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AUBURN COMMUNITY HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
AUBURN COMMUNITY HOSPITAL (EIN 15-0532054)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-16
IRS object ID
201523209349307697
Schema version
2014v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-16T13:09:36-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161226221PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1FUST CHARLES CHAMBERS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15784 WIDEWATERS PARKWAYAddressLine1Txt
CitySYRACUSECityNm
State AbbreviationNYStateAbbreviationCd
ZIP13214ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN150532054EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AUBURN COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlAUBUBusinessNameControlTxt
Phone3152557011PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 LANSING STREETAddressLine1Txt
CityAUBURNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13021ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJASON LESCHPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone3152557011PhoneNum
Signature2015-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOSEPH J SCHLEGELPreparerPersonNm
PTINP00301329PTIN
Phone3154463600PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJASON LESCHPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 LANSING STREETAddressLine1Txt
CityAUBURNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13021ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$100,097,527GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.AUBURNHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1878FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTHE MISSION OF AUBURN COMMUNITY HOSPITAL IS TO PROVIDE COMPASSIONATE, QUALITY CARE AND IMPROVE THE HEALTH OF OUR COMMUNITY INCLUDING RESIDENTS OF AUBURN, NY AS WELL AS SURROUNDING AREAS.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee974TotalEmployeeCnt
Total Volunteers100TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$359,846PYContributionsGrantsAmt
CY Contributions Grants$5,529,795CYContributionsGrantsAmt
PY Program Service Revenue$91,004,462PYProgramServiceRevenueAmt
CY Program Service Revenue$94,217,105CYProgramServiceRevenueAmt
PY Investment Income$3,969PYInvestmentIncomeAmt
CY Investment Income$25,137CYInvestmentIncomeAmt
PY Other Revenue$2,253,759PYOtherRevenueAmt
CY Other Revenue$325,490CYOtherRevenueAmt
PY Total Revenue$93,622,036PYTotalRevenueAmt
CY Total Revenue$100,097,527CYTotalRevenueAmt
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$50,913,075PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$54,518,674CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$23,792CYTotalFundraisingExpenseAmt
PY Other Expenses$41,758,633PYOtherExpensesAmt
CY Other Expenses$45,248,381CYOtherExpensesAmt
PY Total Expenses$92,671,708PYTotalExpensesAmt
CY Total Expenses$99,767,055CYTotalExpensesAmt
PY Revenues Less Expenses$950,328PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$330,472CYRevenuesLessExpensesAmt
Total Assets BOY$60,938,602TotalAssetsBOYAmt
Total Assets EOY$62,914,051TotalAssetsEOYAmt
Total Liabilities BOY$28,988,240TotalLiabilitiesBOYAmt
Total Liabilities EOY$30,633,217TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$31,950,362NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$32,280,834NetAssetsOrFundBalancesEOYAmt
MissionOUR MISSION IS TO PROVIDE COMPASSIONATE, QUALITY CARE AND IMPROVE THE HEALTH OF OUR COMMUNITY INCLUDING AUBURN, NY AS WELL AS SURROUNDING AREAS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$87,066,485ExpenseAmt
Revenue$94,567,732RevenueAmt
DescTHE PURPOSE OF AUBURN COMMUNITY HOSPITAL IS TO MEET THE HEALTH CARE NEEDS OF THE COMMUNITY BY PROVIDING NECESSARY INPATIENT AND OUTPATIENT SERVICES. TO THAT END, THE HOSPITAL TREATED 4,950 INPATIENTS FOR A TOTAL OF 50,277 PATIENT DAYS AND A TOTAL OF 144,494 OUTPATIENTS IN 2014.Desc
Total Program Service Expenses$87,066,485TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document148IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee974EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JASON LESCH CFOBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3152557245PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 LANSING STREETAddressLine1Txt
CityAUBURNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13021ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JOSEPH RUNKLE
TRUSTEE1.00Yes (X)$0$0$0
PATSY IANNOLO MD
TRUSTEE1.00Yes (X)$0$0$0
RAMA GODISHALA MD
TRUSTEE1.00Yes (X)$0$0$0
JOHN RICCIO MD
TRUSTEE20.00Yes (X)$121,726$0$5,8515.00
LISA RYERSON
TRUSTEE1.00Yes (X)$0$0$0
WILLIAM SIMMONDS
TRUSTEE1.00Yes (X)$0$0$0
LOREN VANRIPER MD
TRUSTEE1.00Yes (X)$161,200$355,343$23,49440.00
DEMETRA VOUNAS MD
TRUSTEE1.00Yes (X)$0$62,916$6,590
ERIC R ALLYN
TRUSTEE1.00Yes (X)$0$0$02.00
JOSEPH BARTOLOTTA
CHAIRMAN1.00Yes (X)$0$0$0Yes (X)
ANTHONY D FRANCESCHELLI
VICE CHAIRMAN/TREASURER1.00Yes (X)$0$0$0Yes (X)
WILLIAM DORR
SECRETARY1.00Yes (X)$0$0$0Yes (X)
JD PABIS
TRUSTEE1.00Yes (X)$0$0$0
LINDA RICE
TRUSTEE1.00Yes (X)$0$0$0
SCOTT BERLUCCHI
PRESIDENT & CEO25.00$437,742$0$23,81913.00Yes (X)
PATRICK FACTEAU
FORMER CHIEF FINANCIAL OFFICER31.00$152,925$0$16,5167.00Yes (X)
JASON LESCH
CFO36.00$52,817$0$2,8932.00Yes (X)
ADAM DUCKETT MD
HOSPITALIST38.00$275,829$0$12,904Yes (X)
MARY BAKER
HOSPITALIST38.00$280,106$0$12,521Yes (X)
GREGORY SERFER
HOSPITALIST38.00$202,123$0$15,868Yes (X)
JOSEPH APONE MD
HOSPITALIST38.00$241,033$0$27,143Yes (X)
CHRISTOPHER RYAN
CHIEF INFORMATION OFFICER38.00$161,238$0$10,819Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,086,739TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$418,259TotReportableCompRltdOrgAmt
Total Other Compensation$158,418TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K23IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
EASTERN FINGERLAKES EMERGENCY
PO BOX 346 5180 WEST TAFT RDNORTH SYRACUSENY13212EMERGENCY ROOM PHYSICIANS$1,403,076
SYRACUSE PSYCHIATRIC SERVICE LLC
109 SOUTH WARREN STREETSYRACUSENY13202PSYCHIATRIC PHYSICIANS$750,000
AUBURN MEDICAL PC
17 LANSING STRETAUBURNNY13021ANESTHESHIA COVERAGE$649,187
ALLIANCE HEALTHCARE SERVICES
100 BAYVIEW CIRCLE SUITE 400NEWPORT BEACHCA92660MRI SERVICES$581,575
RAMA M GODISHALA
281 GRANT AVENUEAUBURNNY13021CARDIOLOGY COVERAGE$412,406
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K23CntrctRcvdGreaterThan100KCnt
Related Organizations$139,288RelatedOrganizationsAmt
Government Grants$5,023,520GovernmentGrantsAmt
All Other Contributions$366,987AllOtherContributionsAmt
Total Contributions$5,529,795TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE623000$93,377,448$93,377,448
VA CLINIC SERVICE623000$839,657$839,657
FieldValueIRS element (for citing)
Total Program Service Revenue$94,217,105TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,810TotalRevenueColumnAmt
Related Or Exempt Func Income$23,810RelatedOrExemptFuncIncomeAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,327TotalRevenueColumnAmt
Related Or Exempt Func Income$1,327RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
DIETARY INCOME623000$298,176$298,176
OTHER REVENUE623000$27,314$27,314
FieldValueIRS element (for citing)
Other Revenue Total$325,490OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$100,097,527TotalRevenueColumnAmt
Related Or Exempt Func Income$94,567,732RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$814,289TotalAmt
Management And General$814,289ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$38,535,617TotalAmt
Program Services$34,372,777ProgramServicesAmt
Management And General$4,145,668ManagementAndGeneralAmt
Fundraising$17,172FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,127,731TotalAmt
Program Services$1,858,607ProgramServicesAmt
Management And General$268,195ManagementAndGeneralAmt
Fundraising$929FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$10,175,561TotalAmt
Program Services$8,888,516ProgramServicesAmt
Management And General$1,282,604ManagementAndGeneralAmt
Fundraising$4,441FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,865,476TotalAmt
Program Services$2,503,040ProgramServicesAmt
Management And General$361,186ManagementAndGeneralAmt
Fundraising$1,250FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$284,709TotalAmt
Management And General$284,709ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$292,890TotalAmt
Management And General$292,890ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$317,183TotalAmt
Program Services$278,412ProgramServicesAmt
Management And General$38,771ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,386,294TotalAmt
Program Services$3,850,140ProgramServicesAmt
Management And General$536,154ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$178,377TotalAmt
Program Services$156,573ProgramServicesAmt
Management And General$21,804ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$226,629TotalAmt
Program Services$198,927ProgramServicesAmt
Management And General$27,702ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$373,397TotalAmt
Program Services$373,397ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$4,352,718TotalAmt
Program Services$4,352,718ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$1,462,552TotalAmt
Program Services$681,925ProgramServicesAmt
Management And General$780,627ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$12,457,412$10,934,693$1,522,719
PURCHASED SERVICES$9,884,986$8,676,705$1,208,281
BAD DEBT$6,481,288$6,481,288
OTHER FEES$4,549,946$3,458,767$1,091,179

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$99,767,055TotalAmt
Program Services$87,066,485ProgramServicesAmt
Management And General$12,676,778ManagementAndGeneralAmt
Fundraising$23,792FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,271,363BOYAmt
EOY$2,338,432EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$11,104,640BOYAmt
EOY$9,832,663EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$14,125,852BOYAmt
EOY$21,000,180EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,941,698BOYAmt
EOY$3,002,764EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$556,255BOYAmt
EOY$956,938EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$91,264,288LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$68,983,059LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$24,895,201BOYAmt
EOY$22,281,229EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$7,043,593BOYAmt
EOY$3,501,845EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$60,938,602BOYAmt
EOY$62,914,051EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$15,236,076BOYAmt
EOY$16,415,327EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$13,303,321BOYAmt
EOY$13,756,702EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$448,843BOYAmt
EOY$461,188EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$28,988,240BOYAmt
EOY$30,633,217EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$31,818,294BOYAmt
EOY$31,764,199EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$132,068BOYAmt
EOY$516,635EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$31,950,362BOYAmt
EOY$32,280,834EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$60,938,602BOYAmt
EOY$62,914,051EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$330,472ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$132,068BeginningYearBalanceAmt
Contributions$915,275ContributionsAmt
Other Expenditures$530,708OtherExpendituresAmt
End Year Balance$516,635EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$90,347BeginningYearBalanceAmt
Contributions$352,670ContributionsAmt
Other Expenditures$310,949OtherExpendituresAmt
End Year Balance$132,068EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$72,372BeginningYearBalanceAmt
Contributions$120,842ContributionsAmt
Other Expenditures$102,867OtherExpendituresAmt
End Year Balance$90,347EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$2,153,040BeginningYearBalanceAmt
Contributions$1,086,795ContributionsAmt
Other Expenditures$3,167,463OtherExpendituresAmt
End Year Balance$72,372EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$58,431BeginningYearBalanceAmt
Contributions$2,496,008ContributionsAmt
Other Expenditures$401,399OtherExpendituresAmt
End Year Balance$2,153,040EndYearBalanceAmt
FieldValueIRS element (for citing)
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$823,418OtherCostOrOtherBasisAmt
Book Value$823,418BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$34,980,768OtherCostOrOtherBasisAmt
Depreciation$21,972,604DepreciationAmt
Book Value$13,008,164BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,558,283OtherCostOrOtherBasisAmt
Depreciation$1,457,646DepreciationAmt
Book Value$100,637BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$53,517,440OtherCostOrOtherBasisAmt
Depreciation$45,552,809DepreciationAmt
Book Value$7,964,631BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$384,379OtherCostOrOtherBasisAmt
Book Value$384,379BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$22,281,229TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
AGENCY RELATIONSHIPS/ INSURANCE RECEIVABLE$846,304
ESTIMATED THIRD PARTY SETTLEMENTS$369,554
PLEDGE RECEIVABLE, NET$56,387
UNAMORTIZED DEBT ISSUANCE COST/ ASSETS LIMITED AS TO USE$2,229,600
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,501,845TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
FUNDS HELD FOR OTHERS$179,280
ASSET RETIREMENT OBLIGATION$281,908
FieldValueIRS element (for citing)
Total Liability$461,188TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE HOSPITAL, EXCEPT FOR AMPC, QUALIFIES AS TAX EXEMPT ORGANIZATIONS. AS OF DECEMBER 31, 2014 AND 2013, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2011 THROUGH 2014. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent100Yes (X)Percent100Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$222,945TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$222,945NetCommunityBenefitExpnsAmt
Total Expense0.00240TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,740,558TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,472,140DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,268,418NetCommunityBenefitExpnsAmt
Total Expense0.06720TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,963,503TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,472,140DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,491,363NetCommunityBenefitExpnsAmt
Total Expense0.06960TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,963,503TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,472,140DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,491,363NetCommunityBenefitExpnsAmt
Total Expense0.06960TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$6,481,288BadDebtExpenseAmt
Bad Debt Expense Attributable$222,945BadDebtExpenseAttributableAmt
Reimbursed By Medicare$35,691,216ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$41,180,410CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$5,489,194MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AUBURN COMMUNITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 LANSING STREETAddressLine1Txt
CityAUBURNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13021ZIPCd
FieldValueIRS element (for citing)
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 Line1AUBURN COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)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
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.AUBURNHOSPITAL.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLWWW.AUBURNHOSPITAL.ORGStrategyWebsiteURLTxt
Strategy Attached0StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care100.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
AUBURN COMMUNITY HOSPITALPART V, SECTION B, LINE 5: THE ACH PHYSICIAN ADVISORY BOARD, WHICH INCLUDES TWO PEDIATRIC PHYSICIANS, THREE PRIMARY CARE PHYSICIANS, TWO GENERAL SURGEONS, TWO OBGYN PHYSICIANS, AN ANESTESHIOLOGIST, A HOSPITALIST, A CARDIOLOGIST, AN ORTHOPEADIC PHYSICIAN, A NEUROLOGIST, AND AN EMERGENCY MEDICINE PHYSICIAN, AS WELL AS LOCAL COMMITTEE LEADERS AND BUSINESS LEADERS WERE INTERVIEWED FOR THEIR INPUT.
AUBURN COMMUNITY HOSPITALPART V, SECTION B, LINE 11: AUBURN COMMUNITY HOSPITAL HAS BEEN EXECUTING ITS RURAL INTEGRATED DELIVERY SYSTEM THAT WAS DEVELOPED IN 2013. AUBURN COMMUNITY HOSPITAL IS A FOUNDING PARTNER IN THE CNY DSRIP COLLABORATIVE CARE SYSTEM WITH FAXTON ST. LUKES, ST. JOSEPH'S AND SUNY.
AUBURN COMMUNITY HOSPITALPART V, SECTION B, LINE 22D: AUBURN COMMUNITY HOSPITAL USED THE HIGHEST VOLUME COMMERCIAL PAYOR TO DETERMINE THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP ELIGIBLES.
PART V, SECTION B, LINE 16FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY
AUBURN COMMUNITY HOSPITAL PART V, SECTION B, LINE 16A WEBSITE:WWW.AUBURNHOSPITAL.ORG
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
FINGER LAKES CENTER FOR LIVING
20 PARK AVENUEAUBURNNY13021SHORT-TERM REHABILITATION AND LONG-TERM RESIDENTIAL CARE CENTER
FINGER LAKES MEDICAL CARE CENTER
303 GRANT AVENUEAUBURNNY13021URGENT CARE CENTER
URGENT MEDICAL CARE OF SKANEATELES
803 GENESEE STREETSKANEATELESNY13152URGENT CARE CENTER

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7:THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE IS A COST-TO-CHARGE RATIO. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES.
PART I, LINE 7, COLUMN (F):THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 6,481,288.
PART III, LINE 4:SEE FOOTNOTE 3(K) ON PAGES 10-12 IN THE ATTACHED AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:THE SHORTFALL SHOWN ABOVE SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS ALL PATIENTS WILL BE SEEN AND TREATED AT AUBURN COMMUNITY HOSPITAL REGARDLESS OF ABILITY TO PAY. THEREFORE, THE FACT THAT THE COSTS TO TREAT MEDICARE PATIENTS EXCEEDED THE REVENUES GENERATED FROM MEDICARE PATIENTS SHOULD ALL BE VIEWED AS A BENEFIT TO THE MEDICARE PATIENTS OF THE COMMUNITY. THE AMOUNT ABOVE WAS CALCULATED BY MULTIPLYING THE GROSS MEDICARE CHARGES FOR THE YEAR BY THE RATIO OF PATIENT CARE COST TO CHARGES AS CALULATED ON WORKSHEET 2.
PART III, LINE 9B:PATIENTS ELIGIBLE ARE REASSESSED AT EACH ADMISSION AND NO FURTHER COLLECTIONS ARE DONE.
PART VI, LINE 2:A STRATEGIC PLANNING PROCESS WHICH INCLUDES AN ANALYSIS BY TREO SOLUTIONS IS USED TO HELP DETERMINE THE NEEDS OF OUR GEOGRAPHIC AREA. THIS ANALYSIS HELPS AUBURN COMMUNITY HOSPITAL IN DETERMINING WHETHER WE HAVE ADEQUATE PHYSICIAN STAFFING TO PROVIDE THE APROPRIATE LEVEL OF CARE TO OUR COMMUNITY.
PART VI, LINE 3:PATIENTS OF AUBURN COMMUNITY HOSPITAL ARE PROVIDED WITH FINANCIAL ASSISTANCE INFORMATION UPON BEING ADMITTED TO THE HOSPITAL, BOTH INPATIENT AND OUTPATIENT. FINANCIAL ASSISTANCE IS EVALUATED EVERY TIME A PERSON PRESENTS AT THE FACILITY. PACKETS ARE PROVIDED TO ANY PATIENT THAT IS DETERMINED TO NEED OR POTENTIALLY NEED FINANIAL ASSISTANCE.
PART VI, LINE 4:AUBURN COMMUNITY HOSPITAL SERVES THE AUBURN, NY COMMUNITY AS WELL AS THE IMMEDIATE SURROUNDING AREAS.
PART VI, LINE 5:AUBURN COMMUNITY HOSPITAL PROMOTES HEALTH TO THE COMMUNITY BY HOSTING EVENTS WHENEVER MONEY PERMITS. THIS INCLUDES AN ANNUAL HEART EXPO TO EDUCATE THE COMMUNITY ON HEART HEALTH. AUBURN COMMUNITY HOSPITAL ALSO PROMOTES WOMEN'S HEALTH CARE THROUGH THE WOMEN'S HEALTH INSTITUTE.
PART VI, LINE 6:AUBURN COMMUNITY HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.
PART VI, LINE 7, REPORTS FILED WITH STATESNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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
LOREN VANRIPER MD
TRUSTEE$161,200$355,343$0$0$0$0$0$13,000$0$10,494$161,200$378,837$0$0
SCOTT BERLUCCHI
PRESIDENT & CEO$391,542$0$40,200$0$6,000$0$13,000$0$10,819$0$461,561$0$0$0
PATRICK FACTEAU
FORMER CHIEF FINANCIAL OFFICER$144,325$0$8,600$0$0$0$7,361$0$9,155$0$169,441$0$0$0
ADAM DUCKETT MD
HOSPITALIST$275,829$0$0$0$0$0$0$0$12,904$0$288,733$0$0$0
MARY BAKER
HOSPITALIST$276,723$0$3,383$0$0$0$0$0$12,521$0$292,627$0$0$0
GREGORY SERFER
HOSPITALIST$202,123$0$0$0$0$0$0$0$15,868$0$217,991$0$0$0
JOSEPH APONE MD
HOSPITALIST$241,033$0$0$0$0$0$11,879$0$15,264$0$268,176$0$0$0
CHRISTOPHER RYAN
CHIEF INFORMATION OFFICER$153,638$0$7,600$0$0$0$0$0$10,819$0$172,057$0$0$0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CAYUGA COUNTY DEVELOPMENT CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN522367265BondIssuerEIN
CUSIP149762AA4CUSIPNum
Bond Issued2013-08-30BondIssuedDt
Issue Price$9,380,000IssuePriceAmt
PurposeREFINANCING BONDS FOR CAPITAL IMPROVEMENTPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool Financing0PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$12,175,000RetiredAmt
Total Proceeds$9,380,000TotalProceedsAmt
Issuance Costs From Proceeds$187,600IssuanceCostsFromProceedsAmt
Substantial Completion2013SubstantialCompletionYr
Current RefundingYes (1)CurrentRefundingInd
Advance Refunding0AdvanceRefundingInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Private Bus Use By Others0.00000PrivateBusUseByOthersPct
Private Bus Concerning UBI0.00000PrivateBusConcerningUBIPct
Total Private Business Use0.00000TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond Remdtd0ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To Rebate0ExceptionToRebateInd
No Rebate DueYes (1)NoRebateDueInd
Variable Rate Issue0VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective Action0ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDATE REBATE COMPUTATION PERFORMEDFormAndLineReferenceDesc
ExplanationISSUER NAME: CAYUGA COUNTY DEVELOPMENT CORPORATION DATE THE REBATE COMPUTATION WAS PERFORMED: 08/30/2013ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
RAMA GODISHALA
OWNER OF RAMA GODISHALA, MD, PC$412,406PROVIDES CARDIOLOGY COVERAGE TO HOSPITAL0
PATSY IANNOLO
OWNER OF EASTERN FINGERLAKES EMERGENCY$1,663,655EMERGENCY ROOM SERVICES0
JOHN RICCIO
OWNER OF AUBURN PATHOLOGY ASSOCIATES, PC$187,804PROVIDES LABORATORY SERVICES TO HOSPITAL0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS, OFFICERS AND HIGHLY COMPENSATED EMPLOYEES ARE REQUIRED TO COMPLETE CONFLICT OF INTEREST FORMS AND SIGN THEM ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS DETERMINE THE PRESIDENT/ CEO COMPENSATION. OTHER TOP OFFICIALS' COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS, CEO AND IS ALSO BASED OFF OF EXPERIENCE, COMPENSATION SURVEYS AND OTHER QUALIFICATIONS.
FORM 990, PART VI, SECTION C, LINE 18COPIES OF THE 990 WILL BE AVAILABLE TO THE PUBLIC UPON REQUEST
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST, COPIES OF DOCUMENTS WILL BE PROVIDED.
FORM 990, PART XII, LINE 2C:THE PROCESSES RELATING TO THE COMMITTEE'S OVERSIGHT OF THE AUDIT HAS NOT CHANGED FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
AUBURN COMMUNITY COMPANIES INC
17 LANSING STREETAUBURNNY13021223271881PROVIDES NURSING HOME ACCOMMODATIONSNY501(C)(3)LINE 9AUBURN COMMUNITY HOSPITALYes (1)
AUBURN COMMUNITY HOSPITAL FOUNDATION INC
PO BOX 918AUBURNNY13021161599892PROVIDES FUNDS TO AUBURN COMMUNITY HOSPITAL, INC. AND RELATED ENTITIESNY501(C)(3)LINE 11AUBURN COMMUNITY HOSPITALYes (1)
ACH PROPERTIES INC
5-19 LANSING STREETAUBURNNY13021161335941PROMOTE AND SUPPORT CHARITABLE PURPOSE OF AUBURN COMMUNITY HOSPITAL, INC.NY501(C)(3)N/AAUBURN COMMUNITY HOSPITALYes (1)
AUBURN MEMORIAL MEDICAL SERVICES PC
17 LANSING STREETAUBURNNY13021261193842PRACTICE OF MEDICINENY501(C)(3)LINE 11AUBURN COMMUNITY HOSPITALYes (1)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1AUBURN MEDICAL PCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line117 LANSING STREETAddressLine1Txt
CityAUBURNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP13021ZIPCd
FieldValueIRS element (for citing)
EIN205111805EIN
Primary ActivitiesANESTHESIOLOGY SERVICESPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
AUBURN COMMUNITY HOSPITAL FOUNDATION INC
C$139,288CASH
AUBURN MEMORIAL MEDICAL SERVICES PC
D$5,459,474FMV
AUBURN MEDICAL PC
D$669,187FMV
AUBURN COMMUNITY COMPANIES INC
K$540,521FMV
ACH PROPERTIES INC
K$29,435FMV