2017-05-12T12:48:22-05:00 2016-06-30 PricewaterhouseCoopers LLP 2001 MARKET ST SUITE 1800 PHILADELPHIA PA 19103 990 2015-07-01 240786657 GUTHRIE TOWANDA MEMORIAL HOSPITAL % MICHELE SISTO GUTH 5702652191 91 HOSPITAL DRIVE TOWANDA PA 188489703 STACI COVEY PRESIDENT 5702652191 2017-05-11 true ANTONIO C RUSSO P00858539 2673303000 2015 2021-01-29 14:40:06Z JOHN L SCHOONOVER III 91 HOSPITAL DRIVE TOWANDA PA 188489703 33931604 false X WWW.MEMORIALHOSPITAL.ORG X 1946 PA THE PROVISION OF SUPERIOR QUALITY CHARITABLE HEALTHCARE SERVICES IN A CARING, EFFICIENT, AND FINANCIALLY RESPONSIBLE MANNER. 16 14 483 24 0 0 533713 2057911 33852555 31067321 294348 11591 1298961 692283 35979577 33829106 0 0 0 0 21871851 20604400 0 0 0 14147550 13590263 36019401 34194663 -39824 -365557 52283080 49545249 23633765 21266176 28649315 28279073 X THE MISSION OF GUTHRIE TOWANDA MEMORIAL HOSPITAL IS TO PROVIDE SUPERIOR QUALITY HEALTHCARE SERVICES IN A CARING, EFFICIENT, AND FINANCIALLY RESPONSIBLE MANNER THAT WILL IMPROVE THE QUALITY OF LIFE IN OUR COMMUNITY. false false 32600258 0 31456834 GUTHRIE TOWANDA MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL AND LONG TERM CARE FACILITY LOCATED IN TOWANDA, PA. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, EMERGENCY CARE, LONG-TERM CARE AND HOME HEALTH SERVICES TO RESIDENTS OF TOWANDA, PA AND SURROUNDING COMMUNITIES. HOSPITAL DOCTORS CONTINUOUSLY WORK WITH QUALIFIED SPECIALISTS AND MANY OTHERS WITHIN THE BRADFORD AND SULLIVAN COUNTY MEDICAL COMMUNITITES, AS WELL AS OUTSIDE OF THIS AREA, IN ORDER TO PROVIDE PATIENTS WITH ACCESS TO QUALITY SPECIALTY CARE. THE HOSPITAL ROUTINELY WORKS WITH SPECIALISTS IN SAYRE, PA; ELMIRA, NY; BINGHAMTON, NY; WILLIAMSPORT, PA; SCRANTON, PA; DANVILLE, PA; AND PHILADELPHIA, PA, TO MEET PATIENTS' HEALTHCARE NEEDS. 32600258 true true false true false false false false true false true false false true true true false true false false false false false false false false true true false false true true false false false false false false false false false false false false false false true true true false false false true 37 0 true 483 true false false false false false false false false false false X 16 14 false false false false false false false true true false false true true true true true true true true false PA X MICHELE SISTO 5708874625 ONE GUTHRIE SQUARE SAYRE PA 18840 X PETER BRODERICK SECRETARY 5.0 2.0 X X 0 0 0 JOSEPH CAMA MD TRUSTEE 5.0 6.0 X 0 0 0 STACI COVEY PRESIDENT AS OF 9/7/2015 5.0 35.0 X X 0 157992 24205 RAY DEPAOLA ESQ TRUSTEE 5.0 0.0 X 0 0 0 MARK GANNON TRUSTEE 5.0 0.0 X 0 0 0 LARRY HUBER TRUSTEE 5.0 0.0 X 0 0 0 MARJORY KREISCHER TRUSTEE 5.0 0.0 X 0 0 0 LEO LAMBERT TRUSTEE 5.0 0.0 X 0 0 0 JAMES PARKS VICE-CHAIRMAN 5.0 2.0 X X 0 0 0 JODY PLACE TRUSTEE 5.0 0.0 X 0 0 0 ERIC R ROWE TREASURER 5.0 2.0 X X 0 0 0 JOHN L SCHOONOVER III CHAIRMAN 5.0 0.0 X X 0 0 0 MARGUERITE SHANER TRUSTEE 5.0 2.0 X 0 0 0 BARBARA YANAK TRUSTEE 5.0 0.0 X 0 0 0 PAUL VERVALIN COO TRUSTEE 1.0 39.0 X 0 481001 33354 STEPHEN IRWIN TRUSTEE 5.0 0.0 X 0 0 0 WILLIAM K ROHRBACH PRESIDENT THROUGH 9/7/2015 40.0 0.0 X 172990 0 9435 WINGROVE JARVIS MD ORTHOPEDIC SURGEON 40.0 0.0 X 449120 0 11891 MARC ALPERT MD GENERAL SURGEON 40.0 0.0 X 247602 0 19833 GEETA KRISHNAN ENT 40.0 0.0 X 158579 0 4757 CYNTHIA LAMBERT PHARMACIST 40.0 0.0 X 138064 0 18906 LYNN DRIBBLE VP PATIENT CARE SERVICES 40.0 0.0 X 130836 0 0 1297191 638993 122381 10 false true false GULFSTREAM ANESTHESIA CONSULTANTS PO BOX 212110 ROYAL PALM BEACH FL 33421 ANESTHESIA SRVCS 602433 TEAM CARE PC 2031 ORANGE HILL ROAD ATHENS PA 18810 ED PHYSICIANS SRVCS 303173 MORRISON MANAGEMENT SPECIALIST PO BOX 102289 ATLANTA GA 303682289 DIETARY MGMT SRVCS 282885 COMPLETE HEALTHCARE RESOURCES 200 DRYDEN ROAD SUITE 3100 DRESHER PA 190251049 NURSING FACIL MGMT 224313 EMCARE PHYSICIAN SERVICES INC 13737 NOEL ROAD SUITE 1600 DALLAS TX 75240 ED PHYSICIANS SRVCS 205573 7 X 50304 2007607 2057911 NET PATIENT SERVICE REVENUES 621990 31067321 31067321 31067321 9023 9023 0 0 77567 64274 13293 0 13293 13293 39692 1100 36754 1470 2938 -370 2568 2568 0 0 0 MEANINGFUL USE 900099 328251 328251 OTHER PATIENT SERVICES 621990 61262 61262 CAFETERIA/VENDING 623000 85245 85245 204232 204232 678990 33829106 31456834 314361 X 0 0 0 0 63482 63482 0 15752690 15010303 742387 238345 238345 3428615 3428615 1121268 1121268 729338 413862 315476 40781 40781 21144 21144 1980 1980 0 0 4047510 3871048 176462 0 23031 22092 939 1151930 968268 183662 0 0 727127 718959 8168 84742 81907 2835 0 19913 19738 175 462809 462809 0 1982398 1982398 925210 925210 MEDICAL SUPPLIES 1447038 1447038 0 DIETARY 497890 482441 15449 0 REPAIR & MAINTENANCE 395303 392591 2712 0 PA NURSING FACILITY ASSESS. 574026 574026 0 458093 439340 18753 34194663 32600258 1594405 0 1139 839 895593 1036340 0 0 5272161 3776049 0 0 0 0 0 0 503649 498693 535223 499158 29184476 2962410 27448282 26222066 66578 60118 1168051 1231420 0 0 0 0 16392404 16220566 52283080 49545249 2442346 2321118 0 0 0 0 12264235 11164653 0 0 0 0 108006 84693 0 0 8819178 7695712 23633765 21266176 X 28077680 26798219 506635 1415854 65000 65000 28649315 28279073 52283080 49545249 -365557 -3947 -738 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 1980 1980 false SCHEDULE C, PART II-B, LINE 1i DETAIL OF LOBBYING ACTIVITIES GUTHRIE TOWANDA MEMORIAL HOSPITAL INCURS LOBBYING EXPENSES ONLY AS A PORTION OF THEIR HAP DUES APPLICABLE TO THE TAX YEAR ENDED 6/30/16. THESE EXPENSES WERE APPROX. 20.00% OF DUES FOR THE YEAR. --------------- true 11196 162451 153687 19960 false 330000 330000 24324776 1658566 22666210 4242426 1284107 2958319 287274 19737 267537 26222066 DEFERRED FINANCING COSTS, NET 91250 INTEREST IN ASSETS HELD BY MH 16116190 OTHER ASSETS 13126 16220566 0 AMTS W/H FROM EMPLOYEES FOR TAXES 90589 BLUE CROSS ADVANCE 184441 AMOUNTS DUE TO AFFILIATES 6677970 ESTIMATED MED MAL CLAIMS LIABILITY 122790 ESTIMATED THIRD PARTY SETTLEMENT 619922 7695712 X SCHEDULE D, PART IV, LINE 1B ESCROW/CUSTODIAL ACCOUNT DETAILS GUTHRIE TOWANDA MEMORIAL HOSPITAL MAINTAINS A SEPARATE ACCOUNT FOR SKILLED NURSING FACILITY RESIDENT FUNDS, OF WHICH THE ORGANIZATION IS THE REPRESENTATIVE PAYEE. FUNDS ARE USED TO PAY PATIENTS' BILLS AND PERSONAL EXPENSES. --------------- SCHEDULE D, PART X, LINE 2 TEXT OF FIN 48 DISCLOSURE ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE THE CORPORATION TO EVALUATE TAX POSITIONS TAKEN BY THE CORPORATION AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF THE CORPORATION HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE CORPORATION HAS CONCLUDED THAT AS OF JUNE 30, 2016 AND 2015, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. --------------- true true X true X true X true true false false 105155 0 105155 0.00300 2963510 1436145 1527365 0.04460 3068665 1436145 1632520 0.04760 19913 0 19913 0.00060 6355298 4041216 2314082 0.06770 6375211 4041216 2333995 0.06830 9443876 5477361 3966515 0.11590 true 2839057 425858 6047158 7025725 -978567 X true true 1 1 GUTHRIE TOWANDA MEMORIAL HOSPITAL 91 HOSPITAL DRIVE TOWANDA PA 18848 LICENSE# 650201 X X X GUTHRIE TOWANDA MEMORIAL HOSPITAL 1 false false true X X X X X X 15 true false false true X SEE SUPPLEMENTAL SECTION X true 15 true SEE SUPPLEMENTAL SECTION false true X 100 300. X X X true true X X X true X SEE SUPPLEMENTAL SECTION X 0 X X X X true X false X X X X true X false false PART V, SECTION B, LINE 5- INPUT FROM COMMUNITY GUTHRIE TOWANDA MEMORIAL HOSPITAL REVIEWED PRIMARY DATA SOURCES, WHICH INCLUDED SURVEY AND FOCUS GROUP DATA THAT HAD BEEN COLECTED THROUGHOUT 2015 AND EARLY 2016. THE ORGANIZATION ALSO REVIEWED SECONDARY DATA SOURCES WHICH INCLUDED THE MOST RECENT COUNTY HEALTH RANKINGS AND DATA COLLECTED THROUGH THE STRATEGIC PLANNING AND MARKETING DEPARTMENT. --------------- PART V, SECTION B, LINE 7 & 10- CHNA & IMP. PLAN PUBLIC AVAILABILITY A COPY OF THE ORGANIZATION'S CHNA AND IMPLEMENTATION PLAN CAN BE FOUND AT: HTTPS://WWW.GUTHRIE.ORG/ABOUT-US/COMMUNITY-BENEFITS/COMMUNITY-HEALTH-NEEDS -ASSESSMENT --------------- PART V, SECTION B, LINE 11- ADDRESSING THE NEEDS IDENTIFIED IN THE CHNA FOR A COMPLETE DESCRIPTION ON HOW THE ORGANIZATION IS ADDRESSING THE NEEDS IDENTIFIED IN THE MOST RECENTLY COMPLETED CHNA, SEE THE FOLLOWING: HTTPS://WWW.GUTHRIE.ORG/SITES/DEFAULT/FILES/TMH_IMPLEMENTATIONPLANS_JULY20 16.PDF --------------- PART V, SECTION B, LINE 16A & 16B FAP PUBLIC AVAILABILITY A COPY OF THE ORGANIZATION'S FAP AND FAP APPLICATION CAN BE FOUND AT: HTTPS://WWW.GUTHRIE.ORG/PATIENTS-VISITORS/PAY-MY-BILL/FINANCIAL-ASSISTANCE --------------- PART V, SECTION B, LINES 15-22 - IRC SECTION 501(R) REGULATIONS PLEASE NOTE THAT THIS ORGANIZATION'S TAX YEAR BEGAN JULY 1, 2015, WHILE THE FINAL REGULATIONS UNDER IRC SECTION 501(R) WERE EFFECTIVE FOR TAX YEARS BEGINNING AFTER DECEMBER 29, 2015. AS A RESULT, THIS ORGANIZATION WAS IN COMPLIANCE WITH THE FINAL IRC SECTION 501(R) REGULATIONS AS OF 7/1/2016. PART I, LINE 7- COSTING METHODOLOGY USED THE RATIO OF COST TO CHARGES WAS COMPUTED USING PATIENT CHARGES AND PATIENT COST EXCLUDING RELATED BAD DEBT COSTS COUNTED ELSEWHERE IN THE COMMUNITY BENEFITS NUMBERS. THE NUMBERS USED IN THE CALCULATION OF THE RATIO WERE OBTAINED FROM THE MEDICARE COST REPORT FOR THE RELATED PERIOD. THIS RATIO WAS USED IN THE CALCULATION OF CHARITY CARE, MEDICAID, OTHER MEANS-TESTED GOVERNMENT PROGRAMS AND SUBSIDIZED HEALTH SERVICES. FOR THE REMAINING LINES, DIRECT EXPENSES WERE IDENTIFIED BY PROGRAMS BASED ON PROGRAM RECORDS. --------------- PART III, SECTION A, LINE 2- BAD DEBT EXPENSE THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINES 2 AND 3 ARE BASED ON ACTUAL CHARGES WRITTEN OFF (AMOUNTS THAT ARE DEEMED TO BE UNCOLLECTIBLE). --------------- --------------- PART III, SECTION A, LINE 3- METHODOLOGY USED TO ESTIMATE FAP BAD DEBTS GUTHRIE TOWANDA MEMORIAL HOSPITAL ("MEMORIAL HOSPITAL"). PROVIDES CARE TO ALL PATIENTS WHO NEED IT, REGARDLESS OF THEIR ABILITY TO PAY. THIS IS PART OF THE HOSPITAL'S MISSION. THE HOSPITAL ESTIMATES THAT 15% OF THE BAD DEBT EXPENSE AT COST IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY THAT HAVE NOT FILLED OUT THE PROPER FORMS OR PROVIDED THE PROPER INFORMATION TO QUALIFY FOR THE PROGRAM. --------------- PART III, SECTION A, LINE 4- BAD DEBT EXPENSE FOOTNOTE THE TEXT OF THE BAD DEBT FOOTNOTE CAN BE FOUND ON PAGE 13 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. --------------- PART III, SECTION B, LINE 8- COSTING METHODOLOGY, MEDICARE SHORTFALL THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNT REPORTED ON LINE 6 IS BASED ON THE THE HOSPITAL'S MEDICARE COST REPORT FILING FOR THE YEAR. CONSISTENT WITH THE CHARITABLE HEALTHCARE MISSION OF MEMORIAL HOSPITAL AND THE COMMUNITY BENEFIT STANDARD SET FORTH IN IRS REVENUE RULING 69-545, THE HOSPITAL PROVIDES CARE FOR ALL PATIENTS COVERED BY MEDICARE SEEKING MEDICAL CARE AT THE HOSPITAL. SUCH CARE IS PROVIDED REGARDLESS OF WHETHER THE REIMBURSEMENT PROVIDED FOR SUCH SERVICES MEETS OR EXCEEDS THE COSTS INCURRED BY THE ROBERT PACKER HOSPITAL TO PROVIDE SUCH SERVICES. AS A RESULT, THE HOSPITAL VIEWS ANY SHORTFALL REPORTED IN LINE 7 AS AN ADDITIONAL ITEM OF COMMUNITY BENEFIT PROVIDED BY THE ORGANIZATION. --------------- PART III, SECTION B, LINE 9B- COLLECTION POLICY PRACTICES IF UPON RESTORATION, PATIENT IS DETERMINED TO HAVE NO INSURANCE AND QUALIFIES FOR FINANCIAL ASSISTANCE THEY ARE ASKED TO PROVIDE COPIES OF A W-2, PAY STUB, OR INCOME TAX RETURN TO COMPLETE OUR CHARITY CARE APPLICATION. DETERMINATION IS BASED ON INFORMATION RECEIVED AND FINANCIAL GUIDELINES BEFORE UNDERTAKING COLLECTION EFFORTS. --------------- PART VI, LINE 2- NEEDS ASSESSMENT MEMORIAL HOSPITAL CONDUCTS ITS OWN HEALTH CARE ASSESSMENT ON AN ONGOING BASIS FOR THE HOSPITAL'S PRIMARY (ZIP CODES: 18837, 18854, 18815, 18853, 18814, 18832, 18833, 18614, 16947, 16926, 17743, 17724 AND 17735) AND SECONDARY (16914, 18817, 18840, 18831, 1850, 18851, 18829, 18845, 18818, 18828, 18839, 18801, 18843, 18846, 18616 AND 18632) SERVICE AREA. THE HOSPITAL USES ITS BOARD OF TRUSTEES, PHYSICIANS ON STAFF, EMPLOYEES AND COMMUNITY MEMBERS TO IDENTIFY NEEDS BASED ON INFORMATION OBTAINED BY THESE INDIVIDUALS OR GROUPS. BASED ON WHAT IS OBTAINED, THE HOSPITAL CAN THEN DETERMINE WHAT HEALTHCARE SERVICES SHOULD BE CONSIDERED TO BE OFFERED IN THE COMMUNITY. --------------- PART VI, LINE 3- PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE INFORMATION IS PROVIDED THROUGHOUT THE HOSPITAL REGARDING THE CHARITY CARE PROGRAM. TELEPHONE CALLS ARE MADE TO ALL SELF PAY PATIENTS AS WELL AS SEEING THEM PERSONALLY IF THEY HAPPEN TO BE AN INPATIENT OF THE HOSPITAL. EVERY INTAKE AREA OF THE HOSPITAL HAS INFORMATION REGARDING THE FINANCIAL ASSISTANCE THE HOSPITAL CAN PROVIDE AND THE CONTACT INFORMATION FOR THE HOSPITAL'S FINANCIAL COUNSELOR IS MADE AVAILABLE. ALL NEW HIRED EMPLOYEES IN INTAKE AREAS ARE TRAINED IN THE FINANCIAL ASSISTANCE POLICIES AS PART OF THEIR ORIENTATION PROCESS. A NOTICE FOR FINANCIAL AID IS POSTED ON THE HOSPITAL'S WEB SITE FOR THOSE SEEKING THE INFORMATION VIA THE WEB. IN THE EVENT AN INTERPRETER IS NEEDED TO ASSIST A PATIENT WHO DOES NOT SPEAK ENGLISH, ONE CAN BE PROVIDED. --------------- PART VI, LINE 4- COMMUNITY INFORMATION MEMORIAL HOSPITAL SERVES A RURAL PORTION OF BRADFORD AND SULLIVAN COUNTIES IN NORTHEAST PA. THE TOTAL POPULATION FOR BOTH COUNTIES IS APPROXIMATELY 67,000. THE HOSPITAL SERVES A HIGH PERCENTAGE OF MEDICAL ASSISTANCE PATIENTS AND IS ELIGIBLE FOR DSH REIMBURSEMENT AS A RESULT. ACCORDING TO THE PENNSYLVANIA HEALTH CARE COST CONTAINMENT COUNCIL (PHC4), MEMORIAL HOSPITAL HAD A 15.09% SHARE OF NET PATIENT REVENUE COMING FROM MEDICAL ASSISTANCE PATIENTS. THE HOSPITAL'S 24 HOUR EMERGENCY ROOM CARES FOR MANY PATIENTS SEEKING PRIMARY CARE WHO DO NOT HAVE AN EXISTING PRIMARY CARE PHYSICIAN. WITHIN BRADFORD AND SULLIVAN COUNTIES THERE ARE AREAS DESIGNATED AS MEDICALLY UNDESERVED, WITH THE HOSPITAL CARING FOR MANY PATIENTS WITHIN THOSE AREAS. --------------- PART VI, LINE 5- PROMOTION OF COMMUNITY HEALTH MEMORIAL HOSPITAL IS GOVERNED BY A 16 MEMBER VOLUNTEER BOARD OF TRUSTEES WITH THE MAJORITY OF THOSE TRUSTEES RESIDING IN THE HOSPITAL'S PRIMARY SERVICE AREA. THE PRESIDENT IS A MEMBER OF THE BOARD OF TRUSTEES. THE REMAINING 14 MEMBERS ARE COMMUNITY MEMBERS OF THE AREAS THE HOSPITAL SERVES THAT ARE NEITHER EMPLOYEES, CONTRACTORS OF THE ORGANIZATION, OR FAMILY MEMBERS THEREOF. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY WHO SEEK THOSE PRIVILEGES. ANY SURPLUS FUNDS GENERATED BY THE HOSPITAL ARE USED FOR FUNDING IMPROVEMENTS IN PATIENT CARE. THE HOSPITAL'S 24 HOUR EMERGENCY ROOM TREATS ALL PATIENTS WHO PRESENT REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PARTICIPATES WITH ALL GOVERNMENT SPONSORED HEALTH CARE PROGRAMS AND OFFERS FINANCIAL ASSISTANCE TO PATIENTS WHO SEEK ASSISTANCE AND MEET THE GUIDELINES. SEE SCHEDULE O, FORM 990, PART III, LINE 1- STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FOR MORE INFORMATION REGARDING HOW THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUMNITY. --------------- PART VI, LINE 6- DETAIL REGARDING AFFILIATED HEALTH CARE SYSTEM ROLES MEMORIAL HOSPITAL IS PART OF THE GUTHRIE CLINIC. SEE SCHEDULE O, FORM 990, PART III, LINE 1- STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS FOR MORE INFORMATION. MEMORIAL HOSPITAL IS ALSO SUPPORTED BY THE MEMORIAL HOSPITAL FOUNDATION, WHICH WAS ESTABLISHED IN 2003 TO FOSTER AND SUPPORT SPECIFIC PROJECTS AND PROGRAMS TO IMPROVE THE HOSPITAL'S SERVICES TO ITS PATIENTS. THE MISSION OF THE MEMORIAL HOSPITAL FOUNDAITON IS TO GENERATE RESOURCES FOR THE SUSTAINABILITY AND ADVANCEMENT OF HEALTHCARE IN THE COMMUNITIES IT HAS THE PRIVILEGE OF SERVING. X X X X false false false false false false false false false STACI COVEY PRESIDENT AS OF 9/7/2015 0 143901 0 14091 0 0 0 11339 0 12866 0 182197 0 0 PAUL VERVALIN COO TRUSTEE 0 417188 0 63359 0 454 0 15900 0 17454 0 514355 0 0 WINGROVE JARVIS MD ORTHOPEDIC SURGEON 449120 0 0 0 0 7789 0 4102 0 461011 0 0 0 MARC ALPERT MD GENERAL SURGEON 247602 0 0 0 0 7211 0 12622 0 267435 0 0 0 WILLIAM K ROHRBACH PRESIDENT THROUGH 9/7/2015 146695 0 26295 0 0 0 5221 0 4214 0 182425 0 0 0 GEETA KRISHNAN ENT 158579 0 0 0 0 0 4757 0 0 0 163336 0 0 0 CYNTHIA LAMBERT PHARMACIST 138064 0 0 0 0 0 4250 0 14656 0 156970 0 0 0 FORM 990, SCHEDULE J, PART I, LINE 3 TOP MANAGEMENT COMPENSATION EXECUTIVE COMPENSATION IS GENERALLY ESTABLISHED WITHIN A WRITTEN EMPLOYMENT AGREEMENT. COMPENSATION IS DETERINED BASED ON MARKET STUDIES, PRESENTED TO THE GUTHRIE CLINIC COMPENSATION COMMITTEE AND SUBSEQUENTLY APPROVED BY THE BOARD OF DIRECTORS. A MUN HOSP AUTH TWNSHP OF N TOWANDA- SERIES 2012 232308413 XXXXXXXXX 2012-10-05 10000000 CONSTRUCTN, RENOVATION & REFINANCE false false false B MUN HOSP AUTH TWNSHP OF N TOWANDA- SERIES 2004 232308413 XXXXXXXXX 2004-10-19 9800000 CONSTRUCTN, RENOVATION & REFINANCE false false false A 1537262 0 10000000 0 0 0 112309 0 0 5279697 4607994 0 2014 true false true true B 7098085 0 9800000 0 0 0 0 0 0 4621214 5178786 0 2004 true false true true A false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true B false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true A false true false false true false 0 false 0 false true B false true false false true false 0 false 0 false true A true B true FORM 990, PART III STATEMENT OF PROGRAM SERVICES ACCOMPLISHMENTS GUTHRIE TOWANDA MEMORIAL HOSPITAL IS A SUBSIDIARY OF THE GUTHRIE CLINIC. THE GUTHRIE CLINIC IS A NONPROFIT HEALTH CARE ORGANIZATION INCORPORATED FOR THE PURPOSE OF CONDUCTING EXCLUSIVELY CHARITABLE, SCIENTIFIC AND EDUCATIONAL ACTIVITIES. THE GUTHRIE CLINIC (TGC) ACTS AS THE PARENT OF AN INTEGRATED SECTION 501(C)(3) HEALTH CARE DELIVERY SYSTEM, CONSISTING OF THE CORPORATION AND OTHER DIRECTLY AND INDIRECTLY CONTROLLED ENTITIES (SEE FORM 990, SCHEDULE R, FOR A LISTING OF THE AFFILIATES OF TGC) INCLUDING BUT NOT LIMITED TO GUTHRIE MEDICAL GROUP, P.C.(GMG) AND ROBERT PACKER HOSPITAL (RPH). THROUGH THE ACTIVITIES OF GMG, RPH AND ITS OTHER AFFILIATES (COLLECTIVELY REFERRED TO AS "GUTHRIE"), THE GUTHRIE CLINIC PROVIDES CHARITABLE COMMUNITY-BASED HEALTH CARE SERVICES AND PROGRAMS TO IMPROVE THE HEALTH AND WELL-BEING OF THE PEOPLE AND COMMUNITIES SERVED BY ITS FACILITIES AND PROVIDERS. THESE CHARITABLE ACTIVITIES INCLUDE PROVIDING PRIMARY CARE AND SPECIALTY PHYSICIAN SERVICES, AS WELL AS OPERATING A TERTIARY CARE TEACHING HOSPITAL, COMMUNITY HOSPITALS, A RESEARCH INSTITUTE, HOME CARE, AND HOSPICE CARE. THE GUTHRIE RESEARCH INSTITUTE AND GUTHRIE CLINICAL RESEARCH FUNCTIONS OF THE DONALD GUTHRIE FOUNDATION, A SUBSIDIARY OF TGC, FURTHERS THESE CHARITABLE ACTIVITIES THROUGH PROVIDING PATIENT ACCESS TO THE REGION'S LARGEST PANEL OF CLINICAL TRIALS. THE FACILITIES AND PROVIDER OFFICES OF GUTHRIE ARE LOCATED IN 23 COMMUNITIES THROUGHOUT THE NORTHERN TIER OF PENNSYLVANIA AND SOUTHERN TIER OF NEW YORK, WITH THE GREATEST CONCENTRATION OF SERVICES PROVIDED PRINCIPALLY IN BRADFORD COUNTY, PENNSYLVANIA AND CHEMUNG AND STEUBEN COUNTIES, NEW YORK. THE VISION OF GUTHRIE IS TO HELP SHAPE THE DELIVERY OF HEALTH CARE IN THE REGION THROUGH WORKING COLLABORATIVELY WITH PHYSICIANS AND OTHER PROVIDERS, AND BY DISTRIBUTING ITS SERVICES THROUGHOUT THE REGION BASED ON COMMUNITY NEEDS. GUTHRIE SEEKS TO BE THE PROVIDER OF CHOICE FOR PATIENTS IN THE TWIN TIER REGION, AND TO BE RECOGNIZED FOR ITS SUPERIOR QUALITY AND SERVICE. IT ALSO STRIVES TO ADVANCE THE PRACTICE OF MEDICINE THROUGH ITS COMMITMENT TO TEACHING AND RESEARCH. IN KEEPING WITH THIS VISION, THE CORE VALUES OF THE GUTHRIE CLINIC ARE AS FOLLOWS: PATIENT-CENTEREDNESS, EXCELLENCE, AND TEAMWORK. GUTHRIE PROVIDERS AND FACILITIES PROVIDE CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE IT DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE ON THE FINANCIAL STATEMENTS OF GUTHRIE ENTITIES. COSTS FOR SERVICES AND SUPPLIES FURNISHED UNDER GUTHRIE'S CHARITY CARE POLICY AMOUNTED TO APPROXIMATELY $1.49 MILLION IN 2016 AND $2.64 MILLION IN 2015 WHEN MEASURED AT THE APPROPRIATE ENTITY'S ESTIMATED COST. AS PART OF ITS CHARITABLE MISSION, GUTHRIE PROVIDES CARE THROUGH ITS HOSPITAL EMERGENCY DEPARTMENTS. IT ENSURES THAT AN EMERGENCY-BASED TREATMENT OR HOSPITAL ADMISSION IS NOT DELAYED OR DENIED PENDING DETERMINATION OF COVERAGE OR A REQUIREMENT FOR PREPAYMENT OR DEPOSIT. AS A RESULT OF THIS POLICY, GUTHRIE EXPERIENCED APPROXIMATELY $2.86 MILLION AND $2.64 MILLION IN BAD DEBTS FOR 2016 AND 2015, RESPECTIVELY. IN ADDITION TO THE CHARITY CARE PROGRAM AND THE EMERGENCY DEPARTMENT BAD DEBTS DISCUSSED ABOVE, GUTHRIE SUPPORTS NUMEROUS OTHER CHARITABLE COMMUNITY ACTIVITIES. EXAMPLES OF THESE ACTIVITIES INCLUDE MEDICAL EDUCATION FOR PHYSICIANS AND NURSES, THE TRAUMA PROGRAM, AND MEDICAL RESEARCH. THE ESTIMATED COST, NET OF REIMBURSEMENT, FOR THESE PROGRAMS WAS $16.1 MILLION AND $17.5 MILLION IN 2016 AND 2015, RESPECTIVELY. GUTHRIE ALSO PROVIDES SERVICES TO PATIENTS WHO PARTICIPATE IN THE MEDICAID PROGRAMS. REVENUES GENERATED FROM PATIENTS WHO PARTICIPATE IN THE MEDICAID PROGRAM ARE SUBJECT TO SUBSTANTIAL DISCOUNTS THAT RESULT IN REIMBURSEMENT FOR SERVICES RENDERED BELOW THE COST OF PROVIDING SUCH SERVICES. IN ORDER FOR PATIENTS TO MEET THE GUIDELINES FOR THE MEDICAID PROGRAM, VARIOUS INCOME-BASED CRITERIA MUST BE MET THAT VALIDATE PATIENTS' INABILITY TO PAY FOR SERVICES AND INELIGIBILITY UNDER OTHER PROGRAMS. THE ESTIMATED LOSS INCURRED BY GUTHRIE FROM PROVIDING SERVICES TO MEDICAID PATIENTS AMOUNTED TO $37.95 MILLION AND $25.48 MILLION IN 2016 AND 2015, RESPECTIVELY. THE TOTAL COST TO GUTHRIE IN SUPPORTING THESE CHARITABLE MISSION PROGRAMS WAS APPROXIMATELY $58.37 MILLION AND $48.27 MILLION IN 2016 AND 2015, RESPECTIVELY. AS DISCUSSED, RPH AND THE GMG WORK CLOSELY TOGETHER IN FULFILLING GUTHRIE'S CHARITABLE MISSION. A REGIONAL LEVEL II TRAUMA CENTER, RPH IS A TERTIARY CARE TEACHING HOSPITAL, LOCATED IN SAYRE, PENNSYLVANIA, SERVING THE SOUTHERN TIER OF NEW YORK AND THE NORTHERN TIER OF PENNSYLVANIA. IT ALSO PROVIDES RESIDENCY PROGRAMS IN FAMILY PRACTICE, INTERNAL MEDICINE, AND GENERAL SURGERY AS WELL AS A FELLOWSHIP PROGRAM IN VASCULAR SURGERY AND CARDIOVASCULAR DISESASE. MEDICAL STUDENT TRAINING IS PROVIDED FOR STUDENTS FROM AFFILIATED MEDICAL SCHOOLS. ALLIED HEALTH EDUCATION IS ALSO PROVIDED FOR RESPIRATORY THERAPY, NURSING, LABORATORY SCIENCE, AND RADIOLOGIC TECHNOLOGY FOR STUDENTS FROM PENNSYLVANIA AND NEW YORK COLLEGES AND UNIVERSITIES. CENTERS OF EXCELLENCE WITHIN RPH INCLUDE THE FOLLOWING: ADVANCED & MINIMALLY INVASIVE SURGERY; BEHAVIORAL HEALTH SERVICES; BREAST AND IMAGING CENTER; COMPREHENSIVE CANCER CENTER; CARDIOVASCULAR CARE CENTER; THE CENTER FOR WOUND CARE AND HYPERBARIC MEDICINE; DIALYSIS CENTERS; JOINT CAMP PROGRAM FOR ORTHOPEDIC SURGERY; SPORTS MEDICINE; KIDNEY STONE TREATMENT CENTER; FIRST IMPRESSIONS BIRTHING CENTER; SLEEP DISORDERS TESTING; AND SPECIALTY EYE CARE. RPH STRIVES TO ENHANCE THE QUALITY OF LIFE IN THE COMMUNITIES IT SERVES BY PROVIDING SUPERIOR HEALTH CARE SERVICES AND BY LEADING CONTINUOUS IMPROVEMENT OF COMMUNITY HEALTH. IT ACHIEVES THIS MISSION BY ORGANIZING SERVICES AND DIRECTING RESOURCES TOWARD MEETING COMMUNITY HEALTH NEEDS THROUGH COLLABORATION WITH COMMUNITY AGENCIES AND BY COMPASSIONATE, EFFECTIVE, AND AFFORDABLE MEANS. RPH WORKS CLOSELY WITH THE GMG TO ENSURE THAT THE SKILLS AND KNOWLEDGE OF THE MEDICAL STAFF PRODUCE THE MAXIMUM COMMUNITY HEALTH BENEFIT. AS A MEMBER OF GUTHRIE, RPH INTEGRATES ITS PROGRAMS AND ACTIVITIES WITH THOSE OF THE LONG-TERM CARE AND EDUCATION AND RESEARCH DIVISIONS, SO THAT CONTINUITY AND SYNERGY RESULT. AS PART OF TGC, THE VISION OF RPH IS TO PLAY A LEADERSHIP ROLE IN THE DEVELOPMENT AND PROVISION OF TERTIARY-LEVEL ACUTE CARE SERVICES. EVIDENCE THAT RPH IS SUCCESSFULLY FULFILLING THIS ROLE CAN BE SEEN IN ITS CONTINUED ACCOMPLISHMENTS. HIGHLIGHTS OF THOSE ACHIEVEMENTS INCLUDE CONTINUED ACCREDITATION BY THE PENNSYLVANIA TRAUMA SYSTEMS FOUNDATION BOARD AS A LEVEL II TRAUMA CENTER AND RECEIPT OF FULL CHEST PAIN CENTER ACCREDITATION WITH PCI (PERCUTANEOUS CORONARY INTERVENTION) FROM THE SOCIETY OF CARDIOVASCULAR PATIENT CARE. GUTHRIE WEIGHT LOSS CENTER HAS BEEN ACCREDITED AS A LEVEL 1 FACILITY UNDER THE BARIATRIC SURGERY CENTER NETWORK (BSCN) ACCREDITATION PROGRAM OF THE AMERICAN COLLEGE OF SURGEONS (ACS). AS PART OF A FULLY-INTEGRATED HEALTH DELIVERY SYSTEM THAT ORGANIZES ITS SERVICES ON A REGIONAL BASIS AND IS ACCOUNTABLE FOR IMPROVING THE HEALTH OF THE POPULATION IT SERVES, RPH ACCEPTS RESPONSIBILITY FOR MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY AND IS ABLE TO DOCUMENT THE COST EFFECTIVENESS AND QUALITY OF SERVICES PROVIDED. CORNING HOSPITAL BREAST CARE CENTER WAS AWARDED A FULL THREE-YEAR ACCREDITATION IN STEREOTACTIC BREAST BIOPSY BY THE AMERICAN COLLEGE OF RADIOLOGY (ACR) AND RECEIVED THE AMERICAN HEART ASSOCIATION/AMERICAN STOKE ASSOCIATION'S GET WITH THE GUIDELINES STROKE GOLD PLUS ACHIEVEMENT AWARD. THE GMG IS A MULTI-SPECIALTY PHYSICIAN GROUP PRACTICE THAT INCLUDES NEARLY 350 SPECIALIST AND PRIMARY CARE PHYSICIANS AND MID-LEVEL PROVIDERS, HEADQUARTERED IN A FACILITY ADJACENT TO RPH. PHYSICIANS WITHIN THE GMG PROVIDE COMPREHENSIVE MEDICAL CARE USING ADVANCED TECHNOLOGIES AND METHODOLOGIES FOR BOTH DIAGNOSIS AND TREATMENT. FURTHER, THE GMG PROVIDES A BROAD RANGE OF EDUCATIONAL OPPORTUNITIES FOR PHYSICIANS AND OTHER HEALTH CARE PROVIDERS. IT ALSO WORKS CLOSELY WITH THE RESEARCH INSTITUTE, WHERE RESEARCH CONTRIBUTES TO RECRUITING AND RETAINING PHYSICIAN SPECIALISTS TO SERVE THE REGION AND SUSTAINING PROFICIENT MEDICAL PRACTICES. THE GMG IS COMMITTED TO THE ADVANCEMENT OF MEDICAL KNOWLEDGE AND SKILLS, AND EVERY EFFORT IS MADE TO PROVIDE PERSONAL, COMPASSIONATE MEDICAL CARE. THE GMG OPERATES A REGIONAL OFFICE NETWORK IN 23 COMMUNITIES IN PENNSYLVANIA AND NEW YORK, ENCOMPASSING ALL OF THE MAJOR POPULATION CENTERS IN THE TWIN TIERS AREA. THE GUTHRIE CLINIC HAS DEVELOPED CERTAIN GUIDING PRINCIPLES FOR THE PROVISION OF PATIENT CARE, WHICH INCLUDE A COMMITMENT THE FOLLOWING: * PRACTICE OF CLINICAL EXCELLENCE, * UTILIZATION OF THE SYNERGY OF A MULTI-SPECIALTY MEDICAL GROUP PRACTICE, * DEVELOPMENT OF AN INTEGRATED SYSTEM THAT PROVIDES A CONTINUUM OF CARE, * PROVISION OF LOC FORM 990 PART IV, LINE 12B DETAIL OF CONSOLIDATED FINANCIAL STATEMENTS THE ORGANIZATION'S FINANCIAL STATEMENTS WERE AUDITED ON A CONSOLIDATED BASIS WITH THE GUTHRIE CLINIC AND AFFILIATES. --------------- FORM 990, PART VI, SECTION A, LINE 6 MEMBERSHIP INFORMATION THE GUTHRIE CLINIC IS THE SOLE MEMBER OF GUTHRIE TOWANDA MEMORIAL HOSPITAL. --------------- FORM 990, PART VI, SECTION A, LINE 7A MEMBERSHIP INFORMATION AS THE SOLE MEMBER OF GUTHRIE TOWANDA MEMORIAL HOSPITAL, THE GUTHRIE CLINIC APPOINTS THE ORGANIZATION'S BOARD OF DIRECTORS. --------------- FORM 990, PART VI, SECTION A, LINE 7B MEMBERSHIP INFORMATION AS THE SOLE MEMBER OF GUTHRIE TOWANDA MEMORIAL HOSPITAL, THE GUTHRIE CLINIC HAS APPROVAL RIGHTS OF CERTAIN BOARD DECISIONS. --------------- FORM 990, PART VI, SECTION B, LINE 11 FORM 990 REVIEW PROCESS THE ORGANIZATION'S FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW AND IS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM PRIOR TO FILING WITH THE IRS. --------------- FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY THE CONFLICT OF INTEREST DISCLOSURE POLICY SETS FORTH THAT ALL PERSONS, INCLUDING EMPLOYEES, AGENTS AND BOARD/COMMITTEE MEMBERS, PARTICULARLY THOSE INVOLVED IN DECISION-MAKING FOR THE GUTHRIE CLINIC (TGC), ACT IN AN APPROPRIATE MANNER AND WILL NOT PARTICIPATE IN ANY ACTIONS THAT MIGHT CREATE A PERSONAL OR PROFESSIONAL CONFLICT OF INTEREST AND/OR NOT BE IN THE BEST INTEREST OF TGC. ALL MEMBERS OF ANY TGH BOARD/ COMMITTEE AND TGH SENIOR MANAGEMENT MUST MAKE FULL DISCLOSURE OF ANY POSSIBLE CONFLICT OF INTEREST THROUGH THE USE OF THE CONFLICT OF INTEREST DISCLOSURE FORM AND REFRAIN FROM VOTING OR PARTICIPATING IN DECISION-MAKING INVOLVING ANY POSSIBLE CONFLICT OF INTEREST. THE FORM IS DISTRIBUTED TO ALL BOARD/COMMITTEE MEMBERS AND EMPLOYEES (WHEN APPLICABLE) ANNUALLY BY THE TGC ADMINISTRATION OFFICE. TGC BOARD/COMMITTEE MEMBERS OR EMPLOYEES MUST COMPLETE THE CONFLICT OF INTEREST DISCLOSURE FORM. THIS FORM SHOULD BE COMPLETED WHEN THERE IS ANY SITUATION WHERE A POSSIBLE CONFLICT OF INTEREST EXISTS, AND/OR ON AN ANNUAL BASIS AND/OR AT THE TIME OF APPOINTMENT OR ELECTION OF NEW BOARD/COMMITTEE MEMBERS. IF THE FORM IS NOT COMPLETED WITHIN 13 MONTHS OF THE LAST SIGNING, THE TGC BOARD CHAIRMAN WILL BE ADVISED. ANY INDIVIDUAL HAVING A CONFLICT OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHOULD EXCUSE THEMSELVES FROM THE PORTION OF THE MEETING OR MEETINGS WHERE THE MATTER IS DISCUSSED AND NOT VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER. THE MINUTES OF THE MEETING OR MEETINGS SHOULD REFLECT THE DISCLOSURE, THE ABSTENTION FROM VOTING, AND ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTED. --------------- FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION REVIEW AND APPROVAL EXECUTIVE COMPENSATION IS GENERALLY ESTABLISHED WITHIN A WRITTEN EMPLOYMENT AGREEMENT. COMPENSATION IS DETERMINED BASED ON MARKET STUDIES, PRESENTED TO THE GUTHRIE CLINIC COMPENSATION COMMITTEE, AND SUBSEQUENTLY APPROVED BY THE BOARD OF DIRECTORS. --------------- FORM 990, PART VI, LINE 19 GOVERNING DOCUMENTS THE ORGANIZATION'S FORMS 1023 AND 990 FILINGS ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. --------------- FORM 990 PART IX LINE 11G DESCRIPTION:MISCELLANEOUS TOTAL FEES:122631 FORM 990 PART IX LINE 11G DESCRIPTION:MEDICAL SERVICES TOTAL FEES:1024068 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:2900811 COMMUNITY HEALTH ASSOCIATES LLC 91 HOSPITAL DRIVE TOWANDA PA 18848 262096228 MEDICAL SRVCS PA 765586 6327733 GTMH THE GUTHRIE CLINIC ONE GUTHRIE SQUARE SAYRE PA 18840 233055017 SUPPORTING PA 501(C)(3) 11C, III NA false GUTHRIE MEDICAL GROUP PC ONE GUTHRIE SQUARE SAYRE PA 18840 250815795 HEALTHCARE PA 501(C)(3) 3 TGC false SAYRE HOUSE OF HOPE ONE GUTHRIE SQUARE SAYRE PA 18840 203979472 HEALTHCARE PA 501(C)(3) 7 TGC false ROBERT PACKER HOSPITAL ONE GUTHRIE SQUARE SAYRE PA 18840 240795463 HEALTHCARE PA 501(C)(3) 3 TGC false DONALD GUTHRIE FOUNDATION 200 S WILBUR AVE SAYRE PA 18840 246022957 MED RESEARCH PA 501(C)(3) 4 TGC false TROY COMMUNITY HOSPITAL INC 275 GUTHRIE DR troy PA 16947 240800337 HEALTHCARE PA 501(C)(3) 3 TGC false TIOGA HEALTHCARE FACILITY ONE GUTHRIE SQUARE SAYRE PA 18840 150532257 HOUSING NY 501(C)(3) 3 TGC false GUTHRIE HOME CARE 421 TOMAHAWK RD TOWANDA PA 18848 232394345 HOME HEALTH PA 501(C)(3) 9 TGC false GUTHRIE RISK RETENTION GROUP 151 MEETING ST CHARLESTON SC 29401 201090801 SUPPORTING SC 501(C)(3) 11A, I TGC false TIOGA NURSING FACILITY ONE GUTHRIE SQUARE SAYRE PA 18840 222979677 NURSING FAC. NY 501(C)(3) 3 TGC false THE MEMORIAL HOSPITAL FOUNDATION 91 HOSPITAL DRIVE TOWANDA PA 18848 651160811 SUPPORTING PA 501(C)(3) 11A, I GTMH true CORNING HOSPITAL 1 GUTHRIE DRIVE CORNING NY 14830 160393490 HEALTHCARE NY 501(C)(3) 3 TGC false TWIN TIER MANAGEMENT CORP INC PO BOX 310 SAYRE PA 18840 232209439 MANAGEMENT CO PA TGC C CORP false CORNING PROPERTIES INC 1 GUTHRIE DRIVE CORNING NY 14830 383977095 REAL ESTATE HOLD NY NA C CORP false true false true false false false false false false true true true true false true false false false false THE MEMORIAL HOSPITAL FOUNDATION C 50304 FMV