MARGARETVILLE MEMORIAL HOSPITAL: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization: MARGARETVILLE MEMORIAL HOSPITAL (EIN 15-0552726)
Tax period: 2016-01-01 to 2016-12-31
Filed: 2017-10-30
IRS object ID: 201723039349300917
Schema version: 2016v3.1
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 G
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2017-10-30T10:22:00-05:00	ReturnTs
Tax Period End	2016-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	5 TIMES SQUARE	AddressLine1Txt
City	NEW YORK	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	10036	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2016-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	150552726	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MARGARETVILLE MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% ERIN NAGY	InCareOfNm
Business Name Control	MARG	BusinessNameControlTxt
Phone	8459436084	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	42084 STATE ROUTE 28	AddressLine1Txt
City	MARGARETVILLE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12445	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DAVID SCARPINO	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	8459436024	PhoneNum
Signature	2017-10-26	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	LAURA KIELCZEWSKI	PreparerPersonNm
PTIN	P00740769	PTIN
Phone	2127733000	PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	164.57.159.254	IPv4AddressTxt

Field	Value	IRS element (for citing)
Federal Original Submission Id	26308520173035000009	FederalOriginalSubmissionId
Federal Original Submission Id	2017-10-30	FederalOriginalSubmissionIdDt
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	050F75853A9F423F493495C03CDD05FDA32C01D0	AtSubmissionCreationDeviceId
At Submission Filing Device Id	050F75853A9F423F493495C03CDD05FDA32C01D0	AtSubmissionFilingDeviceId

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	DAVID SCARPINO	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	741 GRANT AVENUE	AddressLine1Txt
City	LAKE KATRINE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12449	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$15,995,198	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	http://www.margaretvillehosp.org/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1930	FormationYr
Legal Domicile State	NY	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE IMMEDIATE ACCESS TO HIGH QUALITY MEDICAL CARE AND DIAGNOSTIC TESTING SERVICES TO MEDICALLY UNDERSERVED AREAS IN THE CATSKILL MOUNTAINS.	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	12	VotingMembersIndependentCnt
Total Employee	147	TotalEmployeeCnt
Total Volunteers	22	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$1,752,614	PYContributionsGrantsAmt
CY Contributions Grants	$2,988,507	CYContributionsGrantsAmt
PY Program Service Revenue	$9,248,871	PYProgramServiceRevenueAmt
CY Program Service Revenue	$9,053,829	CYProgramServiceRevenueAmt
PY Investment Income	$75,458	PYInvestmentIncomeAmt
CY Investment Income	$362,189	CYInvestmentIncomeAmt
PY Other Revenue	$535,616	PYOtherRevenueAmt
CY Other Revenue	$1,347,338	CYOtherRevenueAmt
PY Total Revenue	$11,612,559	PYTotalRevenueAmt
CY Total Revenue	$13,751,863	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	$6,712,242	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$7,076,052	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$6,689,303	PYOtherExpensesAmt
CY Other Expenses	$5,799,118	CYOtherExpensesAmt
PY Total Expenses	$13,401,545	PYTotalExpensesAmt
CY Total Expenses	$12,875,170	CYTotalExpensesAmt
PY Revenues Less Expenses	-$1,788,986	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$876,693	CYRevenuesLessExpensesAmt
Total Assets BOY	$9,166,004	TotalAssetsBOYAmt
Total Assets EOY	$7,183,706	TotalAssetsEOYAmt
Total Liabilities BOY	$8,212,354	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$5,048,393	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$953,650	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$2,135,313	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	TO PROVIDE IMMEDIATE ACCESS TO HIGH QUALITY MEDICAL CARE AND DIAGNOSTIC TESTING SERVICES TO MEDICALLY UNDERSERVED AREAS IN THE CATSKILL MOUNTAINS.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$10,154,924	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$9,053,829	RevenueAmt
Desc	MARGARETVILLE MEMORIAL HOSPITAL PROVIDES ACUTE HEALTH CARE SERVICES TO RESIDENTS AND VISITORS TO THE CATSKILL REGION. MARGARETVILLE MEMORIAL HOSPITAL RECORDED 1,492 PATIENT DAYS, 4,167 EMERGENCY ROOM VISITS, 163 OUTPATIENT SURGERIES, 238 DISCHARGES AND 84 INFUSION THERAPIES IN 2016.	Desc
Total Program Service Expenses	$10,154,924	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	32	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	147	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	16	GoverningBodyVotingMembersCnt
Independent Voting Member	12	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	Yes (true)	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	NY	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	ERIN NAGY	PersonNm
Phone	8459436084	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	741 GRANT AVENUE	AddressLine1Txt
City	LAKE KATRINE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12449	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 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	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Carey Wagner
CHAIR	1.0	4.0	Yes (X)	$0	$0	$0
JANE Piasek
Trustee	1.0	1.0	Yes (X)	$0	$0	$0
Fred Marguiles
Secretary	1.0	1.0	Yes (X)	$0	$0	$0
Arthur Martello
Trustee	1.0	1.0	Yes (X)	$0	$0	$0
Jenny Morrill-Liddle
1st Vice Chair	1.0	1.0	Yes (X)	$0	$0	$0
Thomas O'Brien
Trustee	1.0	1.0	Yes (X)	$0	$0	$0
Philip Mehl
TRUSTEE (effective 04/16)	1.0	39.0	Yes (X)	$0	$50,429	$5,534
David Riordan
Trustee	1.0	1.0	Yes (X)	$0	$0	$0
Nancy Slauson
Trustee	1.0	1.0	Yes (X)	$0	$0	$0
David Scarpino
CHIEF EXECUTIVE OFFICER	1.2	36.3	Yes (X)	$0	$490,944	$23,443	Yes (X)
Kent Garrett
Trustee	1.0	1.0	Yes (X)	$0	$0	$0
Thomas Collins
EX-OFFICIO TRUSTEE	1.0	4.0	Yes (X)	$0	$0	$0
James Howie
Trustee	1.0	1.0	Yes (X)	$0	$0	$0
Rita Herbst
Trustee	1.0	1.0	Yes (X)	$0	$0	$0
WEYMIN HAGO MD
EX-OFFICIO TRUSTEE	1.0	1.0	Yes (X)	$69,077	$0	$0
MARK POHAR
TRUSTEE (effective 5/4/16)	18.25	19.25	Yes (X)	$0	$140,335	$19,876
CHRISTOPHER ESOLA
TRUSTEE (effective 5/1/16)	37.5	0.0	Yes (X)	$0	$80,179	$2,475
Patricia Gavis
CHIEF FINANCIAL OFFICER	0.5	37.0		$0	$259,863	$20,854	Yes (X)
Sandra Horan
Chief Nursing Officer	0.0	37.5		$0	$200,755	$12,950		Yes (X)
John Finch
CIO & CCO (resigned 12/22/16)	1.0	36.5		$0	$237,451	$33,909		Yes (X)
Eileen King
CLINICAL COORDINATOR	40.0	0.0		$239,167	$0	$15,844		Yes (X)
Joseph Marsicovete
Chief Operating Officer	3.0	34.5		$0	$296,183	$16,654		Yes (X)
Paul Llobet MD
Chief Medical Director	5.65	31.85		$0	$312,458	$1,783		Yes (X)
Steven Haas
FORMER CFO	0.0	0.0		$0	$116,471	$14,919			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$308,244	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,185,068	TotReportableCompRltdOrgAmt
Total Other Compensation	$168,241	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	1	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	Yes (true)	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
Laboratory Corp of America
PO Box 12140	BURLINGTON	NC	27216	Laboratory Services	$454,858
Seco Physical Occupational Therap
PO Box 1046	NORWICH	NY	13815	CONSULTING	$194,926
Llobet Medical
PO Box 1020	MARGARETVILLE	NY	12455	Medical	$143,608
MEDICAL STAFFING NETWORK
PO Box 840292	DALLAS	TX	75284	STAFFING AGENCY	$123,007

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	4	CntrctRcvdGreaterThan100KCnt
Fundraising	$0	FundraisingAmt
Related Organizations	$5,000	RelatedOrganizationsAmt
Government Grants	$2,847,408	GovernmentGrantsAmt
All Other Contributions	$136,099	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$2,988,507	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	NET PATIENT SERVICE REVENUE	Desc
Business	621300	BusinessCd
Total Revenue Column	$9,053,829	TotalRevenueColumnAmt
Related Or Exempt Func Income	$9,053,829	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$9,053,829	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$122,218	TotalRevenueColumnAmt
Exclusion	$122,218	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$77,504	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$14,974	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$62,530	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$62,530	TotalRevenueColumnAmt
Exclusion	$62,530	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$2,459,271	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$2,219,300	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$239,971	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$239,971	TotalRevenueColumnAmt
Exclusion	$239,971	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$38,317	FundraisingGrossIncomeAmt
Fundraising Direct Expenses	$9,061	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$29,256	TotalRevenueColumnAmt
Exclusion	$29,256	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

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$0	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$0	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
PHARMACY REVENUE	446110	$502,201	$0	$0	$502,201
PHARMACY SALES TO EMPLOYEES	446110	$337,554	$0	$0	$337,554
REPAYMENT OF LOAN PROCEEDS	900099	$222,500	$0	$0	$222,500

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$193,297	TotalRevenueColumnAmt
Related Or Exempt Func Income	$76,625	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$116,672	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,255,552	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$13,751,863	TotalRevenueColumnAmt
Related Or Exempt Func Income	$9,130,454	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$1,632,902	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	$69,077	TotalAmt
Program Services	$69,077	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	$5,423,315	TotalAmt
Program Services	$4,099,445	ProgramServicesAmt
Management And General	$1,323,870	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$17,272	TotalAmt
Program Services	$12,954	ProgramServicesAmt
Management And General	$4,318	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,195,164	TotalAmt
Program Services	$896,515	ProgramServicesAmt
Management And General	$298,649	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$371,224	TotalAmt
Program Services	$278,418	ProgramServicesAmt
Management And General	$92,806	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$595	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$595	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$72,479	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$72,479	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$23,085	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$23,085	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	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,239,617	TotalAmt
Program Services	$1,094,749	ProgramServicesAmt
Management And General	$144,868	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$7,538	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$7,538	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$565,826	TotalAmt
Program Services	$224,627	ProgramServicesAmt
Management And General	$341,199	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	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	$102,749	TotalAmt
Program Services	$2,200	ProgramServicesAmt
Management And General	$100,549	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$21,437	TotalAmt
Program Services	$10	ProgramServicesAmt
Management And General	$21,427	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	$122,006	TotalAmt
Program Services	$119,887	ProgramServicesAmt
Management And General	$2,119	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$67,676	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$67,676	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	$1,369,834	TotalAmt
Program Services	$1,369,834	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$90,623	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$90,623	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$897,437	$896,730	$707	$0
EQUIPMENT SVCS CONTRACTS	$788,230	$752,224	$36,006	$0
PHYSICIAN FEES	$300,430	$254,030	$46,400	$0
ALL OTHER EXPENSES	$129,556	$84,224	$45,332	$0

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$12,875,170	TotalAmt
Program Services	$10,154,924	ProgramServicesAmt
Management And General	$2,720,246	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Joint Costs TotalJointCostsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$429,384	BOYAmt
EOY	$1,763,237	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$182,396	BOYAmt
EOY	$40,362	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$946,561	BOYAmt
EOY	$872,399	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	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$210,747	BOYAmt
EOY	$248,866	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$144,607	BOYAmt
EOY	$133,304	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$21,652,728	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$19,515,619	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$3,206,285	BOYAmt
EOY	$2,137,109	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$4,046,024	BOYAmt
EOY	$1,988,429	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$9,166,004	BOYAmt
EOY	$7,183,706	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$2,149,936	BOYAmt
EOY	$2,191,385	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,545,120	BOYAmt
EOY	$1,536,554	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$181,303	BOYAmt
EOY	$109,528	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$4,335,995	BOYAmt
EOY	$1,210,926	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$8,212,354	BOYAmt
EOY	$5,048,393	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,031,454	BOYAmt
EOY	$2,135,313	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$144,696	BOYAmt
EOY	$0	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$222,500	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$953,650	BOYAmt
EOY	$2,135,313	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$9,166,004	BOYAmt
EOY	$7,183,706	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$876,693	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$272,847	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Investment Expense	$0	InvestmentExpenseAmt
Prior Period Adjustments	$0	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$577,817	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	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 (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Media Advertisements	$0	MediaAdvertisementsAmt
Mailings Members	false	MailingsMembersInd
Mailings Members	$0	MailingsMembersAmt
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Publications Or Broadcast	$0	PublicationsOrBroadcastAmt
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Grants Other Organizations	$0	GrantsOtherOrganizationsAmt
Direct Contact Legislators	false	DirectContactLegislatorsInd
Direct Contact Legislators	$0	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Rallies Demonstrations	$0	RalliesDemonstrationsAmt
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$23,085	OtherActivitiesAmt
Total Lobbying Expenditures	$23,085	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind
Form4720 Filed4912 Tax	false	Form4720Filed4912TaxInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE C, PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	MARGARETVILLE MEMORIAL HOSPITAL PAYS DUES TO THE IROQUOIS HEALTHCARE ALLIANCE OF NEW YORK STATE (IHA). IN ACCORDANCE WITH SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY IHA, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2016 IHA ANNUAL DUES WERE $23,085.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$23,128	OtherCostOrOtherBasisAmt
Book Value	$23,128	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$4,648,500	OtherCostOrOtherBasisAmt
Depreciation	$3,845,776	DepreciationAmt
Book Value	$802,724	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$456,812	OtherCostOrOtherBasisAmt
Depreciation	$355,058	DepreciationAmt
Book Value	$101,754	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$0	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$16,524,288	OtherCostOrOtherBasisAmt
Depreciation	$15,314,785	DepreciationAmt
Book Value	$1,209,503	BookValueAmt

Field	Value	IRS element (for citing)
Other Land Buildings		OtherLandBuildingsGrp
Total Book Value Land Buildings	$2,137,109	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDesc	Book ValueBookValueAmt
DUE FROM RELATED PARTIES	$1,488,455
INTEREST IN NA - MH FOUNDATION	$329,778
OTHER RECEIVABLE	$121,701
DUE FROM 3RD PARTY PAYORS	$44,137
ASSETS LIMITED AS TO USE	$4,358

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$1,988,429	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
DUE TO THIRD PARTY PAYORS	$1,117,048
OTHER NON-CURRENT LIABILITIES	$93,878

Field	Value	IRS element (for citing)
Total Liability	$1,210,926	TotalLiabilityAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	HARVEST MOON	Event1Nm
Gross Receipts Event1	$24,255	GrossReceiptsEvent1Amt
Gross Revenue Event1	$24,255	GrossRevenueEvent1Amt
Food And Beverage Event1	$3,634	FoodAndBeverageEvent1Amt
Entertainment Event1	$578	EntertainmentEvent1Amt
Other Direct Expenses Event1	$2,811	OtherDirectExpensesEvent1Amt
Event2	FLEA MARKET	Event2Nm
Gross Receipts Event2	$14,062	GrossReceiptsEvent2Amt
Gross Revenue Event2	$14,062	GrossRevenueEvent2Amt
Rent Facility Costs Event2	$120	RentFacilityCostsEvent2Amt
Food And Beverage Event2	$723	FoodAndBeverageEvent2Amt
Entertainment Event2	$400	EntertainmentEvent2Amt
Other Direct Expenses Event2	$795	OtherDirectExpensesEvent2Amt
Other Events Total	0	OtherEventsTotalCnt
Gross Receipts Total	$38,317	GrossReceiptsTotalAmt
Gross Revenue Total Events	$38,317	GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events	$120	RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events	$4,357	FoodAndBeverageTotalEventsAmt
Entertainment Total Events	$978	EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events	$3,606	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$9,061	DirectExpenseSummaryEventsAmt
Net Income Summary	$29,256	NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent150	Yes (X)	Percent150Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$132,753	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$16,317	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$116,436	NetCommunityBenefitExpnsAmt
Total Expense	0.00960	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,898,862	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,116,347	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$782,515	NetCommunityBenefitExpnsAmt
Total Expense	0.06440	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,031,615	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,132,664	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$898,951	NetCommunityBenefitExpnsAmt
Total Expense	0.07400	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,169	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$4,169	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,553,276	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,590,645	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,962,631	NetCommunityBenefitExpnsAmt
Total Expense	0.16150	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$4,557,445	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,590,645	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,966,800	NetCommunityBenefitExpnsAmt
Total Expense	0.16180	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,589,060	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$3,723,309	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,865,751	NetCommunityBenefitExpnsAmt
Total Expense	0.23580	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$455,441	BadDebtExpenseAmt
Reimbursed By Medicare	$3,752,937	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$3,177,866	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	$575,071	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 (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	MARGARETVILLE MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	42084 STATE ROUTE 28	AddressLine1Txt
City	MARGARETVILLE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	12455	ZIPCd

Field	Value	IRS element (for citing)
Website Address	HTTP://WWW.HAHV.ORG/HAHV/HOME.ASPX	WebsiteAddressTxt
State License	1226701C	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MARGARETVILLE MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	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
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	16	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	16	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE SECTION C	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	150.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	SEE SECTION C	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	SEE SECTION C	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE SECTION C	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 Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Prospective Medicare Medicaid	Yes (X)	ProspectiveMedicareMedicaidInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Part V, Section B, Line 5: 2016-2018 CHNA Implementation Plan

IN ACCORDANCE WITH THE AFFORDABLE CARE ACT (ACA) OF 2010 AND THE NEW YORK STATE (NYS) HEALTH IMPROVEMENT PLAN'S PREVENTION AGENDA REQUIREMENTS, HEALTHALLIANCE OF THE HUDSON VALLEY (HEALTHALLIANCE), A MEMBER OF THE WESTCHESTER MEDICAL CENTER HEALTH NETWORK (WMCHEALTH), PARTICIPATED WITH OTHER AREA HOSPITALS, PUBLIC AND GOVERNMENT AGENCIES, COMMUNITY PARTNERS AND THE ULSTER COUNTY DEPARTMENT OF HEALTH AND MENTAL HEALTH (UCDOHMH) TO CONDUCT A COMMUNITY HEALTH ASSESSMENT AND DEVELOP A LOCAL COMMUNITY HEALTH IMPROVEMENT PLAN. A WORK GROUP CONSISTING OF UCDOHMH AND LOCAL AREA HOSPITALS MET REGULARLY BEGINNING IN MAY 2016 TO IDENTIFY AND PRIORITIZE COMMUNITY HEALTH NEEDS. THE 2016-2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN IS AN UPDATE TO THE PREVIOUSLY CREATED 2014-2016 CHNA AND COMMUNITY HEALTH IMPROVEMENT PLAN. AS SUCH, THE 2014-2016 PLANS SERVED AS A FOUNDATION FOR CREATING THE 2016-2018 PLANS. PARTNERS MET ON A MONTHLY TO BIMONTHLY BASIS TO ANALYZE DATA SETS AND COMMUNITY STRENGTHS. THE COMMUNITY PARTICIPATED IN THE PROCESS TO PRIORITIZE IMPROVING THE HEALTH OF ULSTER COUNTY BY MEANS OF A COMMUNITY HEALTH SURVEY. HEALTHALLIANCE'S CONTINUING PROGRESS AND MONITORING OF GOALS IDENTIFIED IN THIS CHNA WILL BE MANAGED BY AN INTERNAL COMMUNITY BENEFITS COMMITTEE (CBC). THIS COMMITTEE MET ON APRIL 26, 2016, FOR AN UPDATE BY THE UCDOHMH ON THE NYS PREVENTION AGENDA AND THE PROGRESS MADE SINCE 2013 WHEN THE LAST COMMUNITY SERVICE PLAN WAS WRITTEN, AND TO STRATEGIZE THE 2016-2018 INTERVENTIONS. THE CBC WILL ENGAGE INTERNAL AND EXTERNAL RESOURCES TO DEVELOP AND IMPLEMENT EVIDENCE BASED STRATEGIES ACROSS THE SERVICE AREAS TO DIRECTLY ADDRESS IDENTIFIED HEALTH NEEDS THAT HEALTHALLIANCE WILL PURSUE. CURRENT AND NEW OUTREACH STRATEGIES WILL BE MODIFIED, IF NEEDED, AND DEVELOPED DURING THE CURRENT TERM OF THE 2016-2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). Part V, Section B, Line 6a: The CHNA was conducted with the following other hospital facilities: HealthAlliance Hospital Broadway Campus and HEALTHALLIANCE HOSPITAL MARY'S AVENUE CAMPUS Part V, Section B, Line 6b: The CHNA was conducted with the following other NON-hospital facilities: Ulster County Department of Health and Mental Health Part V, Section B, Line 7: CHNA Website The hospitals CHNA report is widely available to the public at the below website url: http://hahv.org/hahv/community-service-plan.aspx Part V, Section B, Line 10: Implementation Strategy Website The Hospitals most recently adopted implementation strategy is posted at the below website url: http://hahv.org/hahv/community-service-plan.aspx Part V, Section B, line 11 HEALTHALLIANCE'S CONTINUING PROGRESS AND MONITORING OF GOALS IDENTIFIED IN THE CHNA WILL BE MANAGED BY AN INTERNAL COMMUNITY BENEFITS COMMITTEE (CBC). THIS COMMITTEE MET ON APRIL 26, 2016, FOR AN UPDATE BY THE UCDOHMH ON THE NYS PREVENTION AGENDA AND THE PROGRESS MADE SINCE 2013 WHEN THE LAST COMMUNITY SERVICE PLAN WAS WRITTEN, AND TO STRATEGIZE THE 2016-2018 INTERVENTIONS. THE CBC WILL ENGAGE INTERNAL AND EXTERNAL RESOURCES TO DEVELOP AND IMPLEMENT EVIDENCE BASED STRATEGIES ACROSS THE SERVICE AREAS TO DIRECTLY ADDRESS IDENTIFIED HEALTH NEEDS THAT HEALTHALLIANCE WILL PURSUE. CURRENT AND NEW OUTREACH STRATEGIES WILL BE MODIFIED, IF NEEDED, AND DEVELOPED DURING THE CURRENT TERM OF THE 2016-2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). Implementation Strategy In accordance with the NYS Prevention Agenda mandate, HealthAlliance will align with UCDOHMH to focus on two priority areas: Prevent Chronic Disease and Promote Mental Health/Prevent Substance Abuse. These priorities consist of focus areas that impact 12 of the 16 health needs identified in the CHNA and will be addressed by HealthAlliance. HEALTH NEEDS IDENTIFIED THE 16 HEALTH NEEDS IDENTIFIED IN THE 2013 CHNA CONTINUE TO BE RELEVANT IN 2016. THE HEALTH NEEDS INCLUDE CANCER, HEART DISEASE, TOBACCO USE, OBESITY AND MENTAL HEALTH, AMONG OTHERS. ACCORDING TO THE 2015 PUBLICATION "ONE REGION, ONE COMMUNITY NEEDS ASSESSMENT", AN EIGHT COUNTY COMMUNITY NEEDS ASSESSMENT OF THE HUDSON VALLEY REGION UNDERTAKEN IN COLLABORATION WITH WESTCHESTER MEDICAL CENTER, THE MONTEFIORE HUDSON VALLEY COLLABORATIVE, REFUAH HEALTH CENTER AND HEALTHALLIANCE OF THE HUDSON VALLEY AS PART OF DSRIP TO EXTENSIVELY ASSESS REGIONAL NEEDS, RANKED THE TOP HEALTH ISSUES IN THE COMMUNITY (OUT OF 17) AS CANCER, OBESITY, MENTAL HEALTH, DIABETES AND HEART DISEASE. THESE INCLUDE THE SAME HEALTH NEEDS IDENTIFIED BY THE COMMUNITY IN THE 2016 ULSTER COUNTY COMMUNITY HEALTH SURVEY (DRUG ABUSE, MENTAL HEALTH AND OBESITY). THESE IDENTIFIED AREAS WILL BE ADDRESSED IN HEALTHALLIANCE'S 2016-2018 IMPLEMENTATION STRATEGY, AFTER WHICH THE NEXT COMMUNITY HEALTH NEEDS ASSESSMENT WILL BE PERFORMED. The Cancer Committee of the HealthAlliance Hospitals Commission on Cancer (COC) Accredited Cancer Program is comprised of physicians, nurses, social workers and other allied health professionals focused on cancer-related care for hospital patients and community members. HealthAlliances Cancer Committee is dedicated to improving survival and quality of life for cancer patients through standard-setting, prevention, research, education and the monitoring of comprehensive quality care. The committee is responsible for planning, initiating, implementing, evaluating and improving all cancer related activities in our facility. The Cancer Committee of the HealthAlliance Hospital established a prevention goal for 2016/2017, and for the 2016-2018 Ulster County Community Service Plan, that is aimed at reducing obesity in an effort to decrease the risk of chronic diseases, including certain forms of cancer. HealthAlliances Oncology Support Program helps to address this by offering ongoing dance and exercise classes, such as yoga, Tai Chi and Smart Bells classes to the general population in an effort to increase physical activity in Ulster County, including those with chronic disease. Monthly plant-based diet cooking classes are also offered in an attempt to increase the consumption of whole grains and plant-based foods. These programs and similar will continue through 2018. In October 2016 the Oncology Support Program also developed the Wellness and Weight Management Series, a free, six-session program that incorporates the services of a dietitian and includes healthy food demonstrations presented at the Reuner Cancer Support House. The goals of the prevention program are to reduce the Body Mass Index (BMI) for participants who are overweight, increase usage of fruits and vegetables and increase physical exercise. The program met three times and was well attended by a range of 6-18 participants at classes. 100% of participants surveyed reported improved health after attending classes as measured by a pre and posttest. Participants reported they were able to identify effective weight loss strategies, understand how to overcome weight management obstacles at work and identify support mechanisms. Additionally during 2016, The Cancer Committee developed a referral form through which health care professionals involved in cancer care can refer patients to the wellness programs available at HealthAlliance Hospital, the Oncology Support Program and in the community. Breast Cancer Screening Program Breast Cancer Screenings are regularly offered at the HealthAlliance Fern Feldman Anolick Center for Breast Health, part of the comprehensive breast care program at HealthAlliance Hospital Marys Avenue Campus. Our integrated practice brings together a multispecialty cancer treatment team of experts to ensure you get the best care available. The experts include breast health specialists, radiation oncologists, medical oncologists, surgeons, plastic surgeons, pathologists, radiologists and a skilled support staff - all working as a multidisciplinary team to provide whole-person care for women. Our certified Breast Patient Navigator ensures seamless, coordinated care among physicians, diagnostic tests and cancer treatments, while offering education, guidance and supporting the patient and HIS/HER family. The center, an FDA certified mammography facility, received certification in mammography, stereotactic biopsy and breast ultrasound from the American College of Radiology and is designated as a Breast Imaging Center of Excellence by the American College of Radiology. The Cancer Committee of HealthAlliance Hospital identified the need to ensure that low income members of Ulster County have access to breast cancer screenings in order to reduce breast cancer mortality in this population. On three occasions in 2016, the Breast Patient Navigator and the manager of the Center for Breast Health conducted outreach to the low income population that accesses the food pantry at Peoples Place. This afforded HealthAlliance the opportunity to identify the barriers to breast cancer screening, help members of the community access breast cancer screening, and guide those

2016 update:

HAHV provided professional outreach to the community at PP on six dates during 8/16/16-11/29/16 providing DEX heel scans, Breast Health Outreach and Diabetes Education interacting with 271 participants. Live Well Kingston is a city-endorsed coalition focused on improving active living and healthy eating opportunities in Kingston, NY. It is fiscally sponsored and coordinated by Cornell Cooperative Extension of Ulster County (CCEUC) in accordance with a Memorandum of Understanding with the City of Kingston. The coalition grew out of a four-year partnership initiative to reverse childhood obesity entitled Healthy Kingston for Kids, and funded by the Robert Wood Johnson Foundation. HealthAlliance of the Hudson Valley was a founding funding partner supporting the Live Well Kingston (LWK) coalition in its infancy and in the development of its focus teams and action plans. In 2014, the LWK coalition finalized its Articles of Collaboration, established a leadership team, and determined and formed its priority focus teams. Each focus team is now developing action plans. 2016 Update: > The LWK coalition implemented a communications strategy which included new logos and design for website, social media, brochures and other outreach materials to increase the impact of healthy messaging within the community. > Four focus teams were active in 2015 Age Well, Eat Well, Heal Well and Travel Well. New leadership was recruited for Play Well. > Age Well conducted a series of focus groups at different locations to assess barriers to healthy eating and physical activity. This revealed a need for transportation to healthy activities, including farmers markets and parks, as well as a need for both the availability of internet access and training on how to utilize technology to access resources. Negotiations for Wi-Fi and a computer in the common room of two low income senior residences were successful, and the project is underway. In addition, the Hudson Valley Resource List created by IPRO, was released in August 2016. IPROs list will be used to develop a list inclusive of Ulster County services and opportunities. Transportation needs are in discussion with mangers of the senior residences as well as with Ulster County Area Transit (UCAT) and the City of Kingston bus system. > Eat Well held a retreat for focus team members and invited the Mayor of Kingston. They developed a plan to hold 8-10 listening sessions at multiple sites within Kingston to assess barriers to healthy eating. These are set to begin late fall/early winter of 2016-2017. > Heal Well held a series of Walk and Talk with a Doc, in local parks and trails and, through the winter months, at the indoor track at the YMCA of Kingston and Ulster County. > Play Well has two new co-chairs which include the director of the YMCA of Kingston and Ulster County and the owner of Innate Parkour. They are currently recruiting focus team members and will be developing an action plan in early 2017. > Travel Well, which includes three active transportation groups in Kingston the Kingston Complete Streets Advisory Council, the Kingston Land Trust: Kingston Greenline Committee and Bike Friendly Kingston forwarded several active transportation projects in cooperation with the City of Kingston. These included the Kingston Connectivity Project, the Kingston Point Rail Trail and Complete Streets on Cornell, Foxhall, North Street and Broadway. The Kingston Greenline completed construction on the Trolley Trail portion of the Greenline. Funding has been awarded for other sections of the Greenline and design and construction is in progress. In addition, A SAFE ROUTES TO SCHOOL PROJECT AND THE HUDSON LANDING PROMENADE AND DEVELOPMENT PROJECT ARE UNDERWAY. BIKE FRIENDLY KINGSTON HELD SEVERAL COMMUNITY BIKE RIDES, IMPLEMENTED BICYCLE EDUCATION AND OPENED A REPAIR CAF. THEY ARE CURRENTLY ORGANIZING A BICYCLE AND PEDESTRIAN BICYCLE COUNT ON BROADWAY IN COLLABORATION WITH THE ULSTER COUNTY TRANSPORTATION COUNCIL. > AS A SUCCESSFUL HEALTH COALITION, THE STRUCTURE, FUNCTION, SUCCESSES AND CHALLENGES OF LWK WERE SHARED IN PRESENTATIONS AT SEVERAL CONFERENCES INCLUDING THE 2016 NEW YORK STATE PUBLIC HEALTH ASSOCIATION, THE 2015 AMERICAN PLANNING ASSOCIATION OF THE GREATER METRO AREA AND THE 2015 NEW YORK DASH-NY COALITION CONFERENCE. HEALTH NEEDS NOT ADDRESSED BY HEALTHALLIANCE OF THE HEALTH NEEDS IDENTIFIED BY ULSTER COUNTY, HEALTHALLIANCE IS FOCUSING ON THE PRIORITIES OUTLINED ABOVE. PEDIATRIC ASTHMA HOSPITALIZATIONS, UNPLANNED PREGNANCY, MOTOR VEHICLE CRASH DEATHS AND FALL HOSPITALIZATIONS WERE AMONG THE PRIORITIZED HEALTH NEEDS HEALTHALLIANCE CHOSE NOT TO FOCUS ON. HEALTHALLIANCE DOES NOT POSSESS THE INFRASTRUCTURE AND RESOURCE'S TO AID IN PREVENTION AND CONTINUOUS MEASUREMENT OF THESE HEALTH NEEDS, NOR DOES IT ALIGN WITH NYS PREVENTION AGENDA PRIORITIES. WE RECOGNIZE THAT WE CANNOT PURSUE ALL OF THE IDENTIFIED HEALTH NEEDS AND THAT DECISIONS ARE BASED UPON INTERNAL AND EXTERNAL ASSETS TO SUSTAIN PROGRAMS THAT WOULD MAKE A MEANINGFUL IMPACT. BOARD APPROVAL PRIOR TO FINALIZATION, SUBMISSION AND RELEASE OF THE HOSPITAL'S COMMUNITY SERVICE AND IMPLEMENTATION PLAN, COMMENTS AND INPUT FROM THE BOARD OF DIRECTORS ARE IMPLEMENTED BEFORE FINALIZING. Part V, Section B, Line 16a, b and c:FAP Policy Website The Hospital's financial assistance policy and FAP application are available at the following website: http://hahv.org/hahv/financial-assistance.aspx PART V, SECTION C, LINE 5 IN ACCORDANCE WITH THE AFFORDABLE CARE ACT (ACA) OF 2010 AND THE NEW YORK STATE (NYS) HEALTH IMPROVEMENT PLAN'S PREVENTION AGENDA REQUIREMENTS, HEALTHALLIANCE OF THE HUDSON VALLEY (HEALTHALLIANCE), A MEMBER OF THE WESTCHESTER MEDICAL CENTER HEALTH NETWORK (WMCHEALTH), PARTICIPATED WITH OTHER AREA HOSPITALS, PUBLIC AND GOVERNMENT AGENCIES, COMMUNITY PARTNERS AND THE ULSTER COUNTY DEPARTMENT OF HEALTH AND MENTAL HEALTH (UCDOHMH) TO A COMMUNITY HEALTH ASSESSMENT AND DEVELOP A LOCAL COMMUNITY HEALTH IMPROVEMENT PLAN. A WORK GROUP CONSISTING OF UCDOHMH AND LOCAL AREA HOSPITALS MET REGULARLY BEGINNING IN MAY 2016 TO IDENTIFY AND PRIORITIZE COMMUNITY HEALTH NEEDS. THE 2016-2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) AND COMMUNITY HEALTH IMPROVEMENT PLAN IS AN UPDATE TO THE PREVIOUSLY CREATED 2014-2016 CHNA AND COMMUNITY HEALTH IMPROVEMENT PLAN. AS SUCH, THE 2014-2016 PLANS SERVED AS A FOUNDATION FOR CREATING THE 2016-2018 PLANS. PARTNERS MET ON A MONTHLY TO BIMONTHLY BASIS TO ANALYZE DATA SETS AND COMMUNITY STRENGTHS. THE COMMUNITY PARTICIPATED IN THE PROCESS TO PRIORITIZE IMPROVING THE HEALTH OF ULSTER COUNTY BY MEANS OF A COMMUNITY HEALTH SURVEY. PART V, SECTION C, LINE 11 HEALTHALLIANCE'S CONTINUING PROGRESS AND MONITORING OF GOALS IDENTIFIED IN THE CHNA WILL BE MANAGED BY AN INTERNAL COMMUNITY BENEFITS COMMITTEE (CBC). THIS COMMITTEE MET ON APRIL 26, 2016, FOR AN UPDATE BY THE UCDOHMH ON THE NYS PREVENTION AGENDA AND THE PROGRESS MADE SINCE 2013 WHEN THE LAST COMMUNITY SERVICE PLAN WAS WRITTEN, AND TO STRATEGIZE THE 2016-2018 INTERVENTIONS. THE CBC WILL ENGAGE INTERNAL AND EXTERNAL RESOURCES TO DEVELOP AND IMPLEMENT EVIDENCE BASED STRATEGIES ACROSS THE SERVICE AREAS TO DIRECTLY ADDRESS IDENTIFIED HEALTH NEEDS THAT HEALTHALLIANCE WILL PURSUE. CURRENT AND NEW OUTREACH STRATEGIES WILL BE MODIFIED, IF NEEDED, AND DEVELOPED DURING THE CURRENT TERM OF THE 2016-2018 COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). HEALTH NEEDS IDENTIFIED THE 16 HEALTH NEEDS IDENTIFIED IN THE 2013 CHNA CONTINUE TO BE RELEVANT IN 2016. THE HEALTH NEEDS INCLUDE CANCER, HEART DISEASE, TOBACCO USE, OBESITY AND MENTAL HEALTH, AMONG OTHERS. ACCORDING TO THE 2015 PUBLICATION "ONE REGION, ONE COMMUNITY NEEDS ASSESSMENT", AN EIGHT COUNTY COMMUNITY NEEDS ASSESSMENT OF THE HUDSON VALLEY REGION UNDERTAKEN IN COLLABORATION WITH: WESTCHESTER MEDICAL CENTER, MONTEFIORE MEDICAL CENTER, REFUAH HEALTH CENTER AND HEALTHALLIANCE OF THE HUDSON VALLEY AS PART OF DSRIP TO EXTENSIVELY ASSESS REGIONAL NEEDS, RANKED THE TOP HEALTH ISSUES IN THE COMMUNITY (OUT OF 17) AS CANCER, OBESITY, MENTAL HEALTH, DIABETES AND HEART DISEASE. THESE INCLUDE THE SAME HEALTH NEEDS IDENTIFIED BY THE COMMUNITY IN THE 2016 ULSTER COUNTY COMMUNITY HEALTH SURVEY (DRUG ABUSE, MENTAL HEALTH AND OBESITY). THESE IDENTIFIED AREAS WILL BE ADDRESSED IN HEALTHALLIANCE'S 2016-2018 IMPLEMENTATION STRATEGY, AFTER WHICH THE NEXT COMMUNITY HEALTH NEEDS ASSESSMENT WILL BE PERFORMED. HEALTH NEEDS NOT ADDRESSED OF THE HEALTH NEEDS IDENTIFIED BY ULSTER COUNTY, HEALTHALLIANCE IS FOCUSING ON THE PRIORITIES OUTLINED ABOVE. PEDIATRIC ASTHMA HOSPITALIZATIONS, UNPLANNED PREGNANCY, MOTOR VEHICLE CRASH DEATHS AND FALL HOSPITALIZATIONS WERE AMONG THE PRIORITIZED HEALTH NEEDS HEALTHALLIANCE CHOSE NOT TO FOCUS ON. HEALTHALLIANCE DOES NOT POSSESS THE INFRASTRUCTURE AND RESOURCE'S TO AID IN PREVENTION AND CONTINUOUS MEASUREMENT OF THESE HEALTH NEEDS, NOR DOES IT ALIGN WITH NYS PREVENTION AGENDA PRIORITIES. WE RECOGNIZE THAT WE CANNOT PURSUE ALL OF THE IDENTIFIED HEA

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 7 - EXPLANATION OF COSTING METHODOLOGY	Margaretville Memorial Hospitals costing methodology was based upon the internal cost accounting system of the hospital. The cost-to-charge ratio was used for the various sub-line items of line # 7. Part I, Line 7b, Column d In 2015, Margaretville Memorial Hospital incurred expenses related to Medicaid rate adjustments, which it reported on Part I, Line 7b, Column c. However, due to a timing difference, the revenue related to the Medicaid rate adjustments was not received until 2016. As a result, the direct offsetting revenue related to the Medicaid rate adjustments was not reported on Margaretville Memorial Hospitals Schedule H in 2015. Margaretville Memorial Hospital has reported this revenue on Part I, Line 7b, Column d in the current year. PART I, LINE 7G: COST ASSOCIATED WITH PHYSICIAN CLINICS The costs on line 7G include $0 of costs attributable to physician clinics.
Part III, Line 2: Methodology Used to Estimate Amount of Bad Debt Expense	The amount reported on line 2 is equal to the provision for bad debt expense per the audited financial statements (AFS). The explanation of the methodology used to estimate this amount can be found in Footnote #2 on pages 10-11 of the attached AFS.
Part III, Line 4: Description of Bad Debt Expense	The text of the footnote that describes bad debt expense can be found on Pages 10-11 of the attached audited financial statements.
Part III, Line 8: Costing Methodology	Since Margaretville Memorial Hospital is a critical access hospital, the hospital receives 101% of its cost for most of its services; therefore Margaretville should always have a surplus from Medicare. The amount reported on Line 6 was derived by using the Medicare allowable costs as reported on the Medicare cost report and the applicable adjustments from Worksheet A. For 2016, Margaretville Memorial Hospital does not have a loss from Medicare therefore it is not considered a community benefit.
PART III LINE 9B: COLLECTION PRACTICES	The credit and collection policy for self-pay balances provides that, in some cases, non-insured patients that do not qualify for Medicaid qualify for Charity Care. In those instances, the credit and collection department will follow the guidelines as set forth in the Charity Care policy. The Charity Care policy provides that the financial counselor evaluates the information provided in patients charity care applications in conjunction with Federal income poverty guidelines to determine the write-off percentage. If the patient/guarantor qualifies for charity care based on the sliding scale, the patient will be required to pay the outstanding amount. A payment plan is established not to exceed 10% of the guarantors gross monthly income.
PART VI, LINE 2: COMMUNITY NEEDS ASSESSMENT	COMMUNITY NEEDS ASSESSMENT IS DONE ON TWO LEVELS. BELOW WE EXPLAIN THE CHNA PROCESS WE ENGAGED IN DURING 2016, THE MACRO LEVEL OF ASSESSMENT THAT OCCURS EVERY THREE YEARS. ON A MICRO LEVEL AND ON AN ONGOING BASIS, STAFF FROM VARIOUS LEVELS OF THE ORGANIZATION ARE ENGAGED OUTSIDE THE WALLS OF THE HOSPITAL IN THE COMMUNITY IMPLEMENTING THE NEEDS THAT WERE GENERATED AS A RESULT OF THE MACRO CHNA ASSESSMENT AND REASSESSING HOW THE VARIOUS PLANS ARE PROGRESSING. STAFF THAT INTERFACE WITH THE COMMUNITY INCLUDE THE CEO WHO MEETS ON AN ONGOING BASIS WITH THE FAITH BASED COMMUNITY, COORDINATORS WHO SERVE ON THE LIVE WELL KINGSTON COMMISSION AND GATHER COMMUNITY INFO FROM THAT MONTHLY MEETING, AND THE COMMUNITY HEALTH COORDINATOR WHO SERVES ON THE HEALTHY ULSTER COUNCIL AND MEETS WITH OTHER AGENCY LEADERS TO LEARN OF COMMUNITY NEEDS. PARTNERS BEGINNING MAY 2016, THE HEALTHALLIANCE COMMUNITY HEALTH COORDINATOR MET WITH THE STAFF OF THE UCDOHMH AND COMMENCED THE COMMUNITY HEALTH NEEDS PLANNING INITIATIVE. ADDITIONAL HEALTH CARE LEADERS WERE INVITED TO PARTICIPATE IN THE INITIATIVE, INCLUDING ELLENVILLE REGIONAL HOSPITAL. MEETINGS WERE HELD MAY 17, MAY 31, JUNE 14, JUNE 28, JULY 26, AUGUST 9, SEPTEMBER 27, OCTOBER 25 AND NOVEMBER 22. THE COMMUNITY PARTICIPATED IN THE PROCESS TO PRIORITIZE IMPROVING THE HEALTH OF THE COUNTY BY MEANS OF A COMMUNITY HEALTH SURVEY THAT WAS DRAFTED AND DISTRIBUTED AS A RESULT OF THESE MEETINGS. IT WAS PROVIDED TO THE COMMUNITY ONLINE AND IN PAPER FORMAT WITH A COLLECTION BOX AT COMMUNITY AGENCIES STRATEGICALLY LOCATED FOR POPULATIONS WITH THE GREATEST NEED. ULTIMATELY, MORE THAN 600 COMMUNITY SURVEYS WERE COLLECTED AND TABULATED. METHODOLOGY AND PROCESS THE PREVIOUS CHNA, DEMOGRAPHIC DATA AND TRENDS, NYS PREVENTION AGENDA DASHBOARD, COUNTY HEALTH RANKINGS, EBRFSS DATA, A REGIONAL COMMUNITY NEEDS ASSESSMENT (CNA) UNDERTAKEN IN COLLABORATION WITH WMCHEALTH, MONTEFIORE MEDICAL CENTER, HEALTHALLIANCE AND AN ULSTER COUNTY COMMUNITY HEALTH SURVEY COMPLETED BY OVER 600 RESIDENTS OF ULSTER COUNTY, WERE USED TO DEVELOP THE CHNA. THE SURVEY WAS AVAILABLE BOTH ONLINE AND IN PAPER COPIES THAT WERE STRATEGICALLY PLACED TO BE ACCESSIBLE TO LOW INCOME, CHRONICALLY ILL AND MINORITY COMMUNITIES WITH THE GREATEST NEED.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:	The hospital informs the patient of the availability of charity care several ways: 1- Notice is on every patient bill with an application on the back of the bill 2- On the hospital website 3- All members of the Patient Accounting Department are trained to screen patients for Charity Care when discussing bills and concerns regarding inability to pay 4- fliers ARE posted in registration areas of the hospital 5- Registration clerks will identify patients without a pay source and refer the patient to a Financial Counselor and hand the patient a financial assistance form 6- Financial Counselors assist patients in securing Medicaid and screen for Charity Care 7- The Collection agencies that HAHV engages with are aware of the charity care policy and assist patients IN applying up to 180 post placement with them HealthAlliance is committed to: > Providing access to quality healthcare services with compassion, dignity and respect for those we serve, particularly the poor and the underserved in our communities. > Caring for all persons, regardless of their ability to pay for services. > Assisting patients who cannot pay for part or all of the care they receive. > Balancing needed financial assistance for some patients with broader fiscal responsibilities in order to sustain viability and provide the quality and quantity of services for all who may need care in a community. In accordance with AHA recommendations, HealthAlliance adopted the following guiding principles when handling the billing, collection and financial support functions for our patients: > Provide effective communications with patients regarding hospital bills > Make affirmative efforts to help patients apply for public and private financial support programs > Offer financial support to patients with limited means > Implement policies for assisting low-income patients in a consistent manner > Implement fair and consistent billing and collection practices for all patients with patient payment obligations HealthAlliance effectively communicates with patients regarding patient payment obligations. Financial counseling is provided to patients about their payment obligation and hospital bills. Information on hospital-based financial support policies and external programs that provide coverage for services are made available to patients during the pre-registration and registration processes and in response to patients seeking financial assistance. Information regarding the financial assistance is also provided by the onsite financial counseling staff in both inpatient and outpatient areas. Patient accounting also supports the financial counseling program by providing patients with information and applications while handling customer service calls. Our financial counselors and county Medicaid workers also provide guidance regarding the financial assistance program when necessary. Financial assistance is available on the back of every hospital bill as well as the hospital website at http://hahv.org/hahv/financial-assistance.aspx. Financial counselors, both internal staff and a paid external vendor, make affirmative efforts to help patients apply for public and private programs for which they may qualify and that may help them obtain and pay for healthcare services. The hospital has onsite representatives from Fidelis Insurance Company to help patients who are in need of insurance coverage navigate through the application process. The patient does not need to have an account with the hospital; they just have to be in a situation where they are in need of insurance coverage. Fidelis screens the patient to see which plan will fit them and they are certified to enroll the patients in many different insurance policies based on their insurance needs. Every effort is made to determine a patients eligibility prior to or at the time of admission or service. However, determination for financial support can be made during any stage of the patients stay after stabilization or collection cycle. HealthAlliance offers financial support to patients with limited means. This support is available to uninsured and underinsured patients who do not qualify for public programs or other assistance. Notification about financial assistance, including contact information, is available through the hospital website, hospital posters and flyers, financial assistance applications and hospital statements. The FINANCIAL ASSISTANCE POLICY(FAP) and application are available on our website at http://www.hahv.org/hahv/financial-assistance.aspx and are supplied in both English and Spanish as well as plain language summary format. If additional assistance is needed, HealthAlliance offerS translation services for patients. HealthAlliance has an established written policy for the billing, collection and support for patients with payment obligations. The organization makes every effort to adhere to the policy and is committed to implementing and applying the policy for assisting patients with limited means in a professional, consistent manner. Educated staff members work closely with patients (including those working in Patient Registration and Admitting, Financial Assistance, Customer Service, Billing and Collections) about these policies with an emphasis on treating all patients with dignity and respect regardless of their insurance status or their ability to pay for services. All patient registration staff receive in-service training regarding the Financial Assistance Program. Patient Accounting also receives information about the program and how to handle patients seeking financial assistance. Financial counselors receive in depth training to handle financial assistance requests, process applications, and manage outcomes. HealthAlliance of The Hudson Valley provides several options for patients who either do not have insurance coverage or who have inadequate insurance coverage. Our many programs have been very successful and many have taken advantage of our offerings. Often utilized, financial counseling offers a patient the opportunity to speak to a financial counselor to determine what assistance can be accessible based on family income. Patients often shop around for the most economical healthcare and we offer price quotes. This allows the patient to know their financial obligation up front and understand the competitive pricing being offered. Despite millions of dollars of charity care distributed to needy patients every year, a consistent challenge is patients not utilizing the programs we offer. Often they dont want to provide the necessary financial information to initiate the financial aid process. Continual outreach and education is occurring to minimize confusion and improve utilization. HealthAlliance is committed to providing the best possible healthcare and is very sensitive to low income patients ability to pay. Our call center offers the convenience of calling one telephone number for all billing inquiries regardless of which hospital the patient is calling about. We are staffed Monday through Friday, 8AM to 4PM. The Financial Assistance policy was updated November 2016 to conform with the 501(r) requirements. All responses to the questions in Part V sections FAP and Billing and Collections were answered to coincide with this updated policy.
PART VI, LINE 4: COMMUNITY INFORMATION	Community Description Margaretville Memorial Hospital (Margaretville Hospital), a member of HealthAlliance of the Hudson Valley and the Westchester Medical Center Health Network (WMCHealth) is a rural Critical Access Hospital whose mission is to provide immediate access to high quality medical care and diagnostic testing services to medically underserved areas in the Catskill Mountains. Margaretville Hospital provides linkages to high tech and specialty medical care through an active relationship with HealthAlliance and WMCHealth. Margaretville Hospital is the Delaware County affiliate of HealthAlliance of the Hudson Valley (HealthAlliance), a multi-campus health care system consisting of HealthAlliance Hospitals Marys Ave. and Broadway campuses in Kingston, NY, and Margaretville Hospital, which is co-located on a single campus in Margaretville, NY (Delaware County), with the Mountainside Residential Care Center, a skilled nursing facility. HealthAlliance defines its primary service area by a federal definition that consists of the top 75% of hospital discharges from the lowest number of contiguous zip codes. Margaretville hospital serves the communities of Margaretville, Arkville, Andes, Fleischmanns, Roxbury, Halcott Center, Halcottsville, and New Kingston. Due to the geographical location of acute care hospitals affiliated with HealthAlliance, there are two distinct primary services areas within Ulster and Delaware Counties, though not encompassing all of each county. For operational and community needs development, HealthAlliance regards these two service areas as a single primary service area with the predominant population in Ulster County. However, for the purposes of this document, which will align with the Delaware County Community Health Assessment and the Community Health Improvement Plan, we will present the information pertaining to the Margaretville Hospital service area, located in Delaware County and described in the beginning of this section. Margaretville Hospital Service Area Other community health services and resources available in Delaware County include 20 ambulance services, mostly consisting of volunteer membership. In addition to Margaretville Hospital, there are three other hospitals, operated by two other healthcare systems: Delaware Valley Hospital affiliated with United Health Services, as well as OConnor Hospital and Tri-Town Hospital, both affiliated with the Bassett Healthcare Network. Additionally, there are two nursing homes in the county, 15 primary care offices including health centers and private physician offices, 15 locations and 9 full-time equivalent dentists, and two mental health clinics with multiple locations within the county. Delaware County covers 1,446 square miles in upstate New York, belonging to both the Southern Tier region and the Catskill Mountain range. Delaware County is the fourth largest county in New York by area and is the sixth most rural with a population density of 32.3 persons per square mile. The county includes the Catskill/Delaware Watershed, which is the largest unfiltered drinking water supply in the United States. The watershed region encompasses the central and eastern sections of Delaware County and includes roughly 65% of the countys land area and 11 of its 19 townships. Approximately 55% of Delaware Countys population lies within the Watershed. Based on the 2010 Census, the population of Delaware County is 47,840, 50.2% male and 49.8% female. In 2013, the population decreased to 46,772, representing a 2.3% reduction in population (Table 1). At the time of the 2010 Census, 9,405 people were less than 18 (19.6%), 38,575 were 18 and over (80.4%) and 9,331, were 65 and over (19.4%). It is estimated that 46.5% of the total population is 45 years of age or older. A majority of Delaware County residents over the age of 15 are married (72.5%), followed by never married (42%); separated (2.8%), widowed (2%), and divorced (1.8%) make up a smaller portion of the population. Delaware Countys population is 95% White, 1.9% African-American, 0.2% American Indian/Eskimo, 0.8% Asian, and 3.4% of Hispanic Origin (U.S. Census Bureau, 2010-2014 American Community Survey). In 2015, the median family income in Delaware County, $44,617, is less than New York States at $58,687. According to the NYS Poverty Report released in March 2015, the population below the poverty line was 16.4%, higher than the rate of 15.9% for New York. Notably, the percentage of children living below the poverty line has increased between 2000 and 2013 from 18% to 22%. The communities of Davenport (33.8%) and Walton (35.1%) have the highest rates of child poverty in Delaware County (U.S. Census Bureau, 2009-2013 American Community Survey). Based on the NYS Department of Health Behavioral Health Survey from 2013-2014, 83.9% of the population has healthcare coverage compared to 88.7% in the Southern Tier and 84.7% in the Mohawk Valley region, with only 62.2% of Delaware County adults aged 18-64 visiting a doctor for a routine checkup. Accordingly, 8.7% of residents reported not receiving medical care in the past year because of cost, compared to 10.0% in the Southern Tier, 12.2% in the Mohawk Valley region, and 13.1% in New York State.
PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:	2016 Progress This has been a year of much change for HealthAlliance and Margaretville Hospital. This year we engaged in assessment and planning for the 2016-2018 Community Service Plan. - On March 30, 2016, Westchester County Health Care Corp. became the sole corporate member of HealthAlliance. This adoption has the potential to significantly increase resources particularly in terms of mental health resources that can be brought to the community. - On May 19, 2016, Margaretville Hospital hired a new executive director, Mark Pohar. Mr. Pohar works with the Community Health Coordinator and the Margaretville Hospital Wellness Committee to gain agreement with regard to the plans for the 2016-2018 Community Service Plan. - Margaretville Hospitals mobile van conducted community outreach at the following community events: Spring on Main Street: 5/14 Fleischmanns Memorial Day Street Fair: 5/28 Margaretville Auxiliary Antique Flea Market: 8/6 Kansas City Society Barbeque Contest/Fleischmann: 8/27 Cauliflower Festival: 9/24 - The Margaretville Hospital Executive Director and the Community Health Coordinator met several times between July and October 2016 to plan for the 2016-2018 Community Service Plan contributions of Margaretville Hospital and HealthAlliance. - Health Fair Prevention Efforts took place on October 7, 2016, and included flu shots, fasting blood sugars, respiratory assessments, bone density testing and community introductions to telemedicine. - Also in October 2016, the following activities have taken plan to contribute to the impact of the previous Community Service Plan: - The Margaretville Hospital executive director has initiated meetings with the school administration of Margaretville schools to discuss the availability of mental health services in the community. - A new psychologist has been hired to begin November 1, 2016. This person will work with the Margaretville Hospital community based on referrals from local school districts and the community. - The release of a public announcement, alerting the community to a new telemedicine program which links Margaretville Hospital to Westchester Medical Center Health Network to bring psychiatric services to the community. Margaretville Hospital will post the Hospital Community Service Plan on HealthAlliances website. News and events related to the interventions will also be posted. The Community Health component of the hospital systems website can be found at: http://www.hahv.org/healthy-neighborhood/community-health/ For the community based strategies, Margaretville Hospital will continue to actively participate in a work group consisting of the Public Health Department and three other local hospitals for the purposes of maintaining engagement with local partners over the next three-year period. Progress will be tracked by the work group. Mid-course corrections will be made based on the discussions surrounding the review of the Community Service Plan and detailed tasks. Anecdotal feedback will be obtained from work group meetings, meetings involving health and wellness groups such as the Rural HealthAlliance, and from patients and individuals participating in interventions. Finally, as available, local, state and national health status indicators will be reviewed. A. Health Needs Addressed by HealthAlliance Priority Area 1: Prevent Chronic Diseases Focus Area 1: Reduce obesity in children and adults. Goal 1: Create community environments that promote and support health food and beverage choices, and physical activity. Outcome Objective: Reduce the percentage of adults ages 18 and older who are obese. Margaretville Hospital will work with the communities in their service area to increase retail availability of affordable healthy foods that meet the needs of communities, especially those with limited access to nutritious foods. The Margaretville Hospital Wellness Committee will recommend healthy vending guidelines that will be adopted by the hospital and impact employees, patients and visitors at the Margaretville Hospital and Mountainside Residential Care Center. Currently under review are vending policies implemented in other locales. Ulster County and the City of Kingston, the primary home of HealthAlliance, have adopted a Healthy Vending Policy. Through this action, Margaretville Hospital expects that the percentage of adults who are obese, ages 18 years and older, will have the option to select lower calorie foods when dining at Margaretville Hospital and Mountainside Residential Care Center. This strategy will help to drive a reduction in obesity statistics. Margaretville Hospital staff will assess the food that is being offered to ensure adherence with newly adopted nutrition vending standards. Goal 2: Expand the role of public and private employers in obesity prevention. Outcome Objective: Increase the percentage of small and medium worksites that offer a comprehensive worksite wellness program for all employees. The hospital has begun to implement an evidence-based wellness program for all employees in cooperation with the participating health plan and community partnerships that include but are not limited to increased opportunities for physical activity; access to and promotion of healthful foods and beverages, and health benefit coverage and/or incentives for obesity prevention. The hospital will implement nutrition and beverage standards in public institutions, worksites and other key locations such as Margaretville Hospital and Mountainside Nursing Home. As a role model, HealthAlliance has begun to implement system-wide changes that incentivize employee participation in a personal health assessment (PHA), annual physical and the adoption of at least one healthy behavior by structuring health insurance rates favorably for those that participate in wellness activities. This may serve as a template for other community organizations that are interested in creating worksite wellness programs. The HealthAlliance administration will review and report data aggregated by CDPHP on employee participation and success. In partnership with the HealthAlliance Employee Wellness Committee, HealthAlliance will offer healthy eating classes and gym memberships at reduced rates. Priority Area 4: Promote Mental Health and Prevent Substance Abuse Focus Area 3: Strengthen infrastructure across systems. Goal 1: Strengthen infrastructure for MEB health promotion and MEB disorder prevention. Outcome Objective: Enhance telemedicine and referral systems to build infrastructure of psychiatric services. Focus Area 2: Prevent Substance Abuse and other Mental Emotional Behavioral Disorders Goal 2: Prevent suicides among youth and adults. Outcome Objective: Decrease age-adjusted suicide rates. Outcome Objective: Decrease the number of suicide attempts. Margaretville Hospital will work with the following entities to achieve the goal of preventing suicides among youth and adults Delaware County Public Health, OConnor Hospital, Tri-Town Regional Hospital and Delaware Valley Hospital. These entities will share data on suicides, attempted suicides and suicidal ideation. Margaretville Hospital will establish telemedicine capabilities with input from WMCHealth to bring psychiatric services to the Delaware County community. Utilizing resources from HealthAlliance and WMCHealth, and with referrals provided to the Margaretville and Roxbury schools, Margaretville Hospital foresees high value and potential in meeting the needs of the identified disparate population. In regards to suicide prevention, the entities described above will take responsibility for the following: - Delaware County Public Health will share data on gender, age and means of suicide deaths with the Delaware County Suicide Prevention Network; - OConnor Hospital will collect the numbers of suicide attempts and ideation statistics from all Emergency Departments in Delaware County. This data will also be reported to the Delaware County Suicide Prevention Network; and - Margaretville Hospital, Tri-Town Regional Medical Center and Delaware Valley Hospital will report the numbers of suicide attempts and suicide ideation to OConnor Hospital, where the complete data will be aggregated. The intended impact behind the collaboration of resources will be to decrease the age-adjusted suicide rate in Delaware County by 10% (from 17.2 to 15.5) per 100,000, and to decrease the number of suicide attempts in Delaware County by December 31, 2018. To strengthen infrastructure for MEB health promotion and MEB behavior prevention, Margaretville Hospital will partner with community organizations and coalitions, as well as the Margaretville Hospital Wellness Committee, Westchester Medical Center psychiatry and psychology departments, the Margaretville and Roxbury schools and potentially other school districts. Also included in this partnership will be Delaware County Public Health and Mental Health. Telemedicine equipment will be operational, and a system
PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEM	HAHV is the parent company to affiliate members HA Marys Avenue campus, formerly Benedictine Hospital; Broadway Campus, formerly The Kingston Hospital; Margaretville Memorial Hospital, a rural critical access hospital; Mountainside Residential Care Center, a skilled nursing facility; and HealthAlliance Senior Living Corp, a continuing care retirement community. This integrated healthcare system is committed to providing quality and compassionate medical care for our patients, their families and our community. The consolidation of two acute care hospital campuses was a focus of HAHV when incorporating in 2008, responding directly to New York States Berger Commission mandate to form a corporate alliance between the formerly known Benedictine Hospital and HAHV Broadway Campus to bring down the costs of hospital-based care. In addition to service consolidation between the two Kingston Hospitals, HAHV also committed to streamlining operations and improving care at the other affiliate locations. Despite significant operational improvement and at the suggestion of NYS Department of Health, HAHV joined in 2014 with the Westchester Medical Health Performing Provider System in the Delivery System Reform Incentive Payment (DSRIP) again seeking to transform healthcare delivery to a more effective and efficient model that will benefit Ulster County on many levels. On March 30, 2016, Westchester County Healthcare Corp, through its newly created, wholly owned subsidiary, WMCHealth Ulster, Inc. (WMCHealth-Ulster), became the sole corporate member of HealthAlliance, Inc. HealthAlliance remains an active participant in the WMCHealth Performing Provider System (PPS) within the New York State Delivery System Reform Incentive Program (DSRIP). WMCHealth-Ulster oversees operations at the HealthAlliance campuses. PART VI, Line 7: STATE FILING OF COMMUNITY BENEFIT REPORT NY

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	Yes (true)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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
Sandra Horan
Chief Nursing Officer	$0	$192,355	$0	$0	$0	$8,400	$0	$4,879	$0	$8,071	$0	$213,705	$0	$0
David Scarpino
CHIEF EXECUTIVE OFFICER	$0	$481,380	$0	$0	$0	$9,564	$0	$6,625	$0	$16,818	$0	$514,387	$0	$0
John Finch
CIO & CCO (resigned 12/22/16)	$0	$228,160	$0	$0	$0	$9,291	$0	$12,906	$0	$21,003	$0	$271,360	$0	$0
Steven Haas
FORMER CFO	$0	$0	$0	$0	$0	$116,471	$0	$391	$0	$14,528	$0	$131,390	$0	$0
Eileen King
CLINICAL COORDINATOR	$238,651	$0	$0	$0	$516	$0	$240	$0	$15,604	$0	$255,011	$0	$0	$0
Patricia Gavis
CHIEF FINANCIAL OFFICER	$0	$254,438	$0	$0	$0	$5,425	$0	$0	$0	$20,854	$0	$280,717	$0	$0
Joseph Marsicovete
Chief Operating Officer	$0	$288,627	$0		$0	$7,556	$0	$6,625	$0	$10,029	$0	$312,837	$0	$0
Paul Llobet MD
Chief Medical Director	$0	$307,465	$0		$0	$4,993	$0	$1,783	$0	$0	$0	$314,241	$0	$0
MARK POHAR
TRUSTEE (effective 5/4/16)	$0	$128,672	$0	$0	$0	$11,663	$0	$0	$0	$19,876	$0	$160,211	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule J, Part I, line 3

The organization's top management officials (CEO/Executive Director) received compensation from HealthAlliance Hospital Broadway Campus (EIN: 14-1349558), a related organization. HealthAlliance Broadway Campus determines compensation of top management officials through the engagement of an independent compensation consultant performing a compensation study/survey with the goal to target the 50th percentile. Once completed, the findings and recommendations from the consultant are brought to the Compensation Committee of the Board of Directors. This committee shall consist of three (3) directors. They, among other things, shall evaluate the performance of the official, including a review against any pre-established performance goals; review and approve the official's compensation and bonus arrangements; and review all matters involving policies related to equity for executives and employees.

Schedule J, Part I, Line 4a

STEVEN HAAS RECEIVED SEVERANCE PAYMENTS OF $100,831 IN 2016 FROM A RELATED ORGANIZATION.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, LINE 4	HealthAlliance, Inc. entered into an affiliation agreement with Westchester County Health Care Corporation ("WCHCC"), d/b/a Westchester Medical Center Health Network ("WMC"). WMC Health Network - Ulster, Inc. became the sole corporate member of HealthAlliance Inc. As a result, HealthAlliance, Inc. is considered a blended component unit of WMC, and the governing documents of Margaretville Memorial Hospital were updated to reflect this change. FORM 990, PART VI, LINE 6 HEALTHALLIANCE, INC., WHICH IS A TAX-EXEMPT ORGANIZATION, IS THE SOLE CORPORATE MEMBER OF MARGARETVILLE MEMORIAL HOSPITAL.
FORM 990, PART VI, LINE 7A	HEALTHALLIANCE, INC., THE SOLE CORPORATE MEMBER OF MARGARETVILLE MEMORIAL HOSPITAL, HAS THE POWER TO ELECT ONE OR MORE MEMBERS OF THE LOCAL GOVERNING BODY OF THE HOSPITAL.
FORM 990, PART VI, LINE 7B	ALL DECISIONS MADE AT THE LOCAL BOARD LEVEL OF MARGARETVILLE MEMORIAL HOSPITAL, OTHER THAN THOSE RELATED TO QUALITY ASSURANCE AND BUILDING AND GROUNDS, ARE SUBJECT TO APPROVAL BY MEMBERS OF HEALTHALLIANCE, INC. BOARD OF TRUSTEES. THESE DECISIONS INCLUDE ELECTION AND REMOVAL OF MEMBERS OF THE LOCAL LEVEL GOVERNING BODY, APPOINTMENT/REMOVAL OF CORPORATE OFFICERS, APPROVAL OF BYLAW AMENDMENTS, REVIEW OF ANNUAL CAPITAL AND OPERATING BUDGETS, REVIEW AND/OR MODIFICATIONS OF ANY CERTIFICATE OF NEED APPLICATIONS, REVIEW INCURRENCE OF DEBT AND DEVELOP AND IMPLEMENT JOINT MEDICAL STAFF APPOINTMENTS.
FORM 990, PART VI, LINE 11B	The Form 990 was prepared by our tax advisors together with our finance department with the assistance from various departments throughout the organization. The Form 990 was reviewed by internal leadership. Upon completion of the various reviews, the Form 990 was presented to the board of the organization for approval prior to filing with the IRS.
FORM 990, PART VI, LINE 12C	The organization monitors and enforces compliance with the Conflict of Interest policy by means of a survey developed and approved by the WMCHealth Chief Compliance Officer. The survey is sent to all trustees, officers, and key executives for completion. All survey responses are reviewed by the Chief Compliance Officer. Any potential conflicts identified in the responses are discussed with senior management and/or referred to the WMCHealth Conflicts of Interest Committee for discussion. Potential actions to be taken in response to a conflict can be one or more of the following: 1) disclosure of the conflict, 2) individual recusal from decisions for transactions where that individual may have a conflict, 3) request in writing the individual alleviate the conflict, or 4) removal of the individual from employment.
FORM 990, PART VI, LINE 19	Governing documents, conflicts of interest policy and financial statements are made available to the public upon request. FORM 990, PART IX, LINE 11G FEES FOR OTHER PROFESSIONAL SERVICES - $1,216,532
FORM 990, PART XI, LINE 9	REVERSAL OF FASB REQUIRED ARO LIABILITY . . . . . . . . . $ 722,514 GASB CONVERSION OF TEMPORARILY RESTRICTED NET ASSETS . . . $ (144,697) TOTAL. . . . . . . . . . . . . . . . . . . . . . . . . . . $ 577,817
FORM 990, PART XII, LINE 2C	SELECTION PROCESS WAS CHANGED AS BIDS WERE SOLICITED FOR FY2016 AUDIT.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
WMC HEALTH NETWORK - ROCKLAND INC
100 WOODS ROAD	VALHALLA	NY	10595	320467873	SUPPORTING	NY	501(C)(3)	12A	NA	false
WMC HEALTH NETWORK - ULSTER INC
100 WOODS ROAD	VALHALLA	NY	10595	320477183	SUPPORTING	NY	501(C)(3)	12A	WCHCC	false
WESTCHESTER COUNTY HEALTH CARE CORP
100 WOODS ROAD	VALHALLA	NY	10595	133964321	HEALTHCARE	NY	115	N/A	NA	false
WMC NEW YORK INC
100 WOODS ROAD	VALHALLA	NY	10595	134107894	FUNDRAISING	NY	501(C)(3)	12A	WCHCC	false
NORTH ROAD LHCSA INC
241 NORTH ROAD	POUGHKEEPSIE	NY	12601	465293268	HOMECARE SVCS	NY	501(C)(3)	10	WCHCC	false
MID-HUDSON VALLEY EARLY EDUCATION CENTER
241 NORTH ROAD	POUGHKEEPSIE	NY	12601	465534882	PRESCHOOL	NY	501(C)(3)	10	WCHCC	false
WESTCHESTER MEDICAL CENTER FOUNDATION
100 WOODS ROAD	VALHALLA	NY	10595	134095845	FUNDRAISING	NY	501(C)(3)	7	WCHCC	false
HEALTHALLIANCE INC
741 GRANT AVENUE	LAKE KATRINE	NY	12449	261850453	SUPPORTING	NY	501(C)(3)	12A	WCHCC	false
HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS
396 BROADWAY	KINGSTON	NY	12401	141349558	EXEMPT HOSP	NY	501(C)(3)	3	HA INC	Yes (true)
HEALTHALLIANCE HOSP MARY'S AVE CAMPUS
105 MARYS AVENUE	KINGSTON	NY	12401	141338470	EXEMPT HOSP	NY	501(C)(3)	3	HA INC	Yes (true)
HEALTHALLIANCE SENIOR LIVING CORP
396 BROADWAY	KINGSTON	NY	12401	300164277	RTMNT COMM	NY	501(C)(3)	10	HA INC	Yes (true)
MARGARETVILLE NURSING HOME INC
42158 STATE HIGHWAY 28	MARGARETVILLE	NY	12455	223143565	NURSING HOME	NY	501(C)(3)	10	MMH	Yes (true)
MARGARETVILLE HEALTH FOUNDATION
42084 STATE HIGHWAY 28	MARGARETVILLE	NY	12455	261998454	SUPPORT FDN	NY	501(C)(3)	12A	MMH	Yes (true)
FASC FOUNDATION
741 GRANT AVENUE	LAKE KATRINE	NY	12449	264201295	SUPPORT FDN	NY	501(C)(3)	7	HAH BWAY	Yes (true)
GOOD SAMARITAN FDN FOR BETTER HEALTH
255 LAFAYETTE AVE	SUFFERN	NY	10901	133400353	SUPPORT FDN	NY	501(C)(3)	7	BSCHSI	false
BON SECOURS COMMUNITY HOSPITAL FDN
255 LAFAYETTE AVE	SUFFERN	NY	10901	810667395	SUPPORT FDN	NY	501(C)(3)	7	BSCHSI	Yes (true)
BON SECOURS WARWICK HEALTH FOUNDATION
255 LAFAYETTE AVE	SUFFERN	NY	10901	141972807	SUPPORT FDN	NY	501(C)(3)	7	BSCHSI	Yes (true)
BON SECOURS CHARITY HEALTH SYSTEM INC
255 LAFAYETTE AVE	SUFFERN	NY	10901	912135195	SUPPORTING	NY	501(C)(3)	12C, III-FI	WCHCC	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Legal Domicile StateLegalDomicileStateCd
HUDSON RIVER WEST INSURANCE (BARBADOS)
38 PINE ROAD	BELLEVILLE ST MICHAEL	BB	CAP INSURANCE	BB	BSCHSI	C CORP	Yes (true)
KINGSTON INSURANCE (BARBADOS) LIMITED
38 PINE ROAD	BELLEVILLE ST MICHAEL	BB	CAP INSURANCE	BB	HEALTHALLIANCE	C CORP	Yes (true)
NORTHEAST PROVIDER SOLUTIONS INC
			MSO & HEARING AID		NA	c corp	Yes (true)	100 WOODS ROAD	VALHALLA	NY	10595	133991673	NY
WMC ADVANCED PHYSICIAN SERVICES PC
			PHYSICIAN OFFICES		NA	c corp	Yes (true)	19 BRADHURST AVENUE	HAWTHORNE	NY	10595	264709927	NY
WESTCHESTER MEDICAL REGIONAL PHYS SVCS
			PHYSICIAN OFFICES		NA	c corp	Yes (true)	241 NORTH ROAD	POUGHKEEPSIE	NY	10532	465522536	NY
WCHCC (BERMUDA) LIMITED
VICTORIA HALL 11 VICTORIA STREET	HAMILTON	BD	CAP INSURANCE	BD	NA	c corp	Yes (true)
KINGSTON REGIONAL HEALTH CARE ENTERPRISE
			INVESTMENT		HAH BWAY	c corp	Yes (true)	396 BROADWAY	KINGSTON	NY	12401	161514994	NY
MID HUDSON PHYSICIANS PC
			MEDICAL SVCS		HAH BWAY	c corp	Yes (true)	396 BROADWAY	KINGSTON	NY	12401	203564769	NY

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
MARGARETVILLE NURSING HOME INC
O	$253,430	COST
MARGARETVILLE NURSING HOME INC
P	$154,978	COST

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE R, PART II, Bon Secours Charity Health System, Inc. (BSCHS)

Margaretville Memorial Hospital has a brother-sister relationship with BSCHS's six subordinates in a group exemption within BSCHS.

SCHEDULE R, PART II, HASLC

ON MARCH 24, 2016 HEALTHALLIANCE SENIOR LIVING CORP. (HASLC) BECAME A SELF-SPONSORED CONTINUING CARE RETIREMENT COMMUNITY (CCRC) NAMED WOODLAND POND INC. AND THE RELATIONSHIP WITH HEALTHALLIANCE, INC. AS THE FORMER SOLE CORPORATE MEMBER OF HASLC WAS TERMINATED WITH NO CONSIDERATION PROVIDED BY EITHER PARTY. ALL POWERS PREVIOUSLY HELD BY THE OFFICERS OF THE BOARD OF DIRECTORS OF HEALTHALLIANCE, INC. HAVE BEEN TRANSFERRED TO WOODLAND POND,INC.'S BOARD OF DIRECTORS. THE CHANGE IN OWNERSHIP REQUIRED THE UNAMINOUS APPROVAL OF THE BOARDS OF DIRECTORS OF HEALTHALLIANCE, INC. AND WOODLAND PONDS, INC. AS WELL AS THE NEW YORK STATE DEPARTMENT OF HEALTH, ULSTER COUNTY INDUSTRIAL DEVELOPMENT AGENCY, ULSTER COUNTY CAPITAL RESOURCE CORPORATION, AND BONDHOLDER.