COMMUNITY MEMORIAL HOSPITAL INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY MEMORIAL HOSPITAL INC (EIN 15-0548010)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-12
- IRS object ID
- 201443169349301624
- Schema version
- 2013v3.0
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-12T10:13:20-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5784 WIDEWATERS PARKWAY | AddressLine1 |
| City | SYRACUSE | City |
| State | NY | State |
| ZIP Code | 13214 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 150548010 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEMORIAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 3158246081 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 BROAD STREET | AddressLine1 |
| City | HAMILTON | City |
| State | NY | State |
| ZIP Code | 13346 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHRISTOPHER W GRAHAM | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 3158246081 | PhoneNum |
| Signature | 2014-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA M FRANCO | PreparerPersonNm |
| PTIN | P00589741 | PTIN |
| Phone | 3154463600 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHRISTOPHER W GRAHAM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 BROAD STREET | AddressLine1 |
| City | HAMILTON | City |
| State | NY | State |
| ZIP Code | 13346 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $43,339,504 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | COMMUNITYMEMORIAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1949 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | COMMUNITY MEMORIAL HOSPITAL'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE EMERGENCY AND INPATIENT CARE TO THE GENERAL POPULATION WITHOUT REGARD TO ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 18 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 432 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $744,789 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,525,478 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,204,010 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $39,395,336 | CYProgramServiceRevenueAmt |
| PY Investment Income | $32,047 | PYInvestmentIncomeAmt |
| CY Investment Income | $98,546 | CYInvestmentIncomeAmt |
| PY Other Revenue | $325,442 | PYOtherRevenueAmt |
| CY Other Revenue | $223,893 | CYOtherRevenueAmt |
| PY Total Revenue | $41,306,288 | PYTotalRevenueAmt |
| CY Total Revenue | $43,243,253 | 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 | $21,769,730 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,879,986 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,178,114 | PYOtherExpensesAmt |
| CY Other Expenses | $20,119,228 | CYOtherExpensesAmt |
| PY Total Expenses | $40,947,844 | PYTotalExpensesAmt |
| CY Total Expenses | $41,999,214 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $358,444 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,244,039 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,681,324 | TotalAssetsBOYAmt |
| Total Assets EOY | $22,932,498 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,587,385 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,890,716 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,093,939 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,041,782 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | COMMUNITY MEMORIAL HOSPITAL'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE EMERGENCY AND INPATIENT CARE TO THE GENERAL POPULATION WITHOUT REGARD TO ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $22,495,708 | ExpenseAmt |
| Revenue | $19,436,556 | RevenueAmt |
| Desc | OPERATION OF AN ACUTE CARE GENERAL HOSPITAL WITH AN ATTACHED SKILLED NURSING FACILITY. ACUTE CARE SNFBEDS 36 40PATIENT DAYS OF CARE 4412 13979ADMISSIONS 1540 83COMMUNITY MEMORIAL HOSPITAL HAS RECEIVED MANY AWARDS FOR OUTSTANDING CARE TO INCLUDE: 1) A LEADER IN UPSTATE NEW YORK IN PATIENT SATISFACTION2) JUDGED OUTSTANDING IN PATIENT CARE AND PATIENT SAFETY BY BOTH STATE AND FEDERAL SURVEYORS3) HEALTHGRADES MULTI-YEAR 5 STAR RATING IN ORTHOPEDIC SURGERY INCLUDING HIP AND KNEE REPLACEMENTS. 4) EXCELLUS AWARD FOR QUALITY OF CARE A) LOW RATE OF SURGICAL COMPLICATIONS B) PATIENT SATISFACTION SCORES5) JOINT COMMISSION RECOGNITION AS TOP PERFORMER IN QUALITY MEASURES6) LEAPFROG GROUP A RATING ON PATIENT SAFETYCOMMUNITY MEMORIAL HOSPITAL STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITY BY:1) PARTICIPATING IN LOCAL HEALTH FAIRS2) IMPROVING ACCESS TO PRIMARY CARE3) IMPROVING THE CARE OF CHRONIC ILLNESSES SUCH AS DIABETES4) IMPROVING MENTAL HEALTH SERVICES WORKING WITH LOCAL SCHOOL DISTRICTS5) HEALTH CAREER SUMMER PROGRAM FOR AREA CHILDREN6) INCREASING ACCESS TO SPECIALTY SERVICESCOMMUNITY MEMORIAL HOSPITAL HAS A CHARITY CARE PROGRAM FOR PATIENTS WHO CANNOT AFFORD TO PAY HOSPITAL BILLS AND FALL WITHIN THE NATIONAL POVERTY GUIDELINES, UP TO 300% OF THE POVERTY GUIDELINES. IN 2013 COMMUNITY MEMORIAL HOSPITAL PROVIDED CHARITY CARE IN THE AMOUNT OF $361665 TO APPROXIMATELY 268 PATIENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,721,795 | ExpenseAmt |
| Revenue | $6,588,803 | RevenueAmt |
| Desc | OPERATION OF AN AMBULATORY SURGERY UNITTOTAL VISITS 2294 | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,833,168 | ExpenseAmt |
| Revenue | $9,627,545 | RevenueAmt |
| Desc | OPERATION OF EMERGENCY SERVICES AND OUTPATIENT REFERRED AMBULATORY TESTING EMERGENCY ROOM VISITS 8681REFERRED AMBULATORY VISITS 35449 | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,337,910 | ExpenseAmt |
| Revenue | $3,742,432 | RevenueAmt |
| Desc | OPERATION OF PRIMARY CARE CLINICS TOTAL VISITS 35776 | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $4,337,910 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $3,742,432 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $38,388,581 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | 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 | 0 | TaxExemptBondsInd |
| 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 | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 432 | 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 | 18 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | 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 | 0 | 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 | CHRISTOPHER W GRAHAM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3158246081 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 BROAD STREET | AddressLine1 |
| City | HAMILTON | City |
| State | NY | State |
| ZIP Code | 13346 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| LAWRENCE BAKER | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PATRICIA CAPRIO | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM GETMAN | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| IVAN GOWAN | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JS HOPE | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL KRONENBERG | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GLORIA LENHART | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM MAGEE | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MATTHEW NORRIS | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD RUSSELL | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EVE ANN SCHWARTZ | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KERRI TAYLOR | |||||||
| TRUSTEE | 40.00 | Yes (X) | $177,546 | $0 | $26,658 | ||
| ROBERT TYBURSKI | |||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LAWRENCE TULLY | |||||||
| CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SUSIE GUSTAFSON | |||||||
| VICE CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| BRAD WHELER | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JEFFREY RUBENSTEIN | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SEAN FADALE | |||||||
| PRESIDENT/CEO | 40.00 | Yes (X) | $250,885 | $0 | $54,052 | Yes (X) | |
| RICHARD KIRBY | |||||||
| EXEC VP/COO/CFO | 40.00 | $206,132 | $0 | $31,247 | Yes (X) | ||
| RAYMOND CARLSON | |||||||
| PHYSICIAN | 40.00 | $364,300 | $0 | $26,658 | Yes (X) | ||
| ROBERT DELORME | |||||||
| PHYSICIAN | 40.00 | $259,238 | $0 | $26,658 | Yes (X) | ||
| MARTIN ERNITS | |||||||
| PHYSICIAN | 40.00 | $271,988 | $0 | $1,697 | Yes (X) | ||
| JENNIFER MEYERS | |||||||
| PHYSICIAN | 40.00 | $164,699 | $0 | $26,658 | Yes (X) | ||
| EUFROSINA YOUNG | |||||||
| PHYSICIAN | 40.00 | $263,463 | $0 | $26,658 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,958,251 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $220,286 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HAMILTON CRITICAL CARE & EMERGENCY | |||||
| PO BOX 605 | DEWITT | NY | 13214 | EMERGENCY ROOM SERVICES | $117,896 |
| FUST CHARLES CHAMBERS LLP | |||||
| 5784 WIDEWATERS PARKWAY | SYRACUSE | NY | 13214 | AUDIT SERVICES | $105,916 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,340,478 | GovernmentGrantsAmt |
| All Other Contributions | $185,000 | AllOtherContributionsAmt |
| Total Contributions | $3,525,478 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INPATIENT | 622110 | $19,436,556 | $19,436,556 |
| REFERRED AMBULATORY | 621990 | $9,627,545 | $9,627,545 |
| AMBULATORY SURGERY | 621990 | $6,588,803 | $6,588,803 |
| CLINIC | 621110 | $3,742,432 | $3,742,432 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $39,395,336 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,546 | TotalRevenueColumnAmt |
| Exclusion | $98,546 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $192,660 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $96,251 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $96,409 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $96,409 | TotalRevenueColumnAmt |
| Exclusion | $96,409 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA SALES | 900099 | $51,534 | $51,534 |
| WELLNESS CTR DUES | 900099 | $40,231 | $40,231 |
| CCC-SERVICES | 900009 | $24,000 | $24,000 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,719 | TotalRevenueColumnAmt |
| Exclusion | $11,719 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $127,484 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,243,253 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $39,395,336 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $322,439 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $746,520 | TotalAmt |
| Program Services | $204,204 | ProgramServicesAmt |
| Management And General | $542,316 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,887,509 | TotalAmt |
| Program Services | $14,436,007 | ProgramServicesAmt |
| Management And General | $1,451,502 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,153,828 | TotalAmt |
| Program Services | $1,048,413 | ProgramServicesAmt |
| Management And General | $105,415 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,946,182 | TotalAmt |
| Program Services | $2,677,016 | ProgramServicesAmt |
| Management And General | $269,166 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,145,947 | TotalAmt |
| Program Services | $1,022,966 | ProgramServicesAmt |
| Management And General | $122,981 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,068 | TotalAmt |
| Management And General | $28,068 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,507 | TotalAmt |
| Management And General | $117,507 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,509 | TotalAmt |
| Management And General | $75,509 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,245,963 | TotalAmt |
| Program Services | $1,154,838 | ProgramServicesAmt |
| Management And General | $91,125 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,403 | TotalAmt |
| Program Services | $77,344 | ProgramServicesAmt |
| Management And General | $77,059 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,067 | TotalAmt |
| Program Services | $64,260 | ProgramServicesAmt |
| Management And General | $196,807 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,541 | TotalAmt |
| Program Services | $144,767 | ProgramServicesAmt |
| Management And General | $257,774 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $760,182 | TotalAmt |
| Program Services | $756,715 | ProgramServicesAmt |
| Management And General | $3,467 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,665 | TotalAmt |
| Program Services | $22,978 | ProgramServicesAmt |
| Management And General | $12,687 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,141 | TotalAmt |
| Program Services | $4,141 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,318,556 | TotalAmt |
| Program Services | $1,260,431 | ProgramServicesAmt |
| Management And General | $58,125 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $409,361 | TotalAmt |
| Program Services | $409,361 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $8,624,666 | $8,624,666 | |
| PURCHASED SERVICES | $5,000,858 | $4,865,360 | $135,498 |
| PROVISION FOR BAD DEBTS | $850,934 | $850,934 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $829,807 | TotalAmt |
| Program Services | $764,180 | ProgramServicesAmt |
| Management And General | $65,627 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,999,214 | TotalAmt |
| Program Services | $38,388,581 | ProgramServicesAmt |
| Management And General | $3,610,633 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,323,754 | BOYAmt |
| EOY | $7,073,285 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $178,128 | BOYAmt |
| EOY | $214,417 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,613,435 | BOYAmt |
| EOY | $3,870,295 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $695,119 | BOYAmt |
| EOY | $755,608 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $776,142 | BOYAmt |
| EOY | $768,792 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $38,710,106 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $30,195,384 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,172,714 | BOYAmt |
| EOY | $8,514,722 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $922,032 | BOYAmt |
| EOY | $1,735,379 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,681,324 | BOYAmt |
| EOY | $22,932,498 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,237,672 | BOYAmt |
| EOY | $5,935,223 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,844,080 | BOYAmt |
| EOY | $2,223,853 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,505,633 | BOYAmt |
| EOY | $2,731,640 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,587,385 | BOYAmt |
| EOY | $10,890,716 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,942,787 | BOYAmt |
| EOY | $12,041,782 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,152 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,093,939 | BOYAmt |
| EOY | $12,041,782 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,681,324 | BOYAmt |
| EOY | $22,932,498 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,244,039 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,703,804 | OtherChangesInNetAssetsAmt |
| 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | Yes (1) | MailingsMembersInd |
| Mailings Members | $15,509 | MailingsMembersAmt |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $60,000 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $75,509 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | COMMUNITY MEMORIAL HOSPITAL HAS LIMITED LOBBYING ACTIVITIES. SEVERAL ACTIVITIES ARE CONDUCTED ON BEHALF OF THE ORGANIZATION THROUGH MEMBERSHIP IN THE IROQUOIS HEALTHCARE ALLIANCE AND HEALTHCARE ASSOCIATION OF NYS. THESE ACTIVITIES INCLUDE ADVERTISEMENTS AND CONTACT WITH THE LEGISLATORS ON VARIOUS HEALTHCARE ISSUES. IROQUOIS HEALTHCARE ALLIANCE - MEMBERSHIP DUES $12946 OF WHICH $5541 WAS FOR LOBBYING. HEALTHCARE ASSOCIATION OF NYS - MEMBERSHIP DUES $21046 OF WHICH $5893 WAS FOR LOBBYING. AHA-MEMBERSHIP DUES $17231 OF WHICH $4075 WAS FOR LOBBYING. LOBBYIST WILSON,ELSER,MARKOWITZ,ET AL RETAINED FOR $60000 FOR STATE LOBBYING REGARDING ENHANCEMENT OF ACUTE CARE MEDICAL RATES. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,077,446 | BeginningYearBalanceAmt |
| Contributions | $469,906 | ContributionsAmt |
| Investment Earnings Or Losses | $43,085 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | -$185,000 | GrantsOrScholarshipsAmt |
| Other Expenditures | -$154,800 | OtherExpendituresAmt |
| End Year Balance | $1,250,637 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $798,751 | BeginningYearBalanceAmt |
| Contributions | $430,594 | ContributionsAmt |
| Investment Earnings Or Losses | $35,937 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $187,836 | OtherExpendituresAmt |
| End Year Balance | $1,077,446 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $488,980 | BeginningYearBalanceAmt |
| Contributions | $557,783 | ContributionsAmt |
| Investment Earnings Or Losses | $11,988 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $260,000 | OtherExpendituresAmt |
| End Year Balance | $798,751 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $638,615 | BeginningYearBalanceAmt |
| Contributions | $244,911 | ContributionsAmt |
| Investment Earnings Or Losses | $5,454 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $400,000 | OtherExpendituresAmt |
| End Year Balance | $488,980 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $682,787 | BeginningYearBalanceAmt |
| Contributions | $250,127 | ContributionsAmt |
| Investment Earnings Or Losses | $5,701 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $300,000 | OtherExpendituresAmt |
| End Year Balance | $638,615 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment Balance EOY | 1.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $62,115 | OtherCostOrOtherBasisAmt |
| Book Value | $62,115 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,825,531 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,285,644 | DepreciationAmt |
| Book Value | $5,539,887 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $47,146 | OtherCostOrOtherBasisAmt |
| Depreciation | $35,732 | DepreciationAmt |
| Book Value | $11,414 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,488,092 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,052,516 | DepreciationAmt |
| Book Value | $2,435,576 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,287,222 | OtherCostOrOtherBasisAmt |
| Depreciation | $821,492 | DepreciationAmt |
| Book Value | $465,730 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,514,722 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| HAMILTON CRITICAL CARE | $54,771 |
| PROFESSIONAL LIABILITY RESERVE | $1,680,608 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,735,379 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCRUED RETIREMENT OBLIGATIONS, NET | $1,245,101 |
| OTHER LONG-TERM LIABILITIES | $1,486,539 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,731,640 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | ENDOWMENT FUNDS ARE USED TO FURTHUR THE HOSPITAL'S TAX EXEMPT PURPOSE, SUCH AS FOR THE PURCHASE OF CAPITAL ASSETS. |
| PART X, LINE 2: | THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND HAVE BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2013 AND 2012, THE HOSPITAL AND THE FOUNDATION DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2010 THROUGH 2013. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | 0 | 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 | $403,980 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $166,891 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $237,089 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00580 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,945,541 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,064,495 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $881,046 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02140 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,349,521 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,231,386 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,118,135 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02720 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $106,352 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,231 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $66,121 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $106,352 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $40,231 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $66,121 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,455,873 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,271,617 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,184,256 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02880 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $850,934 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $707,126 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,391,357 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $9,365,796 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$974,439 | 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 | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEMORIAL HOSPITAL INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 BROAD ST | AddressLine1 |
| City | HAMILTON | City |
| State | NY | State |
| ZIP Code | 13346 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEMORIAL HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.COMMUNITYMEMORIAL.ORG | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Develop Community Wide Plan | Yes (X) | DevelopCommunityWidePlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | 0 | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Provided On Admission | Yes (X) | ProvidedOnAdmissionInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| 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 (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| COMMUNITY MEMORIAL HOSPITAL, INC | PART V, SECTION B, LINE 3: COMMUNITY MEMORIAL HOSPITAL PARTICIPATED IN AN EXTENSIVE COMMUNITY HEALTH ASSESSMENT AND WAS CO-CHAIRMAN OF THE STEERING COMMITTEE WITH MADISON COUNTY PUBLIC HEALTH FOR THE EFFORT. THERE WAS WIDE-SPREAD REPRESENTATION FROM THE COMMUNITY ON THE STEERING COMMITTEE INCLUDING: REACH NY; EXCELLUS BLUE CROSS BLUE SHIELD; ONEIDA HEALTHCARE; COMMUNITY ACTION PLAN FOR MADISON COUNTY; MADISON COUNTY YOUTH BUREAU; MADISON COUNTY BOARD OF HEALTH; HCR HOMECARE; HEALTH FOUNDATION FOR WESTERN AND CENTRAL NEW YORK; CHILD CARE COUNCIL OF CORNELL COOPERATIVE EXTENSION; MADISON COUNTY DEPARTMENT OF SOCIAL SERVICES; MADISON CORTLAND ARC; HEALTHECONNECTIONS HEALTH PLANNING; MADISON COUNTY PLANNING DEPARTMENT; BRIDGES, HAMILTON COLLEGE; MADISON COUNTY MENTAL HEALTH; AND MADISON COUNTY OFFICE FOR THE AGING. THE STEERING COMMITTEE DEVELOPED FOCUS GROUPS TO ANALYZE AND DISCUSS INFORMATION GATHERED AND PRESENTED BY A REPRESENTATIVE FROM HEALTHECONNECTS AS WELL AS SET PRIORITIES AND SUGGEST INTERVENTIONS. IN ADDITION TO THE STEERING COMMITTEE MEMBERS THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THE FOCUS GROUPS: MID YORK CCC/DAY CARE; ARISE; MADISON-ONEIDA BOCES; CABVI; HAZEL L. CARPENTER HOME, INC.; LORETTO LIFELINE; WIC; CNY AHEC; CORNELL COOPERATIVE EXTENSION; LONG-TERM CARE CONSULTANT; HERITAGE FARMS; MORRISVILLE COLLEGE; BROOKFIELD TOWN SUPERVISOR; HEAD START, CANASTOTA PSYCHOLOGIST; AND LIBERTY RESOURCES. |
| COMMUNITY MEMORIAL HOSPITAL, INC | PART V, SECTION B, LINE 4: THE OTHER HOSPITAL THAT PARTICIPATED WAS ONEIDA HEALTHCARE. |
| COMMUNITY MEMORIAL HOSPITAL, INC | PART V, SECTION B, LINE 7: COMMUNITY MEMORIAL HOSPITAL IS UNABLE TO ADDRESS ALL OF THE NEEDS IDENTIFIED IN THE COMMUNITY NEEDS ASSESSMENT FOR MANY REASONS. FIRST OF ALL THE NEEDS IDENTIFIED ARE TOO NUMEROUS AND WIDE-SPREAD FOR ANY FACILITY TO ADDRESS. SOME OF THE NEEDS WERE RELATED TO SERVICES THAT COMMUNITY MEMORIAL DOES NOT PROVIDE SUCH AS PRENATAL CARE AND TRANSPORTATION. |
| COMMUNITY MEMORIAL HOSPITAL, INC | PART V, SECTION B, LINE 14G: A MESSAGE IS PRINTED ON PATIENTS' BILLS THAT STATES "COMMUNITY MEMORIAL HOSPITAL OFFERS FINANCIAL ASSISTANCE TO QUALIFYING PATIENTS. PLEASE CALL 315-824-6553." |
| COMMUNITY MEMORIAL HOSPITAL, INC | PART V, SECTION B, LINE 20D: WE USED THE NEGOTIATED COMMERCIAL INSURANCE RATE OF OUR HIGHEST VOLUME COMMERCIAL PAYOR. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| COMMUNITY MEMORIAL HOSPITAL SNF | ||||
| 150 BROAD ST | HAMILTON | NY | 13346 | ATTACHED SKILLED NURSING FACILITY |
| COMMUNITY MEMORIAL HOSPITAL FHC | ||||
| 164 BROAD ST | HAMILTON | NY | 13346 | PRIMARY CARE PHYSICIAN OFFICE |
| COMMUNITY MEMORIAL HOSPITAL FHC | ||||
| 3460 SOUTH ST | MORRISVILLE | NY | 13408 | PRIMARY CARE PHYSICIAN OFFICE |
| COMMUNITY MEMORIAL HOSPITAL FHC | ||||
| 117 WEST MAIN ST | WATERVILLE | NY | 13480 | PRIMARY CARE PHYSICIAN OFFICE |
| COMMUNITY MEMORIAL HOSPITAL FHC | ||||
| 4180 SOUTH MAIN ST | MUNNSVILLE | NY | 13409 | PRIMARY CARE PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | LINE 7A - A COST-TO-CHARGE RATIO WAS USED, DERIVED FROM WORKSHEET 2LINE 7B - A COST-TO-CHARGE RATIO WAS USED, DERIVED FROM WORKSHEET 2.LINE 7E - WE USED OUR ACTUAL EXPENSES AND ACTUAL REVENUE FROM OUR WELLNESS CENTER. |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE OF 850934 WAS SUBTRACTED FROM FORM 990, PART IX, LINE 25, COLUMN A |
| PART III, LINE 4: | THE FOOTNOTES TO THE FINANCIAL STATEMENTS STATE "THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS EVALUATED ON A REGULAR BASIS BY MANAGEMENT AND IS BASED UPON MANAGEMENT'S PERIODIC REVIEW OF THE COLLECTIBILITY OF THE RECEIVABLES IN LIGHT OF HISTORICAL EXPERIENCE, THE NATURE AND VOLUME OF THE RECEIVABLES, OR ADVERSE SITUATION THAT MAY AFFECT THE PATIENT OR RESIDENT'S ABILITY TO REPAY AND PREVAILING ECONOMIC CONDITIONS."LINE 2 METHODOLOGY- THE HOSPITAL ESTIMATES BAD DEBT EXPENSE BASED ON HISTORICAL EXPERIENCE EXPRESSED AS A PERCENTAGE OF CURRENT YEAR GROSS REVENUE..LINE 3 METHODOLOGY- WE TOOK THE APPROVAL PERCENTAGE OF 83.1% ON ALL PATIENTS WHO APPLIED FOR CHARITY CARE IN 2013 AND MULTIPLIED IT BY THE AMOUNT ON LINE 2. THE RATIONAL BEING THAT THAT % WOULD HOLD ACROSS ALL OF OUR BAD DEBTS EXPENSE IF THOSE PATIENTS HAD APPLIED FOR CHARITY CARE. WE DID NOT INCLUDE BAD DEBT AMOUNTS IN COMMUNITY BENEFITS. BAD DEBTS EXPENSE IS NET OF DISCOUNTS AND PAYMENTS. |
| PART III, LINE 8: | FOR LINE 6 - THE HOSPITAL USED THE 2013 MEDICARE COST REPORT IN DETERMINING MEDICARE COSTS. THE MEDICARE COST REPORT CALCULATES A COST-TO-CHARGE RATIO FOR EACH COST CENTER USING HOSPITAL TOTAL ALLOWABLE CHARGES AND TOTAL ALLOWABLE COSTS; THESE RATIOS ARE THEN APPLIED AGAINST MEDICARE CHARGES IN EACH COST CENTER RESULTING IN MEDICARE COSTS.THE SHORTFALL OF $974439 ON LINE 7 REPRESENTS UNRECOGNIZED COMMUNITY BENEFIT INHERENT IN PROVIDING MEDICAL CARE TO THE COMMUNITY. OUR UNREIMBURSED COSTS FROM MEDICARE ARE INCURRED BY PROVIDING SERVICES TO OUR RURAL COMMUNITIES THAT HAVE A HIGHER THAN AVERAGE MEDICARE POPULATION, MANY OF WHOM ARE INDIGENT. |
| PART III, LINE 9B: | IN THE COLLECTION POLICY FOR COMMUNITY MEMORIAL HOSPITAL IT STATES THAT WHEN A SELF-PAY STATEMENT GENERATES FOR A PATIENT KNOWN TO HAVE RECEIVED UNCOMPENSATED SERVICE AID FROM COMMUNITY MEMORIAL WITHIN THE LAST YEAR, THE STATEMENT IS PULLED AND AN UNCOMPENSATED SERVICE APPROVAL LETTER IS MAILED TO THE PATIENT. |
| PART VI, LINE 2: | COMMUNITY MEMORIAL WAS AN ACTIVE PARTNER WITH THE MADISON COUNTY HEALTH DEPARTMENT, OTHER HEALTH AND HUMAN SERVICE AGENCIES, AND AREA COMMUNITY AND INDUSTRY LEADERS IN PERFORMING AN EXTENSIVE ASSESSMENT OF THE HEALTH NEEDS OF OUR AREA. THE SHARED INFORMATION COLLECTED HAS BEEN USEFUL IN OUR EFFORTS TO PLAN FOR THE CHANGING NEEDS AND DEMOGRAPHICS OF OUR SERVICE AREA POPULATIONS. INFORMATION USED IN OUR PLANNING AND ASSESSMENT IS DERIVED FROM THE FOLLOWING SOURCES: 1)PRIMARY - PATIENT SATISFACTION SURVEYS, BOARD OF DIRECTORS, AUXILIARY MEMBERSHIP, MEDICAL STAFF, AND EMPLOYEES 2)PRIMARY - MADISON COUNTY DEPARTMENT OF HEALTH AND COMMUNITY NEEDS ASSESSMENT PLAN 2013, SECONDARY - CHENANGO COUNTY COMMUNITY NEEDS ASSESSMENT, SPARCS, NYSDOH REPORTS AND DATA SOURCES, PHYSICIAN AND HEALTH SERVICES USAGE DATA BASES, MARKET SHARE AND DEMOGRAPHICS DATA BASES, HEALTHCARE ASSOCIATION OF NYS, AMERICAN HOSPITAL ASSOCIATION, IROQUOIS HEALTH ASSOCIATION, AND VOLUNTARY HOSPITALS OF AMERICA STATISTICAL REPORTS. |
| PART VI, LINE 3: | SIGNS ARE POSTED IN OUR ADMITTING/REGISTRATION AREA REGARDING OUR POLICY OF PROVIDING SERVICES AT A REDUCED CHARGE OR NO CHARGE TO PATIENTS WHO HAVE FAMILY INCOME BELOW CERTAIN FEDERAL STANDARDS, INCLUDING A PHONE NUMBER TO CALL IN OUR CREDIT DEPARTMENT. A SUMMARY OF OUR UNCOMPENSATED CARE PROGRAM IS AVAILABLE FOR THEM TO TAKE. PATIENTS THAT ARE SELF PAY ON ADMISSION ARE SEEN BY THE CREDIT DEPARTMENT PERSONNEL AND THE UNCOMPENSATED SERVICE PROGRAM IS DISCUSSED AND AN APPLICATION IS GIVEN. PATIENTS THAT RECEIVE OUTPATIENT SERVICES ARE CALLED TO ADVISE THEM OF OUR POLICY WHEN THE FIRST ITEMIZED STATEMENT PRINTS AND WHEN SUBSEQUENT COLLECTION PHONE CALLS ARE MADE. A MESSAGE IS AUTOMATICALLY PRINTED ON ALL PATIENT STATEMENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE FOR THOSE WHO QUALIFY, WITH THE PHONE NUMBER TO CALL. PATIENTS ARE MADE AWARE THAT THEY MAY APPLY TO THE COUNTY IN WHICH THEY RESIDE FOR MEDICAID ASSISTANCE. |
| PART VI, LINE 4: | COMMUNITY MEMORIAL HOSPITAL IN HAMILTON, NY, SERVES 45000 PEOPLE IN 27 CENTRAL NEW YORK COMMUNITIES. THE REGION IS NOTED FOR ITS RICH AGRICULTURAL HISTORY AND A STRONG TRADITION OF HIGHER EDUCATION. TODAY, IN ADDITION TO THE DAIRY INDUSTRY, THERE ARE HORSE FARMS, GRASS FED BEEF AND HOMESTEADS PRODUCING ORGANIC FRUITS AND VEGETABLES. COLGATE UNIVERSITY, MORRISVILLE STATE COLLEGE, AND CAZENOVIA COLLEGE OFFER CURRICULUMS THAT ARE RENOWN NATIONWIDE. THE COMMUNITIES WE SERVE ALSO HAVE A SIGNIFICANT NUMBER OF FRAIL AND POOR ELDERLY, MEDICAID OF ALL AGES AND WORKING POOR. COMMUNITY MEMORIAL HOSPITAL PROVIDES CARE TO ALL OF THESE GROUPS REGARDLESS OF ABILITY TO PAY. THIS APPLIES TO ALL HOSPITAL AND OUTPATIENT SERVICES. COMMUNITY MEMORIAL HOSPITAL HAS A CHARITY CARE PROGRAM FOR THOSE WHO CANNOT AFFORD TO PAY FOR THEIR HOSPITAL BILLS. |
| PART VI, LINE 5: | A MAJORITY OF COMMUNITY MEMORIAL HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE HOSPITAL'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE HOSPITAL, NOR FAMILY MEMBERS. COMMUNITY MEMORIAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. THE HOSPITAL USES SURPLUS FUNDS TO BUY STATE-OF-THE-ART CAPITAL EQUIPMENT, I.E. CARDIAC MONITOR FOR SPECIAL CARE UNIT, PHARMACY COMPUTER SYSTEM, SURGICAL EQUIPMENT, AND ADDITIONAL COMPUTERS/SERVERS.IN 1989, COMMUNITY MEMORIAL HOSPITAL EXPANDED ITS MISSION TO PROVIDE PRIMARY CARE IN THE RURAL COMMUNITIES OF ITS SERVICE AREA. SEVERAL PHYSICIANS HAD RETIRED OR WERE ABOUT TO CLOSE THEIR PRACTICES AND MANY SMALL TOWNS AND VILLAGES WERE LEFT WITHOUT ANY COVERAGE. THE HOSPITAL HAS A NETWORK OF FOUR FAMILY HEALTH CENTERS( IN HAMILTON, MORRISVILLE, MUNNSVILLE AND WATERVILLE). THE HOSPITAL EMPLOYS FIVE FAMILY PRACTICE SPECIALISTS, ONE PEDIATRICIAN, ONE CARDIOLOGIST, ONE NEUROLOGIST, AND NURSE PRACTIONERS/PHYSICIAN ASSISTANTS. ALL PATIENTS WHO COME TO THE FAMILY HEALTH CENTERS ARE SERVED WITHOUT REGARD TO THEIR ABILITY TO PAY. THE HOSPITAL HAS DEVELOPED A SAFETY NET FOR LOW INCOME, UNINSURED AND/OR UNDERINSURED PATIENTS WHILE ENSURING PRIMARY CARE WILL REMAIN AVAILABLE IN RURAL CENTRAL NEW YORK. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | NY |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KERRI TAYLOR | ||||||||||||||
| TRUSTEE | $155,208 | $0 | $22,338 | $0 | $0 | $0 | $0 | $0 | $26,658 | $0 | $204,204 | $0 | $0 | $0 |
| SEAN FADALE | ||||||||||||||
| PRESIDENT/CEO | $250,885 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $54,052 | $0 | $304,937 | $0 | $0 | $0 |
| RICHARD KIRBY | ||||||||||||||
| EXEC VP/COO/CFO | $206,132 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $31,247 | $0 | $237,379 | $0 | $0 | $0 |
| RAYMOND CARLSON | ||||||||||||||
| PHYSICIAN | $359,500 | $0 | $4,800 | $0 | $0 | $0 | $0 | $0 | $26,658 | $0 | $390,958 | $0 | $0 | $0 |
| ROBERT DELORME | ||||||||||||||
| PHYSICIAN | $234,000 | $0 | $25,238 | $0 | $0 | $0 | $0 | $0 | $26,658 | $0 | $285,896 | $0 | $0 | $0 |
| MARTIN ERNITS | ||||||||||||||
| PHYSICIAN | $271,988 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,697 | $0 | $273,685 | $0 | $0 | $0 |
| JENNIFER MEYERS | ||||||||||||||
| PHYSICIAN | $155,077 | $0 | $9,622 | $0 | $0 | $0 | $0 | $0 | $26,658 | $0 | $191,357 | $0 | $0 | $0 |
| EUFROSINA YOUNG | ||||||||||||||
| PHYSICIAN | $239,239 | $0 | $24,224 | $0 | $0 | $0 | $0 | $0 | $26,658 | $0 | $290,121 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE CEO AND THE CFO PRESENT THE 990 TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS PRIOR TO SUBMISSION TO THE IRS. THE FINANCE COMMITTEE ADVISES THE FULL BOARD OF IT'S REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CEO AND THE PRESIDENT OF THE BOARD OF DIRECTORS REVIEW THE CONFLICT OF INTEREST POLICIES ANNUALLY WITH THE FULL BOARD. ANY POSSIBLE CONFLICTS ARE REVIEWED AND APPROPRIATE ACTION TAKEN. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE CEO AND THE CFO IS DETERMINED BY THE BOARD OF DIRECTORS. THE BOARD REVIEWS COMPARATIVE DATA PROVIDED BY HOSPITAL TRADE ORGANIZATIONS SUCH AS HANYS. THE BOARD USES SALARY SURVEYS COMPLETED BY INDEPENDANT CONSULTANTS GAFFE & ASSOCIATES.THE BOARD EMPLOYS THE SERVICES OF OUTSIDE CONSULTANT, HARBRIDGE CONSULTING.THE BOARD REVIEWS SALARIES FOR SIMILAR POSTIONS AT OTHER COMPARABLE HOSPITALS.THE BOARD SETS BOTH QUALITY AND FINANCIAL GOALS AND REVIEWS PERFORMANCE ANNUALLY. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL STATEMENTS ARE FILED WITH THE CHARITIES BUREAU AND ARE PART OF THE PUBLIC RECORD. IN ADDITION, THE ORGANIZATION PROVIDES ALL DOCUMENTS REQUIRED BY THE INTERNAL REVENUE CODE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | RETIREMENT PLAN OBLIGATION CHANGES OTHER THAN NET PERIODIC BENEFIT COSTS 2,703,804. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY MEMORIAL HOSPITAL FOUNDATION | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 150 BROAD ST | AddressLine1 |
| City | HAMILTON | City |
| State | NY | State |
| ZIP Code | 13346 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161603283 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Exempt Code Section | 501 C 3 | ExemptCodeSectionTxt |
| Public Charity Status | 11- TYPE I | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 0 | 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 | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |