SCHUYLER HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: SCHUYLER HOSPITAL INC (EIN 15-0533564)
Tax period: 2012-01-01 to 2012-12-31
Filed: 2013-11-07
IRS object ID: 201303169349301340
Schema version: 2012v2.0
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 D
Schedule H
Schedule J
Schedule L
Schedule O
Schedule R
Reasonable Cause Explanation

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-11-07T13:54:32-07:00	Timestamp
Tax Period End Date	2012-12-31	TaxPeriodEndDate
Return Type	990	ReturnType
Tax Period Begin Date	2012-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	150533564	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	SCHUYLER HOSPITAL INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	SCHU	NameControl
Phone	6075357121	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	220 Steuben Street	AddressLine1
City	Montour Falls	City
State	NY	State
ZIP Code	14865	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Amy Castle	Name
Title	CFO / VP of Finance	Title
Phone	6075357121	Phone
Date Signed	2013-10-25	DateSigned

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Andrew Manzer CEO	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	220 Steuben Street	AddressLine1
City	Montour Falls	City
State	NY	State
ZIP Code	14865	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	30789836	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	http://www.schuylerhospital.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1929	YearFormation
State Legal Domicile	NY	StateLegalDomicile
Activity Or Mission Description	Schuyler Hospital is a community healthcare facility that provides a broad range of both inpatient and outpatient healthcare services. Schuyler is a critical access hospital that provides care to patients without regard for their financial status or ability to pay, and under its charity care policy provides services without charge or at amounts less than its established rates. The organization also provides a 120 bed Skilled Nursing Facility for long term care services, which is the only SNF in the county.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	14	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	14	NbrIndependentVotingMembers
Total Nbr Employees	477	TotalNbrEmployees
Total Nbr Volunteers	163	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	996862	ContributionsGrantsPriorYear
Contributions Grants Current Year	788977	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	31339651	ProgramServiceRevenuePriorYear
Program Service Revenue CY	27975299	ProgramServiceRevenueCY
Investment Income Prior Year	317106	InvestmentIncomePriorYear
Investment Income Current Year	51128	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1112417	OtherRevenuePriorYear
Other Revenue Current Year	1696647	OtherRevenueCurrentYear
Total Revenue Prior Year	33766036	TotalRevenuePriorYear
Total Revenue Current Year	30512051	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	21919236	SalariesEtcPriorYear
Salaries Etc Current Year	20699252	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	129400	TotalFundrsngExpCurrentYear
Other Expense Prior Year	12686076	OtherExpensePriorYear
Other Expenses Current Year	11447402	OtherExpensesCurrentYear
Total Expenses Prior Year	34605312	TotalExpensesPriorYear
Total Expenses Current Year	32146654	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-839276	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	-1634603	RevenuesLessExpensesCY
Total Assets BOY	17423451	TotalAssetsBOY
Total Assets EOY	25425100	TotalAssetsEOY
Total Liabilities BOY	12786088	TotalLiabilitiesBOY
Total Liabilities EOY	14287866	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	4637363	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	11137234	NetAssetsOrFundBalancesEOY
Mission Description	Schuyler Hospital is a network of providers, programs, and services that meets the healthcare needs of a population of over 32,000 residents, through a wide range of medical services, highly skilled medical staff, and our devotion to customer service. Our Mission: To optimize the health and healing experience of all people we serve in a safe, compassionate, and respectful environment. Our Vision: As a community led organization, we will be the healthcare provider of choice, delivering excellent, innovative services to meet the needs of the communities we serve. Our Values include: Integrity and Honesty- We keep our word and treat everyone with mutual trust; Quality and Accountability- We accept responsibility for the trust placed in us; Dignity and Respect-We treat everyone with honor and compassion; Teamwork- We align our energies and enhance patient/resident care by working together; and Continuous Learning- We encourage and foster individual growth and learning.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	27687977	Expense
Grants	0	Grants
Revenue	30512051	Revenue
Description	Schuyler Hospital is a 25 bed acute care facility with critical access hospital status and a 24 hour emergency services. It provides a full complement of healthcare services to the public in support of the community need for healthcare close to home, which includes the residents of Schuyler County and its surrounding communities (population 32,000). Medical services in 2012 included 4,566 inpatient days, 42,567 Long Term Care days, 166,289 outpatient procedures and 28,034 clinic visits. In 2012 Schuyler Hospital provided over 633k in free and reduced cost care through its charity care policy and incurred over $2.1 million in bad debt due to the increasing uninsured and underinsured population in the community.	Description
Total Of Other Program Service Exp	0	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	0	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	0	TotalOfOtherProgramServiceRev
Total Program Service Expense	27687977	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	0	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	0	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	1	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	0	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	1	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	1	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	1	RelatedOrgControlledEntity
Transaction Related Entity	1	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	393	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	477	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	14	NbrVotingGoverningBodyMembers
Number Independent Voting Members	14	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	0	MembersOrStockholders
Election Of Board Members	0	ElectionOfBoardMembers
Decisions Subject To Approval	0	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	NY	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	Amy Castle CFO	NamePerson
Telephone Number	6075358639	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	220 Steuben Street	AddressLine1
City	Montour Falls	City
State	NY	State
ZIP Code	14865	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
Fred Tannenberger
Board President & Chair	3	0	X	0	0	0
Suzanne Blowers
Vice Chair	2	0	X	0	0	0
Jerry Mickelson CPA
Treasurer	2	0	X	0	0	0
Kyle Tuttle
Board Member / Secretary	2	0	X	0	0	0
Zahid Asgher MD
Board Member and Laboratory Medical Director	1	0	X	64689	0	0
Wendy Field
Board Member	1	0	X	0	0	0
Kathy Fragola
Board Member	1	0	X	0	0	0
Joseph Hinterberger MD
Board Member	1	0	X	19900	0	0
Holly Mosher
Board Member	1	0	X	0	0	0
Chris Stamp
Board Member	1	0	X	0	0	0
Richard Weakland
Board Member	1	0	X	0	0	0
Blanche Borzell MD
Med Staff VP; Ex-Officio Board Member(non voting)	1	0	X	21650	0	0
Carol Bower
Auxiliary President / Ex-Officio with vote	1	0	X	0	0	0
Benjamin Saks
Board Member and Physician	40	0	X	206529	0	50439
Andrew Manzer
CEO AND PRESIDENT	40	2		189160	0	32080	X
Amy Castle
CFO / VP OF FINANCE	40	2		104831	0	22497	X
Michael Eisman MD
Medical Director / Internal Medicine	40	0		190248	0	50752		X
Jann Marks
CHIEF NURSING OFFICER	40	0		167393	0	41464		X
Ashraf Sabahat MD
Anesthesiologist	40	0		323833	0	71575			X
Jagmohan Singh MD
Internal Medicine Physician	40	0		310141	0	63153			X
William Saks
GYN Physician	40	0		195230	0	56165			X
Tariq Hussain MD
Orthopedic Surgeon	40	0		183034	0	35882			X
Zarmina Aman
OB/GYN Physician	40	0		180218	0	48387			X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2156856	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	0	TotalReportableCompFrmRltdOrgs
Total Other Compensation	472394	TotalOtherCompensation
Number Individuals GT100 K	18	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Delphi Healthcare PLLC
2701 Culver Rd	Rochester	NY	14622	Emergency Room Physicians	413262
Medical Information Technology
Meditech Circle	Westwood	MA	02090	Software System & Support Fees	342880
Postler & Jaeckle
615 South Avenue	Rochester	NY	146201385	Service Contract	291591
Kings Medical
PO Box 72483	Cleveland	OH	44192	MRI services (equipment and tech)	286555
Cayuga Medical Associates PC
821 Cliff Street	Ithaca	NY	14850	Orthopedic Physicians	277865

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	10	NumberOfContractorsGT100K
Federated Campaigns	0	FederatedCampaigns
Membership Dues	0	MembershipDues
Fundraising Events	0	FundraisingEvents
Related Organizations	288685	RelatedOrganizations
Government Grants	456892	GovernmentGrants
All Other Contributions	43400	AllOtherContributions
Noncash Contributions	0	NoncashContributions
Total Contributions	788977	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	Net Patient Service Revenues	Description
Business Code	622000	BusinessCode
Total Revenue Column	27975299	TotalRevenueColumn
Related Or Exempt Function Income	27975299	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	27975299	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	35163	TotalRevenueColumn
Related Or Exempt Function Income	35163	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn
Related Or Exempt Function Income	0	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	0	Real
Personal	0	Personal

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	283841	Securities
Other	9909	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	277785	Securities
Other	0	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	6056	Securities
Other	9909	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	15965	TotalRevenueColumn
Related Or Exempt Function Income	15965	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Cntrbtns Rprtd Fundraising Events	0	CntrbtnsRprtdFundraisingEvents

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	ExclusionExclusionAmount
Cafe Sales	622000	168677	168677	$0
NYS Pools Receipts	622000	1065928	1065928	$0
Retail Pharmacy	622000	232460	232460	$0

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	229582	TotalRevenueColumn
Related Or Exempt Function Income	229582	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	1696647	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	30512051	TotalRevenueColumn
Related Or Exempt Function Income	29723074	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$0	ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	720846	Total
Program Services	426855	ProgramServices
Management And General	293991	ManagementAndGeneral
Fundraising	0	Fundraising

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	15211204	Total
Program Services	13876237	ProgramServices
Management And General	1281815	ManagementAndGeneral
Fundraising	53152	Fundraising

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	1517846	Total
Program Services	1362655	ProgramServices
Management And General	150127	ManagementAndGeneral
Fundraising	5064	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	2124879	Total
Program Services	1878028	ProgramServices
Management And General	240266	ManagementAndGeneral
Fundraising	6585	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	1124477	Total
Program Services	1009107	ProgramServices
Management And General	111176	ManagementAndGeneral
Fundraising	4194	Fundraising

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	43471	Total
Program Services	39026	ProgramServices
Management And General	4300	ManagementAndGeneral
Fundraising	145	Fundraising

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	70642	Total
Program Services	380	ProgramServices
Management And General	70262	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	80890	Total
Program Services	9337	ProgramServices
Management And General	65414	ManagementAndGeneral
Fundraising	6139	Fundraising

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total
Fundraising	0	Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	2862	Total
Program Services	0	ProgramServices
Management And General	2862	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	16900	Total
Program Services	0	ProgramServices
Management And General	16900	ManagementAndGeneral
Fundraising	0	Fundraising

Advertising Advertising

Field	Value	IRS element (for citing)
Total	162507	Total
Program Services	2306	ProgramServices
Management And General	144607	ManagementAndGeneral
Fundraising	15594	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	2702764	Total
Program Services	2487607	ProgramServices
Management And General	193750	ManagementAndGeneral
Fundraising	21407	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	228586	Total
Program Services	0	ProgramServices
Management And General	228586	ManagementAndGeneral
Fundraising	0	Fundraising

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	590310	Total
Program Services	418976	ProgramServices
Management And General	165523	ManagementAndGeneral
Fundraising	5811	Fundraising

Travel Travel

Field	Value	IRS element (for citing)
Total	9963	Total
Program Services	8717	ProgramServices
Management And General	1246	ManagementAndGeneral
Fundraising	0	Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	41209	Total
Program Services	33501	ProgramServices
Management And General	7693	ManagementAndGeneral
Fundraising	15	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	230253	Total
Program Services	0	ProgramServices
Management And General	230253	ManagementAndGeneral
Fundraising	0	Fundraising

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total
Program Services	0	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	1109614	Total
Program Services	712365	ProgramServices
Management And General	397204	ManagementAndGeneral
Fundraising	45	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	329861	Total
Program Services	168302	ProgramServices
Management And General	161559	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (2 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral	FundraisingFundraising
Purchased Services	3269213	2921058	345512	2643
Provisions for Bad Debt	2132412	2132412	0	0

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	425945	Total
Program Services	201108	ProgramServices
Management And General	216231	ManagementAndGeneral
Fundraising	8606	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	32146654	Total
Program Services	27687977	ProgramServices
Management And General	4329277	ManagementAndGeneral
Fundraising	129400	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	930680	BOY
EOY	511253	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	304047	BOY
EOY	581014	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	135135	BOY
EOY	6528310	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	4261882	BOY
EOY	3783305	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	616308	BOY
EOY	705472	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	265597	BOY
EOY	1287001	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	21124157	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	12905898	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	7048948	BOY
EOY	8218259	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	420591	BOY
EOY	149101	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	3440263	BOY
EOY	3661385	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	17423451	BOY
EOY	25425100	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	7534212	BOY
EOY	8459898	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
EOY	0	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
EOY	0	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
EOY	0	EOY

Escrow Account Liability EscrowAccountLiability

Field	Value	IRS element (for citing)
EOY	0	EOY

Loans From Officers Directors LoansFromOfficersDirectors

Field	Value	IRS element (for citing)
EOY	0	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	4046239	BOY
EOY	4043009	EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

Field	Value	IRS element (for citing)
BOY	0	BOY
EOY	0	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	1205637	BOY
EOY	1784959	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	12786088	BOY
EOY	14287866	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1126473	BOY
EOY	1326030	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2547015	BOY
EOY	8772744	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	963875	BOY
EOY	1038460	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	4637363	BOY
EOY	11137234	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	17423451	BOY
EOY	25425100	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	-1634603	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	6295	ReconciliationUnrealizedInvest
Reconcilation Donated Services	0	ReconcilationDonatedServices
Reconcilation Invest Expenses	0	ReconcilationInvestExpenses
Reconcilation Prior Adjustment	0	ReconcilationPriorAdjustment
Reconcilation Other Changes	8128179	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	896303	BeginningOfYearBalance
Contributions	0	Contributions
Investment Earnings Or Losses	72873	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	0	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	969176	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	936072	BeginningOfYearBalance
Contributions	0	Contributions
Investment Earnings Or Losses	-39769	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	0	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	896303	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	869853	BeginningOfYearBalance
Contributions	0	Contributions
Investment Earnings Or Losses	66219	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	0	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	936072	EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	0	BeginningOfYearBalance
Contributions	869853	Contributions
Investment Earnings Or Losses	0	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	0	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	869853	EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	0	BeginningOfYearBalance
Contributions	0	Contributions
Investment Earnings Or Losses	0	InvestmentEarningsOrLosses
Grants Or Scholarships	0	GrantsOrScholarships
Other Expenditures	0	OtherExpenditures
Administrative Expenses	0	AdministrativeExpenses
End Of Year Balance	0	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	0	BoardDesignatedEOYBalance
Permanent Endowment EOY Balance	0	PermanentEndowmentEOYBalance
Term Endowment EOY Balance	1	TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs	1	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	119099	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Book Value	119099	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	12841454	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	7609692	Depreciation
Book Value	5231762	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	20143	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	13542	Depreciation
Book Value	6601	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	8107529	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	5255176	Depreciation
Book Value	2852353	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	35932	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	0	OtherCostOrOtherBasis
Depreciation	27488	Depreciation
Book Value	8444	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	8218259	TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescription	Book ValueBookValue
Benficial Interest in Schuyler Health Foundation (Affiliate)	2534510
Due From Affiliate	4869
Assets whose use is limited - Trust	1038460
Other Assets	83546

Field	Value	IRS element (for citing)
Total Book Value Other Assets	3661385	TotalBookValueOtherAssets
Federal Income Tax Liability	0	FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	ACCRUED PENSION LIABILITY	Description
Amount	$1,784,959	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	1784959	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	28867171	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	6295	NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities	0	DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants	0	RecoveriesOfPriorYearGrants
Other Revenues	481237	OtherRevenues
Revenue Not Rptd F990	487532	RevenueNotRptdF990
Revenue Subtotal	28379639	RevenueSubtotal
Investment Expenses Not Included	0	InvestmentExpensesNotIncluded
Other Revenues Not Included	2132412	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	2132412	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	30512051	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	30014242	TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities	0	DonatedServicesUseOfFacilities
Prior Year Adjustments	0	PriorYearAdjustments
Losses Reported	0	LossesReported
Other Expenses Included	0	OtherExpensesIncluded
Expenses Not Rptd F990	0	ExpensesNotRptdF990
Expenses Subtotal	30014242	ExpensesSubtotal
Investment Expenses Not Included2	0	InvestmentExpensesNotIncluded2
Other Expenses Not Included	2132412	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	2132412	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	32146654	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchD_P05_S00_L04	Schedule D, Part V, Line 4	Schuyler Health Foundation a subsidiary of Schuyler Hospital has been named a beneficiary of 50% of a Term Endowment. At the occurrence of a particular event, the investments will become unrestricted assets of Schuyler Health Foundation. Upon that time Schuyler Health Foundation will determine the best use of the funds.
SchD_P10_S00_L02	Schedule D, Part X, Line 2	See Page 15 of the Audited Financial Statements: The Hospital and the Foundation are not -for-profit corporations and are exempt from income taxes under Section 501(c )(3) of the Internal Revenue Code. The Hospital and the Foundation have been classified by the IRS as entities that are not private foundations. As of December 31, 2012 and 2011, Schuyler did not have a liability for unrecognized tax benefits. Schuler files information returns in the US federal jurisdiction and New York State. Schuyler is no longer subject to US federal and state return examinations by tax authorities for years before 2009.
SchD_P11_S00_L02d	Schedule D, Part XI, Line 2d	481,237 represents difference of current year cash vs. GAPP fund accounting in the ledger. This amount consists of $421,984 difference of release of temp restricted net assets in trial balance vs. release of net assets; ($1,088,559) of Meaningful Use attestation revenues not received until 2013; and $178,728 difference between actual funds received from affiliate Schuyler Health Foundation and amounts in the Trial balance.
SchD_P11_S00_L04b	Schedule D, Part XI, Line 4b	Amount represents Provisions for Bad Debts as per Audited Financial Statements - See page 29
SchD_P12_S00_L04b	Schedule D, Part XII, Line 4b	Amount represents provisions for bad debts, see page 29 of the Audited Finanical Statements.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent100	X	Pcent100
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	1000	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	317129	TotalCommunityBenefitExpense
Direct Offsetting Revenue	216746	DirectOffsettingRevenue
Net Community Benefit Expense	100383	NetCommunityBenefitExpense
Percent Of Total Expense	0.0033	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2521866	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1799228	DirectOffsettingRevenue
Net Community Benefit Expense	722637	NetCommunityBenefitExpense
Percent Of Total Expense	0.0241	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	2838995	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2015974	DirectOffsettingRevenue
Net Community Benefit Expense	823020	NetCommunityBenefitExpense
Percent Of Total Expense	0.0274	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	99983	TotalCommunityBenefitExpense
Direct Offsetting Revenue	22867	DirectOffsettingRevenue
Net Community Benefit Expense	77116	NetCommunityBenefitExpense
Percent Of Total Expense	0.0026	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	122212	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	122212	NetCommunityBenefitExpense
Percent Of Total Expense	0.0041	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6405384	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3519117	DirectOffsettingRevenue
Net Community Benefit Expense	2886267	NetCommunityBenefitExpense
Percent Of Total Expense	0.0962	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	0	NetCommunityBenefitExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5860	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	5860	NetCommunityBenefitExpense
Percent Of Total Expense	0.0002	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	6633439	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3541984	DirectOffsettingRevenue
Net Community Benefit Expense	3091455	NetCommunityBenefitExpense
Percent Of Total Expense	0.1031	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Benefit Expense	9472434	TotalCommunityBenefitExpense
Direct Offsetting Revenue	5557958	DirectOffsettingRevenue
Net Community Benefit Expense	3914475	NetCommunityBenefitExpense
Percent Of Total Expense	0.1305	PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Economic Development EconomicDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	4653	TotalCommunityBuildingExpense
Direct Offsetting Revenue	1843	DirectOffsettingRevenue
Net Community Building Expense	2810	NetCommunityBuildingExpense
Percent Of Total Expense	0.0001	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Total Community Building Expense	0	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	0	NetCommunityBuildingExpense
Percent Of Total Expense	0	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	2630	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	2630	NetCommunityBuildingExpense
Percent Of Total Expense	0.0001	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	3510	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	3510	NetCommunityBuildingExpense
Percent Of Total Expense	0.0001	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	8511	TotalCommunityBuildingExpense
Direct Offsetting Revenue	2200	DirectOffsettingRevenue
Net Community Building Expense	6311	NetCommunityBuildingExpense
Percent Of Total Expense	0.0002	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	2000	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	2000	NetCommunityBuildingExpense
Percent Of Total Expense	0.0001	PercentOfTotalExpense

Other Other

Field	Value	IRS element (for citing)
Total Community Building Expense	2600	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	2600	NetCommunityBuildingExpense
Percent Of Total Expense	0.0001	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	0	NumberOfActivitiesOrPrograms
Persons Served	0	PersonsServed
Total Community Building Expense	23904	TotalCommunityBuildingExpense
Direct Offsetting Revenue	4043	DirectOffsettingRevenue
Net Community Building Expense	19861	NetCommunityBuildingExpense
Percent Of Total Expense	0.0007	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$1,067,585	BadDebtExpenseAmount
Amount Attributable To	543765	AmountAttributableTo
Amount Reimbursed By Medicare	8065226	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	10352435	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-2287209	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	0	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Schuyler Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	220 Steuben Street	AddressLine1
City	Montour Falls	City
State	NY	State
ZIP Code	14865	ZIPCode

Field	Value	IRS element (for citing)
Website Address	http://www.schuylerhospital.org/	WebsiteAddress
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours
Other	Surgical Services, Lab, Imaging/Respiratory/Rehab/Skilled Nursing Facility/ Employed Physicians	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Schuyler Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Needs Assessment Conducted	09	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	0	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Other Method	X	OtherMethod
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Prioritize Health Needs	X	PrioritizeHealthNeeds
All Needs Addressed	1	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	100	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	1000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Admission Office	X	PostedInAdmissionOffice
Provided On Admission	X	ProvidedOnAdmission
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	1	NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Seneca View Long Term Care Skilled Nursing Facility	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	220 Steuben Street	AddressLine1
City	Montour Falls	City
State	NY	State
ZIP Code	14865	ZIPCode

Field	Value	IRS element (for citing)
Facility Type	120 bed Skilled Nursing Facility,attached to and operated under Schuyler Hospital (provider-based).	FacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SchH_P01_S00_L03c	Schedule H, Part I, Line 3c	The organization uses a sliding fee scale for persons over 100% of the poverty guideline. There is no family income limit (though had to put a % in box on line 3 of 1000%) sliding fee scale is based on number of persons in household, % above FPG and then % off gross charges is determined by % over FPG as follows: 90% off 101-125% FPG, 80% off 126-150% FPG, 45% off 151-200% FPG, 40% off 201-250% FPG, and 30% off 251% + above FPG.
SchH_P01_S00_L07	Schedule H, Part I, Line 7	Used ratio of cost to charge calculation for lines 7a, 7b and 7g and used actual costs on lines 7e, 7f and 7i.
SchH_P01_S00_L072f	Schedule H, Part I, Line 7, Column f	$2,132,412 amount of bad debt expense that was included in Form 990, Part IX, line 25, Column (A), but removed for this figure for purposes of calculating the percentage in Schedule H, Part I, Line 7, column (f).
SchH_P01_S00_L07g	Schedule H, Part I, Line 7g	No physician amounts were included.
SchH_P02_S00_L00	Schedule H, Part II	Schuyler Hospital, the county's largest employer of over 350 people, supports and promotes the community it operates in. The Hospital extends use of its facilities for health care related meetings of any type, along with other community meets and events. It hosts blood draws each year, annually sends employees to Leadership Schuyler, provides a local credit union with space within the facility for no rent to provide its employees easier access to banking due to its rural location, and is a disaster preparedness hub for the county. Its employees volunteered over 550 hours to support community events this year. Schuyler actively works with the County Depart of Health and the Schuyler Health foundation to enrich the healthcare of the population it serves.
SchH_P03_S0A_L04	Schedule H, Part III, Section A, Line 4	Schuyler estimates the amount to be recognized in the consolidated financial statements for doubtful accounts by analyzing patient and resident accounts for collectability and applying historically established percentages for self-pay and various third-party payers to the aging categories in the accounts receivable aging and reviewing specific outstanding balances. Accounts for which no payments have been received for a significant amount of time are considered delinquent and the account is written-off when customary collection efforts are exhausted. See page 8 of Consolidated Audited Financial Statements. The hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than their established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The amount of charges foregone for services and supplies furnished under the Hospital's charity care policy aggregated approximately $633,438 and $704,320 in 2012 and 2011, respectively. As part of its charitable mission, the Hospital provides care through its emergency department without regard to payment. It ensures that an emergency admission or treatment is not delayed or denied pending determination of coverage. Also, revenue generated from patients who participate in the Medicaid program are subject to substantial discounts that result in reimbursement for services rendered below costs of providing such services. In order for patients to meet the guidelines for the Medicaid program, various income-based criteria must be met that validate the patients' inability to pay for services and ineligibility under other programs. Line 2 - Costing methodology used in determining the "cost" of bad debt was the actual bad debt expense times the Ratio of Cost to Charge for the 2012 Medicare cost Report. Line 3 - Cost methodology used in determining the cost of bad debt attributable to patients eligible under the hospital charity care policy was that about 85% of our bad debt is self pay uninsured and underinsured, of which our charity care policy at a minimum will cover 30% of charges no matter what income is. Many patients who are unable to pay for their; medical services would likely qualify for charity care if they completed the financial assistance application. Care for those patients, written off as bad debt expense, should therefore qualify as a community benefit. These patients are often part of the underserved communities, included seniors and medical indigents. See page 13 of Consolidated Audited Financial Statements.
SchH_P03_S0B_L08	Schedule H, Part III, Section B, Line 8	The Medicare shortfall of uncompensated care should be included as a community benefit due to the rural demographic area in which the hospital is located, as it consists of a high Medicare/Medicaid (dual eligible) payer mix. Medicare is the Hospital's largest payer, consisting of 37% of our patients. Due to accessibility and transportation, (which is why we are a critical access hospital), it is easier for community member to come to the hospital for services that it is for them to travel 25 miles or more on rural roads to access care at other facilities. The costing methodology to determine Medicare allowable costs of care relating to payments on line 5 was the ratio of cost from the 2012 Medicare cost report from charges from our system on gross Medicare charges for dates of service 01/01/2012 to 12/31/2012.
SchH_P03_S0C_L09b	Schedule H, Part III, Section C, Line 9b	The policy does not specifically contain a provision on the collection practices to be followed for patients who are known to qualify for charity care of financial assistance, however the hospital's financial counselors do not send an account to collection if they are aware that the patient qualifies for charity care or financial assistance, as they are also the persons responsible for the charity care or financial assistance processes.
SchH_P05_S0B_L05	Schedule H, Part V, Section B, Line 5	Schuyler also filed Community Health Needs Assessment with NYS DOH, as the Annual Required Community Service Plan.
SchH_P05_S0B_L20	Schedule H, Part V, Section B, Line 20	The hospital facility used Finanical Assistance sliding scale rates, which when averaged together are below the average of the three lowest commercial rates.
SchH_P06_S00_L02	Schedule H, Part VI, Line 2	The Mobilizing for Action through Planning and Partnership process was used to conduct a comparable Community Health Assessment and included four major components. The first assessment examined the Community Health Status Indicators. Two methods were used to examine indictors. The first was to collect relevant statistical data using the HIN and a variety of other secondary sources. This was completed by the S2AY Network Contract staff and data collected and analyzed by the Finger Lakes Health Systems Agency. The second method was to collect primary data by conducting a comprehensive survey amount a random sample of community residents to determine their opinions, health-related behaviors and health needs. A total of 231 completed surveys were returned in Schuyler County. Surveys were conducted electronically through a Survey Monkey link, along with paper copies which were distributed to the public through employers, health education and human service agencies and through other community groups. The survey was designed to encompass questions in the ten Prevention Agenda areas that the NYS Dept of Health identified as high priority issues. Results of the Health Priorities Survey and reports were then combined with additional statistical data and information regarding community resources to develop the Community Health Assessment. The second assessment evaluated the effectiveness of the Public Health System and the role of the Public Health Dept within that system. This was done using a modification of the Local Public Health System Assessment tool developed by CDC and NACCHO, and was also conducted via Survey Monkey. A diverse group of key informants were chosen to complete the survey including community leaders who are familiar in some way with the local public health system. Each of the ten essential public health services was ranked by the group to determine areas of strength and areas needing improvement within the Local Public Health System. The third assessment was the Community Themes and Strengths Assessment that was conducted through Focus Group meetings throughout the County. This assessment looked at the issues that affect the quality of life among community residents and the assets the County has available to address health needs. A number of focus groups were held, with locations/audiences including: bone Builders-Catherine Court Senior Housing, Fireman/First Responders-Valois-Logan-Hector Fire Station, Catholic Charities Youth Group - Schuyler County Teen Center, ARC Self Advocates Group - ARC of Schuyler and Schuyler Hospital healthcare Providers-Schuyler Hospital. On-line surveys were available on the Public Health and Schuyler Hospital websites. They were also emailed to all county employees, physicians and county agencies. Notices, posters and postcards were distributed to banks, the Hospital and county buildings, Office for the Aging Nutrition sites, post offices, schools, town and village offices, medical offices, the medical reserve corps, WIC, Dept of Social Services, Head Start, Cooperative Extension, Families First and P&C Foods. Public service announcements were also sent to the local medical, Members of the Community Assessment Planning committee were notified and asked to participate in the committee by email and phone, and met monthly to develop the plan. The fourth assessment was also conducted through Focus Group meetings and looked at the "Forces of Change" that are at work locally, statewide and nationally, and what types of threats/opportunities are created by these changes. The five Focus Groups conducted in Schuyler County included a youth group, a group of human service agency representatives, a group of senior citizens, a rural Fire Dept, and the ARC of Schuyler County. These groups were chosen to ensure that adequate representation of the public was included in the CHA. When the assessment process was completed, the Network Consultants combined and analyzed the results of the assessments, and prepared a list of the issues that had either been identified through more than one assessment as a top issue OR that were identified in one of the assessments as a major issue. Once these results were tallied, a finalized list of the top issues from all components of the assessment process was compiled, and the data was presented at a meeting of community representatives including the Hospital, Public Health staff and staff of a variety of health and human service agencies. They were charged with ranking the priorities and decided to keep four priorities, because the issues within the areas were so inter-related. Specifically targeted groups include the low-income, uninsured, especially for access to care and chronic disease prevention efforts. These groups are at especially high risk for chronic disease such as cancer. Schuyler County Public Health will work with the S2AY Rural Health Network and other community partners to implement the Local Health Dept Communities Capacity Building Initiative to make a strong start on obesity reduction to improve access to care by supplementing current efforts to improve enrollment in health insurance, especially public health insurance products for which residents may be eligible in the County. The plan's 4 actions items became: 1. Access to Healthcare - Includes physical and dental, preventative care, transportation insurance, poverty, and cultural issues. To construct and initiate a plan that provides for comprehensive diabetes prevention, case management and education. Develop basic community multidisciplinary focus groups to include Schuyler Hospital, Schuyler County Public Health, and other pertinent community organizations to plan and effect change in developing a comprehensive diabetic prevention, case management and education program. Involve physician champion and target diabetic educator from the hospital to train and certify as the Certified Diabetic Educator for the hospital and the Community; 2. Mental Health & Substance Abuse - Includes behavioral issues with children age 12 and under, substance and alcohol abuse for teens through seniors, and the need to break through barriers to assist senior citizens with mental health issues (i.e., depression, anxiety). To identify those within the geriatric population (>65 y/o) whose depression and anxiety interferes with their activities of daily living and provide alternate strategies. Develop basic community multidisciplinary focus groups to include Schuyler Hospital, Schuyler County Public Health, and other pertinent community organizations to plan and effect change in identifying the geriatric population whose depression and anxiety interferes with their activities of daily living, and provide alternative strategies. Multi-community groups met and decided to establish mechanisms to target the depressed over 65 and develop plans to institute change. Involvement will include Family physicians and clinics, mental health specialists, Community mental health, Schuyler Hospital and Office of the Aging. 3. Healthy Moms & Children - Includes teen pregnancy, low birth rate, working poor, poor family conditions, early intervention, and lead screening. To indentify and implement interventions that would assist families with young children to enhance their family experience. Develop basic community multidisciplinary focus groups to include Schuyler Hospital, Schuyler County Public Health and other pertinent community organizations to plan to identify and implement interventions. Multi-community groups meet and agreed upon various needs of families with young children. Parenting skills were identified as a need and a team will be developed to identify ways to effect change and offer resources. 4. Physical Activity & Nutrition - Includes obesity, diabetes, increasing physical activity and healthier eating, increased breast-feeding. To apply the Healthy Communities Capacity Building Initiative grant for community-based planning and to use that information as a foundation for the recommendation of policy-based change. Identify two individuals to go to training for the focus of organizing/developing community organizations with the focus of decreasing obesity in Schuyler County's identified service area. A member of social service from the community and one from Schuyler Hospital began training in 2009 under the Healthy Communities Capacity Building Initiative grant.
SchH_P06_S00_L03	Schedule H, Part VI, Line 3	Schuyler Hospital recognizes the needs in our community to provide financial counseling and assistance to those patients with limited income, no insurance, or high deductible insurance plans, who find it difficult to meet the expenses incurred in receiving health care services. The hospital has successfully been administering its financial aid policies and procedures for reducing charges otherwise applicable to low-income individuals without health insurance, or who have exhausted their health insurance benefits, and who can demonstrate an inability to pay full charges. Our Financial Assistance and Charity Program Policy defines the Financial Assistance Program and establishes the necessary criteria, guidelines and approval process for the provision of financial assistance and Sliding Fee Scale to eligible individuals to help ease the burden of the costs of health care services provided. Therefore, Schuyler Hospital updated its financial assistance program in 2007, and then again in 2010. In 2010 we established a self pay task force to review our policies and followup on any issues that arose from such financial aid policies and procedures. Currently, the monthly Revenue Cycle meetings handle any issues that may arise. We have a prompt pay discount for any payments from an individual, which is good for all balances except co-pays. Also, Schuyler Hospital has been able to discount co-pays and deductible payments from those individuals who can demonstrate an inability to pay such amounts. All patients who are self pay or have large self pay balances are proactively given information regarding our charity care program and our sliding scale program, which is administered using the federal poverty guidelines. The hospital employs two full time financial counselors, who are located by the Admissions Department in the Emergency Room of the Hospital from 7:30am to 4:30pm Monday through Friday, who make it their mission to reach out to those in need and help find a way to fund their health services needs. Schuyler Hospital has also worked to provide monthly on-site facilitated enrollment for Medicaid and Child Health Plus and Family Health Plus programs. A large challenge Schuyler Hospital faces is actually getting people to apply for the program. It is a challenge to get the paperwork filled out and have patients who may be eligible under our financial aid policies and procedures to complete the application requirements and necessary documentation. The application process has been simplified in an attempt to make it easier for those in need to get the assistance they so desperately need. However, it continues to be a barrier to the success of the program. Also, it has been challenging ensuring that we have disseminated the information about the many policies we have that can be taken advantage of by patients. But the largest challenge has been the financial burden of such programs; reduced reimbursement for quality services provided additional overhead costs and additional time/resources. Schuyler Hospital provides emergency care and medically necessary Essential Health Services without regard to a patient's source of payment.
SchH_P06_S00_L04	Schedule H, Part VI, Line 4	Schuyler Hospital, Inc, located in Montour Falls, Schuyler County, is situated in rural upstate New York in the heart of the Finger Lakes, and is the only hospital in Schuyler County, a Federally Designated Medically Underserved Population and a Health Professional Shortage Area. Schuyler Hospital, established in 1920, is a 25-bed Critical Access Hospital that provides acute, ambulatory and long-term care services in Primary and Secondary Service areas with a population of 32,000. This rural population includes Schuyler County residents and the rural residents of adjoining Chemung, Steuben, Tompkins, Seneca and Yates counties. Additionally, Schuyler Hospital is the resource for medical services to over 1.5 million tourists who visit Schuyler County and the surrounding area each year. Schuyler County itself is the second smallest county in NYS and a rural county with a declining population. The 2012 census revealed population holding steady with a minimal growth of less than 1% (0.9%), to a total of 18,514 residents. Schuyler County is largely a "bedroom" community, with residents traveling a mean average of 25.5 minutes to/from their workplace. With that said, due to the county's rural nature, transportation to and from remote areas of the county is a challenge. In 2010, the county began operating its first public transit system, which reaches into the more populated villages of the county. Our service area also encompasses a large Amish and Mennonite population. Median household income is $47,804 (under the NYS median income of $56,951) and 9.0% of the county's population lives below the poverty level. The county's current rate of unemployment as of December 2012 is 9.3%. 30% of Schuyler Hospital patients are on Medicaid. Also, 10% of Schuyler Hospital patients are uninsured and another 15% are under insured. While Schuyler Hospital's main campus is located in Montour Falls, Schuyler has evolved over the years into a network of providers, programs, and services that reaches throughout Schuyler County and into southern Yates and Seneca Counties. For the purpose of the Community Service Plan, Schuyler Hospital and Schuyler County Public Health consider Schuyler County to be the Primary Service Area - encompassing the towns of Montour, Reading, Dix, Orange, Hector, Cayuta, Catherine and Tyrone; as well as the villages of Montour Falls, Burdett, Odessa and Watkins Glen. Schuyler County has a population of 18,514 within 328 square miles. This underserved rural population experiences significant social, economic and health issues. For nearly 100 years, Schuyler Hospital has provided basic and emergency care to the people of this community. As the county's largest employer, it is a large economic generator - over $57 million last year - due to jobs, purchasing, and taxes. Schuyler Hospital is accredited by The Joint Commission (formerly JCAHO). The medical staff includes physicians, specializing in internal medicine, family practice, gynecology, surgery, orthopedics and sports medicine, pathology, critical care, pain management, sleep disorders, colon-rectal and anesthesiology. The hospital offers a wide array of services - including 24 hour ER, ICU, maternity, and Imaging department (MRI, CT, Ultrasound, X-ray, Mammo, bone density testing). Extensive physical, occupational, respiratory and speech therapy programs, as well as pulmonary testing are offered. The primary care and family health centers in Montour Falls and Ovid provide pediatric, adolescent, prenatal, and adult health and wellness care. Seneca View, our 120 bed skilled nursing facility, located in the hospital offering inpatient services that include physical, speech and occupational rehabilitation. Schuyler Hospital was officially recognized as a Critical Access Hospital (CAH) in 2005. CAH's must be located in a rural area and meet one of the following criteria: over 35 mile distance to another hospital, or 15 miles from another hospital in mountainous terrain or areas with only secondary roads.
SchH_P06_S00_L05	Schedule H, Part VI, Line 5	Schuyler Hospital, Inc. is proud to provide care to our community. Our doors are open 24 hours a day, seven days a week, 365 days a year. Every year, we serve thousands of individuals and keep our community healthy, strong, and vibrant. This record of service is, and always will be, our most valuable contribution to the community. Additionally, Schuyler Hospital, being the largest employer in the county, is seeking to have a positive impact in the region, promote area development and hopefully also advance economic development, for which there is a documented need. The people of Appalachia must have adequate healthcare to promote socially and economically competitive communities, and Schuyler Hospital helps fulfill this need. It has been especially difficult to deliver services to remote rural regions due to the closing of independent community hospitals and/or some of the services they provide. Schuyler Hospital does not plan on being one of them and has continued to morph its vision and strategic plan to survive and continue to move forward, especially during difficult financial and economic times, to remain a pillar of strength in the community. In general, health-care and the delivery of medical services to patients, as well as the underlying operations to support patient services, have become increasingly dependent upon technology - especially communications and information technology.
SchH_P06_S00_L06	Schedule H, Part VI, Line 6	N/A
SchH_P06_S00_L07	Schedule H, Part VI, Line 7	New York

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Form990 Of Other Organizations	X	Form990OfOtherOrganizations
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	0	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Andrew Manzer
CEO AND PRESIDENT	166360	0	22800	0	0	0	1393	0	30687	0	221240	0	0	0
Michael Eisman MD
Medical Director / Internal Medicine	190248	0	0	0	0	0	10500	0	40252	0	241000	0	0	0
Jann Marks
CHIEF NURSING OFFICER	167393	0	0	0	0	0	1650	0	39814	0	208857	0	0	0
Benjamin Saks
Board Member and Physician	206529	0	0	0	0	0	9260	0	41179	0	256968	0	0	0
Ashraf Sabahat MD
Anesthesiologist	323833	0	0	0	0	0	22754	0	48821	0	395408	0	0	0
Jagmohan Singh MD
Internal Medicine Physician	229952	0	80189	0	0	0	15316	0	47837	0	373294	0	0	0
William Saks
GYN Physician	195230	0	0	0	0	0	2023	0	54142	0	251395	0	0
Zarmina Aman
OB/GYN Physician	180218	0	0	0	0	0	1875	0	46512	0	228605	0	0	0
Tariq Hussain MD
Orthopedic Surgeon	183034	0	0	0	0	0	4258	0	31624	0	218916	0	0

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
Welliver McGuire Inc
Lorraine Welliver - Former Board Member is part owner; not related to work as a board member	71412	Construction Services	0
Zahid Asgher MD
Board Member	64689	Payment for services as Medical Director of Lab, not related to work as board memeber	0
Blanche Borzell
Ex-officio Board Member with vote	21650	Provided family practice locum coverage to hospital, not related to services as board member.	0
Joseph Hinterberger
Board Member	19900	Provides family practice locum coverage to hospital, not related to service on hospital board.	0
Suzzane Blowers
Board Member	0	Board member of hospital affiliate, Schuyler Health Foundation	0
Jerry Mickelson
Board Treasurer	0	Board member of hospital affiliate - Schuyler Health Foundation	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
F990_P06_S0B_L11b	Form 990, Part VI, Section B, Line 11b	The hospital Controller prepares the annual form 990 (with oversight from CFO) and CFO distributes to the Board of Directors and member of the Hospital Executive Team for review, comment, and questions prior to filing with IRS.
F990_P06_S0B_L12c	Form 990, Part VI, Section B, Line 12c	The hospital has a written conflict of interest policy. Each board member reviews annually and signs the corresponding conflict of interest statement. In addition, as new members are inducted, they read the policy and sign the conflict of interest statement.
F990_P06_S0B_L15	Form 990, Part VI, Section B, Line 15	The executive compensation policy involves an annual survey of wages for the CEO, CFO, and CNO/COO, compared to the market using the Healthcare Associated of New York State Wage survey, Integrated Healthcare Strategies and Yaffe & Company, Inc. Due to constraints of the economy, these positions' compensation many not be adjusted annually. In addition, the Medical Director's salary is compared to the MGMA data at the contract renewal date. Any changes in executive compensation are approved by the Executive Committee or the Board of directors.
F990_P06_S0C_L19	Form 990, Part VI, Section C, Line 19	Upon request, appropriate schedules of the annual financial statements, IRS Form 990 and conflict of interest forms can be released to the public. The forms are housed in the executive office of the CEO and are available at a minimum copying fee.
F990_P11_S00_L09	Form 990, Part XI, Line 9	$8,128,179 consists of the following: $481,238 difference of actual cash received/reported on Statement of Revenues and required accrual reporting by GAPP. Remainder is made up of $1,106,629 in Net Assets released from restriction and used for the purchase of property and equipment; $291,506 change in Pension obligation; $114,062 change in beneficial interest in Schuyler Health Foundation; $6,060,160 net change in Temporarily Restricted Contributions and Grants income (for difference of current year cash vs. GAPP fund accounting in the ledger of receivable); and $74,585 change in permanently restricted Net Assets. (See page 30 of Audited Financial Statements).

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	Schuyler Health Foundation Inc	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	PO Box 828	AddressLine1
City	Montour Falls	City
State	NY	State
ZIP Code	14865	ZIPCode

Field	Value	IRS element (for citing)
EIN	222890619	EIN
Primary Activities	To raise funds to support the mission of Schuyler Hosptial	PrimaryActivities
Legal Domicile State	NY	LegalDomicileState
Exempt Code Section	501(c)(3)	ExemptCodeSection
Public Charity Status	7	PublicCharityStatus
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Controlled Org	0	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	1	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	0	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	1	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	0	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
Schuyler Health Foundation Inc
c	176724	Schuyler Health Foundation holds an annual capital fund raising campaign to benefit Schuyler Hospital. Each year those funds are released to Schuyler Hospital as the purpose of the funds is met. In 2012, Schuyler Health Foundation transferred $169,390 to update the existing Skilled Nursing Facility; $7,334 was transferred for the purpose of technology, activities equipment and car seat purchases.
Schuyler Health Foundation Inc
e	0	Schuyler Hospital has a $1M line of credit with Elmira Savings Bank which is secured by investments owned by Schuyler Health Foundation.
Schuyler Health Foundation Inc
q	67545	Schuyler Health Foundation reimburses Schuyler Hospital for expenses paid on their behalf. These expenses include the, employee benefits, utilization of space, and associated costs of office space and a copier/scanner/fax, supplies, and audit fees. Expenses are reconciled and reimbursed on a monthly basis.
Schuyler Health Foundation Inc
o	44416	Schuyler Hospital reports and processes wages for the two employees who carry out the Foundation responsibilities. The Schuyler Health Foundation reimburses the hospital for part of these wages.

Reasonable Cause Explanation ReasonableCauseExplanation

Field	Value	IRS element (for citing)
Explanation	In order to ensure that data submitted is accurate and correct for the end user and to have the Audited Financial Statements, the organization was unable to complete by May 15, 2013. Extensions were filed timely and extensions granted by IRS to extend filing date to November 15, 2013.	Explanation