RIVER HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- RIVER HOSPITAL INC (EIN 81-0600548)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201323179349304677
- 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 | 2013-11-13T14:38:44-06:00 | 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 | 810600548 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVER HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | RIVE | NameControl |
| Phone | 3154822511 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4 FULLER STREET | AddressLine1 |
| City | ALEXANDRIA BAY | City |
| State | NY | State |
| ZIP Code | 13607 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BEN MOORE | Name |
| Title | CEO | Title |
| Phone | 3154822511 | Phone |
| Date Signed | 2013-11-08 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOSEPH J SCHLEGEL | Name |
| PTIN | P00301329 | PTIN |
| Phone | 3154463600 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | BEN MOORE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4 FULLER STREET | AddressLine1 |
| City | ALEXANDRIA BAY | City |
| State | NY | State |
| ZIP Code | 13607 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 14047253 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.RIVERHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2003 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | IT IS THE MISSION OF RIVER HOSPITAL TO PROVIDE COMPASSIONATE, COST EFFECTIVE AND ACCESSIBLE PRIMARY HEALTH CARE TO THE YEAR ROUND AND SEASONAL RESIDENTS, AND VISITORS OF THE RIVER COMMUNITIES. THE HOSPITAL PRIDES ITSELF ON HIGH QUALITY OUTPATIENT, INPATIENT AND SPECIALTY SERVICES TO MEET INDIVIDUAL AND COMMUNITY NEEDS THROUGH PARTNERSHIPS WITH OUR PATIENTS AND COMMUNITIES WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 211 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1722592 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 424661 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 11741535 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 12267916 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 81530 | InvestmentIncomePriorYear |
| Investment Income Current Year | 98236 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 86830 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1186732 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 13632487 | TotalRevenuePriorYear |
| Total Revenue Current Year | 13977545 | 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 | 8121424 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8914575 | 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 | 4993597 | OtherExpensePriorYear |
| Other Expenses Current Year | 5023731 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 13115021 | TotalExpensesPriorYear |
| Total Expenses Current Year | 13938306 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 517466 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 39239 | RevenuesLessExpensesCY |
| Total Assets BOY | 12793530 | TotalAssetsBOY |
| Total Assets EOY | 14205206 | TotalAssetsEOY |
| Total Liabilities BOY | 6453137 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 7654057 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6340393 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6551149 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | IT IS THE MISSION OF RIVER HOSPITAL TO PROVIDE COMPASSIONATE, COST EFFECTIVE AND ACCESSIBLE PRIMARY HEALTH CARE TO THE YEAR ROUND AND SEASONAL RESIDENTS, AND VISITORS OF THE RIVER COMMUNITIES. THE HOSPITAL PRIDES ITSELF ON HIGH QUALITY OUTPATIENT, INPATIENT AND SPECIALTY SERVICES TO MEET INDIVIDUAL AND COMMUNITY NEEDS THROUGH PARTNERSHIPS WITH OUR PATIENTS AND COMMUNITIES WE SERVE. | MissionDescription |
| Significant New Program Services | 1 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 10984549 | Expense |
| Revenue | 13454648 | Revenue |
| Description | RIVER HOSPITAL, INC. PROVIDED GENERAL INPATIENT, OUTPATIENT, AND EMERGENCY SERVICES TO RESIDENTS IN THE NORTHERN NEW YORK AREA. DURING 2012, THE HOSPITAL PROVIDED 1,423 SWING BED DAYS AND 447 DAYS OF CRITICAL ACCESS CARE TO THE SICK AND INJURED. RIVER HOSPITAL STRIVES TO IDENTIFY AND UPDATE SERVICES BASED UPON THE COMMUNITY NEEDS. WE ARE ALSO IN THE PROCESS OF IMPLEMENTING ELECTRONIC HEALTH RECORDS AND ARE PARTICIPATING IN THE REGIONAL HEALTH INFORMATION EXCHANGE (RHIO). THE HOSPITAL SERVES A COMMUNITY PAYOR MIX OF 49% GOVERNMENT PAYORS, 36% COMMERCIAL PAYORS AND OTHER AND 15% UNINSURED. | Description |
| Total Program Service Expense | 10984549 | 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 | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 97 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 211 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 1 | 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 | 0 | 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 | TRACI MINTONYE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3154822511 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4 FULLER STREET | AddressLine1 |
| City | ALEXANDRIA BAY | City |
| State | NY | State |
| ZIP Code | 13607 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| JOSEPH RUSSELL | |||||||||
| CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | |||
| ROBERT TOOLE | |||||||||
| VICE CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | |||
| JEANNE SNOW | |||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | 2.00 | ||
| ROBERT TAGUE DDS | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| FRANCES BROWN | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| CRAIG GARLOCK | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| NORMAN SNYDER | |||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | |||
| RONALD MILLER | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| ROBERT NELSON | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| RICHARD MACSHERRY | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| RONALD RANDALL | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| JAMES DONEGAN | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| FREDRICK SCHMITT | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| LYNN BROWN | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | 5.00 | |||
| BEN MOORE | |||||||||
| CEO | 40.00 | X | 240000 | 0 | 0 | ||||
| TRACI MINTONYE | |||||||||
| CFO | 35.00 | X | 104165 | 0 | 12453 | 5.00 | |||
| WILLIAM H CONNOR | |||||||||
| COO | 40.00 | X | 88997 | 0 | 0 | ||||
| TROY JOHNSON | |||||||||
| MEDICAL DIRECTOR/ER DIRECT | 40.00 | 195635 | 0 | 0 | X | ||||
| HARRIET BURRIS | |||||||||
| MEDICAL DIRECTOR/ER DIRECT | 40.00 | 145045 | 0 | 9344 | X | ||||
| AARON HUIZENGA | |||||||||
| PHYSICIAN - CLINIC | 40.00 | 203793 | 0 | 12453 | X | ||||
| REBECCA ALBERTO-TAN | |||||||||
| CHIEF OF ANESTHESIOLOGY | 40.00 | 293302 | 0 | 12453 | X | ||||
| WAYNE JACKSON | |||||||||
| PHYSICIAN ASSISTANT-ER | 40.00 | 130414 | 0 | 12453 | X | ||||
| FREDRICK TONTARSKI | |||||||||
| PHYSICIAN ASSISTANT-ER | 40.00 | 129264 | 0 | 9344 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1530615 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 68500 | TotalOtherCompensation |
| Number Individuals GT100 K | 11 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Related Organizations | 189932 | RelatedOrganizations |
| Government Grants | 179916 | GovernmentGrants |
| All Other Contributions | 54813 | AllOtherContributions |
| Total Contributions | 424661 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PROGRAM SERVICE REVENUE | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 12267916 | TotalRevenueColumn |
| Related Or Exempt Function Income | 12267916 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 12267916 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 97961 | TotalRevenueColumn |
| Exclusion | $97,961 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 56213 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 62670 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -6457 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -6457 | TotalRevenueColumn |
| Related Or Exempt Function Income | -6457 | RelatedOrExemptFunctionIncome |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7313 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 7038 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 275 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 275 | TotalRevenueColumn |
| Exclusion | $275 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| OTHER OPERATING REVENUE | 623000 | 1163155 | 1163155 |
| CAFETERIA REVENUE | 623000 | 16191 | 16191 |
| OTHER NON-OPERATING REVENUE | 623000 | 10869 | 10869 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2974 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2974 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1193189 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 13977545 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13454648 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $98,236 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 641250 | Total |
| Program Services | 512945 | ProgramServices |
| Management And General | 128305 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7088074 | Total |
| Program Services | 5669936 | ProgramServices |
| Management And General | 1418138 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1185251 | Total |
| Program Services | 947379 | ProgramServices |
| Management And General | 237872 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95761 | Total |
| Management And General | 95761 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 152495 | Total |
| Program Services | 44086 | ProgramServices |
| Management And General | 108409 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 172054 | Total |
| Program Services | 172054 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93095 | Total |
| Program Services | 77996 | ProgramServices |
| Management And General | 15099 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48058 | Total |
| Program Services | 34400 | ProgramServices |
| Management And General | 13658 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 201664 | Total |
| Program Services | 184890 | ProgramServices |
| Management And General | 16774 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 878147 | Total |
| Program Services | 702453 | ProgramServices |
| Management And General | 175694 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 331168 | Total |
| Program Services | 264910 | ProgramServices |
| Management And General | 66258 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| OUTSIDE SERVICES | 820106 | 491175 | 328931 |
| BAD DEBT | 817147 | 817147 | |
| SUPPLIES | 778807 | 754092 | 24715 |
| UTILITIES | 228091 | 182456 | 45635 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 407138 | Total |
| Program Services | 128630 | ProgramServices |
| Management And General | 278508 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13938306 | Total |
| Program Services | 10984549 | ProgramServices |
| Management And General | 2953757 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 146854 | BOY |
| EOY | 1176960 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 690826 | BOY |
| EOY | 740456 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1727987 | BOY |
| EOY | 2129877 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 253114 | BOY |
| EOY | 308373 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82285 | BOY |
| EOY | 95787 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 11004850 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5659381 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4932693 | BOY |
| EOY | 5345469 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3955619 | BOY |
| EOY | 3389664 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 491157 | BOY |
| EOY | 359763 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 512995 | BOY |
| EOY | 658857 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12793530 | BOY |
| EOY | 14205206 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1714409 | BOY |
| EOY | 2743007 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4114423 | BOY |
| EOY | 4390066 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 624305 | BOY |
| EOY | 520984 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6453137 | BOY |
| EOY | 7654057 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1909623 | BOY |
| EOY | 2527388 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3910918 | BOY |
| EOY | 3503909 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 519852 | BOY |
| EOY | 519852 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6340393 | BOY |
| EOY | 6551149 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12793530 | BOY |
| EOY | 14205206 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 39239 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 302911 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -131394 | 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 Separate | X | FinancialStatementSeparate |
| 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 | 4430770 | BeginningOfYearBalance |
| Contributions | 424661 | Contributions |
| Investment Earnings Or Losses | -39795 | InvestmentEarningsOrLosses |
| Other Expenditures | 791875 | OtherExpenditures |
| End Of Year Balance | 4023761 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 3733112 | BeginningOfYearBalance |
| Contributions | 1722592 | Contributions |
| Investment Earnings Or Losses | -19964 | InvestmentEarningsOrLosses |
| Other Expenditures | 1004970 | OtherExpenditures |
| End Of Year Balance | 4430770 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2910665 | BeginningOfYearBalance |
| Contributions | 2020137 | Contributions |
| Investment Earnings Or Losses | 37447 | InvestmentEarningsOrLosses |
| Other Expenditures | 1235136 | OtherExpenditures |
| End Of Year Balance | 3733113 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1338898 | BeginningOfYearBalance |
| Grants Or Scholarships | -4542 | GrantsOrScholarships |
| Other Expenditures | -1567225 | OtherExpenditures |
| End Of Year Balance | 2910665 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 1393497 | BeginningOfYearBalance |
| Grants Or Scholarships | -4223 | GrantsOrScholarships |
| Other Expenditures | 58822 | OtherExpenditures |
| End Of Year Balance | 1338898 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.12920 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.87080 | 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 | 11000 | OtherCostOrOtherBasis |
| Book Value | 11000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3646359 | OtherCostOrOtherBasis |
| Depreciation | 1560889 | Depreciation |
| Book Value | 2085470 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6779916 | OtherCostOrOtherBasis |
| Depreciation | 4098492 | Depreciation |
| Book Value | 2681424 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 567575 | OtherCostOrOtherBasis |
| Book Value | 567575 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5345469 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| INSURANCE RESERVE | $291,219 |
| GRANT LIABILITY | $229,765 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 520984 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 14040215 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 14040215 | RevenueSubtotal |
| Other Revenues Not Included | -62670 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -62670 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 13977545 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 14000976 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 14000976 | ExpensesSubtotal |
| Other Expenses Not Included | -62670 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | -62670 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 13938306 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | PERMANENT ENDOWMENT FUNDS ARE TO BE HELD IN PERPETUITY WITH THE INCOME TO BE USED TO SUPPORT HEALTHCARE SERVICES. TEMPORARY ENDOWMENT FUNDS ARE TO BE USED TO PURCHASE CAPITAL EQUIPMENT FOR HEALTHCARE SERVICES, HOSPITAL OPERATIONS AND SCHOLARSHIPS. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN A HOSPITAL'S 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. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -62,670. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -62,670. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 592758 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 81634 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 511124 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03670 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1386730 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1147013 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 239717 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01720 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 65944 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11999 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 53945 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00390 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2045432 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1240646 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 804786 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05780 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2045432 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1240646 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 804786 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05780 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $629,120 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 3665258 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 3981208 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -315950 | 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 | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVER HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4 FULLER STREET | AddressLine1 |
| City | ALEXANDRIA BAY | City |
| State | NY | State |
| ZIP Code | 13607 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVER HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Uninsured Discount | X | UninsuredDiscount |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 0 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: WORKSHEETS 1, 2 & 3 WERE USED TO COMPLETE LINES 7A, 7B AND 7C. | ||
| PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES CONSIST OF PSA SCREENINGS AND MAMMOGRAPHY SCREENINGS GIVEN TO UNINSURED PATIENTS DURING 2012 | ||
| PART III, LINE 4: PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST PAYMENT HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL 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 DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS 31% OF THE RELATED PATIENT ACCOUNTS RECEIVABLE, NET OF CONTRACTUAL ALLOWANCES AT DECEMBER 31, 2012 AND 2011. AN ALLOWANCE FOR DOUBTFUL ACCOUNTS RECEIVABLE IS ESTIMATED BY MANAGEMENT BASED ON PERIODIC REVIEWS OF THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE CONSIDERING HISTORICAL EXPERIENCE AND PREVAILING ECONOMIC CONDITIONS. | ||
| PART III, LINE 8: THE SHORTFALL REPORTED ON LINE 7 WAS SETTLED IN 2013 WITHIN THE 2012 MEDICARE COST REPORT SETTLEMENT CALCULATION, THEREFORE, THIS AMOUNT SHOULD NOT BE CONSIDERED TO BE PART OF THE COMMUNITY BENEFIT. | ||
| PART III, LINE 9B: UNDER OUR CHARITY CARE PROGRAM, PATIENTS MAY APPLY FOR ASSISTANCE WITHIN 90 DAYS OF DISCHARGE OR DATE OF SERVICE. ONCE THE APPLICATION IS REQUESTED AND RECEIVED BY THE APPLICANT, THE APPLICATION MUST BE RETURNED TO RIVER HOSPITAL WITHIN 20 DAYS. RIVER HOSPITAL DOES NOT PURSUE FURTHER COLLECTION ACTION WHILE THIS APPLICATION IS IN PROCESS PROVIDING THAT THE APPLICATION IS COMPLETED IN A TIMELY FASHION. RIVER HOSPITAL PROCESSES THIS APPLICATION WITHIN 30 DAYS OF RECEIPT. APPLICANTS ARE NOTIFIED IN WRITING OF OUR DECISION. AN INSTALLMENT AGREEMENT IS THEN SENT TO THE APPLICANT, AN INTEREST FREE AGREEMENT, TO BE SIGNED AND RETURNED. | ||
| PART VI, LINE 2: THROUGH A COLLABORATIVE TRI-COUNTY EFFORT NORTH COUNTRY HEALTH COMPASS PARTNERSHIP HAS BEEN ESTABLISHED TO ADDRESS THE NEW YORK STATE HEALTH AGENDA. IN ORDER TO APPROPRIATELY ADDRESS THE NEEDS OF THE NORTH COUNTRY, A NEEDS ASSESSMENT WAS PERFORMED. DATA COLLECTED HAS BEEN COMPILED AND PRIORITIZED IN ALIGNMENT WITH THE NEW YORK STATE HEALTH AGENDA. | ||
| PART VI, LINE 3: PATIENTS ARE PROVIDED INFORMATION ABOUT OUR CHARITY CARE PROGRAM AND THE ELIGIBILITY GUIDELINES AT THE TIME OF SERVICE. WE ALSO HAVE THE INFORMATION AVAILABLE ON OUR WEBSITE. | ||
| PART VI, LINE 4: RIVER HOSPITAL IS LOCATED WITHIN THE VILLAGE OF ALEXANDRIA BAY, NEW YORK, THE HEART OF THE THOUSAND ISLAND REGION, AND INCLUDES AREAS OF BOTH JEFFERSON AND ST. LAWRENCE COUNTIES. RIVER HOSPITAL IS SITUATED DIRECTLY ON THE SHORE OF THE ST. LAWRENCE SEAWAY, A VERY RURAL AREA, YET, ONE OF THE MAJOR COMMERCIAL WATERWAYS, CONNECTING THE GREAT LAKES TO THE WATER WAYS OF THE WORLD. RIVER HOSPITALS IMMEDIATE SERVICE AREA REACHES A RADIUS OF APPROXIMATELY 25 MILES. THE FACILITY PROVIDES HEALTH CARE SERVICES TO SEVERAL SURROUNDING COMMUNITIES. WITHIN THE RANGE OF THE RIVER HOSPITAL SERVICE AREA IS THE EXPANSIVE UNITED STATES ARMY'S 10TH MOUNTAIN LIGHT INFANTRY DIVISION AT FORT DRUM AND THE INFLUX OF FAMILY MEMBERS AND ASSOCIATED POPULATION. DIRECTLY TO THE NORTH, ON THE OPPOSITE SHORE OF THE ST. LAWRENCE RIVER IS THE PROVINCE OF ONTARIO, CANADA, CONFINING AVAILABILITY OF UNITED STATES HEALTH CARE SYSTEM TO 180 DEGREE RADIUS. THE LARGEST NEARBY UNITED STATES POPULATION CENTER IS SYRACUSE, NEW YORK, LOCATED 100 MILES TO THE SOUTH.IN ADDITION TO THE FULL TIME RESIDENTS OF THESE COMMUNITIES, RIVER HOSPITAL SERVES A LARGE POPULATION OF SEASONAL RESIDENTS AND VISITORS FROM THE UNITED STATES AND OTHER COUNTRIES OF THE WORLD, DUE IN PART TO THE SEASONAL TOURISM INDUSTRY. THIS ENTIRE REGION IS A MEDICALLY UNDERSERVED AREA (MUA) AND FEDERALLY DESIGNATED HEALTH PROVIDER SHORTAGE AREA (HPSA) WITH POVERTY AND UNEMPLOYMENT RATES THAT SIGNIFICANTLY EXCEED BOTH STATE AND NATIONAL AVERAGES. | ||
| PART VI, LINE 5: RIVER HOSPITAL CONTINUES TO BE VERY INVOLVED WITH OTHER PARTNERS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THIS REGION ON NORTHERN NEW YORK STATE, INCLUDING RELATIONSHIPS WITH JEFFERSON COUNTY PUBLIC HEALTH DEPARTMENT, OTHER NORTH COUNTRY HOSPITALS AND AGENCIES/ORGANIZATIONS TO SHARE INFORMATION AND WORK TOGETHER TO EDUCATE THE PUBLIC ON THE AVAILABILITY OF SERVICES IN THIS REGION. RIVER HOSPITAL WORKS CLOSELY WITH FORT DRUM REGIONAL HEALTH PLANNING ORGANIZATION (FDRHPO), WHICH WAS ESTABLISHED TO LINK MILITARY FAMILIES ASSIGNED TO FORT DRUM MILITARY INSTALLATION TO QUALITY HEALTH CARE SERVICES AND RESOURCES IN THE SURROUNDING REGION AS THERE IS NO ON-BASE HOSPITAL. | ||
| PART VI, LINE 6: RIVER HOSPITAL PARTICIPATED IN HEALTH AND WELLNESS FAIRS WHERE HEALTH INFORMATION WAS DISTRIBUTED ALONG WITH INFORMATION ABOUT THE HOSPITAL. IN APRIL, THE HOSPITAL PARTNERED WITH THOUSAND ISLANDS YOUNG LEADERS ORGANIZATION (TIYLO) TO BRING A HEALTH AND WELLNESS FAIR TO THE CLAYTON COMMUNITY. IN OCTOBER, THE HOSPITAL HOSTED ALEXANDRIA CENTRAL SCHOOL'S SECOND GRADE CLASS FOR THE ANNUAL SCHOOL TOUR OF THE HOSPITAL. THE HOSPITAL ALSO CONTINUES TO WORK WITH OTHER AGENCIES SUCH AS CANCER SERVICES PROGRAM OF JEFFERSON AND LEWIS COUNTIES, WHICH TOGETHER WITH OTHER REGIONAL FACILITIES BROUGHT THE "LOVE YOURSELF" EVENT, HELD IN MAY, TO INDIVIDUALS WITHOUT ADEQUATE HEALTH INSURANCE WHO NEEDED MAMMOGRAMS. RIVER HOSPITAL WAS THE HEALTHCARE PROVIDER AT THE HOOD PLANT ANNUAL EMPLOYEE/FAMILY HEALTH FAIR AND OFFERED FLU VACCINES, PHYSICAL THERAPY TECHNIQUES, BLOOD PRESSURE CHECKS, PROPER NUTRITION GUIDELINES AS WELL AS INFORMATION TO IMPROVE/MAINTAIN GOOD HEALTH AND GENERAL RIVER HOSPITAL SERVICES INFORMATION.RIVER HOSPITAL ALSO HOSTED MASH CAMP STUDENTS, SPONSORED BY THE NORTHERN NEW YORK RURAL HEALTH CARE ALLIANCE, WHEREBY STUDENTS FROM AREA SCHOOLS EXPLORED CAREERS IN HEALTHCARE AT RIVER HOSPITAL. RIVER HOSPITAL ALSO ATTENDED MEETINGS WITH SEVERAL COMMUNITY ORGANIZATIONS TO INFORM THEM OF THE SERVICES OFFERED. THOSE ORGANIZATIONS INCLUDED: ALEXANDRIA BAY ROTARY, AMERICAN LEGION POST 904, TOWN OF CLAYTON AND ALEXANDRIA, VILLAGE OF ALEXANDRIA, AND TOWN OF HAMMOND.IN 2012, RIVER HOSPITAL CONTINUED TO WORK WITH OTHER REGIONAL HOSPITALS ON A COLLABORATION TO DEVELOP A STRATEGY TO ADDRESS THE DELIVERY OF AFFORDABLE HEALTH CARE SOLUTIONS TO RESIDENTS IN THE TRI-COUNTY AREA. THE SEVEN HOSPITAL COLLABORATION INCLUDE RIVER HOSPITAL, ALEXANDRIA BAY; CLAXTON HEPBURN MEDICAL CENTER, OGDENSBURG; EJ NOBLE HOSPITAL, GOUVERNEUR; CLIFTON-FINE HOSPITAL, STAR LAKE; LEWIS COUNTY GENERAL HOSPITAL, LOWVILLE; SAMARITAN MEDICAL CENTER, WATERTOWN AND CARTHAGE AREA HOSPITAL, CARTHAGE.RIVER HOSPITAL ACTIVELY PARTICIPATES WITH THE NEW YORK STATE CRITICAL ACCESS HOSPITALS WHO WORK TOGETHER ON QUALITY IMPROVEMENT PROCESSES AND PATIENT SATISFACTION OUTCOMES. | ||
| NY | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BEN MOORE | ||||||||||||||
| CEO | 240000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 240000 | 0 | 0 | 0 |
| TROY JOHNSON | ||||||||||||||
| MEDICAL DIRECTOR/ER DIRECT | 195635 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 195635 | 0 | 0 | 0 |
| HARRIET BURRIS | ||||||||||||||
| MEDICAL DIRECTOR/ER DIRECT | 145045 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 9344 | 0 | 154389 | 0 | 0 | 0 |
| AARON HUIZENGA | ||||||||||||||
| PHYSICIAN - CLINIC | 203793 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 12453 | 0 | 216246 | 0 | 0 | 0 |
| REBECCA ALBERTO-TAN | ||||||||||||||
| CHIEF OF ANESTHESIOLOGY | 293302 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 12453 | 0 | 305755 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NEW PROGRAM SERVICES | FORM 990, PART III, LINE 2 | RIVER HOSPITAL, INC. BEGAN ITS CONVENIENT CARE CLINIC, OBSERVATION BED AND MENTAL HEALTH SERVICES IN 2012. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE DIRECTORS OF THE ORGANIZATION MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS MADE AVAILABLE TO THE BOARD MEMBERS PRIOR TO ITS FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH MEMBER OF THE BOARD IS REQUIRED TO COMPLETE AND SIGN A CONFLICT OF INTEREST POLICY ANNUALLY. IF A CONFLICT ARISES IN BETWEEN ANNUAL REVIEW OF THE POLICY, THE BOARD MEMBER IS REQUIRED TO AND RESPONSIBLE FOR REPORTING THE CONFLICT OF INTEREST. | |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CEO'S WAGES ARE REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES AND COMPARABLE REGIONAL WAGE DATA PROVIDED BY PAYSCALE AND THE IROQUOIS HEALTHCARE ASSOCIATION SURVEY OF WAGE DATA ARE USED TO DETERMINE COMPETITIVE WAGES. THE CEO IS MONITORED AND EVALUATED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. THE EXECUTIVE DIRECTOR, AND OTHER TOP MANAGEMENT OFFICERS ARE MONITORED AND REVIEWED ON AN ANNUAL BASIS BY THE CEO. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE COMPANY'S WEBSITE. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE PUBLIC CHARITY WEBSITE. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN FOUNDATION -131,394. |
| FORM 990, PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVER HOSPITAL FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 567 | AddressLine1 |
| City | ALEXANDRIA BAY | City |
| State | NY | State |
| ZIP Code | 13607 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 421585479 | EIN |
| Primary Activities | RAISES FUNDS FOR HOSPITAL CONSTRUCTION, REMODELING AND MEDICAL EQUIPMENT. | PrimaryActivities |
| Legal Domicile State | NY | LegalDomicileState |
| Exempt Code Section | 501 (C) 3 | ExemptCodeSection |
| Public Charity Status | 11C | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVER HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | 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 | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |