STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS (EIN 14-1349558)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-10-30
IRS object ID
201733039349300548
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-10-30T10:45:34-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15 TIMES SQUAREAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10036ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN141349558EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HEALTHALLIANCE HOSPITAL BROADWAY CAMPUSBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% ERIN NAGY DIRECTOR OF FINANInCareOfNm
Business Name ControlHEALBusinessNameControlTxt
Phone8459436084PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1396 BROADWAYAddressLine1Txt
CityKINGSTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12401ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID SCARPINOPersonNm
Person TitleCEOPersonTitleTxt
Phone8459436024PhoneNum
Signature2017-10-26SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAURA KIELCZEWSKIPreparerPersonNm
PTINP00740769PTIN
Phone2127733000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address164.57.159.254IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id26308520173035000012FederalOriginalSubmissionId
Federal Original Submission Id2017-10-30FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id050F75853A9F423F493495C03CDD05FDA32C01D0AtSubmissionCreationDeviceId
At Submission Filing Device Id050F75853A9F423F493495C03CDD05FDA32C01D0AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDAVID SCARPINOPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1396 BROADWAYAddressLine1Txt
CityKINGSTONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12401ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$105,553,470GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HAHV.ORG/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1891FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionPROVIDE HIGH QUALITY HEALTHCARE, WITH COMPASSION AND COMPETENCE, TO PERSONS WHO LIVE, WORK, AND VISIT THE COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee1145TotalEmployeeCnt
Total Volunteers95TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$759,839PYContributionsGrantsAmt
CY Contributions Grants$2,575,095CYContributionsGrantsAmt
PY Program Service Revenue$102,712,203PYProgramServiceRevenueAmt
CY Program Service Revenue$100,823,742CYProgramServiceRevenueAmt
PY Investment Income$102,454PYInvestmentIncomeAmt
CY Investment Income$148,279CYInvestmentIncomeAmt
PY Other Revenue$1,854,693PYOtherRevenueAmt
CY Other Revenue$1,999,065CYOtherRevenueAmt
PY Total Revenue$105,429,189PYTotalRevenueAmt
CY Total Revenue$105,546,181CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$57,096,432PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$60,493,306CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$46,797,811PYOtherExpensesAmt
CY Other Expenses$46,932,784CYOtherExpensesAmt
PY Total Expenses$103,894,243PYTotalExpensesAmt
CY Total Expenses$107,426,090CYTotalExpensesAmt
PY Revenues Less Expenses$1,534,946PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,879,909CYRevenuesLessExpensesAmt
Total Assets BOY$63,712,062TotalAssetsBOYAmt
Total Assets EOY$44,142,163TotalAssetsEOYAmt
Total Liabilities BOY$47,955,984TotalLiabilitiesBOYAmt
Total Liabilities EOY$37,592,511TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$15,756,078NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,549,652NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe mission of HealthAlliance Hospital Broadway Campus is to provide the highest quality health care services to all people in our communities.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$88,801,468ExpenseAmt
Grant$0GrantAmt
Revenue$101,811,911RevenueAmt
DescHealthAlliance Hospital Broadway Campus IS A 150 BED COMMUNITY HEALTH AND MEDICAL INSTITUTION WHOSE BASIC MISSION IS TO OFFER HIGH QUALITY CARE, WITH COMPASSION AND COMPETENCE, TO PERSONS WHO LIVE, WORK, AND VISIT THE COMMUNITY OF KINGSTON, NY. THROUGHOUT 2016, HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS RECORDED 33,641 PATIENT DAYS, 42,718 EMERGENCY ROOM VISITS AND 2,012 SURGERIES (979 Inpatient & 1,033 Ambulatory). HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS OFFERS VARIOUS OUTPATIENT SERVICES SUCH AS WOUND CARE, DIABETES COUNSELING, RENAL DIALYSIS, AND ALL RADIOLOGIC SERVICES (MRI, CT, ULTRASOUND, MAMMOGRAPHY). TOTAL VISITS FOR THESE SERVICES IN 2016 WERE 78,466.Desc
Total Program Service Expenses$88,801,468TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document104IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1145EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsYes (true)ChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonERIN NAGY DIRECTOR OF FINANPersonNm
Phone8459436084PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1741 GRANT AVENUEAddressLine1Txt
CityLAKE KATRINECityNm
State AbbreviationNYStateAbbreviationCd
ZIP12449ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
THOMAS COLLINS
CHAIR (Effective 03/30/2016)1.04.0Yes (X)$0$0$0
KEVIN RYAN VICE CHAIR
(Effective 03/30/16)1.04.25Yes (X)$0$0$0
CRAIG SICKLER TREASURER
(Resigned 03/30/16)1.04.0Yes (X)$0$0$0
CYNTHIA LOWE
SECRETARY (Effective 03/30/16)1.04.0Yes (X)$0$0$0
JAMAL MAHDAVIAN MD
TRUSTEE (Effective 02/01/16)1.04.0Yes (X)$0$0$0
MARSHA CASEY
TRUSTEE (Effective 03/30/16)1.039.0Yes (X)$0$973,748$102,971
JOHN HEIMERDINGER
TRUSTEE (Effective 03/30/16)1.09.0Yes (X)$0$0$0
MICHAEL ISRAEL VICE CHAIR
(Effective 03/30/16)1.039.0Yes (X)$0$2,510,955$144,460
SAMUEL SIMON MD
TRUSTEE (Effective 03/30/16)1.04.0Yes (X)$0$0$0
JEROME SIMONETTY
TRUSTEE (Effective 03/30/16)1.04.0Yes (X)$0$0$0
JULIE SWITZER
TRUSTEE (Effective 03/30/16)1.039.0Yes (X)$0$766,318$105,213
WILLIAM FRISHMAN MD
TRUSTEE (Effective 03/30/16)1.039.0Yes (X)$0$537,155$34,502
RICHARD WISHNIE VICE CHAIR
(Effective 03/30/16)1.06.0Yes (X)$0$0$0
MARTIN CASCIO MD
TRUSTEE (Effective 03/30/16)1.04.0Yes (X)$0$0$0
NANCY DAVENPORT
TRUSTEE (Effective 03/30/16)1.04.0Yes (X)$0$0$0
CAREY WAGNER
TRUSTEE (Effective 03/30/16)1.04.0Yes (X)$0$0$0
DONALD LOUIE MD
TRUSTEE (Resigned 03/29/16)1.00.0Yes (X)$0$0$0
DONNA MOSS MD
TRUSTEE (Resigned 03/29/16)1.00.0Yes (X)$0$0$0
JOANNE FREDENBERG
CHAIR (Resigned 03/29/16)1.00.0Yes (X)$0$0$0
JUDITH GREENFIELD
SECRETARY (Resigned 03/29/16)1.00.0Yes (X)$0$0$0
LYDIA REIDY
TRUSTEE (Resigned 03/29/16)1.00.0Yes (X)$0$0$0
ALEXANDER COHEN
TRUSTEE (Resigned 03/29/16)1.00.0Yes (X)$0$0$0
MARK JOSEFSKI
TRUSTEE (Resigned 01/31/16)1.02.0Yes (X)$0$0$0
RONALD MYERS
TRUSTEE (Resigned 3/29/16)1.00.0Yes (X)$0$0$0
David Scarpino
Chief Executive Officer17.4420.06$490,944$0$23,443Yes (X)
PATRICIA GAVIS
Chief Financial Officer18.2519.25$259,863$0$20,854Yes (X)
Sandra Horan
Chief Nursing Officer23.5313.97$200,755$0$12,950Yes (X)
JOSHUA RATNER Resigned 102916
Chief Strategic Officer22.2215.28$188,130$0$23,553Yes (X)
Joseph Marsicovete
Chief Operating Officer20.6316.87$296,183$0$16,654Yes (X)
JOHN FINCH
CIO & CCO (Resigned 12/22/16)5.7731.73$0$237,451$33,909Yes (X)
PAUL LLOBET MD
CHIEF MEDICAL OFFICER17.1220.38$312,458$0$1,783Yes (X)
Steven Haas
FORMER CHIEF FINANCIAL OFFICER0.00.0$116,471$0$14,919Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,864,804TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,025,627TotReportableCompRltdOrgAmt
Total Other Compensation$535,211TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K25IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Institute for Family Health
2006 Madison Avenue 5th FloorNEW YORKNY10035Physician Services$3,273,916
Laboratory Corporation of America
PO Box 12140BURLINGTONNC272162140Laboratory Services$2,202,736
Orthopedic Associates of Dutchess C
1910 South RoadPOUGHKEEPSIENY12601Physician Services$728,380
STAT STAFF PROFESSIONALS INC
18 DIVISION STRET SUITE 311SARATOGA SPRINGSNY12866Staffing Agency$678,483
NISTEL INC
741 GRANT AVENUELAKE KATRINENY12449STAFFING AGENCY$2,994,707
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K24CntrctRcvdGreaterThan100KCnt
Fundraising$0FundraisingAmt
Related Organizations$37,090RelatedOrganizationsAmt
Government Grants$2,537,755GovernmentGrantsAmt
All Other Contributions$250AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$2,575,095TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Business621300BusinessCd
Total Revenue Column$100,823,742TotalRevenueColumnAmt
Related Or Exempt Func Income$100,823,742RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$100,823,742TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$148,279TotalRevenueColumnAmt
Exclusion$148,279ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$133,784RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$7,289RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$126,495RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$126,495TotalRevenueColumnAmt
Exclusion$126,495ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
CONTRACTED SERVICES900099$1,125,226$1,125,226$0$0
CAFETERIA REVENUE722514$408,913$0$0$408,913
REBATE REVENUE900099$84,953$0$0$84,953

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$253,478TotalRevenueColumnAmt
Related Or Exempt Func Income-$137,057RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$390,535ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,872,570OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$105,546,181TotalRevenueColumnAmt
Related Or Exempt Func Income$101,811,911RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,159,175ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,847,568TotalAmt
Program Services$1,847,568ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$131,390TotalAmt
Program Services$131,390ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$44,857,911TotalAmt
Program Services$36,784,666ProgramServicesAmt
Management And General$8,073,245ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$505,783TotalAmt
Program Services$379,337ProgramServicesAmt
Management And General$126,446ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$10,157,078TotalAmt
Program Services$7,620,248ProgramServicesAmt
Management And General$2,536,830ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,993,576TotalAmt
Program Services$2,245,182ProgramServicesAmt
Management And General$748,394ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$103,916TotalAmt
Program Services$0ProgramServicesAmt
Management And General$103,916ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$94,788TotalAmt
Program Services$0ProgramServicesAmt
Management And General$94,788ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

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

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

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

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$12,833,992TotalAmt
Program Services$11,310,140ProgramServicesAmt
Management And General$1,523,852ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$91,953TotalAmt
Program Services$0ProgramServicesAmt
Management And General$91,953ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,257,386TotalAmt
Program Services$1,278,963ProgramServicesAmt
Management And General$1,978,423ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

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

Royalties RoyaltiesGrp

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

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$882,457TotalAmt
Program Services$0ProgramServicesAmt
Management And General$882,457ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$77,091TotalAmt
Program Services$3,505ProgramServicesAmt
Management And General$73,586ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$19,399TotalAmt
Program Services$458ProgramServicesAmt
Management And General$18,941ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$280,109TotalAmt
Program Services$0ProgramServicesAmt
Management And General$280,109ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

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

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,205,172TotalAmt
Program Services$4,205,172ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,238,917TotalAmt
Program Services$0ProgramServicesAmt
Management And General$1,238,917ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES$13,358,702$13,410,718-$52,016$0
PHYSICIAN FEES$5,565,419$5,565,419$0$0
EQUIPMENT SERVICE CONTRACTS$1,309,145$1,153,598$155,547$0
INPATIENT ALLOWANCES$976,961$976,961$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,637,377TotalAmt
Program Services$1,888,143ProgramServicesAmt
Management And General$749,234ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$107,426,090TotalAmt
Program Services$88,801,468ProgramServicesAmt
Management And General$18,624,622ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Joint Costs TotalJointCostsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$5,971,165BOYAmt
EOY$2,005,694EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$138,496BOYAmt
EOY$150,443EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$63,491BOYAmt
EOY$87,986EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,680,066BOYAmt
EOY$9,611,002EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,226,493BOYAmt
EOY$1,283,066EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$767,750BOYAmt
EOY$430,461EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$136,492,448LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$111,059,553LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$28,160,965BOYAmt
EOY$25,432,895EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$542,510BOYAmt
EOY$553,245EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$16,161,126BOYAmt
EOY$4,587,371EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$63,712,062BOYAmt
EOY$44,142,163EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$19,069,910BOYAmt
EOY$17,899,063EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$521,979BOYAmt
EOY$1,097,495EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,142,936BOYAmt
EOY$2,417,936EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$6,561,091BOYAmt
EOY$4,026,797EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,660,068BOYAmt
EOY$12,151,220EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$47,955,984BOYAmt
EOY$37,592,511EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$14,630,345BOYAmt
EOY$5,960,807EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$536,888BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$588,845BOYAmt
EOY$588,845EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,756,078BOYAmt
EOY$6,549,652EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$63,712,062BOYAmt
EOY$44,142,163EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,879,909ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$29,473NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$7,355,990OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$534,410BeginningYearBalanceAmt
Investment Earnings Or Losses$32,759InvestmentEarningsOrLossesAmt
Administrative Expenses$10,198AdministrativeExpensesAmt
End Year Balance$556,971EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$546,980BeginningYearBalanceAmt
Investment Earnings Or Losses-$2,272InvestmentEarningsOrLossesAmt
Administrative Expenses$10,298AdministrativeExpensesAmt
End Year Balance$534,410EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$535,502BeginningYearBalanceAmt
Investment Earnings Or Losses$17,039InvestmentEarningsOrLossesAmt
Administrative Expenses$5,561AdministrativeExpensesAmt
End Year Balance$546,980EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$482,694BeginningYearBalanceAmt
Investment Earnings Or Losses$57,281InvestmentEarningsOrLossesAmt
Administrative Expenses$4,473AdministrativeExpensesAmt
End Year Balance$535,502EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$460,430BeginningYearBalanceAmt
Investment Earnings Or Losses$26,009InvestmentEarningsOrLossesAmt
Administrative Expenses$3,745AdministrativeExpensesAmt
End Year Balance$482,694EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,389,152OtherCostOrOtherBasisAmt
Book Value$1,389,152BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$62,905,988OtherCostOrOtherBasisAmt
Depreciation$43,210,273DepreciationAmt
Book Value$19,695,715BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,300,258OtherCostOrOtherBasisAmt
Depreciation$2,295,728DepreciationAmt
Book Value$4,530BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$67,651,014OtherCostOrOtherBasisAmt
Depreciation$63,534,136DepreciationAmt
Book Value$4,116,878BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,246,036OtherCostOrOtherBasisAmt
Depreciation$2,019,416DepreciationAmt
Book Value$226,620BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$25,432,895TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
DUE FROM RELATED PARTIES$3,219,208
INTEREST IN FOUNDATION$1,322,706
OTHER RECEIVABLES$45,457
FieldValueIRS element (for citing)
Total Book Value Other Assets$4,587,371TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
DUE TO THIRD PARTY PAYORS$6,033,585
OTHER NON-CURRENT LIABILITIES$4,454,238
POST RETIREMENT BENEFITS$1,663,397
FieldValueIRS element (for citing)
Total Liability$12,151,220TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PART V, LINE 4FormAndLineReferenceDesc
ExplanationINTENDED USES OF ENDOWMENT FUNDS THESE FUNDS ARE TO BE HELD IN PERPETUITY AS RESTRICTED BY THE DONORS. FUNDS ARE MEANT TO EARN INTEREST OF WHICH SHOULD BE USED TO FUND PROGRAMS AND SERVICES AT HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,785,889TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,203,147DirectOffsettingRevenueAmt
Net Community Benefit Expns$582,742NetCommunityBenefitExpnsAmt
Total Expense0.00540TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,250,917TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,147,772DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,103,145NetCommunityBenefitExpnsAmt
Total Expense0.04750TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,036,806TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$18,350,919DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,685,887NetCommunityBenefitExpnsAmt
Total Expense0.05290TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$65,771TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$65,771NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,401,515TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,839,937DirectOffsettingRevenueAmt
Net Community Benefit Expns$561,578NetCommunityBenefitExpnsAmt
Total Expense0.00520TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,002,526TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$13,688,253DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,314,273NetCommunityBenefitExpnsAmt
Total Expense0.04020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$20,469,812TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,528,190DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,941,622NetCommunityBenefitExpnsAmt
Total Expense0.04600TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$44,506,618TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$33,879,109DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,627,509NetCommunityBenefitExpnsAmt
Total Expense0.09890TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$11,320,513BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$35,792,622ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$30,849,817CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$4,942,805MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HealthAlliance Hosp Broadway CampusBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1396 BroadwayAddressLine1Txt
CityKingstonCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12401ZIPCd
FieldValueIRS element (for citing)
Website Addresshttp://www.hahv.org/hahv/home.aspxWebsiteAddressTxt
State License5501000HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1HEALTHALLIANCE HOSP BROADWAY CAMPUSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted16CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSee Section COwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt16ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLSee Section CStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free Care150.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.FPGFamilyIncmLmtDscntCarePct
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLSee Section CFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLSee Section CFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLSee Section CFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Section B, Line 5: 2016-2018 CHNA Implementation PlanIN 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 Mary's Avenus Campus and Margaretville Memorial Hospital 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 10A: FAP PLAIN LANGUAGE SUMMARY THE HOSPITALS MOST RECENT PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS POSTED AS THE BELOW WEBSITE URL: http://www.hahv.org/hahv/financial-assistance.aspx
Part V, Section B, line 11HEALTHALLIANCE'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 with positive findings of breast cancer. Further outreach efforts are scheduled for 2016 and more will be coordinated through 2018. Additionally, the Center for Breast Health will increase access to breast cancer screening for uninsured and underinsured women by opening the center for a special period of time when women enrolled in the Cancer Services Program will be offered free breast cancer screenings. A Spanish translator will be available to provide support to Spanish-speaking women, and child care will be provided. Colon Cancer Screening Program The HealthAlliance Gastroenterology Departments dedicated and experienced team assists patients at every stage - from admission, through your procedure, recovery and discharge - with expert care. We provide patient focused services and use well-established techniques to perform procedures and testing. Services offered include esophageal dilation, bronchoscopy, upper endoscopy and gastroscopy, endoscopic retrograde cholangiopancreatography and colonoscopy. The HealthAlliance Cancer Committee identified the need to increase education about, and the screening rates of colon cancer. HealthAlliance will provide colon cancer screening education through marketing efforts and event outreach, where specialists will connect the uninsured and underinsured with free colon cancer screenings offered through the Cancer Services Program. The HealthAlliance Diabetes Education Center in Kingston, NY, is committed to providing individuals with the skills and knowledge to manage diabetes and prevent diabetic complications. The Diabetes Education Center is also a community resource center where we host trainings and educational programs and offer information resources for our community to learn about diabetes. The Diabetes Education Center offers education and training to adults and teens with Type 1, Type 2 or gestational diabetes including weekly classes, a free, monthly support group, pump trainings and continuous glucose monitoring studies. Our Diabetes Educational Program has been recognized since 2003 by the American Diabetes Association for meeting its high-educational standards and for offering quality self-management diabetes education. We remain the only American Diabetes Association accredited education center in Ulster County. 2016 Update Patient Volume: The HealthAlliance Diabetes Education Center had a total of 1,278 total visits in 2016. Of these, 854 were individual appointments for diabetes self-management, weight management and nutrition consults. Classes: The center held 104 diabetes self-management classes in 2016. There were 424 total class visits. Outcomes: Of the 11

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7 - EXPLANATION OF COSTING METHODOLOGYHEALTHALLIANCE HOSPITAL ("HA") BROADWAY CAMPUS' 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 2014 and 2015, HeathAlliance Hospital Broadway Campus incurred expenses related to Medicaid rate adjustments, which it reported on Part I, Line 7b, Column c. However, due to a timing difference due to lack of CMS approval 50% of funding until 2016, 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 Healthalliance hospital broadway Campus' Schedule H in 2014 or 2015. HealthAlliance Hospital Broadway campus 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 ExpenseThe 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 #1 on pages 8 and 10-16 of the attached AFS.
Part III, Line 4: Description of Bad Debt ExpenseThe text of the footnote that describes bad debt expense can be found on Pages 10-16 of the attached AFS.
Part III, Line 8: Costing MethodologyThe costs on line 6 were taken directly from the cost report costs (D & E-Series where applicable) less subsidized services Medicare losses which were taken from Exhibit 46 of the New York State Institutional Cost Report. For the Broadway Campus, there was no shortfall from Medicare for 2016. therefore, it is not considered a community benefit.
PART III LINE 9B: PROVISIONS ON COLLECT PRACTICES FOR QUALIFIED PATIENTSThe 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 ASSESSMENTCommunity 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. A. 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. B. 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 www.hahv.org. 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 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 lowincome 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 (Attachment A) 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 INFORMATIONCommunity Description HealthAlliance of the Hudson Valley, a member of the Westchester Medical Center Health Network (WMCHealth), operates a 315-hospital-bed health care system comprising HealthAlliance Hospital Marys Avenue Campus and HealthAlliance Hospital Broadway Campus in Kingston, NY, and the Margaretville Hospital in Margaretville, NY. It also operates Mountainside Residential Care Center, an 82-bed nursing home in Margaretville adjacent to Margaretville Hospital. HealthAlliance is guided by the needs of its patients and their families. HealthAlliance delivers the best health care of the highest value in a safe, compassionate environment; invests in innovative technologies and leading-edge therapies to advance health care delivery; and improves the overall health and well-being of the diverse communities it serves. March 2016 was a pivotal month for HealthAlliance. On March 4, 2016 HealthAlliance received from the New York State Department of Health (NYSDOH) and the state Dormitory Authority an $88.8 million Capital Restructuring Financing Program award, the second highest single award in the state, to transform its Marys Avenue Campus into a single, state-of-the art hospital and to redevelop its Broadway Campus into a "medical village." On March 30, 2016 Westchester County Health Care Corp., through its newly created, wholly owned subsidiary WMCHealth Ulster Inc. (WMCHealthUlster), became the sole corporate member of HealthAlliance. 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 HealthAlliance. The change in ownership, along with state funding to transform health care delivery in Ulster County, will have a significant positive impact on operations. HealthAlliance defines its primary service area (PSA) by a federal definition that consists of the top 75% of hospital discharges from the lowest number of contiguous zip-codes. Due to the geographical location of acute care hospitals under HealthAlliance, there are two distinct primary service areas that lie within Ulster and Delaware counties, though not encompassing all of each county. Although defined as two service areas, HealthAlliance regards it as a single primary service area for operational community need development. The PSA population in 2016 was 145,441, while the broader population for Ulster County was 180,441 in 2014 and 46,772 for Delaware County in 2013, with populations concentrated in the cities of Kingston, New Paltz and Saugerties. Patients from adjacent counties also visit the hospital or one of our outpatient locations for services that many not be available in their respective communities. Unlike the population growth in the U.S. of 4.9%, the overall population for the primary service area is expected to decline slightly over the next five years. However, the population of the region is aging rapidly, with a 12% growth rate of pre-Medicare and Medicare populations of seniors (Truven Health, Market Expert). These demographic changes, consistent with national trends, are one of the defining aspects of HealthAlliances future community health planning. In 2014, HealthAlliances PSA market share for inpatient hospital services was 51%, while the market share for inpatient behavioral health (psychiatric and substance abuse services) was 77%. For maternity services, HealthAlliance had a 26% market share, with over 75% of these patients being Medicaid enrollees, given the accessible location within a high-need, lower-income area. Within our region, projections for women of childbearing age and pediatric populations show a decline of 4.5%, or 2,563 people. However, HealthAlliances share of maternity patients is expected to remain steady as HealthAlliance serves as a safety net provider for lower income, higher risk patients. The stable maternity volume is due to our partnership with the Mid-Hudson Family Practice Residency Program. It is one of the few family practice residency programs in the country whose physicians provide maternity and pediatric care for primary care patients at the nearby Institute for Family Health clinic. Of HealthAlliance patients, 6.3 % are enrolled in Medicaid and 24.7% have Medicaid Managed Care. An estimated additional 9.2% have no health insurance (census.gov, 2014 SAHIE). In 2014 the median household income for the county is $58,592 and $43,560 for the City of Kingston, while persons below poverty level are 13.7% for the county and 21.5% for the City of Kingston. The region is economically diverse, but adjacent areas in Delaware County have unemployment rates that exceed NYS averages. According to Ulster County HHI-eBRFFS data, the percentage of adult smokers in Ulster County with income below $25,000 is 36.3% compared to 24.2% for NYS, while the rate of lung cancer incidence is 72.5 per 100,000 of the population, which is significantly higher than the state average of 63.3 per 100,000 people. Mental health and substance abuse indicators are also higher than state levels. Ulster County residents report 17.1 days of poor mental health per year, higher than an average of NYS residents who report of 11.2 days. Ulster County has an age adjusted suicide rates of 8.5 per 100,000 people as opposed to 7.9 per 100,000 people for NYS. Diet and exercise are also areas of public health concern. The percentage of obese adults as reported in the 2013-2014 eBRFSS is 26.4% as compared to 24.4% in the Mid-Hudson region and 24.6% in NYS.
PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:The Cancer Committee In October 2016 the Oncology Support Program 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 has 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. 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 with positive findings of breast cancer. The Diabetes Center 2016 Update: Patient Volume: The HealthAlliance Diabetes Education Center had a total of 1,278 total visits in 2016. Of these, 854 were individual appointments for diabetes self-management, weight management and nutrition consults. Classes: The center held 104 diabetes self-management classes in 2016. There were 424 total class visits. Outcomes: Of the 114 patients with serial hgb A1c values, the average decrease was .5%. Support Groups and Community Outreach: We held 10 monthly Type 2 diabetes support groups and six Type 1 diabetes support groups. Many area physicians, fitness centers and diabetes company educators have presented at the meetings, including Dexcom, Dr. Ali Hammoud (Cardiology), Mac Fitness, Tandem Diabetes, Keith Bennett Karate, Dr. Geoffrey Lee (Nephrology), Sanofi A1cChampions, Hudson Valley Foot Associates, Dr. Mohsin Cheema (Opthalmology), Dr. Raymond Lippert (Endocrinology), Juvenile Diabetes Research Foundation, Omnipod and the Ulster County Office of the Aging. For 2016, 167 people attended the free events. Staff from the center also participated in the Ulster Association for Retarded Citizens Health Fair and the O+ Festival. Family Birth Place The Family Birth Place is in the final stage before designation as a "Baby-Friendly" hospital. This accreditation recognized hospitals that successfully implemented evidence-based breastfeeding initiatives. The Baby-Friendly Initiative is predicated on the fact that breastfeeding is the normal way for human infants to be nourished. An abundance of scientific evidence points to lower risks for certain diseases and improved health outcomes for both mothers and babies who breastfeed. With the correct information and the right supports in place, most women who choose to breast-feed are able to achieve their goal. Education of hospital staff in preparation for the "Baby-Friendly" on-site visit has brought awareness of breastfeeding to other departments such as housekeeping and all medical floors. During 2016, 59.2% of mothers breastfed exclusively during hospitalization. Additionally, practices such as skin-to-skin contact after birth and rooming-in have also become routine. As soon as a baby is born, he or she will be placed on the mothers chest after being dried. This is called "skin-to-skin careHealthAlliance offers it for at least an hour for all babies regardless of the mothers feeding choice, as long as you or your baby dont need special medical attention. Skin-to-skin can help a baby regulate his or her heart rate and body temperature, and rooming-in can help with the babys sleep cycle because he or she can sense his/her mother nearby. To encourage rooming-in, the Family Birth Place uses its baby nursery only for babies who need special medical attention or certain procedures. In working with the community, The Family Birth Place partners with the Breastfeeding Initiative of Ulster County (BIUC), members of which include the Institute for Family Health, the Ulster County Department of Health, the Ulster County Women, Infant and Children (WIC) program, and the Maternal Infant Services Network (MISN). Other community outreach includes sitting on the conference committee for the MISN conference in May, providing a Rock and Rest tent at the Ulster County fair in August and distributing breastfeeding information at the O+ Festival in Kingston in October 2016. Employee Wellness: Employee wellness nutrition classes were held at the HealthAlliance Hospital: Marys Avenue Campus, HealthAlliance Hospital: Broadway Campus, Grant Avenue offices and the HealthAlliance Outpatient Dialysis Center. The 10-week series was attended by 119 employees who completed at least one class. During 2016, 49% of Kingston based employees completed three wellness activities to qualify for a $15 wellness credit per pay period. During 2016, the following fitness classes were organized by the Employee Wellness Program and attended by HAHV employees. Strength and Conditioning class: 2/18/16-5/5/16 26 employees Total Body Conditioning: 10/13/16 -11/17/16 26 employees Kickboxing: 12/1/16 12/29/16 21 employees Fitness Seminars 2/9/16 11 employees 3/8/17 10 employees 4/12/17 5 employees 2016 Update - Measure of success The measures of success used to determine the effectiveness of the program are a Patient Satisfaction Survey and the collection of statistical data each month to monitor recidivism rates. The Satisfaction Survey results for 2016 as follows: APHP satisfaction survey: Patients gave an average rating of 8.5 on a scale of 1-10 95% of patients said that they used the DBT skills Usually or Always. 87% of patients said that they would recommend the program to others. PHP satisfaction survey: Patients gave an average rating of 9.5 on a scale of 1-10 78% of patients said that they used the DBT skills Usually or Always. 79% of patients said that they would recommend the program to others APHP/PHP recidivism rates: 0% of patients were readmitted to the APHP within 15 days. 0% of patients were readmitted to APHP within 30 days. Achievements 2016- Partial Hospitalization Program The successes of the APHP are best illustrated by the following data highlighting program participation and accomplishments listed below. APHP participation and outcomes: - The total number of admissions was 87 patients - The average annual daily census was 6. The maximum daily census is 10 - The average LOS was 16 days. The bench mark is 15 days - Chart audits showed a 93% compliance rate for treatment planning and utilization review. PHP participation and outcomes: - The total number of admissions was 134 patients - The average annual daily census was 6. The maximum daily census is 10 - Chart audits showed an 82% compliance rate for treatment planning and utilization review. - APHP/PHP accomplishments: - The Benedictine Health Foundation has funded the following programs at APHP: - Nutrition program which teaches basic nutrition, reinforces healthy eating habits, and addresses eating disorders. In 2016, 65% of patients identified having better eating habits due to the APHP nutrition program. - YMCA membership for all patients to be able to use the YMCA facilities during program hours while admitted to the program. - Scholarships for APHP patients to participate in an Equine Assisted Therapy Program at Horse Play in Accord, NY. EAP provides a nonverbal animal assisted therapy which allows youth to learn how to express their emotions appropriately. - Music therapy program funded by The Hudson Valley Foundation for Youth Health and The Benedictine Health Foundation which provides patients with musical instruments, recording equipment, and computer software to create musical pieces and help to reinforce the DBT skills. - Both Programs offer pet therapy, music groups, and cooking/nutrition groups. - The APHP/PHP staff serves on the following committees in the community: - SPOA, Children Services Planning Committee, Suicide Prevention Task Force, UC System of Care Committee, Eating Disorder Coalition, and the MHA in Ulster County. - The APHP/PHP staff attended in-services or conferences on the following: - PMCS, Suicide Prevention, DBT, Somatic Experiencing, Coherent Breat
PART VI, LINE 6: AFFILIATED HEALTH CARE SYSTEMHAHV 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 Health Care Corp., through its newly created, wholly owned subsidiary WMCHealth Ulster Inc. (WMCHealthUlster), became the sole corporate member of HealthAlliance. PART VI, Line 7: STATE FILING OF COMMUNITY BENEFIT REPORT NY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Steven Haas
FORMER CHIEF FINANCIAL OFFICER$0$0$0$0$116,471$0$391$0$14,528$0$131,390$0$0$0
Sandra Horan
Chief Nursing Officer$192,355$0$0$0$8,400$0$4,879$0$8,071$0$213,705$0$0$0
MARSHA CASEY
TRUSTEE (Effective 03/30/16)$0$783,748$0$190,000$0$0$0$74,695$0$28,276$0$1,076,719$0$0
MICHAEL ISRAEL VICE CHAIR
(Effective 03/30/16)$0$1,428,330$0$1,082,625$0$0$0$68,255$0$76,205$0$2,655,415$0$0
JULIE SWITZER
TRUSTEE (Effective 03/30/16)$0$617,068$0$149,250$0$0$0$70,205$0$35,008$0$871,531$0$0
WILLIAM FRISHMAN MD
TRUSTEE (Effective 03/30/16)$0$495,913$0$41,242$0$0$0$10,600$0$23,902$0$571,657$0$0
JOSHUA RATNER Resigned 102916
Chief Strategic Officer$183,848$0$0$0$4,282$0$4,827$0$18,726$0$211,683$0$0$0
Joseph Marsicovete
Chief Operating Officer$288,627$0$0$0$7,556$0$6,625$0$10,029$0$312,837$0$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
David Scarpino
Chief Executive Officer$481,380$0$0$0$9,564$0$6,625$0$16,818$0$514,387$0$0$0
PAUL LLOBET MD
CHIEF MEDICAL OFFICER$307,465$0$0$0$4,993$0$1,783$0$0$0$314,241$0$0$0
PATRICIA GAVIS
Chief Financial Officer$254,438$0$0$0$5,425$0$0$0$20,854$0$280,717$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 4AFormAndLineReferenceDesc
ExplanationSteven Haas received severance payments of $116,471 in 2016.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Ulster County Capital Resource CorporationBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN273282033BondIssuerEIN
CUSIP000000000CUSIPNum
Bond Issued2010-12-29BondIssuedDt
Issue Price$12,500,000IssuePriceAmt
PurposeSEE PART VIPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$7,327,064RetiredAmt
Bond Defeased$0BondDefeasedAmt
Total Proceeds$12,500,000TotalProceedsAmt
In Reserve Fund$0InReserveFundAmt
Capitalized Interest$0CapitalizedInterestAmt
Refunding Escrow$0RefundingEscrowAmt
Issuance Costs From Proceeds$250,000IssuanceCostsFromProceedsAmt
Credit Enhancement$0CreditEnhancementAmt
Working Capital Expenditures$8,182,783WorkingCapitalExpendituresAmt
Capital Expenditures$4,067,217CapitalExpendituresAmt
Other Spent Proceeds$0OtherSpentProceedsAmt
Unspent$0UnspentAmt
Current RefundingYes (true)CurrentRefundingInd
Advance RefundingfalseAdvanceRefundingInd
Final Allocation MadefalseFinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Private Bus Use By Others0PrivateBusUseByOthersPct
Bond Iss Meet Prvt Sec Pymt TestfalseBondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Remedial Action TakenfalseRemedialActionTakenInd
Procs Nonqualified Bond RemdtdfalseProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebatefalseExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssuefalseVariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1Txt
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsfalseWrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionfalseProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COL (F) - DESCRIPTION OF PURPOSEFormAndLineReferenceDesc
ExplanationTHE BONDS WERE ISSUED TO FINANCE A CONSTRUCTION AND EQUIPMENT FACILITY AND TO REFUND PREVIOUSLY ISSUED BONDS (I.E., THE SERIES 1999 REVENUE BONDS).ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonMahdavian MahdavianPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionEntity is 35% owned by TrusteeRelationshipDescriptionTxt
Transaction$152,500TransactionAmt
TransactionPHYSICIAN ON-CALL PAYMENTTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, LINE 4Effective March 30, 2016, 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 HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS WERE UPDATED TO REFLECT THIS CHANGE. FORM 990, PART VI, LINE 6 HEALTHALLIANCE, INC. IS THE SOLE CORPORATE MEMBER OF HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS.
FORM 990, PART VI, LINE 7AHealthAlliance, Inc. is the sole corporate member of HealthAlliance Hospital Broadway Campus. FORM 990, PART VI, LINE 7B All decisions with relation to the Broadway Campus are made at the HealthAlliance, Inc. board level. These decisions include approval/removal of corporate officers, approval of bylaw amendments, review of annual capital and operating budgets, review and/or modificiation of any CON applications, review incurrence of debt and develop and implement joint medical staff appointments.
FORM 990, PART VI, LINE 11BThe 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 12CThe 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 15A & 15BThe determination of the CEO's compensation involves the engagement of an independent compensation consultant to perform a compensation Study/Survey. 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 CEO, including a review against any pre-established performance goals; review and approve annually the CEO's compensation and bonus arrangements; and review and approve annually the compensation and bonus arrangements for the Corporation's executive staff set by the CEO and review all matters involving policies related to equity for executives and employees. For other top management officials, the same process is used with the exception that the independent study for those positions are not necessarily updated annually. The CEO would review the latest report, if applicable, and propose a recommendation to the Compensation Committee who would review and approve accordingly.
FORM 990, PART VI, LINE 19Governing documents, conflicts of interest policy and financial statements are made available to the public upon request.
FORM 990, PART XI, LINE 9EQUITY TRANSFER TO RELATED ORGANIZATIONS. . . . . . . . . ($5,550,777.) WOODLAND POND LOAN WRITE OFF . . . . . . . . . . . . . . . .($942,443.) GASB CONVERSION OF TEMPORARILY RESTRICTED NET ASSET. . . . .($536,892.) GASB CONVERSION OF DEFERRED FINANCING. . . . . . . . . . . .($325,878.) TOTAL. . . . . . . . . . . . . . . . . . . . . . . . . . .($7,355,990.)
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACTED SERVICES TOTAL FEES:6832305
FORM 990 PART IX LINE 11GDESCRIPTION:NISTEL STAFFING AGENCY FEES TOTAL FEES:2994707
FORM 990 PART IX LINE 11GDESCRIPTION:MANPOWER FEES TOTAL FEES:2105040
FORM 990 PART IX LINE 11GDESCRIPTION:BIOMEDICAL SERVICES TOTAL FEES:328916
FORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING & MANAGEMENT TOTAL FEES:202844
FORM 990 PART IX LINE 11GDESCRIPTION:WASTE DISPOSAL TOTAL FEES:196545
FORM 990 PART IX LINE 11GDESCRIPTION:COLLECTION FEES TOTAL FEES:173385
FORM 990 PART IX LINE 11GDESCRIPTION:OUTSIDE SERVICES TOTAL FEES:250

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (18 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
WMC HEALTH NETWORK - ROCKLAND INC
100 WOODS ROADVALHALLANY10595320467873SUPPORTINGNY501(C)(3)12ANAfalse
WMC HEALTH NETWORK - ULSTER INC
100 WOODS ROADVALHALLANY10595320477183SUPPORTINGNY501(C)(3)12AWCHCCfalse
WESTCHESTER COUNTY HEALTH CARE CORP
100 WOODS ROADVALHALLANY10595133964321HEALTHCARENY115N/ANAfalse
WMC NEW YORK INC
100 WOODS ROADVALHALLANY10595134107894FUNDRAISINGNY501(C)(3)12AWCHCCfalse
NORTH ROAD LHCSA INC
241 NORTH ROADPOUGHKEEPSIENY12601465293268HOMECARE SVCSNY501(C)(3)10WCHCCfalse
MID-HUDSON VALLEY EARLY EDUCATION CENTER
241 NORTH ROADPOUGHKEEPSIENY12601465534882PRESCHOOLNY501(C)(3)10WCHCCfalse
WESTCHESTER MEDICAL CENTER FOUNDATION
100 WOODS ROADVALHALLANY10595134095845FUNDRAISINGNY501(C)(3)7WCHCCfalse
HEALTHALLIANCE INC
741 GRANT AVENUELAKE KATRINENY12449261850453SUPPORTINGNY501(C)(3)12AWCHCCfalse
HEALTHALLIANCE HOSP MARY'S AVE CAMPUS
105 MARYS AVENUEKINGSTONNY12401141338470EXEMPT HOSPNY501(C)(3)3HA INCYes (true)
MARGARETVILLE MEMORIAL HOSPITAL
42084 STATE ROUTE 28MARGARETVILLENY12455150552726EXEMPT HOSPNY501(C)(3)3HA INCYes (true)
HEALTHALLIANCE SENIOR LIVING CORP
396 BROADWAYKINGSTONNY12401300164277RTMNT COMMNY501(C)(3)10HA INCYes (true)
MARGARETVILLE NURSING HOME INC
42158 STATE HIGHWAY 28MARGARETVILLENY12455223143565NURSING HOMENY501(C)(3)10MMHYes (true)
MARGARETVILLE HEALTH FOUNDATION
42084 STATE HIGHWAY 28MARGARETVILLENY12455261998454SUPPORT FDNNY501(C)(3)12AMMHYes (true)
FASC FOUNDATION
741 GRANT AVENUELAKE KATRINENY12449264201295SUPPORT FDNNY501(C)(3)7HAH BWAYYes (true)
GOOD SAMARITAN FDN FOR BETTER HEALTH
255 LAFAYETTE AVESUFFERNNY10901133400353SUPPORT FDNNY501(C)(3)7BSCHSIfalse
BON SECOURS COMMUNITY HOSPITAL FDN
255 LAFAYETTE AVESUFFERNNY10901810667395SUPPORT FDNNY501(C)(3)7BSCHSIYes (true)
BON SECOURS WARWICK HEALTH FOUNDATION
255 LAFAYETTE AVESUFFERNNY10901141972807SUPPORT FDNNY501(C)(3)7BSCHSIYes (true)
BON SECOURS CHARITY HEALTH SYSTEM INC
255 LAFAYETTE AVESUFFERNNY10901912135195SUPPORTINGNY501(C)(3)12C, III-FIWCHCCfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (8 entries)

Address Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINLegal Domicile StateLegalDomicileStateCd
HUDSON RIVER WEST INSURANCE (BARBADOS)
38 PINE ROADBELLEVILLE ST MICHAELBBCAP INSURANCEBBBSCHSIC CORPYes (true)
KINGSTON INSURANCE (BARBADOS) LIMITED
38 PINE ROADBELLEVILLE ST MICHAELBBCAP INSURANCEBBHEALTHALLIANCEC CORPYes (true)
NORTHEAST PROVIDER SOLUTIONS INC
MSO & HEARING AIDNAc corpYes (true)100 WOODS ROADVALHALLANY10595133991673NY
WMC ADVANCED PHYSICIAN SERVICES PC
PHYSICIAN OFFICESNAc corpYes (true)19 BRADHURST AVENUEHAWTHORNENY10595264709927NY
WESTCHESTER MEDICAL REGIONAL PHYS SVCS
PHYSICIAN OFFICESNAc corpYes (true)241 NORTH ROADPOUGHKEEPSIENY10532465522536NY
WCHCC (BERMUDA) LIMITED
VICTORIA HALL 11 VICTORIA STREETHAMILTONBDCAP INSURANCEBDNAc corpYes (true)
KINGSTON REGIONAL HEALTH CARE ENTERPRISE
INVESTMENTHAH BWAYc corpYes (true)396 BROADWAYKINGSTONNY12401161514994NY
MID HUDSON PHYSICIANS PC
MEDICAL SVCSHAH BWAYc corpYes (true)396 BROADWAYKINGSTONNY12401203564769NY
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HEALTHALLIANCE HOSPITAL MARY'S AVENUE CAMPUSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeSTransactionTypeTxt
Involved$4,871,681InvolvedAmt
Method Of Amount DeterminationALLOCATED COSTMethodOfAmountDeterminationTxt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART II, Bon Secours Charity Health System, Inc. (BSCHS)FormAndLineReferenceDesc
ExplanationHealthalliance, Inc. 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.ExplanationTxt