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NATHAN LITTAUER HOSPITAL ASSOCIATION: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
NATHAN LITTAUER HOSPITAL ASSOCIATION (EIN 14-1338465)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-09
IRS object ID
201123199349301132
Schema version
2010v3.4
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)
Timestamp2011-11-09T11:13:40-07:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN141338465EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NATHAN LITTAUER HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNATHNameControl
Phone5187258621Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line199 East State StreetAddressLine1
CityGloversvilleCity
StateNYState
ZIP Code12078ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameHenry LegendziewiczName
TitleSenior Vice-President & CFOTitle
Phone5187735480Phone
Date Signed2011-11-09DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLaurence E KellyNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line199 East State StreetAddressLine1
CityGloversvilleCity
StateNYState
ZIP Code12078ZIPCode
FieldValueIRS element (for citing)
Gross Receipts85661323GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.nlh.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1894YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionNathan Littauer Hospital and Nursing Home and its family of health services is committed to providing safe high quality health and wellness services and improving the health of our communities in a caring, contemporary environment.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees1120TotalNbrEmployees
Total Nbr Volunteers236TotalNbrVolunteers
Total Gross UBI639530TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year668830ContributionsGrantsPriorYear
Contributions Grants Current Year604271ContributionsGrantsCurrentYear
Program Service Revenue Prior Year77503438ProgramServiceRevenuePriorYear
Program Service Revenue CY81315493ProgramServiceRevenueCY
Investment Income Prior Year1194707InvestmentIncomePriorYear
Investment Income Current Year712724InvestmentIncomeCurrentYear
Other Revenue Prior Year1504921OtherRevenuePriorYear
Other Revenue Current Year1670735OtherRevenueCurrentYear
Total Revenue Prior Year80871896TotalRevenuePriorYear
Total Revenue Current Year84303223TotalRevenueCurrentYear
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 Year51127330SalariesEtcPriorYear
Salaries Etc Current Year54181326SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year19036TotalFundrsngExpCurrentYear
Other Expense Prior Year25603398OtherExpensePriorYear
Other Expenses Current Year27575869OtherExpensesCurrentYear
Total Expenses Prior Year76730728TotalExpensesPriorYear
Total Expenses Current Year81757195TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4141168RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2546028RevenuesLessExpensesCY
Total Assets BOY53322299TotalAssetsBOY
Total Assets EOY55877521TotalAssetsEOY
Total Liabilities BOY24464197TotalLiabilitiesBOY
Total Liabilities EOY21828324TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY28858102NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY34049197NetAssetsOrFundBalancesEOY
Mission DescriptionNathan Littauer Hospital and Nursing Home and its family of health services is committed to providing safe high quality health and wellness services and improving the health of our communities in a caring, contemporary environment.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense44742452Expense
Grants0Grants
Revenue61601131Revenue
Description74 bed general medical surgical hospital providing inpatient and outpatient services including the following service statistics for 2010: 15,377 inpatient days, 984 newborn days, 3,693 adult & pediatric adminssions, 425 newborn admissions, 22,861 emergency room visits, 90,584 outpatient visits, and 4,960 day surgery visits. Included are 1,394 patients approved for financial assistance at a cost to the hospital of $594,000.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense22081324Expense
Grants0Grants
Revenue12394214Revenue
DescriptionThe Nathan Littauer Primary/Specialty Care Centers provide care for the whole family. Our eight conveniently located Centers offer a range of services and specialties with direct access to the specialists and state-of-the-art technology at Nathan Littauer Hospital. Several Centers are located in remote rural parts of our service area. The Centers employ 30 physicians and over 25 other healthcare providers such as nurse practioners, physician assistants and mid-wives. During 2010 the Centers collectively incurred 104,840 visits.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense8621617Expense
Grants0Grants
Revenue7087325Revenue
DescriptionThe Nathan Littauer Nursing Home located on the Nathan Littauer Hospital campus is a short and long term residential healthcare facility that provides a wide range of medical services with 84 beds. In 2010 the facility had a total of 30,304 patient days.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense474761Expense
Grants0Grants
Revenue232823Revenue
DescriptionHealthLink is Nathan Littauer Hospital's Wellness Education Center located in Johnstown. HealthLink's role is to promote wellness by increasing community awareness and providing resources for those wishing to make positive, healthy lifestyle changes. Since its launch in 1989, HealthLink has served over 155,000 area residents with more than 6,500 free or low-cost education programs and health screenings. Our wide variety of programs are chosen based on the interests and needs of the community. Program categories include Health & Wellness, Mind & Body, Childbirth & Parenting, Health Screenings, Support Groups, Special Events, and Vitality Plus (ViP)...especially for adults 50+. We also offer Worksite Wellness programs, including health screenings and wellness education programs, to promote health & wellness on the job. Speakers are available for presentations to schools, churches, community groups, organizations, etc., on a variety of topics. HealthLink's growing library of books, videos/DVD's, magazines and brochures cover many health-related issues. Most are free or loaned at no charge. The Hospital also offers a Lifeline Program. Lifeline is a personal emergency response system which connects subscribers with the Hospitals emergency department through a telephone based communication system. A total of 528 subscribers are members of NLHs Lifeline Program. Other community services include community health fairs, speakers bureau, organ donation program, Camp Superstarrs and New Visions Program for high school students. Health Insurance Counseling: Nathan Littauer Hospital is the lead agency in the New York State Child and Family Health Plus grant funded facilitated enrollment insurance program for Fulton, Montgomery and Hamilton counties. Child and Family Health Plus is a facilitated insurance enrollment program for children and adults that do not have or cannot afford health insurance. In 2010 more than 1,400 children, 59 pregnant women and more than 783 families were enrolled in health insurance programs through our agency. These enrollments included Medicaid and participating HMOs. (2242 Individuals and families)Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp474761TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev232823TotalOfOtherProgramServiceRev
Total Program Service Expense75920154TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached0FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109635NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1120NumberOfEmployees
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 Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLawrence A MelitaNamePerson
Telephone Number5187735481TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line199 East State StreetAddressLine1
CityGloversvilleCity
StateNYState
ZIP Code120781293ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Neil McGovern
Chair0X000
David Seward Esq
Treasurer0X000
Arlene M Sitterly
Secretary0X000
John Comstock
Member0X000
Matthew Kearney DDS
Member0X000
David Handron MD
Member0X000
Susan Johnson Esq
Member0X000
John Fox DDS
Member0X000
Robert C Munn
Member0X000
Shriraj Shah MD
Member0X000
Brian Hanaburgh
Member0X000
Holly Chamberlain
Member0X000
Paul Perreault MD
Member0X000
Laurence E Kelly
President & CEO & Member403546550154213X
Henry Legendziewicz
Senior Vice President & CFO40193201069121X
James Anania MD
Physician40443815024833X
Paul Moberg MD
Physician40408382024833X
Michael Martynik MD
Physician40408382015610X
Peter Dowling MD
Physician40285521024833X
Patricia Nguyen MD
Phycian40281921024833X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2375877TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation338276TotalOtherCompensation
Number Individuals GT100 K52NumberIndividualsGT100K
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
AOW Associates Inc
30 Essex StreetAlbanyNY12206Construction Services2604457
Sodexho Operations
PO Box 905374CharlotteNC28290Dietary Services1387622
Alliance Healthcare Services
PO Box 96485ChicagoIL60693MRI Imaging Servies886496
Saratoga Emergency Physicians PC
211 Church StreetSaratoga SpringsNY12866Emergency Room Physician Services692990
Linde Healthcare Staffing
PO Box 915241DallasTX75391Contract Medical Employees514326
FieldValueIRS element (for citing)
Number Of Contractors GT100 K21NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations200000RelatedOrganizations
Government Grants394541GovernmentGrants
All Other Contributions9730AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions604271TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Inpatient & Outpatient Services62200061601131616011310$0
Primary Care Centers62111012394214123942140$0
Nursing Home623000708732570873250$0
Lifeline6219902161122161120$0
Healthlink61171016711167110$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue81315493TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column755885TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$755,885ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities1308441Securities
Other6498Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities1358100Securities
Other0Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-49659Securities
Other6498Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-43161TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion-$43,161ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Retail Pharmacy4461106395300639530$0
Cafeteria Sales72221047479500$474,795

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column556410TotalRevenueColumn
Related Or Exempt Function Income538137RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$18,273ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1670735TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column84303223TotalRevenueColumn
Related Or Exempt Function Income81853630RelatedOrExemptFunctionIncome
Unrelated Business Revenue639530UnrelatedBusinessRevenue
Exclusion$1,205,792ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total771190Total
Program Services0ProgramServices
Management And General771190ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total42328944Total
Program Services40192530ProgramServices
Management And General2136414ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2726355Total
Program Services2640870ProgramServices
Management And General85485ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total5410431Total
Program Services5138529ProgramServices
Management And General271902ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2944406Total
Program Services2780915ProgramServices
Management And General163491ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total417270Total
Program Services413410ProgramServices
Management And General0ManagementAndGeneral
Fundraising3860Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total296162Total
Program Services0ProgramServices
Management And General296162ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total209180Total
Program Services0ProgramServices
Management And General209180ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total187157Total
Program Services0ProgramServices
Management And General187157ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1150939Total
Program Services1150939ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total283147Total
Program Services0ProgramServices
Management And General282448ManagementAndGeneral
Fundraising699Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3095730Total
Program Services2773394ProgramServices
Management And General308150ManagementAndGeneral
Fundraising14186Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total346799Total
Program Services332501ProgramServices
Management And General14298ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1465290Total
Program Services1452983ProgramServices
Management And General12307ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total286998Total
Program Services249907ProgramServices
Management And General37091ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total641794Total
Program Services641794ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3153361Total
Program Services2953069ProgramServices
Management And General200292ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1455482Total
Program Services1455482ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Medical Supplies780459778042243730
Non-Medical Supplies100031299367866340
Purchased Services348580831660723197360
Food85184085184000
Assessment700777700693840

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total743226Total
Program Services227324ProgramServices
Management And General515611ManagementAndGeneral
Fundraising291Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total81757195Total
Program Services75920154ProgramServices
Management And General5818005ManagementAndGeneral
Fundraising19036Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2000119BOY
EOY4518747EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY9550130BOY
EOY157581EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY2034813BOY
EOY1280000EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY9237020BOY
EOY9337139EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY46326BOY
EOY30000EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY478460BOY
EOY527854EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY892001BOY
EOY938338EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis65384253LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec42228027LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY19177082BOY
EOY23156226EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6062138BOY
EOY11503378EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3844210BOY
EOY4428258EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY53322299BOY
EOY55877521EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY7549685BOY
EOY5471945EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY102459EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY5345246BOY
EOY4982369EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4710693BOY
EOY4517866EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6858573BOY
EOY6753685EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY24464197BOY
EOY21828324EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY26073789BOY
EOY32486697EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2501813BOY
EOY1280000EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY282500BOY
EOY282500EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY28858102BOY
EOY34049197EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY53322299BOY
EOY55877521EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2546028ReconcilationRevenueExpenses
Reconcilation Other Changes2645067ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review1AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance261573BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses43367InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses1641AdministrativeExpenses
End Of Year Balance303299EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance193361BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses69682InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses1470AdministrativeExpenses
End Of Year Balance261573EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance344557BeginningOfYearBalance
Contributions0Contributions
Investment Earnings Or Losses-149499InvestmentEarningsOrLosses
Grants Or Scholarships0GrantsOrScholarships
Other Expenditures0OtherExpenditures
Administrative Expenses1697AdministrativeExpenses
End Of Year Balance193361EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.07BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.93PermanentEndowmentEOYBalance
Term Endowment EOY Balance0TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis404197OtherCostOrOtherBasis
Book Value404197BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis32733120OtherCostOrOtherBasis
Depreciation19284919Depreciation
Book Value13448201BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis1272920OtherCostOrOtherBasis
Depreciation853398Depreciation
Book Value419522BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis26731502OtherCostOrOtherBasis
Depreciation19224333Depreciation
Book Value7507169BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis4242514OtherCostOrOtherBasis
Depreciation2865377Depreciation
Book Value1377137BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings23156226TotalOfBookValueLandBuildings

Other Assets OtherAssets (10 entries)

DescriptionDescriptionBook ValueBookValue
AWUL by Debt & Lease Agreement1410892
AWUL by Board Designation424181
Accrued Interest Expense6007
Agency Funds36068
Miscellaneous Receivable208829
Other Assets576287
Software License242285
Deferred Financing275335
Deferred Lease40304
Other Deferred Asset1208070
FieldValueIRS element (for citing)
Total Book Value Other Assets4428258TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
Due to Third Party Reimbursement Agencies$573,600
Asset Retirement Obligation$514,158
Accrued Long-Term Pension Obligation$4,554,855
Section 457 Plans$1,009,106
Due to 1199$101,966
FieldValueIRS element (for citing)
Total Of Amounts6753685TotalOfAmounts
Total Revenue84303223TotalRevenue
Total Expenses81757195TotalExpenses
Excess Or Deficit For Year2546028ExcessOrDeficitForYear
Net Unrealized GL On Investments0NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS2546028ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt89581442TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues5278219OtherRevenues
Revenue Not Rptd F9905278219RevenueNotRptdF990
Revenue Subtotal84303223RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99084303223TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt87035414TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included5278219OtherExpensesIncluded
Expenses Not Rptd F9905278219ExpensesNotRptdF990
Expenses Subtotal81757195ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99081757195TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchD_P05_S00_L04Schedule D, Part V, Line 4The principle donation is permanently restricted, income generated by the fund can be used in the daily operations of the Hospital.
SchD_P12_S00_L02dSchedule D, Part XII, Line 2dProvision for Bad Debts
SchD_P13_S00_L02dSchedule D, Part XIII, Line 2dProvision for Bad Debts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
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)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served2642PersonsServed
Total Community Benefit Expense687013TotalCommunityBenefitExpense
Direct Offsetting Revenue132275DirectOffsettingRevenue
Net Community Benefit Expense554738NetCommunityBenefitExpense
Percent Of Total Expense0.0068PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served54287PersonsServed
Total Community Benefit Expense17090143TotalCommunityBenefitExpense
Direct Offsetting Revenue12409759DirectOffsettingRevenue
Net Community Benefit Expense4680384NetCommunityBenefitExpense
Percent Of Total Expense0.0572PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served56929PersonsServed
Total Community Benefit Expense17777156TotalCommunityBenefitExpense
Direct Offsetting Revenue12542034DirectOffsettingRevenue
Net Community Benefit Expense5235122NetCommunityBenefitExpense
Percent Of Total Expense0.0640PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs19NumberOfActivitiesOrPrograms
Persons Served6501PersonsServed
Total Community Benefit Expense658601TotalCommunityBenefitExpense
Direct Offsetting Revenue456609DirectOffsettingRevenue
Net Community Benefit Expense201992NetCommunityBenefitExpense
Percent Of Total Expense0.0025PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served24PersonsServed
Total Community Benefit Expense90629TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense90629NetCommunityBenefitExpense
Percent Of Total Expense0.0011PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served0PersonsServed
Total Community Benefit Expense11510751TotalCommunityBenefitExpense
Direct Offsetting Revenue9037981DirectOffsettingRevenue
Net Community Benefit Expense2472770NetCommunityBenefitExpense
Percent Of Total Expense0.0302PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served100PersonsServed
Total Community Benefit Expense14853TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense14583NetCommunityBenefitExpense
Percent Of Total Expense0.0002PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs23NumberOfActivitiesOrPrograms
Persons Served6625PersonsServed
Total Community Benefit Expense12274834TotalCommunityBenefitExpense
Direct Offsetting Revenue9494590DirectOffsettingRevenue
Net Community Benefit Expense2779974NetCommunityBenefitExpense
Percent Of Total Expense0.0340PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs24NumberOfActivitiesOrPrograms
Persons Served63554PersonsServed
Total Community Benefit Expense30051990TotalCommunityBenefitExpense
Direct Offsetting Revenue22036624DirectOffsettingRevenue
Net Community Benefit Expense8015096NetCommunityBenefitExpense
Percent Of Total Expense0.0980PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,039,796BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare12480348AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare14782722CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2302374MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
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 Line1Nathan Littauer Hospital AssociationBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line199 East State StreetAddressLine1
CityGloversvilleCity
StateNYState
ZIP Code12078ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Nathan Littauer Hospital AssociationBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Permit LawsuitXPermitLawsuit
Permit Lien On ResidenceXPermitLienOnResidence
Collection Activities1CollectionActivities
LawsuitXLawsuit
Lien On ResidenceXLienOnResidence
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Lowest Negotiated RatesXLowestNegotiatedRates
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Nathan Littauer Hospital Nursing Home
99 East State StreetGloversvilleNY1207884 Bed Nursing Home.
Nathan Littauer Hospital Primary Care Centers
99 East State StreetGloversvilleNY12078Primary/Specialty Care Centers (Clinics).
Perth-Broadalbin Primary Care Center
4100 State Highway 30AmsterdamNY12010Primary/Specialty Care Center (Clinic)
Johnstown Primary Care Center
23 South Perry StreetJohnstownNY12095Primary/Specialty Care Center (Clinic)
Mayfield Primary Care Center
2497 State Highway 30MayfieldNY12117Primary/Specialty Care Center (Clinic)
Steele Avenue Primary Care Center
182 Steele AvenueGloversvilleNY12078Pediatric Care Center (Clinic)
Caroga Lake Primary Care Center
1840 State Highway 10Caroga LakeNY12032Primary Care Center (Clinic)
Speculator Primary Care Center
Route 8SpeculatorNY12164Primary Care Center (Clinic)
Terrace Primary Care Center
2 Fonclair TerraceJohnstownNY12095Primary Care Center (Clinic)

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchH_P01_S00_L06aSchedule H, Part I, Line 6aOur annual community benefit report is prepared by Nathan Littauer Hospital. The report can be found at www.nlh.org. We also mail the report to organizations in our communty. Our State requires the filing of a community benefit report every 3 years, rather than on an annual basis. Our reporting is designed to conform to this standard.
SchH_P01_S00_L07Schedule H, Part I, Line 7The costing methodology used to calculate the amounts reported in the Table for Line 7 is the Ratio of Patient Care Cost to Charges.
SchH_P01_S00_L072fSchedule H, Part I, Line 7, Column fOur total expense from Form 990, Part IX, line 25 column (A) was $81,757,195. Bad debt expense is not included in this amount. It is reported as a deduction to net patient revenue and not included in column (f).
SchH_P01_S00_L07gSchedule H, Part I, Line 7gSubsidized health services reported included details from the Primary Care Centers, licensed clinics. The Centers operated despite financial losses to the organization for at least the past seven years. The Hospital is committed to operate the Centers as a benefit to the community in order to address an identified community need and to improve access to healthcare.
SchH_P03_S0A_L02Schedule H, Part III, Section A, Line 2The ratio of patient care cost to charges is applied to the bad debt attributable to patient accounts to calculate the estimated cost of bad debt attributable to patient accounts that is reported on line 2. Discounts and payments on patient accounts are recorded as an adjustment to revenue, not bad debt expense.
SchH_P03_S0A_L04Schedule H, Part III, Section A, Line 4The Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The Hospital maintains records to identify and monitor the level of charity care it provides. Those records include the amount of charges for services and supplies furnished to paitents at no charge. The Hospital grants credit without collateral to patients, most of who are residents and are insured under third party agreements. Additions to allowance for estimated uncollectible accounts are made by means of the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon management's assessment of historical and expected net collections, local 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 other collection indicators. Services rendered to individuals when payment is expected and ultimately not received are written off to the allowance for estimated uncollectible accounts. The calculation method used to determine costs reported on Line 2 is the ratio of cost to charges.
SchH_P03_S0B_L07Schedule H, Part III, Section B, Line 7The actual cost for Medicare patients when all costs to the organization are included is $15,770,848 which amounts to an actual $2,433,996 shortfall between payments and costs.
SchH_P03_S0B_L08Schedule H, Part III, Section B, Line 8Medicare allowable costs were calculated using a cost to charge ratio. Community Benefit: Medicare shortfall should be considered a community benefit because our mission is to promote health in the community and we do not limit the care available to any patients, including those covered by Medicare. We are relieving a government burden by providing care to Medicare patients even though costs exceed reimbursements by $2,302,374. Tax exempt hospitals are expected to participate in the Medicare program. For many of the medical services provided by the Hospital, Medicare does not provide sufficient reimbursement to cover the cost of providing care to the patients forcing the hospital to use other funds to cover the deficit. Medicare Cost Reports that hospitals are required to file do not include all of the costs required to treat Medicare patients. Therefore the amount reflected on the Medicare Cost Report differs from actual losses. In 2010 the Hospital realized an additional shortfall of $1,499,627 resulting from Medicare Advantage and non PPS Medicare patients. The total shortfall for all types of Medicare patients was $3,802,001.
SchH_P03_S0C_L09bSchedule H, Part III, Section C, Line 9bThe Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The Hospital maintains records to identify and monitor the level of charity care it provides. Those records include the amount of charges for services and supplies furnished to paitents at no charge. The Hospital grants credit without collateral to patients, most of who are residents and are insured under third party agreements. Additions to allowance for estimated uncollectible accounts are madeby means of the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon management's assessment of historical and expected net collections, local 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 other collection indicators. Services rendered to individuals when payment is expected and ultimately not received are written off to the allowance for estimated uncollectible accounts.
SchH_P06_S00_L02Schedule H, Part VI, Line 2Nathan Littauer Hospital is involved in numerous community building activities which promote the health of the communities we serve. The concerns addressed include health improvement, education, poverty,workforce development, access to care and emergency services. We encourage our employees to serve on community collaboration boards and health advocacy programs to further demonstrate our commitment. And, we work with schools and work sites to promote and wellness and prevent disease. The most visible coalition program is our membership in the Adirondack Rural Health Network, a network of six counties that share similar geographic, demographic, and health care issues. ARHN is preparing the agenda and programming suggestions for our six counties in the battle to address physical activity and nutrition, voted as the number 1 health issue in our areas. In addition to the regional network, Littauer partners with Fulton County Public Health, schools, pediatric providers, New York State Department of Health and others to address the number one local issue, childhood asthma. Over the next two years we will identify and implement strategies to further eradicate this health issue plaguing our children. Not to be overlooked are our annual donations to organizations of used equipment and unused supplies.
SchH_P06_S00_L03Schedule H, Part VI, Line 3The hospital's financial assistance policy is communicated in both English and Spanish in a variety of ways. Communications include: bilingual signage throughout the hospital, including the emergency department and outpatient registration areas; distribution of brochures describing the policy and how to apply for assistance; posting of the policy and application on the website, and a statement added to all publications indicating the availability of charity care. Interpretation services are available for patients needing information in languages other than English and Spanish.
SchH_P06_S00_L04Schedule H, Part VI, Line 4Nathan Littauer Hospital and Nursing Home is located in a rural, upstate area of New York State. Our primary service area is Fulton County with additional service areas in neighboring Hamilton and Montgomery Counties. Both Fulton and Hamilton Counties are designated as Healthcare Professional Shortage Areas. A snapshot of our primary service area shows the 2010 population is 55,053 and of those reporting one race, 95% are white. 51% of the population is female and 49% male. The median age is 41.4 years and 16% of the population is age 65 and older. The median household income in Fulton County is $44,175 (below the national median of $52,175) with 13.7% of families below the poverty level. 82.2% of the population has a high school degree or higher, 18% are high school drop outs. The leading industries are educational services, health care and social assistance employing 26% of the workforce followed by manufacturing employing 15%. Unemployment sits at nearly 10%. The major health issues inFulton County include respiratory diseases/childhood asthma, cancers of the lung and colon, lack of physical fitness and nutrition, unintentional injuries, tobacco use and chronic diseases of lung heart. The demographics and public health issues of our area clearly demonstrate why Nathan Littauer Hospital and Nursing Home and our eight outpatient centers are vital resources in the communities we serve. Specifically, aging population, high unemployment/households below poverty level and major health issues will continue challenging Nathan Littauer to continue providing needed health care in a safe, quality and accessible environment.
SchH_P06_S00_L05Schedule H, Part VI, Line 5The Board of Directors of Nathan Littauer Hospital and Nursing Home is made up of medical and business professionals, all of whom reside in our primary service area. These volunteers give countless hours to the organization in their oversight role. They are involved in the community needs assessment process, in fundraising and in general stewardship. Littauer utilizes excess funds to reinvest in our technology, computerization and facilities to keep our organization safe, efficient and accessible as well as to ensure quality patient care. For example we recently Excess funds help to support free and low cost education programs offered by Littauer to our community. Opened a new pediatric center and purchased and renovated an outpatient surgery center. Invested millions of dollars in computer resources to meet the Federal standards.
SchH_P06_S00_L06Schedule H, Part VI, Line 6The Board of Directors of Nathan Littauer Hospital and Nursing Home is made up of medical and business professionals, all of whom reside in our primary service area. These volunteers give countless hours to the organization in their oversight role. They are involved in the community needs assessment process, in fundraising and in general stewardship. Littauer utilizes excess funds to reinvest in our technology, computerization and facilities to keep our organization safe, efficient and accessible as well as to ensure quality patient care. For example we recently renovated the aging maternity unit, expanded the emergency department and built a needed outpatient Primary Care Center in one of the fastest growing parts of our service area. Excess funds help to support free and low cost education programs offered by Littauer to our community.
SchH_P06_S00_L07Schedule H, Part VI, Line 7Community benefit report is filed with New York State.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 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
Laurence E Kelly
35368900016890138457015033050886803917320
Henry Legendziewicz
1902020002999054624014497026232202419290
James Anania MD
44336500045009800015033046864804584520
Paul Moberg MD
40769200069009800015033043321504234920
Michael Martynik MD
4076920006900980005810042399204155150
Peter Dowling MD
284231000129009800015033031035402889070
Patricia Nguyen MD
281231000690098000150330306754000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchJ_P01_S00_L01aSchedule J, Part I, Line 1aThe Chief Executive Officer's employment contract allows his spouse to accompany him to one conference per year. A 1099 tax form is filed for the associated travel expense as necessary.
SchJ_P01_S00_L04Schedule J, Part I, Line 4Payments were made on behalf of the CEO and CFO to a 457(f) plan during 2010.

Schedule M IRS990ScheduleM

Real Estate Commercial RealEstateCommercial

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F9900NoncashContribsRptdF990
Method Of Determining RevenuesApprasialMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Number Of8283 Received0NumberOf8283Received
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Form990 Schedule M Part II Form990ScheduleMPartII

FieldValueIRS element (for citing)
IdentifierSchM_P01_S00_L33Identifier
Return ReferenceSchedule M, Part I, Line 33ReturnReference
ExplanationThe commercial real estate donated increased the net assets of the hospital and was not recorded as income.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P01_S00_L06Form 990, Part I, Line 6Total volunteer hours for 2010 18,160 which includes Auxilians, Candy Stripers and Jr. Volunteers.
F990_P06_S0A_L06Form 990, Part VI, Section A, Line 6The sole member of the Nathan Littauer Hospital Association is Colonial Healthcare Corp. which shall be represented at all meetings of the Association by the President of the Board of Directors of Colonial Healthcare Corp. or such person designated by the President in writing.
F990_P06_S0A_L07bForm 990, Part VI, Section A, Line 7bColonial Healthcare Corp., the sole member of Nathan Littauer Hospital Association, must consent to any changes to the hospital's bylaws.
F990_P06_S0B_L11aForm 990, Part VI, Section B, Line 11aThe form 990 was presented at a regular meeting of the Board of Directors on October 24, 2011 by Henry Legendziewicz, CFO and Laurence Kelly, CEO prior to the filing of the form. The Chairman and Vice Chairman of the Board were presented with copies prior to the board meeting.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cThe hospital's Conflict of Interest policy requires the filing of an annual disclosure statement by Covered Persons. Covered persons are defined as "Any director, officer, member of a committee with governing board delegated powers, or any member of the Capital Acquisition Committee, Pharmacy & Therapeutics Committee or Value Analysis Committee and Hospital employees who have a position which involves the acquisition of equipment and supplies or who authorize payments for such materials." The Board or Committee is informed annually of any possible conflicts. The covered person has a duty to disclose the possible conflict when a matter is brought before the board or committee and the board or committee makes the determination if a conflict actually exists. The conflicted party will not participate in the discussion of the matter at hand and will leave the meeting which a vote of the disinterested parties takes place. The Corporate Compliance Officer and the Chairman of the Board or Committee are responsible for compliance with policy.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15The hospital's Compensation Committee is composed of the Chairman, Vice-Chairman, and immediate past Chairman of the Board of Directors. All members are independent directors. The Committee utilizes comparable compensation data in its deliberations. The compensation of the President (CEO) of the hospital is in the form of a recommendation to the full Board of Directors in an Executive Session of the meeting. Only independent directors are present at the meeting. The Compensation Committee also advises and assists the President (CEO) in determining the compensation for senior management of the hospital using comparable compensation data.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19The Hospital publishes an annual report distributed by mail and made available for distribution through a number of public outlets such as civic and social organizations. The report includes condensed financial statements and various statistical data relative to services provided to the community including free clinics, education programs, health fairs, etc. The Form 990 is available to the public upon request. The Hospital's governing documents, conflict of interest policy and internal financial statements are not available to the public.
F990_P11_S00_L05Form 990, Part XI, Line 5Pension Related Changes - $686,333 Change in Net Unrealized Gains and Losses - $206,945 Contribution of Capital Asset - $1,800,000 Restricted Gifts and Grants - $66,602 Distributions from NL Foundation - $640,000 Change in Interest in Net Assets of NL Foundation - $(754,813)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
Gloversville Extended Care & Nursing Home Co Inc
99 East State StreetGloversvilleNY12078237065255Leasing an 84 bed Skilled Nursing Facility to HospitalNY501(c)37N/A0
NLH Realty Corp
99 East State StreetGloversvilleNY12078141641020Realty holding companyNY501(c)2N/A0
Nathan Littauer Foundation
99 East State StreetGloversvilleNY12078141638991Support the Hospital & promote healthcare programs in the community through donations.NY501(c)3Type IIIN/A0
Nathan Littauer Hospital Auxiliary
99 East State StreetGloversvilleNY12078146086641Assisting Hospital in promoting health & welfare of the communityNY501(c)3Type IIIN/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Nathan Littauer Foundation
c590000Cash received.
Gloversville Extended Care & Nursing Home Co Inc
j138953Payments made for the lease.