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ELLIS HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ELLIS HOSPITAL (EIN 14-1338428)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-11
IRS object ID
201113159349303756
Schema version
2010v3.2
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)
Timestamp2011-11-11T13:32:25-08:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1515 BROADWAYAddressLine1
CityALBANYCity
StateNYState
ZIP Code122072930ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN141338428EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Ellis HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlELLINameControl
Phone5186128668Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11101 Nott StreetAddressLine1
CitySchenectadyCity
StateNYState
ZIP Code12308ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDaniel RinaldiName
TitleCFOTitle
Date Signed2011-11-11DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameKPMG LLPName
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJames W ConnollyNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11101 Nott StreetAddressLine1
CitySchenectadyCity
StateNYState
ZIP Code123082425ZIPCode
FieldValueIRS element (for citing)
Gross Receipts380259334GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.ellismedicine.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1885YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionThe Mission of Ellis Hospital (d/b/a Ellis Medicine) is to meet the health needs of our community with excellence.Our vision is to be an exceptional healthcare system by providing patient-centered care and collaborating with our physicians.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees3854TotalNbrEmployees
Total Nbr Volunteers332TotalNbrVolunteers
Total Gross UBI5367185TotalGrossUBI
Net Unrelated Business Txbl Income-332951NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year8498619ContributionsGrantsPriorYear
Contributions Grants Current Year2423015ContributionsGrantsCurrentYear
Program Service Revenue Prior Year362337375ProgramServiceRevenuePriorYear
Program Service Revenue CY339223921ProgramServiceRevenueCY
Investment Income Prior Year-478450InvestmentIncomePriorYear
Investment Income Current Year2348370InvestmentIncomeCurrentYear
Other Revenue Prior Year3607958OtherRevenuePriorYear
Other Revenue Current Year3728742OtherRevenueCurrentYear
Total Revenue Prior Year373965502TotalRevenuePriorYear
Total Revenue Current Year347724048TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year49579GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY46340GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year190185909SalariesEtcPriorYear
Salaries Etc Current Year197881755SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year168772108OtherExpensePriorYear
Other Expenses Current Year143261987OtherExpensesCurrentYear
Total Expenses Prior Year359007596TotalExpensesPriorYear
Total Expenses Current Year341190082TotalExpensesCurrentYear
Revenues Less Expenses Prior Year14957906RevenuesLessExpensesPriorYear
Revenues Less Expenses CY6533966RevenuesLessExpensesCY
Total Assets BOY209642227TotalAssetsBOY
Total Assets EOY217214711TotalAssetsEOY
Total Liabilities BOY121545872TotalLiabilitiesBOY
Total Liabilities EOY120618747TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY88096355NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY96595964NetAssetsOrFundBalancesEOY
Mission DescriptionThe Mission of Ellis Hospital (d/b/a Ellis Medicine) is to meet the health needs of our community with excellence.Our vision is to be an exceptional healthcare system by providing patient-centered care and collaborating with our physicians.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense264338953Expense
Grants46340Grants
Revenue314123541Revenue
DescriptionHealthcare services - Ellis is a community and teaching hospital with 455 certified beds (of which 365 were staffed in 2010) across three hospital campuses. The hospital is overseen by a volunteer Board of Trustees from the community. Ellis is the sole provider of acute hospital care in Schenectady County, following a state-mandated restructuring which resulted in consolidation of three hospitals into one in 2007-2008. Ellis balances state-of-the-art technology and advanced medical procedures with a tradition of community-based caring and a firm committment to quality. Ellis treated over 18,700 inpatients and had 653,000 outpatient visits in 2010.The hospital provides services to anyone who walks through its doors, regardless of the ability to pay.Ellis has earned numerous recognitions for clinical excellence and community service. Ellis is a "Top 50 Cardiovascular Hospital for 2011" as rated in 2010 by Thomson Reuters. From 2007 through 2010, Ellis has received recognition from the American Stroke Association (ASA) through the ASA's Gold and Gold Plus Achievement awards. Ellis is recognized for using the ASA's "Get with the Guidelines" program for improving the quality care and patient outcomes. Ellis is also a designated Stroke Center by the New York State Department of Health. The hospital is also a designated "Center of Excellence" by the American Society for Metabolic and Bariatric Surgery. In addition, the Sleep Disorders Center is accredited by the American Academy of Sleep Medicine, the Ellis Belanger School of Nursing is accredited by the National League for Nursing Accrediting Commission, and the Ellis Medicine Glenville Health and Ellis Family Practice Associates both achieved National Commission on Quality Assurance (NCQA) "Patient-Centered Medical Home" certification in 2010. The City Mission of Schenectady awarded Ellis the "Partners Award" for 2010, specifically recognizing the hospital's free community shuttle, health service navigators, and other services for the underserved. The Schenectady ARC named Ellis "Employer of the Year" for 2010, recognizing the hospital for providing employment, with opportunities for growth and meaningful experience, to individuals with developmental disabilities. The Sight Society of Northeastern New York named Ellis "Hospital of the Year" for 2010 for commitment and compassion to grieving families along with outstanding accomplishments and best practices use to facilitate cornea donations.Ellis operates two Emergency Departments which had 76,853 visits in 2010, the Bellevue Woman's Care Center which delivered 2,547 babies in 2010, four primary care practices (in Schenectady (2), Glenville, and Latham), an 82-bed skilled nursing facility and short-stay rehabilitation facility, two off-site blood draw stations, two Bariatric Care locations, a Sleep Disorders Center, a Wound Care Center, A Family Medicine Residency including Osteopathic Residency, a General Dental Residency, and a School of Nursing. Residents enrolled in the Family Medical Residency and the General Dental Residency provide primary and dental care to patients, the majority of whom are uninsured or are patients in government programs such as Medicaid, Family Health Plus, and Child Health Plus through three clinics located at the Ellis Health Center: the Family Health Center, the Pediatric Health Center, and the Dental Health Center. Ellis is also the sole sponsor of the Visiting Nurse Service of Schenectady and Saratoga Counties (VNS), a not-for-profit home health care agency which is the only State-licensed provider of home health care services to the general population in Schenectady County.The Ellis Belanger School of Nursing prepares students for licensure as professional Registered Nurses. One hundred percent of the school's graduates passed the New York State nursing licensure examination in 2010. Total enrollment in December 2010 was 109 students. The graduates in the class of 2010 (combined day and evening/weekend programs) were 47, of which 32 joined the nursing staff at Ellis.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense21424913Expense
Revenue18445279Revenue
DescriptionMental Health Services - Ellis operates a 52 bed inpatient mental health unit and expanded outpatient services. This is the only inpatient mental health facility in Schenectady County, and one of only two inpatient units in a 16-county region providing services to adolescents. Ellis' mental health services include: inpatient care for adults and adolescents; outpatient child, adolescent, and adult mental health services; crisis intervention, including a 24-hour crisis information hotline; a social club for people recovering from mental illness; and a support and education group for those suffering from schizophrenia and other major disorders and their families. In response to a nationally-studied "Schenectady Suicide Cluster" of teenage African-American females, Ellis moved the outpatient child and adolescent mental health clinic to substantially expanded facilities at the Ellis Health Center, where it is co-located with an office of the Schenectady City School District and the hospitals' Medical Home. In 2010, the mental health programs had 16,786 inpatients and 50,914 outpatient visits.Form 990, Part III, Line 4a- Program Service Accomplishments (continued from above)Ellis Hospital is the only provider of maternity care in Schenectady County. Ellis has centralized services at the Bellevue Woman's Care Center. Bellevue has 55 beds (certified and staffed) including a 15-bed neonatal intensive care unit, one of only three ICUs in the area specializing in the care of premature and low birth weight infants. During 2010, Ellis instituted the area's first Ob/Gyn hospitalist program, aimed at enhancing patient care and safety. Through this program, a hospital-employed board-certified Ob/Gyn physician is on-site at Bellevue 24/7, ready to provide emergency obstetrical care or deliveries in the event a patient's private physician is unavailable.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense11171744Expense
Revenue8328896Revenue
DescriptionLong Term Care - The Ellis Center, an 82-bed skilled nursing facility and short-stay rehabilitation facility specializing in medically complex cases, relocated to a renovated facility on the Ellis Health Center campus in June 2010. The new facility provides residents with more private rooms and such amenities as a cyber-center, a larger hair salon, and a roof-top garden. This relocation freed up two floors at Ellis Hospital-one floor has been renovated to create The Neuroscience Center wherein neuroscience services are now centralized, and the other floor is available for surge capacity in the event of a community disaster or epidemic. Inpatient days for 2010 were 28,716.Description
FieldValueIRS element (for citing)
Total Program Service Expense296935610TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedfalseFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096322NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3854NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Own WebsiteXOwnWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonEllis Medicine Finance DeptNamePerson
Telephone Number5186128668TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11101 Nott StreetAddressLine1
CitySchenectadyCity
StateNYState
ZIP Code12308ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (36 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeIndividual Trustee Or DirectorIndividualTrusteeOrDirectorHighest Compensated EmployeeHighestCompensatedEmployeeOfficerOfficer
William B Faubion
Trustee0.00000
Wendy Rosher
Vice President Clinical Services0.00205399027114X
Vincent Zeccola MD
Trustee-end 3/12.00000X
Terence Clarke MD
MD Surgery50.005655190314213X
Sarah Schermerhorn
Trustee2.00000XX
Robert Murray
Treasurer2.00000X
Robert McKay MD
M.D. Surgery50.0074205708202X
Robert Kennedy MD
Trustee1.00750000X
Richard Toll MD
Trustee2.007500500X
Quintin Bullock PhD
Trustee-new 6/150.00000X
Paul Spurgas MD
M.D. Neurosurgery0.0048723604814X
Paul A Milton
EVP/COO1.00312827033044X
Patti S Hammond
Vice President, Physician Relations0.00209294026110X
Patrick Kehoe
Trustee1.00000X
Max S Laguerre MD
Rad. Oncologist50.00466630026681X
Mary Ellen Crittenden
Vice President Quality0.00159588013309X
Marshall G Jones PhD
Trustee2.00000X
Mark Breslin PE
Vice Chair3.00000XX
Linda Breault
Trustee1.00000X
Laura Schweitzer PhD
Trustee3.00000X
Judith B McIlduff
Trustee2.00000X
Joseph Giansante
Vice President, Human Resources0.00212977030472X
John A Nolan MD
Trustee4.003746500XX
James W Connolly
President & CEO0.00503894041775
Howard Foote
Trustee2.00000X
Herbert Reich MD
M.D. Cardiac Surg50.00458867074196X
George B Boyar MD
Trustee-new 3/150.001000000X
Donald J McLaughlin
Vice President Facility and Support0.00176683028279X
Deborah Mullaney
Secretary0.00000
David Snyder
Vice President Information Services0.00171808017989X
David M Liebers MD
Vice President, Medical Affairs/CMO0.00335154031173X
Daniel J Rinaldi
CFO0.90278487017026X
D Joseph Gersuk
Trustee2.00000X
Cristine Cioffi
Chairman10.00000XX
Cecilia A Lynch
Vice President, Nursing/CNO0.00207262025325X
Carolyn Jones
Trustee3.00000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org5623652TotalReportableCompFromOrg
Total Other Compensation719722TotalOtherCompensation
Number Individuals GT100 K193NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
U W Marx Inc
20 Gurley AveTroyNY12182Construction4559689
Sodexho Operations LLC
PO Box 905374CharlotteNC282905374Food & Environ Svcs3374536
Siemens Medical Solutions
51 Valley Stream ParkwayMalvernPA19355Information Tech4206354
Laboratory Corp of America
PO Box 12140BurlingtonNC27216Laboratory Svcs1362705
Atlas Health Care Linen
414 West Taylor StreetSyracuseNY13202Linen Services994458
FieldValueIRS element (for citing)
Number Of Contractors GT100 K57NumberOfContractorsGT100K
Government Grants728794GovernmentGrants
All Other Contributions1694221AllOtherContributions
Total Contributions2423015TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Sunnyview Hosp Svcs62199025343142534314
Mental Health Services6219901844527918445279
Long Term Care62300083288968328896
Lab-Physician Referrals62150026491562649156
General Hospital621990306753545306753545

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column512731TotalRevenueColumn
Related Or Exempt Function Income512731RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue339223921TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1237693TotalRevenueColumn
Exclusion$1,237,693ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities33633776Securities
Other12187Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities32535286Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities1098490Securities
Other12187Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column1110677TotalRevenueColumn
Exclusion$1,110,677ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Rent-Nonresidential Space531120878169$878,169
Purchase Discounts900099481776481776
Lifeline Rental624100355567355567

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column2013230TotalRevenueColumn
Related Or Exempt Function Income836452RelatedOrExemptFunctionIncome
Unrelated Business Revenue183715UnrelatedBusinessRevenue
Exclusion$993,063ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue3728742TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column347724048TotalRevenueColumn
Related Or Exempt Function Income335714246RelatedOrExemptFunctionIncome
Unrelated Business Revenue5367185UnrelatedBusinessRevenue
Exclusion$4,219,602ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total46340Total
Program Services46340ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3139994Total
Program Services75005ProgramServices
Management And General3064989ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total162494841Total
Program Services148657216ProgramServices
Management And General13837625ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total5138347Total
Program Services4700056ProgramServices
Management And General438291ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total15423014Total
Program Services14079302ProgramServices
Management And General1343712ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total11685559Total
Program Services10523548ProgramServices
Management And General1162011ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2256397Total
Program Services2256397ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3071962Total
Management And General3071962ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total311803Total
Management And General311803ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total53463Total
Management And General53463ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total178579Total
Management And General178579ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4240291Total
Program Services4174442ProgramServices
Management And General65849ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total806992Total
Program Services1598ProgramServices
Management And General805394ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total55672339Total
Program Services53970135ProgramServices
Management And General1702204ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4148883Total
Management And General4148883ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total11093221Total
Program Services9789309ProgramServices
Management And General1303912ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total832882Total
Program Services488353ProgramServices
Management And General344529ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total100676Total
Program Services100676ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total13116251Total
Program Services11861845ProgramServices
Management And General1254406ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total4264828Total
Management And General4264828ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Purchased Services13759315113642202395095
Other Fees-Non Medical1166487318534847953
NYS Assessment14742921474292
Equip Rental/Maint922882877109221517906
Bad Debt1446062614460626

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total3023872Total
Program Services882794ProgramServices
Management And General2141078ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total341190082Total
Program Services296935610ProgramServices
Management And General44254472ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY10936BOY
EOY11165EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY15360972BOY
EOY4820260EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY7261504BOY
EOY408198EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY43156413BOY
EOY39949115EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

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BOY3982413BOY
EOY4796799EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1339875BOY
EOY1080238EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis288842258LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec197689040LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY88163843BOY
EOY91153218EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY36067093BOY
EOY57062260EOY

Investments Other Securities InvestmentsOtherSecurities

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EOY0EOY

Investments Program Related InvestmentsProgramRelated

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EOY0EOY

Intangible Assets IntangibleAssets

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Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY14299178BOY
EOY17933458EOY

Total Assets TotalAssets

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BOY209642227BOY
EOY217214711EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY27794468BOY
EOY29557479EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY3488191BOY
EOY2977724EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY44488704BOY
EOY40138711EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1838078BOY
EOY920709EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY43936431BOY
EOY47024124EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY121545872BOY
EOY120618747EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY75635737BOY
EOY81189149EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY8541108BOY
EOY11437216EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3919510BOY
EOY3969599EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY88096355BOY
EOY96595964EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY209642227BOY
EOY217214711EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses6533966ReconcilationRevenueExpenses
Reconcilation Other Changes1965643ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

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)
Form4720 Filed4955 TaxfalseForm4720Filed4955Tax
Correction MadefalseCorrectionMade
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$53,463OtherActivitiesAmount
Total Lobbying Expenditures IIB53463TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierPart II-B, Line 1iIdentifier
Return ReferencePart II-B, Line 1i - Other Activities DescriptionReturnReference
ExplanationEllis Hospital pays dues to the Healthcare Association of New York State, Iroquois Healthcare Alliance, and American Hospital Association. The portion of the dues that were attributable to lobbying activities are shown on form 990, Part IX, Line 11 D and above in Schedule C, Part II-B, Line 1i.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance3919510BeginningOfYearBalance
Investment Earnings Or Losses50089InvestmentEarningsOrLosses
End Of Year Balance3969599EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3819437BeginningOfYearBalance
Investment Earnings Or Losses100073InvestmentEarningsOrLosses
End Of Year Balance3919510EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4143281BeginningOfYearBalance
Investment Earnings Or Losses-323844InvestmentEarningsOrLosses
End Of Year Balance3819437EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2956826OtherCostOrOtherBasis
Book Value2956826BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis102945726OtherCostOrOtherBasis
Depreciation60174547Depreciation
Book Value42771179BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1177542OtherCostOrOtherBasis
Depreciation1009512Depreciation
Book Value168030BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis175064561OtherCostOrOtherBasis
Depreciation136504981Depreciation
Book Value38559580BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6697603OtherCostOrOtherBasis
Book Value6697603BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings91153218TotalOfBookValueLandBuildings

Other Assets OtherAssets (11 entries)

DescriptionDescriptionBook ValueBookValue
Rounding2
Rent receivable36494
Miscellaneous receivables216142
Loan receivable19300
Interest in Net Assets of Foundation15690756
Grant receivable152185
Due from Insurance group71900
Due from Foundation65424
Deposits185231
Deferred financing costs1341578
Accrued interest receivable154446
FieldValueIRS element (for citing)
Total Book Value Other Assets17933458TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (12 entries)

DescriptionDescriptionAmountAmount
Retainage payable$1,000
Miscellaneous payables$384,303
Estimated self-insurance$12,037,000
Estimated payables to 3rd Party Payers$7,436,000
Employee withholdings$261,720
Claims payable$1,509,476
Asset retirement obligation$1,393,651
Accrued vacation payable$7,650,672
Accrued sick payable$4,684,989
Accrued post retirement benefits$320,557
Accrued pension$11,181,651
Accrued interest payable$163,105
FieldValueIRS element (for citing)
Total Of Amounts47024124TotalOfAmounts
Total Revenue347724048TotalRevenue
Total Expenses341190082TotalExpenses
Excess Or Deficit For Year6533966ExcessOrDeficitForYear
Net Unrealized GL On Investments1939683NetUnrealizedGLOnInvestments
Other$25,960OtherAmount
Total Adjustments1965643TotalAdjustments
Excess Or Deficit Per FS8499609ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt349511112TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments1939683NetUnrealizedGainsInvestments
Other Revenues25960OtherRevenues
Revenue Not Rptd F9901965643RevenueNotRptdF990
Revenue Subtotal347545469RevenueSubtotal
Investment Expenses Not Included178579InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt178579RevenueNotRptdOnFinStmt
Total Revenue Per Form990347724048TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt341011503TotExpensesEtcAuditedFinclStmt
Expenses Subtotal341011503ExpensesSubtotal
Investment Expenses Not Included2178579InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt178579ExpensesNotRptdOnFinStmt
Total Expenses Per Form990341190082TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XPart X : FIN48 FootnoteFIN48 disclosures not applicable.
Part XII, Line 2dPart XII, Line 2d: Other revenue amounts included in F/S but not included on form 990Change in Interest in Foundation $3747787 Pension & Post Retirement $-3721827
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesChange in Interest in Foundation $3747787 Pension & Post Retirement $ -3721827
Part V, Line 4Part V, Line 4: Intended uses of the endowment fund.Permanently Restricted Net Assets (Endowment Funds) are investments to be held in perpetuity, the income from which is expendable to support health care services (reported as Other Operating Revenue). These Net Assets amounted to $692,674 at 12/31/2010. The remaining amount of $3,276,925 are Net Assets held by the Foundation (including $1,213,972 for beneficial interest in perpetual trusts in 2010). Grand total was $3,969,599.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CarefalseFPGReferenceDiscountedCare
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense7547006TotalCommunityBenefitExpense
Direct Offsetting Revenue3705223DirectOffsettingRevenue
Net Community Benefit Expense3841783NetCommunityBenefitExpense
Percent Of Total Expense0.01180PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense51401590TotalCommunityBenefitExpense
Direct Offsetting Revenue44355048DirectOffsettingRevenue
Net Community Benefit Expense7046542NetCommunityBenefitExpense
Percent Of Total Expense0.02160PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense58948596TotalCommunityBenefitExpense
Direct Offsetting Revenue48060271DirectOffsettingRevenue
Net Community Benefit Expense10888325NetCommunityBenefitExpense
Percent Of Total Expense0.03340PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1272305TotalCommunityBenefitExpense
Direct Offsetting Revenue89902DirectOffsettingRevenue
Net Community Benefit Expense1182403NetCommunityBenefitExpense
Percent Of Total Expense0.00360PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense7581593TotalCommunityBenefitExpense
Direct Offsetting Revenue3071789DirectOffsettingRevenue
Net Community Benefit Expense4509804NetCommunityBenefitExpense
Percent Of Total Expense0.01380PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense8267004TotalCommunityBenefitExpense
Direct Offsetting Revenue7791073DirectOffsettingRevenue
Net Community Benefit Expense475931NetCommunityBenefitExpense
Percent Of Total Expense0.00150PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense33565TotalCommunityBenefitExpense
Net Community Benefit Expense33565NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense17154467TotalCommunityBenefitExpense
Direct Offsetting Revenue10952764DirectOffsettingRevenue
Net Community Benefit Expense6201703NetCommunityBenefitExpense
Percent Of Total Expense0.01900PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense76103063TotalCommunityBenefitExpense
Direct Offsetting Revenue59013035DirectOffsettingRevenue
Net Community Benefit Expense17090028NetCommunityBenefitExpense
Percent Of Total Expense0.05240PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense7101TotalCommunityBuildingExpense
Net Community Building Expense7101NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense244688TotalCommunityBuildingExpense
Net Community Building Expense244688NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense251789TotalCommunityBuildingExpense
Net Community Building Expense251789NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$3,929,300BadDebtExpenseAmount
Amount Attributable To52000AmountAttributableTo
Amount Reimbursed By Medicare71269790AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare76785562CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5515772MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number0FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Ellis HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11101 Nott StreetAddressLine1
CitySchenectadyCity
StateNYState
ZIP Code12308ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours
Other82 Bed Skilled Nursing FacilityOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Ellis HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedfalseCHNAConducted
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.0000FPGFreePercent
Uses FPG DiscountedfalseUsesFPGDiscounted
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Uninsured DiscountXUninsuredDiscount
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities13NumberOfOtherFacilities

Other Facilities OtherFacilities (13 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Ellis Hospital Rehabilitation Services
650 McClellan StreetSchenectadyNY12304Physical Therapy Services
Ellis Hospital Continuing Day Treatment
216 Lafayette StreetSchenectadyNY12308Mental Health Services
Ellis Hospital Blood Draw Station
949 Route 146Clifton ParkNY12065Patient Service Center
Ellis Hospital Collage Social Program
1328 State StreetSchenectadyNY12304Mental Health Services
Ellis Hospital Neurology
1201 Nott StreetSchenectadyNY12308Outpatient Neurology
Ellis Hospital Primary Care
1201 Nott StreetSchenectadyNY12308Primary Care Services
Mobile Mammography Van
2210 Troy RoadNiskayunaNY12309Mammography Services
Pelvic Health Center
930 Albany Shaker RoadLathamNY12110Pelvic Health Services
Ellis Hospital Bariatric Center
1405 Fulton AvenueSchenectadyNY12308Bariatric Care Services
Glenville Healthcare Center
460 Saratoga RoadGlenvilleNY12302Primary Care Services
Ellis Hospital Mental Health Clinic
216 Lafayette StreetSchenectadyNY12308Mental Health Services
Bellevue Womans Center
2210 Troy RdNiskayunaNY12309Maternity and Womens' Hospital
Ellis Health Center
600 McClellan StreetSchenectadyNY12304Medical Home and 24/7 Emergency Department

Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - Affilated Health Care System Roles and PromotionNot Applicable
Part VI - Explanation Of How Organization Furthers Its Exempt Purpose1.Ellis has a volunteer Board of Trustees that is comprised of community, medical staff members, and the CEO, who serve three year terms. The Board must have no less than twelve and no more that twenty Trustees, including the ex officio directors, with vote. In 2010, The Board was comprised of 20 trustees-15 non-physician citizens of the community, 4 physicians, and the Hospital's President/CEO. Ellis does not have a parent corporation.2. Ellis has an open medical staff consisting of approximately 600 affiliated physicians. Medical privileges at Ellis Hospital are available to all qualified physicians in the area. Approximately 150 of these physicians are employed by Ellis, including 30 residents participating in the Family Medicine Residency and 3 in the General Dental Residency. Ellis' medical staff is led by a Medical-Dental Executive Committee (MDEC). The MDEC plays an integral part in the hospital's corporate structure and daily operations. The MDEC and the department chairs, who oversee specific clinical services, work collaboratively with the hospital's volunteer Board of Trustees, administrators and staff to ensure the highest quality of care is delivered to patients and that the community's healthcare needs are met with excellence. Physicians also serve as members of the hospital's Board of Trustees, and are directly involved in the hospital's annual budget process: they rank and prioritize all capital items in the hospitals' capital budget and they sign off on volume projections for the hospital's annual operating budget.3. Ellis operates two emergency rooms on two separate campuses, both of which are open 24 hours-a-day/seven days-a-week/365 days-a-year. Ellis' emergency rooms care for all those in need of emergency care regardless of their ability to pay. 4. The Foundation for Ellis Medicine, is a 501(c)(3) tax-exempt charitable organization whose sole purpose is to encourage philanthropic support for Ellis Hospital. The Ellis Hospital Foundation was established in 1982 and is governed by a separate board of trustees. Funds raised through the Foundation's activities are used to assist the hospital in acquiring state-of-the-art medical equipment and support a wide range of health care programs and services.5. Surplus funds are reinvested to expand/replace/modernize its facilities and medical equipment; support programs/activities aimed at improving quality of care and patient safety; train and educate its medical and nursing staffs; and to improve the overall delivery of and accessibility to health care services in the community. Ellis Medicine demonstrates leadership as a charitable institution by organizing and participating in communitywide efforts for the needy; reaching out to the underserved to provide needed primary and preventive healthcare services and health education, especially though its Medical Home; attracting and using funds to serve the needy; participating in Medicaid and other federal, state, and local healthcare reimbursement programs for the needy such as Child Health Plus; and formally planning for and providing charity care and maintaining a policy of administering care to all persons in need.Ellis Medicine provides essential healthcare services by cooperating with other community healthcare providers to maximize the meeting of essential community health needs; rendering healthcare services and educational services that are specifically designed to meet assessed community needs and improving community health status.Ellis Medicine is accountable to the community by having a volunteer governing board comprised of members of the Schenectady community; inviting and responding to community input and involvement in planning and review of hospital activities; voluntarily disclosing information to the public on hospital services, financial status, community benefit activities and charity care; and advocating for healthcare cost containment and promoting the efficient use of healthcare resources within the community.
Part VI - Community Building Activities-Ellis Medicine continues to restructure healthcare services in its community following the New York State-mandated hospital consolidation in 2007-2008. Ellis is now the sole acute provider and arguably the largest primary care provider in Schenectady County having assumed the responsibility for the services of two former hospitals which closed during this State-driven "rightsizing" process. In this important role, Ellis worked tirelessly to engage the community and to develop coalitions with community partners in order to ensure access to a full range of healthcare services, with special attention paid to disadvantaged members of our community. Ellis has undertaken, and is planning, a number of significant capital projects to consolidate care, enhance access to care and improve the overall quality, efficiency and cost-effectiveness of our local healthcare system.-One of Ellis Medicine's key community building activities is its innovative Medical Home, which is a centralization of primary care and outpatient services on a single campus aimed at improving access to healthcare, especially among the uninsured and underinsured. The Ellis Medical Home offers primary care (adult and pediatric), dental care, child/adolescent mental health, diabetes education, and emergency services among a number of outpatient services such as medical imaging, laboratory, a sleep disorders center, wound care, and day surgery. The Medical Home features specially trained Registered Nurses (Health Service Navigators), one an Ellis employee and the other contracted from Schenectady County Public Health Services, and a counselor (Community Service Navigator) employed by the local community action agency who help patients connect to healthcare and social service programs they need, including Medicaid facilitated enrollment services, and a free Community Shuttle which provides transportation to the campus. The Medical Home is an efficient partnership among Ellis Medicine and numerous community groups, including the Schenectady Community Action Program, the Salvation Army, the City Mission, YWCA, YMCA, Schenectady City School District, and Schenectady County Public Health Services, among other social service and community agencies.-Another example of Ellis' coalition building activities is its participation in the Schenectady County Public Health Services' federally funded Strategic Alliance for Health (SAH), which brings together a host of healthcare and community organizations to address chronic disease and to promote disease prevention and wellness. An Ellis representative participates in regular meetings of the SAH board.-Ellis also works closely with the Schenectady County Public Health Services and the Healthy Capital District Initiative (HCDI) to assess community need and to develop the State-required community service plan to identify health priorities. -Additionally, Ellis partners with a number of community partners, such as the American Cancer Society and the YWCA, to provide health screenings to uninsured and underinsured populations in our service area, and utilizes a Mobile Mammography van to bring detection screenings to rural and underserved areas. in collaboration with community partners, Ellis offers outpatient smoking cessation courses and sponsors peer-driven mental health and cancer patient support groups. And, acting in collaboration with Schenectady County Planning Department and the Cooperative Extension, Ellis hosts a weekly Farmer's Market in the parking lot of the Ellis Health Center during the summer months.-Ellis staff sit on numerous community boards and health area coalitions to target improvements in such areas as diabetes, long term care, cancer, hospital readmission rates and healthy living.-Ellis is an active and results-driven member of H2E: Hospitals for a Healthy Environment, a program to eliminate mercury, reduce waste and pollution and to improve utilization of environmentally friendly products and vendors. Ellis also staffs a "Green Team" that works to promote recycling and eco-friendly practices.
Part VI - Community InformationIn accordance with industry standards, Ellis Hospital's community is defined by the hospital's Primary and Secondary Service Areas, accounting for 80% of the hospital's discharge volume. These include all or portions of Schenectady, Saratoga, Albany, Fulton and Montgomery Counties and are comprised of 22 zip codes. Since the State-mandated consolidation of Schenectady's hospitals in 2007-2008, Ellis Hospital has become the sole provider of acute hospital care in Schenectady County, and it is the largest hospital within its Service Areas.The Primary Service Area is focused on the City of Schenectady, an older industrial city with a population of about 60,000, a substantial decline from the 1940 high of over 90,000. According to the City of Schenectady's "2010-2014 Consolidation Plan," 67% of households in the city are considered low or moderate income, while the poverty rate in the Hamilton Hill neighborhood, adjacent to Ellis Hospital, is over 28%. Nearly all (95%) of the City's housing stock was built before 1978, and Schenectady neighborhoods have been identified as having among the highest concentrated of elevated blood levels for lead in New York State.An impact of the level of poverty in the City of Schenectady has been the extent to which Ellis' patients are either covered by government health programs or are uninsured. During 2010, Medicare represented 41% of total patient revenues, Medicaid was 17%, and self-payment by uninsured patients was 5%, for a total of 63% of revenues. Insurance company payments (including Workers Compensation and no-fault) accounted for 37%.There is only one Medically Underserved Population (MUP) within Ellis' Primary Service Area. The homebound population of Schenectady County is designated MUP 06211. In response, at least three physicians on the staff of Ellis Family Health Center make housecalls, and residents in the hospital's Family Medicine Residency may include housecalls in their training.The Secondary Service Area is a much wider geographic area, including rural and farming communities, as well as affluent suburbs. Overall, the combined Service Areas represent a study in contrasts. Nearly a quarter (23%) of the households have annual incomes over $100,000, while an almost identical share (24%) are under $30,000. Health status variations are similarly dramatic. For example, the rates of asthma-related Emergency Department visits per 10,000 people vary from 292.4 in the 12307 ZIP code to 19.5 in the 12309 ZIP code, a distance of about five miles.Overall Census data for the combined Service Areas for 2010 show a total population of 352,001, comprised of 142,463 households. This is projected to increase to 355,954 (144,397 households) in 2015. The 2010 median household income was $59,948, and the average (mean) income was $73,758. The gender distribution is 49% male and 51% female. The age distribution in 2010 was: 22.2% under age 18, 50% aged 19-54, and 27.9% age 55 and older. The distribution by largest categories of race in 2010 was: 87.9% Caucasian, 5.3% African-American, and 3% Asian. By 2015, the Caucasian population is projected to decline by 3,116 people, while the Asian population will increase by 2,535 people and the African-American population will increase by 2,487 people.
Part VI - Patient Education of Eligibility for AssistanceEllis Medicine provides financial assistance information about programs available to assist patients in paying for their bills, including discount programs and charity care, on its external web site (www.ellismedicine.org), in readily available and publicly distributed brochures, and though flyers and posters visible throughout the organization. Applications for financial assistance are available online at the Ellis website. Additionally, Ellis employs Financial Advocates who assist patients in determining the availability of and their eligibility for free or low-cost care, and then assist them with completing the necessary paperwork.Since 2009, Ellis Medicine has included affirmative financial assistance outreach as part of an innovative Medical Home through which it aims to increase access to care and provide healthcare navigation services to patients (especially the underserved and uninsured/underinsured), including education about assistance with charity care and financial assistance services.Additionally, Ellis publicizes its Financial Call Center & Information Line (sharing with our 3,300 employees; our local, state and federal lawmaker offices in case they receive constituent inquiries related to hospital costs and/or financial services at Ellis; and the general public),highlighting a number to call (518-243-1695) through which patients can receive information about how much their care will cost at Ellis Medicine as a way to be transparent and helpful in providing this information, as more and more patients are paying higher deductibles and are concerned about the cost to them out-of-pocket. This is particularly significant in Ellis' Primary Service Area, as the largest local employer has converted to a high-deductible health insurance plan for many of its employees.Ellis has also participated in health fairs and employer information functions to advise small businesses and their employees of Ellis' Financial Call Center & Information Line. Ellis' Call Center has trained specialists who can help enroll qualifying patients in Financial Assistance programs, estimate a patient's out-of-pocket expenses based on their medical plan, provide pricing for procedures and tests at Ellis Medicine and assist patients in completing Medicaid applications when applicable. Ellis' Information Line helps with physician referrals, scheduling outpatient testing and providing general information about programs and services at Ellis Medicine.
Part VI - Needs AssessmentEllis Medicine assesses the health care needs of its community through analysis of federal, state and local healthcare data, through collaboration with healthcare and community partners, and through engagement of the public in meetings and surveys.Ellis participates as a dues-paying member of the Healthy Capital District Initiative (HCDI), a State-recognized regional health planning and research agency. HCDI members include county health departments from New York's Capital Region (Albany, Schenectady and Rensselaer Counties), local hospitals, health insurance companies, and other healthcare and community partners. HCDI coordinates regional needs assessments and collaborative responses to identified service gaps. An Ellis representative attends bi-monthly meetings of the HCDI Board, and Ellis has provided staff expertise for various workgroups.During 2010, as part of the State's HEAL-9 initiative, HCDI conducted an intensive study of Emergency Department (ED) utilization in a three-county region. Ellis participated by distributing HCDI's surveys to patients in both Emergency Departments, and by assigning staff to work on several HCDI workgroups. The analysis found that nearly half of ED visits could have been treated in a primary care setting or prevented by appropriate primary care, and also found an unusually large share of Ellis' ED visits were by uninsured patients as compared with other hospitals in the area. In response, Ellis has increased efforts to make primary care services available in Schenectady, and has met with Schenectady County officials and community organizations to develop ways to encourage uninsured patients to obtain Medicaid coverage. Between 2009 and 2010, patient visits to the Ellis Family Health Center, a primary care clinic which largely serves uninsured and Medicaid patients, increased by 17%.HCDI continued to make available to the public the 2009 Community Health Profile through which multiple data sources were analyzed to identify and rank the top health concerns in Albany, Schenectady and Rensselaer Counties. As part of this process, a public health forum, "How Healthy is the Capital District?", was held in Spring 2009 at a local television station, allowing audience and call-in participation during the hour-long broadcast. Additionally, a public survey of community members was also administered. Of the more than 1,100 community members surveyed, 41.6% of respondents resided in Schenectady County. The main issues covered by the survey included access to care, health insurance coverage, barriers to healthcare, Emergency Department utilization, and chronic disease experiences.In addition to this Capital Region-wide effort, Ellis Hospital works with Schenectady County Public Health Services to identify health priorities and strategies to address them. From this process, Ellis produces a Community Service Plan and the County Health Department produces its Community Health Assessment. In accordance with New York State law, Ellis filed a three year (2010-2012) Community Service Plan with the State Department of Health in September 2009, and then filed an annual update to the Plan in September 2010. Following review, the State Department of Health accepted Ellis' 2010 update without requiring any revisions.Finally, Ellis holds regular meetings in the community and has engaged the Siena Research Institute to conduct public surveys regarding local health concerns and priorities. During 2010, Ellis conducted 18 "Community Conversation" meetings between community groups, such as neighborhood associations and senior citizen organizations, and Ellis executives. In addition, the CEO met with the Mayor and Council of the City of Schenectady. Ellis also engaged in a "Siena Survey" to assess community satisfaction with overall healthcare services and with specialty care services. The results of these surveys and the public input via community meetings provide feedback from the general public about hospital services/health needs/health concerns.
Part V, Line 19d - Other Billing Determination of Individuals Without InsuranceUninsured patients with incomes exceeding 200% of Federal Poverty Guidelines (FPG) are automatically eligible for a reduction of charges to the reimbursement rate from Ellis' highest volume health maintenance organization.Number of Hospital Faciltiy - 0
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsEllis Hospital does not use presumptive eligibility for charity care. All patients applying for charity care must submit a complete application which is then reviewed by Ellis to determine charity care eligibility.
Part III, Line 4 - Bad Debt ExpenseEllis Hospital grants credit without collateral to patients, most of whom are local residents and are insured under third-party payor agreements. Additions to the allowance for doubtful accounts are made by means of the provision for bad debts. Accounts written off as uncollectable are deducted from the allowance. The amount of the provision for bad debts is based upon management's assessment of historical expected net collections, business and economic conditions, trends in Federal and State government 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. The costing methodology used in determining the amounts reported on Part III, Section A, lines 2 and 3, is Ellis' cost to charge ratio.The Bad Debt Expense included on Form 990, Part IX, line 25, column (A) but removed from the percent of expense on Schedule H, line 7 through k, column (f) was $14,460,626.
Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used)Uninsured patients with incomes exceeding 200% of Federal Poverty Guidelines (FPG) are automatically eligible for a reduction of charges to the reimbursement rate from Ellis' highest volume health maintenance organization.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000
Total Nbr Of501 C3 And Govt Grants0TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSchool of Nursing ScholarshipTypeOfGrant
Number Of Recipients111NumberOfRecipients
Amount Of Cash Grant5250AmountOfCashGrant
Amount Of Non Cash Assistance41090AmountOfNonCashAssistance
Method Of ValuationFMVMethodOfValuation
Description Of Non Cash AssistanceTuition ReductionDescriptionOfNonCashAssistance

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationThe School of Nursing (SON) works with the office of the Vice President for Nursing and the Ellis Hospital Foundation to track awards and to assure that the grants and monies are used for the intended purpose. It is the responsibility of the Ellis Finance Department to release the funds and account for the remaining balance. In the case of the Auer Scholarship, the faculty interviews the potential recipients and makes a recommendation (in rank order) of who should receive the scholarship. The Director of the SON meets with the VP for Nursing and they make a decision on how many scholarships to award to the top candidates. The Finance Department then credits the student tuition receivable account and draws the money from the Scholarship fund. There are scholarship monies that community organizations give. The organizations either send a check or hand it to the student at commencement.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgtrueCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (16 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
Wendy Rosher
17653528419445952817586232513
Terence Clarke MD
25663430869219330356510648879732295692
Robert McKay MD
233485491627169457548654750259
Paul Spurgas MD
47825789794814492050
Paul A Milton
7500575005
Patti S Hammond
18201326836445798518125235404
Max S Laguerre MD
448569180611636910312493311
Mary Ellen Crittenden
13565523488445319910110172897
Joseph Giansante
176867290917019832522147243449
James W Connolly
Herbert Reich MD
42314318923168016120012996533063
Donald J McLaughlin
144678241507855686721412204962
David Snyder
163397800041117989189797
David M Liebers MD
29119643513445852622647366327
Daniel J Rinaldi
Cecilia A Lynch
17747329488301801417311232587

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Sch J, Part III, Additional InformationPart III, Additional InformationDr. Terence Clarke is a Surgeon employed by Ellis Hospital. In addition to his base salary, he participates in an incentive compensation plan. In Schedule J Column F, the $295,692 represents the incentive compensation he earned in 2009. This amount was included in his 2010 W-2 and is included in column B (ii). This amount was reported as Deferred Compensation in the 2009 990 in Column C.
Sch J, Part I, Line 1aPart I, Line 1a: Relevant information in regards to selections on 1a.Ellis Hospital has a corporate membership at the Mohawk Golf Club that is in the CEO's name, however, the club is used for business purposes and functions only.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Dorm Auth of NYSBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN146000293IssuerEIN
CUSIP Number64983TQ97CUSIPNumber
Date Issued2004-11-23DateIssued
Issue Price16834363IssuePrice
Description Of PurposeConstruction of new ICUDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired1415000AmountRetired
Total Proceeds16834363TotalProceeds
Amount In Reserve Fund1224505AmountInReserveFund
Capitalized Interest861840CapitalizedInterest
Issuance Costs From Proceeds57858IssuanceCostsFromProceeds
Capital Expenditures14407431CapitalExpenditures
Amount Unspent282729AmountUnspent
Year Of Subst Completion2006YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedtrueBondCounselRoutinelyEngaged
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Explanation1-As of December 31, 2010, there are $282,729 of unspent bond proceeds. Since 2006, Ellis has been working with the contractor to rectify water leak issues. The unspent bond proceeds are expected to be expended in 2011. 2-The bond issuer, Dormitory Authority of the State of New York, has completed arbitrage rebate calculations for this bond issue as required and it has been determined tht no arbitrage rebate exists.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonJohn A Nolan MDNamePerson
FieldValueIRS element (for citing)
RelationshipTrusteeRelationship
Amount Of Transaction324392AmountOfTransaction
Description Of TransactionMedical ServicesDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
ExplanationDr. Nolan is a founding member and President of Cardiology Associates of Schenectady (CAS). CAS is a prominent group of 22 cardiologists, with six offices, that provides comprehensive cardiac care to patients in Schenectady, Montgomery, Fulton and Saratoga counties. CAS received payment for the direction of the cardiology program at Ellis Hospital. Ellis Hospital also leased Physicians' Assistants from CAS during 2010.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableCorporate Compliance Policies (including Conflicts of Interest Policy) and audited Financial Statements are available to the general public via posting on the Ellis Hospital website: www.ellismedicine.org. In addition, these documents and governing documents are available to the public upon request.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsEllis Hospital's Conflict of Interest Policy applies to all Hospital Trustees, Officers, employees, Medical/Dental staff members, Directors, Managers, appointees with administrative and/or decision-making responsibilities, Volunteers or any of these parties' immediate families (collectively called Hospital Agents). The Ellis Hospital Corporate Bylaws require Hospital Agents and other selected individuals as identified by the Vice President, Human Resources and the Vice President, Corporate Compliance and Internal Audit (VP-CC/IA), to file a conflict of interest disclosure statement with the Hospital on a annual basis. When the statements are completed they are returned to the VP-CC/IA. Upon receipt, the VP-CC/IA will review the disclosure and, if a potential conflict is disclosed, will meet with the Hospital Agent and/or his/her appropriate supervisor to discuss the disclosure and need for action if any. All statements for Trustees are also reviewed by the VP-CC/IA, and if a potential conflict has been disclosed, he/she will meet with the Board Chairperson to discuss the disclosure and need for action, if any. All potential conflicts involving the Board of Trustees will be summarized by the VP-CC/IA and reported to the Audit Committee of the Board. This Committee will then share this information with the Board Chairperson. When a potential or actual conflict exists, An interested person may make a presentation to the Board or at a Committee meeting, but after such presentation, he/she shall leave the meeting during the discussion of, and the vote upon, the transaction or arrangement that could constitute the conflict of interest. The Board or Committee members shall determine by a majority vote whether the transaction or arrangement is in the Hospital's best interest.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessA copy of the Ellis Hospital's 990 was prepared and submitted for review to the Senior Management team comprised of the Chief Executive Officer, the Chief Operating Officer, Chief Financial Officer, and Vice Presidents. After their review was completed, the Form 990 was sent to each member of the Audit Committee for review. After review by the Audit committee, a copy of the Form 990, including all required schedules, as ultimately filed with the IRS, was given to each voting member of Ellis' Board of Trustees, prior to its filing with the IRS. After review by the Board of Trustees, and upon the recommendation of the Audit Committee, approval is given for filing the return with the IRS.