AUBURN COMMUNITY HOSPITAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- AUBURN COMMUNITY HOSPITAL (EIN 15-0532054)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-14
- IRS object ID
- 201743189349308984
- 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 D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-14T15:38:14-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161226221 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUST CHARLES CHAMBERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5784 WIDEWATERS PARKWAY | AddressLine1Txt |
| City | SYRACUSE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13214 | 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 | 150532054 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUBURN COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AUBU | BusinessNameControlTxt |
| Phone | 3152557011 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LANSING STREET | AddressLine1Txt |
| City | AUBURN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13021 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON LESCH | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 3152557011 | PhoneNum |
| Signature | 2017-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DEBORAH STUCK | PreparerPersonNm |
| PTIN | P01281391 | PTIN |
| Phone | 3154463600 | PhoneNum |
| Preparation | 2017-11-10 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 24.39.85.114 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-14 | IPDt |
| IP Tm | 13:30:38 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 517AEBE328CBAAA90E396C2FD1060AA56161F780 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 315614A2A569D91B0F4A84342C1D145A8997199D | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JASON LESCH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LANSING STREET | AddressLine1Txt |
| City | AUBURN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13021 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $108,924,082 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AUBURNHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1878 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF AUBURN COMMUNITY HOSPITAL IS TO PROVIDE COMPASSIONATE, QUALITY CARE AND IMPROVE THE HEALTH OF OUR COMMUNITY INCLUDING RESIDENTS OF AUBURN, NY AS WELL AS SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1080 | TotalEmployeeCnt |
| Total Volunteers | 102 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,302,996 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,855,124 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $98,384,891 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $102,819,990 | CYProgramServiceRevenueAmt |
| PY Investment Income | $27,928 | PYInvestmentIncomeAmt |
| CY Investment Income | $21,180 | CYInvestmentIncomeAmt |
| PY Other Revenue | $700,122 | PYOtherRevenueAmt |
| CY Other Revenue | $1,227,788 | CYOtherRevenueAmt |
| PY Total Revenue | $100,415,937 | PYTotalRevenueAmt |
| CY Total Revenue | $108,924,082 | 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 | $54,806,283 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $55,622,814 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $52,640 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $39,938,631 | PYOtherExpensesAmt |
| CY Other Expenses | $41,507,498 | CYOtherExpensesAmt |
| PY Total Expenses | $94,744,914 | PYTotalExpensesAmt |
| CY Total Expenses | $97,130,312 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,671,023 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $11,793,770 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $70,750,707 | TotalAssetsBOYAmt |
| Total Assets EOY | $80,850,691 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,830,292 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,174,670 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $37,920,415 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $49,676,021 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OUR MISSION IS TO PROVIDE COMPASSIONATE, QUALITY CARE AND IMPROVE THE HEALTH OF OUR COMMUNITY INCLUDING AUBURN, NY AS WELL AS SURROUNDING AREAS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $84,777,045 | ExpenseAmt |
| Revenue | $104,047,778 | RevenueAmt |
| Desc | THE PURPOSE OF AUBURN COMMUNITY HOSPITAL IS TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITY BY PROVIDING NECESSARY INPATIENT AND OUTPATIENT SERVICES. TO THAT END, THE HOSPITAL TREATED 5,648 INPATIENTS FOR A TOTAL OF 51,036 PATIENT DAYS AND A TOTAL OF 144,214 OUTPATIENTS IN 2016. | Desc |
| Total Program Service Expenses | $84,777,045 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 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 | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 151 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1080 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 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 | JASON LESCH CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3152557231 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LANSING STREET | AddressLine1Txt |
| City | AUBURN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13021 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JOSEPH RUNKLE | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PATSY IANNOLO MD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL BRADY DDS | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN RICCIO MD | ||||||||
| TRUSTEE | 20.00 | Yes (X) | $128,301 | $0 | $5,946 | 5.00 | ||
| LISA RYERSON | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHRISTINE CUFF | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ELANE DALY | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DEMETRA VOUNAS MD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $272,873 | $24,458 | 40.00 | ||
| ERIC R ALLYN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | 2.00 | ||
| JOSEPH BARTOLOTTA | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ANTHONY D FRANCESCHELLI | ||||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| WILLIAM DORR | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JD PABIS | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CARL WEISS MDPHD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SCOTT BERLUCCHI | ||||||||
| PRESIDENT & CEO | 25.00 | $436,986 | $0 | $25,451 | 13.00 | Yes (X) | ||
| JASON LESCH | ||||||||
| CHIEF FINANCIAL OFFICER | 31.00 | $228,142 | $0 | $12,201 | 7.00 | Yes (X) | ||
| TAMARA BENYASHVILI | ||||||||
| HOSPITALIST | 38.00 | $370,284 | $0 | $9,282 | Yes (X) | |||
| KHAWAJA KASHIF | ||||||||
| HOSPITALIST | 38.00 | $332,300 | $0 | $12,201 | Yes (X) | |||
| NYLA MALIK | ||||||||
| HOSPITALIST | 38.00 | $329,831 | $0 | $14,943 | Yes (X) | |||
| JOSEPH APONE | ||||||||
| HOSPITALIST | 38.00 | $280,739 | $0 | $18,896 | Yes (X) | |||
| SHEHZAD KHIZAR | ||||||||
| HOSPITALIST | 38.00 | $216,138 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,322,721 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $272,873 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $123,378 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 32 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EASTERN FINGERLAKES EMERGENCY | |||||
| PO BOX 346 5180 WEST TAFT RD | NORTH SYRACUSE | NY | 13212 | EMERGENCY ROOM PHYSICIANS | $1,561,391 |
| SYRACUSE PSYCHIATRIC SERVICE LLC | |||||
| 109 SOUTH WARREN STREET | SYRACUSE | NY | 13202 | PSYCHIATRIC PHYSICIANS | $688,167 |
| AUBURN MEDICAL BUILDING | |||||
| 77 NELSON STREET | AUBURN | NY | 13021 | OFFICE SPACE RENTAL | $304,629 |
| ALLIANCE HEALTHCARE SERVICES | |||||
| 100 BAYVIEW CIRCLE SUITE 400 | NEWPORT BEACH | CA | 92660 | MRI SERVICES | $260,774 |
| RAMA M GODISHALA | |||||
| 281 GRANT AVENUE SUITE 4 | AUBURN | NY | 13021 | PHYSICIAN SERVICES | $228,734 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $754,750 | RelatedOrganizationsAmt |
| Government Grants | $3,734,711 | GovernmentGrantsAmt |
| All Other Contributions | $365,663 | AllOtherContributionsAmt |
| Total Contributions | $4,855,124 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE | 623000 | $101,928,948 | $101,928,948 |
| VA CLINIC SERVICE | 623000 | $891,042 | $891,042 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $102,819,990 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,882 | TotalRevenueColumnAmt |
| Exclusion | $18,882 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,298 | TotalRevenueColumnAmt |
| Exclusion | $2,298 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OTHER REVENUE | 623000 | $954,791 | $954,791 |
| DIETARY INCOME | 623000 | $272,997 | $272,997 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,227,788 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $108,924,082 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $104,047,778 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $21,180 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $837,027 | TotalAmt |
| Program Services | $134,247 | ProgramServicesAmt |
| Management And General | $702,780 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,393,891 | TotalAmt |
| Program Services | $37,315,877 | ProgramServicesAmt |
| Management And General | $5,037,101 | ManagementAndGeneralAmt |
| Fundraising | $40,913 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,135,947 | TotalAmt |
| Program Services | $1,843,698 | ProgramServicesAmt |
| Management And General | $290,228 | ManagementAndGeneralAmt |
| Fundraising | $2,021 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,127,995 | TotalAmt |
| Program Services | $6,152,712 | ProgramServicesAmt |
| Management And General | $968,537 | ManagementAndGeneralAmt |
| Fundraising | $6,746 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,127,954 | TotalAmt |
| Program Services | $2,699,974 | ProgramServicesAmt |
| Management And General | $425,020 | ManagementAndGeneralAmt |
| Fundraising | $2,960 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,432 | TotalAmt |
| Management And General | $221,432 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,107 | TotalAmt |
| Management And General | $34,107 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $336,876 | TotalAmt |
| Program Services | $299,984 | ProgramServicesAmt |
| Management And General | $36,892 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,930,296 | TotalAmt |
| Program Services | $5,280,851 | ProgramServicesAmt |
| Management And General | $649,445 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,104 | TotalAmt |
| Program Services | $57,974 | ProgramServicesAmt |
| Management And General | $7,130 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $229,947 | TotalAmt |
| Program Services | $204,765 | ProgramServicesAmt |
| Management And General | $25,182 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $428,878 | TotalAmt |
| Program Services | $428,878 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,685,480 | TotalAmt |
| Program Services | $3,685,480 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,561,013 | TotalAmt |
| Program Services | $784,052 | ProgramServicesAmt |
| Management And General | $776,961 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $12,654,224 | $11,268,420 | $1,385,804 |
| PURCHASED SERVICES | $8,998,853 | $8,013,361 | $985,492 |
| BAD DEBT | $4,438,275 | $4,438,275 | |
| PHYSICIAN FEES | $1,816,622 | $1,816,622 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,106,391 | TotalAmt |
| Program Services | $351,875 | ProgramServicesAmt |
| Management And General | $754,516 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,130,312 | TotalAmt |
| Program Services | $84,777,045 | ProgramServicesAmt |
| Management And General | $12,300,627 | ManagementAndGeneralAmt |
| Fundraising | $52,640 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,937,424 | BOYAmt |
| EOY | $5,762,375 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,100,067 | BOYAmt |
| EOY | $10,611,180 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,269,250 | BOYAmt |
| EOY | $34,413,322 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,960,463 | BOYAmt |
| EOY | $2,869,252 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $901,898 | BOYAmt |
| EOY | $658,318 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $97,622,144 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $74,127,319 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,688,929 | BOYAmt |
| EOY | $23,494,825 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,892,676 | BOYAmt |
| EOY | $3,041,419 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,750,707 | BOYAmt |
| EOY | $80,850,691 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,660,874 | BOYAmt |
| EOY | $17,723,009 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,652,759 | BOYAmt |
| EOY | $12,880,015 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $516,659 | BOYAmt |
| EOY | $571,646 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,830,292 | BOYAmt |
| EOY | $31,174,670 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,540,720 | BOYAmt |
| EOY | $49,569,663 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $379,695 | BOYAmt |
| EOY | $106,358 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,920,415 | BOYAmt |
| EOY | $49,676,021 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,750,707 | BOYAmt |
| EOY | $80,850,691 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $11,793,770 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $35 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$38,199 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $379,695 | BeginningYearBalanceAmt |
| Contributions | $805,955 | ContributionsAmt |
| Other Expenditures | $1,079,292 | OtherExpendituresAmt |
| End Year Balance | $106,358 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $516,635 | BeginningYearBalanceAmt |
| Contributions | $470,553 | ContributionsAmt |
| Other Expenditures | $607,493 | OtherExpendituresAmt |
| End Year Balance | $379,695 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $132,068 | BeginningYearBalanceAmt |
| Contributions | $915,275 | ContributionsAmt |
| Other Expenditures | $530,708 | OtherExpendituresAmt |
| End Year Balance | $516,635 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $90,347 | BeginningYearBalanceAmt |
| Contributions | $352,670 | ContributionsAmt |
| Other Expenditures | $310,949 | OtherExpendituresAmt |
| End Year Balance | $132,068 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $72,372 | BeginningYearBalanceAmt |
| Contributions | $120,842 | ContributionsAmt |
| Other Expenditures | $102,867 | OtherExpendituresAmt |
| End Year Balance | $90,347 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | 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 | $823,418 | OtherCostOrOtherBasisAmt |
| Book Value | $823,418 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,245,385 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,675,000 | DepreciationAmt |
| Book Value | $12,570,385 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,581,882 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,509,652 | DepreciationAmt |
| Book Value | $72,230 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $57,642,736 | OtherCostOrOtherBasisAmt |
| Depreciation | $48,942,667 | DepreciationAmt |
| Book Value | $8,700,069 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,328,723 | OtherCostOrOtherBasisAmt |
| Book Value | $1,328,723 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $23,494,825 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| FUNDS HELD FOR OTHERS | $188,938 |
| ASSET RETIREMENT OBLIGATION - ASBESTOS | $382,708 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $571,646 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL, EXCEPT FOR AMPC, QUALIFIES AS TAX EXEMPT ORGANIZATIONS. AS OF DECEMBER 31, 2016 AND 2015, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2013 THROUGH 2016. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $300,610 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $300,610 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00320 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,649,408 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,258,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,391,408 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04740 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,950,018 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,258,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,692,018 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05060 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,950,018 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,258,000 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,692,018 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05060 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,438,275 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $300,610 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $39,696,448 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $40,722,542 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$1,026,094 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUBURN COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LANSING STREET | AddressLine1Txt |
| City | AUBURN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13021 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUBURN COMMUNITY 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 | 0 | CHNAConductedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| 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.AUBURNHOSPITAL.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | AUBURN COMMUNITY HOSPITAL | FormAndLineReferenceDesc |
| Explanation | PART V, SECTION B, LINE 11: DURING 2016, AUBURN COMMUNITY HOSPITAL PREPARED A 2016 THROUGH 2018 COMMUNITY HEALTH ASSESSMENT, IMPROVEMENT AND COMMUNITY SERVICE PLAN WITH THE INTENTIONS OF ADDRESSING IDENTIFIED ISSUES IN CAYUGA COUNTY AS WELL AS SURROUNDING AREAS WITH THE AID OF THE CAYUGA COUNTY HEALTH DEPARTMENT THAT WOULD SATISFY THE REQUIREMENTS OF THE COMMUNITY HEALTH NEEDS ASSESSMENT. WITHIN THE DOCUMENT, WHICH IS LOCATED IN THE ABOUT US SECTION ON WWW.AUBURNHOSPITAL.ORG, WE ADDRESS ALL AREAS DESCRIBED IN SECTION B QUESTION 3 OF THE CHNA SECTION ON SCHEDULE H OF THE 990. A DEFINITION OF THE COMMUNITY SERVED BY THE HOSPITAL FACILITY AS WELL AS THE COMMUNITY DEMOGRAPHICS ARE LISTED IN QUESTION 1 OF THE REPORT SECTION. THE REPORT ALSO ADDRESSES THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY, INCLUDING PRIMARY AND CHRONIC DISEASE NEEDS AND OTHER HEALTH ISSUES OF LOW INCOME PERSONS. BEGINNING ON PAGE 12 OF THE REPORT, PRIORITY AREAS ARE IDENTIFIED AND OBJECTIVES ON HOW TO MEET THESE PRIORITY AREAS ARE LISTED BELOW EACH GOAL. AUBURN COMMUNITY HOSPITAL'S COLLABORATION WITH THE CAYUGA COUNTY HEALTH DEPARTMENT ENSURES THAT THE COMMUNITY'S INTERESTS ARE REPRESENTED. THE IMPACT OF PREVIOUS ACTIONS TAKEN IS STILL BEING ASSESSED THROUGH MEETINGS WITH THE CAYUGA COUNTY HEALTH DEPARTMENT AS WELL AS THE UNITY HOUSE, AND CAYUGA COMMUNITY HEALTH NETWORK. THE INTENT OF THE REPORT WAS IN PART TO SATISFY FEDERAL CHNA REQUIREMENTS. HOWEVER, IT WAS NOTED IN 2017 DURING THE PREPARATION OF THE 2016 990 THAT NOT ALL OFF THE REQUIRED STEPS WERE COMPLETED TO QUALIFY THE CURRENT CHNA AS IRS 501R ACCEPTABLE. THE MAJOR ISSUES IDENTIFIED INCLUDED THE LACK OF APPROVAL AND ADOPTION BY THE GOVERNING BOARD AND THE ADOPTION OF THE IMPLEMENTATION STRATEGY TO MEET THE SIGNIFICANT COMMUNITY HEALTH NEEDS. UPON THIS DETERMINATION, AUBURN COMMUNITY HOSPITAL IMMEDIATELY IMPLEMENTED A REVIEW AND CORRECTIVE ACTION PLAN OF THE CURRENTLY INTENDED CHNA. ACH IS CURRENTLY WORKING ON A CORRECTED CHNA THAT WILL SATISFY THE AFFORDABLE CARE ACT 501R REQUIREMENTS FOR IMMEDIATE IMPLEMENTATION. | ExplanationTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - FINGER LAKES CENTER FOR LIVING | ||||
| 20 PARK AVENUE | AUBURN | NY | 13021 | SHORT-TERM REHABILITATION AND LONG-TERM RESIDENTIAL CARE CENTER |
| 2 - FINGER LAKES MEDICAL CARE CENTER | ||||
| 303 GRANT AVENUE | AUBURN | NY | 13021 | URGENT CARE CENTER |
| 3 - URGENT MEDICAL CARE OF SKANEATELES | ||||
| 803 GENESEE STREET | SKANEATELES | NY | 13152 | URGENT CARE CENTER |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | DURING 2016, AUBURN COMMUNITY HOSPITAL HOSTED A NUMBER OF EVENTS AS A BENEFIT TO THE SURROUNDING COMMUNITY. IN CELEBRATION OF NATIONAL PATIENT SAFETY AWARENESS WEEK, ON MARCH 16, 2016 FROM 7AM TO 4:30PM, THE FIRST FLOOR HALLWAY OF THE HOSPITAL WAS FILLED WITH APPROXIMATELY 29 DISPLAYS MANNED BY KNOWLEDGEABLE STAFF MEMBERS. THERE WERE 37 OUTSIDE VENDORS/AGENCIES THAT PARTICIPATED IN THIS EVENT, ALONG WITH 23 HOSPITAL DEPARTMENTS PROVIDING PATIENT SAFETY INFORMATION AND EDUCATION TO STAFF AND MEMBERS OF THE COMMUNITY. THE PATIENT SAFETY FAIR IS OPEN TO THE PUBLIC AS WELL AS HOSPITAL EMPLOYEES WITH THE INTENTION OF SPREADING EDUCATION ON SAFETY CENTERED TOPICS, SUCH AS HOW TO PREVENT FALLS; PROPER WAYS TO CLEAN ITEMS, FOR EXAMPLE CELL PHONES; STROKE RECOGNITION; MENTAL HEALTH AWARENESS, AND HOW TO PROPERLY HANDLE, COOK AND STORE FOOD. IN ADDITION, THROUGHOUT THE 2016 CALENDAR YEAR, AUBURN COMMUNITY HOSPITAL HOSTED 6 MEDICALLY SPEAKING LECTURE SERIES. TOPICS INCLUDED BONE AND JOINT CARE, PRESENTED BY OUR ORTHOPAEDIC SURGEONS AND NURSE PRACTITIONERS; WALKER SAFETY, PRESENTED BY OUR OCCUPATIONAL AND PHYSICAL THERAPISTS; OPIOIDS AND HEROIN ADDICTION, PRESENTED BY OUR AUBURN NATIVE FAMILY MEDICINE PHYSICIAN; AND A SURGICAL WEIGHT LOSS SEMINAR, PRESENTED BY OUR SURGICAL SERVICES PHYSICIAN. THE LECTURES WERE PRESENTED AT DIFFERENT LOCATIONS THROUGHOUT THE COMMUNITY AND SURROUNDING TOWNS, INCLUDING CONFERENCE ROOMS WITHIN THE HOSPITAL, THE BOYLE CENTER AND BLUE FIELD MANOR IN AUBURN, THE AUBURN YMCA CONFERENCE ROOM, AND THE AMMSPC OFFICE IN SENECA FALLS, NY. AT VARIOUS TIMES THROUGHOUT THE YEAR, THE HOSPITAL HOSTS CLINICS FOR MEN AND WOMEN'S HEALTH. SUBJECT TO FINANCIAL QUALIFICATION, MEN ARE OFFERED A PROSTATE SCREENING AND COLORECTAL CANCER SCREENINGS FREE OF CHARGE AND WOMEN ARE OFFERED FREE MAMMOGRAMS AND COLORECTAL CANCER SCREENINGS.ON SATURDAY, OCTOBER 15, 2016 AT THE HOLIDAY INN IN AUBURN, AUBURN COMMUNITY HOSPITAL HOSTED THE 19TH ANNUAL WOMEN'S HEALTH INSTITUTE. THIS YEAR'S KEYNOTE ADDRESS WAS DELIVERED BY GWEN WEBBER-MCLEOD, PRESIDENT AND CEO OF GWEN, INC. LOCATED IN AUBURN NY. GWEN SPOKE ON RESILIENCE AND FINDING STRENGTH DURING TIMES OF GRIEF AND HARDSHIP. FOLLOWING HER PRESENTATION, WORKSHOPS WERE OFFERED ON A WIDE VARIETY OF HEALTH AND WELLNESS TOPICS. TEN HEALTHCARE PROVIDERS, TWO FINANCIAL ADVISORS AND EXHIBITORS WERE ON HAND TO RELAY IMPORTANT INFORMATION ABOUT THE SERVICES THAT ARE AVAILABLE TO THE WOMEN OF OUR COMMUNITY. |
| PART I, LINE 7: | THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE IS A COST-TO-CHARGE RATIO. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. |
| 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 $ 4,438,275. |
| PART III, LINE 2: | TO CALCULATE THE CURRENT BAD DEBT EXPENSE, A PERCENTAGE OF THE SELF-PAY ACCOUNTS ARE RESERVED BASED ON THE AGING BY BILLED DATE AT MONTH END. SELF-PAY ACCOUNTS FROM ZERO TO 60 DAYS ARE RESERVED AT 60%, 61 TO 180 DAYS ARE RESERVED AT 70% AND OVER 180 DAYS IS RESERVED AT 90%. ALL OTHER ACCOUNTS NET OF THE CONTRACTUAL ALLOWANCE AGED AT 91 TO 180 DAYS ARE RESERVED AT 25%, WHILE THE ACCOUNTS AGED OVER 180 DAYS ARE RESERVED AT 75%. |
| PART III, LINE 3: | TO CALCULATE THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY, FIRST A RATIO OF PATIENT CARE COST TO CHARGES IS CALCULATED FROM THE TOTAL OPERATING EXPENSE TO THE GROSS PATIENT CHARGES. THIS PERCENTAGE IS THEN MULTIPLIED BY THE GROSS PATIENT CHARGES THAT WERE WRITTEN OFF PURSUANT TO THE CHARITY CARE POLICIES OF THE HOSPITAL. THE RESULT IS THE BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY. |
| PART III, LINE 4: | SEE FOOTNOTES 3(M) AND 3(N) ON PAGES 12-14 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | THE SHORTFALL SHOWN ABOVE SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS ALL PATIENTS WILL BE SEEN AND TREATED AT AUBURN COMMUNITY HOSPITAL REGARDLESS OF ABILITY TO PAY. THEREFORE, THE FACT THAT THE COSTS TO TREAT MEDICARE PATIENTS EXCEEDED THE REVENUES GENERATED FROM MEDICARE PATIENTS SHOULD ALL BE VIEWED AS A BENEFIT TO THE MEDICARE PATIENTS OF THE COMMUNITY. THE AMOUNT ABOVE WAS CALCULATED BY MULTIPLYING THE GROSS MEDICARE CHARGES FOR THE YEAR BY THE RATIO OF PATIENT CARE COST TO CHARGES AS CALULATED ON WORKSHEET 2. |
| PART III, LINE 9B: | PATIENTS ELIGIBLE ARE REASSESSED AT EACH ADMISSION AND NO FURTHER COLLECTIONS ARE PURSUED. |
| PART VI, LINE 2: | A STRATEGIC PLANNING PROCESS WHICH INCLUDES AN ANALYSIS BY 3M IS USED TO HELP DETERMINE THE NEEDS OF OUR GEOGRAPHIC AREA. THIS ANALYSIS HELPS AUBURN COMMUNITY HOSPITAL IN DETERMINING WHETHER WE HAVE ADEQUATE PHYSICIAN STAFFING TO PROVIDE THE APROPRIATE LEVEL OF CARE TO OUR COMMUNITY. |
| PART VI, LINE 3: | PATIENTS OF AUBURN COMMUNITY HOSPITAL ARE PROVIDED WITH FINANCIAL ASSISTANCE INFORMATION UPON BEING ADMITTED TO THE HOSPITAL, BOTH INPATIENT AND OUTPATIENT. FINANCIAL ASSISTANCE IS EVALUATED EVERY TIME A PERSON PRESENTS AT THE FACILITY. PACKETS ARE PROVIDED TO EVERY PATIENT. |
| PART VI, LINE 4: | AUBURN COMMUNITY HOSPITAL SERVES THE AUBURN, NY COMMUNITY AS WELL AS THE IMMEDIATE SURROUNDING AREAS. |
| PART VI, LINE 5: | AUBURN COMMUNITY HOSPITAL PROMOTES HEALTH TO THE COMMUNITY BY HOSTING EVENTS WHENEVER MONEY PERMITS. THIS INCLUDES AN ANNUAL HEART EXPO TO EDUCATE THE COMMUNITY ON HEART HEALTH. AUBURN COMMUNITY HOSPITAL ALSO PROMOTES WOMEN'S HEALTH CARE THROUGH THE WOMEN'S HEALTH INSTITUTE. |
| PART VI, LINE 6: | AUBURN COMMUNITY HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEMETRA VOUNAS MD | ||||||||||||||
| TRUSTEE | $0 | $268,855 | $0 | $4,018 | $0 | $0 | $0 | $10,171 | $0 | $14,287 | $0 | $297,331 | $0 | $0 |
| SCOTT BERLUCCHI | ||||||||||||||
| PRESIDENT & CEO | $398,679 | $0 | $31,807 | $0 | $6,500 | $0 | $13,250 | $0 | $12,201 | $0 | $462,437 | $0 | $0 | $0 |
| JASON LESCH | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $214,143 | $0 | $13,999 | $0 | $0 | $0 | $0 | $0 | $12,201 | $0 | $240,343 | $0 | $0 | $0 |
| TAMARA BENYASHVILI | ||||||||||||||
| HOSPITALIST | $370,284 | $0 | $0 | $0 | $0 | $0 | $9,282 | $0 | $0 | $0 | $379,566 | $0 | $0 | $0 |
| KHAWAJA KASHIF | ||||||||||||||
| HOSPITALIST | $332,300 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,201 | $0 | $344,501 | $0 | $0 | $0 |
| NYLA MALIK | ||||||||||||||
| HOSPITALIST | $329,831 | $0 | $0 | $0 | $0 | $0 | $9,297 | $0 | $5,646 | $0 | $344,774 | $0 | $0 | $0 |
| JOSEPH APONE | ||||||||||||||
| HOSPITALIST | $280,739 | $0 | $0 | $0 | $0 | $0 | $13,250 | $0 | $5,646 | $0 | $299,635 | $0 | $0 | $0 |
| SHEHZAD KHIZAR | ||||||||||||||
| HOSPITALIST | $216,138 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $216,138 | $0 | $0 | $0 |
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 | CAYUGA COUNTY DEVELOPMENT CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 522367265 | BondIssuerEIN |
| CUSIP | 149762AA4 | CUSIPNum |
| Bond Issued | 2013-08-30 | BondIssuedDt |
| Issue Price | $9,380,000 | IssuePriceAmt |
| Purpose | REFINANCING BONDS FOR CAPITAL IMPROVEMENT | 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 | $12,175,000 | RetiredAmt |
| Total Proceeds | $9,380,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $187,600 | IssuanceCostsFromProceedsAmt |
| Substantial Completion | 2013 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | 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 | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| 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 | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | DATE REBATE COMPUTATION PERFORMED | FormAndLineReferenceDesc |
| Explanation | ISSUER NAME: CAYUGA COUNTY DEVELOPMENT CORPORATION DATE THE REBATE COMPUTATION WAS PERFORMED: 08/30/2013 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| PATSY IANNOLO | |||
| OWNER OF EASTERN FINGERLAKES EMERGENCY | $1,561,391 | EMERGENCY ROOM SERVICES | 0 |
| JOHN RICCIO | |||
| OWNER OF AUBURN PATHOLOGY ASSOCIATES, PC | $121,000 | PROVIDES LABORATORY SERVICES TO HOSPITAL | 0 |
| ALAN BERLUCCHI | |||
| SON OF OFFICER (SCOTT BERLUCCHI) | $49,759 | COMPENSATION PAYMENTS | 0 |
| WILLIAM FRANCESCHELLI | |||
| SON OF VICE CHAIRMAN (ANTHONY FRANCESCHELLI) | $33,301 | COMPENSATION PAYMENTS FROM RELATED ORGANIZATION | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | 990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS, OFFICERS AND HIGHLY COMPENSATED EMPLOYEES ARE REQUIRED TO COMPLETE CONFLICT OF INTEREST FORMS AND SIGN THEM ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS DETERMINE THE PRESIDENT/ CEO COMPENSATION. OTHER TOP OFFICIALS' COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS, CEO AND IS ALSO BASED OFF OF EXPERIENCE, COMPENSATION SURVEYS AND OTHER QUALIFICATIONS. |
| FORM 990, PART VI, SECTION C, LINE 18 | COPIES OF THE 990 WILL BE AVAILABLE TO THE PUBLIC UPON REQUEST |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON REQUEST, COPIES OF DOCUMENTS WILL BE PROVIDED. |
| FORM 990, PART XI, LINE 9: | EQUITY TRANSFER TO AFFILIATE -38,199. |
| FORM 990, PART XII, LINE 2C: | THE PROCESSES RELATING TO THE COMMITTEE'S OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| AUBURN COMMUNITY COMPANIES INC | ||||||||||
| 17 LANSING STREET | AUBURN | NY | 13021 | 223271881 | PROVIDES NURSING HOME ACCOMMODATIONS | NY | 501(C)(3) | LINE 9 | AUBURN COMMUNITY HOSPITAL | Yes (1) |
| AUBURN COMMUNITY HOSPITAL FOUNDATION INC | ||||||||||
| PO BOX 918 | AUBURN | NY | 13021 | 161599892 | PROVIDES FUNDS TO AUBURN COMMUNITY HOSPITAL, INC. AND RELATED ENTITIES | NY | 501(C)(3) | LINE 11 | AUBURN COMMUNITY HOSPITAL | Yes (1) |
| ACH PROPERTIES INC | ||||||||||
| 5-19 LANSING STREET | AUBURN | NY | 13021 | 161335941 | PROMOTE AND SUPPORT CHARITABLE PURPOSE OF AUBURN COMMUNITY HOSPITAL, INC. | NY | 501(C)(3) | N/A | AUBURN COMMUNITY HOSPITAL | Yes (1) |
| AUBURN MEMORIAL MEDICAL SERVICES PC | ||||||||||
| 17 LANSING STREET | AUBURN | NY | 13021 | 261193842 | PRACTICE OF MEDICINE | NY | 501(C)(3) | LINE 11 | AUBURN COMMUNITY HOSPITAL | Yes (1) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUBURN MEDICAL PC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LANSING STREET | AddressLine1Txt |
| City | AUBURN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13021 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205111805 | EIN |
| Primary Activities | ANESTHESIOLOGY SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| AUBURN COMMUNITY HOSPITAL FOUNDATION INC | ||
| C | $754,750 | CASH |
| AUBURN MEMORIAL MEDICAL SERVICES PC | ||
| D | $6,806,784 | FMV |
| AUBURN MEDICAL PC | ||
| D | $838,998 | FMV |
| AUBURN COMMUNITY COMPANIES INC | ||
| K | $1,140,762 | FMV |
| ACH PROPERTIES INC | ||
| K | $29,900 | FMV |