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PHELPS MEMORIAL HOSPITAL ASSOCIATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
PHELPS MEMORIAL HOSPITAL ASSOCIATION (EIN 13-1725076)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-09
IRS object ID
201203149349300420
Schema version
2011v1.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-11-09T08:59:56-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN221478099EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1COHNREZNICK LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11212 6TH AVENUEAddressLine1
CityNEW YORKCity
StateNYState
ZIP Code10036ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN131725076EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PHELPS MEMORIAL HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPHELNameControl
Phone9143663000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 NORTH BROADWAYAddressLine1
CitySLEEPY HOLLOWCity
StateNYState
ZIP Code105911020ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEITH F SAFIANName
TitlePRESIDENTTitle
Phone9143663000Phone
Date Signed2012-11-08DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTHOMAS LANNINGName
PTINP00851654PTIN
Phone2122970400Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEITH F SAFIANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1701 NORTH BROADWAYAddressLine1
CitySLEEPY HOLLOWCity
StateNYState
ZIP Code105911020ZIPCode
FieldValueIRS element (for citing)
Gross Receipts205224124GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SitePHELPSHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1952YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTAX EXEMPT HOSPITAL PROVIDING A FULL RANGE OF COMPREHENSIVE CARE IN A SAFE MODERN ENVIRONMENT TO IMPROVE THE HEALTH OF OUR SURROUNDING COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees1842TotalNbrEmployees
Total Nbr Volunteers300TotalNbrVolunteers
Total Gross UBI298517TotalGrossUBI
Net Unrelated Business Txbl Income-146310NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1711337ContributionsGrantsPriorYear
Contributions Grants Current Year1852022ContributionsGrantsCurrentYear
Program Service Revenue Prior Year181970030ProgramServiceRevenuePriorYear
Program Service Revenue CY194986621ProgramServiceRevenueCY
Investment Income Prior Year530808InvestmentIncomePriorYear
Investment Income Current Year530459InvestmentIncomeCurrentYear
Other Revenue Prior Year6015921OtherRevenuePriorYear
Other Revenue Current Year6507916OtherRevenueCurrentYear
Total Revenue Prior Year190228096TotalRevenuePriorYear
Total Revenue Current Year203877018TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year48000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY54000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year115219052SalariesEtcPriorYear
Salaries Etc Current Year121465066SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year36754TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY45915TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year843600TotalFundrsngExpCurrentYear
Other Expense Prior Year68724970OtherExpensePriorYear
Other Expenses Current Year72580205OtherExpensesCurrentYear
Total Expenses Prior Year184028776TotalExpensesPriorYear
Total Expenses Current Year194145186TotalExpensesCurrentYear
Revenues Less Expenses Prior Year6199320RevenuesLessExpensesPriorYear
Revenues Less Expenses CY9731832RevenuesLessExpensesCY
Total Assets BOY172544197TotalAssetsBOY
Total Assets EOY184798554TotalAssetsEOY
Total Liabilities BOY75798871TotalLiabilitiesBOY
Total Liabilities EOY78064697TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY96745326NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY106733857NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionIMPROVE THE HEALTH OF OUR SURROUNDING COMMUNITY, BY PROVIDING COMPREHENSIVE CARE IN A SAFE MODERN ENVIROMENT WHERE ADVANCED MEDICAL TECHNIQUES ARE COUPLED WITH A STRONG TRADITION OF COURTESY AND CARING.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense83332095Expense
Grants54000Grants
Revenue71881701Revenue
DescriptionPHELPS MEMORIAL HOSPITAL ASSOCIATION PROVIDES ACUTE AND REHABILITATION INPATIENT HEALTH CARE SERVICES TO MEMBERS OF THE COMMUNITY REGARDLESS OF ABILITY TO PAY. THE HOSPITAL HAD 7,735 ACUTE CARE ADMISSIONS AND 198 REHABILITATION ADMISSIONS. PHELPS MEMORIAL HOSPITAL ASSOCIATION PROVIDED $4,314,778 IN CHARITY CARE FOR ACUTE AND REHABILIATION INPATIENT HEALTH CARE SERVICES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense73308964Expense
Revenue104736446Revenue
DescriptionPHELPS MEMORIAL HOSPITAL ASSOCIATION PROVIDES OUTPATIENT HEALTH CARE SERVICES TO MEMBERS OT THE COMMUNITY REGARDLESS OF ABILITY TO PAY. THE HOSPITAL PROVIDED $4,424,113 IN CHARITY CARE FOR OUTPATIENT HEALTH SERVICES. PHELPS MEMORIAL HOSPITAL ASSOCIATION'S LARGER OUPATIENT PROGRAMS INCLUDE THE FOLLOWING SERVICES:EMERGENCY SERVICES 25,734 VISITSRADIOLOGY SERVICES 40,824 PROCEDURESWOUND AND DIABETIC CARE 7,154 VISITSPHYSICAL THERAPY, ACQUA THERAPY AND OCCUPATIONAL THERAPY 69,252 PROCEDURES HYPERBARIC TREATMENTS 8,926 PROCEDURESHOSPICE HOME CARE 14,805 VISITSDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense21797127Expense
Revenue18069957Revenue
DescriptionPHELPS MEMORIAL HOSPITAL ASSOCIATION PROVIDES INPATIENT AND OUTPATIENT BEHAVORIAL HEALTH SERVICES TO MEMBERS OF THE COMMUNITY REGARDLESS OF ABILITY TO PAY. THE HOSPITAL PROVIDED $891,459 IN CHARITY CARE FOR BEHAVORIAL HEALTH SERVICES. PHELPS MEMORIAL HOSPITAL ASSOCIATION HAD 1,321 BEHAVORIAL HEALTH ADMISSIONS AND 50,060 OUTPATIENT BEHAVORIAL HEALTH VISITS.Description
FieldValueIRS element (for citing)
Total Program Service Expense178438186TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities1ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising1ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals1GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096132NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1842NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1KAREN ROSENTHALBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9143663000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1701 NORTH BROADWAYAddressLine1
CitySLEEPY HOLLOWCity
StateNYState
ZIP Code10591ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
ANDREW C MERRYMAN
CHAIRMAN1.00XX000
BARD BUNAES
DIRECTOR1.00X000
BRUCE HECKMAN MD
SECRETARY1.00XX6901800
DAVID COULAM
DIRECTOR1.00X000
ELIO IPPOLITO MD
DIRECTOR1.00X7500000
FRANKLIN H ZIMMERMAN
DIRECTOR1.00X000
GAY BERGER
DIRECTOR1.00X000
GLENN D KAUFMAN
DIRECTOR1.00X000
HSIN CHENG CHAO MD
DIRECTOR1.00X000
JAMES GOLDSMITH
DIRECTOR1.00X000
KATHERINE MACKIE
ASSISTANT SECRETARY1.00XX000
KEITH F SAFIAN
PRESIDENT37.50XX11902720208367
LOUIS J POULIN
DIRECTOR1.00X000
MARK FREDERICH
DIRECTOR1.00X000
RICHARD SINNI
DIRECTOR1.00X000
ROBERT A GOLDSCHMIDT
DIRECTOR1.00X000
RUSSEL WATSON
DIRECTOR1.00X000
SALEEM MIR MD
DIRECTOR1.00X3700000
SEAN F X DUGAN
VICE CHAIRMAN1.00XX000
WILLIAM O MELVIN JR
TREASURER1.00XX000
BARBARA ALLAR
VP STRATEGY & DEVELOPMENT37.50X189057015470
DANIEL BLUM
SR VP37.50X455190061703
JOANNE STURANS
VP FOR HUMAN RESOURCES37.50X364296053734
KERRY PISANO
VP FOR SUPPORT SERVICES37.50X449031040878
LAWRENCE FALTZ
SR VP FOR MED AFFAIRS37.50X719960072443
LEONARD FOGEL
VP MANAGED CARE & BUS.37.50X585677064605
LUCY ENGELHARDT
VP FOR NURSING37.50X556465061798
VINCENT DESANTIS
VP FINANCE AND CFO37.50X728415077760
EMIL NIGRO
PHYSICIAN37.50554659032721X
GASPAR PARRINO
PHYSICIAN37.50518064036631X
MICHAEL KYI
PHYSICIAN37.50457083036111X
STEPHEN HEIER
PHYSICIAN37.501026061036828X
VARGHESE MATTHEW
PHYSICIAN37.50429995034131X
BRUCE DAVIDOW
SR VP AND COO37.50679410019787X
FieldValueIRS element (for citing)
Total Reportable Comp From Org9084653TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation852967TotalOtherCompensation
Number Individuals GT100 K171NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CHILDREN & WOMENS PHYSICIANS OF WESTCHES
NY MEDICAL COLLEGEVALHALLANY10595PHYSICIANS533371
GARFUNKEL WILD & TRAVIS PC
111 GREAT NECK ROADGREAT NECKNY11021ATTORNEYS457436
ENT AND ALLERGY ASSOCIATES
560 WHITE PLAINS ROADTARRYTOWNNY10591SLEEP DIAGNOSTICS370941
TRITECH HEALTHCARE MANAGEMENT LLC
125 NEWTOWN RD SUITE 200PLAINVIEWNY11803RECEIVABLE COLLECTION235612
KPMG LLP
345 PARK AVENUENEW YORKNY10154AUDITORS177400
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
Fundraising Events391664FundraisingEvents
Related Organizations5600RelatedOrganizations
Government Grants99506GovernmentGrants
All Other Contributions1355252AllOtherContributions
Noncash Contributions382680NoncashContributions
Total Contributions1852022TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PATIENT SERVICE REVENU623000194688104194688104
LAB OUTREACH INCOME621500298517298517
FieldValueIRS element (for citing)
Total Program Service Revenue194986621TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column529700TotalRevenueColumn
Exclusion$529,700ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1945330Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1121100Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real824230Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column824230TotalRevenueColumn
Exclusion$824,230ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other7498Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other6739Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other759Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column759TotalRevenueColumn
Related Or Exempt Function Income759RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events125759GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events391664CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses219267FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-93508TotalRevenueColumn
Exclusion-$93,508ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
COMMUNITY PHARMACY44611029036952903695
CAFETERIA INCOME722210578803$578,803
OMH & OASIS623000499672499672

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1795024TotalRevenueColumn
Related Or Exempt Function Income1225778RelatedOrExemptFunctionIncome
Exclusion$569,246ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue5777194TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column203877018TotalRevenueColumn
Related Or Exempt Function Income199318008RelatedOrExemptFunctionIncome
Unrelated Business Revenue298517UnrelatedBusinessRevenue
Exclusion$2,408,471ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total54000Total
Program Services54000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6775338Total
Program Services3285405ProgramServices
Management And General3285405ManagementAndGeneral
Fundraising204528Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total89042618Total
Program Services81784074ProgramServices
Management And General6832139ManagementAndGeneral
Fundraising426405Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4213346Total
Program Services3749283ProgramServices
Management And General445796ManagementAndGeneral
Fundraising18267Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total15007186Total
Program Services13351449ProgramServices
Management And General1587512ManagementAndGeneral
Fundraising68225Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6426578Total
Program Services5712069ProgramServices
Management And General679175ManagementAndGeneral
Fundraising35334Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total531581Total
Program Services503737ProgramServices
Management And General27844ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total184350Total
Program Services184350ProgramServices

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total75072Total
Program Services75072ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total45915Total
Fundraising45915Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total12841832Total
Program Services12071401ProgramServices
Management And General770431ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2178390Total
Program Services1886970ProgramServices
Management And General246494ManagementAndGeneral
Fundraising44926Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3508715Total
Program Services3337413ProgramServices
Management And General171302ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4746056Total
Program Services4699282ProgramServices
Management And General46774ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total239681Total
Program Services177057ProgramServices
Management And General62624ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total7944Total
Program Services3972ProgramServices
Management And General3972ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1207627Total
Program Services1086864ProgramServices
Management And General120763ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total10548876Total
Program Services10548876ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total6478880Total
Program Services6478880ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PHARMACEUTICALS93628579362857
MEDICAL SUPPLIES77444247744424
PROSTHESIS58522575852257
EQUIP RENTAL & MAINT33061182845643460475

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3765545Total
Program Services3642851ProgramServices
Management And General122694ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total194145186Total
Program Services178438186ProgramServices
Management And General14863400ManagementAndGeneral
Fundraising843600Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY419817BOY
EOY2124546EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY23166505BOY
EOY31377549EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY588530BOY
EOY432864EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY22226010BOY
EOY26123231EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY17926BOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1844824BOY
EOY2287465EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1181602BOY
EOY1275737EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis237503519LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec139186599LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY102041752BOY
EOY98316920EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY11770537BOY
EOY12754061EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY9286694BOY
EOY10106181EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY172544197BOY
EOY184798554EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY15559723BOY
EOY15594803EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY24510000BOY
EOY23700000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3949422BOY
EOY2957167EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY31779726BOY
EOY35812727EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY75798871BOY
EOY78064697EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY91897249BOY
EOY101818243EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2945247BOY
EOY3002496EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1902830BOY
EOY1913118EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY96745326BOY
EOY106733857EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY172544197BOY
EOY184798554EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses9731832ReconcilationRevenueExpenses
Reconcilation Other Changes256699ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$75,072OtherActivitiesAmount
Total Lobbying Expenditures IIB75072TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationPHELPS MEMORIAL HOSPITAL ASSOCIATION COMPENSATED ITS LOBBYIST FOR BUDGET, REGULATORY AND LEGISLATIVE ISSUES PERTAINING TO HEALTHCARE AND HOSPITALS. NY STATE EXECUTIVE AND LEGISLATIVE BRANCHES WERE LOBBIED.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3360893BeginningOfYearBalance
Investment Earnings Or Losses109904InvestmentEarningsOrLosses
Other Expenditures14011OtherExpenditures
End Of Year Balance3456786EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2969273BeginningOfYearBalance
Contributions7746Contributions
Investment Earnings Or Losses386175InvestmentEarningsOrLosses
Other Expenditures2301OtherExpenditures
End Of Year Balance3360893EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2479718BeginningOfYearBalance
Contributions76638Contributions
Investment Earnings Or Losses427708InvestmentEarningsOrLosses
Other Expenditures14791OtherExpenditures
End Of Year Balance2969273EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3480267BeginningOfYearBalance
Contributions10000Contributions
Investment Earnings Or Losses-566216InvestmentEarningsOrLosses
Other Expenditures444333OtherExpenditures
End Of Year Balance2479718EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.37410BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.62590PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis579734OtherCostOrOtherBasis
Book Value579734BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis137598804OtherCostOrOtherBasis
Depreciation64945451Depreciation
Book Value72653353BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis182458OtherCostOrOtherBasis
Depreciation45091Depreciation
Book Value137367BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis85709519OtherCostOrOtherBasis
Depreciation69585966Depreciation
Book Value16123553BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis13433004OtherCostOrOtherBasis
Depreciation4610091Depreciation
Book Value8822913BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings98316920TotalOfBookValueLandBuildings

Other Securities OtherSecurities (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
OTHER ALTERNATIVE INVESTMENTS699893F
OTHER INVT IN MEDICAL OFFICE BUILDING1887870C
OTHER INVESTMENTS10166298F
FieldValueIRS element (for citing)
Total Of Book Value Securities12754061TotalOfBookValueSecurities

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
INSURANCE RECOVERIES9430000
DEFERRED FINANCING COSTS676181
FieldValueIRS element (for citing)
Total Book Value Other Assets10106181TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
THIRD PARTY LIABILITY$11,873,926
ACCRUED PAYROLL AND RELATED EXPENSES$10,331,486
DEFERRED COMPENSATION PLANS$3,427,315
MALPRACTICE CONTINGENCY$750,000
INSURANCE LIABILITIES$9,430,000
FieldValueIRS element (for citing)
Total Of Amounts35812727TotalOfAmounts
Total Revenue203877018TotalRevenue
Total Expenses194145186TotalExpenses
Excess Or Deficit For Year9731832ExcessOrDeficitForYear
Net Unrealized GL On Investments122026NetUnrealizedGLOnInvestments
Prior Period Adjustments141371PriorPeriodAdjustments
Other-$6,698OtherAmount
Total Adjustments256699TotalAdjustments
Excess Or Deficit Per FS9988531ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt204740915TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments122026NetUnrealizedGainsInvestments
Other Revenues60300OtherRevenues
Revenue Not Rptd F990182326RevenueNotRptdF990
Revenue Subtotal204558589RevenueSubtotal
Other Revenues Not Included-681571OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-681571RevenueNotRptdOnFinStmt
Total Revenue Per Form990203877018TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt194914435TotExpensesEtcAuditedFinclStmt
Other Expenses Included1121100OtherExpensesIncluded
Expenses Not Rptd F9901121100ExpensesNotRptdF990
Expenses Subtotal193793335ExpensesSubtotal
Other Expenses Not Included351851OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt351851ExpensesNotRptdOnFinStmt
Total Expenses Per Form990194145186TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:ALL INTEREST EARNED ON THE ENDOWMENT SUPPORT THE GENERAL OPERATION OF THE HOSPITAL. BOARD DESIGNATED FUNDS SUPPORT THE HOSPICE PROGRAM.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:PMHA IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE CODE AND IS EXEMPT FROM FEDERAL, STATE, AND LOCAL INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THERE ARE CERTAIN TRANSACTIONS THAT COULD BE DEEMED "UNRELATED BUSINESS INCOME" AND WOULD RESULT IN A TAX LIABILITY. MANAGEMENT REVIEWS TRANSACTIONS TO ESTIMATE POTENTIAL TAX LIABILITIES USING A THRESHOLD OF MORE LIKELY THAN NOT. IT IS MANAGEMENT'S ESTIMATION THAT THERE ARE NO MATERIAL TAX LIABILITIES, WHICH NEED TO BE RECORDED.
PART XI, LINE 8 - OTHER ADJUSTMENTS:CHANGE IN VALUATION OF PLEDGES -69,000. ELIMINATIONS 50,000. ROUNDING 12,302. TOTAL TO SCHEDULE D, PART XI, LINE 8: -6,698.
PART XII, LINE 2D - OTHER ADJUSTMENTS:CHANGE IN VALUATION OF PLEDGES -69,000. ELIMINATIONS 129,300.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RENTAL EXPENSES -1,121,100. AUXILIARY REVENUE 309,651. MEDICAL STAFF REVENUE 129,878.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSE 1,121,100.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:AUXILIARY EXPENSES 150,597. MEDICAL STAFF EXPENSES 147,254. NURSING SCHOLARSHIPS 54,000.

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCENTRAL AMERICA AND THE CARIBBEANRegion
Type Of Activities ConductedPROGRAM SERVICE EXPENSESTypeOfActivitiesConducted
Specific Services ProvidedPAYMENTS FOR MALPRACTICE INSURANCE PREMIUMSSpecificServicesProvided
Total Expenditures1755558TotalExpenditures
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent1755558SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent1755558TotalAmountSpent
Transfer To Foreign Corp0TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp0OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Email SolicitationsXEmailSolicitations
Phone SolicitationsXPhoneSolicitations
In Person SolicitationsXInPersonSolicitations
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref Fundraising1AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation (2 entries)

Name Of IndividualNameOfIndividualAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeActivityActivityFundraiser Control Of FundsFundraiserControlOfFundsGross ReceiptsGrossReceiptsAmount Retained By ContractorAmountRetainedByContractorNet To OrganizationNetToOrganization
(no name)
SUSAN FORMATO6 HEMLOCK ROADBRONXVILLENY10708DEVELOPMENT OF DONORS AND ASSISTANCE RECRUTING VP FOR DEVELO042657414091248
KETCHUM INC
5151 BELR LINE ROADDALLASTX75254FUNDRAISING STRATEGY004506-4506
FieldValueIRS element (for citing)
Total Gross Receipts42657TotalGrossReceipts
Total Retained By Contractors45915TotalRetainedByContractors
Total Net To Organization-3258TotalNetToOrganization
Licensed StatesNYLicensedStates

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1CHAMPAGNE BALLNameOfEvent1
Gross Receipts Event1361848GrossReceiptsEvent1
Charitable Contributions Event1302774CharitableContributionsEvent1
Gross Revenue Event159074GrossRevenueEvent1
Rent Facility Costs Event159100RentFacilityCostsEvent1
Entertainment Event126824EntertainmentEvent1
Other Direct Expenses Event145955OtherDirectExpensesEvent1
Name Of Event2GOLF CLASSICNameOfEvent2
Gross Receipts Event2141100GrossReceiptsEvent2
Charitable Contributions Event284715CharitableContributionsEvent2
Gross Revenue Event256385GrossRevenueEvent2
Non Cash Prizes Event27885NonCashPrizesEvent2
Rent Facility Costs Event251550RentFacilityCostsEvent2
Other Direct Expenses Event29731OtherDirectExpensesEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events14475GrossReceiptsOtherEvents
Charitable Contrib Other Events4175CharitableContribOtherEvents
Gross Revenue Other Events10300GrossRevenueOtherEvents
Rent Facility Costs Other Events12566RentFacilityCostsOtherEvents
Other Direct Expenses Other Events5656OtherDirectExpensesOtherEvents
Gross Receipts Total517423GrossReceiptsTotal
Charitable Contributions Total391664CharitableContributionsTotal
Gross Revenue Total Events125759GrossRevenueTotalEvents
Non Cash Prizes Total Events7885NonCashPrizesTotalEvents
Rent Facility Costs Total Events123216RentFacilityCostsTotalEvents
Entertainment Total Events26824EntertainmentTotalEvents
Other Direct Expenses Total Events61342OtherDirectExpensesTotalEvents
Direct Expense Summary Events219267DirectExpenseSummaryEvents
Net Income Summary-93508NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage500.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5296157TotalCommunityBenefitExpense
Net Community Benefit Expense5296157NetCommunityBenefitExpense
Percent Of Total Expense0.02730PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense29642846TotalCommunityBenefitExpense
Direct Offsetting Revenue21461163DirectOffsettingRevenue
Net Community Benefit Expense8181683NetCommunityBenefitExpense
Percent Of Total Expense0.04210PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense34939003TotalCommunityBenefitExpense
Direct Offsetting Revenue21461163DirectOffsettingRevenue
Net Community Benefit Expense13477840NetCommunityBenefitExpense
Percent Of Total Expense0.06940PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2277291TotalCommunityBenefitExpense
Net Community Benefit Expense2277291NetCommunityBenefitExpense
Percent Of Total Expense0.01170PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense754897TotalCommunityBenefitExpense
Direct Offsetting Revenue216539DirectOffsettingRevenue
Net Community Benefit Expense538358NetCommunityBenefitExpense
Percent Of Total Expense0.00280PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3032188TotalCommunityBenefitExpense
Direct Offsetting Revenue216539DirectOffsettingRevenue
Net Community Benefit Expense2815649NetCommunityBenefitExpense
Percent Of Total Expense0.01450PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense37971191TotalCommunityBenefitExpense
Direct Offsetting Revenue21677702DirectOffsettingRevenue
Net Community Benefit Expense16293489NetCommunityBenefitExpense
Percent Of Total Expense0.08390PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,119,000BadDebtExpenseAmount
Amount Reimbursed By Medicare65161306AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare85200758CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-20039452MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (5 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 PHELPS PROFESSIONAL
CONSTRUCT, DEVELOP, OWN,0.657000.34300
2 BUILDING CO LP
OPERATE AND MAINTAIN A
3
MEDICAL OFFICE BUILDING
4
ON THE CAMPUS OF PHELPS
5
MEMORIAL HOSPITAL ASSOCIATION.
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1PHELPS MEMORIAL HOSPITAL ASSOCIATIONBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1701 NORTH BROADWAYAddressLine1
CitySLEEPY HOLLOWCity
StateNYState
ZIP Code10591ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PHELPS MEMORIAL HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent500.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities7NumberOfOtherFacilities

Other Facilities OtherFacilities (7 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
PHELPS - ATS
22 ROCKLEDGE AVEOSSININGNY10562INTENSIVE OUTPATIENT AND SUBSTANCE ABUSE CLINIC
PHELPS- CDT
315 SOUTH HIGHLAND AVEBRIARCLIFF MANORNY10510SEVERLY AND PERSISTENT MENTALLY ILL OUTPATIENT CLINIC (SPMI)
PHELPS - SCMICM
315 SOUTH HIGHLAND AVEBRIARCLIFF MANORNY10510OUTPATIENT CLINIC FOR THE SPMI POPULATION LIVING IN THE COMMUNITY
PHELPS COUNSELING
755 NORTH BROADWAYSLEEPY HOLLOWNY10591MENTAL HEALTH OUTPATIENT CLINIC
OSSINING COUNSELING
22 ROCKLEDGE AVEOSSININGNY10562MENTAL HEALTH OUTPATIENT CLINIC
PHELPS - THRESHOLD
155 WHITEPLAINS ROAD - SUITE 210TARRYTOWNNY10591SUBSTANCE ABUSE OUTPATIENT CLINIC
ECHO HILLS
457 BROADWAYHASTINGSONHUDSONNY10706MENTAL HEALTH OUTPATIENT CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 7G: THE HOSPTIAL PROVIDES PRE-NATAL CARE TO UNINSURED PATIENTS AND UNDOCUMENTED IMMIGRANTS. THIS SERVICE HAS BEEN IDENTIFIED AS A COMMUNITY NEED SERVICE.
PART I, L7 COL(F): PHELPS MEMORIAL HOSPITAL HAS INCLUDED BAD DEBT EXPENSE IN THE AMOUNT OF $1,119,000 ON THE FORM 990, PART IX, LINE 25. THIS AMOUNT IS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7 COLUMN F AS PER THE INSTRUCTIONS.
PART III, LINE 4: PATIENTS' ACCOUNTS RECEIVABLEPATIENTS' ACCOUNTS RECEIVABLE ARE RECORDED AT THE CONTRACTED AMOUNT AND DO NOT BEAR INTEREST. THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IS PMHC'S BEST ESTIMATE OF THE AMOUNT OF PROBABLE CREDIT LOSSES IN PMHC'S EXISTING ACCOUNTS RECEIVABLE. PMHC DETERMINES THE ALLOWANCE BASED ON HISTORICAL WRITE-OFF EXPERIENCE. PMHC REVIEWS ITS ALLOWANCE FOR DOUBTFUL ACCOUNTS PERIODICALLY. PAST-DUE BALANCES ARE REVIEWED INDIVIDUALLY FOR COLLECTIBILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE. AMOUNTS REPORTED ON LINES 2 AND 3 WERE BASED UPON THE HOSPITAL'S COST TO CHARGE RATIO AS CALCULATED IN ACCORDANCE WITH WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES, INCLUDED IN THE SCHEDULE H INSTRUCTIONS.
PART III, LINE 8: THE HOSPITAL IS GOVERNED BY A BOARD OF DIRECTORS COMPRISED OF INDEPENDENT PERSONS REPRESENTING THE COMMUNITY THE HOSPITAL SERVES. THE HOSPITAL OPERATES AN EMERGENCY DEPARTMENT THAT IS OPEN 24/7 TO ALL PEOPLE REGARDLESS OF ONE'S ABILITY TO PAY. THE MEDICAL STAFF IS OPEN TO ALL QUALIFIED PHYSICIANS. FINALLY, THE HOSPITAL PARTICIPANTS IN THE MEDICARE, MEDICAID AND ALL OTHER APPLICABLE GOVERNMENT-SPONSORED HEALTH PROGRAMS.TO PROVIDE READILY ACCESSIBLE, STATE-OF-THE-ART AND HIGHEST QUALITY CARE POSSIBLE TO ALL PATIENTS, THE BOARD OF DIRECTORS HAS EMBRACED THE NEED TO SUBSIDIZE THE COST OF CARE PROVIDED TO INDIVIDUALS COVERED BY GOVERNMENT-SPONSORED HEALTH PROGRAMS, SINCE IN MANY CASES THE REIMBURSEMENT DOES NOT COVER THE COST OF SERVICES. THEREFORE, SIMILAR TO THE UNREIMBURSED COST OF CARE PROVIDED TO MEDICAID COVERED PATIENTS, THE SHORTFALL ATTRIBUTABLE TO MEDICARE COVERED PATIENTS IS A MEASURE OF THE BENEFIT THE HOSPITAL PROVIDES TO ITS COMMUNITY.
PART III, LINE 9B: THE HOSPITAL HAS ESTABLISHED A FINANCIAL COUNSELING GROUP THAT ASSISTS PATIENTS IN COMPLETING FORMS AND PROVIDING FINANCIAL DATA IN SUPPORT OF CHARITY CARE REQUESTS. THE GROUP FOLLOWS THE POLICIES AND PROCEDURES ESTABLISHED BY THE HOSPITAL IN PROVIDING THIS COMMUNITY BENEFIT.
PART V, SECTION B, LINE 19D: THE HOSPITAL FACILITY USED ITS MEDICAID RATE FOR HOSPITAL INPATIENT ADMISSIONS WHICH IS ITS LOWEST HOSPITAL INPATIENT RATE. THE HOSPITAL INCURRED A LOSS IN EXCESS OF $5,800,000 AS A RESULT OF PROVIDING CARE TO MEDICAID PATIENTS. THE HOSPITAL FACILITY USED THE AVERAGE NEGOTIATED COMMERCIAL INSURANCE RATES FOR OUTPATIENT SERVICES PROVIDED TO OUTPATIENT PROCEDURES. IN ADDITION THE HOSPITAL FACILITY USES A SLIDING SCALE FOR CERTAIN CLINIC AND RECURRING OUTPATIENT SERVICES.PHELPS MEMORIAL HOSPITAL ASSOCIATION
PART VI, LINE 2: NEEDS ASSESSMENT:PHELPS MEMORIAL HOSPITAL CENTER (PHMC) IS A 238-BED ACUTE CARE COMMUNITY HOSPITAL, LOCATED IN CENTRAL WESTCHESTER COUNTY. SINCE ITS BEGINNING IN 1956, PHELPS MEMORIAL HAS STRIVED TO PROVIDE ITS COMMUNITY WITH THE FINEST QUALITY HEALTHCARE. THE EXTENT OF SERVICES MADE AVAILABLE TO THOSE WE SERVE RANGES FROM EMERGENCY SERVICES TO ACUTE CARE INPATIENT SERVICES, AS WELL AS A HOST OF OUTPATIENT SERVICES DESIGNED TO ADDRESS THE NEEDS OF THOSE WHO MAKE UP THE PHELPS SERVICE AREA.OUR STRUCTURE:PHELPS MEMORIAL HOSPITAL CENTER IS ONE OF THE FOUR MEMBERS OF THE STELLARIS HEALTH NETWORK. PHELPS WORKS COLLABORATIVELY WITH OPEN DOOR FAMILY HEALTH CENTERS TO PROVIDE PRENATAL CARE AND HAS AN AGREEMENT WITH WESTCHESTER MEDICAL CENTER TO PROVIDE CARE FOR HIGH-RISK MOTHERS AND NEONATES. CANCER CARE IS PROVIDED BY MEMORIAL SLOAN-KETTERING CANCER CENTER ON PHELPS' CAMPUS. THROUGH OUR CLINIC AFFILIATION WITH THE MOUNT SINAI MEDICAL CENTER, EXPERT SENIOR HEALTH SERVICES ARE ACCESSIBLE IN THE LOCAL COMMUNITY. THE HOSPITAL MAINTAINS AN EXTENSIVE NETWORK OF OUTPATIENT MENTAL HEALTH SERVICES, OUTPATIENT MEDICAL DIAGNOSTIC AND TREATMENT FACILITIES, AS WELL AS A HOME-BASED HOSPICE PROGRAM. OVERSIGHT IS PROVIDED BY A 22-MEMBER BOARD OF DIRECTORS, ALL OF WHOM VOLUNTEER THEIR TIME AND EXPERTISE.OUR MISSION:THE MISSION OF PHELPS IS TO:- IMPROVE THE HEALTH OF THE COMMUNITY- OFFER PREVENTATIVE, DIAGNOSTIC, AND TREATMENT SERVICES- EDUCATE THE COMMUNITY TO ACHIEVE OPTIMAL QUALITY OF LIFE- PROVIDE COMPREHENSIVE CARE IN A SAFE, MODERN ENVIRONMENTOUR ASSESSMENT:PHELPS MEMORIAL HOSPITAL CENTER ASSESSES COMMUNITY HEALTH NEEDS BY ANALYZING DATA COLLECTED BY THE WESTCHESTER COUNTY DEPARTMENT OF HEALTH, THE WESTCHESTER COUNTY DEPARTMENT OF COMMUNITY MENTAL HEALTH, AND THE NEW YORK OFFICE OF ALCOHOLISM AND SUSBTANCE ABUSE SERVICES.RECOGNIZING THAT PEOPLE WHO LIVE AND WORK IN OUR COMMUNITY PROVIDE VALUABLE INFORMATION, PHELPS SOLICITS FEEDBACK FROM PRE-HOSPITAL AND POST-HOSPITAL CARE PROVIDERS, INCLUDING PHYSICIANS, AMBULANCE CORPS, CLINICS, NURSING HOMES AND HOME HEALTH AGENCIES. THROUGH ONGOING DIALOGUE WITH SCHOOLS AND CHURCHES, COMMUNITY COALITIONS AND KEY COMMUNITY LEADERS, WE HAVE BEEN ABLE TO RECOGNIZE GAPS IN COMMUNITY HEALTH EDUCATION. MOST IMPORTANTLY, THE RESPONSE OF INDIVIDUALS TO SURVEYS AND FOCUS GROUPS HAS BROUGHT TO LIGHT THE NEED FOR NEW SERVICES OR IMPROVED ACCESS.BASED ON OUR ASSESSMENT, WE DEFINED THE FOLLOWING PRIORITIES: CRISIS RESPONSE, BEHAVIORAL HEALTH, WELLNESS PROMOTION AND FAMILY HEALTH. OUR GOALS ARE IN CONCERT WITH THE VISION OF THE NEW YORK STATE HEALTHIEST STATE INITIATIVE; NAMELY,- TO INCREASE QUALITY AND YEARS OF HEALTHY LIFE- TO ELIMINATE HEALTH DISPARITIES, INCREASING ACCESS TO PREVENTION AND EARLY DETECTION
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: THE HOSPITAL IS A LEADER IN THE DEVELOPMENT OF FINANCIAL ASSISTANCE PROGRAMS FOR THE UNINSURED. THE PROGRAM PROVIDES FOR REDUCED FEES FOR THE UNINSURED RESIDENTS OF ITS SERVICE AREA. THE CURRENT FEE SCHEDULE INCLUDES PATIENTS WITH HOUSEHOLD INCOMES UPTO 500% OF THE FPL. WHILE THE FEE SCHEDULE SERVES AS A GUIDE, ALL HARDSHIP CASES ARE EVALUATED ON A CASE-BY-CASE BASIS, TAKING INTO ACCOUNT THE INDIVIDUAL'S FINANCIAL AND PERSONAL CIRCUMSTANCES.ALL MEDICALLY NECESSARY SERVICES ARE COVERED UNDER THE FINANCIAL ASSISTANCE PROGRAM AND THE PUBLIC IS NOTIFIED OF THE AVAILABILITY OF THE PROGRAM THROUGH:"MULTILINGUAL EDUCATIONAL BROCHURES AT KEY POINTS OF PATIENT CONTACT SPECIFICALLY IN THE ADMITTING OFFICE AND EMERGENCY DEPARTMENT"CENTRALIZED PROGRAM ADMINISTRATION ACCESSIBLE VIA PHONE (914-366-3133)"STAFF OUTREACH"PATIENT BILLS - ALL BILLS INCLUDE A NOTICE ABOUT THE FNANCIAL ASSISTANCE PROGRAM.THE HOSPITAL INFORMS AND EDUCATES PATIENTS ON A VARIETY OF FINANCIAL ASSISTANCE PROGRAMS. IT HAS A FULLY STAFFED FINANCIAL ASSISTANCE SERVICES DEPARTMENT STAFFED WITH BI-LINGUAL FINANCIAL COUNSELORS (DEPUTIZED MEDICAID WORKERS) THAT HELP EDUCATE AND PROVIDE ASSISTANCE IN APPLYING FOR MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTH PLUS, CHARITY CARE AND DISCOUNTED CARE.
PART VI, LINE 4: COMMUNITY INFORMATION:THE PHELPS SERVICE AREA BY ZIP CODE INCLUDES THE FOLLOWING:10562 OSSINING 10548 MONTROSE 10591 TARRYTOWN10522 DOBBS FERRY 10510 BRIARCLIFF MANOR 10520 CROTON ON HUDSON10511 BUCHANAN 10566 PEEKSKILL 10706 HASTINGS ON HUDSON10596 VERPLANCK 10570 PLEASANTVILLE 10546 MILLWOOD10533 IRVINGTON 10545 MARYKNOLL 10503 ARDSLEY ON HUDSON10517 CROMPOND 10523 ELMSFORD 10521 CRUGERSFOR COMMUNITY HEALTH PLANNING, PHELPS HAS DEFINED A PRIMARY SERVICE AREA BASED UPON ZIP CODES OF RESIDENCE OF THE HIGHEST VOLUME OF MEDICAL-SURGICAL,PSYCHIATRIC AND OBSTETRICAL/GYNECOLOGICAL HOSPITAL DISCHARGES. THIS PRIMARY SERVICE AREA INCLUDES:10562 OSSINING 22.5% OF DISCHARGES POPULATION 29,52410591 TARRYTOWN 16.8% OF DISCHARGES POPULATION 20,30210520 CROTON 10.9% OF DISCHARGES POPULATION 7,60610510 BRIARCLIFF 7.5% OF DISCHARGES POPULATION 7,696WE HAVE ALSO INCLUDED 10545 MARYKNOLL, BECAUSE 82% OF THE RESIDENTS UTILIZE PHELPS FOR BOTH INPATIENT AND OUTPATIENT HEALTHCARE SERVICES. UNIQUE TO PHELPS, IS THE COLLABORATION WITH OPEN DOOR FAMILY MEDICAL CENTER FOR PERINATAL CARE. IN ADDITION TO SERVING THE OSSINING AND TARRYTOWN/SLEEPY HOLLOW COMMUNITY, WE HAVE INCORPORATED THE PORTCHESTER COMMUNITY FORMERLY SERVED BY UNITED HOSPITAL. WE ALSO SUPPORT PLANNED PARENTHOOD, WHICH BRINGS RESIDENTS OF GREENBERG. BEHAVIORAL REHABILITATION PATIENT ORIGIN IS WIDELY DISPERSED ACROSS THE TRI-STATE AREA, WITH NO ZIP CODE CONTRIBUTING MORE THAN 3% OF THE ANNUAL 700 DISCHARGES.COMMUNITY HEALTH PLANNINGANALYSIS OF DEMOGRAPHICS1. WESTCHESTER FACTS:- 1.8% INCREASE IN POPULATION- 14% > 65 YEARS OLD- 52.2% FEMALE- 71.3% WHITE- 14.2% BLACK- 4.5% ASIAN- 15.6% LATINO- 41% PERSONS > 25 YEARS OLD HAVE B.S. DEGREE OR HIGHER2. CHANGES:- LARGEST % CHANGE IN GROWTH OF THOSE > 60 YEARS OLD IS AMONG ASIANS- 75-85 YEARS OLD AND 85+ COHORTS INCREASED FROM 1990 TO 20003. OUR SERVICE AREA FACTS:- 75% BELONG TO A RELIGIOUS ORGANIZATION- 20-34 YEARDS OLD MOVE OUT OF COUNTY; THOSE HERE, GOT OLDER- ELDERLY ARE MOSTLY WHITE FEMALES; 36-40% OF FEMALES ARE LIVING ALONE- 55-59 YEARDS OLD ARE OUR LARGEST COHORT4. 1990 TO 2000 % CHANGE OF THOSE > 85+ (NOTE: ELDERLY STAY; YOUNG MOVING OUT):- BRIARCLIFF 63%- CROTON 25%- DOBBS FERRY 31%- IRVINGTON 46%- OSSINING 5%- PLEASANTVILLE 74%- SLEEPY HOLLOW 44%- TARRYTOWN 14%
PART VI, LINE 6: PHELPS MEMORIAL HOSPITAL ASSOCIATION (PMHA) D/B/A PHELPS MEMORIAL HOSPITAL CENTER IS A NON-FOR-PROFIT 235 BED ACUTE FACILITY LOCATED IN SLEEPY HOLLOW, NEW YORK. PMHA PROVIDES A FULL RANGE OF HOSPITAL AND HEALTHCARE SERVICES TO THE SURROUNDING COMMUNITIES. THE BOARD OF DIRECTORS (THE BOARD) OF PMHA APPROVED AND EXECUTED AN AFFILIATION AGREEMENT WITH HEALTHSTAR NETWORK, INC., D/B/A STELLARIS HEALTH NETWORK, INC. (STELLARIS), A NEW YORK STATE NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE (THE CODE), EXEMPT FROM FEDERAL, STATE, AND LOCAL INCOME TAXES. THE AFFILIATION AGREEMENT RESULTED IN ESTABLISHING STELLARIS AS THE SOLE MEMBER OF PMHA, JOINING WHITE PLAINS, NORTHERN WESTCHESTER, AND LAWRENCE HOSPITALS. THE PRIMARY PURPOSE OF STELLARIS IS TO PRESERVE A STRONG COMMUNITY-BASED HEALTHCARE SYSTEM FOR WESTCHESTER AND PUTNAM COUNTIES, EXPAND ACCESS TO AND IMPROVE THE QUALITY OF CARE FOR THE COMMUNITIES SERVED, DEVELOP A COMPREHENSIVE NETWORK OF PROVIDERS, AND ACHIEVE AND CAPITALIZE ON ECONOMIES OF SCALE TO EXECUTE THE DELIVERY OF EFFICIENT HEALTH CARE FOR THE COMMUNITY.STELLARIS HAS A JOINT COMMUNITY HEALTH COMMITTEE WHICH USES HEALTH DEPARTMENT NEEDS ASSESSMENTS AND SUPPORTS THEIR SELECTED PRIORITIES. WE JOINTLY PLAN, IMPLEMENT AND EVALUATE SELECT INTERVENTIONS THAT COMPLEMENT INDIVIDUAL FACILITY PRIMARY SERVICE AREA ACTIVITIES.THE COMMUNITY HEALTH COMMITTEE, A COMMITTEE OF THE BOARD OF DIRECTORS IS CHARGED WITH THE OVERALL HEALTH OF THE POPULATION SERVED BY STELLARIS HEALTH THROUGH OVERSIGHT OF COORDINATED LINKS BETWEEN LOCAL HEALTH DEPARTMENT NEEDS ASSESSMENT AND THE LARGER PUBLIC HEALTH ARENA. THE OBJECTIVES OF THE COMMITTEE INCLUDE: (A) REVIEW INFORMATION WHICH ASSESSES THE HEALTH STATUS OF THE COMMUNITY SERVED.(B) PROMOTE ACTIVITIES WHICH HAVE BEEN SHOWN TO POSITIVELY IMPACT HEALTH STATUS INDICATORS OF THE PUBLIC.(C) STUDY AND RECOMMEND COMMUNITY HEALTH INTERVENTIONS TO BE PROVIDED BY THE HEALTH SYSTEM INDEPENDENTLY OR IN COOPERATION WITH COMMUNITY BASED ORGANIZATIONS AND GOVERNMENT.(D) PROPOSE POLICY RECOMMENDATIONS TO GUIDE CURRENT PROGRAMS OR DEVELOP NEW PROGRAMS.(E) IDENTIFY OPPORTUNITIES TO MEET HEALTH CARE NEEDS THROUGH IMPROVED DELIVERY OF HEALTH CARE.
NYREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantNURSING TUITION ASSISTANCETypeOfGrant
Number Of Recipients8NumberOfRecipients
Amount Of Cash Grant54000AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE NURSING PROMISE PROGRAM AWARDS FINANCIAL ASSISTANCE IN THE FORM OF A FORGIVABLE LOAN TO COVER LIVING EXPENSES FOR ELIGIBLE EMPLOYEES WHO ARE ACCEPTED AND ENROLLED IN AN ACCREDITED REGISTERED NURSING SCHOOL. CONTINUED ELIGIBILITY IN THE PROGRAM IS SUBJECT TO THE NURSING PROMISE STUDENT SUCCESSFULLY COMPLETING EACH SEMESTER'S NURSING COURSE WORK AND MAINTAINING SATISFACTORY WORK PERFORMANCE AT PHELPS MEMORIAL HOSPITAL. NURSING PROMISE STUDENTS WHO START WORK AT PHELPS MEMORIAL HOSPITAL AS A GRADUATE NURSE OR R.N. WITHIN TWO MONTHS OF GRADUATION ARE ELIGIBLE TO EARN LOAN FORGIVENESS. THE NURSING PROMISE COORDINATOR AND NURSE EDUCATOR SERVE AS MENTORS TO THE NURSING PROMISE STUDENTS AND ARE RESPONSIBLE TO MONITOR EACH STUDENT'S COMPLIANCE WITH THE PROGRAM. MENTORS MEET WITH THE STUDENTS ON A REGULAR BASIS AND DISCUSS THE STUDENTS WORK PERFORMANCE WITH THE STUDENT'S SUPERVISOR.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KEITH F SAFIAN
8113510321265057656018377002459701398639000
BARBARA ALLAR
67822065217056018063890908102045270332880
DANIEL BLUM
3617020676670258210363660253370516893000
JOANNE STURANS
3086020341510215430322090215250418030000
KERRY PISANO
365912056820026299037230036480489909000
LAWRENCE FALTZ
55996601193870406070489470234960792403000
LEONARD FOGEL
4621100886800348870432860213190650282000
LUCY ENGELHARDT
4507260728150329240420490197490618263000
VINCENT DESANTIS
56920001186750405400488830288770806175000
EMIL NIGRO
4625470774920146200174640152570587380000
GASPAR PARRINO
486073000319910174640191670554695000
MICHAEL KYI
372808074611096640174640186470493194000
STEPHEN HEIER
830429016500003063201606102076701062889000
VARGHESE MATTHEW
348612071719096640174640166670464126000
BRUCE DAVIDOW
00006794100001978706991970565230

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINES 4A-BReturnReference
ExplanationLINE 4A BRUCE DAVIDOW RECEIVED SEVERANCE PAYMENT FROM PHELPS MEMORIAL HOSPITAL. THE AMOUNT OF SEVERANCE IS TAXABLE AND REPORTED ON SCH J, COLUMN B(III). PART I, LINE 4B: PHELPS MEMORIAL HOSPITAL MAKES CONTRIBUTIONS TO A 457(F)SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ON BEHALF OF ITS EXECUTIVES. THESE CONTRIBUTIONS ARE NON TAXABLE AND REPORTED IN "RETIREMENT AND OTHER DEFERRED COMPENSATION". BRUCE DAVIDOW AND BARBARA ALLAR RECEIVED TAXABLE DISTRIBUTIONS FROM 457(F) PLAN. THESE CONTRIBUTIONS ARE REPORTED ON SCH J, COLUMN B(III) AS OTHER REPORTABLE COMPENSATION.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1TOWN OF MOUNT PLEASANT INDUSTRIAL DEV AGENCYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN136019835IssuerEIN
Date Issued2005-06-30DateIssued
Issue Price27440000IssuePrice
Description Of PurposeCONST & REN OF HOSP FACILITIESDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds27440000TotalProceeds
Issuance Costs From Proceeds478960IssuanceCostsFromProceeds
Capital Expenditures26961040CapitalExpenditures
Year Of Subst Completion2007YearOfSubstCompletion
Current Refunding0CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate1ExceptionToRebate

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTraded

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions6NumberOfContributions
Noncash Contribs Rptd F99063642NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues

Securities Prtnrshp Trust Intrsts SecuritiesPrtnrshpTrustIntrsts

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990318038NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionCOPIER/FAXDescription
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9901000NoncashContribsRptdF990
Method Of Determining RevenuesFMVMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierMETHOD FOR DETERMINING NUMBER OF CONTRIBUTORS:Identifier
Return ReferencePART I, COLUMN (B):ReturnReference
ExplanationSHOWS NUMBER OF CONTRIBUTORS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6PHELPS MEMORIAL HOSPITAL ASSOCIATION (PMHA) APPROVED AND EXECUTED AN AFFILIATION AGREEMENT WITH HEALTHSTAR NETWORK, INC D/B/A STELLARIS HEALTH NETWORK, INC (STELLARIS), A NEW YORK STATE NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXEMPT FROM FEDERAL, STATE, AND LOCAL INCOME TAXES. THE AFFILIATION AGREEMENT RESULTED IN ESTABLISHING STELLARIS AS THE SOLE MEMBER OF PMHA. ALL APPOINTMENTS TO THE BOARD OF DIRECTORS OF PMHA ARE SUBJECT TO APPROVAL BY STELLARIS. STELLARIS IS QUALIFIED TO ORIGINATE AND TAKE PART IN THE DISCUSSION OF ANY SUBJECT THAT MAY PROPERLY COME BEFORE IT AND SHALL HAVE SUCH OTHER AND ADDITIONAL RIGHTS AND PRIVILEGES AND BE SUBJECT TO SUCH OTHER DUTIES AND RESTRICTIONS AS ARE SET FORTH IN THE NOT-FOR-PROFIT CORPORATION LAW OF THE STATE OF NEW YORK, THE CERTIFICATE OF INCORPORATION OF THE ASSOCIATION OR ITS BYLAWS. A VOTE OF AT LEAST EIGHTY PERCENT(80%) OF THE ENTIRE BOARD OF DIRECTORS THEN IN OFFICE SHALL BE REQUIRED TO APPROVE CERTAIN ACTIONS.
FORM 990, PART VI, SECTION A, LINE 7ASEE EXPLANATION FOR LINE 6
FORM 990, PART VI, SECTION A, LINE 7BSEE EXPLANATION FOR LINE 6
FORM 990, PART VI, SECTION B, LINE 11FOR THE YEAR ENDED DECEMBER 31, 2011 THE FORM 990 WAS PREPARED BY A CERTIFIED PUBLIC ACCOUNTING FIRM (PAID PREPARERS) BASED ON THE INFORMATION PROVIDED BY THE HOSPITAL'S MANAGEMENT. THEN THE RETURN WAS REVIEWED BY HOSPITAL'S MANAGEMENT PRIOR TO ITS FILING, A FINAL COPY OF THE FORM 990 WAS PROVIDED TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR REVIEW AND COMMENTS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CALL GOVERNING BOARD MEMBERS, SENIOR MANAGEMENT AND OTHER PERSONNEL WHO MIGHT FIND THEMSELVES IN A POSITION WHERE THEIR PERSONAL INTERESTS CONFLICT WITH THE INTERESTS OF PHELPS MEMORIAL HOSPITAL ARE REQUIRED TO FILE AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT WITH THE COMPLIANCE OFFICER AND IMMEDIATELY DISCLOSE TO THE COMPLIANCE OFFICER ANY POSSIBLE CONFLICTS OF INTERESTS AS THEY ARISE. IT IS THE RESPONSIBILITY OF THE COMPLIANCE OFFICER TO OBTAIN AND REVIEW CONFLICT OF INTEREST DISCLOSURE STATEMENTS AT LEAST ANNUALLY. THE COMPLIANCE OFFICER AS NECESSARY WILL CONSULT WITH OUTSIDE COUNSEL AND REPORT TO THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15THE CHAIRMAN OF THE BOARD APPOINTS AN EXECUTIVE COMPENSATION COMMITTEE. THE COMMITTEE ENGAGES AN INDEPENDENT COMPENSATION CONSULTANT, IE, ASTRON SOLUTIONS, TO PROVIDE CURRENT MARKET COMPENSATION DATA FOR EACH SENIOR EXECUTIVE POSITION. THIS IS UPDATED ON AN ANNUAL BASIS. THE COMMITTEE REVIEWS WRITTEN BOARD-APPROVED MANAGEMENT GOALS, WRITTEN DOCUMENTATION OF PROGRESS TOWARDS EACH GOAL, AND AN EXECUTIVE COMPENSATION SCORECARD THAT HAS PRE-DETERMINED WEIGHTS. THE COMMITTEE DELIBERATES IN AN EXECUTIVE SESSION WHEN THEY REVIEW THE PRESIDENT'S PERFORMANCE TOWARDS THE APPROVED GOALS AND THEN MAKES RECOMMENDATIONS DIRECTLY TO THE FULL BOARD OF DIRECTORS. THE PRESIDENT PRESENTS TO THE FULL BOARD OF DIRECTORS THE RECOMMENDED COMPENSATION FOR EACH SENIOR EXECUTIVE AND THE BOARD REVIEWS THEM. ONCE THE BOARD ENDORSES THE RECOMMENDATIONS, THEY ARE GRANTED TO THE INDIVIDUAL. THE PRESIDENT'S PERFORMANCE AND COMPENSATION IS REVIEWED IN AN EXECUTIVE SESSION OF THE FULL BOARD OF DIRECTORS, FROM WHICH THE PRESIDENT IS EXCUSED. THE FULL BOARD VOTES ON THE PRESIDENT'S COMPENSATION EACH YEAR.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE CONSIDERED PUBLIC INFORMATION. THEREFORE, THESE DOCUMENTS ARE ATTAINABLE BY THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 122,026. PRIOR PERIOD ADJUSTMENTS: 141,371. CHANGE IN VALUATION OF PLEDGES -69,000. ELIMINATIONS 50,000. ROUNDING 12,302. TOTAL TO FORM 990, PART XI, LINE 5: 256,699.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2C:THE OVERSIGHT AND SELECTION PROCESSES DID NOT CHANGE FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
PHELPS CHILD CARE CENTER
3 PHELPS LANESLEEPY HOLLOWNY10591133467714CHILD CARENY501(C)(3)2PHELP MEMORIAL HOSPITAL ASSOCIATION0
PHELPS COMMUNITY CORPORATION
701 NORTH BROADWAYSLEEPY HOLLOWNY10591133263295FOUNDATIONNY501(C)(3)11APHELP MEMORIAL HOSPITAL ASSOCIATION0
HEALTHSTAR NETWORK DBA STELLARIS HEALTH
1 NORTH GREENWICH ROADARMONKNY10504133911773HEALTHCARENY501(C)(3)11B0N/A
WHITE PLAINS HOSPITAL MEDICAL CENTER
41 EAST POST ROAD DAVIS AVENUEWHITE PLAINSNY10601131740130HEALTHCARENY501(C)(3)3HEALTHSTAR NETWORK DBA STELLARIS HEALTH0
NORTHERN WESTCHESTER HOSPITAL
400 EAST MAIN STREETMOUNT KISCONY10549131740118HEALTHCARENY501(C)(3)3HEALTHSTAR NETWORK DBA STELLARIS HEALTH0
LAWRENCE HOSPITAL CENTER
55 PALMER AVENUEBRONXVILLENY10708131740110HEALTHCARENY501(C)(3)3HEALTHSTAR NETWORK DBA STELLARIS HEALTH0

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1PHELPS PROFESSIONAL BUILDING CO LPBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1777 NORTH BROADWAYAddressLine1
CitySLEEPY HOLLOWCity
StateNYState
ZIP Code10591ZIPCode
FieldValueIRS element (for citing)
EIN133645137EIN
Primary ActivityREAL ESTATEPrimaryActivity
Legal Domicile StateNYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PHELPS MEMORIAL HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeType
Share Of Total Income321031ShareOfTotalIncome
Share Of EOY Assets3303583ShareOfEOYAssets
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner1GeneralOrManagingPartner
Percentage Ownership0.65700PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipDirect Controlling Entity NADirectControllingEntityNA
PMHC REALTY CORP
701 NORTH BROADWAYSLEEPY HOLLOWNY10591133645135REAL ESTATENYPHELPS MEMORIAL HOSPITAL ASSOCIATIONC4932149891.00000
HEALTH DELIVERY ANALYSIS INC
701 NORTH BROADWAYSLEEPY HOLLOWNY10591133352327INACTIVENYPHELPS MEMORIAL HOSPITAL ASSOCIATIONC1.00000
PHELPS MANAGEMENT SERVICES INC
701 NORTH BROADWAYSLEEPY HOLLOWNY10591131726635INACTIVENYPHELPS MEMORIAL HOSPITAL ASSOCIATIONC1.00000
PHELPS SERVICES INC
701 NORTH BROADWAYSLEEPY HOLLOWNY10591131742995INACTIVENYPHELPS MEMORIAL HOSPITAL ASSOCIATIONC1.00000
PHELPS MEDICAL SERVICES PC
701 NORTH BROADWAYSLEEPY HOLLOWNY10591274416017HEALTHCARENYCN/A
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (7 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
PHELPS PROFESSIONAL BUILDING
N114180
PHELPS PROFESSIONAL BUILDING
J1499525
PHELPS PROFESSIONAL BUILDING
R274017
PHELPS PROFESSIONAL BUILDING
R325342
PHELPS PROFESSIONAL BUILDING
I53739
PHELPS MEDICAL SERVICES
P1312006
PHELPS MEDICAL SERVICES
A115748

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierPHELPS MEDICAL SERVICES, P.C.Identifier
Return ReferenceSCH R, PART IVReturnReference
ExplanationSINCE PHELPS MEDICAL SERVICES, P.C. IS A CAPTIVE PC, THE PHELPS MEMORIAL HOSPITAL IS THE BENEFICIAL OWNER OF THE PHELPS MEDICAL SERVICES PC.Explanation