORE CONSISTENT MEDICAL CARE ON A REGULAR BASIS. THIS IS A PRIMARY GOAL OF THE HEALTH HOME PROJECT. A MAJOR GOAL OF BLYTHEDALE'S SYSTEM OF CARE COORDINATION IS TO ALLOW THE FAMILIES OF MEDICALLY FRAGILE CHILDREN TO LIVE THEIR LIVES AND THRIVE, RATHER THAN SIMPLY SURVIVE. HELPING FAMILIES NAVIGATE THE COMPLEX MAZE OF HEALTHCARE FOR MEDICALLY FRAGILE CHILDREN WHILE ASSISTING WITH SOCIAL ISSUES THAT IMPACT THEIR ABILITY TO CARE FOR THE CHILD IS A COMBINATION THAT WILL RESULT IN MORE EFFICIENT AND APPROPRIATE USE OF THE HEALTHCARE SYSTEM, WITH THE "RIGHT CARE" BEING PROVIDED AT THE "RIGHT TIME" IN THE "RIGHT PLACE." BLYTHEDALE'S MODEL INCLUDES IN-HOME VISITS WITH THE CHILD AND FAMILY, CARE PLANNING MEETINGS WITH THE FAMILY AND RELEVANT PROVIDERS, AND TOOLS TO ENSURE 24 HOUR/SEVEN DAYS A WEEK ACCESS TO CARE MANAGEMENT SUPPORT. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $3,280,865 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $6,613,934 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $53,930,803 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 150 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 571 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | Yes (1) | ForeignFinancialAccountInd |
| Foreign Country | LU | ForeignCountryCd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 29 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 29 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN CANNING | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9145927555 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 BRADHURST AVE | AddressLine1Txt |
| City | VALHALLA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10595 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (43 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| DAVID R PEDOWITZ | ||||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PETER D RITTMASTER | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SCOTT R LEVY | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TIM EVNIN | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LUCY SCHMOLKA | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ABBY POPPER | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ADAM GALEON | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ALAN GERSTEIN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DARREN M FOGEL | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| FARREL STARKER | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| FRANK A STERN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HOWARD ADLER | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN J BARKER | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN L FURTH | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JON M BURNHAM | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JORDANA HOLOVACH | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JUDITH R GOODHUE | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LANCE WACHENHIEM | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LARRY W COHEN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LESLIE WEISSMAN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL MARGULIES | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| NANCY R BLAINE | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| OWEN GUTFREUND | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PATRICIA B STANLEY | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVEN SOLOMON | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TERRI HERENSTEIN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| VIRGINIA FURTH WEISMAN | ||||||||
| TRUSTEE (AS OF 05/16) | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM ANDY CAHN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM G LEVY | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LAWRENCE LEVINE | ||||||||
| CHIEF EXECUTIVE OFFICER | 37.50 | $996,321 | $0 | $85,982 | Yes (X) | |||
| JOHN CANNING | ||||||||
| CHIEF FINANCIAL OFFICER | 37.50 | $416,291 | $0 | $115,986 | Yes (X) | |||
| SCOTT KLEIN | ||||||||
| CHIEF MEDICAL OFFICER | 37.50 | $465,759 | $0 | $63,309 | Yes (X) | |||
| JILL WEGENER | ||||||||
| CHIEF NURSING OFFICER | 37.50 | $214,972 | $0 | $13,404 | Yes (X) | |||
| JANE MACDONALD | ||||||||
| CHIEF DEVELOPMENT OFFICER | 37.50 | $234,315 | $0 | $54,205 | Yes (X) | |||
| RONALD GALLO | ||||||||
| CHIEF HUMAN RESOURCES OFFICER | 37.50 | $229,271 | $0 | $74,904 | Yes (X) | |||
| MAUREEN DESIMONE | ||||||||
| CHIEF OPERATING OFFICER | 37.50 | $322,933 | $0 | $63,521 | Yes (X) | |||
| SUSAN GOODBODY MURRAY | ||||||||
| CHIEF ENGAGEMENT OFFICER | 37.50 | $197,376 | $0 | $27,740 | Yes (X) | |||
| BYRON FERNANDEZ | ||||||||
| UNIT CHIEF PEDIATRICS | 37.50 | $292,979 | $0 | $52,775 | Yes (X) | |||
| JAY SELMAN | ||||||||
| CHIEF NEUROLOGY | 22.50 | $201,892 | $0 | $126 | Yes (X) | |||
| KATHY SILVERMAN | ||||||||
| UNIT CHIEF PEDIATRICS | 37.50 | $222,741 | $0 | $56,251 | Yes (X) | |||
| MILICENT MITCHELL | ||||||||
| CHIEF PULONOLOGY | 37.50 | $258,358 | $0 | $12,184 | Yes (X) | |||
| XIAOFANG WEI | ||||||||
| ATTENDING PSYCHIATRIST | 37.50 | $178,756 | $0 | $58,530 | Yes (X) | |||
| REGINA KELLY | ||||||||
| FORMER CHIEF PLANNING OFFICER | 0.00 | $119,051 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,351,015 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $678,917 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 95 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BOVIS LEND LEASE | |||||
| 200 PARK AVENUE 9TH FLOOR | NEW YORK | NY | 10166 | CONSTRUCTION | $5,370,193 |
| SODEXO INC & AFFILIATES | |||||
| PO BOX 81049 | WOBURN | MA | 01813 | DIETARY, FACILITIES,HOUSEKEEPING | $3,218,946 |
| PRESIDIO NETWORKED SOLUTIONS | |||||
| 12120 SUNSET HILLS ROAD | RESTON | VA | 20190 | IT INFRASTRUCTURE | $1,995,022 |
| BURKE MEDICAL RESEARCH INSTITUTE | |||||
| 785 MAMARONECK AVENUE | WHITE PLAINS | NY | 10605 | MEDICAL RESEARCH | $466,512 |
| DELOITTE TAX LLP | |||||
| PO BOX 7247-6446 | PHILADELPHIA | PA | 191706446 | ACCOUNTING | $294,492 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 55 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $1,288,125 | FundraisingAmt |
| All Other Contributions | $2,140,062 | AllOtherContributionsAmt |
| Noncash Contributions | $169,913 | NoncashContributionsAmt |
| Total Contributions | $3,428,187 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INPATIENT | 622110 | $48,432,073 | $48,432,073 |
| DAY HOSPITAL | 622110 | $10,689,208 | $10,689,208 |
| OUTPATIENT / EARLY INT | 621400 | $1,102,416 | $1,102,416 |
| LONG TERM CARE | 622110 | $1,077,802 | $1,077,802 |
| BUFSD SCHOOL | 611710 | $944,646 | $944,646 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $706,559 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $706,559 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $62,952,704 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $658,102 | TotalRevenueColumnAmt |
| Exclusion | $658,102 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $13,648,683 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $17,418,259 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$3,769,576 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,769,576 | TotalRevenueColumnAmt |
| Exclusion | -$3,769,576 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $216,976 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $1,288,125 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $305,614 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$88,638 | TotalRevenueColumnAmt |
| Exclusion | -$88,638 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| SPENDING POLICY | 900099 | $3,586,023 | $3,586,023 | |
| CAFETERIA | 722514 | $191,996 | $191,996 | |
| MEDICAL RECORDS | 900099 | $55,837 | $55,837 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $218,453 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $218,453 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,052,309 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $67,233,088 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $66,813,017 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$3,008,116 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,910,781 | TotalAmt |
| Program Services | $2,317,152 | ProgramServicesAmt |
| Management And General | $2,196,879 | ManagementAndGeneralAmt |
| Fundraising | $396,750 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,054,081 | TotalAmt |
| Program Services | $25,903,750 | ProgramServicesAmt |
| Management And General | $2,810,935 | ManagementAndGeneralAmt |
| Fundraising | $339,396 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,568,233 | TotalAmt |
| Program Services | $3,963,562 | ProgramServicesAmt |
| Management And General | $523,779 | ManagementAndGeneralAmt |
| Fundraising | $80,892 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,480,598 | TotalAmt |
| Program Services | $3,855,276 | ProgramServicesAmt |
| Management And General | $529,620 | ManagementAndGeneralAmt |
| Fundraising | $95,702 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,335,294 | TotalAmt |
| Program Services | $1,943,070 | ProgramServicesAmt |
| Management And General | $334,144 | ManagementAndGeneralAmt |
| Fundraising | $58,080 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,473,814 | TotalAmt |
| Program Services | $1,984,551 | ProgramServicesAmt |
| Management And General | $420,601 | ManagementAndGeneralAmt |
| Fundraising | $68,662 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $388,085 | TotalAmt |
| Management And General | $388,085 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308,477 | TotalAmt |
| Management And General | $308,477 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,813 | TotalAmt |
| Management And General | $22,813 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $460,150 | TotalAmt |
| Management And General | $460,150 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,672 | TotalAmt |
| Program Services | $27,950 | ProgramServicesAmt |
| Management And General | $62,722 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,050 | TotalAmt |
| Program Services | $47,259 | ProgramServicesAmt |
| Management And General | $53,303 | ManagementAndGeneralAmt |
| Fundraising | $2,488 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,263,424 | TotalAmt |
| Management And General | $1,257,121 | ManagementAndGeneralAmt |
| Fundraising | $6,303 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,650,681 | TotalAmt |
| Program Services | $5,291,406 | ProgramServicesAmt |
| Management And General | $293,428 | ManagementAndGeneralAmt |
| Fundraising | $65,847 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,672 | TotalAmt |
| Program Services | $26,342 | ProgramServicesAmt |
| Management And General | $11,960 | ManagementAndGeneralAmt |
| Fundraising | $370 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,309 | TotalAmt |
| Program Services | $72,117 | ProgramServicesAmt |
| Management And General | $67,192 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,640 | TotalAmt |
| Management And General | $81,640 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,167,363 | TotalAmt |
| Program Services | $4,709,307 | ProgramServicesAmt |
| Management And General | $1,438,393 | ManagementAndGeneralAmt |
| Fundraising | $19,663 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $815,077 | TotalAmt |
| Program Services | $663,742 | ProgramServicesAmt |
| Management And General | $116,537 | ManagementAndGeneralAmt |
| Fundraising | $34,798 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACTED LABOR | $2,789,672 | $2,359,740 | $406,975 | $22,957 |
| TAXES FEES ASSESSMENTS | $856,376 | $92,747 | $758,969 | $4,660 |
| UTILITIES | $792,773 | $672,832 | $113,433 | $6,508 |
| DEBT SERVICE FEES | $448,770 | $448,770 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,239,805 | TotalAmt |
| Program Services | $53,930,803 | ProgramServicesAmt |
| Management And General | $13,105,926 | ManagementAndGeneralAmt |
| Fundraising | $1,203,076 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,606,698 | BOYAmt |
| EOY | $7,794,272 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,386,155 | BOYAmt |
| EOY | $4,278,854 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,667,235 | BOYAmt |
| EOY | $10,369,642 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,412,697 | BOYAmt |
| EOY | $5,435,792 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $353,602 | BOYAmt |
| EOY | $382,663 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400,214 | BOYAmt |
| EOY | $568,738 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $121,411,284 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $43,737,879 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,354,417 | BOYAmt |
| EOY | $77,673,405 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,525,063 | BOYAmt |
| EOY | $61,438,217 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,082,313 | BOYAmt |
| EOY | $53,071,466 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $855,048 | BOYAmt |
| EOY | $870,780 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,643,442 | BOYAmt |
| EOY | $221,883,829 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,741,481 | BOYAmt |
| EOY | $3,098,523 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,441,481 | BOYAmt |
| EOY | $21,800,557 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,551,791 | BOYAmt |
| EOY | $2,537,230 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,737,593 | BOYAmt |
| EOY | $26,522,123 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,472,346 | BOYAmt |
| EOY | $53,958,433 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,086,231 | BOYAmt |
| EOY | $152,263,235 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,055,979 | BOYAmt |
| EOY | $11,713,215 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,028,886 | BOYAmt |
| EOY | $3,948,946 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $163,171,096 | BOYAmt |
| EOY | $167,925,396 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,643,442 | BOYAmt |
| EOY | $221,883,829 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,006,717 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $5,591,090 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $169,927 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $22,813 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $22,813 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1, LOBBYING ACTIVITIES: | FormAndLineReferenceDesc |
| Explanation | BLYTHEDALE CHILDREN'S HOSPITAL, AS A MEMBER OF STATE-WIDE HOSPITAL ORGANIZATIONS, HAS A PORTION OF ITS DUES FOR LOBBYING. IN ADDITION, BLYTHEDALE HAS ENGAGED AN OUTSIDE LOBBYIST TO LOBBY ON ITS BEHALF ON ISSUES RELATING TO THE STATE BUDGET. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $18,084,864 | BeginningYearBalanceAmt |
| Contributions | $2,554,980 | ContributionsAmt |
| Investment Earnings Or Losses | $874,730 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $5,852,414 | OtherExpendituresAmt |
| End Year Balance | $15,662,160 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,559,343 | BeginningYearBalanceAmt |
| Contributions | $9,177,628 | ContributionsAmt |
| Investment Earnings Or Losses | -$154,788 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,497,319 | OtherExpendituresAmt |
| End Year Balance | $18,084,864 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $11,065,150 | BeginningYearBalanceAmt |
| Contributions | $1,908,465 | ContributionsAmt |
| Investment Earnings Or Losses | $609,854 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $2,024,123 | OtherExpendituresAmt |
| End Year Balance | $11,559,346 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $10,130,991 | BeginningYearBalanceAmt |
| Contributions | $926,397 | ContributionsAmt |
| Investment Earnings Or Losses | $1,758,628 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,750,866 | OtherExpendituresAmt |
| End Year Balance | $11,065,150 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $9,207,439 | BeginningYearBalanceAmt |
| Contributions | $1,230,427 | ContributionsAmt |
| Investment Earnings Or Losses | $923,951 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,230,826 | OtherExpendituresAmt |
| End Year Balance | $10,130,991 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.25200 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.74800 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,383,879 | OtherCostOrOtherBasisAmt |
| Book Value | $1,383,879 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,998,367 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,021,774 | DepreciationAmt |
| Book Value | $40,976,593 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $61,258,512 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,283,125 | DepreciationAmt |
| Book Value | $33,975,387 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,770,526 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,432,980 | DepreciationAmt |
| Book Value | $1,337,546 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $77,673,405 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LIMITED LIABILITY PARTNERSHIP (HEDGE FUNDS) | Desc |
| Book Value | $53,071,466 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $53,071,466 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ASSET RETIREMENT | $133,940 |
| ACCRUED PENSION LIABILITY | $25,291,183 |
| EST MALPRACTICE LIABILITIES | $1,097,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $26,522,123 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $72,158,689 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $4,719,490 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $3,153,679 | OtherRevenueAmt |
| Revenue Not Reported | $7,873,169 | RevenueNotReportedAmt |
| Revenue Subtotal | $64,285,520 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $460,150 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $2,487,418 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $2,947,568 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $67,233,088 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $68,085,370 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $305,615 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $305,615 | ExpensesNotReportedAmt |
| Expenses Subtotal | $67,779,755 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $460,050 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $460,050 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $68,239,805 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | TEMPORARILY RESTRICTED NET ASSETS ARE THOSE WHOSE USE BY BLYTHEDALE CHILDREN'S HOSPITAL (THE "HOSPITAL") HAS BEEN LIMITED BY DONORS TO A SPECIFIC PERIOD OR PURPOSE. PERMANENTLY RESTRICTED NET ASSETS HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED BY THE HOSPITAL IN PERPETUITY. THE HOSPITAL'S ENDOWMENT CONSISTS OF APPROXIMATELY 20 INDIVIDUAL FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. THE HOSPITAL BECAME SUBJECT TO NYPMIFA (THE NEW YORK PRUDENT MANAGEMENT OF INSTITUTIONAL FUNDS ACT) WHICH WAS ENACTED IN SEPTEMBER 2010. THE BOARD OF TRUSTEES INTERPRETED NYPMIFA AS (A) REQUIRING THE PRESERVATION OF THE ORIGINAL GIFT AS OF THE GIFT DATE OF THE DONOR-RESTRICTED ENDOWMENT FUNDS ABSENT EXPLICIT DONOR STIPULATIONS TO THE CONTRARY. AS A RESULT OF THIS INTERPRETATION, THE HOSPITAL CLASSIFIES AS PERMANENTLY RESTRICTED NET ASSETS: (A) THE ORIGINAL VALUE OF GIFTS DONATED TO THE PERMANENT ENDOWMENT, (B) THE ORIGINAL VALUE OF SUBSEQUENT GIFTS TO THE PERMANENT ENDOWMENT, AND (C) ACCUMULATIONS OF INCOME ARE ADDED TO THE FUND IN ACCORDANCE WITH THE DIRECTION OF THE APPLICABLE DONOR GIFT INSTRUMENT AT THE TIME THE ACCUMULATION IS ADDED TO THE FUND. THE REMAINING PORTION OF THE DONOR-RESTRICTED ENDOWMENT FUND THAT IS NOT CLASSIFIED IN PERMANENTLY RESTRICTED NET ASSETS IS CLASSIFIED AS TEMPORARILY RESTRICTED UNTIL THOSE AMOUNTS ARE APPROPRIATED FOR EXPENDITURE BY THE ORGANIZATION. IN ACCORDANCE WITH NYPMIFA THE ORGANIZATION CONSIDERS THE FOLLOWING FACTORS IN MAKING A DETERMINATION TO APPROPRIATE OR ACCUMULATE DONOR-RESTRICTED ENDOWMENT FUNDS: (A) THE DURATION AND PRESERVATION OF THE FUND (B) THE PURPOSES OF THE ORGANIZATION AND THE DONOR-RESTRICTED ENDOWMENT FUND (C) GENERAL ECONOMIC CONDITIONS (D) THE POSSIBLE EFFECT OF INFLATION AND DEFLATION (E) THE EXPECTED TOTAL RETURN FROM INCOME AND THE APPRECIATION OF INVESTMENTS (F) OTHER RESOURCES OF THE ORGANIZATION (G) THE INVESTMENT POLICIES OF THE ORGANIZATION TEMPORARILY RESTRICTED NET ASSETS AS OF DECEMBER 31, 2016 AND 2015, ARE AVAILABLE FOR THE FOLLOWING PURPOSES: 2016 2015 PLANT REPLACEMENT $4,278,854 $6,501,832 TEMPORARILY RESTRICTED $5,115,360 $4,582,599 MEDICAL EQUIPMENT $19,091 $15,873 OTHER $2,299,910 $2,955,675 TOTALS $11,713,215 $14,055,979 PERMANENTLY RESTRICTED NET ASSETS AS OF DECEMBER 31, 2016 AND 2015, ARE RESTRICTED TO THE FOLLOWING: 2016 2015 INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES $3,948,946 $4,028,886 BLYTHEDALE CHILDREN'S HOSPITAL HAS A CHARITABLE REMAINDER TRUST HELD BY TRUSTEES CITIBANK, CALLED THE HENRY STERN TRUST. THE PRINCIPLE IS PERMANENTLY RESTRICTED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | NET ASSETS RELEASED FROM RESTRICTION 3,153,679. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RESTRICTED INVESTMENT INCOME 3,130. FUNDRAISING EXPENSE RECLASS -305,615. RESTRICTED CONTRIBUTIONS 2,789,892. ROUNDING 11. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSE RECLASS 305,615. |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp (2 entries)
| RegionRegionTxt | OfficesOfficesCnt | EmployeeEmployeeCnt | Type Of Activities ConductedTypeOfActivitiesConductedTxt | Region Total ExpendituresRegionTotalExpendituresAmt |
|---|---|---|---|---|
| CENTRAL AMERICA & THE CARIBBEAN | 0 | 0 | INVESTMENTS | $27,333,530 |
| EUROPE (INCLUDING ICELAND AND GREENLAND) | 0 | 0 | INVESTMENTS | $5,677,483 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continutation Total Office | 0 | ContinutationTotalOfficeCnt |
| Continutation Total Employee | 0 | ContinutationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $33,011,013 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $33,011,013 | TotalSpentAmt |
| Transfer To Foreign Corp | Yes (1) | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | Yes (1) | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | Yes (1) | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SPRING GALA | Event1Nm |
| Gross Receipts Event1 | $786,123 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $679,113 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $107,010 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $1,837 | NonCashPrizesEvent1Amt |
| Food And Beverage Event1 | $107,010 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $2,500 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $39,371 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF EVENT | Event2Nm |
| Gross Receipts Event2 | $398,664 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $319,409 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $79,255 | GrossRevenueEvent2Amt |
| Rent Facility Costs Event2 | $79,255 | RentFacilityCostsEvent2Amt |
| Other Direct Expenses Event2 | $7,280 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 4 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $320,314 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $289,603 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $30,711 | GrossRevenueOtherEventsAmt |
| Rent Fclty Costs Other Events | $40,810 | RentFcltyCostsOtherEventsAmt |
| Food And Beverage Other Events | $584 | FoodAndBeverageOtherEventsAmt |
| Entertainment Other Events | $15,000 | EntertainmentOtherEventsAmt |
| Oth Direct Expnss Other Events | $11,967 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $1,505,101 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $1,288,125 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $216,976 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $1,837 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $120,065 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $107,594 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $17,500 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $58,618 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $305,614 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$88,638 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 400.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $517,728 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $517,728 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00770 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $665,847 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $579,391 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $86,456 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,183,575 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $579,391 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $604,184 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00900 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $169,322 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $38,528 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $130,794 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $279,627 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $199,604 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $80,023 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00120 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $495,368 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $117,745 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $377,623 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00560 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $423,279 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $347,337 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $75,942 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $191,061 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $181,677 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,384 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,558,657 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $884,891 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $673,766 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00990 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,742,232 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,464,282 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,277,950 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01890 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,353,070 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,053,825 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,299,245 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01930 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,353,070 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,053,825 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,299,245 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01930 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $970,396 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $0 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $0 | CostOfCareReimbursedByMedcrAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLYTHEDALE CHILDREN'S HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 95 BRADHURST AVE | AddressLine1Txt |
| City | VALHALLA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10595 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.BLYTHEDALE.ORG | WebsiteAddressTxt |
| State License | 5957000H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Childrens Hospital | Yes (X) | ChildrensHospitalInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLYTHEDALE CHILDREN'S HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.BLYTHEDALE.ORG | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.BLYTHEDALE.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 400.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.BLYTHEDALE.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.BLYTHEDALE.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.BLYTHEDALE.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | 0 | NondisEmergencyCarePolicyInd |
| No Emergency Care | Yes (X) | NoEmergencyCareInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| BLYTHEDALE CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 5: IN JANUARY 2016, THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH CONVENED A WORKGROUP OF LOCAL HOSPITALS TO SELECT TWO PRIORITIES FROM THE STATE'S PREVENTION AGENDA AND COLLABORATIVELY DEVELOP PLANS TO ADDRESS THESE PRIORITIES AS PART OF THE COUNTY HEALTH DEPARTMENT'S COMMUNITY HEALTH ASSESSMENT AND THE HOSPITALS' COMMUNITY SERVICE PLANS. IN ADDITION TO WORKGROUP MEETINGS, THE COUNTY HEALTH DEPARTMENT ALSO HELD A HEALTH CARE SUMMIT IN AUGUST 2016 TO GATHER ADDITIONAL COMMUNITY INPUT. THE COUNTY HAS RECONVENED METINGS WITH THE GROUP PERIODICALLY TO REASSESS COMMUNITY NEEDS & SELECT PRIORITIES FOR THE 2016-2018 PLAN. THE FOLLOWING COMMUNITY ORGANIZATIONS PARTICIPATED IN THE SUMMIT:AFFINITY HEALTH PLANAMERICAN DIABETES ASSOCIATIONAMERICAN HEART ASSOCIATIONAMERICAN LUNG ASSOC.POW'R TOBACCO CESSATION CENTERHAGAN SCHOOL OF BUSINESS, IONA COLLEGEHUDSON HEALTH PLANLOWER HUDSON VALLEY PERINATAL NETWORKCHILDREN'S HEALTH AND RESEARCH FOUNDATION, INC.MARCH OF DIMESNEW YORK MEDICAL COLLEGESCHOOL OF HEALTH SCIENCES AND PRACTICEPACE UNIVERSITYPLANNED PARENTHOOD HUDSON PECONIC, INC.POW'R AGAINST TOBACCORYE YMCAST. FRANCES AFRICAN METHODIST EPISCOPAL ZION CHURCHTHINCUNITED WAY OF WESTCHESTER AND PUTNAMWESTCHESTER COUNTY DEPARTMENT OF SOCIAL SERVICESWESTCHESTER COUNTY OFFICE OF WOMENWESTCHESTER COUNTY DEPT. OF SENIOR PROGRAMS & SERVICESYONKERS PUBLIC SCHOOLS |
| BLYTHEDALE CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 6B: BURKE REHABILITATION CENTERHUDSON VALLEY HOSPITAL CENTERLAWRENCE HOSPITAL CENTERMOUNT VERNON NEIGHBORHOOD CENTERNORTHERN WESTCHESTER HOSPITALOPEN DOOR FAMILY MEDICAL CENTERPHELPS MEMORIAL HOSPITAL CENTERSAINT JOSEPH'S HOSPITALSOUND SHORE MEDICAL CENTERST. JOHN'S RIVERSIDE HOSPITALST. VINCENT'S HOSPITAL WESTCHESTERSTELLARIS HEALTH NETWORKWESTCHESTER MEDICAL CENTERWHITE PLAINS HOSPITALWESTCHESTER COUNTY DEPARTMENT OF HEALTH |
| BLYTHEDALE CHILDREN'S HOSPITAL | PART V, SECTION B, LINE 11: ONE OF THE PRIORITY INITIATIVES IDENTIFIED BY THE COALITION ASSEMBLED BY THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH RELATED TO CHRONIC DISEASE IN THE ADULT POPULATION AND THUS IS NOT WITHIN BLYTHEDALE'S MISSION AND SCOPE. THUS BLYTHEDALE HAS SELECTED ANOTHER PRIORITY FROM THE STATE'S PREVENTION AGENDA WHICH ADDRESSES AN ISSUE OF CONCERN TO BLYTHEDALE'S COMMUNITY OF REFERRING HOSPITALS: PREVENT HOSPITAL ACQUIRED INFECTIONS, SPECIFICALLY REDUCING INFECTIONS CAUSED BY MULTIDRUG-RESISTANT ORGANISMS (MDROS). PRIORITY INITIATIVES SELECTED FOR THE 2016-2018 PLAN RELATED TO CHRONIC DISEASE, SPECIFICALLY PREVENTION OF OBESITY IN ADULTS & CHILDREN. THE SECOND PRIORITY RELATED TO PROMOTING MENTAL HEALTH & PREVENTING SUBSTANCE ABUSE. THIS SECOND PRIORITY IS NOT WITHIN BLYTHEDALE CHILDREN'S HOSPTAL'S MISSION AND SCOPE. THUS, BLYTHEDALE CHILDREN'S HOSPITAL HAS SELECTED THE PREVENTION AGENDA GOAL OF PREVENT HEALTHCARE-ASSOCIATED INFECTIONS AND ACTIVITIES BY SECTOR. |
| PART V, SECTION B, LINE 22D: | THE HOSPITAL FACILITY USED THE PUBLISHED MEDICAID RATES WHEN CALCULATING THE MAXIMUM AMOUNTS THAT CAN BE CHARGED. |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | EXPLANATION: BLYTHEDALE DETERMINES A PATIENT'S COST USING AVAILABLE COST DATA AND RATIOS FROM THE MOST RECENTLY FILED NYS ICR. A PROSPECTIVE PATIENT'S GROSS CHARGES ARE ESTIMATED FOR EACH OF THE SERVICES AND ALLOWANCED DOWN TO COST BASED UPON THE RATIO OF COST TO CHARGES. WE THEN DISCOUNT THE COST DOWN ON A SLIDING % BASIS IN THE FAP SCHEDULE USING A PATIENT'S ADJUSTED GROSS INCOME (AGI) FROM THEIR MOST RECENT TAX RETURN AND TAKING INTO ACCOUNT THEIR NUMBER OF DEPENDENTS / FAMILY SIZE REPORTED. |
| 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 $ 970,396. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | BLYTHEDALE IS INVOLVED IN NUMEROUS COMMUNITY BUILDING ACTIVITIES WHICH PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES. NUMEROUS COMMUNITY CONCERNS ARE ADDRESSED, INCLUDING HEALTH IMPROVEMENT (SEE DETAILS UNDER LINE 6 BELOW) AND ACCESS TO CARE. BLYTHEDALE ACTIVELY PARTICIPATES IN THE WESTCHESTER CHILDREN'S ASSOCIATION'S CHILD HEALTH TASK FORCE, WHOSE PRINCIPAL GOAL IS TO MAXIMIZE ENROLLMENT OF ELIGIBLE CHILDREN IN NEW YORK STATE'S MEDICAID AND CHILD HEALTH PLUS PROGRAMS. ADDITIONALLY, THROUGH THE NEW YORK STATE WORKGROUP ON MEDICALLY FRAGILE CHILDREN, BLYTHEDALE HAS WORKED TO ADVOCATE FOR SERVICES TO SUPPORT FAMILIES CARING FOR MEDICALLY FRAGILE CHILDREN AT HOME. |
| PART III, LINE 2: | REVENUE IS RECOGNIZED WHEN THE CLAIM HAS (1) PERVASIVE EVIDENCE OF A PAYMENT AGREEMENT / AUTHORIZATION, RATE SHEET OR CONTRACT (2) SERVICES HAVE BEEN RENDERED (3) PRICE IS FIXED AND DETERMINABLE (4) COLLECTABILITY IS REASONABLE ASSURED. BAD DEBT IS RECOGNIZED IF MANAGEMENT IS UNABLE TO COLLECT THE DEBT AFTER THESE CRITERIA HAVE BEEN MET.BAD DEBTS DO NOT INCLUDE CHARITY CARE, COURTESY DISCOUNTS, SELF PAY ALLOWANCES, OR ALLOWANCES FOR OUTPATIENT SERVICES PROVIDED THAT ARE NOT AUTHORIZED.BAD DEBTS WILL BE RECORDED AND RECOGNIZED IN THE PERIOD IN WHICH IT IS DETERMINED THE DEBT IS UNCOLLECTIBLE. BAD DEBT IS RECOGNIZED AS THE AMOUNT CONTRACTUALLY OBLIGATED AND RECOGNIZED AS REVENUE FOR WHICH ALL AVENUES OF COLLECTION HAVE BEEN EXHAUSTED. ALL WRITE OFFS IN EXCESS OF $10,000 REQUIRE APPROVAL FROM THE CFO PRIOR TO RECORDING ENTRY IN MEDITECH SYSTEM. ALL BAD DEBT ALLOWANCE ENTRIES ARE TO BE CODED USING "XFR PROCEDURE IN MEDITECH.THE FOLLOWING EXAMPLE WILL DEMONSTRATE THE COMPONENTS OF BAD DEBT TO BE RECORDED:TOTAL PATIENT CHARGES: $250,000LESS CONTRACTUAL ALLOWANCES: -$150,000NET REVENUE: $100,000ACTUAL PAYMENTS: -$75,000ACCOUNT BALANCE UNCOLLECTED: $25,000 <==BAD DEBT VALUE AFTER ALL EFFORTS TO COLLECT ARE EXHAUSTEDCOMPONENTS OF BAD DEBT REPORTING:THE RESERVE BALANCE SHOULD REFLECT 9.0% OF THE GROSS AR AS RECORDED IN STEP 1. THE VARIANCE FROM THE 12/31 RESERVE BALANCE IS RECORDED ON A MONTHLY BASIS. THE NET OF THE ACTUAL BAD DEBTS + CHANGE IN RESERVE BALANCE FROM 12/31 IS RECORDED AS BAD DEBT EXPENSE IN THE FINANCIAL STATEMENTS |
| PART III, LINE 4: | CHARITY CARE - THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ESTABLISHED RATES. BECAUSE THE COLLECTIONS OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE IS NOT PURSUED, THEY ARE NOT REPORTED AS REVENUE. THE AMOUNT OF IDENTIFIED CHARITY CARE PROVIDED AT COST, NET OF ANY REIMBURSEMENTS DURING THE YEARS ENDED DECEMBER 31, 2016 AND 2015, WERE APPROXIMATELY $517,728 AND $343,417 RESPECTIVELY. THE ESTIMATED COST OF THESE CHARITY CARE SERVICES WAS DETERMINED USING A RATIO OF COST TO GROSS CHARGES AND APPLYING THAT RATIO TO THE GROSS CHARGES ASSOCIATED WITH PROVIDING CARE TO CHARITY PATIENTS FOR THE PERIOD.PROVISION AND ALLOWANCE FOR DOUBTFUL ACCOUNTS - TO PROVIDE FOR ACCOUNTS RECEIVABLE THAT COULD BECOME UNCOLLECTIBLE IN THE FUTURE, THE HOSPITAL ESTABLISHES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS TO REDUCE THE CARRYING VALUE OF SUCH RECEIVABLES TO THEIR ESTIMATED NET REALIZABLE VALUE. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR DOUBTFUL ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR DOUBTFUL ACCOUNTS FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE EXHAUSTED THIRD PARTY BENEFITS RELATIVE TO SERVICES PROVIDED AT THE HOSPITAL AND HAVE NO SECONDARY SOURCE OF COVERAGE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL DID NOT CHANGE ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEAR 2016. THE HOSPITAL MAINTAINED AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IN 2016 AND 2015 IN THE AMOUNTS OF APPROXIMATELY $961,000 AND $892,000, RESPECTIVELY. THESE AMOUNTS REPRESENT 1.6% AND 1.5% OF NET PATIENT SERVICE REVENUE RESPECTIVELY. |
| PART III, LINE 8: | BLYTHEDALE, AS A CHILDREN'S HOSPITAL RECEIVED IMMATERIAL AMOUNTS OF MEDICARE REIMBURSEMENT. IN 2016, THE HOSPITAL FILED A LOW/NO COST UTILIZATION REPORT WITH CMS. |
| PART III, LINE 9B: | COLLECTION POLICIES ARE THE SAME FOR ALL PATIENTS. ALL PATIENTS HAVING DIFFICULTY PAYING THEIR BILLS ARE DIRECTED TO HOSPITAL STAFF WHO ASSIST THE FAMILY IN COMPLETING A FINANCIAL ASSESSMENT AND TRY TO QUALIFY THE PATIENT FOR ASSISTANCE. ONCE A LEVEL OF FINANCIAL ASSISTANCE IS DETERMINED, THE ACCOUNT BALANCE IS PRORATED FOR CONTRACTUAL ADJUSTMENTS AND THEN PRO-RATED TO COST. FROM COSTS, THE LEVEL OF FINANCIAL ASSISTANCE IS THEN APPLIED, ANY REMAINING BALANCE IS COLLECTABLE AS PATIENT RESPONSIBILITY.PATIENTS ARE SCREENED FOR ELIGIBILTY FOR FINANCIAL ASSISTANCE BEFORE COLLECTION PROCEDURE BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS, DOCUMENTATION IS RECEIVED THAT INDICATES THAT THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, THE ACCOUNT IS REFERRED BACK FOR A FINANCIAL ASSISTANCE REVIEW. BLYTHEDALE DOES NOT PURSUE COLLECTION OF AMOUNTS FROM PATIENTS DETERMINED TO QUALIFY FOR CHARITY CARE.IF A PATIENT HAS REQUESTED AND/OR FILLED OUT A FINANCIAL ASSISTANCE APPLICATION, ALL DEBT COLLECTION ACTIVITIES STOP UNTIL ELIGIBILTY FOR FINANCIAL ASSISTANCE CAN BE DETERMINED. BLYTHEDALE'S POLICY PROVIDES THAT WE WILL NOT REFER ANY ACCOUNTS FOR COLLECTION UNTIL IT IS DETERMINED WHETHER THE INDIVIDUAL IS INSURED AND NOT ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| PART VI, LINE 2: | SINCE THE VAST MAJORITY OF ADMISSIONS TO BLYTHEDALE COME BY REFERRAL FROM OTHER HOSPITALS, PARTICULARLY THE LARGE MEDICAL CENTERS IN THE METROPOLITAN NEW YORK AND HUDSON VALLEY AREA, BLYTHEDALE'S SENSE OF NEED FOR CLINICAL SERVICES LARGELY EMANATES FROM REFERRING HOSPITALS AND THEIR PHYSICIANS. BLYTHEDALE CONTINUOUSLY REVIEWS WITH REFERRING HOSPITALS AND PHYSICIANS THEIR NEEDS FOR SERVICES. HOWEVER, IN ADDITION TO ITS REFERRAL HOSPITALS, BLYTHEDALE ALSO WORKS CLOSELY WITH A VARIETY OF LOCAL AGENCIES, NOTABLY THE WESTCHESTER, HOWEVER, IN ADDITION TO ITS REFERRAL HOSPITALS, BLYTHEDALE ALSO WORKS ROCKLAND AND PUTNAM COUNTY DEPARTMENTS OF HEALTH TO IDENTIFY COMMUNITY HEALTH PRIORITIES THAT ARE RELEVANT TO BLYTHEDALE'S MISSION AND SERVICES. PARTICIPANTS IN THESE COALITIONS INCLUDE THE MAJOR CHILD AND ADOLESCENT HEALTH-FOCUSED COMMUNITY-BASED ORGANIZATIONS IN WESTCHESTER. BLYTHEDALE ALSO HAS CLOSE WORKING RELATIONSHIPS WITH MANY OF THE SCHOOL DISTRICTS IN WESTCHESTER COUNTY, THROUGH ITS NUTRITION EDUCATION ACTIVITIES, AND THROUGH ARRANGEMENTS WHEREBY BLYTHEDALE STAFF ARE CONTRACTED TO PROVIDE PHYSICAL, OCCUPATIONAL AND SPEECH THERAPY SERVICES TO CHILDREN IN THE SCHOOLS. |
| PART VI, LINE 3: | CONSISTENT WITH ITS MISSION AND STATE REQUIREMENTS (NEW YORK STATE PUBLIC HEALTH LAW 2807(K) (9-A), BLYTHEDALE HAS DEVELOPED GUIDELINES THAT DELINEATE THE CIRCUMSTANCES AND PROCEDURES UNDER WHICH FREE OR REDUCED COST CARE IS AVAILABLE. THESE GUIDELINES ARE MADE AVAILABLE TO ALL FAMILIES UPON REGISTRATION, AND HOSPITAL STAFF PROVIDE COUNSELING AS NECESSARY. INTERPRETATION SERVICES ARE AVAILABLE FOR PATIENTS NEEDING INFORMATION IN LANGUAGES OTHER THAN ENGLISH. PATIENTS ARE ALSO NOTIFIED OF BLYTHEDALE'S CHARITY CARE FINANCIAL ASSISTANCE POLICIES THROUGH NOTICES IN ENGLISH AND SPANISH POSTED IN THE HOSPITAL'S LOBBY AND IN PATIENT REGISTRATION AND WAITING AREAS. IN ADDITION, BLYTHEDALE'S PATIENT ASSISTANCE FUNDS HELPS PROVIDE CHILDREN WITH VARIOUS ITEMS (I.E., EQUIPMENT, CLOTHING, ETC.) WHERE FAMILY RESOURCES ARE LIMITED AND INSURANCE DOES NOT COVER. |
| PART VI, LINE 4: | AS A SPECIALTY CHILDREN'S HOSPITAL SERVING CHILDREN WITH A BROAD RANGE OF DIAGNOSES, BLYTHEDALE'S SERVICE AREA IS WIDESPREAD, WITH PATIENTS COMING FROM THE ENTIRE SOUTHERN PORTION OF NEW YORK STATE AS WELL AS ADJACENT AREAS OF NEW JERSEY AND CONNECTICUT: NEW YORK CITY (53%), HUDSON VALLEY (29%), LONG ISLAND (6%), OUT OF STATE (12%). THE HOSPITAL IS LOCATED IN A SUBURBAN COUNTY (WESTCHESTER) THAT IS PART OF THE GREATER NEW YORK METROPOLITAN AREA. BLYTHEDALE'S PATIENT POPULATION REFLECTS THE ETHNIC AND RACIAL DIVERSITY OF ITS LARGE SERVICE AREA, AS ILLUSTRATED BY ITS INPATIENT POPULATION: ASIAN (5%); BLACK OR AFRICAN-AMERICAN (28%); HISPANIC OR LATINO (34%); WHITE (24%); OTHER (14%). TO ADDRESS THIS DIVERSITY, THE HOSPITAL PROVIDES STAFF TRAINING IN CULTURAL DIVERSITY, INTERPRETER SERVICES, DIETARY VARIETY AND OTHER ACCOMMODATIONS TO SUPPORT FAMILIES FROM DIFFERENT CULTURAL BACKGROUNDS WHILE THEIR CHILDREN ARE PATIENTS AT BLYTHEDALE. |
| PART VI, LINE 5: | BLYTHEDALE OFFERS A NUMBER OF COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND SPECIAL PROGRAMS FOR DEVELOPMENT OF THE PEDIATRIC PROFESSIONAL COMMUNITY: NUTRITION EDUCATION: IN A MAJOR INITIATIVE TO HELP REDUCE THE PREVALENCE OF CHILDHOOD OBESITY AND PREVENT ITS LONG TERM NEGATIVE HEALTH EFFECTS, BLYTHEDALE IS REACHING OUT TO SCHOOL DISTRICTS THROUGHOUT WESTCHESTER AND SURROUNDING COUNTIES WITH ITS EAT WELL BE WELL SCHOOL BASED NUTRITION EDUCATION PROGRAM. THE EAT WELL, BE WELL PROGRAM, WITH SUPPORT FROM KOHLS DEPARTMENT STORES, IS DESIGNED TO PROVIDE SCHOOL STAFF AND STUDENTS WITH THE TOOLS NECESSARY TO HELP CHILDREN DEVELOP HEALTHY EATING HABITS THROUGH A COMPREHENSIVE CURRICULUM DEVELOPED BY BLYTHEDALE'S REGISTERED DIETICIANS. TO DATE THIS PROGRAM HAS REACHED MORE THAN 110,000 STUDENTS, AS WELL AS OVER 5,500 PARENTS AND SCHOOL STAFF IN SCHOOLS THROUGHOUT WESTCHESTER, ROCKLAND AND PUTNAM COUNTIES, WITH INFORMATION ON HOW TO MAKE FOOD AND LIFESTYLE CHOICES THAT WILL PROMOTE HEALTHY LIVING FOR A LIFETIME. THIS PAST YEAR THE PROGRAM WAS PROVIDED IN 23 SCHOOLS (OFTEN MORE THAN ONE VISIT) AND 16 SCHOOL DISTRICTS, TO 17,763 K-8 STUDENTS AND 1,057 ADULTS. FIRST RESPONDER TRAINING PROGRAM: BLYTHEDALE, IN COORDINATION WITH THE WESTCHESTER REGIONAL EMS OFFICE, WESTCHESTER COUNTY DEPARTMENT OF ENVIRONMENTAL SERVICES, AND THE NYS EMS FOR CHILDREN PROGRAM, HAS DEVELOPED A SPECIAL PEDIATRIC CME SERIES FOR FIRST RESPONDERS OF THE WESTCHESTER EMS REGION. THE SERIES COVERS SUBJECTS VITAL TO FIRST RESPONDERS, INCLUDING TRAUMATIC BRAIN INJURY, AUTISM, TECHNOLOGY AND CARE OF THE INFANT OR CHILD, CHILD ABUSE/NEGLECT AND CHILD/INFANT SAFETY DURING TRANSFER. THE COURSES WERE PRESENTED BY BLYTHEDALE CLINICAL EXPERTS, INCLUDING PHYSICIANS, NURSES, THERAPISTS AND OTHER CLINICAL EXPERTS AND REACHED OVER 230 FIRST RESPONDERS. CPR TRAINING CENTER: BLYTHEDALE IS A COMMUNITY TRAINING CENTER FOR THE AMERICAN HEART ASSOCIATION, PROVIDING TRAINING IN HEARTSAVER CPR, HEARTSAVER AED, HEARTSAVER FIRST AID, BASIC LIFE SUPPORT AND PEDIATRIC ADVANCED LIFE SUPPORT AND RELATED PROGRAMS. THOSE 3,836 INDIVIDUALS TRAINED IN 2016 INCLUDED HEALTH CARE PROFESSIONALS, MEMBER OF LOCAL POLICE AND FIRE DEPARTMENTS, STUDENTS AT AREA SCHOOLS AND STAFF FROM VARIOUS COMMUNITY AGENCIES. SERVICES TO THE PROFESSIONAL COMMUNITY: BLYTHEDALE ALSO PROVIDES CLINICAL TRAINING FOR SCORES OF PROFESSIONAL STUDENTS IN A WIDE RANGE OF FIELDS, INCLUDING MEDICINE, NURSING, RESPIRATORY THERAPY, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY AND SOCIAL WORK. BLYTHEDALE ALSO SPONSORS SPECIALIZED COURSES ON PEDIATRIC ISSUES FOR AREA PHYSICAL, OCCUPATIONAL AND SPEECH THERAPISTS. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAWRENCE LEVINE | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $603,840 | $0 | $123,600 | $0 | $268,881 | $0 | $41,748 | $0 | $44,234 | $0 | $1,082,303 | $0 | $0 | $0 |
| JOHN CANNING | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $347,352 | $0 | $57,680 | $0 | $11,259 | $0 | $69,238 | $0 | $46,748 | $0 | $532,277 | $0 | $0 | $0 |
| SCOTT KLEIN | ||||||||||||||
| CHIEF MEDICAL OFFICER | $406,051 | $0 | $58,898 | $0 | $810 | $0 | $13,530 | $0 | $49,779 | $0 | $529,068 | $0 | $0 | $0 |
| JILL WEGENER | ||||||||||||||
| CHIEF NURSING OFFICER | $199,950 | $0 | $14,063 | $0 | $959 | $0 | $10,400 | $0 | $3,004 | $0 | $228,376 | $0 | $0 | $0 |
| JANE MACDONALD | ||||||||||||||
| CHIEF DEVELOPMENT OFFICER | $210,153 | $0 | $21,390 | $0 | $2,772 | $0 | $37,089 | $0 | $17,116 | $0 | $288,520 | $0 | $0 | $0 |
| RONALD GALLO | ||||||||||||||
| CHIEF HUMAN RESOURCES OFFICER | $205,099 | $0 | $21,400 | $0 | $2,772 | $0 | $41,337 | $0 | $33,567 | $0 | $304,175 | $0 | $0 | $0 |
| MAUREEN DESIMONE | ||||||||||||||
| CHIEF OPERATING OFFICER | $266,294 | $0 | $43,968 | $0 | $12,671 | $0 | $30,853 | $0 | $32,668 | $0 | $386,454 | $0 | $0 | $0 |
| SUSAN GOODBODY MURRAY | ||||||||||||||
| CHIEF ENGAGEMENT OFFICER | $178,792 | $0 | $18,030 | $0 | $554 | $0 | $25,408 | $0 | $2,332 | $0 | $225,116 | $0 | $0 | $0 |
| BYRON FERNANDEZ | ||||||||||||||
| UNIT CHIEF PEDIATRICS | $292,703 | $0 | $0 | $0 | $276 | $0 | $16,928 | $0 | $35,847 | $0 | $345,754 | $0 | $0 | $0 |
| JAY SELMAN | ||||||||||||||
| CHIEF NEUROLOGY | $193,587 | $0 | $5,833 | $0 | $2,472 | $0 | $0 | $0 | $126 | $0 | $202,018 | $0 | $0 | $0 |
| KATHY SILVERMAN | ||||||||||||||
| UNIT CHIEF PEDIATRICS | $216,024 | $0 | $5,803 | $0 | $914 | $0 | $41,887 | $0 | $14,364 | $0 | $278,992 | $0 | $0 | $0 |
| MILICENT MITCHELL | ||||||||||||||
| CHIEF PULONOLOGY | $256,717 | $0 | $0 | $0 | $1,641 | $0 | $0 | $0 | $12,184 | $0 | $270,542 | $0 | $0 | $0 |
| XIAOFANG WEI | ||||||||||||||
| ATTENDING PSYCHIATRIST | $178,480 | $0 | $0 | $0 | $276 | $0 | $15,002 | $0 | $43,528 | $0 | $237,286 | $0 | $0 | $0 |
| REGINA KELLY | ||||||||||||||
| FORMER CHIEF PLANNING OFFICER | $0 | $0 | $0 | $0 | $119,051 | $0 | $0 | $0 | $0 | $0 | $119,051 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINES 4A-B | LINE 4A - DURING 2016, REGINA KELLY WAS PAID SEVERANCE IN THE AMOUNT OF $119,051 AFTER TERMINATING EMPLOYMENT ON MUTUALLY AGREED TERMS IN NOVEMBER OF 2015. LINE 4B - SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN - EFFECTIVE AS OF JANUARY 1, 2008, THE HOSPITAL IMPLEMENTED THE BLYTHEDALE CHILDREN'S HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO PROVIDE PENSION BENEFITS FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. THIS PLAN IS UNFUNDED AND A TARGET DEFINED BENEFIT PLAN. LAWRENCE LEVINE RECEIVED PAYMENTS FROM A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN DURING THE YEAR IN THE AMOUNT OF $256,383 UNDER THE TERMS OF THE BLYTHEDALE CHILDREN'S HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN FOR LAWRENCE LEVINE. EFFECTIVE AS OF JANUARY 1, 2012 THE HOSPITAL IMPLEMENTED AN ADDITIONAL SERP. THIS PLAN IS UNFUNDED AND A DEFINED CONTRIBUTION PLAN. FOR EACH PLAN YEAR THE HOSPITAL WILL MAKE A CONTRIBUTION ON BEHALF OF THE PARTICIPANT IN AN AMOUNT EQUAL TO TEN PERCENT (10%) OF THE PARTICIPANT'S BASE COMPENSATION. BOTH PLANS ARE MAINTAINED TO PROVIDE DEFERRED COMPENSATION TO A MEMBER OF A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. IN 2016, THE HOSPITAL CONTRIBUTED $58,833 TO A SERP ON BEHALF OF JOHN CANNING. IN 2016, THE ANNUAL CONTRIBUTION RATE OF THE ADDITIONAL DEFINED CONTRIBUTION SERP PLAN WAS AMENDED TO FIFTEEN PERCENT (15%) OF THE PARTICIPANT'S BASE COMPENSATION. |
| PART I, LINE 7 | BLYTHEDALE ENGAGED SULLIVAN COTTER IN 2016 TO DEVELOP AND PROVIDE RECOMMENDATIONS TO THE COMPENSATION COMMITTEE OF THE BOARD REGARDING PAYMENT OF AN ANNUAL PERFORMANCE INCENTIVE PLAN FOR EMPLOYEES WITH MANAGEMENT RESPONSIBILITIES. THIS INCENTIVE PLAN CONDITIONS PAYMENTS BASED UPON THE ACHIEVEMENT OF MULTIPLE INDIVIDUAL AND ORGANIZATIONAL MEASURES. FUNDING FOR THE PLAN IS DEPENDENT UPON ANNUAL BOARD OF TRUSTEES APPROVAL. BASED UPON THE FINANCIAL CONDITIONS TOWARD THE END OF EACH FISCAL YEAR, THE BOARD WILL EVALUATE THE APPROPRIATENESS OF ESTABLISHING A LUMP SUM POOLED AMOUNT. EVEN IF ALL RELEVANT PERFORMANCE MEASURES ARE ACHIEVED, THE BOARD OF TRUSTEES RETAINS FULL DISCRETION TO MAKE, NOT MAKE OR REDUCE THE AMOUNT OF ANY INCENTIVE AWARDS. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DORMITORY AUTHORITY OF NY (DASNY) | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 146000293 | BondIssuerEIN |
| CUSIP | 649905DG8 | CUSIPNum |
| Bond Issued | 2009-06-19 | BondIssuedDt |
| Issue Price | $27,000,000 | IssuePriceAmt |
| Purpose | CONSTRUCTION | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $3,755,000 | RetiredAmt |
| Total Proceeds | $26,748,127 | TotalProceedsAmt |
| In Reserve Fund | $83,885 | InReserveFundAmt |
| Issuance Costs From Proceeds | $540,000 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $820,868 | CreditEnhancementAmt |
| Capital Expenditures | $25,387,259 | CapitalExpendituresAmt |
| Substantial Completion | 2011 | SubstantialCompletionYr |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | 0 | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | Yes (1) | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | Yes (1) | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, COLUMN (E) & PART II, LINE 3: | THE DIFFERENCE BETWEEN THE ISSUE PRICE (PART I, COLUMN (E)) AND TOTAL PROCEEDS (PART II, LINE 3) IS DUE TO (A) AN INCREASE FOR INVESTMENT EARNINGS OF $227,835, AND (B) A DECREASE DUE TO SALE PROCEEDS OF $479,707 THAT WAS USED TO CALL AND RETIRE OUTSTANDING BONDS. |
| PART II, LINE 4: | THE AMOUNT ENTERED HERE IS A DEBT SERVICE FUND BALANCE. |
| PART IV, LINE 2C: | THE DATE OF THE COMPUTATION IS NOT KNOWN BY BLYTHEDALE CHILDREN'S HOSPITAL. ARBITRAGE REPORTING IS HANDLED BY THE ACTUAL ISSUER OF THE BONDS, AND BLYTHEDALE CHILDREN'S HOSPITAL DOES NOT HAVE A COPY OF THE ACTUAL REBATE REPORT. |
| PART IV, LINE 6: | SUCH AMOUNTS WERE APPROPRIATELY YIELD RESTRICTED. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| SUBSTANTIAL CONTRIBUTOR | |||
| SUBSTANTIAL CONTRIBUTOR | $5,370,193 | PROFESSIONAL SERVICES | 0 |
| SUBSTANTIAL CONTRIBUTOR | |||
| SUBSTANTIAL CONTRIBUTOR | $3,218,946 | PROFESSIONAL SERVICES | 0 |
| SUBSTANTIAL CONTRIBUTOR | |||
| SUBSTANTIAL CONTRIBUTOR | $460,000 | PROFESSIONAL SERVICES | 0 |
| SUBSTANTIAL CONTRIBUTOR | |||
| SUBSTANTIAL CONTRIBUTOR | $325,514 | PROFESSIONAL SERVICES | 0 |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 14 | ContributionCnt |
| Noncash Contributions Rpt F990 | $169,613 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST/SELLING PRICE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE AMOUNT REPORTED IN COLUMN (B) REFERS TO THE NUMBER OF CONTRIBUTIONS RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | BLYTHEDALE OPENED UP THE 24 BED STEVEN AND ALEXANDRA COHEN PEDIATRIC LONG TERM CARE UNIT IN SEPTEMBER OF 2016. |
| FORM 990, PART III, LINE 4A | INPATIENT SERVICES - BLYTHEDALE CHILDREN'S HOSPITAL, FOUNDED IN 1891, IS A LICENSED ACUTE CARE FREE-STANDING CHILDREN'S HOSPITAL THAT SPECIALIZES IN THE CARE OF CHILDREN REQUIRING REHABILITATIVE, RESPIRATORY AND COMPLEX MEDICAL CARE. BLYTHEDALE IS DESIGNATED BY CMS AS A PPS EXEMPT, FREESTANDING CHILDREN'S HOSPITAL. WITHIN BLYTHEDALE CHILDREN'S HOSPITAL, WE PROVIDE A COMPREHENSIVE RANGE OF SERVICES WHICH INCLUDE BUT ARE NOT LIMITED TO GENERAL PEDIATRICS, ADOLESCENT MEDICINE, PEDIATRIC PULMONOLOGY, CHILD NEUROLOGY, PSYCHIATRY, ORTHOPEDICS, PHYSICAL MEDICINE, AND REHABILITATION OF MULTIPLE PEDIATRIC SPECIALTIES (SUCH AS CARDIOLOGY, INFECTIOUS DISEASE, ENT, OPHTHALMOLOGY, ETC.) BLYTHEDALE MAINTAINS A CORE GROUP OF FULL TIME SPECIALTY COVERAGE IN PEDIATRICS, PULMONOLOGY, ADOLESCENT MEDICINE, NEUROLOGY, AND PSYCHIATRY. OTHER SUBSPECIALTY COVERAGE IS MAINTAINED AND UTILIZED AS NEEDED THROUGH A VARIETY OF CONTRACTUAL RELATIONSHIPS WITH THE AREA'S LEADING ACADEMIC MEDICAL CENTERS. BLYTHEDALE ALSO PROVIDES OTHER VITAL CLINICAL SERVICES SUCH AS NURSING, RESPIRATORY THERAPY, PSYCHOLOGY, CHILD LIFE, RESPIRATORY, SPEECH, OCCUPATIONAL AND PHYSICAL THERAPY, THERAPEUTIC RECREATION, SOCIAL WORK AND CASE MANAGEMENT. THE INPATIENT SERVICES ARE PRIMARILY COMPOSED OF 4 MAJOR PROGRAMS, PHYSICAL MEDICINE AND REHABILITATION SERVICES, VENTILATOR WEANING, TRAUMATIC BRAIN INJURY AND MEDICAL THERAPIES FOR COMPLEX AND CHRONIC HEALTH CONDITIONS. THE HOSPITAL OPERATES 86 LICENSED ACUTE BEDS AND PROVIDED CARE TO OVER 75 INPATIENTS PER DAY ON AVERAGE IN 2016. THE HOSPITAL RECEIVED OVER 850 REGIONAL REFERRALS IN THE YEAR AND ADMITTED 628 KIDS. OVER 71% OF OUR INPATIENT ADMISSIONS WERE REIMBURSED THROUGH THE MEDICAID PROGRAM (FFS & MANAGED) IN 2016. WHILE 100% OF THE HOSPITALS INPATIENT POPULATION IS REFERRED IN FROM OTHER ACUTE CARE HOSPITALS IN THE REGION, OVER >45% COME DIRECTLY FROM INTENSIVE CARE UNITS (ICU'S). THIS SPEAKS TO THE HIGH ACUITY OF THE PATIENT POPULATION BEING MANAGED AT BLYTHEDALE. IN 2016 ALMOST 60% OF PATIENTS TREATED WERE BELOW THE AGE OF 4 YEARS. THIS FACT PRESENTS MANY UNIQUE CHALLENGES TO THE DELIVERY OF CARE AS THE HOSPITAL PROVIDES HIGH QUALITY TO BOTH THE PATIENTS AND THE FAMILY. BLYTHEDALE CHILDREN'S HOSPITAL DOESN'T OPERATE PRIMARY CARE CLINICS, OR AN EMERGENCY DEPARTMENT OR OBSTETRICAL SERVICES. THESE SERVICES ARE OFTEN THE PRIMARY DRIVERS OF UNINSURED PATIENTS AT ACUTE CARE HOSPITALS. SECONDLY, CHILDREN, MORE SO THAN ADULTS HAVE GREATER ACCESS TO MEDICAID REIMBURSEMENT AS A PAYER OF LAST RESORT BECAUSE OF STATE CHILD HEALTH PLUS LAWS. THESE TWO FACTORS SIGNIFICANTLY IMPACT THE REPORTED AMOUNT OF CARE CLASSIFIED AS TRUE CHARITY CARE RELATIVE TO FULL SERVICE ACUTE CARE HOSPITALS. |
| FORM 990, PART III, LINE 4B, DESCRIPTION OF PROGRAM SERVICE: | DAY HOSPITAL PROGRAM - BLYTHEDALE OFFERS A DAY HOSPITAL PROGRAM FOR THOSE CHILDREN WHO ARE ABLE TO LIVE AT HOME, BUT STILL REQUIRE A LEVEL OF MEDICAL AND REHABILITATIVE CARE THAT CANNOT BE MET BY THEIR SCHOOL OR OUTPATIENT PROGRAM. IN 2016, BLYTHEDALE ADMITTED 136 CHILDREN TO THE PROGRAM. 60 % OF THE PROGRAM COMES DIRECTLY FROM BLYTHEDALE'S INPATIENT SETTING, WHILE THE BALANCE COME DIRECTLY FROM REFERRALS IN THE COMMUNITY AND THROUGH THE EARLY INTERVENTION/CPSE PROGRAMS THROUGHOUT THE REGION. IN 2016, THE PROGRAM SERVED ON AVERAGE OF 92 PATIENTS PER SCHOOL DAY FOR A TOTAL OF 20,060 VISITS. OVER 82% OF THESE PATIENTS WERE REIMBURSED BY THE MEDICAID PROGRAM. THE DAY HOSPITAL PROGRAM PROVIDES A NURTURING ENVIRONMENT WHERE CHILDREN WITH VARIOUS SPECIAL MEDICAL NEEDS CAN RECEIVE DAILY MEDICAL SUPERVISION, NURSING CARE, AND HAVE THEIR NEEDS FOR PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES MET, ALL WHILE RETURNING HOME AT THE END OF THE DAY. EACH CHILD'S PROGRAM IS INDIVIDUALIZED TO ADDRESS THEIR UNIQUE MEDICAL, PSYCHOLOGICAL AND THERAPEUTIC NEEDS. IN ADDITION, EVERY CHILD IS ASSIGNED A SOCIAL WORKER TO PROVIDE FAMILY SUPPORT AND CASE MANAGEMENT. AS NECESSARY, ONGOING PSYCHOSOCIAL SUPPORT AND COUNSELING, AND CASE MANAGEMENT ARE PROVIDED. SERVICES FOR SCHOOL-AGE CHILDREN ARE PROVIDED IN CONJUNCTION WITH A FULL ACADEMIC PROGRAM UNDER THE AUSPICES OF THE MOUNT PLEASANT-BLYTHEDALE UNION FREE SCHOOL DISTRICT. COMMITTEE ON PRESCHOOL SPECIAL EDUCATION (CPSE PROGRAM): BLYTHEDALE CHILDREN'S HOSPITAL PROVIDES EVALUATION AND TREATMENT SERVICES FOR YOUNG CHILDREN BETWEEN THE AGES OF 3 TO 5 YEARS WHO ARE REFERRED THROUGH THEIR LOCAL COMMITTEE ON PRESCHOOL SPECIAL EDUCATION (CPSE). THESE PATIENTS ARE ELIGIBLE FOR ASSESSMENT AT NO COST TO THEIR FAMILIES. THE NEW YORK STATE EDUCATION DEPARTMENT OVERSEES A STATEWIDE PRESCHOOL SPECIAL EDUCATION PROGRAM WITH SCHOOL DISTRICTS, MUNICIPALITIES, APPROVED PROVIDERS, AND PARENTS. EVALUATIONS AND SERVICES ARE PROVIDED TO ELIGIBLE CHILDREN WHO HAVE A DISABILITY THAT AFFECTS THEIR LEARNING. FUNDING FOR EVALUATIONS AND SERVICES IS PROVIDED BY MUNICIPALITIES AND THE STATE. IN 2016, THE PROGRAM SERVED ON AVERAGE OF 20 PATIENTS PER SCHOOL DAY FOR A TOTAL OF 3,972 VISITS. EVALUATION AND TREATMENT PLANNING ARE PERFORMED BY A MULTIDISCIPLINARY TEAM THAT MAY CONSIST OF THERAPISTS, SPECIAL EDUCATION TEACHERS, AUDIOLOGISTS, PHYSIATRISTS (REHABILITATION DOCTORS), NEUROLOGISTS, PSYCHIATRISTS, PSYCHOLOGISTS, SOCIAL WORKERS, NURSES, NUTRITIONISTS, AND OTHER SPECIALTY CONSULTANTS. AT BLYTHEDALE, WE PROVIDE INDIVIDUALIZED RELATED SERVICES TO ELIGIBLE CHILDREN AGE'S THREE TO FIVE THROUGH OUR OUTPATIENT DEPARTMENT. WE SERVE CHILDREN WITH A WIDE RANGE OF NEEDS INCLUDING DIFFICULTIES THAT MAY INTERFERE WITH THEIR LEARNING AND FUNCTIONING IN PRESCHOOL. CHILDREN WITH THE FOLLOWING DIFFICULTIES ARE MOST COMMON IN THE PROGRAM: - DELAYS OR LAGS IN COGNITIVE, LANGUAGE, MOTOR OR SOCIAL EMOTIONAL DEVELOPMENT - CONGENITAL OR ACQUIRED ABNORMALITIES - DIAGNOSED MEDICAL CONDITIONS SUCH AS CEREBRAL PALSY, NEUROMUSCULAR OR OTHER NEUROLOGICAL DISORDERS |
| FORM 990, PART III, LINE 4C, DESCRIPTION OF PROGRAM SERVICE: | THE STEVEN AND ALEXANDRA COHEN PEDIATRIC LONG TERM CARE PAVILION, WHICH OPENED IN FALL 2016, IS A UNIQUE 24-BED FACILITY DEDICATED TO THE HIGHLY SPECIALIZED NEEDS OF INFANTS AND CHILDREN WHO REQUIRE EXTENDED MEDICAL CARE AND REHABILITATION. THE PAVILION SERVES CHILDREN WITH COMPLEX MEDICAL NEEDS, INCLUDING THOSE WHO REQUIRE A LONGER PERIOD OF TIME TO BE WEANED FROM THE VENTILATOR, AND PREMATURE INFANTS WITH FEEDING DIFFICULTIES, CONGENITAL CONDITIONS OR NEUROLOGICAL DISORDERS. THE PAVILION IS STAFFED BY A FULL-TIME PEDIATRICIAN WHO WORKS IN CONSULTATION WITH A VARIETY OF PEDIATRIC SUBSPECIALISTS INCLUDING PEDIATRIC PULMONOLOGY, PEDIATRIC PHYSICAL MEDICINE AND REHABILITATION, AND PEDIATRIC NEUROLOGY. THE COMPREHENSIVE TEAM ALSO INCLUDE REGISTERED NURSES, CERTIFIED RESPIRATORY THERAPISTS, PHYSICAL/OCCUPATIONAL/SPEECH THERAPISTS, RECREATIONAL THERAPISTS, CHILD PSYCHOLOGISTS, CHILD LIFE SPECIALISTS AND A DEDICATED SOCIAL WORKER. FEATURES OF THE NEW PAVILION INCLUDE 11 DOUBLE-BEDDED ROOMS AND TWO PRIVATE ROOMS, ALL WITH PIPED-IN OXYGEN, A SPACIOUS DINING AND RECREATION AREA, DEDICATED THERAPY SPACE, AN INFANT PLAY ROOM AND TEEN LOUNGE. AN ATTRACTIVE COURTYARD INCLUDES PLAY AREAS, WALKING PATHS AND SITTING AREAS FOR RESIDENTS AND THEIR FAMILIES. CHILDREN IN THE PEDIATRIC LONG TERM CARE UNIT HAVE ACCESS TO EDUCATION THROUGH THE ON-SITE MT. PLEASANT-BLYTHEDALE SCHOOL AND EARLY CHILDHOOD CENTER, AND RECREATIONAL PROGRAMMING ON EVENINGS, WEEKENDS AND HOLIDAYS. FAMILY INVOLVEMENT IS A KEY COMPONENT OF CARE AT BLYTHEDALE, AND PROGRESS TOWARD GOALS (ESTABLISHED UPON ADMISSION) WILL BE REVIEWED DURING PERIODIC FAMILY CONFERENCES. AN INTERDISCIPLINARY APPROACH TO TREATMENT IS A HALLMARK OF BLYTHEDALE, AND EACH PATIENT'S CLINICAL CARE TEAM WILL MEET EVERY TWO WEEKS TO DISCUSS THE INDIVIDUALIZED PLAN FROM EVERY PERSPECTIVE: MEDICAL, SOCIAL, PSYCHOLOGICAL AND EDUCATIONAL. |
| FORM 990, PART VI, SECTION A, LINE 2 | JOHN FURTH AND OWEN GUTFREUND (BOARD MEMBERS) HAVE A FAMILY RELATIONSHIP. DAVID PEDOWITZ HAS A BUSINESS RELATIONSHIP WITH PATRICIA STANLEY, LARRY COHEN, AND PEGGY TANNER (BOARD MEMBERS, AND FORMER BOARD MEMBER, RESPECTIVELY). FRANK STERN HAS A BUSINESS RELATIONSHIP WITH BOTH DAVID PEDOWITZ AND JOHN BARKER (BOARD MEMBERS). |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 IS PROVIDED TO EACH MEMBER OF THE BLYTHEDALE CHILDREN'S HOSPITAL'S BOARD OF TRUSTEES PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE. THE FORM 990 IS REVIEWED BY THE BLYTHEDALE FINANCE DEPARTMENT AS WELL AS BY DELOITTE TAX, LLP, BEFORE IT IS PRESENTED TO THE BOARD'S EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE THEN PROVIDES AN OVERVIEW OF THE FORM 990 TO THE FULL BOARD OF TRUSTEES. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS, SENIOR MANAGEMENT AND KEY EMPLOYEES OF BLYTHEDALE CHILDREN'S HOSPITAL MUST COMPLETE A STATEMENT ANNUALLY AND WHENEVER NEW INFORMATION ARISES, WHICH DISCLOSES ANY POTENTIAL CONFLICT OF INTEREST, AS REQUIRED BY THE HOSPITAL'S CONFLICT OF INTEREST POLICY. THESE STATEMENTS ARE REVIEWED BY THE HOSPITAL'S COMPLIANCE OFFICER WHO PREPARES A REPORT ON DISCLOSURES FOR THE BOARD'S EXECUTIVE COMMITTEE. HOSPITAL BOARD MEMBERS AND STAFF ARE TRAINED AND EDUCATED ON THEIR OBLIGATIONS UNDER THIS POLICY, INCLUDING ITS GIFT AND GRATUITIES PROVISIONS. |
| FORM 990, PART VI, SECTION B, LINE 15 | BLYTHEDALE CHILDREN'S HOSPITAL MAINTAINS A DILIGENT, THOROUGH AND TRANSPARENT PROCESS TO EVALUATE EXECUTIVE COMPENSATION. ON AN ANNUAL BASIS, BLYTHEDALE FORMALLY ENGAGES SULLIVAN, COTTER AND ASSOCIATES TO PROVIDE THE COMPENSATION COMMITTEE WITH A COMPLETE TOTAL COMPENSATION STUDY OF ALL ELEMENTS OF EXECUTIVE COMPENSATION. THIS IS DONE TO ENSURE THE OVERALL REASONABLENESS OF THE TOTAL COMPENSATION PROVIDED TO ITS CHIEF EXECUTIVE OFFICER AND ALL OTHER CHIEF OFFICERS. IN ADDITION, BLYTHEDALE ALSO ENGAGES SULLIVAN, COTTER AND ASSOCIATES TO REVIEW BOTH THE NATIONAL AND REGIONAL HEALTHCARE MARKETPLACE TO DETERMINE ANNUAL BASE PAY INCREASE PROJECTIONS FOR ALL MAIN EMPLOYEE CATEGORIES INCLUDING EXECUTIVES. SULLIVAN, COTTER AND ASSOCIATES IS A WELL REGARDED COMPENSATION CONSULTING FIRM WITH REGIONAL AND NATIONAL EXPERTISE. THE FIRM COMPARES BLYTHEDALE'S EXECUTIVE COMPENSATION TO A PRIMARY COMPARATOR MARKET OF SIMILARLY SITUATED ORGANIZATIONS THAT INCLUDES REGIONAL CHILDREN'S AND REHABILITATION NOT-FOR-PROFIT HOSPITALS; NOT-FOR-PROFIT HOSPITALS IN THE METROPOLITAN NEW YORK AREA; AND NOT-FOR-PROFIT HOSPITALS IN THE HUDSON VALLEY REGION. THE PRIMARY COMPARATOR MARKET REFLECTS THE ORGANIZATION'S EXECUTIVE RECRUITMENT AND RETENTION MARKET AND COMPLIES WITH THE DEFINITION OF "COMPARABLE ORGANIZATIONS AS SET FORTH IN THE IRS INTERMEDIATE SANCTIONS REGULATIONS. IN NOVEMBER 2016, SULLIVAN, COTTER AND ASSOCIATES PROVIDED TO THE BOARD'S COMPENSATION COMMITTEE AN ASSESSMENT OF THE COMPETITIVENESS OF THE TOTAL COMPENSATION PROVIDED TO BLYTHEDALE'S EXECUTIVES RELATIVE TO PREVALENT AND COMPARABLE MARKETPLACE PRACTICES. FURTHERMORE, SULLIVAN COTTER ASSISTED THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES IN REVIEWING BLYTHEDALE'S EXECUTIVE COMPENSATION PHILOSOPHY STATEMENT AND REVIEWED THE RANGES FOR INCENTIVE COMPENSATION AWARDS FOR THE CEO AND OTHER EXECUTIVES. IN ADDITION TO ANALYZING THE DATA PROVIDED BY SULLIVAN, COTTER AND ASSOCIATES, THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES CONSIDERS A NUMBER OF FACTORS WHEN REVIEWING AND ESTABLISHING COMPENSATION FOR THE CEO AND ALL OTHER CHIEF OFFICERS INCLUDING BUT NOT LIMITED TO THE FOLLOWING: DEVELOPMENT OF NEW PROGRAMS; MOBILIZING THE HOSPITAL TO STRIVE FOR EXCELLENT RESULTS IN PATIENT CARE; MANAGEMENT PERFORMANCE AND COMPLIANCE WITH ALL PROFESSIONAL AND REGULATORY STANDARDS; AND INITIATIVES AND FACILITIES TO SUPPORT AND ADVANCE BLYTHEDALE'S MISSION WHILE EFFECTIVELY ALLOCATING AND MANAGING THE HOSPITAL'S RESOURCES. BY REVIEWING THE COMPENSATION DATA FROM INDEPENDENT SOURCES FOR FUNCTIONALLY COMPARABLE POSITIONS IN ORGANIZATIONS COMPARABLE TO BLYTHEDALE AND BY ANALYZING THE INTERNAL PERFORMANCE DATA, THE COMPENSATION COMMITTEE DETERMINES THAT IT PROVIDES A "REBUTTABLE PRESUMPTION OF REASONABLENESS" THAT THE TOTAL COMPENSATION PROVIDED TO BLYTHEDALE EXECUTIVES IS REASONABLE AND CONSISTENT WITH MARKET PRACTICES. IN DECEMBER 2016, WITHOUT INPUT OR VOTING PARTICIPATION BY THE INDIVIDUALS WHOSE COMPENSATION WAS APPROVED, THE COMPENSATION COMMITTEE APPROVED INCENTIVE COMPENSATION AWARDS FOR THE CEO AND EXECUTIVE MANAGEMENT TEAM AND APPROVED THE PROPOSED 2017 EXECUTIVE BASE COMPENSATION. THE FINAL DETERMINATION OF THE COMMITTEE WAS DOCUMENTED AND AN OVERVIEW WAS PROVIDED TO THE FULL BOARD OF TRUSTEES TO ENSURE FULL DISCLOSURE AND TRANSPARENCY OF EXECUTIVE COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | BLYTHEDALE CHILDREN'S HOSPITAL MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC BY RETAINING A COPY OF EACH AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. THE ORGANIZATION' S FORM 990 IS ALSO AVAILABLE FOR PUBLIC INSPECTION ON WWW.GUIDESTAR.ORG. THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION. |
| FORM 990, PART XI, LINE 9: | CHANGE IN PENSION LIABILITY 404,950. WRITE OFF OF PLEDGES -234,912. ROUNDING -111. |