NATHAN LITTAUER HOSPITAL ASSOCIATION: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- NATHAN LITTAUER HOSPITAL ASSOCIATION (EIN 14-1338465)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201333199349303598
- Schema version
- 2012v2.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-13T08:40:51-07:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141338465 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NATHAN LITTAUER HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | NATH | NameControl |
| Phone | 5187258621 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 99 East State Street | AddressLine1 |
| City | Gloversville | City |
| State | NY | State |
| ZIP Code | 12078 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Laurence Kelly | Name |
| Title | President & CEO | Title |
| Phone | 5187735480 | Phone |
| Date Signed | 2013-11-13 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Nathan Littauer Hospital and Nursing Home | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Laurence E Kelly | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 99 East State Street | AddressLine1 |
| City | Gloversville | City |
| State | NY | State |
| ZIP Code | 12078 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 96252452 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.nlh.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1894 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | Nathan Littauer Hospital and Nursing Home and its family of health services is committed to providing safe high quality health and wellness services and improving the health of our communities in a caring, contemporary environment. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1090 | TotalNbrEmployees |
| Total Nbr Volunteers | 228 | TotalNbrVolunteers |
| Total Gross UBI | 667468 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 602415 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 684587 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 85183984 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 89815422 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 246733 | InvestmentIncomePriorYear |
| Investment Income Current Year | 898165 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1617585 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4546299 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 87650717 | TotalRevenuePriorYear |
| Total Revenue Current Year | 95944473 | 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 | 57082754 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 59923228 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 12173 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 29129673 | OtherExpensePriorYear |
| Other Expenses Current Year | 30934826 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 86212427 | TotalExpensesPriorYear |
| Total Expenses Current Year | 90858054 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1438290 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5086419 | RevenuesLessExpensesCY |
| Total Assets BOY | 59240851 | TotalAssetsBOY |
| Total Assets EOY | 66197835 | TotalAssetsEOY |
| Total Liabilities BOY | 26886203 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 29241061 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 32354648 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 36956774 | NetAssetsOrFundBalancesEOY |
| Mission Description | Nathan Littauer Hospital and Nursing Home and its family of health services is committed to providing safe high quality health and wellness services and improving the health of our communities in a caring, contemporary environment. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 50719672 | Expense |
| Grants | 0 | Grants |
| Revenue | 67287350 | Revenue |
| Description | 74 bed general medical surgical hospital providing inpatient and outpatient services with the following service statistics for 2012; 13,312 inpatient days, 1,158 observation visits, 860 new born days, 3,173 adult and pediatric admissions, 365 nursery admissions, 24,486 emergency room visits, 92,927 outpatient visits and 4,480 day surgery visits. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 24454842 | Expense |
| Grants | 0 | Grants |
| Revenue | 15408000 | Revenue |
| Description | The Nathan Littauer Primary and Specialty Care Centers provide care for the whole family. Our eight conveniently located centers offer a range of services and specialties with direct access to the specialists and state-of-the-art technology available at Nathan Littauer Hospital. Several Centers are located in remote rural parts of our service area. The Centers employ 33 physicians and over 27 other healthcare professionals During 2012 the Centers collectively incurred 118,539 patient visits. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 9065523 | Expense |
| Grants | 0 | Grants |
| Revenue | 6889580 | Revenue |
| Description | The Nathan Littauer Nursing Home located on the Nathan Littauer Hospital campus is a short and long term residential healthcare facility that provides a wide range of medical services with 84 beds. In 2012 the facility had a total of 30,271 patient days. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 582195 | Expense |
| Grants | 0 | Grants |
| Revenue | 3747735 | Revenue |
| Description | HealthLink is Nathan Littauer Hospital's Wellness Education Center located in Johnstown. HealthLink's role is to promote wellness by increasing community awareness and providing resources for those wishing to make positive, healthy lifestyle changes. Since its launch in 1989, HealthLink has served nearly 172,000 area residents with more than 7,120 free or low-cost education programs and health screenings. Our wide variety of programs are chosen based on the interests and needs of the community. Program categories include Health & Wellness, Mind & Body, Childbirth & Parenting, Health Screenings, Support Groups, Special Events, and Vitality Plus (ViP)...especially for adults 50+. We also offer Worksite Wellness programs, including health screenings and wellness education programs, to promote health & wellness on the job. Speakers are available for presentations to schools, churches, community groups, organizations, etc., on a variety of topics. HealthLink's growing library of books, videos/DVD's, magazines and brochures cover many health-related issues. Most are free or loaned at no charge. The Hospital also offers a Lifeline Program. Lifeline is a personal emergency response system which connects subscribers with the Hospitals emergency department through a telephone based communication system. A total of 500 subscribers are members of NLHs Lifeline Program. Other community services include community health fairs, speakers bureau, organ donation program, Camp Superstarrs and New Visions Program for high school students. Health Insurance Counseling: Nathan Littauer Hospital is the lead agency in the New York State Child and Family Health Plus grant funded facilitated enrollment insurance program for Fulton, Montgomery and Hamilton counties. Child and Family Health Plus is a facilitated insurance enrollment program for children and adults that do not have or cannot afford health insurance. In 2012 more than 1,215 children, 50 pregnant women and more than 740 families were enrolled in health insurance programs through our agency. These enrollments included Medicaid and participating HMOs. (2,011 Individuals and families) Also included here is the Meaningful Use Funds received (EHR) of $2,878,753 and other operating and non-operating revenue of $638,490. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 582195 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 3747735 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 84822232 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 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 | 1 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 34 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1090 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 1 | Form8899Filed |
| Form1098 C Filed | 1 | Form1098CFiled |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | 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 | 1 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Michael Redcross | NamePerson |
| Telephone Number | 5187735481 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 99 East State Street | AddressLine1 |
| City | Gloversville | City |
| State | NY | State |
| ZIP Code | 120781293 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| David Seward Esq | ||||||||
| Chair | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Brian Hanaburgh | ||||||||
| Vice Chair | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Susan Johnson Esq | ||||||||
| Treasurer | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Arlene M Sitterly | ||||||||
| Secretary | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Neil McGovern | ||||||||
| Member | 0.5 | 0 | X | 0 | 0 | 0 | ||
| John Fox DDS | ||||||||
| Member | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Shriraj Shah MD | ||||||||
| Member | 0.5 | 0 | X | 41957 | 0 | 0 | ||
| John Comstock | ||||||||
| Member | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Holly Chamberlin Esq | ||||||||
| Member | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Michael Bowker | ||||||||
| Member | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Anita Moore | ||||||||
| Member | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Mike McBiles | ||||||||
| Member | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Kevin Smith | ||||||||
| Member | 0.5 | 0 | X | 0 | 0 | 0 | ||
| Laurence E Kelly | ||||||||
| President & CEO & Member | 40 | 0 | X | 350205 | 0 | 156114 | X | |
| Henry Legendziewicz | ||||||||
| Senior Vice President & CFO | 40 | 0 | 200946 | 0 | 74749 | X | ||
| Mike Ostrander | ||||||||
| Vice President of Finance & CFO | 40 | 0 | 5262 | 0 | 210 | X | ||
| James Anania MD | ||||||||
| Physician | 40 | 0 | 435685 | 0 | 27494 | X | ||
| Paul Husson MD | ||||||||
| Physician | 40 | 0 | 306219 | 0 | 10000 | X | ||
| Paul Moberg MD | ||||||||
| Physician | 40 | 0 | 401290 | 0 | 27494 | X | ||
| Peter Dowling MD | ||||||||
| Physician | 40 | 0 | 301290 | 0 | 27494 | X | ||
| Patricia Nguyen MD | ||||||||
| Phycian | 40 | 0 | 300690 | 0 | 27494 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2343544 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 351049 | TotalOtherCompensation |
| Number Individuals GT100 K | 58 | 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 |
|---|---|---|---|---|---|
| Sodexho Operations | |||||
| PO Box 905374 | Charlotte | NC | 28290 | Dietary Services | 1676547 |
| Alliance Healthcare Services | |||||
| PO Box 96485 | Chicago | IL | 60693 | MRI Imaging Servies | 1220535 |
| AOW Associates Inc | |||||
| 30 Essex Street | Albany | NY | 12206 | Construction Services | 1102079 |
| Saratoga Emergency Physicians PC | |||||
| 211 Church Street | Saratoga Springs | NY | 12866 | Emergency Room Physician Services | 714661 |
| Quest Diagnostics | |||||
| 1 Malcolm Avenue | Teterboro | NJ | 07608 | Laboratory Services | 601583 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 20 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 200000 | RelatedOrganizations |
| Government Grants | 473167 | GovernmentGrants |
| All Other Contributions | 11420 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 684587 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Inpatient & Outpatient Services | 622000 | 67287350 | 67287350 | 0 | $0 |
| Primary Care & Specialty Care Centers | 621110 | 15408000 | 15408000 | 0 | $0 |
| Nursing Home | 623000 | 6889580 | 6889580 | 0 | $0 |
| Life Line | 621990 | 222905 | 222905 | 0 | $0 |
| Healthlink | 611710 | 7587 | 7587 | 0 | $0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 89815422 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 808087 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $808,087 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 375645 | Securities |
| Other | 22412 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 307979 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 67666 | Securities |
| Other | 22412 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 90078 | TotalRevenueColumn |
| Related Or Exempt Function Income | 90078 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Retail Pharmacy | 446110 | 667468 | 0 | 667468 | $0 |
| Cafeteria Sales | 722210 | 433948 | 0 | 0 | $433,948 |
| Meaningful Use Funds | 921190 | 2878753 | 2878753 | 0 | $0 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 566130 | TotalRevenueColumn |
| Related Or Exempt Function Income | 548412 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $17,718 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4546299 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 95944473 | TotalRevenueColumn |
| Related Or Exempt Function Income | 93332665 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 667468 | UnrelatedBusinessRevenue |
| Exclusion | $1,259,753 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 556413 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 556413 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45948044 | Total |
| Program Services | 43573287 | ProgramServices |
| Management And General | 2374757 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3490851 | Total |
| Program Services | 3207878 | ProgramServices |
| Management And General | 282973 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6727717 | Total |
| Program Services | 6351760 | ProgramServices |
| Management And General | 375957 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3200203 | Total |
| Program Services | 3018534 | ProgramServices |
| Management And General | 181669 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 474794 | Total |
| Program Services | 474794 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 241731 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 241731 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 148376 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 148376 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31485 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 31485 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Fundraising | 0 | Fundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1182150 | Total |
| Program Services | 1019442 | ProgramServices |
| Management And General | 162708 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 276955 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 276955 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3243749 | Total |
| Program Services | 2941127 | ProgramServices |
| Management And General | 295862 | ManagementAndGeneral |
| Fundraising | 6760 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 457102 | Total |
| Program Services | 442716 | ProgramServices |
| Management And General | 14386 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1145245 | Total |
| Program Services | 1140002 | ProgramServices |
| Management And General | 5243 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 254983 | Total |
| Program Services | 218687 | ProgramServices |
| Management And General | 36296 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 506886 | Total |
| Program Services | 506886 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3682717 | Total |
| Program Services | 3500462 | ProgramServices |
| Management And General | 182255 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1446453 | Total |
| Program Services | 1446453 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Medical Supplies | 10076500 | 10076500 | 0 | 0 |
| Non-Medical Supplies | 1109497 | 1101819 | 7678 | 0 |
| Purchased Services | 4164241 | 3776205 | 388036 | 0 |
| Food | 924082 | 924082 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1567880 | Total |
| Program Services | 1101598 | ProgramServices |
| Management And General | 460869 | ManagementAndGeneral |
| Fundraising | 5413 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90858054 | Total |
| Program Services | 84822232 | ProgramServices |
| Management And General | 6023649 | ManagementAndGeneral |
| Fundraising | 12173 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1477494 | BOY |
| EOY | 4102977 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 199048 | BOY |
| EOY | 213649 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 973151 | BOY |
| EOY | 311937 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12031047 | BOY |
| EOY | 11621175 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 174306 | BOY |
| EOY | 174306 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 541256 | BOY |
| EOY | 631248 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 881497 | BOY |
| EOY | 1092153 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 73595843 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 48602712 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25713431 | BOY |
| EOY | 24993131 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11593480 | BOY |
| EOY | 15422852 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5656141 | BOY |
| EOY | 7634407 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59240851 | BOY |
| EOY | 66197835 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6923883 | BOY |
| EOY | 7183176 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20492 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4594126 | BOY |
| EOY | 4180883 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5206127 | BOY |
| EOY | 5304305 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10141575 | BOY |
| EOY | 12572697 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26886203 | BOY |
| EOY | 29241061 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31098997 | BOY |
| EOY | 36362337 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 973151 | BOY |
| EOY | 311937 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 282500 | BOY |
| EOY | 282500 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32354648 | BOY |
| EOY | 36956774 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59240851 | BOY |
| EOY | 66197835 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 5086419 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 233071 | ReconciliationUnrealizedInvest |
| Reconcilation Donated Services | 0 | ReconcilationDonatedServices |
| Reconcilation Invest Expenses | 0 | ReconcilationInvestExpenses |
| Reconcilation Prior Adjustment | 0 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | -717364 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $31,485 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 31485 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchC_P2B_S00_L01 | Identifier |
| Return Reference | Schedule C, Part II-B, Line 1 | ReturnReference |
| Explanation | A portion of the organizations dues for the American Hospital Association, Healthcare Association of NY and the Iroquois Healthcare Consortium is used for lobbying purposes. Also the organization engaged in a law firm to seek extension of the Medicare Dependent Hospital designation as part of a group effort on the part of rural hospitals. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 265320 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 54663 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 1388 | AdministrativeExpenses |
| End Of Year Balance | 318595 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 303299 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | -36431 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 1548 | AdministrativeExpenses |
| End Of Year Balance | 265320 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 261573 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 43367 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 1641 | AdministrativeExpenses |
| End Of Year Balance | 303299 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 193361 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | 69682 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 1470 | AdministrativeExpenses |
| End Of Year Balance | 261573 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 344557 | BeginningOfYearBalance |
| Contributions | 0 | Contributions |
| Investment Earnings Or Losses | -149499 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 0 | GrantsOrScholarships |
| Other Expenditures | 0 | OtherExpenditures |
| Administrative Expenses | 1697 | AdministrativeExpenses |
| End Of Year Balance | 193361 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 1 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 404197 | OtherCostOrOtherBasis |
| Book Value | 404197 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 35726209 | OtherCostOrOtherBasis |
| Depreciation | 21608811 | Depreciation |
| Book Value | 14117398 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 1359649 | OtherCostOrOtherBasis |
| Depreciation | 985230 | Depreciation |
| Book Value | 374419 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 31738038 | OtherCostOrOtherBasis |
| Depreciation | 22802008 | Depreciation |
| Book Value | 8936030 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 4367750 | OtherCostOrOtherBasis |
| Depreciation | 3206663 | Depreciation |
| Book Value | 1161087 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 24993131 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (10 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| AWUL by Debt & Lease Agreement | 2267064 |
| AWUL by Board Designation | 543234 |
| Agency Funds | 21655 |
| Miscellaneous Receivables | 1335695 |
| Other Assets | 372802 |
| Deferred Software License | 763141 |
| Deferred Financing | 235807 |
| Deferred Lease | 26554 |
| Deferred 1199 Funds | 274128 |
| Deferred 457 Plans | 1794327 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 7634407 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due To Third Party Reimbursement Agencies | $1,347,104 |
| Assest Retirement Obligation | $88,620 |
| Accrued Long Term Pension Obligation | $9,017,056 |
| Section 457 Plans | $1,842,826 |
| Due to 1199 | $124,630 |
| EHR Reserve | $152,461 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 12572697 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 96428766 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 0 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 0 | DonatedSrvcAndUseOfFacilities |
| Recoveries Of Prior Year Grants | 0 | RecoveriesOfPriorYearGrants |
| Other Revenues | 717364 | OtherRevenues |
| Revenue Not Rptd F990 | 717364 | RevenueNotRptdF990 |
| Revenue Subtotal | 95711402 | RevenueSubtotal |
| Investment Expenses Not Included | 0 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 233071 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 233071 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 95944473 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 90858054 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 0 | DonatedServicesUseOfFacilities |
| Prior Year Adjustments | 0 | PriorYearAdjustments |
| Losses Reported | 0 | LossesReported |
| Other Expenses Included | 0 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 90858054 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 0 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 90858054 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchD_P05_S00_L04 | Schedule D, Part V, Line 4 | The principle donation is permanently restricted, income generated by the fund is used in the daily operations of the hospital. |
| SchD_P10_S00_L02 | Schedule D, Part X, Line 2 | The Hospital is a not-for-profit organization, as described in Section 501(c)3 of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. The Hospital recognizes income tax positions when it is more-likely than not that the position will be sustainable based on the merits of the position. Management has concluded that there are no material tax liabilities that need to be recorded as of December 31, 2012. |
| SchD_P11_S00_L02d | Schedule D, Part XI, Line 2d | Distributions from NL Foundation $640,000, Change in interest in NL Foundation ($661,214), Pension related changes other than net periodic pension cost ($696,150). |
| SchD_P11_S00_L04b | Schedule D, Part XI, Line 4b | Net unrealized gains on investments |
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 |
| 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) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 2549 | PersonsServed |
| Total Community Benefit Expense | 782116 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 112124 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 669992 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0074 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 57757 | PersonsServed |
| Total Community Benefit Expense | 17415122 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11040923 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6374199 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0702 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Persons Served | 60306 | PersonsServed |
| Total Community Benefit Expense | 18197238 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 11153047 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7044191 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0776 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 26 | NumberOfActivitiesOrPrograms |
| Persons Served | 7044 | PersonsServed |
| Total Community Benefit Expense | 781682 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 274662 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 507020 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0056 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 24 | PersonsServed |
| Total Community Benefit Expense | 120287 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 120287 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0013 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 24454842 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21562211 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2892631 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0318 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 3 | NumberOfActivitiesOrPrograms |
| Persons Served | 200 | PersonsServed |
| Total Community Benefit Expense | 11634 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11634 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0001 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 31 | NumberOfActivitiesOrPrograms |
| Persons Served | 7268 | PersonsServed |
| Total Community Benefit Expense | 25368445 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21836873 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3531572 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0388 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 33 | NumberOfActivitiesOrPrograms |
| Persons Served | 67574 | PersonsServed |
| Total Community Benefit Expense | 43565683 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 32989920 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10575763 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.1164 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $6,824,417 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 13757068 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 17973674 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -4216606 | 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 | Nathan Littauer Hospital Association | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 99 East State Street | AddressLine1 |
| City | Gloversville | City |
| State | NY | State |
| ZIP Code | 12078 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.nlh.org | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| 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 | Nathan Littauer Hospital Association | 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 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| 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 |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| 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 | 9 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (9 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| Nathan Littauer Hospital Nursing Home | ||||
| 99 East State Street | Gloversville | NY | 12078 | 84 Bed Nursing Home. |
| Nathan Littauer Hospital Primary Care Center | ||||
| 99 East State Street | Gloversville | NY | 12078 | Primary/Specility Care Center (Clinic). |
| Perth-Broadalbin Primary Care Center | ||||
| 4100 State Highway 30 | Amsterdam | NY | 12078 | Primary/Specialty Care Center (Clinic). |
| Johnstown Primary Care Center | ||||
| 23 South Perry Street | Gloversville | NY | 12095 | Primary/Specialty Care Center (Clinic). |
| Mayfield Primary Care Center | ||||
| 2497 State Highway 30 | Mayfield | NY | 12117 | Primary/Specialty Care Center (Clinic). |
| Steele Avenue Primary Care Center | ||||
| 182 Steele Avenue | Gloversville | NY | 12078 | Primary/Specialty Care Center (Clinic). |
| Caroga Lake Primary Care Center | ||||
| 1840 State Highway 10 | Caroga Lake | NY | 12032 | Primary/Specialty Care Center (Clinic). |
| Speculator Primary Care Center | ||||
| Route 8 | Speculator | NY | 12164 | Primary/Specialty Care Center (Clinic). |
| Decker Drive Primary Care Center | ||||
| 110 Decker Drive | Johnstown | NY | 12095 | Primary/Specialty Care Center (Clinic). |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchH_P01_S00_L06a | Schedule H, Part I, Line 6a | Our annual community benefit report is prepared by Nathan Littauer Hospital. The report can be found at www.nlh.org. We also mail the report to organizations in our community. Our State requires the filing of a community benefit report every three years, rather than on an annual basis. Our reporting is designed to conform to this standard. |
| SchH_P01_S00_L07 | Schedule H, Part I, Line 7 | The costing methodology used to calculate the amounts reported in the Table for Line 7 is ratio of patient care cost to charges. |
| SchH_P01_S00_L07g | Schedule H, Part I, Line 7g | Subsidized health services reported included details from the Primary/Specialty Care Centers, licensed clinics. The Centers operated despite financial losses to the organization for at least the past nine years. The Hospital is committed to operate the Centers as a benefit to the community in order to address an identified community need and to improve access to healthcare, including our remote rural communities. |
| SchH_P03_S0A_L04 | Schedule H, Part III, Section A, Line 4 | Patient accounts receivable are reflected net of an allowance for estimated uncollectible accounts. In evaluating the collectability of patient accounts receivable, the Hospital analyzes its past collection history, business and economic conditions, trends in governmental and employee health care coverage and other collection indicators for each of its major categories of revenue by payor to estimate the appropriate allowance for estimated uncollectible accounts. Management regularly reviews data about these major categories of revenue in evaluating the sufficiency of the allowance for estimated uncollectible accounts. Throughout the year, the Hospital, after all reasonable collection efforts have been exhausted, will write off the difference between the standard rates (or discounted rates if applicable) and the amounts actually collected against the allowance for estimated uncollectible accounts. In addition to the review of the categories of revenue, management monitors the write offs against established allowances to determine the appropriateness of the underlying assumptions used in estimating the allowance for estimated uncollectible accounts. During 2012, the Hospital increased the amount of the allowance for estimated uncollectibles to provide for the increasing amount of write offs the Hospital is experiencing annually from changes in employer and governmental health care coverages which has resulted in a growth in the level of uninsured and under-insured patients. |
| SchH_P03_S0B_L08 | Schedule H, Part III, Section B, Line 8 | Medicare allowable costs were calculated using a cost to charge ratio based upon the cost finding methodology in the Medicare 2552-10 Cost Report. Community Benefit rationale: The Medicare shortfall should be considered a community benefit because our mission is to promote health in the community and we do not limit the care available to any patient, including those covered by Medicare. We are relieving a government burden by providing care to Medicare patients even though costs exceed reimbursements by $4,216,606. Tax exempt hospitals are expected to participate in the Medicare program. For many of the medical services provided by the Hospital, Medicare does not provide sufficient reimbursement to cover the cost of providing care to our patients, forcing the Hospital to use other funds to cover the deficit. Medicare Cost Reports that hospitals are required to file do not include the costs required to treat all Medicare patients. Therefore the amount reflected on the Medicare Cost Report differs from actual losses. In 2012 the Hospital realized an additional shortfall of $3,121,084 resulting from Medicare Advantage and non-PPS Medicare patients. The total shortfall for all types of Medicare patients was $7,337,690. |
| SchH_P03_S0C_L09b | Schedule H, Part III, Section C, Line 9b | Requests for Financial Assistance may be made at any point before, during or after the provision of care. Anyone seeking Financial Assistance will be given an application. Financial Assistance requests may be proposed by sources other than the patient, such as the patient's physician, family members, social services, or hospital personnel. Pending final eligibility determination, Nathan Littauer Hospital will not initiate collection efforts or requests for deposits provided that the responsible party is cooperative with Nathan Littauer Hospital's efforts to get payment from other sources. If initial screening does not disqualify someone for Financial Assistance they will be given an application, which includes instructions on how to apply. For non-Medicare patients, if the balance is under $100.00 for Primary Care and $500.00 for Hospital services, the Short Form Application can be utilized. |
| SchH_P06_S00_L02 | Schedule H, Part VI, Line 2 | Assessment of Public Health Priorities With ARHN facilitating the process the Community Health Planning Committee (the Committee) was formed with representatives from all six of the hospitals and all six of the local health departments in the region. Members of the Committee participated in a collaborative approach to community health assessment and planning. Relying on regional information gathered and analyzed by ARHN as well as information specific to each hospital's service area, each ARHN hospital prepared a Community Service Plan in collaboration with the other participating hospitals and local health departments. There were five main sources of data that were used to assess the public health priorities: The New York State Department of Health conducted an extensive Behavioral Risk Factor Surveillance Survey (BRFSS) in 2008. The BRFSS was conducted by telephone surveys and collected information on health risk behaviors, preventive health practices, and health care access primarily related to chronic disease and injury. Existing data, especially public health, statewide and national data New York State Prevention quality Indicatory data (PQI) Statewide Planning and Research Cooperative System (SPARCS) Stakeholder focus groups offer a unique perspective by gathering in a focus group setting individuals who have insight on the health of a community or the region. These individuals also provided suggested activities for improving the health of the region. ARHN used a prioritization matrix to identify the regional health priorities by using data to score criteria and issues. An ad hoc subcommittee was convened to develop the criteria for the matrix. The subcommittee researched a variety of prioritization matrices and compiled a list of 25 possible criteria, of which eight were applied. The eight criteria included: Leadership support available Magnitude of the problem Variance against benchmarks or goals Importance to the public health system Impact on the other health outcomes System resources Impact on the physical or social environment Ease of implementing solutions. The criteria were applied to the prioritization matrix to assist the Committee in reaching consensus on priority health issues. The regional community health assessment and community services plan data collection and reporting identified 34 distinct issues for prioritization. The Committee used the OptionFinder audience response polling system to rate each of the issues on each of the eight criteria noted above. The scores of the 34 individual health issues were then compiled into each of the ten NYSDOH Prevention Agenda areas. |
| SchH_P06_S00_L03 | Schedule H, Part VI, Line 3 | Nathan Littauer Hospital & Nursing Home educates our patient population for our Financial Assistance policy in the following ways: NLH has provided a "Frequently Asked Question" section on our website (www.nlh.org) to answer questions our patients may have. We have posted the complete Charity/Financial assistance policy on our website (www.NLH.org). NLH posts in their registration areas the availability of Financial Assistance and the appropriate contact information to obtain and complete the application process. NLH also provides pamphlets in all of our inpatient and outpatient registration areas literature providing information on insurances and, again, providing information on our Financial Assistance program and contact information. NLH has four facilitated enrollers available to assist patients with their application for Medicaid, Family Health Plus and Child Health Plus. They will also assist patients in completing our charity care application. Our staff has been trained in assisting our patients with obtaining application and providing direction and contact information for the completion of same. Our in-patient statements and our billing agency provides information advising patients to contact our offices to request the application and assistance in its completion. |
| SchH_P06_S00_L04 | Schedule H, Part VI, Line 4 | Nathan Littauer Hospital and Nursing Home is located in a rural area in Upstate New York. Our primary service area is Fulton County with additional services available in neighboring Hamilton and Montgomery Counties. Both Fulton and Hamilton counties are designated as Healthcare Professional Shortage Areas (HPSA). Within our main service area, Fulton County, 2012 data shows a population of 54,925 and of those reporting one race, 95.7% of those residents identified themselves as white. 50.5% of our population are women. Over 17% of the population has a median age of 65 or older. The median household income in Fulton County is $45,289 (well below the national average of $56,951). Our county has 16.5% of its residents living below the poverty level. 83.4% of the population has a high school degree or higher. The leading industries remain: Educational services, health care and social assistance employing 26% of the workforce followed by manufacturing employing 15%. Unemployment rates for 2011 are at about 11%. Major health issues for our region remain, respiratory diseases/childhood asthma, cancers of the lung and colon, lack of physical fitness and nutrition, unintentional injuries, tobacco use, lead poisoning and chronic diseases of the lung and the heart. The demographics and public health issues of our area clearly demonstrate why Nathan Littauer Hospital and Nursing Home and our eight primary care center are a vital resource in the communities we serve. Of particular note is our aging population and poverty levels, which are much higher than the state average. It is concluded that health issues affecting our population will continue to be addressed by our community hospital. Our mission is in keeping with the community need as we strive to provide care that is effective, clinically astute, safe and accessible. |
| SchH_P06_S00_L05 | Schedule H, Part VI, Line 5 | The Board of Directors of Nathan Littauer Hospital and Nursing Home is made up of medical and business professionals, all of whom reside in our primary service area. These volunteers give countless hours to the organization in their oversight role. They are involved in the community needs assessment process, in fundraising and in general stewardship. Littauer utilizes excess funds to reinvest in our technology, computerization and facilities to keep our organization safe, efficient and accessible as well as to ensure quality patient care. For example we recently used excess funds to support free and low cost education programs offered by Littauer to our community. Renovated Diagnostic Imaging and Health Information Management departments in 2012. |
| SchH_P06_S00_L07 | Schedule H, Part VI, Line 7 | New York |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Laurence E Kelly | ||||||||||||||
| President & CEO & Member | 348915 | 0 | 0 | 0 | 1290 | 0 | 138620 | 0 | 17494 | 0 | 506319 | 0 | 123688 | 0 |
| Henry Legendziewicz | ||||||||||||||
| Senior Vice President & CFO | 197581 | 0 | 0 | 0 | 3365 | 0 | 54910 | 0 | 19839 | 0 | 275695 | 0 | 31200 | 0 |
| Mike Ostrander | ||||||||||||||
| Vice President of Finance & CFO | 5250 | 0 | 0 | 0 | 12 | 0 | 210 | 0 | 0 | 0 | 5472 | 0 | 0 | 0 |
| James Anania MD | ||||||||||||||
| Physician | 435000 | 0 | 0 | 0 | 685 | 0 | 10000 | 0 | 17494 | 0 | 463179 | 0 | 0 | 0 |
| Paul Moberg MD | ||||||||||||||
| Physician | 400000 | 0 | 0 | 0 | 1290 | 0 | 10000 | 0 | 17494 | 0 | 428784 | 0 | 0 | 0 |
| Paul Husson MD | ||||||||||||||
| Physician | 305979 | 0 | 0 | 0 | 240 | 0 | 10000 | 0 | 0 | 0 | 316219 | 0 | 0 | 0 |
| Peter Dowling MD | ||||||||||||||
| Physician | 300000 | 0 | 0 | 0 | 1290 | 0 | 10000 | 0 | 17494 | 0 | 328784 | 0 | 0 | 0 |
| Patricia Nguyen MD | ||||||||||||||
| Phycian | 300000 | 0 | 0 | 0 | 690 | 0 | 10000 | 0 | 17494 | 0 | 328184 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchJ_P01_S00_L04 | Identifier |
| Return Reference | Schedule J, Part I, Line 4 | ReturnReference |
| Explanation | Payments were made on behalf of the CEO and Senior Vice President & CFO to a 457(f) plan during 2012. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Shriraj Shah MD | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | Board Member | Relationship |
| Amount Of Transaction | 41457 | AmountOfTransaction |
| Description Of Transaction | Independent Contractor | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P01_S00_L06 | Form 990, Part I, Line 6 | Total volunteer hours for 2012 were 14,721 based upon the annual report of the Nathan Littauer Hospital Auxiliary. This included Auxilians, Candy Stripers and Junior Volunteers. |
| F990_P06_S0A_L06 | Form 990, Part VI, Section A, Line 6 | The sole member of the Nathan Littauer Hospital Association is Colonial Healthcare Corp. which shall be represented at all meetings of the Association by the President of the Board of Directors of Colonial Healthcare Corp. or such person designated by the President in writing. |
| F990_P06_S0A_L07b | Form 990, Part VI, Section A, Line 7b | Colonial Healthcare Corp., the sole member of the Nathan Littauer Hospital Association, must consent to any changes to the hospital's bylaws. |
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | The form 990 was presented at a regular meeting of the Board of Directors on October 22, 2013 by Mike Ostrander, Vice President of Finance & CFO and Laurence Kelly, President & CEO prior to the filing of the form. The Chairman and Vice-Chairman of the Board were presented with copies prior to the board meeting. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | The Hospital's Conflict of Interest policy requires the filing of an annual disclosure statement by covered persons. Covered persons are defined as "Any director, officer, member of a committee with governing board delegated powers, or any member of the Capital Acquisition Committee, Pharmacy & Therapeutics Committee or Value Analysis Committee and Hospital employees who have a position which involves the acquisition of equipment and supplies or who authorize payments for such material. The Board or Committee is informed annually of any possible conflicts. The covered person has a duty to disclose the possible conflict when a matter is brought before the Board or Committee and the Board or Committee makes the determination if a conflict actually exists. The conflicted party will not particapate in the discussion of the matter at hand and will leave the meeting which a vote of the disinterested parties takes place. The Corporate Compliance Officer and the Chairman of the Board or Committee are responsible for compliance with policy. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | The Hospital's Compensation Committee is composed of the Chairman, Vice Chairman and immediate past Chairman of the Board of Directors. All members are independent directors. The Committee utilizes comparable compensation data in its deliberations. The compensation of the President (CEO) of the hospital is in the form of a recommendation to the full Board of Directors in an Executive Session of the meeting. Only independent directors are present at the meeting. The Compensation committee also advises and assists the President (CEO) in determining the compensation for senior management of the Hospital using comparative compensation data. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | The Hospital publishes an annual report distributed by mail and made available for distribution through a number of public outlets such as civic and social organizations. The report includes condensed financial statements and various statistical data relative to services provided to the community including free clinics, education programs, health fairs, etc. The Form 990 is available to the public upon request. The Hospital's governing documents, conflict of interest policy and internal financial statements are not available to the public. |
| F990_P11_S00_L09 | Form 990, Part XI, Line 9 | Pension Related Changes - (696,150), Distributions from NL Foundation - 640,000, Change in Interest in Net Assets of NL Foundation - (661,214). |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| Gloversville Extended Care & Nursing Home Co Inc | ||||||||||
| 99 East State Street | Gloversville | NY | 12078 | 237065255 | Leasing an 84 bed Skilled Nursing Facility to Hospital | NY | 501(c)3 | Schedule A Line 3 | N/A | 1 |
| NLH Realty Corp | ||||||||||
| 99 East State Street | Gloversville | NY | 12078 | 141641020 | Realty holding company | NY | 501(c)2 | N/A | 0 | |
| Nathan Littauer Foundation | ||||||||||
| 99 East State Street | Gloversville | NY | 12078 | 141638991 | Support the Hospital & promote healthcare programs in the community through donations. | NY | 501(c)3 | Schedule A Line 7 | N/A | 1 |
| Nathan Littauer Hospital Auxiliary | ||||||||||
| 99 East State Street | Gloversville | NY | 12078 | 146086641 | Assisting Hospital in promoting health & welfare of the community | NY | 501(c)3 | Schedule A Line 11 | N/A | 0 |
| Colonial Healthcare Corporation | ||||||||||
| PO Box 586 | Gloversville | NY | 12078 | 141670605 | Support & Supplement the activities, goals and operations of Nathan Littauer Hospital Association. | NY | 501(c)3 | Schedule A Line 7. | N/A | 0 |
| 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 | 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 |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Gloversville Extended Care & Nursing Home Co Inc | ||
| j | 111578 | Payments |
| Nathan Littauer Foundation | ||
| c | 840000 | Receipts |