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ST ELIZABETH COMMUNITY HEALTH SUPPORT: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ST ELIZABETH COMMUNITY HEALTH SUPPORT (EIN 15-0532245)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-14
IRS object ID
201233199349306123
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)
Timestamp2012-11-14T16:09:33-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN454051133EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1FREED MAXICK CPAS PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1800 LIBERTY BLDG 420 MAIN STAddressLine1
CityBUFFALOCity
StateNYState
ZIP Code142023508ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN150532245EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ST ELIZABETH MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTELNameControl
Phone3157988151Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12209 GENESEE STREETAddressLine1
CityUTICACity
StateNYState
ZIP Code135015999ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLOUIS AIELLOName
TitleCFOTitle
Phone3157988151Phone
Date Signed2012-11-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMARY MADONIAName
PTINP00405803PTIN
Phone7168472651Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRICHARD KETCHAMNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12209 GENESEE STREETAddressLine1
CityUTICACity
StateNYState
ZIP Code135015999ZIPCode
FieldValueIRS element (for citing)
Gross Receipts211842631GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.STEMC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1861YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionST. ELIZABETH MEDICAL CENTER COMMUNITY, INSPIRED BY ST. FRANCIS OF ASSISI AND FAITHFUL TO THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH, IS COMMITTED TO EXCELLENCE IN HEALTHCARE AND EDUCATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees2279TotalNbrEmployees
Total Nbr Volunteers178TotalNbrVolunteers
Total Gross UBI376854TotalGrossUBI
Net Unrelated Business Txbl Income-77195NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year2609558ContributionsGrantsPriorYear
Contributions Grants Current Year1455110ContributionsGrantsCurrentYear
Program Service Revenue Prior Year197921236ProgramServiceRevenuePriorYear
Program Service Revenue CY199858890ProgramServiceRevenueCY
Investment Income Prior Year961227InvestmentIncomePriorYear
Investment Income Current Year1270313InvestmentIncomeCurrentYear
Other Revenue Prior Year5017543OtherRevenuePriorYear
Other Revenue Current Year5234727OtherRevenueCurrentYear
Total Revenue Prior Year206509564TotalRevenuePriorYear
Total Revenue Current Year207819040TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year116961087SalariesEtcPriorYear
Salaries Etc Current Year116656665SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year88530469OtherExpensePriorYear
Other Expenses Current Year88012854OtherExpensesCurrentYear
Total Expenses Prior Year205491556TotalExpensesPriorYear
Total Expenses Current Year204669519TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1018008RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3149521RevenuesLessExpensesCY
Total Assets BOY133682865TotalAssetsBOY
Total Assets EOY136782075TotalAssetsEOY
Total Liabilities BOY112978659TotalLiabilitiesBOY
Total Liabilities EOY131891120TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY20704206NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY4890955NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionST. ELIZABETH MEDICAL CENTER COMMUNITY, INSPIRED BY ST. FRANCIS OF ASSISI AND FAITHFUL TO THE TEACHINGS OF THE ROMAN CATHOLIC CHURCH, IS COMMITTED TO EXCELLENCE IN HEALTHCARE AND EDUCATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense108329517Expense
Revenue110871670Revenue
DescriptionINPATIENT SERVICES- ST ELIZABETH MEDICAL CENTER IS A FULL SERVICE GENERAL HOSPITAL WITH 201 LICENSED BEDS. THE HOSPITAL PROVIDES A FULL RANGE OF ROUTINE AND ANCILLARY SERVICES, INCLUDING CARDIAC SURGERY AND ANGIOPLASTY. DISBURSEMENTS MADE BY THE HOSPITAL ARE EXCLUSIVELY FOR SERVICES AND MATERIALS USED IN PERFORMING THE HOSPITAL'S EXEMPT FUNCTIONS. ST. ELIZABETH MEDICAL CENTER PROVIDES CARE TO EVERYONE REGARDLESS OF RACE, RELIGION OR ABILITY TO PAY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense24675670Expense
Revenue25086598Revenue
DescriptionAMBULATORY SURGERY- ST. ELIZABETH MEDICAL CENTER HAS A FULL RANGE OF AMBULATORY SURGERY SERVICES ON ITS CAMPUS FOR PATIENTS THAT DO NOT REQUIRE OVERNIGHT OR LONG INPATIENT STAYS. ST. ELIZABETH MEDICAL CENTER PROVIDES SERVICES TO EVERYONE REGARDLESS OF RACE, RELIGION, OR ABILITY TO PAY.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense13181133Expense
Revenue16394996Revenue
DescriptionOUR EMERGENCY DEPARTMENT CONSISTS OF 33 PRIVATE ROOMS. AS A LEVEL II TRAUMA CENTER, OUR EMERGENCY DEPARTMENT OFFERS 24 HOUR SERVICE FOR EMERGENCY EVALUATION OF PATIENTS. THE EMERGENCY DEPARTMENT SERVES OVER 41,000 PATIENTS EACH YEAR WITH A VARIETY OF ILLNESSES RANGING FROM MINOR ILLNESS TO MAJOR TRAUMAS AND HEART ATTACKS. THE STAFF IS COMPRISED OF BOARD CERTIFIED PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, REGISTERED NURSES, LICENSED PRACTICAL NURSES AND EMERGENCY DEPARTMENT ASSISTANTS.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense37417906Expense
Revenue51797199Revenue
DescriptionOTHER PROGRAM SERVICES INCLUDE COMMUNITY MEDICINE, REFERRED AMBULATORY, CLINICS, FAMILY PRACTICE, SPORTS MEDICINE CENTER, COLLEGE OF NURSING, INTERNS AND RESIDENTS, AND HOME HEALTH AGENCY.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp37417906TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev51797199TotalOfOtherProgramServiceRev
Total Program Service Expense183604226TotalProgramServiceExpense
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 Securities0ReportInvestOthSecurities
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 Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
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 Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096144NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees2279NumberOfEmployees
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 Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
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 Other0CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure0WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ST ELIZABETH MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3157988151TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12209 GENESEE STREETAddressLine1
CityUTICACity
StateNYState
ZIP Code13501ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
SR DONNA MCGARTLAND
VICE CHAIR1.00XX000
CATHERINE COMINSKY
SECRETARY1.00XX000
GREGORY P EVANS
TRUSTEE2.00X000
HARRISON J HUMMEL III
TRUSTEE1.00X000
TIMOTHY PAGE MD
TRUSTEE1.00X5502500
RAYMOND MEIER
TRUSTEE1.00X000
HON NORMAN I SIEGEL
CHAIR2.00XX000
STEVEN WILLIAMS MD
TRUSTEE1.00X000
ERIC YOSS MD
TRUSTEE1.00X2612500
RICHARD F ZWEIFEL
TREASURER1.00XX000
ANDREW S KOWALCZYK III
TRUSTEE1.00X000
ROBERT SCHOLEFIELD
COO40.00X220014023751
RICHARD KETCHAM
CEO40.00X341443012935
LOU AIELLO
CFO40.00X269866022924
ALBERT D'ACCURZIO MD
MEDICAL DIRECTOR40.00280461025374X
VARINYA SHEPPARD
CHIEF NURSING OFFICER40.00159140013060X
OLEG DULKEN MD
PHYSICIAN40.00296252021974X
ERIC FREIBERGER MD
PHYSICIAN40.00315565023359X
SUNDAY ASAJU MD
PHYSICIAN40.00346217024459X
FRANCIS CONSTANTINE MD
PHYSICIAN40.00288396023983X
CLIFFORD SOULTS MD
PHYSICIAN40.0031855906670X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2917063TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation198489TotalOtherCompensation
Number Individuals GT100 K73NumberIndividualsGT100K
Formers Listed0FormersListed
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
UPTOWN ANESTHESIA ASSOC
2405 GENESEE STREETUTICANY13501ANESTHESIA SERVICES1439710
ACUSIS
PO BOX 951107CLEVELANDOH44193TRANSCRIPTION SERVICES1083252
MAYO COLLABORATIVE SERVICES
PO BOX 9146MINNEAPOLISMN55480LABORATORY TESTING843538
SODEXO OPERATIONS LLC
PO BOX 81049WOBURNMA018131049CAFETERIA AND FOOD816665
ATLAS HEALTH CARE LINEN
414 WEST TAYLOR STREETSYRACUSENY13202LAUNDERING SERVICES776341
FieldValueIRS element (for citing)
Number Of Contractors GT100 K40NumberOfContractorsGT100K
Related Organizations784895RelatedOrganizations
Government Grants465533GovernmentGrants
All Other Contributions204682AllOtherContributions
Total Contributions1455110TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
MEDICARE/MEDICAID PAYM900099110635186110635186
PATIENT SERVICE REVENU9000998889319888893198
NURSING HOME LAB TESTI621500224928224928
CYTOLOGY LAB TESTING621500105578105578
FieldValueIRS element (for citing)
Total Program Service Revenue199858890TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column311060TotalRevenueColumn
Exclusion$311,060ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real612648Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real612648Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column612648TotalRevenueColumn
Unrelated Business Revenue46348UnrelatedBusinessRevenue
Exclusion$566,300ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3264879Securities
Other1717965Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities3053071Securities
Other970520Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities211808Securities
Other747445Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column959253TotalRevenueColumn
Exclusion$959,253ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
TUTION: NURSING & X-RA90009916821321682132
EMPLOYEE & VISITOR MEA90009910871041087104
FAMILY PRACTICE SERVIC900099288378288378

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1564465TotalRevenueColumn
Related Or Exempt Function Income1564465RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue4622079TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column207819040TotalRevenueColumn
Related Or Exempt Function Income204150463RelatedOrExemptFunctionIncome
Unrelated Business Revenue376854UnrelatedBusinessRevenue
Exclusion$1,836,613ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1352074Total
Program Services1211052ProgramServices
Management And General141022ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total90591601Total
Program Services81277636ProgramServices
Management And General9313965ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4475834Total
Program Services4009005ProgramServices
Management And General466829ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13770793Total
Program Services12351140ProgramServices
Management And General1419653ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6466363Total
Program Services5802148ProgramServices
Management And General664215ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total14998961Total
Program Services13438424ProgramServices
Management And General1560537ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total33988Total
Program Services30443ProgramServices
Management And General3545ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total155800Total
Program Services145014ProgramServices
Management And General10786ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total33244Total
Program Services29777ProgramServices
Management And General3467ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total304874Total
Program Services304874ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total42152070Total
Program Services37724920ProgramServices
Management And General4427150ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total558652Total
Program Services500385ProgramServices
Management And General58267ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total57596Total
Program Services51589ProgramServices
Management And General6007ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total183871Total
Program Services164693ProgramServices
Management And General19178ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2038145Total
Program Services1825566ProgramServices
Management And General212579ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total8973793Total
Program Services8038294ProgramServices
Management And General935499ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1901209Total
Program Services1702913ProgramServices
Management And General198296ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
BAD DEBT84968297614897881932
EQUIPMENT RENTAL AND MA49116244399803511821
UTILITIES22976432057999239644
DEBT ASSESSMENT60313154022562906

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total311424Total
Program Services383429ProgramServices
Management And General-72005ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total204669519Total
Program Services183604226ProgramServices
Management And General21065293ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6221349BOY
EOY4396864EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY22615059BOY
EOY25265618EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5811795BOY
EOY5806080EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY523888BOY
EOY500747EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis178466868LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec100875675LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY74898945BOY
EOY77591193EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY16917068BOY
EOY14070433EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6694761BOY
EOY9151140EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY133682865BOY
EOY136782075EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY22709215BOY
EOY23117362EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY35327411BOY
EOY32932544EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY6916413BOY
EOY8753914EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY1830163BOY
EOY1568712EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY46195457BOY
EOY65518588EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY112978659BOY
EOY131891120EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY19793513BOY
EOY3783143EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY533779BOY
EOY504322EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY376914BOY
EOY603490EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY20704206BOY
EOY4890955EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY133682865BOY
EOY136782075EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses3149521ReconcilationRevenueExpenses
Reconcilation Other Changes-18962772ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

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 Legislators1DirectContactLegislators
Direct Contact Legislators$0DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$33,244OtherActivitiesAmount
Total Lobbying Expenditures IIB33244TotalLobbyingExpendituresIIB
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
ExplanationACTIVITIES INCLUDE THE PORTION OF DUES PAID TO THE HEALTH CARE ASSOCIATION OF NEW YORK STATE.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance910691BeginningOfYearBalance
Contributions1288402Contributions
Investment Earnings Or Losses16768InvestmentEarningsOrLosses
Grants Or Scholarships16380GrantsOrScholarships
Other Expenditures1091669OtherExpenditures
End Of Year Balance1107812EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1264143BeginningOfYearBalance
Contributions2090040Contributions
Investment Earnings Or Losses16876InvestmentEarningsOrLosses
Grants Or Scholarships32345GrantsOrScholarships
Other Expenditures2428023OtherExpenditures
End Of Year Balance910691EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1650930BeginningOfYearBalance
Contributions976103Contributions
Investment Earnings Or Losses17145InvestmentEarningsOrLosses
Grants Or Scholarships18750GrantsOrScholarships
Other Expenditures1361285OtherExpenditures
End Of Year Balance1264143EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2723095BeginningOfYearBalance
Contributions689098Contributions
Investment Earnings Or Losses20384InvestmentEarningsOrLosses
Grants Or Scholarships17850GrantsOrScholarships
Other Expenditures1763797OtherExpenditures
End Of Year Balance1650930EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.20380BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.34100PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.45520TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis6781653OtherCostOrOtherBasis
Book Value6781653BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis82662347OtherCostOrOtherBasis
Depreciation41469322Depreciation
Book Value41193025BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis89022868OtherCostOrOtherBasis
Depreciation59406353Depreciation
Book Value29616515BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings77591193TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
UNAMORTITZED DEBT FINANCING1019346
OTHER RECEIVABLES1927746
ASSETS WHOSE USE IS LIMITED- BOND FUNDS3227678
INTEREST IN NET ASSETS OF SEMC FOUNDATION1849215
OTHER ASSETS RESTRICTED BY DONORS1127155
FieldValueIRS element (for citing)
Total Book Value Other Assets9151140TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ACCRUED PENSION LIABILITY$56,379,388
LIABILITY TO THIRD PARTY PAYORS$9,039,200
PROFESSIONAL LIABILITY DEDUCTIBLE$100,000
FieldValueIRS element (for citing)
Total Of Amounts65518588TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:ENDOWMENT FUNDS - PART V THE INTENDED PURPOSE OF THE MEDICAL CENTER'S ENDOWMENT FUNDS ARE TO PROVIDE FUTURE SCHOLARSHIP AWARDS FOR STUDENTS IN THE COLLEGE OF NURSING PROGRAMS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE MEDICAL CENTER IS A NOT-FOR-PROFIT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS GENERALLY EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE MEDICAL CENTER FILES ITS RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX IN THE U.S. FEDERAL JURISDICTION. THE TAX YEARS 2008-2011 GENERALLY REMAIN OPEN TO EXAMINATION IN TAXING JURISDICTIONS IN WHICH THE MEDICAL CENTER IS SUBJECT TO THE FILING REQUIREMENTS OF THOSE JURISDICTIONS.

Schedule H IRS990ScheduleH

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

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage160.000000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage230.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2526235TotalCommunityBenefitExpense
Direct Offsetting Revenue879813DirectOffsettingRevenue
Net Community Benefit Expense1646422NetCommunityBenefitExpense
Percent Of Total Expense0.00800PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense31386428TotalCommunityBenefitExpense
Direct Offsetting Revenue27662173DirectOffsettingRevenue
Net Community Benefit Expense3724255NetCommunityBenefitExpense
Percent Of Total Expense0.01820PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense3802320TotalCommunityBenefitExpense
Direct Offsetting Revenue2439191DirectOffsettingRevenue
Net Community Benefit Expense1363129NetCommunityBenefitExpense
Percent Of Total Expense0.00670PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense37714983TotalCommunityBenefitExpense
Direct Offsetting Revenue30981177DirectOffsettingRevenue
Net Community Benefit Expense6733806NetCommunityBenefitExpense
Percent Of Total Expense0.03290PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense193723TotalCommunityBenefitExpense
Direct Offsetting Revenue187217DirectOffsettingRevenue
Net Community Benefit Expense6506NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense7470474TotalCommunityBenefitExpense
Direct Offsetting Revenue4175305DirectOffsettingRevenue
Net Community Benefit Expense3295169NetCommunityBenefitExpense
Percent Of Total Expense0.01610PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2664787TotalCommunityBenefitExpense
Direct Offsetting Revenue2277775DirectOffsettingRevenue
Net Community Benefit Expense387012NetCommunityBenefitExpense
Percent Of Total Expense0.00190PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense81642TotalCommunityBenefitExpense
Direct Offsetting Revenue67308DirectOffsettingRevenue
Net Community Benefit Expense14334NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense10410626TotalCommunityBenefitExpense
Direct Offsetting Revenue6707605DirectOffsettingRevenue
Net Community Benefit Expense3703021NetCommunityBenefitExpense
Percent Of Total Expense0.01810PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense48125609TotalCommunityBenefitExpense
Direct Offsetting Revenue37688782DirectOffsettingRevenue
Net Community Benefit Expense10436827NetCommunityBenefitExpense
Percent Of Total Expense0.05100PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$3,698,992BadDebtExpenseAmount
Amount Attributable To839000AmountAttributableTo
Amount Reimbursed By Medicare41288489AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare44194115CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2905626MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnershipOfficers Etc Profit Or OwnershipOfficersEtcProfitOrOwnershipPhysicans Profit Or OwnershipPhysicansProfitOrOwnership
1 MVHI
CARDIAC SERVICES0.700000.000000.00000
2 MVEC
GASTROENTEROLOGY SRVCS0.200000.000000.00000
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 Line1ST ELIZABETH MEDICAL CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12209 GENESEE STREETAddressLine1
CityUTICACity
StateNYState
ZIP Code13501ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST ELIZABETH MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent160.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent230.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
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
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection Activities1CollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Other ActionsXOtherActions
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
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 Facilities16NumberOfOtherFacilities

Other Facilities OtherFacilities (16 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
SEMC AT FAMILY PRACTICE CENTER
120 HOBART STREETUTICANY13501OUTPATIENT PHYSICIAN CLINIC
WOMEN & CHILDREN'S FAMILY HEALTH CENTER
2212 GENESEE STREETUTICANY13502OUTPATIENT PHYSICIAN CLINIC
MARIAN MEDICAL IMAGING
2211 GENESEE STREETUTICANY13501OUTPATIENT LAB/ XRAY CLINIC
LITTLE FALLS FAMILY PRACTICE
500 MAIN STREETLITTLE FALLSNY13365OUTPATIENT PHYSICIAN CLINIC
COMMUNITY MEDICINE-EAST UTICA
1256 CULVER AVEUTICANY13501OUTPATIENT PHYSICIAN CLINIC
WOUND CARE SERVICES
4401 MIDDLE SETTLEMENT ROADNEW HARTFORDNY13413OUTPATIENT PHYSICIAN CLINIC
ST ELIZABETH MEDICAL GROUP- NEW HARTFORD
86 GENESEE STREETNEW HARTFORDNY13413OUTPATIENT PHYSICIAN CLINIC
NORTH UTICA COMMUNITY HEALTH CENTER
417 TRENTON ROADUTICANY13502OUTPATIENT PHYSICIAN CLINIC
SAUQUOIT COMMUNITY MEDICINE
2888 ONEIDA STREETSAUQUOITNY13456OUTPATIENT PHYSICIAN CLINIC
CLINTON FAMILY HEALTH CENTER
101 COLLEGE STREETCLINTONNY13323OUTPATIENT PHYSICIAN CLINIC
WATERVILLE FAMILY HEALTH CENTER
117 WEST MAIN STREETWATERVILLENY13480OUTPATIENT PHYSICIAN CLINIC
COMMUNITY MEDICAL SERVICES-MOHAWK
5 ANN STREETMOHAWKNY13407OUTPATIENT PHYSICIAN CLINIC
COMMUNITY MEDICAL SERVICES- S UTICA
6 HAMPDEN PLACEUTICANY13501OUTPATIENT PHYSICIAN CLINIC
ADIRONDACK SPORTS MEDICINE
4401 MIDDLE SETTLEMENT ROADNEW HARTFORDNY13413OUTPATIENT REHAB SERVICES
KERNAN ELEMENTARY SCHOOL
926 YORK STREETUTICANY13502SCHOOL BASED HEALTH CENTER
MEDICAL ARTS
4401 MIDDLE SETTLEMENT ROADNEW HARTFORDNY13413OUTPATIENT LAB/ XRAY CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationReturn ReferenceReturnReferenceIdentifierIdentifier
PART I, LINE 7: COSTING METHODOLOGY-CHARITY CARETHE COST TO CHARGE RATIO THAT WAS USED TO COMPLETE THE CHART FOR LINE 7 WAS DERIVED FROM THE WORKSKEET 2 CALCULATION.
PART I, L7 COL(F): BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25BAD DEBT EXPENSE OF $8,501,615 IS INCLUDED ON FORM 990, PARK IX,LINE 25 AND HAS BEEN REMOVED FOR CALCULATING THE PERCENTAGES IN COLUMN 7(F).
PART III, LINE 4: COSTING METHODOLOGY-BAD DEBT EXPENSEPART III, LINE 2 & 3: THE MEDICAL CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CENTER'S POLICY IS NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE. THE ESTIMATED COST OF PROVIDING UNCOMPENSATED CARE TO PATIENTS WAS APPROXIMATELY $1,949,000 OF CHARGES AND $839,000 OF COST FOR THE YEAR ENDED DECEMBER 31, 2011.THE MEDICAL CENTER GRANTS CREDIT WITHOUT COLLATERAL TO PATIENTS, MOST OF WHOM ARE LOCAL RESIDENTS AND ARE INSURED UNDER THIRD-PARTY AGREEMENTS. ADDITIONS TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS ARE MADE BY MEANS OF THE PROVISION FOR DOUBTFUL ACCOUNTS. ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE ARE DEDUCTED FROM THE ALLOWANCE AND SUBSEQUENT RECOVERIES ARE ADDED. THE AMOUNT OF THE PROVISION FOR DOUBTFUL ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL EXPECTED NET COLLECTIONS, BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN FEDERAL AND STATE GOVERNMENTAL HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. SERVICES RENDERED TO INDIVIDUALS WHEN PAYMENT IS EXPECTED AND ULTIMATELY NOT RECEIVED ARE WRITTEN OFF TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.
PART III, LINE 8: COSTING METHODOLOGY- MEDICARETHE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 IS COST TO CHARGE RATIO.
PART III, LINE 9B: DEBT COLLECTION POLICYCOLLECTION POLICY PROVISIONSPATIENTS THAT QUALIFY FOR THE MEDICAL CENTER'S CHARITY CARE PROGRAM HAVE THE CHARGES ON THEIR ACCOUNTS FORGIVEN AS THEY ARE PLACED IN CHARITY CARE AND THE BALANCES ARE WRITTEN OFF. THE MEDICAL CENTER'S CHARITY CARE PROGRAM USED THE FEDERAL POVERTY GUIDELINES (FPG) AS A GUIDE WITH HIGH-END LIMITS AT 160% OF THE FPG. IN THOSE SITUATIONS WHERE THE PATIENT'S INCOME IS BETWEEN 160%- 230% OF THE FPG, A SMALL COST SHARE WOULD BE THE ONLY AMOUNT NOT INCLUDED IN CHARITY CARE. ADDITIONALLY, THIS SMALL COST SHARE WOULD BE THE ONLY AMOUNT TURNED OVER TO COLLECTION WITH THE OPPORTUNITY OF EVENTUALLY BEING WRITTEN OFF TO BAD DEBT IF NOT PAID.
PATIENTS THAT QUALIFY FOR THE MEDICAL CENTER'S CHARITY CARE PROGRAM HAVE THE CHARGES ON THEIR ACCOUNTS FORGIVEN AS THEY ARE PLACED IN CHARITY CARE AND THE BALANCES ARE WRITTEN OFF. THE MEDICAL CENTER'S CHARITY CARE PROGRAM USED THE FEDERAL POVERTY GUIDELINES (FPG) AS A GUIDE WITH HIGH-END LIMITS AT 160% OF THE FPG. IN THOSE SITUATIONS WHERE THE PATIENT;S INCOME IS BETWEEN 160%-230% OF THE FPG, A SMALL COST SHARE WOULD BE THE ONLY AMOUNT NOT INCLUDED IN CHARITY CARE. ADDITIONALLY, THIS SMALL COST SHARE WOULD BE THE ONLY AMOUNT TURNED OVER TO COLLECTION WITH THE OPPORTUNITY OF EVENTUALLY BEING WRITTEN OFF TO BAD DEBT IF NOT PAID.FORM 990, SCHEDULE H, PART III, LINE C, 9B
PART V, SECTION B, LINE 16E: REPORTING TO CREDIT AGENCY, LAWSUITS, LEINS AND ACCEPTED DISCOUNTED SETTLEMENTS.ST ELIZABETH MEDICAL CENTER
PART V, SECTION B, LINE 19D: DURING THE YEAR OUR FACILITY DETERMINED THE MAXIMUM AMOUNTS THAT CAN BE CHARGED TO FAP ELIGIBLE INDIVIDUALS FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE BY ANNUALLY COMPARING THE TOP 10 PAYER RATES AND TAKING OUT THE HIGHEST AND LOWEST, THEN AVERAGING THE REST.ST ELIZABETH MEDICAL CENTER
PART VI, LINE 2: HEALTHCARE NEEDS OF THE COMMUNITYTHE MEDICAL CENTER ASSESSES HEALTHCARE NEEDS OF THE COMMUNITIES IT SERVES BY COLLABORATING WITH ONEIDA AND HERKIMER COUNTIES' DEPARTMENTS OF HEALTH ON COMMUNITY HEALTH ASSESSMENTS. DATA WAS COLLECTED IN 2009 THROUGH A MAPP PROCESS, AROUND THE NYS PREVENTION AGENDA ISSUES. FIVE RESULTING PRIORITY WORK GROUPS THAT CONTAIN MEDICAL CENTER EMPLOYEES CONTINUE TO ASSESS CHANGES AND ADDRESS PRIORITY AREAS. THESE WORK GROUPS ALSO REPORT TO THE SEMC COMMUNITY DESIGN TEAM, WHICH REGULARLY HEARS ABOUT HEALTHCARE NEEDS THROUGH THOSE IN AREA COMMUNITIES.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCETHIS IS COMMUNICATED THROUGH SEMC'S FACILITATED ENROLLMENT PROGRAM AND THE MOTHER BERNARDINA CHARITY CARE PROGRAM. INFORMATION IS INCLUDED IN THE PATIENT INFORMATION GUIDES PRESENTED TO INPATIENTS AND OUTPATIENTS, AND IS AVAILABLE ON THE SEMC'S WEBSITE.ST. ELIZABETH MEDICAL CENTER RECOGNIZES THAT PROVIDING EXCEPTIONAL HEALTHCARE SERVICE TO THE COMMUNITY IS A VITAL COMMUNITY RESOURCE. OUR ACHIEVEMENTS ARE NOT OURS ALONE, BUT ARE OBTAINED BY COLLABORATIVE EFFORTS WITH OUR COMMUNITY AND GOVERNMENT LEADERS WORKING TOGETHER TO IMPROVE THE "HEALTH" OF THE COMMUNITY.SEMC'S FACILITATED ENROLLMENT PROGRAMIN 2000, ST. ELIZABETH MEDICAL CENTER DEVELOPED AND IMPLEMENTED THE FACILITATED ENROLLMENT PROGRAM AS A RESULT OF THE UNIQUE COLLABORATION THAT WAS FORGED BETWEEN ST. ELIZABETH MEDICAL CENTER AND ONEIDA COUNTY SOCIAL SERVICE DEPARTMENT. THIS PROGRAM ALLOWS SEMC STAFF, PATIENT ACCOUNT REPRESENTATIVES, TO ACT AS AN AUTHORIZED REPRESENTATIVE OF THE PATIENT AT THE ONEIDA COUNTY DEPARTMENT OF SOCIAL SERVICES AND SUBMIT THE APPLICATION FOR BENEFITS. THIS SUCCESSFUL PROGRAM HAS EXPANDED THROUGHOUT THE PAST TWELVE YEARS TO INCLUDE OUTPATIENTS AND EMERGENCY DEPARTMENT PATIENTS.SEMC'S MOTHER BERNARDINA CHARITY CARE PROGRAMTO SUPPORT OUR MISSION, THE ST. ELIZABETH MEDICAL CENTER HAS DEVELOPED THE MOTHER BERNARDINA CHARITY CARE PROGRAM. THE MEDICAL CENTER WILL MAKE AVAILABLE A REASONABLE AMOUNT OF UNCOMPENSATED SERVICES TO ELIGIBLE PERSONS.
PART VI, LINE 4: COMMUNITYST. ELIZABETH MEDICAL CENTER'S PRIMARY SERVICE AREA (PSA) CONSISTS OF THE ZIP CODES IN WHICH 80% OF ITS PATIENTS LIVE. ITS SECONDARY SERVICE AREA (SSA) CONSISTS OF ZIP CODES IN WHICH THE REMAINING 10+% OF ITS PATIENTS LIVE. METHODS USED TO DETERMINE THE SERVICE AREA ARE ANALYSIS OF PATIENT ORIGIN, BASED ON HOME ZIP CODE. IT IS AN ETHNICALLY AND ECONOMICALLY DIVERSE REGION, WITH MANY IMMIGRANTS AND AN OLDER POPULATION THAN THE NATIONAL AVERAGE.
PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHTHESE ACTIONS REPRESENT THE MEDICAL CENTER'S EMPLOYEE OUTREACH BEYOND THE HOSPITAL AND MEDICAL GROUP OFFICES INTO AREA COMMUNITIES, AND THEY SPAN A WIDE REACH OF EVENTS AND SITES. ALONG WITH HOSPITALS ACROSS THE STATE AND NATION, ST. ELIZABETH NOW MONITORS HOW OUR FAITHFULNESS TO THE REGIONAL POPULATION MEETS OUR LOCAL COMMUNITIES' UNIQUE HEALTH NEEDS. THEREFORE, COMMUNITY BENEFITS ARE PROGRAMS OR ACTIVITIES THAT PROVIDE TREATMENT AND/OR PROMOTE HEALTH AND HEALING AS A RESPONSE TO IDENTIFIED COMMUNITY NEEDS. OUR CATHOLIC TRADITION AND MEDICAL CENTER MISSION TEACH US TO PUT THE NEEDS OF THE POOR AND VULNERABLE FIRST.AMONG OUR COMMUNITY BENEFIT ACTIVITIES ARE:-CHARITY CARE FOR PEOPLE UNABLE TO AFFORD SERVICE-HEALTH EDUCATION AND ILLNESS PREVENTION-HEALTHCARE INITIATIVES FOR AT-RISK YOUTHS-FREE OR LOW-COST CLINICS AND-INITIATIVES TO RAISE AWARENESS AND RECEIVE PUBLIC INPUTMANY OF THESE ACTIVITIES ARE ADVANCED IN COLLABORATION WITH COMMUNITY MEMBERS AND OTHER ORGANIZATIONS TO IMPROVE HEALTH AND QUALITY OF LIFE. THE MEDICAL CENTER FURTHERS ITS EXEMPT PURPOSE BY PROMOTING THE HEALTH OF THE COMMUNITY THROUGH AN OPEN MEDICAL STAFF AND A COMMUNITY BOARD. SEMC FURTHER PROMOTES THE HEALTH OF THE COMMUNITY BY USING ITS SURPLUS FOR TRAINING AND EDUCATION OF ITS EMPLOYEES AND BY INVESTING IN HEALTHCARE TECHNOLOGY.STATE FILING OF COMMUNITY BENEFIT REPORTNY

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
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 (10 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
ROBERT SCHOLEFIELD
2200140000015527082240243765000
RICHARD KETCHAM
341443000004711082240354378000
LOU AIELLO
2698660000014700082240292790000
ALBERT D'ACCURZIO MD
2804610000017150082240305835000
VARINYA SHEPPARD
1591400000010815022450172200000
OLEG DULKEN MD
27089802535400012110098640318226000
ERIC FREIBERGER MD
297673017892000121180112410338924000
SUNDAY ASAJU MD
30451704170000014595098640370676000
FRANCIS CONSTANTINE MD
218233070163000136190103640312379000
CLIFFORD SOULTS MD
318559000000066700325229000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1ONEIDA COUNTRY IDABusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN166158201IssuerEIN
CUSIP Number682465AA7CUSIPNumber
Date Issued2006-06-22DateIssued
Issue Price14000000IssuePrice
Description Of PurposeEMERGENCY ROOM & CAFETERIA PROJECTDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds14000000TotalProceeds
Issuance Costs From Proceeds280000IssuanceCostsFromProceeds
Credit Enhancement70817CreditEnhancement
Capital Expenditures13649183CapitalExpenditures
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 Agreements1AnyResearchAgreements
Engage Bond Counsel Research1EngageBondCounselResearch
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue1VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
PULMONARY CRITICAL CARE ASSOCIATES
ERIC YOSS MD- TRUSTEE281625PULMONARY CARE- MEDICAL SERVICES0
HUMMEL'S OFFICE PLUS
HARRISON J. HUMMEL, III - TRUSTEE174908OFFICE SUPPLIES PURCHASES0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2THE MEDICAL CENTER FOUNDATION BOARD MEMBER MARLENE ANDERSON IS THE SISTER OF THE MEDICAL CENTER KEY EMPLOYEE DR. D'ACCURZIO.
FORM 990, PART VI, SECTION A, LINE 6RESERVED POWERS TO THE GENERAL MINISTER AND COUNCILORS OF THE SISTERS OF ST. FRANCIS OF THE NEUMANN COMMUNITIES. THE FOLLOWING POWERS SHALL BE RESERVED TO THE CORPORATE MEMBER TO EXERCISE AND SHALL BE REFERRED TO AS RESERVED POWERS: A. TO CHANGE THE PHILOSOPHY, MISSION, AND PURPOSE OF THE CORPORATION. B. TO ADOPT AND/OR AMEND THE CERTIFICATE OF INCORPORATION. C. TO ADOPT AND/OR AMEND THE BYLAWS. D. TO APPOINT THE BOARD OF TRUSTEES AND TO REMOVE BOARD MEMBERS WITH OR WITHOUT CAUSE. E. TO CONFIRM THE APPOINTMENT OF THE PRESIDENT OF THE CORPORATION. F. TO APPOINT THE CHAIR OF THE BOARD OF TRUSTEES. G. TO APPROVE THE PURCHASE, SALE, LEASE, MORTGAGE OF REAL PROPERTY; TO APPROVE THE PURCHASE, SALE OR GIFT OF CAPITAL ASSETS. H. TO APPROVE THE MERGER, CONSOLIDATION, OR AFFILIATION OF THE CORPORATION WITH ANOTHER CORPORATION, ORGANIZATION, OR PROGRAM. I. TO APPROVE THE DISSOLUTION OF THE CORPORATION AND DISPOSITION OF ASSETS.
FORM 990, PART VI, SECTION A, LINE 7ARESERVED POWERS TO THE GENERAL MINISTER AND COUNCILORS OF THE SISTERS OF ST. FRANCIS OF THE NEUMANN COMMUNITIES. THE FOLLOWING POWERS SHALL BE RESERVED TO THE CORPORATE MEMBER TO EXERCISE AND SHALL BE REFERRED TO AS RESERVED POWERS: A. TO CHANGE THE PHILOSOPHY, MISSION, AND PURPOSE OF THE CORPORATION. B. TO ADOPT AND/OR AMEND THE CERTIFICATE OF INCORPORATION. C. TO ADOPT AND/OR AMEND THE BYLAWS. D. TO APPOINT THE BOARD OF TRUSTEES AND TO REMOVE BOARD MEMBERS WITH OR WITHOUT CAUSE. E. TO CONFIRM THE APPOINTMENT OF THE PRESIDENT OF THE CORPORATION. F. TO APPOINT THE CHAIR OF THE BOARD OF TRUSTEES. G. TO APPROVE THE PURCHASE, SALE, LEASE, MORTGAGE OF REAL PROPERTY; TO APPROVE THE PURCHASE, SALE OR GIFT OF CAPITAL ASSETS. H. TO APPROVE THE MERGER, CONSOLIDATION, OR AFFILIATION OF THE CORPORATION WITH ANOTHER CORPORATION, ORGANIZATION, OR PROGRAM. I. TO APPROVE THE DISSOLUTION OF THE CORPORATION AND DISPOSITION OF ASSETS.
FORM 990, PART VI, SECTION A, LINE 7BRESERVED POWERS TO THE GENERAL MINISTER AND COUNCILORS OF THE SISTERS OF ST. FRANCIS OF THE NEUMANN COMMUNITIES. THE FOLLOWING POWERS SHALL BE RESERVED TO THE CORPORATE MEMBER TO EXERCISE AND SHALL BE REFERRED TO AS RESERVED POWERS: A. TO CHANGE THE PHILOSOPHY, MISSION, AND PURPOSE OF THE CORPORATION. B. TO ADOPT AND/OR AMEND THE CERTIFICATE OF INCORPORATION. C. TO ADOPT AND/OR AMEND THE BYLAWS. D. TO APPOINT THE BOARD OF TRUSTEES AND TO REMOVE BOARD MEMBERS WITH OR WITHOUT CAUSE. E. TO CONFIRM THE APPOINTMENT OF THE PRESIDENT OF THE CORPORATION. F. TO APPOINT THE CHAIR OF THE BOARD OF TRUSTEES. G. TO APPROVE THE PURCHASE, SALE, LEASE, MORTGAGE OF REAL PROPERTY; TO APPROVE THE PURCHASE, SALE OR GIFT OF CAPITAL ASSETS. H. TO APPROVE THE MERGER, CONSOLIDATION, OR AFFILIATION OF THE CORPORATION WITH ANOTHER CORPORATION, ORGANIZATION, OR PROGRAM. I. TO APPROVE THE DISSOLUTION OF THE CORPORATION AND DISPOSITION OF ASSETS. .
FORM 990, PART VI, SECTION B, LINE 11INFORMATION IS GATHERED FROM THE ACCOUNTING AND PAYROLL DEPARTMENTS, WHICH IS USED BY THE STAFF ACCOUNTANT TO PREPARE WORKSHEETS USED TO POPULATE THE FORM 990. MEMBERS OF AN EXTERNAL AUDIT AND TAX FIRM (CURRENTLY FREED MAXICK, CPAS, PC) INITIALLY DISCUSS, PREPARE AND REVIEW THE RETURN WITH THE STAFF ACCOUNTANT. THE SEMC MANAGEMENT TEAM REVIEWS THE DRAFT AND HAS THE OPPORTUNITY TO ASK QUESTIONS AND DISCUSS THE RETURN WITH FREED MAXICK CPAS, PC TAX STAFF. AFTER THE MANAGEMENT TEAM'S APPROVAL, THE FORM IS DISTRIBUTED TO THE GOVERNING BODY FOR THEIR REVIEW AND COMMENT PRIOR TO THE FILING OF THE FORM.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST POLICY PART VI, SECTION B, LINE 12C FIRST, EACH BOARD OF TRUSTEE MEMBER, THE PRESIDENT/CEO, CHIEF OPERATING OFFICER, AND EACH VICE PRESIDENT COMPLETE AN ANNUAL CONFLICT OF INTEREST QUESTIONNAIRE. THE RESULTS OF THE QUESTIONNAIRE ARE REVIEWED BY THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES WHICH IDENTITFIES ANY POTENTIAL CONFLICTS. AS PART OF THE POLICY, BOARD MEMBERS THAT HAVE A CONFLICT ARE UNABLE TO VOTE WHEN A SUBJECT THAT THEY HAVE A CONFLICT OF INTEREST IN COMES UP FOR A VOTE AT A BOARD MEETING. BOARD MEMBERS ARE NOT ALLOWED TO BE INVOLVED IN THE DISCUSSIONS RELATED TO THE ISSUE OTHER THAN TO MAKE A BRIEF COMMENT. STARTING IN SEPTEMBER OF 2010, THE MEDICAL CENTER BEGAN TO REQUIRE ALL DEPARTMENT MANAGERS TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ON AN ANNUAL BASIS. STARTING IN SEPTEMBER OF 2010, ALL MEMBERS OF THE MEDICAL STAFF ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE ONCE EVERY TWO YEARS, AS PART OF THE CREDENTIALING PROCESS. FOR ALL OTHER EMPLOYEES, A POLICY IS IN PLACE AS PART OF THE COMPLIANCE PLAN THAT REQUIRES EMPLOYEES TO DISCLOSE ANY CONFLICT OF INTEREST TO THEIR SUPERVISOR. THE SUPERVISOR IS THEN REQUIRED TO DISCLOSE THE INFORMATION TO THE COMPLIANCE OFFICER. BOARD MEMBERS OF SUBSIDIARIES ARE ALSO REQUIRED TO COMPLETE CONFLICT OF INTEREST QUESTIONNAIRES.
FORM 990, PART VI, SECTION B, LINE 15ACOMPENSATION POLICY PART VI, SECTION B, LINE 15 ST. ELIZABETH MEDICAL CENTER (SEMC) RECOGNIZES THAT STRONG AND EFFECTIVE EXECUTIVE LEADERSHIP IS NEEDED TO ACHIEVE ITS MISSION AND TO SERVE ITS COMMUNITY EFFECTIVELY. 1. THE CHAIRMAN OF THE BOARD OF TRUSTEES WILL APPOINT AN EXECUTIVE COMPENSATION COMMITTEE WHICH IS RESPONSIBLE FOR THE REVIEW AND APPROVAL OF ALL FORMS OF COMPENSATION BENEFITS PROVIDED TO THE PRESIDENT AND CEO OF THE MEDICAL CENTER. 2. IN ORDER TO RECRUIT AND RETAIN THE QUALITY OF LEADERSHIP NECESSARY IN A PRESIDENT AND CEO, SEMC WILL TARGET ITS TOTAL COMPENSATION PROGRAM FOR THE PRESIDENT AND CEO BY COMPARING SAME WITH SIMILARILY SIZED COMMUNITY HOSPITALS IN THE NORTHEASTERN UNITED STATES. 3. THE CEO SALARY RANGE WILL BE SET WITHIN THE RANGE FROM THOSE COMPARABLES. THE RANGE WILL BE REVIEWED PERIODICALLY AND ADJUSTMENTS WILL BE MADE WHEN MARKET CONDITIONS WARRANT AND WHEN FINANICAL PERFORMANCE OF THE MEDICAL CENTER ALLOWS. ANY ADJUSTMENT IN CEO SALARY WILL BE BASED ON THE PARTICULAR EXECUTIVE'S EXPERIENCE, PERFORMANCE, AND CONTRIBUTION TO SEMC, AS WELL AS ON THE COMPETITIVENESS OF THE EXECUTIVE'S SALARY WITHIN THE PEER GROUP. 4. SEMC'S CEO TOTAL COMPENSATION PROGRAM ALSO EMPHASIZES AND REWARDS OUTSTANDING PERFORMANCE THROUGH INCENTIVE AWARD OPPORTUNITIES. 5. THE EXECUTIVE COMPENSATION COMMITTEE WILL ANNUALLY REVIEW THE PRESIDENT AND CEO'S PERFORMANCE BASED UPON OBJECTIVE CRITERIA AND SUBJECTIVE CRITERIA IN AWARDING ANY ANNUAL INCENTIVE. THE COMMITTEE WILL CONSIDER VARIOUS FACTORS INCLUDING, BUT NOT LIMITED TO MEETING PREVIOUSLY APPROVED ANNUAL GOALS, THE OVERALL FINANCIAL PERFORMANCE OF THE MEDICAL CENTER, PATIENT SATISFACTION, QUALITY CARE INDICATORS, BOTH PUBLISHED AND NON-PUBLISHED, AND RESPONSE TO ANY OTHER UNUSUAL OR EXTRAORDINARY CIRCUMSTANCES OCCURRING DURING THE YEAR. THE PAYMENT OF THE INCENTIVE AWARD TO THE EXECUTIVE IS COMPLETELY CONTINGENT ON THE JUDGEMENT OF THE COMPENSATION COMMITTEE AS TO THE EXECUTIVE ACHIEVING PRE-ESTABLISHED GOALS AND TARGETS. IN ADDITION, THE POOL OF MONEY AVAILABLE FOR THE INCENTIVE IS ALSO CONTINGENT AND CONDITIONAL ON THE FINANCIAL PERFORMANCE OF THE MEDICAL CENTER. 6. THE EXECUTIVE COMPENSATION COMMITTEE MAY ALSO ESTABLISH AN ANNUAL INCENTIVE COMPENSATION POOL FOR THE VICE PRESIDENTS. WHEN THIS OCCURS, IT IS EXPECTED THAT THE CEO WILL INCLUDE A TEAM COMPONENT, AS WELL AS AN INDIVIDUAL COMPONENT, TO BE CONSIDERED WHEN DISTRIBUTING THIS POOL TO THE SENIOR LEADERSHIP TEAM. 7. THE COMPENSATION COMMITTEE SHALL ALSO REVIEW THE CEO'S PARTICIPATION AND LEADERSHIP IN COMMUNITY AND PROFESSIONAL ORGANIZATIONS ON WHICH THE EXECUTIVE SERVES. SEMC VALUES THE EXECUTIVE'S PARTICIPATING IN COMMUNITY AND PROFESSIONAL ORGANIZATIONS BUT ALSO RECOGNIZES THAT THE RESPONSIBILITIES TO SEMC MUST BE HIS/HER FIRST PRIORITY. 8. SEMC RECOGNIZES ITS RESPONSIBILITY TO ENSURE THAT ITS EXECUTIVE COMPENSATION PROGRAM IS APPROPRIATE IN VIEW OF ITS STATUS AS A NON-FOR-PROFIT COMMUNITY HOSPITAL AND IN ACCORDANCE WITH ITS TAX-EXEMPT STATUS, AND THAT ITS COMPENSATION AND BENEFITS ARE REASONABLE AND NOT EXCESSIVE. TO THAT END, SEMC AND THE COMMITTEE WILL REVIEW AND APPROVE ALL FORMS OF EXECUTIVE COMPENSATION AND BENEFITS IN A MANNER NECESSARY TO QUALIFY FOR THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE INTERMEDIATE SANCTION RULES OF SECTION 4958 OF THE INTERNAL REVENUE CODE. 9. THE COMPENSATION COMMITTEE SHALL ENSURE THAT ALL ELEMENTS OF COMPENSATION AND BENEFITS PROVIDED TO EXECUTIVES OF SEMC ARE DISCLOSED A) TO THE FULL BOARD ON A REGULAR BASIS, AND B) ON IRS FROM 990 TO THE EXTENT REQUIRED BY LAW.
FORM 990, PART VI, SECTION C, LINE 19PUBLIC DISCLOSURE PART VI, SECION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THE ORGANIZATION'S FORM 990 IS POSTED ON WWW.GUIDESTAR.ORG.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -379,472. PENSION RELATED CHANGES -18,716,883. NET CHANGE IN FOUNDATION NET ASSETS 133,583. TOTAL TO FORM 990, PART XI, LINE 5: -18,962,772.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHERE HAS BEEN NO CHANGE IN THE PROCESS BY WHICH THE ORGANIZATION SELECTS ITS INDEPENDENT ACCOUNTANT OR THE PROCESS BY WHICH IT OVERSEES THE AUDIT PROCESS.
FORM 990, PART VII, SECTION A, LINE 1ASEMC DOES NOT COMPENSATE THE BOARD OF TRUSTEES FOR THEIR SERVICES AS BOARD MEMBERS. THE COMPENSATION PAID TO TIMOTHY PAGE AND ERIC YOSS WAS FOR PHYSICIAN SERVICES RENDERED.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
ST ELIZABETH MEDICAL CENTER FOUNDATION
2209 GENESSE STREETUTICANY13501222562170FUNDRAISINGNY501(C)(3)9ST ELIZABETH MEDICAL CENTER1
SRS OF ST FRANCIS OF THE NEUMANN COMM
2500 GRANT BLVDSYRACUSENY13208204292535RELIGIOUS ORDERNY501(C)(3)N/A0N/A
MVHI
2209 GENESSE STREETUTICANY13501161540184OVERSEE CARDIAC SERVICESNY501(C)(3)9FAXTON ST LUKE'S AND ST ELIZABETH MEDICAL CENTER1

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1MVEC LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1116 BUSINESS PARK DRIVEAddressLine1
CityUTICACity
StateNYState
ZIP Code135026213ZIPCode
FieldValueIRS element (for citing)
Primary ActivityGASTROENTEROLOGY SERVICESPrimaryActivity
Legal Domicile StateNYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DIGESTIVE DISEASE MEDICINE FAXTON STLUKE'S & SEMC HAVE MINORITY OWNERSHIPBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeType
Disproportionate Allocations0DisproportionateAllocations
General Or Managing Partner0GeneralOrManagingPartner
Percentage Ownership0.20000PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HEALTHCARE UNDERWRITERS MUTUAL RISK MA NY (UNINCORPORATED)BusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15687 MAIN STREETAddressLine1
CityWILLIAMSVILLECity
StateNYState
ZIP Code14221ZIPCode
FieldValueIRS element (for citing)
EIN161484203EIN
Primary ActivityTO ESTABLISH WORKERS COMP SELF-INSURANCE GROUPPrimaryActivity
Legal Domicile StateNYLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityTTypeOfEntity
Percentage Ownership0.25000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org1LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets1ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
ST ELIZABETH MEDICAL CENTER FOUNDATION INC
A90129ACCOUNTING RECORDS
ST ELIZABETH MEDICAL CENTER FOUNDATION INC
N181148ACCOUNTING RECORDS
ST ELIZABETH MEDICAL CENTER FOUNDATION INC
L783895ACCOUNTING RECORDS
ST ELIZABETH MEDICAL CENTER FOUNDATION INC
Q2201000ACCOUNTING RECORDS
MVEC LLC
B264000ACCOUNTING RECORDS