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 | |||||
| (A)
HEALTHALLAINCE HOSPITAL BROADWAY CAMPUS |
141349558 | 3 | Yes | 0 | 0 | |
| (B)
HEALTHALLAINCE HOSPITAL MARY'S AVENUE CAMPUS |
141338470 | 3 | Yes | 0 | 0 | |
| (C)
MARGARETVILLE MEMORIAL HOSPITAL |
150552726 | 3 | Yes | 0 | 0 | |
|
Total 3
|
0 | 0 | ||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (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) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (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) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (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) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (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) |
||||
| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART I, LINE 1 | The mission of HealthAlliance, Inc. is to be the parent organization of not-for-profit healthcare system that provides the highest quality health care services to all the communities it serves. FORM 990, PART III, LINE 2 IN MARCH 11, 2020, THE WORLD HEALTH ORGANIZATION DECLARED COVID-19, THE DISEASE CAUSED BY THE NOVEL CORONAVIRUS, A GLOBAL PANDEMIC AND ON MARCH 13, 2020, PRESIDENT TRUMP DELCARED A NATIONAL EMERGENCY. ON MARCH 22, 2020 GOVENOR ANDREW CUOMO, VIA EXECUTIVE ORDER 202.10, SUSPENDED ALL BUT ESSENTIAL SURGERIES AND PROCEDURES WITHIN NEW YORK STATE AND MOST OUTPATIENT SERVICES WERE CURTAILED. AS A RESULT, HEALTHALLIANCE (HA) EXPERIENCED A SIGNIFICANT REDUCTION IN NET PATIENT SERVICE REVENUE DUE TO VOLUME AND INCREASE IN COSTS FOR SUPPLIES AND OTHER EXPENSES NECESSARY TO TREAT COVID-19 PATIENTS. ELECTIVE SURGERIES RESUMED DURING THE MONTH OF MAY 2020. THE COVID-19 PANDEMIC REQUIRED AN UNPRECEDENTED MOBLIZATION EFFORT ON THE PART OF HA IN ORDER TO APPROPRIATELY CARE FOR COVID-19 PATIENTS WHILE SIMULTANEOULY ENSURING THE SAFETY AND WELL-BEING OF ITS STAFF. THIS EFFORT CUT ACROSS VIRTUALLY ALL DEPARTMENTS AND DISCIPLINES. THIS ENABLED A SIGNIFICANTLY HIGH LEVEL OF OPERATIONAL AND CLINICAL CORRDINATION THAT ALLOWED HA TO ACHIEVE MEANINGFUL ACCESS AND HIGH QUALITY CLINICAL OUTCOMES FOR ITS PATIENTS. THE PROCESSES AND PROCEDURES IMPLEMENTED FOR COVID-19 PROVIDED FOR ADEQUATE SUPPLIES OF PERSONAL PROTECTIVE EQUIPMENT ("PPE") FOR ALL CLINICAL AND NON-CLINICAL STAFF. MARCH 28, 2020 GOVERNOR ANDREW CUOMO OF NEW YORK ANNOUNCED HA HAS BEEN SELECTED TO BE ONE OF THE SELECT HOSPITALS IN THE STATE TO BE A TEMPORARY CARE CENTER FOR PATIENTS. IN REPONSE, ALL SERVICES WERE MOVED OUT OF THE MARY'S AVENUE CAMPUS, TRANSFERRING TO THE BROADWAY CAMPUS AND OTHER NETWORK FACILITIES. THE MARY'S AVENUE CAMPUS WAS TRANSFORMED INTO A COVID CARE HOSPITAL IN ANTICIPATION OF AN INFLUX OF COVID PATIENTS THROUGHOUT NORTHEASTERN NEW YORK. AT THE ONSET OF THE PANDEMIC, NON-ESSENTIAL STAFF WERE SETUP TO WORK FROM HOME AND ACCOMODATIONS WERE MADE FOR STAFF TO FLEX THEIR TIME BETWEEN HOME AND BEING IN THE OFFICE AS NEEDED. ADDITIONAL MANPOWER WAS EMPLOYED TO HELP IN ESSENTAIL AREAS. AS CASES BEGAN IN THE REGION, HA MADE GRADUAL CHANGES TO VISITATION POLICIES, ULTIMATELY RESULTING IN NO VISITORS ON SITE, EXCEPT PEDIATRICS AND END-OF-LIFE CIRCUMSTANCES. FOLLOWING THAT HA BEGAN TO RESCHEDULE ELECTIVE SURGICAL PROCEDURES AND PROVIDED PATIENTS OF THE OUTPATIENT MEDICAL OFFICES THE ABILITY TO SHIFT TO VIRTUAL VISITS. WHILE DOING THIS, HA INCREASED BED CAPACITY. IN ADDITION TO THE INCREASE IN BED CAPACITY, STAFF ADJUSTMENTS INCLUDED THE DEPLOYMENT OF WORK FROM HOME PROCESSES FOR APPROPRIATE NON-CLINICAL, NON-ESSENTIAL STAFF. NON-CLINICAL, NON-ESSENTIAL STAFF WHO COULD NOT WORK FROM HOME WERE REDEPLOYED TO ASSIST IN OTHER AREAS OF THE FACILITIES. THROUGHOUT THE PANDEMIC SURGE, HA FLEXED ORGANIZATION OPERATIONS AND STAFFING TO MEET THE DEMANDS AND NEEDS OF ITS COMMUNITY AND PATIENTS. THESE SUCCESSFUL OPERATIONAL ADJUSTMENTS ALLOWED HA TO MAINTAIN INTERNAL AND EXTERNAL COMMUNICATION AND QUICKLY DEVELOP PROCESSES TO TEST AND TREAT PATIENTS. HA WORKED WITH LOCAL AND REGIONAL RESOURCES TO COMPLY WITH APPROPRIATE GUIDELINES FOR COVID-19 RELATED RELIEF FUNDS. THIS FUNDING INCLUDED: - DEPARTMENT OF HEALTH & HUMAN SERVICES, AS PART OF THE CARES ACT ALLOCATED $20.9 MILLION TO HA THROUGH DECEMBER 2020. - IN ADDITION, HA RECEIVED $24.1 MILLION IN MEDICARE ADVANCE FUNDS AND WAS ABLE TO SECURE AN EMPLOYEE RETENTION CREDIT OF APPROXIMATELY $847,000. Form 990, Part VI, Line 6 WMC HEALTH NETWORK - ULSTER, INC. IS THE SOLE CORPORATE MEMBER OF HEALTHALLIANCE,INC. |
| FORM 990, PART VI, LINE 7A | WMC HEALTH NETWORK - ULSTER, INC. (THE MEMBER) HAS THE POWER TO APPOINT ALL DIRECTORS, OTHER THAN THOSE DIRECTORS WHO SERVE EX OFFICIO. EFFECTIVE MARCH 30, 2016, HEALTHALLIANCE, INC. ENTERED INTO AN AFFILIATION AGREEMENT WITH WESTCHESTER COUNTY HEALTH CARE CORPORATION (WCHCC), D/B/A WESTCHESTER MEDICAL CENTER HEALTH NETWORK (WMC). WMCHEALTH NETWORK - ULSTER, INC. BECAME THE SOLE CORPORATE MEMBER OF HEALTHALLIANCE, INC. |
| FORM 990, PART VI, LINE 7B | WMC HEALTH NETWORK - ULSTER, INC. HAS THE FOLLOWING POWERS: (A) APPOINT AND DISMISS MANAGEMENT-LEVEL EMPLOYEES; (B) NEGOTIATE PAYOR AND MANAGED CARE CONTRACTS; (C) APPROVE ANNUAL CAPITAL AND OPERATING BUDGETS; AND (D) APPROVE OPERATING POLICIES AND PROCEDURES. |
| FORM 990, PART VI, LINE 11B | THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S TAX ADVISORS WITH ASSISTANCE FROM THE ORGANIZATION'S FINANCE DEPARTMENT AND OTHER DEPARTMENTS THROUGHOUT THE ORGANIZATION. THE FORM 990 WAS REVIEWED BY SENIOR MANAGEMENT. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PROVIDED TO THE BOARD OF THE ORGANIZATION FOR APPROVAL PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, LINE 12C | THE ORGANIZATION MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY MEANS OF A SURVEY DEVELOPED AND APPROVED BY THE CHIEF COMPLIANCE OFFICER OF WESTCHESTER MEDICAL CENTER, AN AFFILIATED ORGANIZATION. THE SURVEY IS SENT TO ALL TRUSTEES, OFFICERS, AND KEY EXECUTIVES FOR COMPLETION. ALL SURVEY RESPONSES ARE REVIEWED BY THE CHIEF COMPLIANCE OFFICER. ANY POTENTIAL CONFLICTS IDENTIFIED IN THE RESPONSES ARE DISCUSSED WITH SENIOR MANAGEMENT AND/OR REFERRED TO THE WMCHEALTH CONFLICTS OF INTEREST COMMITTEE FOR DISCUSSION. POTENTIAL ACTIONS TO BE TAKEN IN RESPONSE TO A CONFLICT CAN BE ONE OR MORE OF THE FOLLOWING: 1) DISCLOSURE OF THE CONFLICT, 2) INDIVIDUAL RECUSAL FROM DECISIONS FOR TRANSACTIONS WHERE THAT INDIVIDUAL MAY HAVE A CONFLICT, 3) REQUEST IN WRITING THE INDIVIDUAL ALLEVIATES THE CONFLICT, OR 4) REMOVAL OF THE INDIVIDUAL FROM EMPLOYMENT. |
| FORM 990, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | TRANSFER FROM AFFILIATES $903,134 |
| Software ID: | |
| Software Version: |