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      <FollowSFAS117>X</FollowSFAS117>
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      <PermanentlyRestrictedNetAssets>
        <BOY>1993764</BOY>
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      <TotalNetAssetsFundBalances>
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      <TotalLiabNetAssetsFundBalances>
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        <EOY>519186566</EOY>
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      <InfoInScheduleOPartXI>X</InfoInScheduleOPartXI>
      <ReconcilationRevenueExpenses>-558374</ReconcilationRevenueExpenses>
      <ReconcilationOtherChanges>-25591921</ReconcilationOtherChanges>
      <MethodOfAccountingAccrual>X</MethodOfAccountingAccrual>
      <AccountantCompileOrReview>false</AccountantCompileOrReview>
      <FSAudited>true</FSAudited>
      <AuditCommittee>true</AuditCommittee>
      <FinancialStatementConsolidated>X</FinancialStatementConsolidated>
      <FederalGrantAuditRequired>false</FederalGrantAuditRequired>
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        <ContributorAddressUS>
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          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
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        <AggregateContributions>RESTRICTED</AggregateContributions>
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      <TotalDirectLobbying />
      <TotalLobbyingExpenditures />
      <OtherExemptPurposeExpenditures />
      <TotalExemptPurposeExpenditures />
      <LobbyingNontaxableAmount />
      <GrassrootsNontaxableAmount />
      <TotLobbyingGrassrootMinusNonTx />
      <TotLobbyExpendMnsLobbyingNontx />
      <Volunteers>false</Volunteers>
      <PaidStaffOrManagement>true</PaidStaffOrManagement>
      <MediaAdvertisements>false</MediaAdvertisements>
      <MailingsMembers>false</MailingsMembers>
      <PublicationsOrBroadcast>false</PublicationsOrBroadcast>
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      <DirectContactLegislators>true</DirectContactLegislators>
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      <OtherActivities>true</OtherActivities>
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      <NotDescribedIn501c3>false</NotDescribedIn501c3>
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        <Identifier>PART II-B</Identifier>
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      <HeldWorksOfArtAmts />
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        <EndOfYearBalance>1933764</EndOfYearBalance>
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        <BookValue>4897415</BookValue>
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        <BookValue>151478993</BookValue>
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        <BookValue>3767320</BookValue>
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      <Equipment>
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      <OtherLandBuildings>
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        <Depreciation>0</Depreciation>
        <BookValue>1559943</BookValue>
      </OtherLandBuildings>
      <TotalOfBookValueLandBuildings>326297598</TotalOfBookValueLandBuildings>
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        <Description>BOND REFINANCE COSTS, NET</Description>
        <BookValue>7019732</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>INSURANCE RECOVERIES REC.</Description>
        <BookValue>15116101</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>OTHER ASSETS</Description>
        <BookValue>738397</BookValue>
      </OtherAssets>
      <OtherAssets>
        <Description>OTHER RECEIVABLES, NET</Description>
        <BookValue>2957513</BookValue>
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      <OtherAssets>
        <Description>DUE FROM THIRD PARTIES</Description>
        <BookValue>4058918</BookValue>
      </OtherAssets>
      <TotalBookValueOtherAssets>29890661</TotalBookValueOtherAssets>
      <FederalIncomeTaxLiability>0</FederalIncomeTaxLiability>
      <OtherLiabilities>
        <Description>THIRD PARTY PAYABLES</Description>
        <Amount>3184687</Amount>
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      <OtherLiabilities>
        <Description>PENSION LIABILITY</Description>
        <Amount>48572602</Amount>
      </OtherLiabilities>
      <OtherLiabilities>
        <Description>LONG-TERM LIAB-WC&amp; MALPRACTICE</Description>
        <Amount>17903755</Amount>
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      <OtherLiabilities>
        <Description>OTHER LIABILITIES</Description>
        <Amount>3850382</Amount>
      </OtherLiabilities>
      <TotalOfAmounts>73511426</TotalOfAmounts>
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        <ReturnReference>SCHEDULE D, PART V, LINE 4</ReturnReference>
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        <Identifier>FIN 48</Identifier>
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      </Form990ScheduleDPartXIV>
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      </CharityCareAtCost>
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      </UnreimbursedCosts>
      <TotalCharityCare>
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        <PercentOfTotalExpense>0.04840</PercentOfTotalExpense>
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      </CommunityHealthServices>
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        <NetCommunityBenefitExpense>7000</NetCommunityBenefitExpense>
      </CashAndInKindContributions>
      <TotalOtherBenefits>
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      <TotalCommunityBenefits>
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      <CostingMethodologyUsed>
        <CostToChargeRatio>X</CostToChargeRatio>
      </CostingMethodologyUsed>
      <WrittenDebtCollectionPolicy>true</WrittenDebtCollectionPolicy>
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        </Name>
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        <AmountsGenerallyBilled>false</AmountsGenerallyBilled>
        <GrossCharges>false</GrossCharges>
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          <Name>
            <BusinessNameLine1>CRYSTAL RUN AMBULATORY SURGERY CNTR OF</BusinessNameLine1>
          </Name>
          <Address>
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            <State>NY</State>
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            <BusinessNameLine1>HUDSON VALLEY AMBULATORY SURGERY LLC</BusinessNameLine1>
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            <AddressLine1>75 CRYSTAL RUN RD BLDG B SUITE 225</AddressLine1>
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            <State>NY</State>
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          </Address>
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        <OtherFacilities>
          <Name>
            <BusinessNameLine1>ORANGE REGIONAL MEDICAL PAVILION</BusinessNameLine1>
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            <ZIPCode>10941</ZIPCode>
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        <OtherFacilities>
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            <BusinessNameLine1>GOSHEN PATIENT SERVICE CENTER</BusinessNameLine1>
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          <Address>
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            <State>NY</State>
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          <Name>
            <BusinessNameLine1>GOSHEN RADIATION ONCOLOGY CENTER</BusinessNameLine1>
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            <State>NY</State>
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        <OtherFacilities>
          <Name>
            <BusinessNameLine1>OUTPATIENT REHABILITATION CENTER</BusinessNameLine1>
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          <Address>
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            <State>NY</State>
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        <OtherFacilities>
          <Name>
            <BusinessNameLine1>ORANGE REGIONAL FAMILY PROGRAM FOR ALCO</BusinessNameLine1>
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          <Address>
            <AddressLine1>420 EAST MAIN ST</AddressLine1>
            <City>MIDDLETOWN</City>
            <State>NY</State>
            <ZIPCode>10940</ZIPCode>
          </Address>
          <FacilityType>SUBSTANCE ABUSE COUNSELING CENTER</FacilityType>
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        <OtherFacilities>
          <Name>
            <BusinessNameLine1>STANLEY S DUNKELMAN DIABETES TREATMENT</BusinessNameLine1>
          </Name>
          <Address>
            <AddressLine1>110 CRYSTAL RUN ROAD</AddressLine1>
            <City>MIDDLETOWN</City>
            <State>NY</State>
            <ZIPCode>10941</ZIPCode>
          </Address>
          <FacilityType>DIABETES TREATMENT SUPPORT CENTER</FacilityType>
        </OtherFacilities>
      </Form990ScheduleHPartVSectionC>
      <Form990ScheduleHPartVI>
        <Identifier>PART I, LINE 3C:</Identifier>
        <Explanation>N/A</Explanation>
      </Form990ScheduleHPartVI>
      <Form990ScheduleHPartVI>
        <Identifier>PART I, LINE 6A:</Identifier>
        <Explanation>A COMMUNITY SERVICE PLAN IS PREPARED BY ORANGE REGIONAL MEDICAL CENTER. PART I, LINE 7: CALCULATION OF COST IS DONE UTILIZING THE RATIO OF PATIENT CARE COST TO CHARGES DEVELOPED ON WORKSHEET 2. THIS AMOUNT IS APPLIED TO THE GROSS CHARGES IDENTIFIED FROM ALLOWANCE CODES USED IN THE PATIENT ACCOUNTING SYSTEM.</Explanation>
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      <Form990ScheduleHPartVI>
        <Identifier>PART I, LINE 7A:</Identifier>
        <Explanation>BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT EXCLUDED FOR PURPOSES OF CALCULATING FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST: $12,993,265.</Explanation>
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      <Form990ScheduleHPartVI>
        <Identifier>PART I, LINE 7G:</Identifier>
        <Explanation>N/A</Explanation>
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        <Identifier>PART II:</Identifier>
        <Explanation>N/A</Explanation>
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      <Form990ScheduleHPartVI>
        <Identifier>PART III, LINE 4:</Identifier>
        <Explanation>ORMC PROVIDES CHARITY CARE TO PATIENTS WHO MEETS CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY, TO PATIENTS WHO ARE UNINSURED AND TO PATIENTS WHO ARE UNDERINSURED AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE ORMC DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY, THEY ARE NOT REPORTED AS REVENUE. THE CALCULATION OF THE COST OF THESE SERVICES IS DONE UTILIZING THE RATIO OF PATIENT CARE COST TO CHARGES BASED UPON THE 2010 INSTITUTIONAL COST REPORT, APPLIED TO THE GROSS CHARITY RELATED ALLOWANCES AND BAD DEBT EXPENSE.</Explanation>
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      <Form990ScheduleHPartVI>
        <Identifier>PART III, LINE 8:</Identifier>
        <Explanation>THE MEDICARE SHORTFALL OF $32,686,800 COULD BE CONSIDERED A COMMUNITY BENEFIT EXPENSE TO THE EXTENT THAT IT IS IN EFFECT A SUBSIDY OF A GOVERNMENTAL HEALTHCARE PLAN WHICH ENABLES THE RECIPIENTS OF THESE BENEFITS TO RECEIVE HEALTHCARE. THE AMOUNT INDICATED ON LINE 6 AS MEDICARE ALLOWABLE COSTS RELATED TO MEDICARE PAYMENTS HAS BEEN CALCULATED BY APPLYING THE RATIO OF PATIENT CARE COST TO CHARGES TO GROSS CHARGES FOR MEDICARE AND MEDICARE ADVANTAGE PLAN LESS PAYMENTS. THIS RATIO IS CONSISTENT WITH THAT USED FOR MEDICAID AND OTHER PROVIDERS.</Explanation>
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      <Form990ScheduleHPartVI>
        <Identifier>PART III, LINE 9B:</Identifier>
        <Explanation>ORMC'S COLLECTION POLICY INDICATES THAT IF A PATIENT IS NOT ABLE TO PAY, THEY WILL BE REFERRED FOR MEDICAID ELIGIBILITY OR FINANCIAL AID. ALSO, CHARITY CARE ELIGIBILITY IS EXTENDED TO 350% OF THE FEDERAL POVERTY GUIDELINES (FPG) FOR THOSE PATIENTS WHO ARE INDIGENT BUT HAVE SOME INCOME AND DO NOT QUALITY FOR A 100% WRITE-OFF.</Explanation>
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      <Form990ScheduleHPartVI>
        <Identifier>PART VI, LINE 2 - NEEDS ASSESSMENT:</Identifier>
        <Explanation>ON MAY 19, 2009, IN ACCORDANCE WITH THE NEW YORK STATE PREVENTION AGENDA AND IN PARTNERSHIP WITH THE ORANGE COUNTY DEPARTMENT OF HEALTH AND THE MIDDLETOWN COMMUNITY HEALTH CENTER, ORANGE REGIONAL MEDICAL CENTER HOSTED THE ORANGE COUNTY REGION 2 TOWN HALL HEALTH MEETING TO SOLICIT PUBLIC INPUT FROM LOCAL COMMUNITY HEALTHCARE AGENCIES AND STAKEHOLDERS REGARDING HEALTHCARE NEEDS. REGION 2 ENCOMPASSES THE NORTH CENTRAL PORTION OF ORANGE COUNTY. PARTICIPANTS DISCUSSED THE FOLLOWING PREVENTION AGENDA PRIORITIES AS THEY RELATED TO ORANGE COUNTY REGION 2: * ACCESS TO QUALITY HEALTHCARE * HEALTHY MOTHERS/HEALTHY BABIES/HEALTHY CHILDREN * CHRONIC DISEASE * PHYSICAL ACTIVITY/NUTRITION * UNINTENTIONAL INJURY; HEALTHY ENVIRONMENT * TOBACCO USE * INFECTIOUS DISEASE * COMMUNITY PREPAREDNESS * MENTAL HEALTH/SUBSTANCE ABUSE IN ADDITION, THE ORANGE COUNTY DEPARTMENT OF HEALTH (OCDOH) HAS COLLABORATED WITH A VARIETY OF EDUCATIONAL, COMMUNITY, VOLUNTARY AND GOVERNMENT AGENCIES; HEALTHCARE FACILITIES AND PROVIDERS INCLUDING ORANGE REGIONAL MEDICAL CENTER; AND CONSUMER GROUPS TO COLLECTIVELY IDENTIFY PRIORITIES FOR IMPROVING COMMUNITY-WIDE HEALTH STATUS. IN CONDUCTING THE 2005-2010 ORANGE COUNTY COMMUNITY HEALTH ASSESSMENT, SEVERAL STRATEGIES WERE USED TO FACILITATE AND INVITE COMMUNITY INPUT IN ESTABLISHING COMMUNITY HEALTH PRIORITIES. ONE STRATEGY WAS TO ENCOURAGE ONGOING COMMUNICATION WITH AND CONSULTATION FROM THE COMMUNITY COLLABORATORS. ORANGE COUNTY DOH REPRESENTATIVES MEET WITH THESE GROUPS REGULARLY TO DISCUSS COMMUNITY-BASED HEALTH INITIATIVES AND EMERGING HEALTH AND SERVICE DELIVERY NEEDS. IN ADDITION, TWO VERSIONS OF A LOCAL HEALTH NEEDS SURVEY WERE DEVELOPED TO SOLICIT INPUT FROM COMMUNITY-BASED HEALTH SERVICES, COMMUNITY AGENCIES, AND RESIDENTS. THE COMMUNITY AGENCY VERSION OF THE LOCAL HEALTH NEEDS SURVEY WAS DESIGNED TO PROVIDE INPUT REGARDING NEEDS BOTH FROM THE AGENCY/HEALTHCARE FACILITY'S PERSPECTIVE AND THAT OF THE TARGET POPULATION SERVED BY EACH AGENCY. THE OTHER SURVEY, COMPLETED BY MORE THAN 750 ORANGE COUNTY RESIDENTS, WAS MADE AVAILABLE IN BOTH ENGLISH AND SPANISH ON THE COUNTY'S WEBSITE. A TOTAL OF 40 SURVEYS WERE COMPLETED BY HEALTHCARE FACILITIES AND AGENCIES INCLUDING ORANGE REGIONAL MEDICAL CENTER. THE FOLLOWING FINDINGS IDENTIFIED BY THE ORANGE COUNTY DEPARTMENT OF HEALTH'S SURVEY AND THE ORANGE COUNTY REGION 2 TOWN HALL HEALTH MEETING DIRECTLY FALL IN LINE WITH THE NEW YORK STATE DEPARTMENT OF HEALTH PREVENTION AGENDA. ORANGE REGIONAL MEDICAL CENTER CURRENTLY OFFERS SERVICES THAT ADDRESS THESE ISSUES. * BEHAVIORAL HEALTH (PREVENTION AGENDA ITEM): THERE WAS UNANIMOUS AGREEMENT THAT SIGNIFICANT NEED FOR BEHAVIORAL HEALTH SERVICES THAT EXISTS IN REGION 2 AND COUNTY-WIDE, PARTICULARLY REGARDING PEDIATRIC AND ADOLESCENT BEHAVIORAL HEALTH. BARRIERS INCLUDE LACK OF TRANSPORTATION/ACCESS AND INSUFFICIENT METHODS OF COMMUNICATION REGARDING THE SERVICES AVAILABLE. * OBESITY: OBESITY IS AN INCREASING PROBLEM FOR ORANGE COUNTY RESIDENTS, IT IS OF SPECIAL CONCERN IN CHILDREN AND TEENS BECAUSE IT NOT ONLY INCREASES THE RISK OF CHRONIC DISEASES LATER IN LIFE, BUT CAN RESULT IN PSYCHOLOGICAL AND SOCIAL DIFFICULTIES AT A DEVELOPMENTALLY SENSITIVE STAGE. * CHRONIC DISEASE (PREVENTION AGENDA ITEM): FINDINGS SUGGEST THAT THERE IS A NEED TO BETTER ADDRESS THE UNDERLYING CAUSES OF CHRONIC DISEASES SUCH AS OBESITY, POOR NUTRITION, AND LACK OF PHYSICAL ACTIVITY IN THE COUNTY. THIS MAY BE ACHIEVED BY EXPANDING THE HEALTH EDUCATION AND PRIMARY PREVENTION SERVICE CAPACITY IN THE ORANGE COUNTY HEALTH DEPARTMENT AND THROUGHOUT COMMUNITY AGENCIES. * ACCESS TO CARE (PREVENTION AGENDA ITEM): IT WAS FELT THERE IS SIGNIFICANT NEED TO EXPAND ACCESS TO HEART DISEASE, CANCER, COPD/CLRD, ASTHMA, AND DIABETES PREVENTION AND EDUCATION INCLUDING ESPECIALLY FOR HIGH RISK MINORITY AND LOW INCOME RESIDENTS, SIGNIFICANT NEED ALSO EXISTS TO EXPAND ACCESS TO BREAST, PROSTATE, AND COLORECTAL SCREENING, ESPECIALLY FOR HIGH RISK MINORITY AND LOW INCOME RESIDENTS. EARLY DETECTION: IT WAS ALSO DETERMINED THAT ACCESSIBILITY AND USE OF EARLY DETECTION AND SCREENING SERVICES WERE LACKING FOR CHRONIC DISEASES, ESPECIALLY BY LOW-INCOME, MINORITY POPULATIONS. PRESENTLY ORANGE REGIONAL MEDICAL CENTER OFFERS SEVERAL PROGRAMS TO ADDRESS THE ISSUES ABOVE. THESE PROGRAMS WILL BE SUPPLEMENTED BY INPUT AND SUPPORT FROM THE LOCAL DEPARTMENT OF HEALTH AND FROM COMMUNITY PARTNERS. IN ADDITION TO SUPPORT THESE EFFORTS, ON AUGUST 18, 2011, ORANGE REGIONAL MEDICAL CENTER'S MANAGER OF PLANNING ATTENDED A SUMMIT WITH THE HUDSON VALLEY REGIONAL HEALTH OFFICER'S NETWORK (HVRHON). THIS IS A LOWER HUDSON VALLEY HEALTH PLANNING INITIATIVE FUNDED BY THE HEALTH CARE EFFICIENCY &amp; AFFORDABILITY LAW (HEAL 9) GRANT PROGRAM. SEVEN COUNTIES ARE COLLABORATING IN THE EFFORT WITH HVRHON AND THE NYMC SCHOOL OF HEALTH PRACTICES &amp; SCIENCES. THE COUNTIES INCLUDE DUTCHESS; ORANGE; PUTNAM; ROCKLAND; SULLIVAN; ULSTER AND WESTCHESTER. KEYNOTE SPEAKER AT THE SUMMIT WAS MICHELLE DAVIS, REGIONAL HEALTH ADMINISTRATOR, UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES. THE HVRHON SCOPE OF WORK INCLUDES COMMUNITY HEALTH ASSESSMENT AND PRIORITIZATION OF NEEDS AND RECOMMENDATIONS INCLUDING: .Developing Regional Performance Monitoring Tool (RPMT) for a Needs Assessment of the three .Priority Areas (based on existing data and regional provider/consumer survey) .IdentifYing and strengthening health systems partnerships and .collaboration .IdentifYing models of health care delivery and disease prevention strategies .Developing a Web-based health information portal to facilitate planning and information sharing .Sponsoring a regional summit for health leaders Key accomplishments of HVRHON presented at the summit were: .Priority areas identified (and analyzed at the August 18 summit) included: Access to Quality Health Care, Chronic Disease Prevention and Control. Maternal and Child Health .Regional Performance Monitoring Survey Tool developed .Surveyed consumers and providers .Administered survey across all counties .Utilized survey data to inform 2010-2013 Community Health Assessment .Counties conducted local focus groups with key providers and stakeholders to inform process PART VI, LINE 3 - PATIENT EDUCATION OF ELIGIBILTY FOR ASSISTANCE: TO INFORM AND EDUCATE OUR PATIENTS REGARDING THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE, ORANGE REGIONAL MEDICAL CENTER UTILIZES SEVERAL METHODS, INCLUDING PROVIDING A FINANCIAL AID SUMMARY AT REGISTRATION, POSTING SIGNS IN PATIENT AREAS, DETAILING THE INFORMATION ON THE ORGANIZATION'S WEBSITE, AND INCLUDING IT ON PATIENT STATEMENTS. Part VI, Line 4 - Community Information: Orange Regional Medical Center (ORMC) is a member of the Greater Hudson Valley Health System (GHVHS). ORMC, in Middletown, NY, expanded its service area to reflect its relationship with Catskill Regional Medical Center (also a member of GHVHS). The GHVHS service area includes all of Orange County and Sullivan County; an area that encompasses 1,828 square miles and approximately 450,000 residents. When it comes to health planning for primary care and core secondary level services, ORMC focuses on 29 zip codes that comprise its local health service area. This service area was determined by identifying the zip codes from which 85% of Orange Regional's discharges originate. Planning for specialty care services takes a more regional perspective and encompasses all of Orange and Sullivan Counties and the needs of their residents. Part VI, Line 5 - Promotion of Community Health The majority of ORMC's Board of Directors consists of local health care consumers who provide expertise in identifying the healthcare needs and priorities of the communities we serve. In addition, ORMC conducts, coordinates, and participates in a broad range of community outreach programs that allow community members the opportunity to interact directly with representatives from the hospital. Part VI, Line 6 - N/A Part VI, Line 7 - Community Service Plan: ORMC performs a community service plan every three years.</Explanation>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>STEPHEN SUGRUE</NamePerson>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>QUAZI AL-TARIQ</NamePerson>
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      <Form990ScheduleJPartII>
        <NamePerson>HAI LUO</NamePerson>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>JOANN SCHULTZ</NamePerson>
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      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>FRANCIS J BACHYRYCZ</NamePerson>
        <BaseCompensationFilingOrg>212154</BaseCompensationFilingOrg>
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        <BonusFilingOrg>2528</BonusFilingOrg>
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        <DeferredCompFilingOrg>768</DeferredCompFilingOrg>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
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        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartII>
        <NamePerson>GEORGE W EIGHMY III</NamePerson>
        <BaseCompensationFilingOrg>175548</BaseCompensationFilingOrg>
        <CompBasedOnRelatedOrgs>0</CompBasedOnRelatedOrgs>
        <BonusFilingOrg>18913</BonusFilingOrg>
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        <TotalCompensationRelatedOrgs>0</TotalCompensationRelatedOrgs>
        <CompReportPrior990FilingOrg>0</CompReportPrior990FilingOrg>
        <CompReportPrior990RelatedOrgs>0</CompReportPrior990RelatedOrgs>
      </Form990ScheduleJPartII>
      <Form990ScheduleJPartIII>
        <Identifier>SEVERANCE PAYMENTS</Identifier>
        <ReturnReference>SCHEDULE J, PART I, LINE 4</ReturnReference>
        <Explanation>SEVERANCE NONQUALIFIED PAYMENT RETIREMENT PLAN MITCHELL AMADO III - 40,353 JOSEPH ANESI - 17,022 SCOTT BATULIS - 135,375 WAYNE BECKER - 13,061 DEBORAH CARR - 12,176 GERARD DUNLAVEY - 11,093 ROSEMARY FRADO - 33,254 SUSAN HODGSON 154,021 - SANDRA IBERGER - 15,805 CHRISTINE MARAIA - 10,108 JAMES OXLEY, MD - 28,604 SYED RAB - 16,653 JONATHAN SCHILLER - 16,797 STEPHEN SUGRUE - 9,810</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>SCHEDULE J, PART I, LINE 1A</Identifier>
        <Explanation>THE HOSPITAL PAYS THE DUES AND ASSESSMENTS FOR THE CEO'S MEMBERSHIP IN LOCAL COUNTRY CLUB FOR BUSINESS RELATED PURPOSES. THE EXECUTIVE IS RESPONSIBLE FOR ALL EXPENSES ASSOCIATED WITH HIS PERSONAL CLUB USAGE.</Explanation>
      </Form990ScheduleJPartIII>
      <Form990ScheduleJPartIII>
        <Identifier>SCHEDULE J, PART I, LINE 7</Identifier>
        <Explanation>DURING THE TAX YEAR THE ORGANIZATION PAID BONUSES TO ITS OFFICERS AND EMPLOYEES. THE NAMES AND AMOUNTS ARE PROPERLY DISCLOSED ON SCHEDULE J, PART II COLUMN B(ii).</Explanation>
      </Form990ScheduleJPartIII>
    </IRS990ScheduleJ>
    <IRS990ScheduleK documentId="IRS990ScheduleK">
      <Form990ScheduleKPartI>
        <IssuerName>
          <BusinessNameLine1>DORMITORY AUTHORITY OF STATE OF NY</BusinessNameLine1>
        </IssuerName>
        <IssuerEIN>146000293</IssuerEIN>
        <CUSIPNumber>649903A27</CUSIPNumber>
        <DateIssued>2008-05-07</DateIssued>
        <IssuePrice>260106200</IssuePrice>
        <DescriptionOfPurpose>CONSTRUCT A REPLACEMENT HOSPITAL</DescriptionOfPurpose>
        <Defeased>false</Defeased>
        <OnBehalfOfIssuer>false</OnBehalfOfIssuer>
        <PoolFinancing>false</PoolFinancing>
      </Form990ScheduleKPartI>
      <Form990ScheduleKPartII>
        <AmountRetired>4020000</AmountRetired>
        <AmountBondDefeased>0</AmountBondDefeased>
        <TotalProceeds>260106200</TotalProceeds>
        <AmountInReserveFund>20230063</AmountInReserveFund>
        <CapitalizedInterest>50673656</CapitalizedInterest>
        <RefundingEscrow>0</RefundingEscrow>
        <IssuanceCostsFromProceeds>8048373</IssuanceCostsFromProceeds>
        <CreditEnhancement>0</CreditEnhancement>
        <WorkingCapitalExpenditures>0</WorkingCapitalExpenditures>
        <CapitalExpenditures>176860294</CapitalExpenditures>
        <OtherSpentProceeds>0</OtherSpentProceeds>
        <AmountUnspent>4293814</AmountUnspent>
        <CurrentRefunding>false</CurrentRefunding>
        <AdvanceRefunding>false</AdvanceRefunding>
        <FinalAllocationMade>false</FinalAllocationMade>
        <AdequateBooksAndRecdsMaintaind>true</AdequateBooksAndRecdsMaintaind>
      </Form990ScheduleKPartII>
      <Form990ScheduleKPartIII>
        <OwningBondFinancedProperty>false</OwningBondFinancedProperty>
        <AnyLeaseArrangements>false</AnyLeaseArrangements>
        <MngmentCntrctBondFinancdPrprty>false</MngmentCntrctBondFinancdPrprty>
        <AnyResearchAgreements>false</AnyResearchAgreements>
        <PrcntgePrvtBusinessUseByOthers>0.00000</PrcntgePrvtBusinessUseByOthers>
        <PercentageOfPrvtBusinessReUBI>0.00000</PercentageOfPrvtBusinessReUBI>
        <TotalPrivateBusinessUse>0.00000</TotalPrivateBusinessUse>
        <PostIssuanceComplianceProcdrs>true</PostIssuanceComplianceProcdrs>
      </Form990ScheduleKPartIII>
      <Form990ScheduleKPartIV>
        <Form8038TFiled>false</Form8038TFiled>
        <VariableRateIssue>false</VariableRateIssue>
        <HedgeIdentifiedInBooksAndRecds>false</HedgeIdentifiedInBooksAndRecds>
        <NameOfHedgeProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfHedgeProvider>
        <GrossProceedsInvestedInGIC>false</GrossProceedsInvestedInGIC>
        <NameOfGICProvider>
          <BusinessNameLine1>0</BusinessNameLine1>
        </NameOfGICProvider>
        <GrossProceedsInvested>false</GrossProceedsInvested>
        <ExceptionToRebate>false</ExceptionToRebate>
      </Form990ScheduleKPartIV>
    </IRS990ScheduleK>
    <IRS990ScheduleL documentId="IRS990ScheduleL">
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>ORANGE PATHOLOGY ASSOCIATES</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>OWNERSHIP INTEREST HELD</Relationship>
        <AmountOfTransaction>362671</AmountOfTransaction>
        <DescriptionOfTransaction>PATHOLOGY SERVICES</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>-</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>BY BOARD MEMBER SCHUYLER</Relationship>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>-</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>NEWMAN</Relationship>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>ORANGE COUNTY LITHOTRIPSY LLC</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>OWNERSHIP INTEREST HELD</Relationship>
        <AmountOfTransaction>114167</AmountOfTransaction>
        <DescriptionOfTransaction>LITHOTRIPSY SERVICES</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>-</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>BY BOARD MEMBER</Relationship>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>-</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>Gerard galarneau</Relationship>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>HISTOPATHOLOGY SERVICES LLC</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>OWNERSHIP INTEREST HELD</Relationship>
        <AmountOfTransaction>1055793</AmountOfTransaction>
        <DescriptionOfTransaction>PATHOLOGY SERVICES</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>-</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>BY BOARD MEMBER</Relationship>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>-</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SCHUYLER NEWMAN</Relationship>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>CARMELLA PISTONE-HALPERN</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>SPOUSE OF BOARD MEMBER</Relationship>
        <AmountOfTransaction>152855</AmountOfTransaction>
        <DescriptionOfTransaction>WAGES</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>-</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>PAUL HALPERN</Relationship>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>ORANGE COUNTY TRUST COMPANY</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>COMMON BOARD MEMBERS -</Relationship>
        <AmountOfTransaction>101494</AmountOfTransaction>
        <DescriptionOfTransaction>FEES AND INTEREST PAID</DescriptionOfTransaction>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
      <Form990ScheduleLPartIV>
        <NameOfInterestedPerson>
          <NamePerson>-</NamePerson>
        </NameOfInterestedPerson>
        <Relationship>HEIMBACH AND RIZZO</Relationship>
        <SharingOfRevenues>false</SharingOfRevenues>
      </Form990ScheduleLPartIV>
    </IRS990ScheduleL>
    <IRS990ScheduleO documentId="IRS990ScheduleO">
      <GeneralExplanation>
        <Identifier>FORM 990, PART III, LINE - ORGANIZATION'S MISSION</Identifier>
        <Explanation>ORANGE REGIONAL MEDICAL CENTER WILL IMPROVE THE HEALTH OF OUR COMMUNITY BY PROVIDING EXCEPTIONAL HEALTHCARE OVER A BROAD RANGE OF QUALITY HEALTHCARE SERVICES. WE WILL PURSUE EXCELLENCE IN ALL WE DO WITH A GOAL OF BECOMING THE PROVIDER OF CHOICE FOR OUR COMMUNITY, THE EMPLOYER OF CHOICE FOR OUR STAFF, AND THE WORKPLACE OF CHOICE FOR OUR DOCTORS. ORANGE REGIONAL BELIEVES STRONGLY THAT THE FEAR OF NOT BEING ABLE TO PAY FOR HEALTHCARE SHOULD NOT BE A DETERENT IN SEEKING HEALTHCARE SERVICES. THEREFORE, WE WORK HARD TO ENSURE THAT HEALTHCARE REMAINS ACCESSIBLE AND AVAILABLE FOR ANY MEMBER OF THE COMMUNITY IN NEED. FORM 990, PART III - PROGRAM SERVICE, LINE 4A ORANGE REGIONAL MEDICAL CENTER IS CURRENTLY LICENSED FOR 383 BEDS AT ITS NEW LOCATION AT 707 EAST MAIN ST, MIDDLETOWN, NY AND PROVIDES A FULL RANGE OF ADULT MEDICAL/SURGICAL INTENSIVE CARE , PEDIATRIC, OBSTETRICAL, REHABILITATION AND BEHAVIORAL HEALTH SERVICES. DURING 2011, ORMC HAD 21,820 INPATIENT DISCHARGES AND PERFORMED 654,713 OUTPATIENT PROCEDURES. IN ADDITION TO PROVIDING INPATIENT CARE, ORMC ALSO OPERATES A NETWORK OF OFF-SITE FACILITIES WHICH PROVIDE A FULL RANGE OF OUTPATIENT DIAGNOSTIC, THERAPEUTIC AND COMMUNITY EDUCATION SERVICES. THROUGHOUT THE YEAR, ORMC ALSO CONDUCTS AND COORDINATES A BROAD RANGE OF COMMUNITY OUTREACH PROGRAMS. THESE PROGRAMS INCLUDE HEALTH TRADE EXPOSITIONS, FACILITY TOURS, SPEAKERS BUREAU, EDUCATIONAL SEMINARS AND LECTURES, SCHOOL CAREER DAYS, COMMUNITY HEALTH SCREENINGS AND SUPPORT PROGRAMS. OTHER PROGRAM SERVICES FORM 990, PART III, LINE 4D $89,589,546 OF EXPENSES INCURRED WHILE PROVIDING OUTPATIENT, EMERGENCY ROOM, AND REFERRED AMBULATORY SERVICES TO PATIENTS IN THE SURROUNDING COMMUNITY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>AUDITED FINANCIAL STATEMENTS</Identifier>
        <ReturnReference>FORM 990, PART IV, LINE 12</ReturnReference>
        <Explanation>AUDITED FINANCIAL STATEMENTS FOR THE HOSPITAL HAVE BEEN PREPARED ON A CONSOLIDATED BASIS AND INCLUDE THE ACTIVITIES OF THE HOSPITAL AND EAST MAIN STREET MANAGEMENT CORPORATION, THE ALPHA NETWORK, INC, AND SYNERA CORPORATION. HOWEVER, BECAUSE ALL OF THESE ENTITIES ARE DORMANT CORPORATIONS, THE FINANCIAL STATEMENTS REFLECT THE STAND ALONE OPERATIONS OF ORMC.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>FAMILY/BUSINESS RELATIONSHIPS</Identifier>
        <ReturnReference>FORM 990, PART VI, LINE 2</ReturnReference>
        <Explanation>BOARD MEMBERS LOUIS HEIMBACH AND VIRGINIA RIZZO ALSO SERVE ON THE BOARD OF A LOCAL FINANCIAL INSTITUTION.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>MEMBERS OR STOCKHOLDERS</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 6</ReturnReference>
        <Explanation>GREATER HUDSON VALLEY HEALTH SYSTEM, INC, AN ORGANIZATION EXEMPT FROM INCOME TAX UNDER IRC SECTION 501(C)(3) IS THE SOLE MEMBER OF ORANGE REGIONAL MEDICAL CENTER.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>ELECTION OF MEMBERS</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION A, LINE 7A AND B</ReturnReference>
        <Explanation>GREATER HUDSON VALLEY HEALTH SYSTEM'S BOARD OF DIRECTORS APPROVES THE DIRECTOR NOMINEES OF THE BOARD OF DIRECTORS FOR ORANGE REGIONAL MEDICAL CENTER. UNDER LIMITED CIRCUMSTANCES, GREATER HUDSON VALLEY HEALTH SYSTEM'S BOARD OF DIRECTORS APPROVES DECISIONS OF ORANGE REGIONAL MEDICAL CENTER'S BOARD OF DIRECTORS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>BOARD REVIEW OF FORM 990</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 11</ReturnReference>
        <Explanation>THE FORM 990 IS REVIEWED BY THE FINANCE DEPARTMENT, MEMBERS OF EXECUTIVE MANAGEMENT, THE CORPORATE COMPLIANCE OFFICER, AND THE AUDIT AND COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS. A COPY IS PROVIDED TO ALL OF THE VOTING MEMBERS OF THE BOARD OF DIRECTORS BEFORE FILING THE RETURN WITH THE IRS.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>CONFLICT OF INTEREST POLICY</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 12C</ReturnReference>
        <Explanation>ORANGE REGIONAL MEDICAL CENTER'S CONFLICT OF INTEREST (COI) POLICY APPLIES TO ALL DIRECTORS, COMMITTEE MEMBERS AND ALL EMPLOYEES WHO ARE IN A POSITION TO INFLUENCE ANY SUBSTANTIVE BUSINESS DECISION BY THE HOSPITAL OR ANY ENTITY CONTROLLED BY THE HOSPITAL. THE HOSPITAL HAS INSTITUTED A CORPORATE COMPLIANCE PROGRAM TO ENSURE THAT ALL OF ITS BUSINESS PRACTICES ARE IN COMPLIANCE WITH APPLICABLE CIVIL AND CRIMINAL LAWS, RULES AND REGULATIONS. THE CONFLICTS POLICY REQUIRES ALL DIRECTORS AND COVERED EMPLOYEES TO READ AND UNDERSTAND THE POLICY AND REVIEW IT AT LEAST ANNUALLY IN ORDER TO BE ALERT TO SITUATIONS THAT COULD CREATE A CONFLICT OF INTEREST OR OTHERWISE BE CONTRARY TO HOSPITAL POLICY. THEY ARE ALSO REQUIRED ANNUALLY TO SIGN A CONFLICTS POLICY DISCLOSURE FORM. THE COMPLIANCE OFFICER MONITORS THE COI DISCLOSURES, AND IS PRESENT AT ALL BOARD MEETINGS TO ASSIST WITH ANY POTENTIAL CONFLICT ISSUES AND PROVIDE ADVICE ON ABSTENTION, RECUSAL, ETC. A SUMMARY OF THE COI DISCLOSURES IS PRODUCED FOR THE BOARD, AS IS ANNUAL UPDATES TO THE COI POLICY.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>COMPENSATION REVIEW</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION B, LINE 15A AND 15B</ReturnReference>
        <Explanation>IN DETERMINING COMPENSATION FOR OFFICERS, ORMC UTILIZES ONE OR MORE OF THE FOLLOWING - A COMPENSATION COMMITTEE MADE UP OF INDEPENDENT MEMBERS OF THE EXECUTIVE COMMITTEE OF THE BOARD, AN INDEPENDENT COMPENSATION CONSULTANT, AND COMPENSATION SURVEYS OR STUDIES. THESE SURVEYS INCLUDE HEALTHCARE PROVIDERS WITH COMPARABLE NET REVENUE AND IN COMPARABLE GEOGRAPHIC REGIONS. FOLLOWING THE RECOMMENDATIONS OF THE BOARD OF DIRECTORS, ORMC LOOKS TO HIRE AT APPROXIMATELY THE 50TH PERCENTILE OF THE MARKET. THIS IS DETERMINED BY USING THE PREVIOUSLY MENTIONED DATA RESOURCES. BASED UPON PARAMETERS DETERMINED BY THE COMPENSATION COMMITTEE, THE CEO IS PERMITTED TO MAKE COMPENSATION DECISIONS FOR SALARIES WITHIN THE 50TH-75TH PERCENTILE. ANY PROPOSED SALARY ABOVE THE 75TH PERCENTILE WOULD REQUIRE PRIOR COMMITTEE APPROVAL. A FULL REVIEW OF EXECUTIVE TEAM SALARIES WAS PERFORMED IN 2010 AND UPDATED IN 2011 BASED ON THESE PARAMETERS. IN ADDITION, THE CHIEF EXECUTIVE OFFICER AND HIS COMPENSATION MUST BE APPROVED BY THE COMPENSATION COMMITTEE. THE REVIEW PROCESS IS DOCUMENTED CONTEMPORANEOUSLY IN THE MINUTES OF THE COMPENSATION COMMITTEE.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>PUBLIC DISCLOSURE</Identifier>
        <ReturnReference>FORM 990, PART VI, SECTION C, LINE 19</ReturnReference>
        <Explanation>THE CONFLICT OF INTEREST POLICY IS AVAILABLE AS PART OF THE ORGANIZATION'S COMPLIANCE POLICY WHICH IS POSTED ON THE HOSPITAL'S WEBSITE. THIS POLICY AND FINANCIAL STATEMENTS ARE ALSO AVAILABLE UPON REQUEST.</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>OTHER CHANGES IN NET ASSETS</Identifier>
        <ReturnReference>FORM 990, PART XI, LINE 6</ReturnReference>
        <Explanation>OTHER CHANGES IN NET ASSETS CONSIST OF: UNREALIZED GAINS 318,784 OTHER PENSION/POST-RETIREMENT CHANGES (13,813,148) NET ASSETS RELEASED TO EXPENSES (3,571) NET CHANGE IN INT IN FOUNDATION (1,349,032) TRANSFER TO CATSKILL REG MEDICAL CNTR (381,795) EQUITY TRANSFER-GENERAL (10,363,159) ----------- (25,591,921) -----------</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:LOUIS HEIMBACH TITLE:CHAIRMAN HOURS:2</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:WILLIAM BASSETT, ED.D. TITLE:VICE CHAIRMAN HOURS:1</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:PATRICIA CLAIBORNE TITLE:SECRETARY HOURS:1</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
        <Explanation>NAME:SHERWOOD H LEVITAN TITLE:TREASURER UNTIL 11/3/2011 HOURS:1</Explanation>
      </GeneralExplanation>
      <GeneralExplanation>
        <Identifier>HOURS DEVOTED FOR RELATED ORGANIZATION</Identifier>
        <ReturnReference>FORM 990 PART VII</ReturnReference>
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