ADIRONDACK MEDICAL CENTER: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ADIRONDACK MEDICAL CENTER (EIN 14-1731786)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-07
- IRS object ID
- 201323119349302117
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-07T16:32:37-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161226221 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FUST CHARLES CHAMBERS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5784 WIDEWATERS PARKWAY | AddressLine1 |
| City | SYRACUSE | City |
| State | NY | State |
| ZIP Code | 13214 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141731786 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADIRONDACK MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ADIR | NameControl |
| Phone | 5188914141 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 471 2233 STATE ROUTE 86 | AddressLine1 |
| City | SARANAC LAKE | City |
| State | NY | State |
| ZIP Code | 12983 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GREG MOORE | Name |
| Title | CFO | Title |
| Phone | 5188914141 | Phone |
| Date Signed | 2013-10-18 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANGELA M FRANCO | Name |
| PTIN | P00589741 | PTIN |
| Phone | 3154463600 | 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 | GREG MOORE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 471 2233 STATE ROUTE 86 | AddressLine1 |
| City | SARANAC LAKE | City |
| State | NY | State |
| ZIP Code | 12983 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 103060224 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ADIRONDACKHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1991 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | THE MEDICAL CENTER PROVIDES ACUTE, SKILLED NURSING AND OUTPATIENT SERVICES TO RESIDENTS OF THE LOCAL GEOGRAPHIC REGION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1152 | TotalNbrEmployees |
| Total Nbr Volunteers | 118 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2358987 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 897941 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 99812547 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 97784775 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 155840 | InvestmentIncomePriorYear |
| Investment Income Current Year | -675069 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1658935 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3399208 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 103986309 | TotalRevenuePriorYear |
| Total Revenue Current Year | 101406855 | 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 | 52454934 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 56776608 | 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 | 50812477 | OtherExpensePriorYear |
| Other Expenses Current Year | 47700596 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 103267411 | TotalExpensesPriorYear |
| Total Expenses Current Year | 104477204 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 718898 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3070349 | RevenuesLessExpensesCY |
| Total Assets BOY | 66671140 | TotalAssetsBOY |
| Total Assets EOY | 67870297 | TotalAssetsEOY |
| Total Liabilities BOY | 26581240 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 30406779 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 40089900 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 37463518 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MEDICAL CENTER PROVIDES EXCELLENT HEALTHCARE CLOSE TO HOME. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 25460740 | Expense |
| Revenue | 29975569 | Revenue |
| Description | ADIRONDACK MEDICAL CENTER IS A 97-BED ACUTE CARE FACILITY IN SARANAC LAKE AND A 2-BED FACILITY IN LAKE PLACID. IT PROVIDES A FULL RANGE OF INPATIENT SERVICES(SURGICAL, MATERNITY AND PEDIATRIC) AS WELL AS MAINTAINS A 60 BED LONG-TERM CARE FACILITY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 50427744 | Expense |
| Revenue | 59363573 | Revenue |
| Description | REFERRED AMBULATORY, AMBULATORY SURGERY AND EMERGENCY SERVICES. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 7074069 | Expense |
| Revenue | 8445633 | Revenue |
| Description | FREE STANDING NURSING HOME THAT HAS 156 BEDS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 82962553 | 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 | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | 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 | 0 | 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 | 67 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1152 | 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 | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | 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 | GREG MOORE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5188914141 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 471 2233 STATE ROUTE 86 | AddressLine1 |
| City | SARANAC LAKE | City |
| State | NY | State |
| ZIP Code | 12983 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| JOHN HOPKINSON PHD | ||||||||
| SECRETARY/TREASURER | 1.00 | X | X | 0 | 0 | 0 | ||
| LAURIE BERGAMINI | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| BARRY BROGAN | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| JULIE CONNORS | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| CHARLES CARROLL | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| EDWARD H ROETMAN | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| MARY SPARKS | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| JOAN KELLY | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| JEANNIE CROSS | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| JOHN BRODERICK MD | ||||||||
| EX-OFFICIO MEDICAL STAFF PRESIDENT | 40.00 | X | 287151 | 0 | 31121 | |||
| SUSAN M DELEHANTY | ||||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| STANLEY T URBAN | ||||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| REV CARLOS J CAGUIAT | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| RICHARD M MOCCIA MD | ||||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | |||
| CHANDLER M RALPH | ||||||||
| EX-OFFICIO PRESIDENT/CEO | 40.00 | X | 0 | 0 | 0 | |||
| PATRICK FACTEAU | ||||||||
| CFO | 40.00 | X | 124983 | 0 | 20423 | |||
| DAVID BRITTON | ||||||||
| INTERIM CFO | 40.00 | X | 122400 | 0 | 0 | |||
| GREG MOORE | ||||||||
| CFO | 40.00 | X | 63577 | 0 | 10472 | |||
| WILLIAM VISCARDO MD | ||||||||
| CMO | 40.00 | 243414 | 0 | 26986 | X | |||
| CYNTHIA MCGUIRE | ||||||||
| COO | 40.00 | 156069 | 0 | 25002 | X | |||
| ANTHONY DOWIDOWICZ | ||||||||
| PHYSICIAN | 40.00 | 268264 | 0 | 19364 | X | |||
| MAJEED SIDDIQUI | ||||||||
| PHYSICIAN | 32.00 | 324924 | 0 | 28003 | X | |||
| NICHOLAS BRODYN | ||||||||
| PHYSICIAN | 40.00 | 497526 | 0 | 29811 | X | |||
| WOODS MCCAHILL | ||||||||
| PHYSICIAN | 32.00 | 225806 | 0 | 26471 | X | |||
| FRANK NOCILLA | ||||||||
| PHYSICIAN | 40.00 | 226108 | 0 | 22199 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2540222 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 239852 | TotalOtherCompensation |
| Number Individuals GT100 K | 47 | 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 |
|---|---|---|---|---|---|
| MATRIX HEALTH SYSTEMS | |||||
| 86 LAKE STREET | BURLINGTON | VT | 05401 | PHYSICIAN FEES | 777108 |
| PREMIER ANESTHESIA | |||||
| 2655 NORTHWINDS PARKWAY | ALPHARETTA | GA | 30368 | PHYSICIAN FEES | 708476 |
| HEALTHTECH MANAGEMENT SERVICES INC | |||||
| 405 DUKE DRIVE SUITE 10 | FRANKLIN | TN | 37067 | MANAGEMENT SERVICES | 654454 |
| INSIGHT HEALTH CORP | |||||
| PO BOX 847689 | DALLAS | TX | 75284 | MRI SERVICE | 504670 |
| LABORATORY CORPORATION OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LAB SERVICES | 457122 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 30 | NumberOfContractorsGT100K |
| Related Organizations | 540014 | RelatedOrganizations |
| All Other Contributions | 357927 | AllOtherContributions |
| Total Contributions | 897941 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT SERVICE RE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 97784775 | TotalRevenueColumn |
| Related Or Exempt Function Income | 97784775 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 97784775 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 47547 | TotalRevenueColumn |
| Exclusion | $47,547 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 427564 | 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 | 427564 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 427564 | TotalRevenueColumn |
| Exclusion | $427,564 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 930753 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 882653 | Securities |
| Other | 770716 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 48100 | Securities |
| Other | -770716 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -722616 | TotalRevenueColumn |
| Exclusion | -$722,616 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| DIETARY REVENUE | 900099 | 199635 | 199635 |
| PURCHASE DISCOUNTS | 900099 | 149434 | 149434 |
| REBATES & REFUNDS | 900099 | 49836 | 49836 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2572739 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2572739 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2971644 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 101406855 | TotalRevenueColumn |
| Related Or Exempt Function Income | 100756419 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | -$247,505 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1111599 | Total |
| Program Services | 318273 | ProgramServices |
| Management And General | 793326 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44886438 | Total |
| Program Services | 36731511 | ProgramServices |
| Management And General | 8154927 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1123660 | Total |
| Program Services | 917915 | ProgramServices |
| Management And General | 205745 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6354542 | Total |
| Program Services | 5176261 | ProgramServices |
| Management And General | 1178281 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3300369 | Total |
| Program Services | 2662696 | ProgramServices |
| Management And General | 637673 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 654454 | Total |
| Management And General | 654454 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 229694 | Total |
| Management And General | 229694 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109994 | Total |
| Management And General | 109994 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10565122 | Total |
| Program Services | 7279471 | ProgramServices |
| Management And General | 3285651 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 189356 | Total |
| Program Services | 870 | ProgramServices |
| Management And General | 188486 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1636275 | Total |
| Program Services | 687522 | ProgramServices |
| Management And General | 948753 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2522150 | Total |
| Program Services | 3222 | ProgramServices |
| Management And General | 2518928 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 411260 | Total |
| Program Services | 245470 | ProgramServices |
| Management And General | 165790 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 774787 | Total |
| Program Services | 774787 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4811931 | Total |
| Program Services | 4811931 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 935860 | Total |
| Management And General | 935860 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 15138449 | 15138449 | |
| BAD DEBT | 3873427 | 3873427 | |
| LEASE EXPENSE | 1143425 | 920436 | 222989 |
| CASH ASSESSMENT | 1107565 | 1107565 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3596847 | Total |
| Program Services | 2312747 | ProgramServices |
| Management And General | 1284100 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 104477204 | Total |
| Program Services | 82962553 | ProgramServices |
| Management And General | 21514651 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8164030 | BOY |
| EOY | 11257449 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13318293 | BOY |
| EOY | 14128496 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1830619 | BOY |
| EOY | 1964432 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3406362 | BOY |
| EOY | 3587422 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 87468159 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 54934322 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 33531187 | BOY |
| EOY | 32533837 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3368975 | BOY |
| EOY | 3214620 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3051674 | BOY |
| EOY | 1184041 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66671140 | BOY |
| EOY | 67870297 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8049390 | BOY |
| EOY | 11596903 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 947292 | BOY |
| EOY | 1163791 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11805346 | BOY |
| EOY | 13327680 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 933000 | BOY |
| EOY | 933000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4846212 | BOY |
| EOY | 3385405 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26581240 | BOY |
| EOY | 30406779 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39102721 | BOY |
| EOY | 36472103 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52117 | BOY |
| EOY | 56353 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 935062 | BOY |
| EOY | 935062 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40089900 | BOY |
| EOY | 37463518 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66671140 | BOY |
| EOY | 67870297 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -3070349 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 155160 | ReconciliationUnrealizedInvest |
| Reconcilation Prior Adjustment | 178476 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | 110331 | 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 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
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 987179 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 4236 | InvestmentEarningsOrLosses |
| End Of Year Balance | 991415 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 987165 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 4018 | InvestmentEarningsOrLosses |
| Other Expenditures | -4004 | OtherExpenditures |
| End Of Year Balance | 987179 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 982116 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 5049 | InvestmentEarningsOrLosses |
| End Of Year Balance | 987165 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.94300 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.05700 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 328539 | OtherCostOrOtherBasis |
| Book Value | 328539 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 42827931 | OtherCostOrOtherBasis |
| Depreciation | 20730583 | Depreciation |
| Book Value | 22097348 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 43202852 | OtherCostOrOtherBasis |
| Depreciation | 33321947 | Depreciation |
| Book Value | 9880905 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1108837 | OtherCostOrOtherBasis |
| Depreciation | 881792 | Depreciation |
| Book Value | 227045 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 32533837 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DEBT-CURRENT | $1,263,823 |
| RESIDENT FUNDS LIABILITY | $93,406 |
| ASSET RETIREMENT AND OTHER LT | $946,883 |
| ESTIMATED THIRD PARTY LIABILITY | $1,081,293 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3385405 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE SYSTEM'S ENDOWMENTS CONSIST OF FUNDS ESTABLISHED FOR A VARIETY OF PURPOSES. ITS ENDOWMENTS INCLUDE DONOR-RESTRICTED ENDOWMENT FUNDS AND FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS AN ENDOWMENT. AS REQUIRED BY GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, NET ASSETS ASSOCIATED WITH ENDOWMENT FUNDS, INCLUDING FUNDS DESIGNATED BY THE BOARD OF TRUSTEES TO FUNCTION AS ENDOWMENTS, ARE CLASSIFIED AND REPORTED BASED ON THE EXISTENCE OR ABSENCE OF DONOR-IMPOSED RESTRICTIONS. TEMPORARILY RESTRICTED FUNDS ARE AVAILABLE FOR NURSING EDUCATION & OTHER PROGRAMS. PERMANENTLY RESTRICTED FUNDS ARE TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE FOR VARIOUS HEALTHCARE SERVICES. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN ADIRONDACK HEALTH'S CONSOLIDATED FINANCIAL STATEMENTS. THESE STANDARDS HAD NO IMPACT ON THE ACCOMPANYING FINANCIAL STATEMENTS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2009 THROUGH 2012. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 0 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| 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 | 136237 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14789 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 121448 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21233453 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21147730 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 85723 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00090 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21369690 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21162519 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 207171 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 179648 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 179648 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00180 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 432436 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 432436 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19351188 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15919405 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3431783 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03410 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2362 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 2362 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19965634 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15919405 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4046229 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04020 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 41335324 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 37081924 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4253400 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04230 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 5923 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5923 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 15745 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 15745 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 21668 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 21668 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,990,249 | BadDebtExpenseAmount |
| Amount Attributable To | 1001230 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 27547830 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 28547710 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -999880 | 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 | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | Er24 HoursEr24Hours | OtherOther | Facility Reporting GroupFacilityReportingGroup |
|---|---|---|---|---|---|---|---|---|
| ADIRONDACK MEDICAL CENTER | ||||||||
| 1 | 2233 STATE ROUTE 86-PO BOX 471 | SARANAC LAKE | NY | 12983 | X | X | 97 ACUTE BEDS; NURSING HOME WITH 60 BEDS; NURSING HOME WITH 157 BEDS | A |
| ADIRONDACK MEDICAL CENTER-LAKE PLACID | ||||||||
| 2 | 29 CHURCH STREET | LAKE PLACID | NY | 12946 | X | X | 2 ACUTE BEDS; OUTPATIENT SERIVCES, EMERGENCY ROOM | A |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FACILITY REPORTING GROUP - A | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 10 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | 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 |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| 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 |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| 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 | 6 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (6 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| TUPPER LAKE MEDICAL OFFICE BUILDING | ||||
| 7 STETSON ROAD | TUPPER LAKE | NY | 12986 | CLINIC; LABORATORY; RADIOLOGY |
| MOUNTAIN HEALTH CENTER | ||||
| 2841 NYS ROUTE 73 | KEENE | NY | 12942 | CLINIC |
| UIHLEIN LIVING CENTER | ||||
| 185 OLD MILITARY ROAD | LAKE PLACID | NY | 12946 | NURSING HOME WITH 156 BEDS |
| MERCY LIVING CENTER | ||||
| 114 WAWBEEK AVENUE | TUPPER LAKE | NY | 12986 | NURSING HOME WITH 60 BEDS; DIALYSIS, REHABILITATION |
| LAKE PLACID HEALTH CENTER | ||||
| 29 CHURCH STREET | LAKE PLACID | NY | 12946 | CLINC; ER; LABORATORY; RADIOLOGY; REHABILITATION |
| WOUND CARE MEDICAL OFFICE BUILDING | ||||
| 285 COUNTY ROUTE 47 | SARANAC LAKE | NY | 12983 | CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (25 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: AMOUNTS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 (TOTAL OPERATING EXPENSE MINUS MEDICAID/PROVIDER TAXES, TOTAL COMMUNITY BENEFIT EXPENSE, AND TOTAL COMMUNITY BUILDING EXPENSE DIVIDED BY GROSS PATIENT CHARGES), AND ADDRESSES ALL PATIENT SEGMENTS. | ||
| PART I, L7 COL(F): BAD DEBT EXPENSE, REMOVED FROM DENOMINATOR, EQUALS 3,873,427. | ||
| PART II: THE CEO ATTENDED AMERICAN HOSPITAL ASSOCIATION BOARD MEETINGS. THIS IS A MEMBERSHIP ORGANIZATION THAT HELPS HOSPITALS TO HELP THEIR COMMUNITIES TO ACHIEVE THE HIGHEST MEASURE OF HEALTH THROUGH EDUCATION, RESEARCH, SUPPORT SYSTEMS, DISSEMINATION OF BEST CLINICAL QUALITY PRACTICES, AND COALITION BUILDING TO IMPROVE THE HEALTH OF OUR COMMUNITIES. ALSO, THE CEO ATTENDED ADIRONDACK HEALTH INSTITUTE MEETINGS. AHI IS A REGIONAL ORGANIZATION THAT INCLUDES THE TRI-LAKES, PLATTSBURGH, AND GLENNS FALLS COMMUNITIES WHOSE PURPOSE IS TO IMPROVE THE OVERALL HEALTH OF THESE ADIRONDACK COMMUNITIES BY WORKING TOGETHER ON A REGIONAL BASIS. THE CHIEF NURSING OFFICER SPENT TIME EDUCATING LOCAL, STATE, AND FEDERAL LEGISLATORS ABOUT IMPORTANT ISSUES IN HEALTHCARE AND COMMUNITY HEALTH. THE CHIEF MEDICAL OFFICER SPENT TIME AT A LOCAL IRON MAN COMPETITION TO PROVIDE MEDICAL COVERAGE OF THE ATHLETES AND PROMOTE HEALTHY EXERCISE ROUTINES. | ||
| PART III, LINE 4: "IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, ADIRONDACK HEALTH ANALYZES PAST PAYMENT HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, ADIRONDACK HEALTH ANALYZES CONTRACTUALY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATES WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), ADIRONDACK HEALTH RECORDS A PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNT RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS."PART III, LINE 3:THE ORGANIZATION'S BAD DEBT EXPENSES IS CALCULATED USING A PERCENTAGE OF BAD DEBT THAT CONTAINS POSSIBLE CHARITY CARE CASES AND APPLYING IT TO LINE 2. RATIONALE FOR WHAT PORTION OF BAD DEBT SHOULD CONSTITUTE COMMUNITY BENEFIT: THE PROVISION OF HEALTH CARE IS DIFFERENT FROM PROVIDING OTHER SERVICES, IN THAT HOSPITALS, ALTHOUGH THEY MAY ATTEMPT TO OBTAIN FINANCIAL INFORMATION BEFORE SERVICE IS PROVIDED, FOCUS ON PROVIDING THE PATIENT WITH NEEDED HEALTH CARE AND LATER TRY TO OBTAIN PAYMENT. IN OTHER INDUSTRIES, THE SERVICE PROVIDER CAN CHECK THE CUSTOMER'S CREDIT RATING, ASK FOR PAYMENT IN ADVANCE, ETC AND IS USUALLY ASKING THIS INFORMATION WHEN THE CONSUMER IS NOT IN A HEALTH CRISIS AND UNDER GREAT STRESS AND WORRY. AT A LATER TIME, WHEN THE PROVIDER ATTEMPTS TO COLLECT PAYMENT AND FINDS THE PATIENT UNWILLING TO PAY, THEIR OPTIONS ARE AGAIN LIMITED GIVEN THE NATURE OF THE SERVICE PROVIDED AND THE INABILITY TO REPOSSESS THE SERVICE.PART III, LINE 2:THE ORGANIZATION'S BAD DEBT EXPENSE IS CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND BAD DEBT EXPENSE. | ||
| PART III, LINE 8: CALCULATED USING COST-TO-CHARGE RATIO FROM WORKSHEET 2 AND APPLYING IT TO GROSS MEDICARE CHARGES. SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFIT BECAUSE MEDICARE PATIENT SERVICES ARE PROVIDED AT A COST THAT IS GREATER THAN REIMBURSEMENT. | ||
| PART III, LINE 9B: ACCORDING TO OUR CHARITY CARE POLICY, FAP-ELIGIBLE PATIENTS ARE WRITTEN-OFF AT 100% SO NO COLLECTION PRACTICES ARE NECESSARY. | ||
| PART VI, LINE 2: ADIRONDACK MEDICAL CENTER USES A NUMBER OF ASSESSMENT METHODS TO DETERMINE HOW WELL WE ARE MEETING COMMUNITY NEEDS AND WHAT ADDITIONAL SERVICES WE CAN OFFER OUR COMMUNITY MEMBERS. AMC USES THE PRESS-GANEY PATIENT SATISFACTION SURVEY FOR CONTINUAL PATIENT FEEDBACK. THE SURVEYS ARE MAILED TO RANDOMLY SELECTED PATIENTS BY PRESS-GANEY, A NATIONALLY RECOGNIZED PATIENT SURVEY FIRM, AND PRESS-GANEY PROCESSES THE RESULTS. THEY GIVE AMC THE RESULTS BENCHMARKED AGAINST OTHER HOSPITALS TO HELP US UNDERSTAND HOW WELL WE ARE SERVING OUR COMMUNITY. THE MAJORITY OF AMC'S STRATEGIC INITIATIVES ARE DRIVEN BY A THREE-YEAR STRATEGIC PLAN, WHICH IS DEVELOPED THROUGH THE COLLABORATION OF THE BOARD, MEDICAL STAFF, AMC STAFF AND COMMUNITY MEMBERS. THE GOALS THAT ARE SET FORTH EVERY THREE YEARS IN THE STRATEGIC PLAN ARE INCORPORATED INTO AMC'S MANAGEMENT ACTION PLAN (MAP), WHICH IS REVIEWED AND REVISED EACH YEAR. AT THE BEGINNING OF EACH YEAR EVERY DEPARTMENT CREATES A MAP THAT OUTLINES THE CONCRETE STEPS THAT THE DEPARTMENT WILL ACCOMPLISH IN MOVING THE HOSPITAL CLOSER TO COMPLETING THE STRATEGIC PLAN GOALS. THE SUCCESS OF AMC, EACH DEPARTMENT, AND EACH EMPLOYEE IS MEASURED BY THE MAP AND THE PROGRESS MADE TOWARD ACCOMPLISHING THE GOALS SET OUT IN THE STRATEGIC PLAN. FOR NEW SERVICES, AMC STAFF DEVELOPS A NEEDS ASSESSMENT USING A VARIETY OF DATA INCLUDING REGIONAL DEMAND FOR THE SPECIFIC SERVICE, DEMOGRAPHICS, AND FINANCIAL ANALYSIS. THE BOARD OF TRUSTEES CAREFULLY REVIEWS THE ANALYSIS AND EITHER SUPPORTS THE RECOMMENDATION OR ASKS FOR FURTHER INFORMATION. AMC ALSO PARTICIPATES WITH ESSEX COUNTY PUBLIC HEALTH AND FRANKLIN COUNTY PUBLIC HEALTH IN THEIR COMMUNITY HEALTH ASSESSMENT (CHA) PROCESS. THIS IS A FORMAL PROCESS, WITH RESULTS REQUIRED BY THE NEW YORK STATE DEPARTMENT OF HEALTH. THE CHA IS AN IMPORTANT PART OF AMC'S STRATEGIC PLANNING AND SERVICE LINE PLANNING PROCESSES. | ||
| PART VI, LINE 3: ANY PATIENT THAT CONTACTS SCHEDULING OR PRESENTS TO ANY AMC DEPARTMENT (INCLUDING ADMITTING, EMERGENCY ROOM, ETC.) THAT DOES NOT IDENTIFY AN INSURANCE COMPANY OR IDENTIFIES THEMSELVES AS SELF-PAY ARE INFORMED OF OUR SELF-PAY PROCESS. THIS PROCESS INCLUDES INFORMATION ABOUT AMC'S CHARITY CARE POLICY AND THE BENEFITS OF VISITING WITH A CERTIFIED FACILITATED ENROLLER WHO CAN CHECK THE PATIENT'S ELIGIBILITY FOR STATE AND FEDERAL HEALTH INSURANCE PROGRAMS. | ||
| PART VI, LINE 4: ADIRONDACK MEDICAL CENTER IS LOCATED IN THE HEART OF THE ADIRONDACK PARK IN RURAL, UPSTATE NEW YORK. THE ADIRONDACK PARK IS A UNIQUE, SIX MILLION ACRE PATCHWORK OF PUBLIC AND PRIVATE LAND. IT IS BEST KNOWN FOR ITS MOUNTAINS - THE HIGHEST IN NEW YORK STATE - AND ITS LAKES. THE REGION HAS AN AVERAGE SEASONAL SNOWFALL IN EXCESS OF 90 INCHES AND THE AVERAGE MEAN TEMPERATURE IN JANUARY IS 16 DEGREES FAHRENHEIT.AMC IS DESIGNATED A SOLE COMMUNITY PROVIDER HOSPITAL WITH THE CLOSEST COMPARABLE FACILITY 50 MILES AWAY FROM OUR MAIN CAMPUS IN SARANAC LAKE. AMC IS AN INTEGRAL PART OF THE COMMUNITY AS THE ONLY ACUTE CARE FACILITY, THE PREDOMINANT PROVIDER OF AMBULATORY SERVICES, AND THE LARGEST PRIVATE EMPLOYER IN THE ADIRONDACK PARK. AMC PROVIDES CARE FOR 70.7% OF THE 22,595 RESIDENTS IN OUR PRIMARY SERVICE AREA AND 25.1% OF THE 12,455 RESIDENTS IN OUR SECONDARY SERVICE AREA. THIS SERVICE AREA COVERS OVER 1,200 SQUARE MILES, HAS AN AVERAGE OF JUST OVER 30 PEOPLE PER SQUARE MILE, AND INCLUDES PORTIONS OF 5 COUNTIES.THE HOSPITAL'S SERVICE AREA IS DESIGNATED AS THE FOLLOWING FEDERAL HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA):- PRIMARY CARE- DENTAL- PSYCHIATRYAMC IS SERVING AN AGING POPULATION WITH HIGH CANCER AND CHRONIC DISEASE RATES, AND VERY LOW INCOME LEVELS. THE PERCENTAGE OF THE POPULATION THAT FALLS INTO THE "BABY BOOMER" AGE GROUP, 55-64 YEARS OF AGE, IS INCREASING, WITH A CORRESPONDING DECREASE IN YOUNGER AGE GROUPS.NEW YORK STATE DEPARTMENT OF HEALTH DATA SHOWS THAT ESSEX AND FRANKLIN COUNTIES ARE WORSE THAN THE STATE OR NATIONAL RATE/PERCENTAGE FOR THE FOLLOWING:- ALL CANCER DEATHS PER 100,000, CORONARY HEART DISEASE PREMATURE DEATHS (AGES 35 64) PER 100,000, CEREBROVASCULAR (STROKE) DEATHS PER 100,000, ADULTS 18+ WHO SMOKE, ADULTS 18+ WHO ARE OBESE, THE AVERAGE UNEMPLOYMENT RATE IN 2012 FOR NEW YORK STATE WAS 8.5% AND THE UNEMPLOYMENT RATES IN THE COUNTIES THAT WE SERVE WAS A SLIGHTLY MORE THAN ONE PERCENTAGE POINT ABOVE THAT AVERAGE. THE NYS DEPARTMENT OF LABOR INDICATES THAT THE PER CAPITA INCOME FOR THE COUNTIES THAT AMC SERVES IS BETWEEN 35% AND 44% BELOW THE STATE AVERAGE. | ||
| PART VI, LINE 5: AS THE LARGEST EMPLOYER AND ONLY FULL SERVICE HOSPITAL IN THE ADIRONDACK PARK AMC IS AN IMPORTANT PARTNER IN COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF OUR COMMUNITY MEMBERS. - BEGAN A PROGRAM SENDING OUR MOBILE DENTAL CLINIC TO SCHOOLS TO PROVIDE DENTAL SEALANTS FOR CHILDREN- CONTINUED THE FREE, MONTHLY HEALTH LECTURE SERIES. LECTURE TOPICS HAVE INCLUDED A WIDE RANGE OF TOPICS SUCH AS SKIN CANCER AWARENESS, SUICIDE, WHOLE FOODS, AND BULLYING. WE HAVE DRAWN ON LOCAL, REGIONAL, AND NATIONAL EXPERTS. LECTURE ATTENDANCE HAS RANGED FROM 25 TO OVER 50 PEOPLE. | ||
| PART VI, LINE 6: AMC'S BOARD OF TRUSTEES IS COMPRISED OF COMMUNITY MEMBERS WHO LISTEN CLOSELY TO THEIR NEIGHBORS, FRIENDS AND FAMILY MEMBERS, WHO ARE OUR PATIENTS. THIS IS AN ACTIVE BOARD WITH MEMBERS SITTING ON MANY OF THE HOSPITAL COMMITTEES. THIS CIRCLE OF INTERACTION HELPS INFORM OUR STAFF AND ENABLES THEM TO MAKE CONTINUOUS IMPROVEMENTS BASED ON COMMUNITY INPUT.AS THE LARGEST EMPLOYER AND ONLY FULL SERVICE HOSPITAL IN THE ADIRONDACK PARK AMC IS AN IMPORTANT PARTNER IN COMMUNITY BUILDING ACTIVITIES THAT PROMOTE THE HEALTH OF OUR COMMUNITY MEMBERS.- BEGAN A PROGRAM SENDING OUR MOBILE DENTAL CLINIC TO SCHOOLS TO PROVIDE DENTAL SEALANTS FOR CHILDREN- CONTINUED THE FREE, MONTHLY HEALTH LECTURE SERIES. LECTURE TOPICS HAVE INCLUDED A WIDE RANGE OF TOPICS SUCH AS SKIN CANCER AWARENESS, SUICIDE, WHOLE FOODS, AND BULLYING. WE HAVE DRAWN ON LOCAL, REGIONAL, AND NATIONAL EXPERTS. LECTURE ATTENDANCE HAS RANGED FROM 25 TO OVER 50 PEOPLE. | ||
| NY | REPORTS FILED WITH STATES | PART VI, LINE 7 |
| SEE BELOW | PART V, LINE 8 FACILITY REPORTING GROUP A | |
| FACILITY 1 -- ADIRONDACK MEDICAL CENTER | PART V, SECTION B, LINE 1J: | |
| IN 2010, AS PART OF THE NEEDS ASSESSMENT OF THE STRATEGIC PLAN, AMC CONDUCTED FOUR COMMUNITY FOCUS GROUPS. THE FOCUS GROUPS WERE COMPRISED OF MEMBERS OF THE CLERGY, LOCAL BUSINESS AND AGENCY LEADERS, ELECTED OFFICIALS, AND LEADERS OF LOCAL HEALTH CARE ORGANIZATIONS. FORTY TWO PEOPLE PARTICIPATED IN THE FOCUS GROUPS. THE FOCUS GROUP RESULTS WERE GIVEN TO ALL OF THE STRATEGIC PLANNING PARTICIPANTS. ALSO, AMC SURVEYED STAFF USING AN ELECTRONIC SURVEY. SIXTY THREE STAFF MEMBERS PARTICIPATED IN THE SURVEY. AMC SERVES A RURAL AREA AND OUR STAFF MEMBERS, THEIR FAMILY MEMBERS AND FRIENDS ARE ALSO OUR COMMUNITY MEMBERS. | FACILITY 1 -- ADIRONDACK MEDICAL CENTER | PART V, SECTION B, LINE 3: |
| IN 2009, AMC PARTICIPATED IN TWO COMMUNITY HEALTH ASSESSMENTS (CHA). IN THE SIX COUNTY CHA SIX HOSPITALS (INCLUDING AMC) AND SIX COUNTY HEALTH DEPARTMENTS PARTICIPATED IN THE ASSESSMENT. IN THE THREE COUNTY SURVEYS FOUR HOSPITALS (INCLUDING AMC) AND THREE COUNTY HEALTH DEPARTMENTS PARTICIPATED IN THE SURVEY. | FACILITY 1 -- ADIRONDACK MEDICAL CENTER | PART V, SECTION B, LINE 4: |
| IN 2009, TWO COMPREHENSIVE CHA DOCUMENT WERE COMPILED. BOTH CHAS CONSISTED OF THE COMMUNITY HEALTH ASSESSMENT DATA AND ALL PARTICIPATING HOSPITALS' COMMUNITY SERVICE PLANS. THESE DOCUMENTS ARE AVAILABLE IN HARD COPY, CD, AND AS A PDF FILE. THE CHAS WERE SUBMITTED TO THE NEW YORK STATE DEPARTMENT OF HEALTH, CAN BE FOUND ON ALL OF THE COUNTY HEALTH DEPARTMENTS' WEB SITES, THE PARTICIPATING HOSPITALS' WEB SITES, AND ON THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) WEB SITE. IN 2010, AMC CREATED A SUMMARY OF THE STRATEGIC PLAN AND PUBLISHED IT IN THE LOCAL NEWSPAPERS. THE SUMMARY CAN ALSO BE FOUND ON THE AMC WEBSITE. | FACILITY 1 -- ADIRONDACK MEDICAL CENTER | PART V, SECTION B, LINE 5C: |
| NYS DEPARTMENT OF HEALTH REQUESTED THAT THE 2009 CHA USE THE NYS PREVENTION AGENDA TO STRUCTURE THE ASSESSMENT. BOTH CHA GROUPS CHOOSE PHYSICAL ACTIVITY AND NUTRITION AND THE FIRST PRIORITY ISSUE AND ACCESS TO CARE AS THE SECOND. AMC, WITH LOCAL PARTNERS, HAS MOVED FORWARD WITH STRATEGIES TO ADDRESS THESE PRIORITY ISSUES. THE CHA REQUIRED PRIORITIZATION, AND ALTHOUGH AMC IS WORKING ON PROJECTS THAT ADDRESS ALL TEN PREVENTION AGENDA ITEMS, IT NOT POSSIBLE FOR AN ORGANIZATION THE SIZE OF AMC TO ADDRESS ALL COMMUNITY HEALTH ISSUES SIMULTANEOUSLY. BY PRIORITIZING AND REPORTING BACK TO NYSDOH, AMC WILL CONTINUE TO WORK ON PRIORITY ISSUES, CONTINUE TO REASSESS, AND MOVE FORWARD WITH MAKING AN IMPACT ON IMPROVING THE HEALTH OF OUR COMMUNITY MEMBERS WITH OUR PARTNERS. | FACILITY 1 -- ADIRONDACK MEDICAL CENTER | PART V, SECTION B, LINE 7: |
| SELF-PAY PATIENTS THAT VISITED OUR MEDICAID SCREENER, AND WERE NOT DETERMINED TO BE FAP-ELIGIBLE, RECEIVED A 30% DISCOUNT. THOSE WHO WERE FAP-ELIGIBLE WERE WRITTEN OFF AT 100%. | FACILITY 1 -- ADIRONDACK MEDICAL CENTER | PART V, SECTION B, LINE 20D: |
| FACILITY 1 -- ADIRONDACK MEDICAL CENTER | PART V, SECTION B, LINE 22: | |
| IN 2010, AS PART OF THE NEEDS ASSESSMENT OF THE STRATEGIC PLAN, AMC CONDUCTED FOUR COMMUNITY FOCUS GROUPS. THE FOCUS GROUPS WERE COMPRISED OF MEMBERS OF THE CLERGY, LOCAL BUSINESS AND AGENCY LEADERS, ELECTED OFFICIALS, AND LEADERS OF LOCAL HEALTH CARE ORGANIZATIONS. FORTY TWO PEOPLE PARTICIPATED IN THE FOCUS GROUPS. THE FOCUS GROUP RESULTS WERE GIVEN TO ALL OF THE STRATEGIC PLANNING PARTICIPANTS. ALSO, AMC SURVEYED STAFF USING AN ELECTRONIC SURVEY. SIXTY THREE STAFF MEMBERS PARTICIPATED IN THE SURVEY. AMC SERVES A RURAL AREA AND OUR STAFF MEMBERS, THEIR FAMILY MEMBERS AND FRIENDS ARE ALSO OUR COMMUNITY MEMBERS. | FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID | PART V, SECTION B, LINE 3: |
| IN 2009, AMC PARTICIPATED IN TWO COMMUNITY HEALTH ASSESSMENTS (CHA). IN THE SIX COUNTY CHA SIX HOSPITALS (INCLUDING AMC) AND SIX COUNTY HEALTH DEPARTMENTS PARTICIPATED IN THE ASSESSMENT. IN THE THREE COUNTY SURVEYS FOUR HOSPITALS (INCLUDING AMC) AND THREE COUNTY HEALTH DEPARTMENTS PARTICIPATED IN THE SURVEY. | FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID | PART V, SECTION B, LINE 4: |
| IN 2009, TWO COMPREHENSIVE CHA DOCUMENT WERE COMPILED. BOTH CHAS CONSISTED OF THE COMMUNITY HEALTH ASSESSMENT DATA AND ALL PARTICIPATING HOSPITALS' COMMUNITY SERVICE PLANS. THESE DOCUMENTS ARE AVAILABLE IN HARD COPY, CD, AND AS A PDF FILE. THE CHAS WERE SUBMITTED TO THE NEW YORK STATE DEPARTMENT OF HEALTH, CAN BE FOUND ON ALL OF THE COUNTY HEALTH DEPARTMENTS' WEB SITES, THE PARTICIPATING HOSPITALS' WEB SITES, AND ON THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) WEB SITE. IN 2010, AMC CREATED A SUMMARY OF THE STRATEGIC PLAN AND PUBLISHED IT IN THE LOCAL NEWSPAPERS. THE SUMMARY CAN ALSO BE FOUND ON THE AMC WEBSITE. | FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID | PART V, SECTION B, LINE 5C: |
| NYS DEPARTMENT OF HEALTH REQUESTED THAT THE 2009 CHA USE THE NYS PREVENTION AGENDA TO STRUCTURE THE ASSESSMENT. BOTH CHA GROUPS CHOOSE PHYSICAL ACTIVITY AND NUTRITION AND THE FIRST PRIORITY ISSUE AND ACCESS TO CARE AS THE SECOND. AMC, WITH LOCAL PARTNERS, HAS MOVED FORWARD WITH STRATEGIES TO ADDRESS THESE PRIORITY ISSUES. THE CHA REQUIRED PRIORITIZATION, AND ALTHOUGH AMC IS WORKING ON PROJECTS THAT ADDRESS ALL TEN PREVENTION AGENDA ITEMS, IT NOT POSSIBLE FOR AN ORGANIZATION THE SIZE OF AMC TO ADDRESS ALL COMMUNITY HEALTH ISSUES SIMULTANEOUSLY. BY PRIORITIZING AND REPORTING BACK TO NYSDOH, AMC WILL CONTINUE TO WORK ON PRIORITY ISSUES, CONTINUE TO REASSESS, AND MOVE FORWARD WITH MAKING AN IMPACT ON IMPROVING THE HEALTH OF OUR COMMUNITY MEMBERS WITH OUR PARTNERS. | FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID | PART V, SECTION B, LINE 7: |
| SELF-PAY PATIENTS THAT VISITED OUR MEDICAID SCREENER, AND WERE NOT DETERMINED TO BE FAP-ELIGIBLE, RECEIVED A 30% DISCOUNT. THOSE WHO WERE FAP-ELIGIBLE WERE WRITTEN OFF AT 100%. | FACILITY 2 -- ADIRONDACK MEDICAL CENTER - LAKE PLACID | PART V, SECTION B, LINE 20D: |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | 1 | SubstantiationRequired |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JOHN BRODERICK MD | ||||||||||||||
| EX-OFFICIO MEDICAL STAFF PRESIDENT | 287151 | 0 | 0 | 0 | 0 | 0 | 9943 | 0 | 21178 | 0 | 318272 | 0 | 0 | 0 |
| WILLIAM VISCARDO MD | ||||||||||||||
| CMO | 243414 | 0 | 0 | 0 | 0 | 0 | 5808 | 0 | 21178 | 0 | 270400 | 0 | 0 | 0 |
| CYNTHIA MCGUIRE | ||||||||||||||
| COO | 156069 | 0 | 0 | 0 | 0 | 0 | 6091 | 0 | 18911 | 0 | 181071 | 0 | 0 | 0 |
| ANTHONY DOWIDOWICZ | ||||||||||||||
| PHYSICIAN | 268264 | 0 | 0 | 0 | 0 | 0 | 9970 | 0 | 9394 | 0 | 287628 | 0 | 0 | 0 |
| MAJEED SIDDIQUI | ||||||||||||||
| PHYSICIAN | 324924 | 0 | 0 | 0 | 0 | 0 | 6897 | 0 | 21106 | 0 | 352927 | 0 | 0 | 0 |
| NICHOLAS BRODYN | ||||||||||||||
| PHYSICIAN | 497526 | 0 | 0 | 0 | 0 | 0 | 9714 | 0 | 20097 | 0 | 527337 | 0 | 0 | 0 |
| WOODS MCCAHILL | ||||||||||||||
| PHYSICIAN | 225806 | 0 | 0 | 0 | 0 | 0 | 7560 | 0 | 18911 | 0 | 252277 | 0 | 0 | 0 |
| FRANK NOCILLA | ||||||||||||||
| PHYSICIAN | 226108 | 0 | 0 | 0 | 0 | 0 | 5294 | 0 | 16905 | 0 | 248307 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | ADIRONDACK MEDICAL CENTER CONTRACTS WITH HEALTH TECH MANAGEMENT SERVICES TO FILL THE POSITION OF PRESIDENT/CEO. THE BOARD OF TRUSTEES PROVIDES DIRECT SUPERVISION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 IS PRESENTED AND REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING THE 990. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL MEMBERS OF THE BOARD OF TRUSTEES ARE REQUIRED TO COMPLETE AND SIGN CONFLICT OF INTEREST STATEMENTS ANNUALLY. | |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION DECISIONS ARE DEVELOPED BASED ON THE USE OF NATIONAL, REGIONAL, AND HEALTH TECH CONSULTING DATA AND THE BOARD OF TRUSTEE'S INPUT. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART IX, LINE 11G | PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 2,066,924. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,066,924. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 801,152. MANAGEMENT AND GENERAL EXPENSES 1,100,852. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,902,004. CONSULTING FEES: PROGRAM SERVICE EXPENSES 2,900. MANAGEMENT AND GENERAL EXPENSES 484,836. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 487,736. LATE CHARGES/FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,341. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,341. LAUNDRY EXPENSE: PROGRAM SERVICE EXPENSES 224,660. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 224,660. CONTRACTED LABOR: PROGRAM SERVICE EXPENSES 316,951. MANAGEMENT AND GENERAL EXPENSES 8,940. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 325,891. CONTRACTED SERVICE: PROGRAM SERVICE EXPENSES 3,865,756. MANAGEMENT AND GENERAL EXPENSES 1,439,719. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,305,475. TRASH REMOVAL: PROGRAM SERVICE EXPENSES 1,128. MANAGEMENT AND GENERAL EXPENSES 152,363. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 153,491. COLLECTION AGENCY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 96,600. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 96,600. | OTHER FEES |
| FORM 990, PART XI, LINE 9: | OTHER 99,420. GIFT SHOP EQUITY 10,911. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADIRONDACK MEDICAL CENTER FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 471 LAKE COLBY DRIVE | AddressLine1 |
| City | SARANAC LAKE | City |
| State | NY | State |
| ZIP Code | 12983 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161528554 | EIN |
| Primary Activities | SUPPORT AND ASSIST ADIRONDACK MEDICAL CENTER | PrimaryActivities |
| Legal Domicile State | NY | LegalDomicileState |
| Exempt Code Section | 501(C)3 | ExemptCodeSection |
| Public Charity Status | BOX 11 | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADIRONDACK MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg | Share Of EOY AssetsShareOfEOYAssets |
|---|---|---|---|---|---|---|---|---|---|---|---|
| TRUDEAU HEALTH SYSTEMS LLC | |||||||||||
| PO BOX 471 2233 STATE ROUTE 86 | SARANAC LAKE | NY | 12983 | 141788211 | CONTACTING - HEALTH SERVICES | NY | AMC AND TRUDEAU HEALTH SYSTEMS | C | 0.50000 | 0 | |
| TRUDEAU HEALTH SYSTEMS IPA | |||||||||||
| PO BOX 471 2233 STATE ROUTE 86 | SARANAC LAKE | NY | 12983 | 141795284 | CONTACTING - HEALTH SERVICES | NY | AMC AND TRUDEAU HEALTH SYSTEMS | C | 0.50000 | 0 | 31855 |
| 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 | 0 | 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 |