HUDSON HEADWATERS HEALTH NETWORK: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- HUDSON HEADWATERS HEALTH NETWORK (EIN 14-1628237)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-07
- IRS object ID
- 201313119349300206
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-07T08:04:26-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 221478099 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COHNREZNICK LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1212 6TH AVENUE | AddressLine1 |
| City | NEW YORK | City |
| State | NY | State |
| ZIP Code | 10036 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141628237 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUDSON HEADWATERS HEALTH NETWORK INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HUDS | NameControl |
| Phone | 5187610300 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9 CAREY ROAD | AddressLine1 |
| City | QUEENSBURY | City |
| State | NY | State |
| ZIP Code | 12804 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DR JOHN RUGGE | Name |
| Title | CEO | Title |
| Phone | 5187610300 | Phone |
| Date Signed | 2013-11-04 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THOMAS LANNING | Name |
| PTIN | P00851654 | PTIN |
| Phone | 2122970400 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DR JOHN RUGGE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9 CAREY ROAD | AddressLine1 |
| City | QUEENSBURY | City |
| State | NY | State |
| ZIP Code | 12804 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 54300383 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.HHHN.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1981 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | FQHC - OUR MISSION IS TO PROVIDE THE BEST HEALTH CARE AND ACCESS TO THAT CARE FOR EVERYONE IN OUR COMMUNITIES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 17 | NbrIndependentVotingMembers |
| Total Nbr Employees | 704 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 1009416 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 12066041 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 7548405 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 35290892 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 45267011 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 17165 | InvestmentIncomePriorYear |
| Investment Income Current Year | 13512 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1533769 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1471455 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 48907867 | TotalRevenuePriorYear |
| Total Revenue Current Year | 54300383 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 791809 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 28496050 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 33708583 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 16555814 | OtherExpensePriorYear |
| Other Expenses Current Year | 16776057 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 45051864 | TotalExpensesPriorYear |
| Total Expenses Current Year | 51276449 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3856003 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3023934 | RevenuesLessExpensesCY |
| Total Assets BOY | 25872941 | TotalAssetsBOY |
| Total Assets EOY | 27101441 | TotalAssetsEOY |
| Total Liabilities BOY | 12396058 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 10600624 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 13476883 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 16500817 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | WE ARE A COMMUNITY BASED HEALTH CLINIC WHICH SERVICED 281,390 PATIENTS IN 2012. TO FURTHER THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES TO THE GENERAL POPULATION OF WARREN, WASHINGTON, SARATOGA, HAMILTON AND ESSEX COUNTIES. TO PROMOTE, SPONSOR, FOSTER AND DELIVER PROGRAMS, ACTIVITIES AND SERVICES WHICH SHALL HAVE THE PURPOSE OF IMPROVING THE HEALTH AND WELL-BEING OF THE POPULATION SERVED BY THIS CORPORATION AND TO CONTINUALLY SEEK NEW AND INNOVATIVE METHODS OF IMPROVING HEALTH CARE DELIVERY AND ITS FINANCING TO THE COMMUNITY SERVED. TO CARRY OUT ANY EDUCATION AND TEACHING ACTIVITIES RELATED TO RENDERING HEALTH CARE OR TO THE PROMOTION OF HEALTH THAT IN THE OPINION OF THE BOARD OF DIRECTORS MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS OR OTHER RESOURCES THAT ARE FOR, OR CAN BE, MADE | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 42031523 | Expense |
| Grants | 791809 | Grants |
| Revenue | 45531448 | Revenue |
| Description | THE CENTER IS A COMMUNITY BASED HEALTH CLINIC WITH MULTIPLE LOCATIONS.IN 2012 WE SERVICED 281,390 PATIENT VISITS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3827190 | Expense |
| Description | 340B PHARMACY PROGRAM - AS A FEDERALLY QUALIFIED HEALTH CENTER WE ARE ABLE TO ACQUIRE DRUGS AS THE LOWER PRICES MANDATED BY THE FEDERAL 340B DRUG PURCHASING PROGRAM, THIS ALLOWS US TO ASSIST INDIGENT PATIENTS WITH THE SOMETIME OVERWHELMING COSTS OF PRESCRIPTION MEDICATIONS, FACILITATE THE HUDSON HEADWATERS HEALTH NETWORK PATIENT ASSISTANCE PROGRAM WHICH ENABLES NEEDY PATIENTS TO RECEIVE MEDICATIONS FREE OF CHARGE FROM THE DRUG MANUFACTURERS, AND GENERATE REVENUE TO SUPPORT HHHN'S OVERALL OPERATIONAL VIABILITY. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 45858713 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | 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 | 0 | 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 | 0 | Hospital |
| Grants To Organizations | 1 | 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 | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | 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 | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 74 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 704 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 17 | 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
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMY GERSTEN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5187610300 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9 CAREY ROAD | AddressLine1 |
| City | QUEENSBURY | City |
| State | NY | State |
| ZIP Code | 12804 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (38 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| BARBARA ORTON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| BARBARA SWEET | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DANA HOGAN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| EILEEN HAYNES | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| EUGENE ARSENAULT | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| GRAHAM GREELEY | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X | |
| HARRY ROBINSON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| IKE WOLGIN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JEAN CRONIN | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| JOSEPH KELLY | |||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | X | |
| MICHAEL MCCARTHY | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| MILDRED ANZALONE | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| PATRICIA HARRISON | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| PATRICIA HUNT | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| PAUL D RICE ED | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| RANDOLPH RAPPLE | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| SHARON CALLAHAN | |||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X | |
| THERESA TREADWAY LLOYD | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| THOMAS GOODROW | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| THOMAS LYONS | |||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| THOMAS ROSS | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | |
| WILLIAM O'DWYER | |||||||
| CHAIR | 1.00 | X | 0 | 0 | 0 | X | |
| CHRISTOPHER TOURNIER | |||||||
| CFO | 40.00 | 174268 | 0 | 24415 | X | ||
| CYNTHIA REYNOLDS | |||||||
| VICE PRESIDENT | 40.00 | 119338 | 0 | 22031 | X | ||
| DANIEL LARSON MD | |||||||
| CMO | 40.00 | 216128 | 0 | 29537 | X | ||
| DEBORAH BARDIN | |||||||
| VICE PRESIDENT | 40.00 | 117343 | 0 | 14475 | X | ||
| EDWARD SHANNON | |||||||
| CDO | 40.00 | 181306 | 0 | 28661 | X | ||
| GEORGE PURDUE | |||||||
| CAO | 40.00 | 227652 | 0 | 28644 | X | ||
| JOHN RUGGE | |||||||
| CEO | 40.00 | 484900 | 0 | 34268 | X | ||
| JOHN SAWYER | |||||||
| CMO | 40.00 | 223090 | 0 | 29109 | X | ||
| LORI GRAVELLE | |||||||
| CCO | 40.00 | 63957 | 0 | 15105 | X | ||
| MARLENE BURNLEY | |||||||
| VICE PRESIDENT | 40.00 | 98727 | 0 | 19005 | X | ||
| PAUL BACHMAN | |||||||
| CMO | 40.00 | 212547 | 0 | 28766 | X | ||
| BRIAN MCDERMOTT | |||||||
| PHYSICIAN | 40.00 | 313844 | 0 | 13898 | X | ||
| DANIEL WAY | |||||||
| PHYSICIAN | 40.00 | 208930 | 0 | 26963 | X | ||
| MICHAEL ADAMS | |||||||
| PHYSICIAN | 40.00 | 203458 | 0 | 27320 | X | ||
| TODD WALDORF | |||||||
| PHYSICIAN | 40.00 | 237385 | 0 | 29904 | X | ||
| WILLIAM BORGOS | |||||||
| PHYSICIAN | 40.00 | 210878 | 0 | 28366 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3293751 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 400467 | TotalOtherCompensation |
| Number Individuals GT100 K | 14 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| RICHARD E JONES ASSOCIATES | |||||
| 339 AVIATION RD | QUEENSBURY | NY | 12804 | ARCHIECTURAL SERVICES | 335492 |
| GLENS FALLS OBGYN | |||||
| 28 S WESTERN AVE | GLENS FALLS | NY | 12801 | MEDICAL SERVICES | 150057 |
| COHNREZNICK LLP | |||||
| 1212 AVENUE OF AMERICAS | NEW YORK | NY | 10036 | ACCOUNTING SERVICES | 142351 |
| FRANCIS AND EILLEN COLLINS | |||||
| PO BOX 64 | GLENS FALLS | NY | 12801 | RENT | 125960 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Related Organizations | 54951 | RelatedOrganizations |
| Government Grants | 5581773 | GovernmentGrants |
| All Other Contributions | 1911681 | AllOtherContributions |
| Total Contributions | 7548405 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| OTHER THIRD-PARTY PAYORS | 621400 | 22224685 | 22224685 |
| MEDICARE | 621400 | 8346145 | 8346145 |
| SELF-PAY | 621400 | 5817216 | 5817216 |
| MEDICAID MANAGED CARE | 621400 | 3027765 | 3027765 |
| MEDICAID | 621400 | 3022442 | 3022442 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2828758 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2828758 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 45267011 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13512 | TotalRevenueColumn |
| Exclusion | $13,512 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 194944 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 194944 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 194944 | TotalRevenueColumn |
| Unrelated Business Revenue | 111657 | UnrelatedBusinessRevenue |
| Exclusion | $83,287 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| 403B CONSULTING | 541610 | 897759 | 897759 | |
| MEANINGFUL USE | 621400 | 264437 | 264437 | |
| ESCIBE REVENUE | 621400 | 67269 | 67269 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 47046 | TotalRevenueColumn |
| Related Or Exempt Function Income | 47046 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1276511 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 54300383 | TotalRevenueColumn |
| Related Or Exempt Function Income | 45645763 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1009416 | UnrelatedBusinessRevenue |
| Exclusion | $96,799 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 791809 | Total |
| Program Services | 791809 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2393273 | Total |
| Program Services | 2152751 | ProgramServices |
| Management And General | 240522 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25200476 | Total |
| Program Services | 22667848 | ProgramServices |
| Management And General | 2532628 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 847860 | Total |
| Program Services | 762651 | ProgramServices |
| Management And General | 85209 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3314929 | Total |
| Program Services | 2981783 | ProgramServices |
| Management And General | 333146 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1952045 | Total |
| Program Services | 1755867 | ProgramServices |
| Management And General | 196178 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 96702 | Total |
| Management And General | 96702 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71694 | Total |
| Management And General | 71694 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59592 | Total |
| Management And General | 59592 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4441019 | Total |
| Program Services | 4398631 | ProgramServices |
| Management And General | 42388 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 145709 | Total |
| Program Services | 117942 | ProgramServices |
| Management And General | 27767 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1231854 | Total |
| Program Services | 939500 | ProgramServices |
| Management And General | 292354 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 547503 | Total |
| Program Services | 481350 | ProgramServices |
| Management And General | 66153 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 862578 | Total |
| Program Services | 711118 | ProgramServices |
| Management And General | 151460 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 285169 | Total |
| Program Services | 205349 | ProgramServices |
| Management And General | 79820 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 84720 | Total |
| Program Services | 61006 | ProgramServices |
| Management And General | 23714 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 216448 | Total |
| Program Services | 50662 | ProgramServices |
| Management And General | 165786 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1463088 | Total |
| Program Services | 1205366 | ProgramServices |
| Management And General | 257722 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 200523 | Total |
| Program Services | 91849 | ProgramServices |
| Management And General | 108674 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 3768142 | 3457037 | 311105 |
| PROVISION FOR BAD DEBT | 1981243 | 1981243 | |
| REPAIRS AND MAINTENANCE | 573807 | 476503 | 97304 |
| DUES AND SUBSCRIPTIONS | 272964 | 177667 | 95297 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 473302 | Total |
| Program Services | 390781 | ProgramServices |
| Management And General | 82521 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51276449 | Total |
| Program Services | 45858713 | ProgramServices |
| Management And General | 5417736 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 459224 | BOY |
| EOY | 584527 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2501471 | BOY |
| EOY | 1228674 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 945866 | BOY |
| EOY | 1265698 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4873228 | BOY |
| EOY | 6650080 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 350000 | BOY |
| EOY | 350000 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1494894 | BOY |
| EOY | 941026 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 21175710 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 6890972 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13957468 | BOY |
| EOY | 14284738 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 300000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1290790 | BOY |
| EOY | 1496698 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25872941 | BOY |
| EOY | 27101441 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5299050 | BOY |
| EOY | 5585751 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4415180 | BOY |
| EOY | 2414025 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2681828 | BOY |
| EOY | 2600848 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12396058 | BOY |
| EOY | 10600624 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13476883 | BOY |
| EOY | 16500817 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13476883 | BOY |
| EOY | 16500817 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25872941 | BOY |
| EOY | 27101441 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 3023934 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| 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 | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1809928 | OtherCostOrOtherBasis |
| Book Value | 1809928 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9844669 | OtherCostOrOtherBasis |
| Depreciation | 1479295 | Depreciation |
| Book Value | 8365374 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3869590 | OtherCostOrOtherBasis |
| Depreciation | 1807985 | Depreciation |
| Book Value | 2061605 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2473923 | OtherCostOrOtherBasis |
| Depreciation | 1574770 | Depreciation |
| Book Value | 899153 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3177600 | OtherCostOrOtherBasis |
| Depreciation | 2028922 | Depreciation |
| Book Value | 1148678 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 14284738 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DEFERRED COMPENSATION ASSET | Description |
| Book Value | 1496698 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1496698 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DEFERRED COMPENSATION PAYABLE | $1,496,698 |
| DUE TO NEW YORK STATE DEPARTMENT OF HEALTH MEDICAID | $1,104,150 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2600848 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 53053090 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 371029 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | -1618322 | OtherRevenues |
| Revenue Not Rptd F990 | -1247293 | RevenueNotRptdF990 |
| Revenue Subtotal | 54300383 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 54300383 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 49852277 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 371029 | DonatedServicesUseOfFacilities |
| Other Expenses Included | 186042 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 557071 | ExpensesNotRptdF990 |
| Expenses Subtotal | 49295206 | ExpensesSubtotal |
| Other Expenses Not Included | 1981243 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1981243 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 51276449 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE COMPANY IS INCORPORATED AS NOT-FOR-PROFIT CORPORATIONS UNDER THE LAWS OF THE STATE OF NEW YORK AND ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AS WELL AS FROM STATE INCOME TAXES. THEREFORE, THERE IS NO PROVISION FOR INCOME TAXES. THE COMPANY HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2012. THE COMPANY'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2009 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RELATED PARTIES REVENUE 431,132. INTERCOMPANY ELIMINATION -68,211. BAD DEBT EXPENSE -1,981,243. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RELATED PARTIES EXPENSES 254,253. INTERCOMPANY ELIMINATION -68,211. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 1,981,243. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADIRONDACK HEALTH INSTITUTE INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9 CAREY ROAD | AddressLine1 |
| City | QUEENSBURY | City |
| State | NY | State |
| ZIP Code | 12804 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 141698269 | EINOfRecipient |
| IRC Section | 501(C)(3) | IRCSection |
| Amount Of Cash Grant | 791809 | AmountOfCashGrant |
| Purpose Of Grant | THE GRANT WAS GIVEN FOR THE HEAL 10 PROGRAM. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: THE GRANT WAS GIVEN TO AN ORGANIZATION THAT SHARES BOARD MEMBERS WITH HUDSON HEADWATERS HEALTH NETWORK. THE BOARD MEMBERS ARE ABLE TO MONITOR AND REPORT BACK TO HHHN'S BOARD THAT THE FUNDS ARE BEING USED PROPERLY. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| 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 (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHRISTOPHER TOURNIER | ||||||||||||||
| CFO | 128830 | 0 | 45099 | 0 | 339 | 0 | 6705 | 0 | 17710 | 0 | 198683 | 0 | 0 | 0 |
| DANIEL LARSON MD | ||||||||||||||
| CMO | 201566 | 0 | 9597 | 0 | 4965 | 0 | 10647 | 0 | 18890 | 0 | 245665 | 0 | 0 | 0 |
| EDWARD SHANNON | ||||||||||||||
| CDO | 131401 | 0 | 48877 | 0 | 1028 | 0 | 7260 | 0 | 21401 | 0 | 209967 | 0 | 0 | 0 |
| GEORGE PURDUE | ||||||||||||||
| CAO | 148863 | 0 | 78129 | 0 | 660 | 0 | 9889 | 0 | 18755 | 0 | 256296 | 0 | 0 | 0 |
| JOHN RUGGE | ||||||||||||||
| CEO | 350503 | 0 | 125700 | 0 | 8697 | 0 | 13960 | 0 | 20308 | 0 | 519168 | 0 | 0 | 0 |
| JOHN SAWYER | ||||||||||||||
| CMO | 210359 | 0 | 8212 | 0 | 4519 | 0 | 10835 | 0 | 18274 | 0 | 252199 | 0 | 0 | 0 |
| PAUL BACHMAN | ||||||||||||||
| CMO | 206263 | 0 | 2057 | 0 | 4227 | 0 | 10363 | 0 | 18403 | 0 | 241313 | 0 | 0 | 0 |
| BRIAN MCDERMOTT | ||||||||||||||
| PHYSICIAN | 300710 | 0 | 13134 | 0 | 0 | 0 | 13898 | 0 | 0 | 0 | 327742 | 0 | 0 | 0 |
| DANIEL WAY | ||||||||||||||
| PHYSICIAN | 204104 | 0 | 2084 | 0 | 2742 | 0 | 9479 | 0 | 17484 | 0 | 235893 | 0 | 0 | 0 |
| MICHAEL ADAMS | ||||||||||||||
| PHYSICIAN | 201128 | 0 | 2023 | 0 | 307 | 0 | 9438 | 0 | 17882 | 0 | 230778 | 0 | 0 | 0 |
| TODD WALDORF | ||||||||||||||
| PHYSICIAN | 234552 | 0 | 2383 | 0 | 450 | 0 | 11588 | 0 | 18316 | 0 | 267289 | 0 | 0 | 0 |
| WILLIAM BORGOS | ||||||||||||||
| PHYSICIAN | 208571 | 0 | 2113 | 0 | 194 | 0 | 10077 | 0 | 18289 | 0 | 239244 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRIMARY CARE DEVELOPMENT CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | JOHN RUGGE IS ON THE BOARD OF DIRECTORS OF PCDC. | Relationship |
| Amount Of Transaction | 500000 | AmountOfTransaction |
| Description Of Transaction | BRIDGE LOAN | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | AN INDEPENDENT ACCOUNTANT PREPARES THE FORM 990. AFTER PREPARATION A MEETING WILL BE SCHEDULED WITH THE BOARD OF DIRECTORS AND OFFICERS TO REVIEW THE COMPLETED 990 AT OUR CAREY ROAD FACILITY PRIOR TO SUBMISSION TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS ITS' CONFLICT OF INTEREST POLICY WITH AN ANNUAL UPDATE OF ALL INTEREST THAT COULD POTENTIALLY LEAD TO A CONFLICT OF INTEREST FOR ALL EMPLOYEES. IF A CONFLICT OF INTEREST POTENTIAL IS RECOGNIZED THE BOARD SHALL DETERMINE WHETHER A CONFLICT EXISTS AND WHETHER SUCH DIRECTOR SHOULD ABSTAIN FROM VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15 | WHEN A NEW KEY EMPLOYEE IS HIRED IN THE PAST YEAR, COMPENSATION WAS DETERMINED THROUGH COMPARISON OF SIMILAR POSITIONS WITHIN THE ORGANIZATION. WE ALSO SURVEY WHERE POSSIBLE, COMPARABLE POSITIONS WITHIN THE REGION. COMPENSATION IS DETERMINED BY A COMBINATION OF SENIOR MANAGEMENT, FINANCE AND HUMAN RESOURCES TO ENSURE FAIRNESS AND CONSISTENCY IN SETTING PAY RATE AND BENEFIT LEVELS. |
| FORM 990, PART VI, SECTION C, LINE 19 | AVAILABLE UPON WRITTEN REQUEST. THEY WILL BE MADE AVAILABLE AT OUR ADMINISTRATIVE OFFICE AT 9 CAREY ROAD, QUEENSBURY, NY. |
| FORM 990, PART XII, LINE 2C: | THE SELECTION AND OVERSIGHT PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. |
| FORM 990, PART IV, QUESTION 20A: | THE ORGANIZATION IS LICENSED UNDER ARTICLE 28 OF NEW YORK STATE PUBLIC HEALTH LAW. HOWEVER, SUBSECTION 10 OF ARTICLE 28 EXCLUDES CERTAIN HEALTHCARE FACILITIES FROM THE DEFINITION OF GENERAL HOSPITAL. THEREFORE, THE ORGANIZATION IS NOT INCLUDING SCHEDULE H IN THE CURRENT YEAR FORM 990 AS THEY DO NOT MEET THIS DEFINITION. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| HUDSON HEADWATERS HEALTH FOUNDATION | ||||||||||
| 9 CAREY RD | QUEENSBURY | NY | 12804 | 651261242 | FINANCIAL SUPPORT TO HUDSON HEADWATERS HEALTH NETWORK | NY | 501(C)(3) | LINE 11A, I | HUDSON HEADWATERS HEALTH NETWORK | 0 |
| COMPRE CARE INC | ||||||||||
| 9 CAREY RD | QUEENSBURY | NY | 12804 | 141692479 | IDLE HEALTH CTR OPERATION | NY | 501(C)(3) | LINE 3 | HUDSON HEADWATERS HEALTH NETWORK | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUDSON HEADWATERS HEALTH MANAGEMENT | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 357 | AddressLine1 |
| City | GLEN FALLS | City |
| State | NY | State |
| ZIP Code | 12801 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141467175 | EIN |
| Legal Domicile State | NY | LegalDomicileState |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | 596 | ShareOfTotalIncome |
| Share Of EOY Assets | 113289 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| 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 | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 1 | 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 | 0 | 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 |