AUBURN COMMUNITY HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- AUBURN COMMUNITY HOSPITAL (EIN 15-0532054)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-08-15
- IRS object ID
- 201342279349302064
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-15T11:08:52-05:00 | 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 | 150532054 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUBURN COMMUNITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | AUBU | NameControl |
| Phone | 3152557245 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LANSING STREET | AddressLine1 |
| City | AUBURN | City |
| State | NY | State |
| ZIP Code | 13021 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PATRICK FACTEAU | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 3152557245 | Phone |
| Date Signed | 2013-08-15 | 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 | PATRICK FACTEAU | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LANSING STREET | AddressLine1 |
| City | AUBURN | City |
| State | NY | State |
| ZIP Code | 13021 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 92143076 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.AUBURNHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1878 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF AUBURN MEMORIAL HOSPITAL IS TO PROVIDE COMPASSIONATE, QUALITY CARE AND IMPROVE THE HEALTH OF OUR COMMUNITY INCLUDING RESIDENTS OF AUBURN, NY AS WELL AS SURROUNDING AREAS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1013 | TotalNbrEmployees |
| Total Nbr Volunteers | 100 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1086795 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 346088 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 83692625 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 88347253 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 7284 | InvestmentIncomePriorYear |
| Investment Income Current Year | 6909 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2802274 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3442826 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 87588978 | TotalRevenuePriorYear |
| Total Revenue Current Year | 92143076 | 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 | 50437321 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 51099726 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 142502 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 36530851 | OtherExpensePriorYear |
| Other Expenses Current Year | 37632346 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 86968172 | TotalExpensesPriorYear |
| Total Expenses Current Year | 88732072 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 620806 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 3411004 | RevenuesLessExpensesCY |
| Total Assets BOY | 52102984 | TotalAssetsBOY |
| Total Assets EOY | 60976727 | TotalAssetsEOY |
| Total Liabilities BOY | 30468821 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 28998721 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 21634163 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 31978006 | NetAssetsOrFundBalancesEOY |
| Mission Description | OUR MISSION IS TO PROVIDE COMPASSIONATE, QUALITY CARE AND IMPROVE THE HEALTH OF OUR COMMUNITY INCLUDING AUBURN, NY AS WELL AS SURROUNDING AREAS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 76624210 | Expense |
| Description | THE PURPOSE OF AUBURN MEMORIAL HOSPITAL IS TO TREAT THE ILL AND INJURED OF AUBURN, NY AND THE IMMEDIATE ENVIRONS. TO THAT END, THE HOSPITAL TREATED 5,849 INPATIENTS FOR A TOTAL OF 56,114 PATIENT DAYS AND A TOTAL OF 151,732 OUTPATIENTS IN 2012. | Description |
| Total Program Service Expense | 76624210 | 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 | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | 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 | 128 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1013 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 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 | AUBURN MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 3152557245 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LANSING STREET | AddressLine1 |
| City | AUBURN | City |
| State | NY | State |
| ZIP Code | 13021 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| WILLIAM FORESMAN MD | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| MICHAEL RIFANBURG | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM DUGAN III | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| ELANE M DALY | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| PETER J EMERSON | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| RAMA GODISHALA MD | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| LISA RYERSON | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM SIMMONDS MDM | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| JOHN RICCIO MD | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| DEMETRA VOUNAS MD | |||||||
| TRUSTEE | 1.00 | X | 0 | 0 | 0 | ||
| ERIC R ALLYN | |||||||
| CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X | |
| JOSEPH BARTOLOTTA | |||||||
| VICE CHAIRMAN | 1.00 | X | 0 | 0 | 0 | X | |
| ANTHONY D FRANESCHELLI | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X | |
| WILLIAM DORR | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | |
| SCOTT BERLUCCHI | |||||||
| PRESIDENT & CEO | 38.00 | 381804 | 0 | 23923 | X | ||
| PATRICK FACTEAU | |||||||
| CFO | 38.00 | 46242 | 0 | 5736 | X | ||
| JOHN BARAN | |||||||
| CFO | 38.00 | 222000 | 0 | 0 | X | ||
| WILLIAM CHILDRES MD | |||||||
| MD | 38.00 | 352814 | 0 | 18924 | X | ||
| ADAM DUCKETT MD | |||||||
| MD | 38.00 | 281018 | 0 | 5242 | X | ||
| TODD LENTZ MD | |||||||
| MD | 38.00 | 290079 | 0 | 10700 | X | ||
| JOSEPH APONE MD | |||||||
| MD | 38.00 | 274787 | 0 | 18436 | X | ||
| MARY BAKER | |||||||
| HOSPITALIST | 38.00 | 196874 | 0 | 357 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2045618 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 83318 | TotalOtherCompensation |
| Number Individuals GT100 K | 15 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| PEGASUS MEDICINE GROUP EMPIRE STATE | |||||
| 1007 EAST MAIN STREET | BOZEMAN | MT | 59715 | EMERGENCY ROOM PHYSICIANS | 1175611 |
| AUBURN MEDICAL PC | |||||
| 17 LANSING STRET | AUBURN | NY | 13021 | MEDICAL PAYMENTS | 840053 |
| SYRACUSE PSYCHIATRIC SERVICE LLC | |||||
| 109 SOUTH WARREN STREET | SYRACUSE | NY | 13202 | PHYSCIATRIC PHYSICIANS | 625000 |
| ALLIANCE HEALTHCARE SERVICES | |||||
| 100 BAYVIEW CIRCLE SUITE 400 | NEWPORT BEACH | CA | 92660 | MRI SERVICES | 481505 |
| MMODAL SERVICES LTD | |||||
| PO BOX 102467 | ATLANTA | GA | 30368 | TRANSCRIPTION SERVICES | 329723 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 18 | NumberOfContractorsGT100K |
| Related Organizations | 101668 | RelatedOrganizations |
| All Other Contributions | 244420 | AllOtherContributions |
| Noncash Contributions | 114716 | NoncashContributions |
| Total Contributions | 346088 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 88347253 | TotalRevenueColumn |
| Related Or Exempt Function Income | 88347253 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 88347253 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6909 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6909 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Business Code | 623000 | BusinessCode |
| Total Revenue Column | 3442826 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3442826 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3442826 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 92143076 | TotalRevenueColumn |
| Related Or Exempt Function Income | 91796988 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 679705 | Total |
| Management And General | 679705 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37145458 | Total |
| Program Services | 32667844 | ProgramServices |
| Management And General | 4387602 | ManagementAndGeneral |
| Fundraising | 90012 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1748150 | Total |
| Program Services | 1545695 | ProgramServices |
| Management And General | 198196 | ManagementAndGeneral |
| Fundraising | 4259 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8840476 | Total |
| Program Services | 7686249 | ProgramServices |
| Management And General | 1133049 | ManagementAndGeneral |
| Fundraising | 21178 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2685937 | Total |
| Program Services | 2335257 | ProgramServices |
| Management And General | 344246 | ManagementAndGeneral |
| Fundraising | 6434 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 523428 | Total |
| Management And General | 523428 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 255196 | Total |
| Management And General | 255196 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 267059 | Total |
| Program Services | 235919 | ProgramServices |
| Management And General | 31140 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4005631 | Total |
| Program Services | 3538565 | ProgramServices |
| Management And General | 467066 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57327 | Total |
| Program Services | 50643 | ProgramServices |
| Management And General | 6684 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 181813 | Total |
| Program Services | 160613 | ProgramServices |
| Management And General | 21200 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 981364 | Total |
| Program Services | 981364 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3742313 | Total |
| Program Services | 3742313 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1163923 | Total |
| Program Services | 696824 | ProgramServices |
| Management And General | 467099 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 12359281 | 10918161 | 1441120 |
| PURCHASED SERVICES | 6668502 | 5890939 | 777563 |
| OTHER FEES | 3825354 | 2593288 | 1232066 |
| BAD DEBT | 3580536 | 3580536 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20619 | Total |
| Fundraising | 20619 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 88732072 | Total |
| Program Services | 76624210 | ProgramServices |
| Management And General | 11965360 | ManagementAndGeneral |
| Fundraising | 142502 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2677675 | BOY |
| EOY | 4725950 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10797563 | BOY |
| EOY | 10270764 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1042814 | BOY |
| EOY | 10970676 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2297906 | BOY |
| EOY | 2425549 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 539092 | BOY |
| EOY | 813241 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 87496234 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 61813386 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27638209 | BOY |
| EOY | 25682848 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7109725 | BOY |
| EOY | 6087699 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52102984 | BOY |
| EOY | 60976727 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14789143 | BOY |
| EOY | 15091579 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15247536 | BOY |
| EOY | 13477418 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 432142 | BOY |
| EOY | 429724 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30468821 | BOY |
| EOY | 28998721 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21561790 | BOY |
| EOY | 31887659 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72373 | BOY |
| EOY | 90347 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21634163 | BOY |
| EOY | 31978006 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52102984 | BOY |
| EOY | 60976727 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 3411004 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 6932839 | 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 | 0 | 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 | 72372 | BeginningOfYearBalance |
| Contributions | 120842 | Contributions |
| Other Expenditures | 102867 | OtherExpenditures |
| End Of Year Balance | 90347 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 2153040 | BeginningOfYearBalance |
| Contributions | 1086795 | Contributions |
| Other Expenditures | 3167463 | OtherExpenditures |
| End Of Year Balance | 72372 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 58431 | BeginningOfYearBalance |
| Contributions | 2496008 | Contributions |
| Other Expenditures | 401399 | OtherExpenditures |
| End Of Year Balance | 2153040 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 58431 | BeginningOfYearBalance |
| End Of Year Balance | 58431 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 58431 | BeginningOfYearBalance |
| End Of Year Balance | 58431 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment EOY Balance | 1.00000 | 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 | 823418 | OtherCostOrOtherBasis |
| Book Value | 823418 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 34707073 | OtherCostOrOtherBasis |
| Depreciation | 20192094 | Depreciation |
| Book Value | 14514979 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1500965 | OtherCostOrOtherBasis |
| Depreciation | 1421140 | Depreciation |
| Book Value | 79825 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 48282445 | OtherCostOrOtherBasis |
| Depreciation | 40200152 | Depreciation |
| Book Value | 8082293 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2182333 | OtherCostOrOtherBasis |
| Book Value | 2182333 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 25682848 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| AGENCY RELATIONSHIPS/ DEBT SERVICE, OPER & REPLACEMENT | 2622463 |
| ESTIMATED THIRD PARTY SETTLEMENTS | -256535 |
| PLEDGE RECEIVABLE, NET | 202705 |
| UNAMORTIZED DEBT ISSUANCE COST/ OTHER ASSETS | 3519066 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 6087699 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| FUNDS HELD FOR OTHERS | $147,816 |
| ASSET RETIREMENT OBLIGATION | $281,908 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 429724 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | AS OF DECEMBER 31, 2012 AND 2011, THE HOSPITAL DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2009 THROUGH 2012. THE HOSPITAL DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS. | Explanation |
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) |
|---|---|---|
| Total Community Benefit Expense | 207436 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 207436 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00230 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12084790 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10609456 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1475334 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01660 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12292226 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10609456 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1682770 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01890 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15821 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4035 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11786 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15821 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4035 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11786 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12308047 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 10613491 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1694556 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01900 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $3,527,329 | BadDebtExpenseAmount |
| Amount Attributable To | 207436 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 36265891 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 39616941 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -3351050 | 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 | AUBURN COMMUNITY HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LANSING STREET | AddressLine1 |
| City | AUBURN | City |
| State | NY | State |
| ZIP Code | 13021 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | AUBURN COMMUNITY HOSPITAL | 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 |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| 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 | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 3 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (3 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| FINGER LAKES CENTER FOR LIVING | ||||
| 20 PARK AVENUE | AUBURN | NY | 13021 | SHORT-TERM REHABILITATION AND LONG-TERM RESIDENTIAL CARE CENTER |
| FINGER LAKES MEDICAL CARE CENTER | ||||
| 303 GRANT AVENUE | AUBURN | NY | 13021 | URGENT CARE CENTER |
| URGENT MEDICAL CARE OF SKANEATELES | ||||
| 803 GENESEE STREET | SKANEATELES | NY | 13152 | URGENT CARE CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE IS A COST-TO-CHARGE RATIO. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGES. | ||
| PART III, LINE 4: 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. DOUBTFUL ACCOUNTS ARE CHARGED AGAINST THE ALLOWANCE WHEN MANAGEMENT BELIEVES THE UNCOLLECTIBILITY OF A RECEIVABLE BALANCE IS CONFIRMED. SUBSEQUENT RECOVERIES, IF ANY, ARE CREDITED TO THE ALLOWANCE. THE BAD DEBT RESERVE IS BASED OFF HISTORIAL PERCENTAGES AS WELL AS PREVIOUS COLLECTION PERCENTAGES FOR SELF PAY PATIENTS. | ||
| PART III, LINE 8: THE SHORTFALL SHOWN ABOVE SHOULD BE CONSIDERED A COMMUNITY BENEFIT AS ALL PATIENTS WILL BE SEEN AND TREATED AT AUBURN COMMUNITY HOSPITAL REGARDLESS OF ABILITY TO PAY. THEREFORE, THE FACT THAT THE COSTS TO TREAT MEDICARE PATIENTS EXCEEDED THE REVENUES GENERATED FROM MEDICARE PATIENTS SHOULD ALL BE VIEWED AS A BENEFIT TO THE MEDICARE PATIENTS OF THE COMMUNITY. THE AMOUNT ABOVE WAS CALCULATED BY MULTIPLYING THE GROSS MEDICARE CHARGES FOR THE YEAR BY THE RATIO OF PATIENT CARE COST TO CHARGES AS CALULATED ON WORKSHEET 2. | ||
| PART III, LINE 9B: PATIENTS ELIGIBLE ARE REASSESSED AT EACH ADMISSION AND NO FURTHER COLLECTIONS ARE DONE. | ||
| PART V, SECTION B, LINE 20D: THERE IS A 50% DISCOUNT GIVEN. | AUBURN COMMUNITY HOSPITAL | |
| PART VI, LINE 2: A STRATEGIC PLANNING PROCESS WHICH INCLUDES AN ANALYSIS BY TREO SOLUTIONS IS USED TO HELP DETERMINE THE NEEDS OF OUR GEOGRAPHIC AREA. THIS ANALYSIS HELPS AUBURN COMMUNITY HOSPITAL IN DETERMINING WHETHER WE HAVE ADEQUATE PHYSICIAN STAFFING TO PROVIDE THE APROPRIATE LEVEL OF CARE TO OUR COMMUNITY. | ||
| PART VI, LINE 3: PATIENTS OF AUBURN COMMUNITY HOSPITAL ARE PROVIDED WITH FINANCIAL ASSISTANCE INFORMATION UPON BEING ADMITTED TO THE HOSPITAL, BOTH INPATIENT AND OUTPATIENT. FINANCIAL ASSISTANCE IS EVALUATED EVERY TIME A PERSON PRESENTS AT THE FACILITY. PACKETS ARE PROVIDED TO ANY PATIENT THAT IS DETERMINED TO NEED OR POTENTIALLY NEED FINANIAL ASSISTANCE. | ||
| PART VI, LINE 4: AUBURN COMMUNITY HOSPITAL SERVES THE AUBURN, NY COMMUNITY AS WELL AS THE IMMEDIATE SURROUNDING AREAS. | ||
| PART VI, LINE 5: AUBURN COMMUNITY HOSPITAL PROMOTES HEALTH TO THE COMMUNITY BY HOSTING EVENTS WHENEVER MONEY PERMITS. THIS INCLUDES AN ANNUAL HEART EXPO TO EDUCATE THE COMMUNITY ON HEART HEALTH. AUBRUN COMMUNITY HOSPITAL ALSO PROMOTES WOMEN'S HEALTH CARE THROUGH THE WOMEN'S HEALTH INSTITUTE. | ||
| PART VI, LINE 6: AUBURN COMMUNITY HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. | ||
| 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT BERLUCCHI | ||||||||||||||
| PRESIDENT & CEO | 375304 | 0 | 2000 | 0 | 4500 | 0 | 11025 | 0 | 12898 | 0 | 405727 | 0 | 0 | 0 |
| JOHN BARAN | ||||||||||||||
| CFO | 222000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 222000 | 0 | 0 | 0 |
| WILLIAM CHILDRES MD | ||||||||||||||
| MD | 324814 | 0 | 28000 | 0 | 0 | 0 | 10142 | 0 | 8782 | 0 | 371738 | 0 | 0 | 0 |
| ADAM DUCKETT MD | ||||||||||||||
| MD | 257465 | 0 | 23553 | 0 | 0 | 0 | 0 | 0 | 5242 | 0 | 286260 | 0 | 0 | 0 |
| TODD LENTZ MD | ||||||||||||||
| MD | 262079 | 0 | 28000 | 0 | 0 | 0 | 10700 | 0 | 0 | 0 | 300779 | 0 | 0 | 0 |
| JOSEPH APONE MD | ||||||||||||||
| MD | 246787 | 0 | 28000 | 0 | 0 | 0 | 11818 | 0 | 6618 | 0 | 293223 | 0 | 0 | 0 |
| MARY BAKER | ||||||||||||||
| HOSPITALIST | 196874 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 357 | 0 | 197231 | 0 | 0 | 0 |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | MEDICAL EQUIP-MONITORS | 1 | 63013 | FAIR MARKET VALUE |
| X | MEDICAL EQUIP-VENTILLATORS | 1 | 51701 | FAIR MARKET VALUE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | 990 IS REVIEWED BY THE BOARD OF TRUSTEES PRIOR TO FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ARE REQUIRED TO REVIEW CONFLICT OF INTEREST FORMS AND SIGN THEM ANNUALLY. | |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS DETERMINE THE PRESIDENT/ CEO COMPENSATION. OTHER TOP OFFICIALS' COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS, CEO AND IS ALSO BASED OFF OF EXPERIENCE AND OTHER QUALIFICATIONS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON REQUEST, COPIES OF DOCUMENTS WILL BE PROVIDED. | |
| FORM 990, PART XI, LINE 9: | CORRECTION OF DECONSOLIDATION OF RELATED ENTITIES 6,932,839. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| AUBURN COMMUNITY COMPANIES INC | ||||||||||
| 17 LANSING STREET | AUBURN | NY | 13021 | 223271881 | PROVIDES NURSING HOME ACCOMMODATIONS | NY | 501(C)(3) | LINE 9 | AUBURN COMMUNITY HOSPITAL | 0 |
| AUBURN COMMUNITY HOSPITAL FOUNDATION INC | ||||||||||
| PO BOX 918 | AUBURN | NY | 13021 | 161599892 | PROVIDES FUNDS TO AUBURN COMMUNITY HOSPITAL, INC. AND RELATED ENTITIES | NY | 501(C)(3) | LINE 11 | AUBURN COMMUNITY HOSPITAL | 0 |
| ACH PROPERTIES INC | ||||||||||
| 5-19 LANSING STREET | AUBURN | NY | 13021 | 161335941 | PROMOTE AND SUPPORT CHARITABLE PURPOSE OF AUBURN COMMUNITY HOSPITAL, INC. | NY | 501(C)(3) | N/A | AUBURN COMMUNITY HOSPITAL | 0 |
| AUBURN MEMORIAL MEDICAL SERVICES PC | ||||||||||
| 17 LANSING STREET | AUBURN | NY | 13021 | 261193842 | PRACTICE OF MEDICINE | NY | 501(C)(3) | LINE 11 | AUBURN COMMUNITY HOSPITAL | 0 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AUBURN MEDICAL PC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17 LANSING STREET | AddressLine1 |
| City | AUBURN | City |
| State | NY | State |
| ZIP Code | 13021 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205111805 | EIN |
| Primary Activity | ANESTHESIOLOGY SERVICES | PrimaryActivity |
| Legal Domicile State | NY | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| 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 | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 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 |