IRA DAVENPORT MEMORIAL HOSPITAL INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- IRA DAVENPORT MEMORIAL HOSPITAL INC (EIN 16-0835446)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-09-29
- IRS object ID
- 201722729349301112
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-09-29T08:42:20-07:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 160835446 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IRA DAVENPORT MEMORIAL HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | IRAD | BusinessNameControlTxt |
| Phone | 6077768500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7571 State Route 54 | AddressLine1Txt |
| City | Bath | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14810 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Ronald Kintz | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6077374325 | PhoneNum |
| Signature | 2017-09-29 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 162.223.206.130 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Ronald J Kintz | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Roe Ave | AddressLine1Txt |
| City | Elmira | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14905 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,780,441 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.arnothealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1910 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | IRA DAVENPORT MEMORIAL HOSPITAL IS DEDICATED TO ENHANCING THE QUALITY OF LIFE WITHIN THEIR RURAL COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 386 | TotalEmployeeCnt |
| Total Volunteers | 28 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $299,583 | PYContributionsGrantsAmt |
| CY Contributions Grants | $504,435 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,924,572 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,355,127 | CYProgramServiceRevenueAmt |
| PY Investment Income | $35,149 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,021 | CYInvestmentIncomeAmt |
| PY Other Revenue | $554,581 | PYOtherRevenueAmt |
| CY Other Revenue | $895,974 | CYOtherRevenueAmt |
| PY Total Revenue | $22,813,885 | PYTotalRevenueAmt |
| CY Total Revenue | $21,758,557 | 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 | $12,175,241 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,426,686 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $11,860,327 | PYOtherExpensesAmt |
| CY Other Expenses | $12,381,031 | CYOtherExpensesAmt |
| PY Total Expenses | $24,035,568 | PYTotalExpensesAmt |
| CY Total Expenses | $24,807,717 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,221,683 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,049,160 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,825,598 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,197,804 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,706,252 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,970,016 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $13,119,346 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,227,788 | NetAssetsOrFundBalancesEOYAmt |
| Mission | IRA DAVENPORT MEMORIAL HOSPITAL IS DEDICATED TO ENHANCING THE QUALITY OF LIFE WITHIN THEIR RURAL COMMUNITY BY PROVIDING LOCAL HIGH QUALITY PRIMARY, ACUTE, RESTORATIVE AND RESIDENTIAL HEALTH SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,951,970 | ExpenseAmt |
| Grant | $504,435 | GrantAmt |
| Revenue | $21,758,557 | RevenueAmt |
| Desc | IRA DAVENPORT PROVIDED BOTH ACUTE CARE AND LONG-TERM CARE SERVICES TO PATIENTS DURING 2016. LONG-TERM CARE DAYS WERE 40,591 AND THE HOSPITAL HAD 391 DISCHARGES. THE FRED AND HARRIETT TAYLOR HEALTH CARE CENTER IS A 120 BED LONG-TERM CARE/SKILLED NURSING FACILITY. THE HEALTH CENTER PROVIDES A COMMUNITY FOR PEOPLE WHO REQUIRE ASSISTANCE WITH DAILY LIVING OR AROUND-THE-CLOCK NURSING SERVICES. THE HEALTH CARE CENTER ALSO PROVIDES DAY CARE SERVICES AND REHABILITATION SERVICES. | Desc |
| Total Other Prog Srvc Expense | $0 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $18,951,970 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 386 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RONALD KINTZ | PersonNm |
| Phone | 6077374325 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 Roe Ave | AddressLine1Txt |
| City | Elmira | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14905 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Patrick J Rogers | |||||||||
| Chairman of the Board | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Scott Sprague | |||||||||
| Vice Chairman | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Bernard Burns | |||||||||
| Secretary | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Joseph F Meade | |||||||||
| Treasurer | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Jeffrey Albright | |||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Patricia Baroody | |||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Mary Hope Benedict | |||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Werner Brammer MD | |||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Mark Hagan | |||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| David Nesbitt | |||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Kathryn Muller | |||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Jaclyn Woollett | |||||||||
| Board Member | 1 | 0 | Yes (X) | $0 | $0 | $0 | |||
| Robert Lambert MD | |||||||||
| President Arnot Health | 1 | 52 | Yes (X) | $0 | $631,140 | $38,237 | Yes (X) | ||
| Ronald J Kintz DHA | |||||||||
| Senior VP/CFO | 1 | 64 | $0 | $372,478 | $38,237 | Yes (X) | |||
| James Watson | |||||||||
| President IDMH | 40 | 0 | $0 | $56,870 | $1,425 | Yes (X) | |||
| Richard Cleland | |||||||||
| Site Adm Acute & Skilled Nursing Services | 30 | 10 | $0 | $92,314 | $0 | Yes (X) | |||
| Dennis O' Connor MD | |||||||||
| Medical Director | 20 | 0 | $60,553 | $0 | $1,806 | Yes (X) | |||
| Kevin Murray | |||||||||
| Director of Pharmacy | 40 | 0 | $152,605 | $0 | $13,632 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $213,158 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,152,802 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $93,337 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | 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 |
|---|---|---|---|---|---|
| Medical Solutions | |||||
| 1010 N 102nd Street Suite 300 | Omaha | NE | 68114 | Contracted RN service | $775,495 |
| Delphi Healthcare PLLC | |||||
| 1160 Chili Ave | Rochester | NY | 14624 | ER Doctor coverage | $601,307 |
| Delphi Hospitalist Services | |||||
| 1160 Chili Ave | Rochester | NY | 14624 | Hospital Physicians | $570,090 |
| Focusone Solutions LLC | |||||
| 13609 California St | Omaha | NE | 68154 | Contracted Employee | $326,658 |
| Elmira Structures Inc | |||||
| 66 Philo Road West | Elmira | NY | 14903 | Contractor build repair building | $265,596 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $0 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $0 | RelatedOrganizationsAmt |
| Government Grants | $397,224 | GovernmentGrantsAmt |
| All Other Contributions | $107,211 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $504,435 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Net Patient Service Revenue | 622110 | $22,354,554 | $22,354,554 | $0 | $0 |
| Bad Debt | 622110 | -$1,999,427 | -$1,999,427 | $0 | $0 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,355,127 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,021 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,021 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $0 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $115,990 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $21,884 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $94,106 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $94,106 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Managements Informations Services | 900099 | $605,738 | $605,738 | $0 | $0 |
| Contracted Therapy | 900099 | $9,934 | $9,934 | $0 | $0 |
| Miscellaneous | 900099 | $186,196 | $186,196 | $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $801,868 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,758,557 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,254,122 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,929,446 | TotalAmt |
| Program Services | $8,439,275 | ProgramServicesAmt |
| Management And General | $1,490,171 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,314 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $142,314 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,626,769 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,626,769 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $728,157 | TotalAmt |
| Program Services | $611,654 | ProgramServicesAmt |
| Management And General | $116,503 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,989 | TotalAmt |
| Program Services | $54,247 | ProgramServicesAmt |
| Management And General | $122,742 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,447 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $12,447 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,031 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $5,031 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,409 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,409 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,243 | TotalAmt |
| Program Services | $30 | ProgramServicesAmt |
| Management And General | $3,213 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,670,571 | TotalAmt |
| Program Services | $2,518,764 | ProgramServicesAmt |
| Management And General | $151,807 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,003 | TotalAmt |
| Program Services | $13 | ProgramServicesAmt |
| Management And General | $16,990 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $665,358 | TotalAmt |
| Program Services | $467,897 | ProgramServicesAmt |
| Management And General | $197,461 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,078 | TotalAmt |
| Program Services | $43,757 | ProgramServicesAmt |
| Management And General | $201,321 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $364,821 | TotalAmt |
| Program Services | $20,211 | ProgramServicesAmt |
| Management And General | $344,610 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,129 | TotalAmt |
| Program Services | $11,009 | ProgramServicesAmt |
| Management And General | $4,120 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,014 | TotalAmt |
| Program Services | $4,906 | ProgramServicesAmt |
| Management And General | $3,108 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,710 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $4,710 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,184,444 | TotalAmt |
| Program Services | $711,415 | ProgramServicesAmt |
| Management And General | $473,029 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,875 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $214,875 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical/Surgical/Pharmaceutical Supplies | $1,727,263 | $1,719,269 | $7,994 | $0 |
| Maintenance Contracts/Purchased Services | $4,306,026 | $2,239,602 | $2,066,424 | $0 |
| leases | $90,994 | $40,785 | $50,209 | $0 |
| Benefit Allocations | $0 | $1,503,931 | -$1,503,931 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $667,626 | TotalAmt |
| Program Services | $565,205 | ProgramServicesAmt |
| Management And General | $102,421 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,807,717 | TotalAmt |
| Program Services | $18,951,970 | ProgramServicesAmt |
| Management And General | $5,855,747 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,485 | BOYAmt |
| EOY | $38,118 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $459,463 | BOYAmt |
| EOY | $560,158 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,276 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,036,129 | BOYAmt |
| EOY | $1,829,951 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,472 | BOYAmt |
| EOY | $48,558 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,205 | BOYAmt |
| EOY | $269,926 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,871 | BOYAmt |
| EOY | $138,240 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $33,636,435 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $22,712,892 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,430,521 | BOYAmt |
| EOY | $10,923,543 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,326,176 | BOYAmt |
| EOY | $3,389,310 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,825,598 | BOYAmt |
| EOY | $17,197,804 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,355,880 | BOYAmt |
| EOY | $1,680,002 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $468,250 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,882,122 | BOYAmt |
| EOY | $5,290,014 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,706,252 | BOYAmt |
| EOY | $6,970,016 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,219,268 | BOYAmt |
| EOY | $7,070,544 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,874,467 | BOYAmt |
| EOY | $3,131,632 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,611 | BOYAmt |
| EOY | $25,612 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,119,346 | BOYAmt |
| EOY | $10,227,788 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,825,598 | BOYAmt |
| EOY | $17,197,804 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,049,160 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $0 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $157,602 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $1,409 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $1,409 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 | FormAndLineReferenceDesc |
| Explanation | IDMH pays annual dues to American Hospital Associations, AHA and Healthcare Association of New York State, HANYS of which a percentage is for lobbying fees. The total fees paid to all in 2016 is $1,409 | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $241,407 | BeginningYearBalanceAmt |
| Contributions | $0 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $215,795 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $25,612 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $194,062 | BeginningYearBalanceAmt |
| Contributions | $133,021 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $85,676 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $241,407 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $407,988 | BeginningYearBalanceAmt |
| Contributions | $134,415 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $348,341 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $194,062 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $536,754 | BeginningYearBalanceAmt |
| Contributions | $118,059 | ContributionsAmt |
| Investment Earnings Or Losses | $0 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $246,825 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $407,988 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $335,165 | BeginningYearBalanceAmt |
| Contributions | $499,265 | ContributionsAmt |
| Investment Earnings Or Losses | $2,324 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $0 | GrantsOrScholarshipsAmt |
| Other Expenditures | $300,000 | OtherExpendituresAmt |
| Administrative Expenses | $0 | AdministrativeExpensesAmt |
| End Year Balance | $536,754 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $52,925 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Book Value | $52,925 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $16,697,615 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,473,383 | DepreciationAmt |
| Book Value | $8,224,232 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $16,885,895 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,239,509 | DepreciationAmt |
| Book Value | $2,646,386 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,923,543 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| IDMH Children's Department Fund (Children Trust Fund) | $2,156,631 |
| Deprecation Funds | $850,000 |
| Interst in Net Assets of Foundation | $382,679 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,389,310 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Self Insurance Reserve | $1,546,607 |
| Accrued Pension Cost | $10,054 |
| Accrued REimbursement Pay Net | $1,305,054 |
| Due to Arnot Health | $2,428,299 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,290,014 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $21,780,441 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $0 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Recoveries Prior Year Grants | $0 | RecoveriesPriorYearGrantsAmt |
| Other Revenue | $21,884 | OtherRevenueAmt |
| Revenue Not Reported | $21,884 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,758,557 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $0 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,758,557 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $24,829,601 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $0 | DonatedServicesUseFcltsAmt |
| Prior Year Adjustments | $0 | PriorYearAdjustmentsAmt |
| Losses Reported | $0 | LossesReportedAmt |
| Other Expenses Included | $21,884 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $21,884 | ExpensesNotReportedAmt |
| Expenses Subtotal | $24,807,717 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $0 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $24,807,717 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part V, Line 4 | The Intended uses of the endowment funds are based upon the designation from the organizations documents which include staff educations, community education, and charity care. the board endowments funds is a board designed or use in the highest area of need. |
| Schedule D, Part XI, Line 2d | Nutritional services expense of 21,884 offset to Nutritional Service Income |
| Schedule D, Part XII, Line 2d | Nutritional Service Expense of 21,884 re class to reduce revenue on the cost of goods sold |
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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| 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) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 162 | PersonsServedCnt |
| Total Community Benefit Expns | $33,496 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | -$2,189 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $35,685 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0014 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 9801 | PersonsServedCnt |
| Total Community Benefit Expns | $4,504,569 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,786,529 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,718,040 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0693 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 9963 | PersonsServedCnt |
| Total Community Benefit Expns | $4,538,065 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,784,340 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,753,725 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0707 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 20 | PersonsServedCnt |
| Total Community Benefit Expns | $417 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $417 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 9 | ActivitiesOrProgramsCnt |
| Persons Served | 87626 | PersonsServedCnt |
| Total Community Benefit Expns | $10,346,559 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,671,575 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,674,984 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1884 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 87646 | PersonsServedCnt |
| Total Community Benefit Expns | $10,346,976 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,671,575 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,675,401 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1884 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 10 | ActivitiesOrProgramsCnt |
| Persons Served | 97609 | PersonsServedCnt |
| Total Community Benefit Expns | $14,885,041 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,455,915 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,429,126 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.2591 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $2,450 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,450 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $2,450 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,450 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0001 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,999,426 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $883,387 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $891,199 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$7,812 | 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 |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp
Entity Name EntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARNOT OGDEN MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activities | ADMINISTRATION & CONSULTING | PrimaryActivitiesTxt |
| Org Profit Or Ownership | 0 | OrgProfitOrOwnershipPct |
| Ofcr Etc Profit Or Ownership | 0 | OfcrEtcProfitOrOwnershipPct |
| Physicians Profit Or Ownership | 0 | PhysiciansProfitOrOwnershipPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | IRA DAVENPORT MEMORIAL HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7571 ROUTE 54 | AddressLine1Txt |
| City | BATH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14810 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.arnothealth.org | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IRA DAVENPORT MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.arnothealth.org | OwnWebsiteURLTxt |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.arnothealth.org | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| 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 | 150 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| 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 |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.arnothealth.org | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.arnothealth.org | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.arnothealth.org | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5-IRA DAVENPORT MEMORIAL HOSPITAL | In the Fall of 2015, Arnot Health participated in a comprehensive assessment of community needs across county lines with partners such as the Chemung County Health Department, Steuben County Public Health, other hospitals and healthcare agencies in Chemung, Steuben and Schuyler Counties, along with a diverse, collaborative community of partners and residents. The year-long process of assessing community health needs was facilitated by consultants contracted by the Chemung County Health Department from the S2AY Rural Health Network. Arnot Health, in partnership with this dual-county collaborative network, used the MAPP process (Mobilizing for Action through Planning and Partnership) to collect and analyze data from a variety of sources. Valuable input was gained from data retrieved and analyzed by the Finger Lakes Health System Agency from the New York State Prevention Agenda Dashboard, multi-payer claims data, EBRFSS, SPARCS and additional sources. Also, input was gained from diverse community focus groups made of both Chemung and Steuben County residents. The focus group meetings were facilitated by S2AY, Chemung and Steuben County Health Departments, Arnot Health and other partnership members. The residents were engaged in discussions concerning their current health status and opinions on specific county-wide health challenges. Areas of disparity were assessed within each county. Findings from the Community Health Assessment (CHA) data and community focus groups identified some overlapping areas of public health concerns and disparities in Chemung and Steuben Counties. |
| Schedule H, Part V, Section B, Line 6a-IRA DAVENPORT MEMORIAL HOSPITAL | Arnot Health is comprised of three hospitals: Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative, and wellness services to meet the needs of residents in Chemung, Steuben, and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. Arnot Health System has more than 300 physicians from over 50 specialties. The independent, not-for-profit regional healthcare system currently has a total of 709 beds; 478 acute care beds and 231 skilled nursing/long-term beds. |
| Schedule H, Part V, Section B, Line 6b-IRA DAVENPORT MEMORIAL HOSPITAL | In 2015, Arnot Health participated in a comprehensive assessment of community needs across county lines with partners such as the Chemung County Health Department, Steuben County Public Health, other hospitals and healthcare agencies in Chemung, Steuben and Schuyler Counties, along with a diverse, collaborative community of partners and residents. |
| Schedule H, Part V, Section B, Line 7d-IRA DAVENPORT MEMORIAL HOSPITAL | Arnot Ogden Medical Center will use a variety of methods to disseminate the community Service Plan for Arnot Ogden Medical Center, St. Joseph's Hospital and Ira Davenport Memorial Hospital, and the CHIPs for Chemung and Steuben Counties: Web site documents will be posted on the healthcares system web site at the following URL: http://www.arnothealth.org/about us. Arnot Health developed a section of the system's web site dedicated to community outreach in 2016, budget permitting to bring community service work to a more prominent place within the website. This can be accessed at: https://www.arnothealth.org/community-service-plans. Partner web sites Chemung and Steuben counties will post links to their CHA and CHIP on their web sites. Presentations at Arnot Health's Community Health Department provide education about the healthcare system and community outreach strategies. |
| Schedule H, Part V, Section B, Line 11-IRA DAVENPORT MEMORIAL HOSPITAL | Beyond involvement in the aforementioned health collaboratives, Arnot Health participates in a number of community efforts aimed at improving health across the continuum. Arnot Health is committed to outreach in underserved populations and preventing chronic disease in the community through free community lectures, preventive health screenings, health promotion presentations , and provision of wellness education. In 2016, Arnot Health provided health promotion programs and screenings for children, adolescents, adults, and seniors. Screenings included blood pressure , blood glucose, body fat analysis, body mass index, diabetes risk assessments, COPD (Lung Age), Carboxyhemoglobin , vascular and skin screenings. Arnot Health participated in community forums and focus groups to assist in the development of strategic plans to increase economic development in the Finger Lakes and Southern Tier regions , reduce poverty in Elmira, and revitalize Elmira Downtown.Arnot Health continues to promote and support breastfeeding as a strategy to reduce obesity in children and mothers by serving on community coalitions, networks and partnerships in Chemung and Steuben Counties. Arnot Health has a leadership role in the Twin Tiers Breastfeeding Network (TTBN) in Chemung County. The TTBN is a collaborative effort to increase the rate of initiation and duration of breastfeeding among women in the Twin Tiers through support, education and referrals. The TTBN worked with the Chemung Library System to offer breastfeeding support free to the community. The Baby Cafe model was adapted to fit the needs and resources of Chemung County and has been named the Baby Bistro. The Baby Bistro is staffed by the network's Peer Lactation Consultants , Certified Lactation Consultants, and the International Board Certified Lactation Consultant (IBCLC) members on a rotating basis at two of the libraries in Elmira. TTBN also received a small grant from the New York Statewide Breastfeeding Coalition to assist with breastfeeding promotion. The funds were used to recognize 31 businesses and organizations for creating and maintaining a breastfeeding friendly environment during World Breastfeeding Week in August. The recognition ceremony was held in Wisner Park at downtown Elmira's weekly farmer's market. n Steuben County, the Public Health Department chairs the Steuben Breastfeeding Coalition and offers a Baby Cafe, which is a free community breastfeeding support group located at the collaboration with community partners, Arnot Health continued to plan and offer programs to promote physical activity and healthy choices in the community. Arnot Health participated in the following events during 2016: Step it Up Community Walking Program, Hunt for Gold Shoes,Fit Families of the Suthern Tier,Strong Kids Safe Kids (Chemung, Steuben, and Schuyler Counties), Chemung County Summer Cohesion Travel Program ,Girls on the Run of the Southern Tier, Davenport and Taylor Run, Wineglass Marathon Arnot Health, in collaboration with Southern Tier Pediatrics, also offers Fit Families in the Southern Tier (FFIST). This eight-week program is designed to teach obese children and their families healthy nutrition habits and physical activity. Each child must have a family member participate with them . To measure progress , staff assess pre- and post-program weight and BMI, and conduct strength and fitness testing. On average, participants experience 70 percent improvement in at least one area measured. |
| Schedule H, Part V, Section B, Line 20e-IRA DAVENPORT MEMORIAL HOSPITAL | Self pay collection staff reviews any prior accounts to check for commercial insurance or Medicaid that may need to applied to current self pay accounts. These accounts are reviewed using the self pay work list. If insurance is located, the self pay collector must verify eligibility for the dates of service. The self pay staff will change the health plan to the correct plan for all covered dates of service and Arnot billing will submit the claim or claims. If no insurance is located, confirm if a patient may have qualified for Medicaid. If Medicaid coverage is approved self pay staff will change the health plan to Medicaid for all covered dates of service and follow correct billing processes. Self Pay Collection Staff attempts to collect the full balance due by check or credit card. If they are unable to make the full payment, the self pay staff will attempt to make payment arrangements and to notify the patient about the Arnot Ogden Medical Center Community Care Program. If the patient wants to apply for the community care program, the patients will be sent an application for the community care program and will be informed of documentation they will need to submit with the application. The self pay collectors document all activity in Sorian, and enter any necessary hold to support resolution. Self pay collections staff enters the payment plan and document comments in Sorian. Payment plan statements are demanded and sent to the patient. If the patient does not enter into a payment plan agreement, or fails to pay as agreed, the account will go through the standard dunning and collection agency activity. Our Collection Agents are also required to provide written notice explaining extraordinary collection efforts. |
| Schedule H, Part V, Section B, Line 24-IRA DAVENPORT MEMORIAL HOSPITAL | Participants in the Medicare System are required to charge all patients the same amount for services regardless of insurance per the Medicare participation guidelines. |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 6a | Arnot Health is comprised of three hospitals: Arnot Ogden Medical Center and St. Joseph's Hospital in Elmira; and Ira Davenport Memorial Hospital in Bath, New York. Arnot Health provides diagnostic, ambulatory, secondary and tertiary acute care, as well as substance abuse, psychiatric, rehabilitative, and wellness services to meet the needs of residents in Chemung, Steuben, and Schuyler Counties in the Southern Tier of New York, and Bradford and Tioga Counties in the Northern Tier of Pennsylvania. Arnot Health System has more than 300 physicians from over 50 specialties. The independent, not-for-profit regional healthcare system currently has a total of 709 beds; 478 acute care beds and 231 skilled nursing/long-term beds. |
| Schedule H, Part I, Line 7 | Arnot Ogden Medical Center uses a Cost to Charge Ratio to calculate the financial assistance and community benefit section. The medical center offers a variety of services to the community it serves as part of an integrated delivery system. it is Necessary to financially subsidized some of these services at the revenue generates does not cover the cost of providing the services. |
| Schedule H, Part II | Beyond involvement in the aforementioned health collaboratives, Arnot Health participates in a number of community efforts aimed at improving health across the continuum. Arnot Health is committed to outreach in underserved populations and preventing chronic disease in the community through free community lectures, preventive health screenings, health promotion presentations , and provision of wellness education. In 2016, Arnot Health provided health promotion programs and screenings for children, adolescents, adults, and seniors. Screenings included blood pressure , blood glucose, body fat analysis, body mass index, diabetes risk assessments, COPD (Lung Age), Carboxyhemoglobin , vascular and skin screenings. Arnot Health participated in community forums and focus groups to assist in the development of strategic plans to increase economic development in the Finger Lakes and Southern Tier regions , reduce poverty in Elmira, and revitalize Elmira Downtown.Arnot Health continues to promote and support breastfeeding as a strategy to reduce obesity in children and mothers by serving on community coalitions, networks and partnerships in Chemung and Steuben Counties. Arnot Health has a leadership role in the Twin Tiers Breastfeeding Network (TTBN) in Chemung County. The TTBN is a collaborative effort to increase the rate of initiation and duration of breastfeeding among women in the Twin Tiers through support, education and referrals. The TTBN worked with the Chemung Library System to offer breastfeeding support free to the community. The Baby Cafe model was adapted to fit the needs and resources of Chemung County and has been named the Baby Bistro. The Baby Bistro is staffed by the network's Peer Lactation Consultants , Certified Lactation Consultants, and the International Board Certified Lactation Consultant (IBCLC) members on a rotating basis at two of the libraries in Elmira. TTBN also received a small grant from the New York Statewide Breastfeeding Coalition to assist with breastfeeding promotion. The funds were used to recognize 31 businesses and organizations for creating and maintaining a breastfeeding friendly environment during World Breastfeeding Week in August. The recognition ceremony was held in Wisner Park at downtown Elmira's weekly farmer's market. n Steuben County, the Public Health Department chairs the Steuben Breastfeeding Coalition and offers a Baby Cafe, which is a free community breastfeeding support group located at the collaboration with community partners, Arnot Health continued to plan and offer programs to promote physical activity and healthy choices in the community. Arnot Health participated in the following events during 2016: Step it Up Community Walking Program, Hunt for Gold Shoes,Fit Families of the Suthern Tier,Strong Kids Safe Kids (Chemung, Steuben, and Schuyler Counties), Chemung County Summer Cohesion Travel Program ,Girls on the Run of the Southern Tier, Davenport and Taylor Run, Wineglass Marathon Arnot Health, in collaboration with Southern Tier Pediatrics, also offers Fit Families in the Southern Tier (FFIST). This eight-week program is designed to teach obese children and their families healthy nutrition habits and physical activity. Each child must have a family member participate with them . To measure progress , staff assess pre- and post-program weight and BMI, and conduct strength and fitness testing. On average, participants experience 70 percent improvement in at least one area measured. |
| Schedule H, Part III, Section A, Line 4 | The Organization's allowance for doubtful accounts increased from 18.2% of gross accounts receivable at December 31, 2015 to 19.0% of gross accounts receivable at December 31, 2016. In addition, the Organization's bad debt write-offs decreased from $1,797,500 for fiscal year 2015 to $1,999,427 in fiscal year 2016. The increase in bad debt write-offs is a result of the Organization assisting self-pay patients obtain medical insurance through marketplace enrollment. The Organization has not changed its charity care or uninsured discount policies during the fiscal year 2015 or 2016. The Organization does not maintain a material allowance for doubtful accounts from third party payors, nor did it have significant write-offs from third party payors. |
| Schedule H, Part III, Section B, Line 8 | Arnot Health uses a Cost to Charges ratio to calculate the Financial Assistance and Community Benefit Section. The organization offers a variety of services to the community it serves as part of an integrated delivery system. It is necessary to financially subsidize some of these services as the revenue generated does not cover the cost of providing the services. |
| Schedule H, Part III, Section C, Line 9b | Self pay collection staff reviews any prior accounts to check for commercial insurance or Medicaid that may need to applied to current self pay accounts. These accounts are reviewed using the self pay worklist. If insurance is located, the self pay collector must verify eligibility for the dates of service. The self pay staff will change the health plan to the correct plan for all covered dates of service and Arnot billing will submit the claim or claims. If no insurance is located, confirm if a patient may have qualified for Medicaid. If Medicaid coverage is approved self pay staff will change the health plan to Medicaid for all covered dates of service and follow correct billing processes. Self Pay Collection Staff attempts to collect the full balance due by check or credit card. If they are unable to make the full payment, the self pay staff will attempt to make payment arrangements and to notify the patient about the Arnot Ogden Medical Center Community Care Program. If the patient wants to apply for the community care program, the patients will be sent an application for the community care program and will be informed of documentation they will need to submit with the application. The self pay collectors document all activity in Soirian, and enter any necessary hold to support resolution. Self pay collections staff enters the payment plan and document comments in Soirian. Payment plan statements are demanded and sent to the patient. If the patient does not enter into a payment plan agreement, or fails to pay as agreed, the account will go through the standard dunning and collection agency activity. |
| Schedule H, Part VI, Line 2 | Findings from the Community Health Assessment (CHA) data and community focus groups identified some overlapping areas of public health concerns and disparities in Chemung and Steuben Counties. The top priority for both Chemung and Steuben Counties: To Prevent Chronic Disease. With the focus areas including: 1. Reduce obesity in children and adults; 2. Reduce Illness, Disability and Death Related to Tobacco Use and Secondhand Smoke Exposure; 3. Increase Access to High Quality Chronic Disease Preventative Care in Both Clinical and Community Settings. Two major contributors to the incidence of chronic disease in Chemung and Steuben Counties are obesity and tobacco use. Over the next two years, Arnot Health and cross-county collaborative partnerships will begin implementing the CHIP and monitoring the effectiveness in Chemung and Steuben Counties. Arnot Health's Annual Community Service Plan will report progress made towards the goals and impact on the community's health. The 2016-2018 Chemung and Steuben CHNAs and CHIPS are available on the Arnot Health website Community Service Plans Page at http://www.arnothealth.org/community-service-plans. |
| Schedule H, Part VI, Line 3 | The Arnot Health communicates our Community Care Program in the following ways: Signage in waiting rooms, brochures in waiting rooms and Admission Packets, notations on billing notices, staff education so they can share availability of program and contact information with patients. Communication and education of our Certified Application Counselor for patient insurance enrollment are done so they are informed of the program details and contact information. Communication is also done with collection agencies and collection attorneys so they can also share the availability of the program and contact information with prospective enrollees. The information is also posted on our website at: www.arnothealth.org. |
| Schedule H, Part VI, Line 4 | Arnot Health's three hospitals are located in two counties. Arnot Ogden Medical Center and St. Joseph's Hospitals are located in Chemung County; Ira Davenport Memorial Hospital is situated in Steuben County. Together, Chemung and Steuben Counties make up approximately 1,801 square miles of geographical area in the Southern Tier of New York. The City of Elmira serves as Chemung County's seat and the primary metropolitan area. The county is characterized as 76 percent urban and 24 percent rural. Steuben County is a rural county, and with a land area of 1,393 miles, it is the seventh largest county in NYS. (http://www.city-data.com/county/Chemung _County-NY.html) |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Robert Lambert MD | ||||||||||||||
| President Arnot Health | $0 | $573,900 | $0 | $57,240 | $0 | $0 | $0 | $13,250 | $0 | $24,987 | $0 | $669,377 | $0 | $0 |
| Ronald J Kintz DHA | ||||||||||||||
| Senior VP/CFO | $0 | $333,618 | $0 | $38,860 | $0 | $0 | $0 | $13,250 | $0 | $24,987 | $0 | $410,715 | $0 | $0 |
| James Watson | ||||||||||||||
| President IDMH | $0 | $56,870 | $0 | $0 | $0 | $0 | $0 | $1,177 | $0 | $247 | $0 | $58,294 | $0 | $0 |
| Richard Cleland | ||||||||||||||
| Site Adm Acute & Skilled Nursing Services | $0 | $92,314 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $92,314 | $0 | $0 |
| Dennis O' Connor MD | ||||||||||||||
| Medical Director | $60,553 | $0 | $0 | $0 | $0 | $0 | $1,806 | $0 | $0 | $0 | $62,359 | $0 | $0 | $0 |
| Kevin Murray | ||||||||||||||
| Director of Pharmacy | $152,605 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $13,632 | $0 | $166,237 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 3 | FormAndLineReferenceDesc |
| Explanation | Compensation for the president and vice president is set pursuant to a policy and compensation philosophy adopted by the boards. The AOMC Board has a compensation committee consisting of outside directors (AOMC board members are referred to as managers). The Compensation committee uses a consultant to advise it on compensation for the officers. The consultant collects and reports data on compensations for similar positions in similar nonprofit hospitals from upstate New York and western Pennsylvania. The compensation committee recommends any adjustments to the executive committee of the board which reviews the recommendations and approves them without employees in the room. This action is then reviewed with the entire board also in executive session we use Yaffee group to help with compensations | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, Line 2 | For Bernard Burns Board Secretary He is Executive Director of Arc of Steuben, Taylor SNF and Adult Day Care contracts with Arc for Transportation. Scott Sprague wife is Director of Keuka Health Care Foundation. Joseph F Meade is the president of Keuka Health Care Foundation and Mercury Aircraft Foundation Gift to Hospital. Werner Brammer, MD receives Stipend for Supervision Trish Brown at Family health Ctr.. Kathryn Muller Hold a contract with Arnot Health/IRA Davenport Hospital for Social Welfare Examine service to process Medical Applications |
| Form 990, Part VI, Section A, Line 3 | as a result of Arnot Ogden Medical Center becoming the "active parent" of Ira Davenport Memorial Hospital the management of several departments were consolidated under a single manager |
| Form 990, Part VI, Section A, Line 7a | Ira Davenport Hospital Board of Directors can only elect the president and hire medical directors and board members at that facility. Affiliated Board of Directors of Arnot Health are responsible for operations of Ira Davenport Memorial Hospital. |
| Form 990, Part VI, Section A, Line 7b | Ira Davenport Hospital Board of Directors can only elect the president and hire medical directors and board members at that facility. Affiliated Board of Directors of Arnot Health are responsible for operations of Ira Davenport Memorial Hospital. |
| Form 990, Part VI, Section B, Line 11b | Once the 990 is in final form it is presented to the board committee and a copy is made available to all board members for review and questions. |
| Form 990, Part VI, Section B, Line 12c | All members of the Board of Managers, officers, and management employees shall be required annually to file a disclosure statement setting forth any respect in which such person, or any person associated with such person, has or may have any interest in any transaction in which there may be, or appear to be, a conflict between the interest of such person and the Arnot Ogden Medical Center, an associated included (1) Spouse, a descendant or an ancestor, of a spouse of a descendant of ancestor; (2) an organization in which the person of an associated is a partner of employee, or such person is an associated owns a more then 10% beneficial interest; (3) a trust in which such person is a trustee, or such person or an associate holds more than 10% beneficial interest and (4) a corporations in which such person or an associate is an officer or a director or employee, or such person or an associate is an owner of more than 10% of any class of securities |
| Form 990, Part VI, Section B, Line 15 | Compensation for the president and vice president is set pursuant to a policy and compensation philosophy adopted by the boards. The AOMC Board has a compensation committee consisting of outside directors (AOMC board members are referred to as managers). The Compensation committee uses a consultant to advise it on compensation for the officers. The consultant collects and reports data on compensations for similar positions in similar nonprofit hospitals from upstate New York and western Pennsylvania. The compensation committee recommends any adjustments to the executive committee of the board which reviews the recommendations and approves them without employees in the room. This action is then reviewed with the entire board also in executive session |
| Form 990, Part VI, Section C, Line 19 | Items required for public disclosure are made available for those who request the information and shared with guidestar.org and EMMA web site |
| Form 990, Part IX, Line 11g | Program contract physicians $1,268,909, contract RN $860,498, Consulting $21,976, Contract Tech $367,381, Management Consult Project $8,477, Fee Collections $112,439, Contract Labor $4,802, Press Ganey surveys $26,089 |
| Form 990, Part XI, Line 9 | Keuka Foundation Net loss (1,920), Donations KHF 121,811, Net assets released from restrictions KHF (93,048), IDMH Pension charge to equity 24,129, IDMH Change in Children Trust/Walker 228,404, IDMH Donation capital 70,310, IDMH Change in Charitable Trust (192,089), Cost of Inventory Adj 5 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| KEUKA HEALTH CARE FOUNDATION | |||||||||||
| 7571 STATE ROUTE 54 | BATH | NY | 14810 | 161461215 | PROVIDE FINANCIAL | NY | 501(C)(3) | 11 | N/A | 0 | |
| ARNOT OGDEN MEDICAL CENTER | |||||||||||
| 600 ROE AVENUE | ELMIRA | NY | 14905 | 160743905 | AFFILIATE | NY | 501 (C)(3) | 11 | N/A | 0 | |
| ARNOT OGDEN MEDICAL CENTER FOUNDATION | |||||||||||
| 600 ROE AVENUE | ELMIRA | NY | 14905 | 161109472 | CONTRIBUTION MGT | NY | 501(C)(3) | 11E | N/A | 0 | |
| ARNOT HEALTH INC | |||||||||||
| 600 ROE AVENUE | ELMIRA | NY | 14905 | 453049405 | MANAGEMENT | NY | 501 (C)(3) | N/A | 0 | ARNOT HEALTH INC | |
| ST JOSEPHS HOSPITAL | |||||||||||
| 555 ST JOSEPHS BLVD | ELMIRA | NY | 14901 | 160743163 | AFFILIATE | NY | 501(C)(3) | 11 | N/A | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IVY STREET DEVELOPMENT CORP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 IVY STREET | AddressLine1Txt |
| City | ELMIRA | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14905 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161009245 | EIN |
| Primary Activities | REAL ESTATE RENTAL | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Ownership | 0 | OwnershipPct |
| 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 | 0 | 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ARNOT OGDEN MEDICAL CENTER | ||
| o | $3,454,921 | Arnot Ogden Medical Center provided employees who provide medical, management information system, and various administrative services to Ira Davenport Memorial Hospital. The method of determining the amount was cost. |
| KEUKA HEALTH CARE FOUNDATION | ||
| c | $70,310 | A gift from Keuka Health Care Foundation to Ira Davenport Memorial Hospital for contribution to the Taylor SNF and remodel of Emergency room entrance |