Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2015 | (b) 2016 | (c) 2017 | (d) 2018 | (e) 2019 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2019 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2019 |
(iii) Distributable Amount for 2019 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2019 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2019: | ||||
| a From 2014....... | ||||
| b From 2015....... | ||||
| c From 2016....... | ||||
| d From 2017....... | ||||
| e From 2018....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2019 distributable amount | ||||
|
i
Carryover from 2014 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2019 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2019 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2019, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2019. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2020. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2015..... | ||||
| b Excess from 2016..... | ||||
| c Excess from 2017..... | ||||
| d Excess from 2018..... | ||||
| e Excess from 2019..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 19009572 |
| Software Version: | v1.00 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part IV, Line 32 | During 2019, Healthcare Partners of Saratoga LTD made equity distributions to Albany Medical Center and Saratoga Hospital of $1,600,000 each, totaling $3,200,000. |
| Form 990, Part VI, Section A, Line 7a | Healthcare Partners of Saratoga, LTD (HCP) has two equal members, Saratoga Hospital (SH) and Albany Medical Center Hospital (AMCH). The HCP Board of Directors consists of eight individuals who are either a member of the governing body or management of one of the corporate members of HCP. The governing bodies of SH and AMCH have the right to designate and elect four Directors each to serve on HCP's Board of Directors. |
| Form 990, Part VI, Section B, Line 11b | A draft of the Form 990 and any required supplemental schedules (collectively the "Form 990") is completed by Saratoga Hospital's (SH) Fiscal Services Department. The completed Form 990 is then reviewed by SH's Director, Financial Accounting and Vice President/Chief Financial Officer to ensure compliance with applicable instructions. The initial phase of review by HCP's Board of Directors occurs at a board meeting. Members of the Board are provided with drafts of the Form 990 prior to the meeting. At the meeting, an agenda item is devoted to providing the members with time to ask questions, and to provide comments or suggestions. The Board evaluates the suggestions and comments and the Form 990 is amended, if necessary. A final version is provided to the full Board prior to filing. Once that is completed, it is then filed with the IRS. |
| Form 990, Part VI, Section B, Line 12c | Healthcare Partners of Saratoga, LTD (HCP) maintains two conflict of interest policies. One applies to members of the Board of Directors and members of the medical staff. A second conflict of interest policy applies to contracted personnel who have the ability to influence purchasing decisions aggregating to $100,000 or more annually. The policies provide clear explanations as to who is covered by each policy, what family members and/or ownership interests (including non-financial interests) must be considered in assessing compliance with the policy, definitions of compensation (including non-monetary compensations) and examples of conflicts including activities that must always be avoided. On an annual basis, a conflict of interest disclosure questionnaire process is undertaken. All members of the Board of Directors, members of the medical staff and any other individuals falling within the parameters stated above are required to complete and file the questionnaire with HCP's Compliance Officer. All members of the fee for service medical staff are required to complete and file the questionnaire as part of their biennial credentialing process. Inquiries included on the questionnaire are designed to allow respondents to provide yes/no answers that will allow a determination to be made as to whether any non-compliance with the applicable conflict of interest policy has occurred, or whether there are any situations that my require further investigation. On an annual basis, all responses submitted by all respondents are reviewed in order to determine whether any disclosures are required for HCP's Form 990. The questionnaire includes a section where respondents are asked, for any person or entity that has or may do business with the HCP entities whose relatives have interest or are employed by. Additionally, if a potential conflict is known of, but not disclosed on the questionnaire, these persons/entities are also identified. Any persons or entities disclosed in this area or otherwise deemed to be potential conflicts are referenced against the accounts payable systems for the HCP and its related entities in order to determine whether business was transacted with any of the disclosed entities during the past year. Materiality of any transactions identified is assessed and a determination is made as to whether the transaction of business with any of these entities was made in accordance with the HCP's purchasing and conflict of interest policies (ex. competitively bid, removal of the conflicted person from the decision making process). |
| Form 990, Part VI, Section C, Line 19 | Healthcare Partners of Saratoga, LTD governing documents, conflict of interest policy and financial statements are available to the public upon request. |
| Form 990, Part IX, Line 11g | Prior to July 2018, all physician services and a large portion of physician extender services rendered at Healthcare Partners of Saratoga LTD (HCP) were provided by practicioners employed by Albany Medical College, which is affiliated with Albany Medical Center. Payments for these contract services were made to Albany Medical College. From July 2018 through July 2019, physician services and physician extender services performed by Albany Medical College employees, were paid directly to the provider as independent contractors. Effective August 2019, all physician services and physician extender services rendered at HCP are provided by practitioners employed by Saratoga Hospital. Included in other fee for services is approximately $3,204,561 representing the amount paid for the cost to provide physician staffing at HCP. All non-practitioner staff providing services to HCP are Saratoga Hospital employees. Included in other fees for service is approximately $8,110,931 representing the amount paid to Saratoga Hospital to provide this staffing at HCP. Certain advanced practitioner services purchased from a non-related vendor during 2019 are reflected as Salary Expenses in MMEC (d/b/a for HCP) column in the audited Combined Statement of Operations and Changes in Net Assets for Albany Medical Center and Related entities, in accordance with internal labor cost reporting policies. As the practitioners providing these services were independent contractors these expenses are reflected as Other Fees for Services in Line 11g of this Statement of Functional Expenses. 11g Program Service Expenses Physician Fees $25,000 Contract Labor AMC $3,204,561 Contract Labor PT Access $725,058 Contract Labor All Other $6,056,774 Other Medical Purchased Services $624,450 Other NonMedical Purchased Services $335,480 Management and General Expenses Contract Labor Admin $344,169 |
| Form 990, Part XI, Line 9 | During 2019, Healthcare Partners of Saratoga LTD made equity distributions to Albany Medical Center and Saratoga Hospital in amounts of $1,600,000 each, totaling $3,200,000. |
| Software ID: | 19009572 |
| Software Version: | v1.00 |