2015-11-10T08:50:36-06:00 2014-12-31 161226221 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2014-01-01 810600548 RIVER HOSPITAL INC RIVE 3154822511 4 FULLER STREET ALEXANDRIA BAY NY 13607 BEN MOORE CEO 3154822511 2015-11-03 1 JOSEPH J SCHLEGEL P00301329 3154463600 2014 2016-02-25 16:41:14Z BEN MOORE 4 FULLER STREET ALEXANDRIA BAY NY 13607 20330849 0 X WWW.RIVERHOSPITAL.ORG X 2003 NY IT IS THE MISSION OF RIVER HOSPITAL TO PROVIDE COMPASSIONATE, COST EFFECTIVE AND ACCESSIBLE, PRIMARY HEALTH CARE TO THE YEAR ROUND AND SEASONAL RESIDENTS, AND VISITORS OF THE RIVER COMMUNITIES. THE HOSPITAL PRIDES ITSELF ON HIGH QUALITY OUTPATIENT, INPATIENT AND SPECIALTY SERVICES TO MEET INDIVIDUAL AND COMMUNITY NEEDS THROUGH PARTNERSHIPS WITH OUR PATIENTS AND COMMUNITIES WE SERVE. 13 13 256 0 0 0 3369828 1448547 14612216 15601902 321294 295367 944306 763492 19247644 18109308 0 0 0 0 11354362 12046625 0 0 0 6686150 8041687 18040512 20088312 1207132 -1979004 17473954 15278690 9421397 9285324 8052557 5993366 X IT IS THE MISSION OF RIVER HOSPITAL TO PROVIDE COMPASSIONATE, COST EFFECTIVE AND ACCESSIBLE, PRIMARY HEALTH CARE TO THE YEAR ROUND AND SEASONAL RESIDENTS, AND VISITORS OF THE RIVER COMMUNITIES. THE HOSPITAL PRIDES ITSELF ON HIGH QUALITY OUTPATIENT, INPATIENT AND SPECIALTY SERVICES TO MEET INDIVIDUAL AND COMMUNITY NEEDS THROUGH PARTNERSHIPS WITH OUR PATIENTS AND COMMUNITIES WE SERVE. 1 0 15257997 16365394 RIVER HOSPITAL, INC. PROVIDED GENERAL INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES TO RESIDENTS IN THE NORTHERN NEW YORK AREA. DURING 2014, THE HOSPITAL PROVIDED 1,557 SWING BED DAYS AND 222 DAYS OF CRITICAL ACCESS CARE TO THE SICK AND INJURED. RIVER HOSPITAL STRIVES TO IDENTIFY AND UPDATE SERVICES BASED UPON THE COMMUNITY NEEDS. WE ARE ALSO IN THE PROCESS OF IMPLEMENTING ELECTRONIC HEALTH RECORDS AND ARE PARTICIPATING IN THE REGIONAL HEALTH INFORMATION EXCHANGE (RHIO). THE HOSPITAL SERVES A COMMUNITY PAYOR MIX OF 55% GOVERNMENT PAYORS, 42% COMMERCIAL PAYORS AND OTHER AND 3% UNINSURED. 15257997 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 124 0 1 256 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 1 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X KELLEY TIERNAN 3153933600 214 KING STREET OGDENSBURG NY 13669 JOSEPH RUSSELL CHAIRMAN 2.00 X X 0 0 0 ROBERT TOOLE SECRETARY 2.00 X X 0 0 0 JEANNE SNOW TREASURER 2.00 0.00 X X 0 0 0 CRAIG GARLOCK TRUSTEE 2.00 X 0 0 0 NORMAN SNYDER VICE CHAIRMAN 2.00 X X 0 0 0 RONALD MILLER TRUSTEE 2.00 X 0 0 0 RICHARD MACSHERRY TRUSTEE 2.00 2.00 X 0 0 0 RONALD RANDALL TRUSTEE 2.00 X 0 0 0 JAMES DONEGAN TRUSTEE 2.00 X 0 0 0 LYNN BROWN TRUSTEE 2.00 5.00 X 0 0 0 RONALD THOMSON TRUSTEE 2.00 X 0 0 0 STEPHANIE WEISS TRUSTEE 2.00 X 0 0 0 ALICIA DEWEY TRUSTEE 2.00 X 0 0 0 BEN MOORE CEO 40.00 X 240000 0 11094 TRACI MINTONYE CFO 35.00 5.00 X 128386 0 16235 JAMES REDMORE COO 40.00 X 148095 0 9401 LAUREN ROMAN CMO 40.00 X 223383 0 10704 AARON HUIZENGA PHYSICIAN - CLINIC 40.00 X 242690 0 18079 TROY JOHNSON DIRECTOR OF ER 40.00 X 177712 0 9831 ROBERT KELLER PSYCHIATRIST 40.00 X 249626 0 15549 ALFREDO TORRES PHYSICIAN 40.00 X 306691 0 17922 JOHN HUSZONEK PSYCHIATRIST 40.00 X 201355 0 10186 1917938 0 119001 9 0 1 0 ANESTHESIA AFFILIATE PC 63 WOOD RUN CIRCLE ROCHESTER NY 14612 ANESTHESIA SERVICE 290144 1 89000 1224573 134974 1448547 PROGRAM SERVICE REVENUE 623000 15601902 15601902 15601902 91643 91643 4070 22783 -18713 -18713 -18713 2402482 2166801 31957 235681 -31957 203724 203724 PHYSICAL THEREPY OTHER REVENUE 623000 398238 398238 OTHER OPERATING REVENUE 623000 340039 340039 OTHER NON-OPERATING REVENUE 623000 23006 23006 20922 20922 782205 18109308 16365394 0 295367 787298 616002 171296 9592805 7506637 2086168 1666522 1301280 365242 268460 600 267860 181334 15008 166326 453131 453131 104794 7388 97406 118143 86237 31906 225144 202465 22679 1185913 928010 257903 374439 293009 81430 SUPPLIES 1457660 1259109 198551 OUTSIDE SERVICES 1394980 798136 596844 BAD DEBT 1325055 1325055 UTILITIES 297756 238205 59551 654878 227725 427153 20088312 15257997 4830315 0 328666 516309 3633877 794917 2328034 2461393 273061 395604 107692 150946 13232120 7862812 5426143 5369308 4486365 3781184 408033 503301 482083 1305728 17473954 15278690 2846456 3518025 5106993 5245240 1467948 522059 9421397 9285324 X 3590859 2598283 3941846 2875231 519852 519852 8052557 5993366 17473954 15278690 X -1979004 -175455 95268 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 4461698 884070 62874 2013559 3395083 4023761 3207476 -3461 2766078 4461698 4430770 424661 -39795 791875 4023761 3733112 1722592 -19964 1004970 4430770 2910665 2020137 37447 1235136 3733113 0.15310 0.84690 0 0 11000 11000 3761394 1979080 1782314 9366121 5883732 3482389 93605 93605 5369308 ESTIMATED THIRD PARTY PAYMENT SETTLEMENTS 1189105 DUE FROM FOUNDATION 21306 DEBT ISSUANCE COST 38050 RESTRICTED CASH 57267 1305728 INSURANCE RESERVE 522059 522059 X 17685238 0 17685238 424070 424070 18109308 19664242 0 19664242 424070 424070 20088312 PART V, LINE 4: PERMANENT ENDOWMENT FUNDS ARE TO BE HELD IN PERPETUITY WITH THE INCOME TO BE USED TO SUPPORT HEALTHCARE SERVICES. TEMPORARY ENDOWMENT FUNDS ARE TO BE USED TO PURCHASE CAPITAL EQUIPMENT FOR HEALTHCARE SERVICES, HOSPITAL OPERATIONS AND SCHOLARSHIPS. PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN A HOSPITAL'S FINANCIAL STATEMENTS. THESE STANDARDS HAD NO IMPACT ON THE ACCOMPANYING FINANCIAL STATEMENTS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2011 THROUGH 2014. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -22,783. VITAL ACCESS PROVIDER GRANT - BAD DEBT 446,853. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -22,783. VITAL ACCESS PROVIDER GRANT - BAD DEBT 446,853. 1 1 1 X 1 X 1 1 1 0 1 1 304742 32655 272087 0.01350 2884531 1533588 1350943 0.06730 60804 15414 45390 0.00230 3250077 1581657 1668420 0.08310 3250077 1581657 1668420 0.08310 1 878203 193720 3291138 3874370 -583232 X 1 1 1 1 RIVER HOSPITAL 4 FULLER STREET ALEXANDRIA BAY NY 13607 X X X X RIVER HOSPITAL INC 1 0 0 1 X X X X X X X X X 13 1 1 1 1 X WWW.RIVERHOSPITAL.ORG X 1 13 1 WWW.RIVERHOSPITAL.ORG 0 0 1 X 100.000000000000 300.000000000000 1 1 X X X X 1 X X X X X X X X 1 X 1 X X X X X 1 X 0 0 RIVER HOSPITAL, INC. PART V, SECTION B, LINE 5: RIVER HOSPITAL TOOK INTO ACCOUNT THE BROAD INTERESTS OF THE COMMUNITY AND THE TRI COUNTY REGION THROUGH COLLABORATIVE EFFORTS OF THE NORTH COUNTRY HEALTH COMPASS PARTNERSHIP, IN THE DEVELOPMENT OF THE 2013 COMMUNITY HEALTH ASSESSMENT AND THE 2013 REGIONAL COMMUNITY HEALTH IMPROVEMENT PLAN. THE NORTH COUNTRY HEALTH COMPASS PARTNERSHIP IS COMPRISED OF REGIONAL REPRESENTATION FROM PUBLIC HEALTH AGENCIES, HOSPITALS AND COMMUNITY-BASED ORGANIZATIONS FROM JEFFERSON, LEWIS AND ST. LAWRENCE COUNTIES, WHO MEET ON A MONTHLY BASIS. THE REGIONAL PRIORITIES WERE SELECTED AFTER CAREFULLY EVALUATING COMMUNITY HEALTH NEEDS, POPULATION HEALTH DATA, REGIONAL ASSETS, AND REGIONAL BARRIERS. PREVENTION AGENDA PRIORITIES AND GOALS WERE RANKED USING AN ONLINE SURVEY TOOL WHICH DISPLAYED HEALTH INDICATORS RELATED TO EACH PRIORITY. RIVER HOSPITAL SELECTED PRIORITIES FOR THE COMMUNITY SERVICE PLAN WHICH ARE IN ALIGNMENT WITH THE PREVENTION AGENDA AND THE EFFORTS OF THE NORTH COUNTRY HEALTH COMPASS PARTNERSHIP. RIVER HOSPITAL, INC. PART V, SECTION B, LINE 6A: CANTON-POTSDAM HOSPITAL, CARTHAGE AREA HOSPITAL, CLAXTON-HEPBURN MEDICAL CENTER, CLIFTON-FINE HOSPITAL, E.J. NOBLE HOSPITAL, LEWIS COUNTY GENERAL HOSPITAL, MASSENA MEMORIAL HOSPITAL, RIVER HOSPITAL AND SAMARITAN MEDICAL CENTER. RIVER HOSPITAL, INC. PART V, SECTION B, LINE 11: THE RESULTS OF THE NORTH COUNTRY INITIATIVE COMMUNITY NEEDS ASSESSMENT IDENTIFY THE TOP FIVE CAUSES OF MEDICAID HOSPITALIZATION AND EMERGENCY ROOM VISITS ACROSS THE REGION AS: MENTAL ILLNESS, CARDIOVASCULAR DISEASE, RESPIRATORY DISEASE (COPD), DIABETES AND SUBSTANCE ABUSE. RIVER HOSPITAL HAS BEEN MOVING TOWARD AN OUT-PATIENT FOCUS TO ADDRESS THESE RESULTS THROUGH THE IMPROVEMENT IN ACCESS TO CARE FOR BEHAVIORAL/MENTAL HEALTH SERVICES AND FOCUS ON PREVENTIVE SERVICE AS A CERTIFIED LEVEL 3 PRIMARY CARE MEDICAL HOME. POPULATION HEALTH BY CARE COORDINATION INVOLVING PRIMARY CARE, BEHAVIORAL HEALTH AND EMERGENCY SERVICES IS EXPECTED TO REDUCE UTILIZATION AND IMPROVE COMPLIANCE AMONG PATIENT POPULATION. PART V, SECTION B, LINE 16 FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY RIVER HOSPITAL, INC. PART V, SECTION B, LINE 16A WEBSITE: WWW.RIVERHOSPITAL.ORG RIVER HOSPITAL, INC. PART V, SECTION B, LINE 16B WEBSITE: WWW.RIVERHOSPITAL.ORG RIVER HOSPITAL, INC. PART V, SECTION B, LINE 16C WEBSITE: WWW.RIVERHOSPITAL.ORG PART I, LINE 7: WORKSHEETS 1, 2 & 3 WERE USED TO COMPLETE LINES 7A, 7B AND 7C. PART III, LINE 2: THIS ALSO APPLIES TO PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST PAYMENT HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS 32% AND 33% OF THE RELATED PATIENT ACCOUNTS RECEIVABLE, NET OF CONTRACTUAL ALLOWANCES AT DECEMBER 31, 2014 AND 2013, RESPECTIVELY.FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, THE HOSPITAL RECOGNIZES REVENUE ON THE BASIS OF ITS STANDARD RATES FOR SERVICES PROVIDED OR ON THE BASIS OF NEGOTIATED DISCOUNTED RATES. THUS, THE HOSPITAL RECORDS A PROVISION FOR BAD DEBTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. PART III, LINE 3: THE METHODOLOGY USED TO CALCULATE THE PORTION OF BAD DEBT ATTRIBUTABLE TO THE PATIENTS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY WAS TO SUM THE BAD DEBT WRITE OFFS FOR PATIENTS CURRENTLY RECEIVING THE CHARITY CARE DISCOUNTS FROM THE DETAILED BAD DEBT WRITE OFF REPORTS FROM THE BILLING SYSTEM. PART III, LINE 8: THE SHORTFALL REPORTED ON LINE 7 WAS SETTLED IN 2015 WITHIN THE 2014 MEDICARE COST REPORT SETTLEMENT CALCULATION, THEREFORE, THIS AMOUNT SHOULD NOT BE CONSIDERED TO BE PART OF THE COMMUNITY BENEFIT. PART III, LINE 9B: UNDER OUR CHARITY CARE PROGRAM, PATIENTS MAY APPLY FOR ASSISTANCE WITHIN 90 DAYS OF DISCHARGE OR DATE OF SERVICE. ONCE THE APPLICATION IS REQUESTED AND RECEIVED BY THE APPLICANT, THE APPLICATION MUST BE RETURNED TO RIVER HOSPITAL WITHIN 30 DAYS FROM THE DATE OF SERVICE. RIVER HOSPITAL DOES NOT PURSUE FURTHER COLLECTION ACTION WHILE THIS APPLICATION IS IN PROCESS PROVIDING THAT THE APPLICATION IS COMPLETED IN A TIMELY FASHION. RIVER HOSPITAL PROCESSES THIS APPLICATION WITHIN 30 DAYS OF RECEIPT. APPLICANTS ARE NOTIFIED IN WRITING OF OUR DECISION. AN INSTALLMENT AGREEMENT IS THEN SENT TO THE APPLICANT, AN INTEREST FREE AGREEMENT, TO BE SIGNED AND RETURNED. PART VI, LINE 2: RIVER HOSPITAL CONTINUES TO COLLABORATE WITH THE TRI-COUNTY "NORTH COUNTRY HEALTH COMPASS" PARTNERS. THIS PARTNERSHIP WAS ESTABLISHED IN 2012. THE MISSION OF THE PARTNERSHIP IS TO DEVELOP, IMPLEMENT AND EVALUATE A REGIONAL HEALTH IMPROVEMENT INITIATIVE THROUGH RESEARCH, DATA ANALYSIS, COMMUNITY ENGAGEMENT AND COLLABORATION AMONG PUBLIC HEALTH DEPARTMENTS, HOSPITALS, COMMUNITY BASED ORGANIZATIONS, GENERAL PUBLIC AND HEALTHCARE PROVIDERS. THROUGH THE EFFORTS OF THIS PARTNERSHIP, IT WAS POSSIBLE TO DO A COMMUNITY HEALTH ASSESSMENT (CHA) AND COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), IN ORDER TO AID IN THE DEVELOPMENT OF THE COMMUNITY HEALTH IMPROVEMENT PLAN AND THE HOSPITAL'S COMMUNITY SERVICE PLAN IN 2013. AS A FOLLOW UP, THE PARTNERSHIP WORKED TOGETHER TO PERFORM A NEEDS ASSESSMENT IN OCTOBER 2014 TO CONDUCT A COMMUNITY NEEDS ASSESSMENT UPDATE.RIVER HOSPITAL WAS THE CATALYST IN THE DEVELOPMENT OF THE NORTH COUNTRY INITIATIVE (NCI), A MULTIHOSPITAL COLLABORATION TO IMPROVE THE HEALTH DELIVERY SYSTEM IN THE NORTH COUNTRY. RIVER HOSPITAL'S CHIEF EXECUTIVE OFFICER AND SEVERAL STAFF MEMBERS PARTICIPATE IN SEVERAL NCI MEETINGS EACH MONTH TO WORK TOWARD THESE EFFORTS.RIVER HOSPITAL BELONGS TO THE TUG HILL SEAWAY REGION PERFORMING PROVIDER SYSTEM (PPS). THE PPS CONDUCTED A COMMUNITY NEEDS ASSESSMENT OVER A SIX MONTH PERIOD OF TIME FROM JUNE 1, 2014 TO DECEMBER 1, 2014 TO PROVIDE THE NCI WITH AN UNDERSTANDING OF THE HEALTH STATUS OF THE POPULATION AND COMPONENTS OF THE HEALTHCARE SYSTEM AND AVAILABLE COMMUNITY RESOURCES TO ENSURE THAT THE DELIVERY SYSTEM REFORM INCENTIVE PAYMENT PROGRAM (DSRIP) PROJECTS SELECTED ADDRESS THE GREATEST NEEDS TO THE COMMUNITY. UTILIZING OUTCOMES DATA, RIVER HOSPITAL DEVELOPED A DSRIP WORK PLAN TO ADDRESS SOME OF THE NEEDS IDENTIFIED IN THE SURVEY. PART VI, LINE 3: PATIENTS ARE PROVIDED INFORMATION ABOUT OUR CHARITY CARE PROGRAM AND THE ELIGIBILITY GUIDELINES AT THE TIME OF SERVICE. WE ALSO HAVE THE INFORMATION AVAILABLE ON OUR WEBSITE. PART VI, LINE 4: RIVER HOSPITAL IS LOCATED WITHIN THE VILLAGE OF ALEXANDRIA BAY, NEW YORK, 'THE HEART OF THE THOUSAND ISLAND REGION', AND INCLUDES AREAS OF BOTH JEFFERSON AND ST. LAWRENCE COUNTIES. RIVER HOSPITAL IS SITUATED DIRECTLY ON THE SHORE OF THE ST. LAWRENCE SEAWAY, A VERY RURAL AREA, YET, ONE OF THE MAJOR COMMERCIAL WATERWAYS, CONNECTING THE GREAT LAKES TO THE WATER WAYS OF THE WORLD. RIVER HOSPITAL'S IMMEDIATE SERVICE AREA REACHES A RADIUS OF APPROXIMATELY 25 MILES. THE FACILITY PROVIDES HEALTH CARE SERVICES TO SEVERAL SURROUNDING COMMUNITIES. WITHIN THE RANGE OF THE RIVER HOSPITAL SERVICE AREA IS THE EXPANSIVE UNITED STATES ARMY'S 10TH MOUNTAIN LIGHT INFANTRY DIVISION AT FORT DRUM AND THE INFLUX OF FAMILY MEMBERS AND ASSOCIATED POPULATION. DIRECTLY TO THE NORTH, ON THE OPPOSITE SHORE OF THE ST. LAWRENCE RIVER IS THE PROVINCE OF ONTARIO, CANADA, CONFINING AVAILABILITY OF UNITED STATES HEALTH CARE SYSTEM TO 180 DEGREE RADIUS. THE LARGEST NEARBY UNITED STATES POPULATION CENTER IS SYRACUSE, NEW YORK, LOCATED 100 MILES TO THE SOUTH.IN ADDITION TO THE FULL TIME RESIDENTS OF THESE COMMUNITIES, RIVER HOSPITAL SERVES A LARGE POPULATION OF SEASONAL RESIDENTS AND VISITORS FROM THE UNITED STATES AND OTHER COUNTRIES OF THE WORLD, DUE IN PART TO THE SEASONAL TOURISM INDUSTRY. THIS ENTIRE REGION IS A MEDICALLY UNDERSERVED AREA (MUA) AND FEDERALLY DESIGNATED HEALTH PROVIDER SHORTAGE AREA (HPSA) WITH POVERTY AND UNEMPLOYMENT RATES THAT SIGNIFICANTLY EXCEED BOTH STATE AND NATIONAL AVERAGES. PART VI, LINE 5: RIVER HOSPITAL CONTINUES TO BE VERY INVOLVED WITH OTHER PARTNERS TO PROVIDE QUALITY HEALTHCARE SERVICE TO THIS REGION OF NORTHERN NEW YORK STATE, INCLUDING RELATIONSHIPS WITH JEFFERSON COUNTY PUBLIC HEALTH DEPARTMENT, OTHER NORTH COUNTRY HOSPITALS AND AGENCIES/ORGANIZATIONS TO SHARE INFORMATION AND WORK TOGETHER TO EDUCATE THE PUBLIC ON THE AVAILABILITY OF SERVICES IN THIS REGION. RIVER HOSPITAL WORKS CLOSELY WITH FORT DRUM REGIONAL HEALTH PLANNING ORGANIZATION (FDRHPO), WHICH WAS ESTABLISHED TO LINK MILITARY FAMILIES ASSIGNED TO FORT DRUM MILITARY BASE TO QUALITY HEALTHCARE SERVICES AND RESOURCES IN THE REGION, AS THERE IS NO ON-BASE HOSPITAL. PART VI, LINE 6: RIVER HOSPITAL PARTICIPATED IN HEALTH AND WELLNESS FAIRS WHERE HEALTH INFORMATION WAS DISTRIBUTED ALONG WITH INFORMATION ABOUT THE HOSPITAL. IN AUGUST, THE HOSPITAL PARTNERED WITH UNITED HEALTHCARE TO HOST A BACK TO SCHOOL VACCINATION EVENT. THE HOSPITAL ALSO CONTINUES TO WORK WITH OTHER AGENCIES SUCH AS CANCER SERVICES PROGRAM OF JEFFERSON AND LEWIS COUNTIES, WHICH TOGETHER WITH OTHER REGIONAL FACILITIES BROUGHT THE "LOVE YOURSELF" EVENT, HELD IN MAY, TO INDIVIDUALS WITHOUT ADEQUATE HEALTH INSURANCE WHO NEEDED MAMMOGRAMS. RIVER HOSPITAL ALSO HOSTED THE 2ND ANNUAL MOCKTAILS, MANICURES AND MAMMOS IN OCTOBER. THIS WAS A FUN EVENING FOR WOMEN WITHOUT ADEQUATE HEALTH INSURANCE WHO NEEDED MAMMOGRAMS. THE 1ST ANNUAL CONVERSATION WITH RIVER HOSPITAL WAS HELD IN OCTOBER. THIS FREE SEMINAR WAS AIMED AT EDUCATING WOMEN ON BREAST HEALTH. RIVER HOSPITAL WAS THE HEALTHCARE PROVIDER AT THE HOOD PLANT ANNUAL EMPLOYEE/FAMILY HEALTH FAIR AND OFFERED FLU VACCINES, PHYSICAL THERAPY TECHNIQUES, BLOOD PRESSURE CHECKS, PROPER NUTRITION GUIDELINES AS WELL AS INFORMATION TO IMPROVE/MAINTAIN GOOD HEALTH AND GENERAL RIVER HOSPITAL SERVICES INFORMATION. IN APRIL, RIVER HOSPITAL HOSTED A FREE VEIN SCREENING FOR THOSE INDIVIDUALS WHO ARE ON THEIR FEET ALL DAY, HAVE LEG PAIN, DISCOMFORT OR SWELLING OR HAVE VARICOSE VEINS. ATTENDEES RECEIVED ADDITIONAL INFORMATION ABOUT VENOUS DISEASE, SPECIFICALLY VENOUS REFLUX DISEASE, A COMMON CAUSE OF VARICOSE VEINS.RIVER HOSPITAL ALSO HOSTED MASH CAMP STUDENTS, SPONSORED BY THE NORTHERN NEW YORK RURAL HEALTH CARE ALLIANCE, WHEREBY STUDENTS FROM AREA SCHOOLS EXPLORED CAREERS IN HEALTHCARE AT RIVER HOSPITAL. WELLS COLLEGE STUDENTS ALSO VISITED RIVER HOSPITAL TO LEARN MORE ABOUT RURAL HEALTHCARE AND THE COMMUNITIES WE SERVE. A GROUP OF 50 2ND GRADE STUDENTS FROM ALEXANDRIA CENTRAL SCHOOL HAD THEIR ANNUAL VISIT TO THE HOSPITAL IN OCTOBER. RIVER HOSPITAL ALSO ATTENDED MEETINGS WITH SEVERAL COMMUNITY ORGANIZATIONS TO INFORM THEM OF THE SERVICES OFFERED. THOSE ORGANIZATIONS INCLUDED: ALEXANDRIA BAY ROTARY, AMERICAN LEGION POST 904, TOWNS OF CLAYTON AND ALEXANDRIA, VILLAGE OF ALEXANDRIA, CAPE VINCENT LIONS CLUB AND TOWN OF HAMMOND.IN 2014, RIVER HOSPITAL CONTINUED TO WORK WITH OTHER REGIONAL HOSPITALS ON A COLLABORATION TO DEVELOP A STRATEGY TO ADDRESS THE DELIVERY OF AFFORDABLE HEALTH CARE SOLUTIONS TO RESIDENTS IN THE TRI-COUNTY AREA. THE SIX HOSPITAL COLLABORATION INCLUDE RIVER HOSPITAL, ALEXANDRIA BAY; CLAXTON HEPBURN MEDICAL CENTER, OGDENSBURG; CLIFTON-FINE HOSPITAL, STAR LAKE; LEWIS COUNTY GENERAL HOSPITAL, LOWVILLE; SAMARITAN MEDICAL CENTER, WATERTOWN AND CARTHAGE AREA HOSPITAL, CARTHAGE.RIVER HOSPITAL ACTIVELY PARTICIPATES WITH THE NEW YORK STATE CRITICAL ACCESS HOSPITALS WHO WORK TOGETHER ON QUALITY IMPROVEMENT PROCESSES AND PATIENT SATISFACTION OUTCOMES. PART VI, LINE 7, REPORTS FILED WITH STATES NY X X X 0 0 0 0 0 0 0 0 0 BEN MOORE CEO 200000 0 40000 0 0 0 0 0 11094 0 251094 0 0 0 JAMES REDMORE COO 148095 0 0 0 0 0 0 0 9401 0 157496 0 0 0 LAUREN ROMAN CMO 223383 0 0 0 0 0 0 0 10704 0 234087 0 0 0 AARON HUIZENGA PHYSICIAN - CLINIC 236090 0 6600 0 0 0 0 0 18079 0 260769 0 0 0 TROY JOHNSON DIRECTOR OF ER 177712 0 0 0 0 0 0 0 9831 0 187543 0 0 0 ROBERT KELLER PSYCHIATRIST 249626 0 0 0 0 0 0 0 15549 0 265175 0 0 0 ALFREDO TORRES PHYSICIAN 306691 0 0 0 0 0 0 0 17922 0 324613 0 0 0 JOHN HUSZONEK PSYCHIATRIST 201355 0 0 0 0 0 0 0 10186 0 211541 0 0 0 FORM 990, PART III, LINE 2 FURTHER EXPANSION OF MENTAL HEALTH AND AMBULATORY SURGICAL SERVICES IN 2014. FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED IN 2014 TO COMPLY WITH THE NEW YORK STATE NON-PROFIT REVITALIZATION ACT. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS OF THE ORGANIZATION MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS MADE AVAILABLE TO THE BOARD MEMBERS PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD IS REQUIRED TO COMPLETE AND SIGN A CONFLICT OF INTEREST POLICY ANNUALLY. IF A CONFLICT ARISES IN BETWEEN ANNUAL REVIEW OF THE POLICY, THE BOARD MEMBER IS REQUIRED TO AND RESPONSIBLE FOR REPORTING THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S WAGES ARE REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES AND COMPARABLE REGIONAL WAGE DATA PROVIDED BY PAYSCALE AND THE IROQUOIS HEALTHCARE ASSOCIATION SURVEY OF WAGE DATA ARE USED TO DETERMINE COMPETITIVE WAGES. THE CEO IS MONITORED AND EVALUATED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. THE EXECUTIVE DIRECTOR, AND OTHER TOP MANAGEMENT OFFICERS ARE MONITORED AND REVIEWED ON AN ANNUAL BASIS BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE COMPANY'S WEBSITE. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE PUBLIC CHARITY WEBSITE. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN FOUNDATION 95,268. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. RIVER HOSPITAL FOUNDATION PO BOX 567 ALEXANDRIA BAY NY 13607 421585479 RAISES FUNDS FOR HOSPITAL CONSTRUCTION, REMODELING AND MEDICAL EQUIPMENT. NY 501 (C) 3 11C RIVER HOSPITAL INC 0 0 0 1 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0