ADIRONDACK MEDICAL CENTER: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- ADIRONDACK MEDICAL CENTER (EIN 14-1731786)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-16
- IRS object ID
- 201543209349304424
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-16T11:04:23-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161226221 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUST CHARLES CHAMBERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5784 WIDEWATERS PARKWAY | AddressLine1Txt |
| City | SYRACUSE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 13214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141731786 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADIRONDACK MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ADIR | BusinessNameControlTxt |
| Phone | 5188914141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 471 2233 STATE ROUTE 86 | AddressLine1Txt |
| City | SARANAC LAKE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12983 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHANDLER M RALPH | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5188914141 | PhoneNum |
| Signature | 2015-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | THOMAS J GIUFRE | PreparerPersonNm |
| PTIN | P00841958 | PTIN |
| Phone | 3154463600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TRISTAN GLANVILLE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 471 2233 STATE ROUTE 86 | AddressLine1Txt |
| City | SARANAC LAKE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12983 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $102,178,000 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ADIRONDACKHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE MEDICAL CENTER PROVIDES ACUTE, SKILLED NURSING AND OUTPATIENT SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHIC REGION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 1024 | TotalEmployeeCnt |
| Total Volunteers | 89 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,067,325 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,023,849 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $97,127,185 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $95,496,380 | CYProgramServiceRevenueAmt |
| PY Investment Income | $357,296 | PYInvestmentIncomeAmt |
| CY Investment Income | $185,586 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,782,544 | PYOtherRevenueAmt |
| CY Other Revenue | $3,077,219 | CYOtherRevenueAmt |
| PY Total Revenue | $101,334,350 | PYTotalRevenueAmt |
| CY Total Revenue | $99,783,034 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $55,145,186 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,068,453 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $44,800,631 | PYOtherExpensesAmt |
| CY Other Expenses | $50,151,874 | CYOtherExpensesAmt |
| PY Total Expenses | $99,945,817 | PYTotalExpensesAmt |
| CY Total Expenses | $99,220,327 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,388,533 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $562,707 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $69,732,137 | TotalAssetsBOYAmt |
| Total Assets EOY | $67,040,883 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $30,744,189 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $27,469,311 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $38,987,948 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $39,571,572 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MEDICAL CENTER PROVIDES EXCELLENT HEALTHCARE CLOSE TO HOME. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $20,111,005 | ExpenseAmt |
| Revenue | $27,645,585 | RevenueAmt |
| Desc | ADIRONDACK MEDICAL CENTER IS A 95-BED ACUTE CARE FACILITY IN SARANAC LAKE. IT PROVIDES A FULL RANGE OF INPATIENT SERVICES(SURGICAL, MATERNITY AND PEDIATRIC) AS WELL AS MAINTAINS A 60 BED LONG-TERM CARE FACILITY. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $51,852,401 | ExpenseAmt |
| Revenue | $61,428,202 | RevenueAmt |
| Desc | REFERRED AMBULATORY, AMBULATORY SURGERY AND EMERGENCY SERVICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,671,840 | ExpenseAmt |
| Revenue | $6,422,592 | RevenueAmt |
| Desc | DISCONTINUED OPERATIONS FROM UIHLEIN LIVING CENTER, FREE STANDING NURSING HOME THAT HAS 156 BEDS. PLANNED SALE TO OCCUR IN 2015. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenue | $2,684,302 | RevenueAmt |
| Desc | MISCELLANEOUS PROGRAM SERVICE REVENUE DERIVED FROM SUPPORT OF ADIRONDACK MEDICAL CENTER, INCLUDING: DIETARY REVENUE, REBATES AND REFUNDS, PURCHASE DISCOUNTS AND OTHER REVENUE. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Revenue | $2,684,302 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $80,635,246 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 77 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1024 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRISTAN GLANVILLE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5188914141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 471 2233 STATE ROUTE 86 | AddressLine1Txt |
| City | SARANAC LAKE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12983 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| GERALD GOLDMAN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BARRY BROGAN | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PATRICIA MONROE MD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $122,384 | $0 | $17,671 | |||
| CHARLES CARROLL | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEANNIE CROSS | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| SUSAN M DELEHANTY | ||||||||
| SECRETARY/TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| STANLEY T URBAN | ||||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| RICHARD M MOCCIA MD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $246,838 | $0 | $37,397 | |||
| F RAYMOND AGNEW | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PETER G BEATTY PHD | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DOUGLAS L HOFFMAN CPA | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHERYL MAID | ||||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WAGUIH KIROLLOS MD | ||||||||
| EX-OFFICIO | 1.00 | Yes (X) | $183,336 | $0 | $20,959 | |||
| CHANDLER M RALPH | ||||||||
| EX-OFFICIO PRESIDENT/CEO | 40.00 | $0 | $0 | $0 | Yes (X) | |||
| CHARLES GLANVILLE | ||||||||
| CFO | 40.00 | $127,815 | $0 | $4,931 | Yes (X) | |||
| JOHN BRODERICK MD | ||||||||
| CMO | 40.00 | $280,206 | $0 | $21,737 | Yes (X) | |||
| WILLIAM VISCARDO MD | ||||||||
| PHYSICIAN | 40.00 | $273,302 | $0 | $10,890 | Yes (X) | |||
| ANTHONY DOWIDOWICZ | ||||||||
| PHYSICIAN | 40.00 | $287,792 | $0 | $17,998 | Yes (X) | |||
| ANTHONY TRAMANTANO | ||||||||
| PHYSICIAN | 40.00 | $461,574 | $0 | $7,112 | Yes (X) | |||
| JONATHAN KRANT | ||||||||
| PHYSICIAN | 40.00 | $311,727 | $0 | $15,795 | Yes (X) | |||
| DARCI BEIRAS | ||||||||
| PHYSICIAN | 40.00 | $270,530 | $0 | $37,719 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,565,504 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $192,209 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 55 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MATRIX HEALTH SYSTEMS | |||||
| 86 LAKE STREET | BURLINGTON | VT | 05401 | PHYSICIAN FEES | $749,715 |
| HEALTHTECH MANAGEMENT SERVICES INC | |||||
| 405 DUKE DRIVE SUITE 10 | FRANKLIN | TN | 37067 | MANAGEMENT SERVICES | $680,340 |
| INSIGHT HEALTH SERVICES CORP | |||||
| PO BOX 847689 | DALLAS | TX | 75284 | MRI SERVICES | $527,042 |
| LABORATORY CORPORATION OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LAB SERVICES | $455,278 |
| REHAB RESOURCES | |||||
| 159 WEST FIRST STREET | OSWEGO | NY | 13126 | REHABILITATION SERVICES | $432,231 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 27 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $517,175 | RelatedOrganizationsAmt |
| Government Grants | $286,489 | GovernmentGrantsAmt |
| All Other Contributions | $220,185 | AllOtherContributionsAmt |
| Total Contributions | $1,023,849 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | $89,073,788 | $89,073,788 |
| UIHLEIN REVENUE- DISCONTINUED OPE | 900099 | $6,422,592 | $6,422,592 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $95,496,380 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,641 | TotalRevenueColumnAmt |
| Exclusion | $61,641 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $392,918 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $392,918 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $392,918 | TotalRevenueColumnAmt |
| Exclusion | $392,918 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,518,911 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,390,852 | SecuritiesAmt |
| Other | $4,114 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $128,059 | SecuritiesAmt |
| Other | -$4,114 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $123,945 | TotalRevenueColumnAmt |
| Exclusion | $123,945 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| DIETARY REVENUE | 900099 | $156,361 | $156,361 |
| REBATES & REFUNDS | 900099 | $147,020 | $147,020 |
| PURCHASE DISCOUNTS | 900099 | $127,515 | $127,515 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,253,405 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,253,405 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,684,301 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $99,783,034 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $98,180,681 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $578,504 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,142,697 | TotalAmt |
| Program Services | $1,675,328 | ProgramServicesAmt |
| Management And General | $467,369 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,249,170 | TotalAmt |
| Program Services | $31,218,315 | ProgramServicesAmt |
| Management And General | $7,030,855 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,038,612 | TotalAmt |
| Program Services | $855,732 | ProgramServicesAmt |
| Management And General | $182,880 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,772,058 | TotalAmt |
| Program Services | $3,903,728 | ProgramServicesAmt |
| Management And General | $868,330 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,865,916 | TotalAmt |
| Program Services | $2,335,600 | ProgramServicesAmt |
| Management And General | $530,316 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $680,340 | TotalAmt |
| Management And General | $680,340 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,684 | TotalAmt |
| Management And General | $91,684 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,331 | TotalAmt |
| Management And General | $150,331 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,490,343 | TotalAmt |
| Program Services | $5,975,387 | ProgramServicesAmt |
| Management And General | $3,514,956 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,761 | TotalAmt |
| Program Services | $12,184 | ProgramServicesAmt |
| Management And General | $218,577 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,238,486 | TotalAmt |
| Program Services | $509,702 | ProgramServicesAmt |
| Management And General | $728,784 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,870,904 | TotalAmt |
| Program Services | $2,722 | ProgramServicesAmt |
| Management And General | $1,868,182 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,973 | TotalAmt |
| Program Services | $115,928 | ProgramServicesAmt |
| Management And General | $61,045 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $530,605 | TotalAmt |
| Program Services | $530,605 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,214,722 | TotalAmt |
| Program Services | $4,214,722 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $841,546 | TotalAmt |
| Management And General | $841,546 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $14,040,699 | $14,025,799 | $14,900 |
| UIHLEIN EXPENSES- DISCO | $8,671,840 | $8,671,840 | |
| BAD DEBT | $3,382,130 | $3,382,130 | |
| OTHER EXPENSE | $2,955,544 | $1,738,356 | $1,217,188 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,584,966 | TotalAmt |
| Program Services | $1,467,168 | ProgramServicesAmt |
| Management And General | $117,798 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,220,327 | TotalAmt |
| Program Services | $80,635,246 | ProgramServicesAmt |
| Management And General | $18,585,081 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,103,781 | BOYAmt |
| EOY | $7,780,194 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,312,157 | BOYAmt |
| EOY | $11,745,763 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,088,390 | BOYAmt |
| EOY | $2,137,353 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,537,482 | BOYAmt |
| EOY | $4,562,669 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $90,829,250 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $63,760,590 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,256,042 | BOYAmt |
| EOY | $27,068,660 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,302,363 | BOYAmt |
| EOY | $12,225,412 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,131,922 | BOYAmt |
| EOY | $1,520,832 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,732,137 | BOYAmt |
| EOY | $67,040,883 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,923,939 | BOYAmt |
| EOY | $11,571,913 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,572,402 | BOYAmt |
| EOY | $653,305 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,046,459 | BOYAmt |
| EOY | $11,250,598 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $933,000 | BOYAmt |
| EOY | $933,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,268,389 | BOYAmt |
| EOY | $3,060,495 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,744,189 | BOYAmt |
| EOY | $27,469,311 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,995,869 | BOYAmt |
| EOY | $38,575,946 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,017 | BOYAmt |
| EOY | $60,564 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $935,062 | BOYAmt |
| EOY | $935,062 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,987,948 | BOYAmt |
| EOY | $39,571,572 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,732,137 | BOYAmt |
| EOY | $67,040,883 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $562,707 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $20,917 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $992,079 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,047 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $500 | OtherExpendituresAmt |
| End Year Balance | $995,626 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $991,415 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,116 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $3,452 | OtherExpendituresAmt |
| End Year Balance | $992,079 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $987,179 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,236 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $991,415 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $987,165 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,018 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | -$4,004 | OtherExpendituresAmt |
| End Year Balance | $987,179 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $982,116 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,049 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $987,165 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.93920 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.06080 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $328,567 | OtherCostOrOtherBasisAmt |
| Book Value | $328,567 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,296,223 | OtherCostOrOtherBasisAmt |
| Depreciation | $24,588,458 | DepreciationAmt |
| Book Value | $18,707,765 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,943,329 | OtherCostOrOtherBasisAmt |
| Depreciation | $38,207,957 | DepreciationAmt |
| Book Value | $6,735,372 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,261,131 | OtherCostOrOtherBasisAmt |
| Depreciation | $964,175 | DepreciationAmt |
| Book Value | $1,296,956 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $27,068,660 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| DEBT-CURRENT | $736,989 |
| RESIDENT FUNDS LIABILITY | $77,265 |
| ASSET RETIREMENT AND OTHER LT | $1,043,934 |
| ESTIMATED THIRD PARTY LIABILITY | $1,202,307 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,060,495 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE SYSTEM'S ENDOWMENTS CONSIST OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. ITS ENDOWMENTS INCLUDE DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS AN ENDOWMENT. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. TEMPORARILY RESTRICTED FUNDS ARE AVAILABLE FOR NURSING EDUCATION & OTHER PROGRAMS. PERMANENTLY RESTRICTED FUNDS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE FOR VARIOUS HEALTHCARE SERVICES. |
| PART X, LINE 2: | ADIRONDACK HEALTH IS A NOT-FOR-PROFIT CORPORATION AND IS AN EXEMPT ORGANIZATION QUALIFIED UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ADIRONDACK HEALTH HAS BEEN CLASSIFIED BY THE INTERNAL REVENUE SERVICE (IRS) AS AN ENTITY THAT IS NOT A PRIVATE FOUNDATION. THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN ADIRONDACK HEALTH'S CONSOLIDATED 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. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $212,224 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,558 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $187,666 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $21,796,747 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,632,868 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,163,879 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06210 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,008,971 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,657,426 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,351,545 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06400 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $106,114 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $106,114 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $684,076 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $684,076 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00690 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,691,944 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,277,954 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,413,990 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03440 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $11,270 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $11,270 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,493,404 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,277,954 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,215,450 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04250 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $47,502,375 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $36,935,380 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,566,995 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10650 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,890 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,890 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,340 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $25,340 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $235 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $235 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,465 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $31,465 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,733,599 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $825,386 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $17,402,841 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $24,187,203 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$6,784,362 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 2 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp (2 entries)
| FacilityFacilityNum | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Licensed HospitalLicensedHospitalInd | Emergency Room24 HrsEmergencyRoom24HrsInd | OtherOtherDesc | Facility Reporting GroupFacilityReportingGroupCd | Emergency Room OtherEmergencyRoomOtherInd |
|---|---|---|---|---|---|---|---|---|---|
| ADIRONDACK MEDICAL CENTER | |||||||||
| 1 | 2233 STATE ROUTE 86-PO BOX 471 | SARANAC LAKE | NY | 12983 | Yes (X) | Yes (X) | 95 ACUTE BEDS; NURSING HOME WITH 60 BEDS; NURSING HOME WITH 157 BEDS | A | |
| ADIRONDACK MEDICAL CENTER-LAKE PLACID | |||||||||
| 2 | 29 CHURCH STREET | LAKE PLACID | NY | 12946 | Yes (X) | OUTPATIENT SERIVCES, EMERGENCY ROOM | A | Yes (X) | |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FACILITY REPORTING GROUP - A | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.ADIRONDACKHEALTH.ORG | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 13 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.ADIRONDACKHEALTH.ORG | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | 0 | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B | FACILITY REPORTING GROUP A |
| FACILITY REPORTING GROUP A CONSISTS OF: | - FACILITY 1: ADIRONDACK MEDICAL CENTER, - FACILITY 2: ADIRONDACK MEDICAL CENTER-LAKE PLACID |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16A WEBSITE: | WWW.ADIRONDACKHEALTH.ORG |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16B WEBSITE: | WWW.ADIRONDACKHEALTH.ORG |
| FACILITY REPORTING GROUP - A PART V, SECTION B, LINE 16C WEBSITE: | WWW.ADIRONDACKHEALTH.ORG |
| GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 5: | ADIRONDACK MEDICAL CENTER AND OUR COLLABORATING PARTNERS, COUNTY PUBLIC HEALTH DEPARTMENTS AND REGIONAL HOSPITALS, WORKED THROUGH THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY THAT GAVE US INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY WE SERVE. ARHN ENGAGED THE CENTER FOR HUMAN SERVICES RESEARCH (CHSR) AT THE UNIVERSITY AT ALBANY, STATE UNIVERSITY OF NEW YORK TO WORK WITH A SUBCOMMITTEE TO DEVELOP THE SURVEY. THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO A REGIONAL EMAIL CONTACT LIST OF 624. ULTIMATELY, 285 SURVEYS WERE COMPLETED DURING THE SIX-WEEK SURVEY PERIOD, A RESPONSE RATE OF 45.7 PERCENT. OF ALL 285 RESPONSES, 86 INDICATED THAT ESSEX COUNTY WAS PART OF THEIR SERVICE AREA AND 83 INDICATED THAT FRANKLIN COUNTY WAS PART OF THEIR SERVICE AREA; HOWEVER, IT SHOULD BE NOTED THAT MANY OF THE RESPONDING HEALTH CARE STAKEHOLDERS SERVICE MULTIPLE COUNTIES WITHIN THE LARGER ARHN REGION. SURVEY PARTICIPANTS REPRESENTED A DIVERSE ARRAY OF DIFFERENT AGENCIES, POPULATION GROUPS, AND SERVICE-AREAS WITHIN THE OVERALL EIGHT-COUNTY ARHN REGION. BELOW, TABLE A.1 SHOWS THE PRIMARY FUNCTIONS SELECTED BY RESPONDENTS AND TABLE A.2 SHOWS THE POPULATIONS THAT THEIR AGENCIES SERVE. HEALTH CARE AND EDUCATIONAL AGENCIES ARE WELL REPRESENTED, AND THE MAJORITY PROVIDES SERVICES TO CHILDREN AND ADOLESCENTS, AS WELL AS PEOPLE LIVING AT OR NEAR THE POVERTY LEVEL. TABLE A.1. PRIMARY FUNCTIONS INDICATED BY SURVEY RESPONDENTSORGANIZATION PRIMARY FUNCTION / PERCENT OF ALL APPLICANTS HEALTH CARE / 36.8 EDUCATION / 36.5 BEHAVIORAL HEALTH / 17.5 HEALTHY ENVIRONMENT / 14.7 EARLY CHILDHOOD SVCS. / 14.4 SOCIAL SERVICES / 11.9 SENIOR SERVICES / 11.2 OTHER SERVICES / 9.1 DEVELOPMENTAL DISABILITY SVCS. / 8.4 EMPLOY & TRAINING / 8.4 HOUSING SERVICES / 8.1 STI/HIV PREVENTION / 6.0 PHYSICAL DISABILITY SVCS. / 4.9 GOVERNMENT AGENCY / 2.1 TESTING AND PREVENTION / 2.1 NOTE: RESPONDENTS COULD SELECT MORE THAN ONE PRIMARY FUNCTION. TABLE A.2. POPULATIONS SERVED BY SURVEY RESPONDENT AGENCIESPOPULATION SERVED / PERCENT OF ALL RESPONDENTS CHILDREN/ADOLESCENTS / 59.6 PEOPLE LIVING AT OR NEAR POVERTY LEVEL / 50.9 SENIORS/ELDERLY / 44.9 PEOPLE WITH DISABILITIES / 38.9 PEOPLE WITH MENTAL HEALTH ISSUES / 32.3 WOMEN OF REPRODUCTIVE AGE / 31.9 PEOPLE WITH SUBSTANCE ABUSE ISSUES / 25.6 SPECIFIC HEALTH CONDITION OR DISEASE / 24.6 FARMERS / 14.0 MIGRANT WORKERS / 11.2 OTHER / 10.5 SPECIFIC RACIAL OR ETHNIC GROUPS / 8.4 SPECIFIC GEOGRAPHIC AREA / 5.3 EVERYONE / 5.3 SPECIFIC AGE GROUP / 3.5 NOTE: RESPONDENTS COULD SELECT MULTIPLE POPULATIONS |
| GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 6A: | OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH OUR PARTNERS ESSEX COUNTY PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, ALICE HYDE MEDICAL CENTER, ELIZABETHTOWN COMMUNITY HOSPITAL, MOSES LUDINGTON HOSPITAL, AND ADIRONDACK RURAL HEALTH NETWORK. |
| GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 11: | ADIRONDACK HEALTH STRIVES TO MEET AS MANY OF THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS AS POSSIBLE. IN MANY CASES, WE PARTNER WITH APPROPRIATE ORGANIZATIONS AND AGENCIES TO ADDRESS NEEDS THAT ADIRONDACK HEALTH DOES NOT. ON INITIATIVES THAT ARE NOT HOSPITAL-LED, ADIRONDACK HEALTH PARTNERS AND WORKS WITH THE LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, SUBSTANCE ABUSE PREVENTION AND TREATMENT PROVIDERS, HOME CARE, AND MANY OTHERS TO INSURE THAT THE NEEDS OF OUR COMMUNITY MEMBERS ARE MET. THE FOLLOWING ARE THE NYS PREVENTION AGENDA ITEMS THAT ADIRONDACK HEALTH DOES NOT DIRECTLY ADDRESS IN OUR IMPLEMENTATION STRATEGY: PROMOTE A HEALTHY AND SAFE ENVIRONMENT FOCUS AREA: INJURIES, VIOLENCE AND OCCUPATIONAL HEALTH THE RATE OF CRIME AND ASSAULT ARE LOW IN ADIRONDACK HEALTH'S SERVICE AREA. FALLS IN THE HOME AND OCCUPATIONAL HEALTH ARE ISSUES THAT COMMUNITY PARTNERS ARE BETTER POSITIONED TO ADDRESS. FOCUS AREA: OUTDOOR AIR AND WATER QUALITYTHE AIR AND WATER QUALITY INDICATORS ARE GOOD. DATA INDICATES THAT IT IS ONLY A FEW DAYS EACH YEAR THAT OUTDOOR AIR QUALITY IS POOR, AND THE LIKELY CAUSE OF THIS IS INDUSTRIAL POLLUTION FROM THE MID- WEST CARRIED HERE ON THE JET STREAM. ADIRONDACK HEALTH DOES NOT HAVE A STRATEGY TO DIRECTLY ADDRESS THIS AT THIS TIME, BUT NATIONAL GROUPS HAVE MADE PROGRESS AND ARE STILL WORKING TO IMPROVE OUTPUTS FROM THESE INDUSTRIAL AREAS.FOCUS AREA: BUILT ENVIRONMENT IN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD PASSING COMPLETE STREETS POLICIES, IMPROVING PARKS AND OTHER RECREATIONAL AREAS, PASSING TOBACCO FREE GROUNDS POLICIES, IMPROVING ACCESS TO FRESH FRUITS AND VEGETABLES IN STORES AND RESTAURANTS, AND OTHER PROJECTS THAT IMPROVE ACCESS TO HEALTHY FOODS AND IMPROVE THE BUILT ENVIRONMENT SO COMMUNITY MEMBERS OF ALL LEVELS OF MOBILITY CAN FEEL SAFE AS PEDESTRIANS AND USING ALTERNATIVE FORMS OF TRANSPORTATION. PREVENT HIV/STDS, VACCINE-PREVENTABLE DISEASE AND HEALTHCARE ASSOCIATED INFECTIONSFOCUS AREA: PREVENT HIV AND STDSTHE RATE OF HIV IS EXTREMELY LOW IN ADIRONDACK HEALTH'S SERVICE AREA. ADIRONDACK HEALTH'S PROVIDERS CONTINUE TO WORK WITH PUBLIC HEALTH AND OTHER PROVIDERS TO DELIVER THE HIGHEST LEVEL OF CARE TO PATIENTS WITH HIV. |
| GROUP A-FACILITY 1 -- ADIRONDACK MEDICAL CENTER PART V, SECTION B, LINE 22D: | SELF-PAY PATIENTS THAT VISITED OUR MEDICAID SCREENER, AND WERE NOT DETERMINED TO BE FAP-ELIGIBLE, RECEIVED A 30% DISCOUNT. THOSE WHO WERE FAP-ELIGIBLE WERE WRITTEN OFF AT 100%. |
| GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 5: | ADIRONDACK MEDICAL CENTER AND OUR COLLABORATING PARTNERS, COUNTY PUBLIC HEALTH DEPARTMENTS AND REGIONAL HOSPTIALS, WORKED THROUGH THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) TO CONDUCT A SURVEY THAT GAVE US INPUT FROM PERSONS WHO REPRESENT THE BROAD INTEREST OF THE COMMUNITY WE SERVE. ARHN ENGAGED THE CENTER FOR HUMAN SERVICES RESEARCH (CHSR) AT THE UNIVERSITY AT ALBANY, STATE UNIVERSITY OF NEW YORK TO WORK WITH A SUBCOMMITTEE TO DEVELOP THE SURVEY. THE SURVEY WAS ADMINISTERED ELECTRONICALLY USING A WEB-BASED SURVEY PROGRAM AND DISTRIBUTED TO A REGIONAL EMAIL CONTACT LIST OF 624. ULTIMATELY, 285 SURVEYS WERE COMPLETED DURING THE SIX-WEEK SURVEY PERIOD, A RESPONSE RATE OF 45.7 PERCENT. OF ALL 285 RESPONSES, 86 INDICATED THAT ESSEX COUNTY WAS PART OF THEIR SERVICE AREA AND 83 INDICATED THAT FRANKLIN COUNTY WAS PART OF THEIR SERVICE AREA; HOWEVER, IT SHOULD BE NOTED THAT MANY OF THE RESPONDING HEALTH CARE STAKEHOLDERS SERVICE MULTIPLE COUNTIES WITHIN THE LARGER ARHN REGION. SURVEY PARTICIPANTS REPRESENTED A DIVERSE ARRAY OF DIFFERENT AGENCIES, POPULATION GROUPS, AND SERVICE-AREAS WITHIN THE OVERALL EIGHT-COUNTY ARHN REGION. BELOW, TABLE A.1 SHOWS THE PRIMARY FUNCTIONS SELECTED BY RESPONDENTS AND TABLE A.2 SHOWS THE POPULATIONS THAT THEIR AGENCIES SERVE. HEALTH CARE AND EDUCATIONAL AGENCIES ARE WELL REPRESENTED, AND THE MAJORITY PROVIDES SERVICES TO CHILDREN AND ADOLESCENTS, AS WELL AS PEOPLE LIVING AT OR NEAR THE POVERTY LEVEL. TABLE A.1. PRIMARY FUNCTIONS INDICATED BY SURVEY RESPONDENTSORGANIZATION PRIMARY FUNCTION / PERCENT OF ALL APPLICANTS HEALTH CARE / 36.8 EDUCATION / 36.5 BEHAVIORAL HEALTH / 17.5 HEALTHY ENVIRONMENT / 14.7 EARLY CHILDHOOD SVCS. / 14.4 SOCIAL SERVICES / 11.9 SENIOR SERVICES / 11.2 OTHER SERVICES / 9.1 DEVELOPMENTAL DISABILITY SVCS. / 8.4 EMPLOY & TRAINING / 8.4 HOUSING SERVICES / 8.1 STI/HIV PREVENTION / 6.0 PHYSICAL DISABILITY SVCS. / 4.9 GOVERNMENT AGENCY / 2.1 TESTING AND PREVENTION / 2.1 NOTE: RESPONDENTS COULD SELECT MORE THAN ONE PRIMARY FUNCTION. TABLE A.2. POPULATIONS SERVED BY SURVEY RESPONDENT AGENCIESPOPULATION SERVED / PERCENT OF ALL RESPONDENTS CHILDREN/ADOLESCENTS / 59.6 PEOPLE LIVING AT OR NEAR POVERTY LEVEL / 50.9 SENIORS/ELDERLY / 44.9 PEOPLE WITH DISABILITIES / 38.9 PEOPLE WITH MENTAL HEALTH ISSUES / 32.3 WOMEN OF REPRODUCTIVE AGE / 31.9 PEOPLE WITH SUBSTANCE ABUSE ISSUES / 25.6 SPECIFIC HEALTH CONDITION OR DISEASE / 24.6 FARMERS / 14.0 MIGRANT WORKERS / 11.2 OTHER / 10.5 SPECIFIC RACIAL OR ETHNIC GROUPS / 8.4 SPECIFIC GEOGRAPHIC AREA / 5.3 EVERYONE / 5.3 SPECIFIC AGE GROUP / 3.5 NOTE: RESPONDENTS COULD SELECT MULTIPLE POPULATIONS |
| GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 6A: | OUR COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED WITH OUR PARTNERS ESSEX COUNTY PUBLIC HEALTH, FRANKLIN COUNTY PUBLIC HEALTH, ALICE HYDE MEDICAL CENTER, ELIZABETHTOWN COMMUNITY HOSPITAL, MOSES LUDINGTON HOSPITAL, AND ADIRONDACK RURAL HEALTH NETWORK. |
| GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 11: | ADIRONDACK HEALTH STRIVES TO MEET AS MANY THE HEALTH NEEDS OF OUR COMMUNITY MEMBERS AS POSSIBLE. IN MANY CASES, WE PARTNER WITH APPROPRIATE ORGANIZATIONS AND AGENCIES TO ADDRESS NEEDS THAT ADIRONDACK HEALTH DOES NOT. ON INITIATIVES THAT ARE NOT HOSPITAL-LED, ADIRONDACK HEALTH PARTNERS AND WORKS WITH THE LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES, BEHAVIORAL HEALTH PROVIDERS, SUBSTANCE ABUSE PREVENTION AND TREATMENT PROVIDERS, HOME CARE, AND MANY OTHERS TO INSURE THAT THE NEEDS OF OUR COMMUNITY MEMBERS ARE MET. THE FOLLOWING ARE THE NYS PREVENTION AGENDA ITEMS THAT ADIRONDACK HEALTH DOES NOT DIRECTLY ADDRESS IN OUR IMPLEMENTATION STRATEGY: PROMOTE A HEALTHY AND SAFE ENVIRONMENT FOCUS AREA: INJURIES, VIOLENCE AND OCCUPATIONAL HEALTH THE RATE OF CRIME AND ASSAULT ARE LOW IN ADIRONDACK HEALTH'S SERVICE AREA. FALLS IN THE HOME AND OCCUPATIONAL HEALTH ARE ISSUES THAT COMMUNITY PARTNERS ARE BETTER POSITIONED TO ADDRESS. FOCUS AREA: OUTDOOR AIR AND WATER QUALITYTHE AIR AND WATER QUALITY INDICATORS ARE GOOD. DATA INDICATES THAT IT IS ONLY A FEW DAYS EACH YEAR THAT OUTDOOR AIR QUALITY IS POOR, AND THE LIKELY CAUSE OF THIS IS INDUSTRIAL POLLUTION FROM THE MID- WEST CARRIED HERE ON THE JET STREAM. ADIRONDACK HEALTH DOES NOT HAVE A STRATEGY TO DIRECTLY ADDRESS THIS AT THIS TIME, BUT NATIONAL GROUPS HAVE MADE PROGRESS AND ARE STILL WORKING TO IMPROVE OUTPUTS FROM THESE INDUSTRIAL AREAS.FOCUS AREA: BUILT ENVIRONMENT IN OUR SERVICE AREA, MUCH OF THIS WORK IS BEING DONE BY COALITIONS TO WHICH ADIRONDACK HEALTH BELONGS. THE COALITIONS, LED BY PUBLIC HEALTH AND THE NORTH COUNTRY HEALTHY HEART NETWORK, ARE WORKING TOWARD PASSING COMPLETE STREETS POLICIES, IMPROVING PARKS AND OTHER RECREATIONAL AREAS, PASSING TOBACCO FREE GROUNDS POLICIES, IMPROVING ACCESS TO FRESH FRUITS AND VEGETABLES IN STORES AND RESTAURANTS, AND OTHER PROJECTS THAT IMPROVE ACCESS TO HEALTHY FOODS AND IMPROVE THE BUILT ENVIRONMENT SO COMMUNITY MEMBERS OF ALL LEVELS OF MOBILITY CAN FEEL SAFE AS PEDESTRIANS AND USING ALTERNATIVE FORMS OF TRANSPORTATION. PREVENT HIV/STDS, VACCINE-PREVENTABLE DISEASE AND HEALTHCARE ASSOCIATED INFECTIONSFOCUS AREA: PREVENT HIV AND STDSTHE RATE OF HIV IS EXTREMELY LOW IN ADIRONDACK HEALTH'S SERVICE AREA. ADIRONDACK HEALTH'S PROVIDERS CONTINUE TO WORK WITH PUBLIC HEALTH AND OTHER PROVIDERS TO DELIVER THE HIGHEST LEVEL OF CARE TO PATIENTS WITH HIV. |
| GROUP A-FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID PART V, SECTION B, LINE 22D: | SELF-PAY PATIENTS THAT VISITED OUR MEDICAID SCREENER, AND WERE NOT DETERMINED TO BE FAP-ELIGIBLE, RECEIVED A 30% DISCOUNT. THOSE WHO WERE FAP-ELIGIBLE WERE WRITTEN OFF AT 100%. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| TUPPER LAKE MEDICAL OFFICE BUILDING | ||||
| 7 STETSON ROAD | TUPPER LAKE | NY | 12986 | CLINIC; LABORATORY; RADIOLOGY |
| MOUNTAIN HEALTH CENTER | ||||
| 2841 NYS ROUTE 73 | KEENE | NY | 12942 | CLINIC |
| UIHLEIN LIVING CENTER | ||||
| 185 OLD MILITARY ROAD | LAKE PLACID | NY | 12946 | NURSING HOME WITH 156 BEDS |
| MERCY LIVING CENTER | ||||
| 114 WAWBEEK AVENUE | TUPPER LAKE | NY | 12986 | NURSING HOME WITH 60 BEDS; DIALYSIS, REHABILITATION |
| LAKE PLACID HEALTH CENTER | ||||
| 29 CHURCH STREET | LAKE PLACID | NY | 12946 | CLINC; ER; LABORATORY; RADIOLOGY; REHABILITATION |
| WOUND CARE MEDICAL OFFICE BUILDING | ||||
| 285 COUNTY ROUTE 47 | SARANAC LAKE | NY | 12983 | CLINIC, PRIMARY CARE HEALTH CENTER |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | AMOUNTS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 (TOTAL OPERATING EXPENSE MINUS MEDICAID/PROVIDER TAXES, TOTAL COMMUNITY BENEFIT EXPENSE, AND TOTAL COMMUNITY BUILDING EXPENSE DIVIDED BY GROSS PATIENT CHARGES), AND ADDRESSES ALL PATIENT SEGMENTS. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE, REMOVED FROM DENOMINATOR, EQUALS 3,328,392. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | THE CEO ATTENDED ADIRONDACK HEALTH INSTITUTE MEETINGS. AHI IS A REGIONAL ORGANIZATION THAT INCLUDES THE TRI-LAKES, PLATTSBURGH, AND GLENS FALLS COMMUNITIES WHOSE PURPOSE IS TO IMPROVE THE OVERALL HEALTH OF THESE ADIRONDACK COMMUNITIES BY WORKING TOGETHER ON A REGIONAL BASIS. THE CHIEF MEDICAL OFFICER SPENT TIME AT A LOCAL IRON MAN COMPETITION TO PROVIDE MEDICAL COVERAGE OF THE ATHLETES AND PROMOTE HEALTHY EXERCISE ROUTINES. |
| PART III, LINE 4: | "IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, ADIRONDACK HEALTH ANALYZES PAST PAYMENT HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, ADIRONDACK HEALTH ANALYZES CONTRACTUALY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE 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), ADIRONDACK HEALTH 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 DISCOUNT RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS."PART III, LINE 3:THE ORGANIZATION'S BAD DEBT EXPENSES IS CALCULATED USING A PERCENTAGE OF BAD DEBT THAT CONTAINS POSSIBLE CHARITY CARE CASES AND APPLYING IT TO LINE 2. RATIONALE FOR WHAT PORTION OF BAD DEBT SHOULD CONSTITUTE COMMUNITY BENEFIT: THE PROVISION OF HEALTH CARE IS DIFFERENT FROM PROVIDING OTHER SERVICES, IN THAT HOSPITALS, ALTHOUGH THEY MAY ATTEMPT TO OBTAIN FINANCIAL INFORMATION BEFORE SERVICE IS PROVIDED, FOCUS ON PROVIDING THE PATIENT WITH NEEDED HEALTH CARE AND LATER TRY TO OBTAIN PAYMENT. IN OTHER INDUSTRIES, THE SERVICE PROVIDER CAN CHECK THE CUSTOMER'S CREDIT RATING, ASK FOR PAYMENT IN ADVANCE, ETC AND IS USUALLY ASKING THIS INFORMATION WHEN THE CONSUMER IS NOT IN A HEALTH CRISIS AND UNDER GREAT STRESS AND WORRY. AT A LATER TIME, WHEN THE PROVIDER ATTEMPTS TO COLLECT PAYMENT AND FINDS THE PATIENT UNWILLING TO PAY, THEIR OPTIONS ARE AGAIN LIMITED GIVEN THE NATURE OF THE SERVICE PROVIDED AND THE INABILITY TO REPOSSESS THE SERVICE.PART III, LINE 2:THE ORGANIZATION'S BAD DEBT EXPENSE IS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND BAD DEBT EXPENSE. |
| PART III, LINE 8: | CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND APPLYING IT TO GROSS MEDICARE CHARGES. SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE PATIENT SERVICES ARE PROVIDED AT A COST THAT IS GREATER THAN REIMBURSEMENT. |
| PART III, LINE 9B: | ACCORDING TO OUR CHARITY CARE POLICY,THE LARGEST NUMBER OF OUR FAP-ELIGIBLE PATIENTS ARE WRITTEN-OFF AT 100% SO NO COLLECTION EFFORTS ARE NECESSARY. |
| PART VI, LINE 2: | ADIRONDACK MEDICAL CENTER USES A NUMBER OF ASSESSMENT METHODS TO DETERMINE HOW WELL WE ARE MEETING COMMUNITY NEEDS AND WHAT ADDITIONAL SERVICES WE CAN OFFER OUR COMMUNITY MEMBERS. AMC USES THE PRESS-GANEY PATIENT SATISFACTION SURVEY FOR CONTINUAL PATIENT FEEDBACK. THE SURVEYS ARE MAILED TO RANDOMLY SELECTED PATIENTS BY PRESS-GANEY, A NATIONALLY RECOGNIZED PATIENT SURVEY FIRM, AND PRESS-GANEY PROCESSES THE RESULTS. THEY GIVE AMC THE RESULTS BENCHMARKED AGAINST OTHER HOSPITALS TO HELP US UNDERSTAND HOW WELL WE ARE SERVING OUR COMMUNITY. THE MAJORITY OF AMC'S STRATEGIC INITIATIVES ARE DRIVEN BY A THREE-YEAR STRATEGIC PLAN, WHICH IS DEVELOPED THROUGH THE COLLABORATION OF THE BOARD, MEDICAL STAFF, AMC STAFF AND COMMUNITY MEMBERS. THE GOALS THAT ARE SET FORTH EVERY THREE YEARS IN THE STRATEGIC PLAN ARE INCORPORATED INTO AMC'S MANAGEMENT ACTION PLAN (MAP), WHICH IS REVIEWED AND REVISED EACH YEAR. AT THE BEGINNING OF EACH YEAR EVERY DEPARTMENT CREATES A MAP THAT OUTLINES THE CONCRETE STEPS THAT THE DEPARTMENT WILL ACCOMPLISH IN MOVING THE HOSPITAL CLOSER TO COMPLETING THE STRATEGIC PLAN GOALS. THE SUCCESS OF AMC, EACH DEPARTMENT, AND EACH EMPLOYEE IS MEASURED BY THE MAP AND THE PROGRESS MADE TOWARD ACCOMPLISHING THE GOALS SET OUT IN THE STRATEGIC PLAN. FOR NEW SERVICES, AMC STAFF DEVELOPS A NEEDS ASSESSMENT USING A VARIETY OF DATA INCLUDING REGIONAL DEMAND FOR THE SPECIFIC SERVICE, DEMOGRAPHICS, AND FINANCIAL ANALYSIS. THE BOARD OF TRUSTEES CAREFULLY REVIEWS THE ANALYSIS AND EITHER SUPPORTS THE RECOMMENDATION OR ASKS FOR FURTHER INFORMATION. |
| PART VI, LINE 3: | ANY PATIENT THAT CONTACTS SCHEDULING OR PRESENTS TO ANY AMC DEPARTMENT (INCLUDING ADMITTING, EMERGENCY ROOM, ETC.) THAT DOES NOT IDENTIFY AN INSURANCE COMPANY OR IDENTIFIES THEMSELVES AS SELF-PAY ARE INFORMED OF OUR SELF-PAY PROCESS. THIS PROCESS INCLUDES INFORMATION ABOUT AMC'S CHARITY CARE POLICY AND THE BENEFITS OF VISITING WITH A CERTIFIED FACILITATED ENROLLER WHO CAN CHECK THE PATIENT'S ELIGIBILITY FOR STATE AND FEDERAL HEALTH INSURANCE PROGRAMS. |
| PART VI, LINE 4: | ADIRONDACK MEDICAL CENTER IS LOCATED IN THE HEART OF THE ADIRONDACK PARK IN RURAL, UPSTATE NEW YORK. THE ADIRONDACK PARK IS A UNIQUE, SIX MILLION ACRE PATCHWORK OF PUBLIC AND PRIVATE LAND. IT IS BEST KNOWN FOR ITS MOUNTAINS - THE HIGHEST IN NEW YORK STATE - AND ITS LAKES. THE REGION HAS AN AVERAGE SEASONAL SNOWFALL IN EXCESS OF 90 INCHES AND THE AVERAGE MEAN TEMPERATURE IN JANUARY IS 16 DEGREES FAHRENHEIT.AMC IS DESIGNATED A SOLE COMMUNITY PROVIDER HOSPITAL WITH THE CLOSEST COMPARABLE FACILITY 50 MILES AWAY FROM OUR MAIN CAMPUS IN SARANAC LAKE. AMC IS AN INTEGRAL PART OF THE COMMUNITY AS THE ONLY ACUTE CARE FACILITY, THE PREDOMINANT PROVIDER OF AMBULATORY SERVICES, AND THE LARGEST PRIVATE EMPLOYER IN THE SIX MILLION ACRE ADIRONDACK PARK. AMC PROVIDES CARE FOR 71.2% OF THE 24,266 RESIDENTS IN OUR PRIMARY SERVICE AREA AND 24.5% OF THE 12,100 RESIDENTS IN OUR SECONDARY SERVICE AREA. THIS SERVICE AREA COVERS OVER 1,200 SQUARE MILES, HAS AN AVERAGE OF JUST OVER 30 PEOPLE PER SQUARE MILE, AND INCLUDES PORTIONS OF 5 COUNTIES.THE HOSPITAL'S SERVICE AREA IS DESIGNATED AS THE FOLLOWING FEDERAL HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA):-PRIMARY CARE-DENTAL-PSYCHIATRYAMC IS SERVING AN AGING POPULATION WITH HIGH CANCER AND CHRONIC DISEASE RATES, AND VERY LOW INCOME LEVELS. THE PERCENTAGE OF THE POPULATION THAT FALLS INTO THE "BABY BOOMER" AGE GROUP, 55-64 YEARS OF AGE, IS INCREASING, WITH A CORRESPONDING DECREASE IN YOUNGER AGE GROUPS.THE AVERAGE UNEMPLOYMENT RATE IN 2014 FOR NEW YORK STATE WAS 5.7% AND THE UNEMPLOYMENT RATES IN THE COUNTIES THAT WE SERVE WAS ONE TO TWO PERCENTAGE POINTS ABOVE THAT AVERAGE. THE NYS DEPARTMENT OF LABOR INDICATES THAT THE PER CAPITA INCOME FOR THE COUNTIES THAT AMC SERVES IS BETWEEN 35% AND 44% BELOW THE STATE AVERAGE. |
| PART VI, LINE 5: | AS THE LARGEST EMPLOYER AND ONLY FULL SERVICE HOSPITAL IN THE ADIRONDACK PARK, AMC IS AN IMPORTANT PARTNER IN COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF OUR COMMUNITY MEMBERS.- OUR PRIMARY CARE HEALTH CENTERS WERE AMONG THE FIRST IN NEW YORK TO PARTNER WITH THE STATE SMOKERS' QUITLINE TO HELP PATIENTS WHO WANT TO KICK THE HABIT WITH A NEW STOP SMOKING AND REFERRAL PROCESS THROUGH THE ELECTRONIC MEDICAL RECORD.- FURTHER EXPANDED THE PAIN MANAGEMENT CLINIC IN RESPONSE TO COMMUNITY NEED.- EXPANDED SURGICAL EQUIPMENT TO INCLUDE A BRONCH NAVIGATION SYSTEM THAT HELPS IDENTIFY LUNG CANCER EARLIER THAN TRADITIONAL METHODS.- TRANSITIONED MED/SURG UNIT TO SINGLE ROOMS IN ORDER TO INCREASE PATIENT SAFETY AND SATISFACTION. |
| PART VI, LINE 6: | ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RICHARD M MOCCIA MD | ||||||||||||||
| TRUSTEE | $246,838 | $0 | $0 | $0 | $0 | $0 | $37,397 | $0 | $0 | $0 | $284,235 | $0 | $0 | $0 |
| WAGUIH KIROLLOS MD | ||||||||||||||
| EX-OFFICIO | $183,336 | $0 | $0 | $0 | $0 | $0 | $20,959 | $0 | $0 | $0 | $204,295 | $0 | $0 | $0 |
| JOHN BRODERICK MD | ||||||||||||||
| CMO | $280,206 | $0 | $0 | $0 | $0 | $0 | $10,376 | $0 | $11,361 | $0 | $301,943 | $0 | $0 | $0 |
| WILLIAM VISCARDO MD | ||||||||||||||
| PHYSICIAN | $273,302 | $0 | $0 | $0 | $0 | $0 | $5,975 | $0 | $4,915 | $0 | $284,192 | $0 | $0 | $0 |
| ANTHONY DOWIDOWICZ | ||||||||||||||
| PHYSICIAN | $287,792 | $0 | $0 | $0 | $0 | $0 | $10,364 | $0 | $7,634 | $0 | $305,790 | $0 | $0 | $0 |
| ANTHONY TRAMANTANO | ||||||||||||||
| PHYSICIAN | $461,574 | $0 | $0 | $0 | $0 | $0 | $555 | $0 | $6,557 | $0 | $468,686 | $0 | $0 | $0 |
| JONATHAN KRANT | ||||||||||||||
| PHYSICIAN | $311,727 | $0 | $0 | $0 | $0 | $0 | $3,727 | $0 | $12,068 | $0 | $327,522 | $0 | $0 | $0 |
| DARCI BEIRAS | ||||||||||||||
| PHYSICIAN | $270,530 | $0 | $0 | $0 | $0 | $0 | $26,623 | $0 | $11,096 | $0 | $308,249 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART 1 LINE 4B | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL HAS A DEFERRED COMPENSATION PLAN FOR PARTICIPATING PHYSICIANS WHO PROVIDE SERVICES THROUGH THE HOSPITAL'S "ON-CALL" PROGRAM. PATRICIA MONROE, MD RECEIVED $122,384 FROM THIS DEFERRED COMPENSATION PLAN AND $17,671 WAS CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HER BEHALF IN 2014. RICHARD MOCCIA, MD RECEIVED $246,838 FROM THIS DEFERRED COMPENSATION PLAN AND $37,397 WAS CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HIS BEHALF IN 2014. WAGUIH KIROLLOS, MD RECEIVED $172,836 FROM THIS DEFERRED COMPENSATION PLAN AND $20,959 WAS CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HIS BEHALF IN 2014. DARCI BEIRAS, MD HAD $19,110 CONTRIBUTED TO THIS DEFERRED COMPENSATION PLAN ON HER BEHALF IN 2014. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRANKLIN COUNTY CIVIC DEVELOPMENT CO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 800627350 | BondIssuerEIN |
| Bond Issued | 2012-11-02 | BondIssuedDt |
| Issue Price | $10,999,965 | IssuePriceAmt |
| Purpose | MULTI-MODE REVENUE BONDS FOR CAPITAL PROJECTS- REFINANCE | PurposeDesc |
| Defeased | Yes (1) | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $9,272,033 | RetiredAmt |
| Total Proceeds | $1,587,879 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $140,053 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $1,502,594 | CapitalExpendituresAmt |
| Other Spent Proceeds | $85,285 | OtherSpentProceedsAmt |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | Yes (1) | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (1) | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | ADIRONDACK MEDICAL CENTER CONTRACTS WITH HEALTHTECH MANAGEMENT SERVICES TO FILL THE POSITION OF PRESIDENT/CEO. THE MANAGEMENT FEE PAID TO HEALTHTECH MANAGEMENT SERVICES IS $680,340, WHICH INCLUDES THE CEO SALARY AND BENEFITS AND A MANAGEMENT FEE. ON AUGUST 1, 2014 THE CONTRACT CHANGED INTO A CEO LEASE AGREEMENT AND A CONSULTING CONTRACT. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE BYLAWS WERE UPDATED TO REFLECT CHANGES IN THE RESPONSIBILITIES OF THE AUDIT AND COMPLIANCE COMMITTEE, TO ENHANCE COMPLIANCE WITH THE NEW YORK STATE NONPROFIT REVITALIZATION ACT. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS PRESENTED AND REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING THE 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL MEMBERS OF THE BOARD OF TRUSTEES ARE REQUIRED TO COMPLETE AND SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY. THESE ARE THEN REVIEWED BY THE BOARD CHAIR. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION DECISIONS ARE DEVELOPED BASED ON THE USE OF NATIONAL, REGIONAL, AND HEALTHTECH SALARY SURVEY DATA WHICH IS ANALYZED BY THE EXECUTIVE COMMITTEE ACTING AS A COMPENSATION COMMITTEE AND THEN APPROVED BY THE FULL BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADIRONDACK MEDICAL CENTER FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 471 LAKE COLBY DRIVE | AddressLine1Txt |
| City | SARANAC LAKE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 12983 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161528554 | EIN |
| Primary Activities | SUPPORT AND ASSIST ADIRONDACK MEDICAL CENTER | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Exempt Code Section | 501(C)3 | ExemptCodeSectionTxt |
| Public Charity Status | BOX 11 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADIRONDACK MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | 0 | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd | Share Of EOY AssetsShareOfEOYAssetsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| TRUDEAU HEALTH SYSTEMS LLC | |||||||||||
| PO BOX 471 2233 STATE ROUTE 86 | SARANAC LAKE | NY | 12983 | 141788211 | CONTACTING - HEALTH SERVICES | NY | AMC AND TRUDEAU HEALTH SYSTEMS | C | 0.50000 | 0 | |
| TRUDEAU HEALTH SYSTEMS IPA | |||||||||||
| PO BOX 471 2233 STATE ROUTE 86 | SARANAC LAKE | NY | 12983 | 141795284 | CONTACTING - HEALTH SERVICES | NY | AMC AND TRUDEAU HEALTH SYSTEMS | C | 0.50000 | 0 | $28,665 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |