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        <ReturnReference>Part X : FIN48 Footnote</ReturnReference>
        <Explanation>r) Income TaxesWith the exception of Madison Avenue Services Corporation, all entities comprising the Albany Medical Center and Related Entities are not-for-profit corporations under Section 501(c)(3) of the Internal Revenue Code and are exempt from federal income taxes pursuant to Section 501(a) of the Code. The Center 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 uncertain tax positions that need to be recorded at December 31, 2012 and 2011.</Explanation>
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      <Form990ScheduleKPartIII>
        <BondReferenceCd>D</BondReferenceCd>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondIssMeetPrvtSecurityPayTest>false</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>false</ChangeInUseBondFinancedProp>
        <NonQualifiedBondRemedProcdrs>true</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>C</BondReferenceCd>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondIssMeetPrvtSecurityPayTest>false</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>false</ChangeInUseBondFinancedProp>
        <NonQualifiedBondRemedProcdrs>true</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>B</BondReferenceCd>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondIssMeetPrvtSecurityPayTest>false</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>false</ChangeInUseBondFinancedProp>
        <NonQualifiedBondRemedProcdrs>true</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIII>
        <BondReferenceCd>A</BondReferenceCd>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <BondIssMeetPrvtSecurityPayTest>false</BondIssMeetPrvtSecurityPayTest>
        <ChangeInUseBondFinancedProp>false</ChangeInUseBondFinancedProp>
        <NonQualifiedBondRemedProcdrs>true</NonQualifiedBondRemedProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>D</BondReferenceCd>
        <Form8038TFiled>true</Form8038TFiled>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>C</BondReferenceCd>
        <Form8038TFiled>true</Form8038TFiled>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
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        <BondReferenceCd>B</BondReferenceCd>
        <Form8038TFiled>true</Form8038TFiled>
        <HedgeIdentifiedInBooksAndRecds>true</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>Bank of America</BusinessNameLine1>
        </NameOfHedgeProvider>
        <TermOfHedge>20.0000</TermOfHedge>
        <SuperintegratedHedge>false</SuperintegratedHedge>
        <HedgeTerminated>false</HedgeTerminated>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartIV>
        <BondReferenceCd>A</BondReferenceCd>
        <Form8038TFiled>true</Form8038TFiled>
        <HedgeIdentifiedInBooksAndRecds>true</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>Citizens</BusinessNameLine1>
        </NameOfHedgeProvider>
        <TermOfHedge>20.0000</TermOfHedge>
        <SuperintegratedHedge>false</SuperintegratedHedge>
        <HedgeTerminated>false</HedgeTerminated>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <WrittenProcToMonitorReqs>true</WrittenProcToMonitorReqs>
      </Form990ScheduleKPartIV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>D</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>C</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>B</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
      <Form990ScheduleKPartV>
        <BondReferenceCd>A</BondReferenceCd>
        <ProcToUndertkCorrectiveAction>true</ProcToUndertkCorrectiveAction>
      </Form990ScheduleKPartV>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL" softwareId="12000229" softwareVersion="2012v2.0">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>Kathryn Stone</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Family Mbr</Relationship>
        <AmountOfTransaction>23376</AmountOfTransaction>
        <DescriptionOfTransaction>Employment</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartV>
        <Explanation>Kathryn Stone is the daughter of Jeffrey Stone, Board Member and is employed by the Center.</Explanation>
      </Form990ScheduleLPartV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO" softwareId="12000229" softwareVersion="2012v2.0">
      <GeneralExplanation>
        <ReturnReference>Form 990 Part VII - Estimate of average hours to related organizations</ReturnReference>
        <Explanation>Hours reported for Board Members, Officers and Key Employees are average work hours related to this organization and it's related organizations. Organizations included in this relationship are Albany Medical Center, Albany Medical Center Hospital, Albany Medical College, Albany Medical Center Foundation, Center for Donation and Transplant, and Kidskeller Inc.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part XI, Line 9</Identifier>
        <ReturnReference>Other Changes In Net Assets Or Fund Balances - Other Increases</ReturnReference>
        <Explanation>Effect of adoption of provisions of FASB #158 = $1567231</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part XI, Line 9</Identifier>
        <ReturnReference>Other Changes In Net Assets Or Fund Balances - Other Increases</ReturnReference>
        <Explanation>Change in fair value of interest rate swaps = $61789</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 19</Identifier>
        <ReturnReference>Form 990, Part VI, Line 19: Other Organization Documents Publicly Available</ReturnReference>
        <Explanation>Documents are made available upon request.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 15b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees</ReturnReference>
        <Explanation>The Compensation Committee of the Board of Directors ("Committee") establishes compensation for the President and Chief Executive Officer of the organization, all Executive Vice Presidents and other top management officials who report directly to the President and Chief Executive Officer, subject to approval by the Board of Directors. The Committee uses professional compensation advisors who are capable of rendering independent advice and independent market surveys. The Committee targets the market median (50th percentile) for cash compensation; benefit programs are intended to be competitive. After the compensation program is determined, the Committee-approved recommendation is forwarded to the Board of Directors for its consideration and approval, and that is contemporaneously substantiated.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 12c</Identifier>
        <ReturnReference>Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts</ReturnReference>
        <Explanation>All candidates for Board membership and Board Committee membership receive a copy of the conflict of interest policy and conflict of interest questionnaire for completion. Actual or potential conflicts reported are reviewed by the Committee on Audit &amp; Compliance of the Board of Directors and appropriate action is taken to mitigate conflicts.Upon hire, all employees receive an employee manual which explains the conflict of interest policy and the requirement to report any actual or potential conflicts. All employees also receive refresher education regarding the policy and a reminder about the reporting requirement as part of their mandatory annual education. All employees are responsible for notifying Center management of any potential conflicts in addition to responding to requests for information if requested. Persons holding significant management positions receive a copy of the conflict of interest questionnaire for completion. Any conflicts which are reported or discovered are reviewed by the Corporate Compliance &amp; Audit Dept. and appropriate action is taken to mitigate the conflict. Employees who violate the conflict of interest policy are subject to the institution's corrective action policies.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part VI, Line 11b</Identifier>
        <ReturnReference>Form 990, Part VI, Line 11b: Form 990 Review Process</ReturnReference>
        <Explanation>The Board of Directors, through it's Audit Committee, engages a prominent accounting firm, KPMG, to conduct a review of it's tax return for compliance with IRS regulations. The Audit Committee engages KPMG as paid preparer to ensure accuracy of filings and raise for discussion issues or concerns that are considered significant. Issues or concerns are raised with management and brought to the attention of the Audit Committee throughout the year as warranted and required. Our process also includes a review of returns by senior management and a presentation and review of the returns at a meeting of the Audit Committee of the Board of Directors.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>Form 990, Part III, Line 4d</Identifier>
        <ReturnReference>Form 990, Part III, Line 4d: Other Program Services Description</ReturnReference>
        <Explanation>OTHER PROGRAM SERVICES 4: Materials Management: Centralized supply related operations for the Center and affiliated exempt organizations. OTHER PROGRAM SERVICES 5: Other Administrative Support Services: The Center coordinates planning, financial, information and policy direction for our affiliated exempt organizations.</Explanation>
      </GeneralExplanation>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="IRS990ScheduleR" softwareId="12000229" softwareVersion="2012v2.0">
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Center for Donation and Transplant</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>218 Great Oaks Blvd</AddressLine1>
          <City>Albany</City>
          <State>NY</State>
          <ZIPCode>12203</ZIPCode>
        </AddressUS>
        <EIN>141820447</EIN>
        <PrimaryActivities>Organ and Tissue Bank</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>11 Type I</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Albany Medical College</BusinessNameLine1>
        </DirectControllingEntityName>
        <ControlledOrg>false</ControlledOrg>
      </Form990ScheduleRPartII>
      <Form990ScheduleRPartII>
        <NameOfDisregardedEntity>
          <BusinessNameLine1>Albany Medical Center Kidskeller</BusinessNameLine1>
        </NameOfDisregardedEntity>
        <AddressUS>
          <AddressLine1>47 New Scotland Avenue</AddressLine1>
          <City>Albany</City>
          <State>NY</State>
          <ZIPCode>12208</ZIPCode>
        </AddressUS>
        <EIN>222635792</EIN>
        <PrimaryActivities>Education Day Program</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>2</PublicCharityStatus>
        <DirectControllingEntityName>
          <BusinessNameLine1>Albany Medical Center</BusinessNameLine1>
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          <BusinessNameLine1>Albany Medical Center Foundation</BusinessNameLine1>
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          <AddressLine1>47 New Scotland Avenue</AddressLine1>
          <City>Albany</City>
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          <ZIPCode>12208</ZIPCode>
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        <PrimaryActivities>Fundraising</PrimaryActivities>
        <LegalDomicileState>NY</LegalDomicileState>
        <ExemptCodeSection>501(c)(3)</ExemptCodeSection>
        <PublicCharityStatus>7</PublicCharityStatus>
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      <GiftGrantOrCapContrFrOtherOrg>false</GiftGrantOrCapContrFrOtherOrg>
      <LoansOrGuaranteesToOtherOrg>false</LoansOrGuaranteesToOtherOrg>
      <LoansOrGuaranteesFromOtherOrg>false</LoansOrGuaranteesFromOtherOrg>
      <DividendsRelatedOrganization>false</DividendsRelatedOrganization>
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      <PurchaseOfAssetsFromOtherOrg>false</PurchaseOfAssetsFromOtherOrg>
      <ExchangeOfAssets>false</ExchangeOfAssets>
      <RentalOfFacilitiesToOtherOrgs>true</RentalOfFacilitiesToOtherOrgs>
      <RentalOfFacilitiesFrOtherOrgs>true</RentalOfFacilitiesFrOtherOrgs>
      <PerformOfServicesForOtherOrgs>true</PerformOfServicesForOtherOrgs>
      <PerformOfServicesByOtherOrgs>false</PerformOfServicesByOtherOrgs>
      <SharingOfFacilities>false</SharingOfFacilities>
      <SharingOfPaidEmployees>false</SharingOfPaidEmployees>
      <ReimbursementPaidToOtherOrg>true</ReimbursementPaidToOtherOrg>
      <ReimbursementPaidByOtherOrg>true</ReimbursementPaidByOtherOrg>
      <OtherTransferToOtherOrg>true</OtherTransferToOtherOrg>
      <OtherTransferFromOtherOrg>true</OtherTransferFromOtherOrg>
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          <BusinessNameLine1>Albany Medical Center Kidskeller</BusinessNameLine1>
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        <TransactionType>r</TransactionType>
        <AmountInvolved>425485</AmountInvolved>
        <MethodOfAmtDetermination>Book Value</MethodOfAmtDetermination>
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      <TransactionsRelatedOrgsTable>
        <NameOfOtherOrganization>
          <BusinessNameLine1>Albany Medical Center Kidskeller</BusinessNameLine1>
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        <TransactionType>q</TransactionType>
        <AmountInvolved>87755</AmountInvolved>
        <MethodOfAmtDetermination>Book Value</MethodOfAmtDetermination>
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    </IRS990ScheduleR>
  </ReturnData>
</Return>