2020-11-14T18:00:09-06:00 2019-12-31 221478099 COHNREZNICK LLP 4 BECKER FARM ROAD ROSELAND NJ 07068 990 2019-01-01 141628237 HUDSON HEADWATERS HEALTH NETWORK HUDS 5187610300 9 CAREY ROAD QUEENSBURY NY 12804 CHRISTOPHER TOURNIER CFO 5187610300 2020-11-13 1 LORI ROTHE YOKOBOSKY CPA P01273422 9732283500 2020-11-11 209.59.242.22 2020-11-13 12:30:05 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 01BADB2B2A6B151C38D19099FC0A101EF8F974BA 2019 2021-01-29 14:40:06Z DAVID T SLINGERLAND MD 9 CAREY ROAD QUEENSBURY NY 12804 126976540 0 X WWW.HHHN.ORG X 1981 NY FQHC - OUR MISSION IS TO PROVIDE THE BEST HEALTH CARE AND ACCESS TO THAT CARE FOR EVERYONE IN OUR COMMUNITIES. 15 15 983 42 5634992 1382971 12962127 13789026 61576612 66516756 68386 478437 36690727 46176687 111297852 126960906 0 0 0 0 65905011 70456218 0 0 0 35313963 39692352 101218974 110148570 10078878 16812336 103944765 126491390 32416858 38145853 71527907 88345537 X WE ARE A COMMUNITY BASED HEALTH CLINIC WHICH SERVICED 82,866 PATIENTS IN 2017. TO FURTHER THE PROVISION OF COMPREHENSIVE HEALTH CARE SERVICES TO THE GENERAL POPULATION OF WARREN, WASHINGTON, SARATOGA, HAMILTON, ESSEX AND CLINTON COUNTIES. TO PROMOTE, SPONSOR, FOSTER AND DELIVER PROGRAMS, ACTIVITIES AND SERVICES WHICH SHALL HAVE THE PURPOSE OF IMPROVING THE HEALTH AND WELL-BEING OF THE POPULATION SERVED BY THIS CORPORATION AND TO CONTINUALLY SEEK NEW AND INNOVATIVE METHODS OF IMPROVING HEALTH CARE DELIVERY AND ITS FINANCING TO THE COMMUNITY SERVED. TO CARRY OUT ANY EDUCATION AND TEACHING ACTIVITIES RELATED TO RENDERING HEALTH CARE OR TO THE PROMOTION OF HEALTH THAT IN THE OPINION OF THE BOARD OF DIRECTORS MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS OR OTHER RESOURCES THAT ARE FOR, OR CAN BE, MADE. 0 0 85508580 106757749 THE CENTER IS A COMMUNITY BASED HEALTH CENTER CLINIC WITH MULTIPLE LOCATIONS. IN 2019, WE SERVICED 90,077 PATIENTS WITH 364,083 VISITS. 8043526 340B PHARMACY PROGRAM - AS A FEDERALLY QUALIFIED HEALTH CENTER WE ARE ABLE TO ACQUIRE DRUGS AT THE LOWER PRICES MANDATED BY THE FEDERAL 340B DRUG PURCHASING PROGRAM, THIS ALLOWS US TO ASSIST INDIGENT PATIENTS WITH THE SOMETIME OVERWHELMING COSTS OF PRESCRIPTION MEDICATIONS. FACILITATE THE HUDSON HEADWATERS HEALTH NETWORK PATIENT ASSISTANCE PROGRAM WHICH ENABLES NEEDY PATIENTS TO RECEIVE MEDICATIONS FREE OF CHARGE FROM THE DRUG MANUFACTURERS AND GENERATE REVENUE TO SUPPORT HHHN'S OVERALL OPERATIONAL VIABILITY. 93552106 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 97 0 1 983 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X JENNY FALCO 5187610300 9 CAREY ROAD QUEENSBURY NY 12804 AMY LANGWORTHY BOARD MEMBER 1.00 0.10 X 0 0 0 BARBARA SWEET VICE CHAIR 1.00 0.10 X X 0 0 0 BRUCE CARR BOARD MEMBER 1.00 0.10 X 0 0 0 CATHY MOSES SECRETARY 1.00 0.10 X X 0 0 0 CELINE RACINE-PAQUETTE EXECUTIVE COMMITTEE MEMBER 1.00 0.10 X 0 0 0 DANA HOGAN OUTGOING BOARD MEMBER 1.00 0.10 X 0 0 0 DONNA NICHOLS BOARD MEMBER 1.00 0.10 X 0 0 0 EILEEN HAYNES BOARD MEMBER 1.00 0.10 X 0 0 0 HARRY ROBINSON BOARD MEMBER 1.00 0.10 X 0 0 0 IKE WOLGIN BOARD CHAIR 1.00 1.10 X X 0 0 0 JIM MORRIS BOARD MEMBER 1.00 0.10 X 0 0 0 KEVIN PORPORA TREASURER 1.00 0.10 X X 0 0 0 MICHAEL MCCARTHY BOARD MEMBER 1.00 0.10 X 0 0 0 PATRICIA ALLEN BOARD MEMBER 1.00 0.10 X 0 0 0 PATRICIA HUNT BOARD MEMBER 1.00 0.10 X 0 0 0 PETER REALE BOARD MEMBER 1.00 0.10 X 0 0 0 CHRISTOPHER TOURNIER CFO 40.00 1.10 X 296114 0 28482 DAVID T SLINGERLAND MD CEO 40.00 1.10 X 411374 0 27877 DOMINICK BIZZARRO PRESIDENT & COO 40.00 1.10 X 437142 0 25865 EDWARD SHANNON CDO 40.00 X 204032 0 25258 JOHN RUGGE MD EXECUTIVE CHAIRMAN 40.00 1.10 X 367662 0 22364 JOHN SAWYER MD CMO 40.00 X 313095 0 29111 KENNETH FRANCE MD PHYSICIAN 40.00 X 276864 0 25057 MICHAEL CELOTTI MD PHYSICIAN 40.00 X 280707 0 25196 THOMAS PORTUESE MD PHYSICIAN 40.00 X 400950 0 29515 WILLIAM BORGOS MD PHYSICIAN 40.00 X 296755 0 26696 WILLIAM PARKER MD PHYSICIAN 40.00 X 332011 0 27008 3616706 0 292429 147 0 1 0 BAST HATFIELD CONSTRUCTION LLC 1399 CRESCENT VISCHER FERRY ROAD CLIFTON PARK NY 12065 CONSTRUCTION 5608686 BBL CONSTRUCTION SERVICES LLC 302 WASHINGTON AVE EXTENSION ALBANY NY 12203 CONSTRUCTION 921683 RICHARD E JONES ASSOCIATES 339 AVIATION ROAD QUEENSBURY NY 12804 ARCHITECTURAL AND ENGINEERING SERVICES 376697 ADIRONDACKS ACO LLC 75 BEEKMAN ST PLATTSBURGH NY 12901 CONSULTING SERVICES 173502 COHN REZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 ACCOUNTING/TAX SERVICES 151563 8 149935 7031891 6607200 13789026 OTHER THIRD-PARTY PAYORS 621400 24032498 24032498 MEDICARE 621400 12341474 12341474 NEW YORK STATE MANAGED CARE WRAP- 621400 9263864 9263864 MEDICAID MANAGED CARE 621400 8997800 8997800 SELF-PAY 621400 7273200 7273200 4607920 4607920 66516756 494071 494071 300702 0 300702 300702 300702 15634 -15634 -15634 -15634 340B PHARMACY 621400 39846580 39846580 340B CONSULTING 541610 5592232 5592232 MEANINGFUL USE 621400 178500 178500 258673 215913 42760 45875985 126960906 106757749 5634992 779139 2188413 1902313 286100 53508291 46509848 6998443 2244106 1952372 291734 8563157 7438460 1124697 3952251 3438458 513793 195096 45089 150007 160857 160857 10848104 8081112 2766992 682068 407370 274698 945668 665922 279746 1819199 340245 1478954 2841714 2632145 209569 489083 352370 136713 254858 111944 142914 630736 630736 3337104 2582743 754361 564310 311016 253294 340B SUPPLIES 8043526 8043526 MEDICAL SUPPLIES 3627161 3608931 18230 PROVISION FOR BAD DEBTS 2091304 2091304 UBIT 341898 341898 2819666 2064304 755362 110148570 93552106 16596464 0 73633 317548 14784081 16228720 94534 20906 14181537 18010906 350000 350000 1745840 2188397 81413215 20389281 49703214 61023934 19083417 23469135 3928509 4881844 103944765 126491390 13106701 15202587 60192 161271 11353474 16972337 3988667 948499 3907824 4861159 32416858 38145853 X 71527907 88345537 71527907 88345537 103944765 126491390 16812336 5294 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4278142 4278142 46842311 9801866 37040445 4267325 2866732 1400593 7057271 3350671 3706600 18968166 4370012 14598154 61023934 DEFERRED COMPENSATION PAYABLE (457B) 4861159 4861159 X 127636530 5294 21948 648382 675624 126960906 0 126960906 110664731 21948 494213 516161 110148570 0 110148570 PART X, LINE 2: THE COMPANIES HAVE NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2019. THE COMPANIES' FEDERAL AND STATE INFORMATION RETURNS PRIOR TO CALENDAR YEAR 2016 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE COMPANIES RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS OPERATING EXPENSES AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE CONSOLIDATED STATEMENT OF FINANCIAL POSITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: RELATED PARTIES REVENUE 659,382. INTERCOMPANY ELIMINATIONS -11,000. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED PARTIES EXPENSES 505,213. INTERCOMPANY ELIMINATIONS -11,000. X X X X 0 0 0 0 0 0 0 1 0 CHRISTOPHER TOURNIER CFO 234490 0 34081 0 27543 0 5600 0 22882 0 324596 0 0 0 DAVID T SLINGERLAND MD CEO 336534 0 64114 0 10726 0 5600 0 22277 0 439251 0 0 0 DOMINICK BIZZARRO PRESIDENT & COO 333913 0 64089 0 39140 0 5600 0 20265 0 463007 0 0 0 EDWARD SHANNON CDO 152517 0 25468 0 26047 0 4061 0 21197 0 229290 0 0 0 JOHN RUGGE MD EXECUTIVE CHAIRMAN 131247 0 218516 0 17899 0 5600 0 16764 0 390026 0 0 0 JOHN SAWYER MD CMO 276618 0 3456 0 33021 0 5600 0 23511 0 342206 0 0 0 KENNETH FRANCE MD PHYSICIAN 224335 0 37832 0 14697 0 5581 0 19476 0 301921 0 0 0 MICHAEL CELOTTI MD PHYSICIAN 197931 0 80436 0 2340 0 5600 0 19596 0 305903 0 0 0 THOMAS PORTUESE MD PHYSICIAN 235415 0 153795 0 11740 0 5600 0 23915 0 430465 0 0 0 WILLIAM BORGOS MD PHYSICIAN 200375 0 87356 0 9024 0 5600 0 21096 0 323451 0 0 0 WILLIAM PARKER MD PHYSICIAN 119731 0 186144 0 26136 0 5600 0 21408 0 359019 0 0 0 PART I, LINE 7 THE ORGANIZATION PROVIDED BONUSES TO VARIOUS OFFICERS, AND HIGHEST COMPENSATED EMPLOYEES. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B(II). A COUNTIES OF WARREN & WASHINGTON CIVIC DEVELOPMENT CORPORATION 383853734 2014-12-16 6500000 LAND, FACILITY & EQUIPMENT FOR HEALTH CENTER 0 0 0 B CLINTON COUNTY CAPITAL RESOURCE CORPORATION 452521133 2015-12-18 6000000 LAND, FACILITY & EQUIPMENT FOR HEALTH CENTER 0 0 0 C SARATOGA COUNTY CAPITAL RESOURCE CORPORATION 140486153 2018-06-28 6600000 LAND, FACILITY & EQUIPMENT FOR HEALTH CENTER 0 0 0 A 1026864 6500000 154168 6345832 2015 0 0 1 1 B 641168 6000000 146845 5853155 2017 0 0 1 1 C 94400 6600000 118207 6458263 23530 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 A 0 0 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 0 0 C 0 0 0 0 0 0 0 0 0 A 0 B 0 C 0 FORM 990, PART VI, SECTION B, LINE 11B AN INDEPENDENT ACCOUNTANT PREPARES THE 990. AFTER PREPARATION, A COPY OF THE DRAFT RETURN IS PROVIDED TO THE BOARD MEMBERS VIA EMAIL OR AT A BOARD MEETING PRIOR TO SUBMISSION WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS ITS' CONFLICT OF INTEREST POLICY WITH AN ANNUAL UPDATE OF ALL INTEREST THAT COULD POTENTIALLY LEAD TO A CONFLICT OF INTEREST FOR ALL EMPLOYEES. IF A CONFLICT OF INTEREST POTENTIAL IS RECOGNIZED THE BOARD SHALL DETERMINE WHETHER A CONFLICT EXISTS AND WHETHER SUCH DIRECTOR SHOULD ABSTAIN FROM VOTING. FORM 990, PART VI, SECTION B, LINE 15A THE BOARD OF DIRECTORS SETS COMPENSATION FOR THE CEO. THE CEO SETS THE COMPENSATION FOR MEMBERS OF SENIOR MANAGEMENT. THE ORGANIZATION ALSO USES A SURVEY WHERE POSSIBLE, COMPARABLE POSITIONS WITHIN THE REGION, COMPENSATION CONSULTANTS AND BOARD REVIEW. COMPENSATION IS DETERMINED BY A COMBINATION OF SENIOR MANAGEMENT, FINANCE AND HUMAN RESOURCES TO ENSURE FAIRNESS AND CONSISTENCY IN SETTING PAY RATE AND BENEFIT LEVELS. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE AVAILABLE UPON WRITTEN REQUEST. THEY ARE MADE AVAILABLE AT OUR ADMINISTRATIVE OFFICE AT 9 CAREY ROAD, QUEENSBURY, NY. FORM 990, PART XII, LINE 2C: THE SELECTION AND OVERSIGHT PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. FORM 990, PART IV, QUESTION 20A: THE ORGANIZATION IS LICENSED UNDER ARTICLE 28 OF NEW YORK STATE PUBLIC HEALTH LAW. HOWEVER, SUBSECTION 10 OF ARTICLE 28 EXCLUDES CERTAIN HEALTHCARE FACILITIES FROM THE DEFINITION OF GENERAL HOSPITAL. THEREFORE, THE ORGANIZATION IS NOT INCLUDING SCHEDULE H IN THE CURRENT YEAR FORM 990 AS THEY DO NOT MEET THIS DEFINITION. 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