TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) ROBERT G MAIN JR...................................................................... CHAIR	2.00 ................. 0.00	X	X		0	0	0
(2) KEVIN HART...................................................................... SECRETARY	2.00 ................. 2.00	X	X		0	0	0
(3) THOMAS FITZPATRICK...................................................................... VICE CHAIR	2.00 ................. 0.00	X	X		0	0	0
(4) CAROL MCKEE RN...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0	0
(5) DONNA KISSANE...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0	0
(6) JASON ELLIS...................................................................... TREASURER	2.00 ................. 0.00	X	X		0	0	0
(7) PAUL KOEHLER...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0	0
(8) BRIAN MONETTE...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0	0
(9) BARBARA MONTOUR CPA...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0	0
(10) CRAIG RICHARDS DO...................................................................... BOARD MEMBER	2.00 ................. 0.00	X			0	0	0
(11) MARINA MEDVED...................................................................... BOARD MEMBER	2.00 ................. 43.00	X			0	351,883	26,882
(12) MICHELLE LEBEAU...................................................................... PRESIDENT & COO	10.00 ................. 40.00		X		0	610,683	113,166
(13) MATEJ KOLLAR...................................................................... VP/CFO	20.00 ................. 30.00		X		0	323,937	53,305
(14) DR LISA MARK...................................................................... CHIEF MEDICAL OFFICER	1.00 ................. 44.00			X	0	462,496	50,610
(15) SUSAN BIONDOLILLO...................................................................... AVP OF LONG TERM CARE	45.00 ................. 0.00			X	188,586	0	6,123
(16) LISA L GOODRICH...................................................................... VP MEDICAL GROUP NTWK DEPTS	1.00 ................. 49.00			X	0	416,444	74,035
(17) DR JASON SANDERS...................................................................... UVMMG PRESIDENT & CEO	1.00 ................. 49.00			X	0	508,675	95,551

(A) Name and business address	(B) Description of services	(C) Compensation
CROSS COUNTRY STAFFING INC 5201 CONGRESS AVENUE SUITE 100 - B BOCA RATON,FL33487	PHYSICIAN SERVICES	4,136,443
WEATHERBY LOCUMS INC PO BOX 972633 DALLAS,TX75397	PHYSICIAN SERVICES	814,577
MEDICAL SVCS SUFFOLK CNTY PC 39 MAIN STREET TIBURON,CA94920	PHYSICIAN SERVICES	369,851
ANJNI BHAGAT 756 WEBSTER STREET MALONE,NY12953	PHYSICIAN SERVICES	315,434
HEALTHCARE WORKFORCE LOGISTICS LLC PO BOX 860573 MINNEAPOLIS,MN55486	PHYSICIAN SERVICES	204,601
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 8

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

ALICE HYDE MEDICAL CENTER

Employer identification number

15-0346515

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 on 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.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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 2023 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-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

ALICE HYDE MEDICAL CENTER

Employer identification number

15-0346515

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization ALICE HYDE MEDICAL CENTER

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization ALICE HYDE MEDICAL CENTER		Employer identification number 15-0346515

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization ALICE HYDE MEDICAL CENTER			Employer identification number 15-0346515
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

ALICE HYDE MEDICAL CENTER

Employer identification number

15-0346515

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	995,509	897,940	1,122,767	949,748	872,503
b	Contributions ...
c	Net investment earnings, gains, and losses	244,720	97,569	-224,827	173,019	77,245
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......	1,240,229	995,509	897,940	1,122,767	949,748

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

14.832 %

Term endowment right arrow

85.168 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	2,051,000		2,051,000
b	Buildings ....	43,350,304	20,224,626	23,125,678
c	Leasehold improvements
d	Equipment ....	15,687,155	11,524,213	4,162,942
e	Other .....	3,187,330	1,793,202	1,394,128
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				30,733,748

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)OTHER ASSETS				880,228
(2)OPERATING LEASE RIGHT-OF-USE ASSETS, NET				455,968
(3)ESTIMATED 3RD PARTY RECEIVABLE				6,540,056
(4)SECURITY DEPOSITS AND RESIDENT FUNDS				270,394
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				8,146,646

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
DUE TO RELATED PARTIES	18,936,098
OTHER LIABILITIES	1,177,966
OPERATING LEASE RIGHT-OF-USE-OBLIGATIONS	455,968
ESTIMATED 3RD PARTY PAYOR SETTLEMENTS	8,024,720
ESTIMATED INCURRED BY UNREPORTED MEDICAL CLAIMS	957,326




Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	29,552,078
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART V, LINE 4:	THE FUNDS, AND ALL NET EARNINGS IN ADDITION THERETO, ARE HELD TO BENEFIT CHARITY, EDUCATION, RESEARCH, AND CHILDREN'S PROGRAMS.
PART X, LINE 2:	ALICE HYDE MEDICAL CENTER IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS FOR THE UNIVERSITY OF VERMONT HEALTH NETWORK. PAGE 18 OF THE CONSOLIDATED FINANCIAL STATEMENTS CONTAIN A FOOTNOTE INDICATING THAT NO PROVISION FOR FEDERAL INCOME TAXES HAS BEEN RECORDED.

Schedule D (Form 990) 2022

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization
ALICE HYDE MEDICAL CENTER

Employer identification number

15-0346515

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990) 2023

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 SILENT VIRTUAL AUCTION (event type)	(b) Event #2 5K WALK/RUN (event type)	(c) Other events (total number)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	6,423	14,308		20,731
2	Less: Contributions . . . .	1,250	12,610		13,860
3	Gross income (line 1 minus line 2) . . . . . .	5,173	1,698		6,871

4	Cash prizes . . . . .		400	400
5	Noncash prizes . . . .		389	389
6	Rent/facility costs . . . .	250	250	500
7	Food and beverages . . .
8	Entertainment . . . .		500	500
9	Other direct expenses . . .	1,311	1,418	2,729
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .			4,518
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .			2,353

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2023

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ALICE HYDE MEDICAL CENTER

Employer identification number

15-0346515

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other 25000.0000000000 %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	1,904,290	426,776	1,477,514	1.310 %
b	Medicaid (from Worksheet 3, column a) . . . . .	26,570,707	9,181,002	17,389,705	15.380 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	28,474,997	9,607,778	18,867,219	16.690 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	197,993		197,993	0.180 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	197,993		197,993	0.180 %
k	Total. Add lines 7d and 7j .	28,672,990	9,607,778	19,065,212	16.870 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

3,281,441

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

116,124

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

16,524,145

Enter Medicare allowable costs of care relating to payments on line 5.....

25,037,604

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-8,513,459

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	ALICE HYDE MEDICAL CENTER 133 PARK STREET MALONE,NY12953 WWW.ALICEHYDE.COM 1624000H	X	X	X	X

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	ALICE HYDE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): SEE PART V, SECTION C

Other website (list url): SEE PART V, SECTION C

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 22

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): SEE PART V, SECTION C

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ALICE HYDE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 250.000000000000%
and FPG family income limit for eligibility for discounted care of 400.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE PART V, SECTION C

The FAP application form was widely available on a website (list url):

SEE PART V, SECTION C

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, SECTION C

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	ALICE HYDE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	ALICE HYDE MEDICAL CENTER
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
ALICE HYDE MEDICAL CENTER	PART V, SECTION B, LINE 5: TO HELP INFORM A COLLABORATIVE APPROACH TO IMPROVING COMMUNITY HEALTH, THE ADIRONDACK RURAL HEALTH NETWORK (ARHN) SOUGHT TO IDENTIFY PRIORITIES, FACTORS AND RESOURCES THAT INFLUENCE THE HEALTH OF RESIDENTS OF THE ADIRONDACK REGION (CLINTON, ESSEX, FRANKLIN, FULTON, HAMILTON, WARREN AND WASHINGTON COUNTIES). ARHN SURVEYED STAKEHOLDERS IN THE SEVEN-COUNTY SERVICE AREA, TO PROVIDE THE CHA COMMITTEE WITH INPUT ON REGIONAL HEALTH CARE NEEDS AND PRIORITIES. STAKEHOLDERS INCLUDED PROFESSIONALS FROM HEALTH CARE, SOCIAL SERVICES, EDUCATIONAL, AND GOVERNMENTAL INSTITUTIONS AS WELL AS COMMUNITY MEMBERS. ALICE HYDE MEDICAL CENTER ENGAGED ESSENTIAL CLINICAL STAFF AS PART OF AN INTERNAL PRIORITIZATION COMMITTEE TO ASSESS AND IDENTIFY THE KEY CRITICAL AREAS FOR TARGETED FOCUS AS DETERMINED BY THE 2022 COMMUNITY STAKEHOLDER SURVEY, AND IN SUPPORT OF THE NEW YORK STATE PREVENTION AGENDA. IN ADDITION TO THE VARIETY OF COMMUNITY AND REGIONAL RESOURCES AVAILABLE, ALICE HYDE MEDICAL CENTER (15-0346515) ASSESSED DATA AND PROGRAMS FROM ITS OUTPATIENT PRIMARY CARE PRACTICES, THE EMERGENCY DEPARTMENT AND OTHER KEY HOSPITAL DEPARTMENTS TO FURTHER IDENTIFY AREAS OF FOCUS AND AVAILABLE ASSETS. LEAD STAFF FROM FRANKLIN COUNTY PUBLIC HEALTH, THE UNIVERSITY OF VERMONT HEALTH NETWORK ALICE HYDE MEDICAL CENTER AND ADIRONDACK HEALTH WORKED WITH PARTNERS TO COLLECT ACTIVITIES AND INTERVENTIONS IN SUPPORT OF THE NEW YORK STATE PREVENTION AGENDA. DETERMINATION OF SPECIFIC INTERVENTIONS RELATED TO EACH PRIORITY AREA WAS BASED ON ALIGNMENT WITH THE SPECIFIC GOALS AND OBJECTIVES EACH AGENCY IS COMMITTED TO; OTHER POPULATION HEALTH BASED INITIATIVES OCCURRING WITHIN THE ORGANIZATION; AND ORGANIZATIONAL ABILITY TO MAKE A SUSTAINED IMPACT WITH THE INTERVENTION.
ALICE HYDE MEDICAL CENTER	PART V, SECTION B, LINE 6A: ADIRONDACK HEALTH - ADIRONDACK MEDICAL CENTER
ALICE HYDE MEDICAL CENTER	PART V, SECTION B, LINE 6B: FRANKLIN COUNTY HEALTH DEPARTMENT - PUBLIC HEALTH UNIT
ALICE HYDE MEDICAL CENTER	PART V, SECTION B, LINE 11: ALICE HYDE MEDICAL CENTER IDENTIFIED TWO NYS PREVENTION AGENDA PRIORITY AREAS FOR THE 2022-2024 COMMUNITY SERVICE PLAN CYCLE: (1) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AND (2) PREVENT CHRONIC DISEASE. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO ALICE HYDE MEDICAL CENTER.THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS:PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: PROMOTE WELL BEINGACTION PLAN:INVESTIGATE AND IMPLEMENT COMMUNITY PARTNERSHIPS FOR EXPANDED PRIMARY CARE OFFERINGS IN THE MALONE COMMUNITY TO IMPROVE ACCESS TO CARE. ACHIEVE GERIATRIC EMERGENCY DEPARTMENT (GEDA) ACCREDITATION IN 2022 TO SUPPORT THE NEEDS OF OUR AGING POPULATION. DEVELOP AND PLAN FOR AN ENHANCED/MODERNIZED/REIMAGINED HOSPITAL CAMPUS THROUGH NYS TRANSFORMATION IV GRANT FUNDING. CONTINUE THE ED PEER NAVIGATOR PROGRAM IMPLEMENTED IN AHMC EMERGENCY DEPARTMENT TO PROVIDE ACCESS TO AND COORDINATION OF COMMUNITY BASED RESOURCES FOR PATIENTS FREQUENTING THE ED, WHO NEED ADDITIONAL SERVICES TO MANAGE THEIR HEALTH AND WELL-BEING.PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: MENTAL AND SUBSTANCE USE DISORDER PREVENTIONACTION PLAN:BUILD SUPPORT SYSTEMS TO CARE FOR OPIOID USERS OR AT RISK OF AN OVERDOSE. INTEGRATE TRAUMA INFORMED APPROACHES IN TRAINING STAFF AND IMPLEMENTING PROGRAM AND POLICY. STRENGTHENING RESOURCES FOR FAMILIES AND CAREGIVERS. CONTINUED COORDINATION/COLLABORATION BETWEEN AHMC ED AND THE CITIZEN ADVOCATES' CRISIS INTERVENTION CENTER TO ENSURE PATIENTS PRESENTING TO THE AHMC ED RECEIVE THE APPROPRIATE LEVEL OF CARE. CREATION OF FULLY TRAINED AHMC CISM TEAM (CRITICAL INCIDENT STRESS MANAGEMENT TEAM) IN 2022 TO SUPPORT STAFF, PATIENTS AND FAMILIES EXPERIENCING CRISIS EVENTS. UTILIZE THE EXPERTISE OF THE UVMHN COMMUNICATIONS AND ENGAGEMENT STRATEGIES TEAM TO EDUCATE PROVIDERS, STAFF AND THE BROADER COMMUNITY ON MENTAL AND SUBSTANCE USE DISORDERS AND PREVENTION/EARLY INTERVENTION STRATEGIES. PREVENT CHRONIC DISEASE: HEALTHY EATING AND FOOD SECURITYACTION PLAN:ESTABLISHMENT AND CONTINUED ENHANCEMENT OF EMPLOYEE WELLNESS COMMITTEE (EWC) TO PROMOTE HEALTH AND WELL-BEING FOR ALL EMPLOYEES. COLLABORATE WITH JCEO FOR ONSITE MOBILE FOOD MARKET PROVIDING ACCESS TO HEALTHY FRUITS AND VEGETABLES WEEKLY DURING THE GROWING SEASON. PARTNER WITH LOCAL ORCHARD FOR ONSITE ACCESS TO LOCAL APPLES, HONEY, AND OTHER NATURALLY GROWN PRODUCTS. UTILIZE THE EXPERTISE OF THE UMVHN COMMUNICATION AND ENGAGEMENT STRATEGIES TO CREATE AND PROMOTE MEDIA PIECES SPOTLIGHTING AND EDUCATING STAFF, PATIENTS AND THE COMMUNITY ABOUT THE HEALTH BENEFITS ASSOCIATED WITH HEALTHY EATING.PREVENT CHRONIC DISEASE: PHYSICAL ACTIVITYACTION PLAN:IMPLEMENT A COMBINATION OF WORKSITE-BASED PHYSICAL ACTIVITY POLICIES, PROGRAMS, OR BEST PRACTICES THROUGH MULTI-COMPONENT WORKSITE PHYSICAL ACTIVITY AND/OR NUTRITION PROGRAMS; ENVIRONMENTAL SUPPORTS OR PROMPTS TO ENCOURAGE WALKING AND/OR TAKING THE STAIRS; OR STRUCTURED WALKING-BASED PROGRAMS FOCUSING ON OVERALL PHYSICAL ACTIVITY THAT INCLUDE GOAL-SETTING, ACTIVITY MONITORING, SOCIAL SUPPORT, COUNSELING, AND HEALTH PROMOTION AND INFORMATION MESSAGING. IMPLEMENT AND/OR PROMOTE A COMBINATION OF COMMUNITY WALKING, WHEELING, OR BIKING PROGRAMS.AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR. INVESTIGATE THE ABILITY TO CREATE EMPLOYEE FITNESS CENTER ON CAMPUS. PREVENT CHRONIC DISEASE: TOBACCO PREVENTIONACTION PLAN:IMPLEMENT WORKFLOW TO ENSURE ALL PRIMARY CARE PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE (ALL FORMS) AND REFERRED FOR INTERVENTION SERVICES WITH ONSITE CTCS OR NYS QUITLINE.UTILIZE AHMC COMMUNICATIONS AND ENGAGEMENT STRATEGIES DIVISION TO CREATE CONTENT TO PROMOTE AND EDUCATE SMOKERS ABOUT THE BENEFITS OF EVIDENCE-BASED QUITTING APPROACHES PROMOTE THE GREAT AMERICAN SMOKEOUT INITIATIVE WORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS. WORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS, INCLUDING ACCESS TO CERTIFIED TOBACCO CESSATION SPECIALISTS AS NEEDED AND ALSO COLLABORATE WITH NORTH COUNTRY HEALTHY HEART NETWORK TO CREATE AND PROVIDE EDUCATION OPPORTUNITIES AND TOBACCO CESSATION INTERVENTION MATERIALS FOR HEALTH CARE PROVIDERS AND PATIENTS.PREVENT CHRONIC DISEASE - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT ACTION PLAN:WORK WITH HEALTH CARE PROVIDERS/CLINICS TO PUT SYSTEMS IN PLACE FOR PATIENT AND PROVIDER SCREENING REMINDERS (E.G., LETTER, POSTCARDS, EMAILS, RECORDED PHONE MESSAGES, ELECTRONIC HEALTH RECORDS [EHR] ALERTS). PROMOTE THE USE OF HEALTH INFORMATION TECHNOLOGY FOR: MEASUREMENT, REGISTRY DEVELOPMENT, PATIENT ALERTS, BI-DIRECTIONAL REFERRALS, REPORTING. EXPAND ACCESS TO EVIDENCE-BASED SELF-MANAGEMENT INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC DISEASE (ARTHRITIS, ASTHMA, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES, AND OBESITY) WHOSE CONDITION(S) IS NOT WELL-CONTROLLED WITH GUIDELINES-BASED MEDICAL MANAGEMENT ALONE.CONTINUE TO OPTIMIZE THE EPIC EMR SYSTEM TO ENHANCE PATIENT CARE DELIVERY, MEASUREMENT AND REPORTING. UTILIZE THE EPIC EMR REMINDER SYSTEM IN PRIMARY CARE TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS, INCLUDING MANAGEMENT OF PATIENT ALERTS AND REMINDERS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. CONTINUE TO DELIVER THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM TO EXISTING PATIENTS (INPATIENTS AS IDENTIFIED) TO EDUCATE PATIENTS ON BEST PRACTICE STRATEGIES FOR MANAGING THEIR CHRONIC CONDITION SPECIFICALLY WITH THE FOCUS ON CHF, COPD AND DIABETES, WITH THE GOAL OF REDUCING AVOIDABLE READMISSIONS AND IMPROVING THE HEALTH OF OUR PATIENT POPULATION LIVING WITH CHRONIC DISEASE.ALICE HYDE MEDICAL CENTER'S PRIMARY SERVICE AREA IS IDENTIFIED AS THE THIRTEEN NORTHERN NEW YORK TOWNSHIPS OF: BOMBAY 12914, BRUSHTON 12916, BURKE 12917, CHATEAUGAY 12920, CHURUBUSCO 12923, CONSTABLE 12926, DICKINSON CENTER 12930, LYON MOUNTAIN 12955, MALONE 12953, MOIRA 12957, NORTH BANGOR 12966, OWLS HEAD 12969, AND ST. REGIS FALLS 12980. ALICE HYDE MEDICAL CENTER'S SECONDARY SERVICE AREA IS IDENTIFIED AS THE EIGHT TOWNSHIPS IN THE NORTHWEST PORTION OF THE FRANKLIN COUNTY BORDER INTO ST. LAWRENCE COUNTY, INCLUDING BRASHER FALLS 13613, CHASE MILLS 13621, HOGANSBURG 13655, MADRID 13660, MASSENA 13662, NORFOLK 13667, NORTH LAWRENCE 12967, AND WINTHROP 13697. THESE TWO SERVICE AREAS COMPRISE 95% OF AHMC'S PATIENT ORIGIN AS OF THE LATEST AVAILABLE DATA.
PART V, LINE 7A, HOSPITAL FACILITY'S WEBSITE:	HTTPS://WWW.ALICEHYDE.COM/ABOUT-US/COMMUNITY-SERVICE-PLANPROGRESS REPORTS AVAILABLE FOR 2023 AND 2024 AT THIS WEBSITE
PART V, LINE 7B, OTHER WEBSITES FOR CHNA REPORT:	HTTPS://AHIHEALTH.ORG/ARHN/ HTTPS://COUNTYFRANKLIN.DIGITALTOWPATH.ORG:1007
PART V, LINE 10A, MOST RECENTLY ADOPTED IMPLEMENTATION STARTEGY'S WEBSITE:	HTTPS://WWW.ALICEHYDE.COM/ABOUT-US/COMMUNITY-SERVICE-PLANRESULTS: FOCUS AREAS: PROMOTE WELL-BEING AND PREVENT MENTAL HEALTH AND SUBSTANCE USE DISORDERS PROMOTE WELL-BEING MENTAL AND SUBSTANCE USE DISORDERS PREVENTIONPREVENT CHRONIC DISEASE HEALTH EATING AND FOOD SECURITY PHYSICAL ACTIVITY TOBACCO PREVENTION PREVENTION AND CARE MANAGEMENT2023: (1) BEGAN PARTNERSHIP WITH HUDSON HEADWATERS TO EXPAND ACCESS TO NEEDED PRIMARY CARE SERVICES IN THE GREATER MALONE SERVICE AREA(2) OPENED HOSPITAL FITNESS CENTER FOR EMPLOYEES, WITH 47% ENROLLMENT TO DATE(3) COLLABORATED WITH COMMUNITY CONNECTIONS OF FRANKLIN COUNTY TO HELP CONNECT ED VISITORS WITH VITAL COMMUNITY RESOURCES ADDRESSING SOCIAL DETERMINANTS OF HEALTH NEEDS FOR AHMC PATIENTS(4) EARNED BRONZE STATUS AS GERIATRIC EMERGENCY DEPARTMENT ACCREDIATION (GEDA); THE GOAL IS GOLD STATUS BY 2026(5) SIMULATOR TRAINING OF EMPLOYEES IN OUR MANNEQUIN LAB (MALE, PREGNANT FEMALE, BABY) (6) MENTAL HEALTH INTERVENTION TEAM COMPRISED OF MULTIPLE PROFESSIONAL DISCIPLINES (7) ALICE HYDE PROVIDED COMMUNITY BENEFIT INVESTMENTS IN THE GREATER MALONE COMMUNITY, SPECIFICALLY TO INCREASE OPPORTUNITIES FOR NAVIGATION TO SOCIAL SUPPORTIVE SERVICES PROVIDED BY COMMUNITY CONNECTIONS OF FRANKLIN COUNTY, FRANKLIN COUNTY OFFICE FOR THE AGING, AND NORTH COUNTRY HEALTHY HEART NETWORK2024: (1) HUDSON HEADWATERS HEALTH NETWORK BEGAN SEEING PATIENTS IN RENTED SPACE FROM ALICE HYDE UNTIL THEIR 15,000 SQ FT BUILDING ON OUR CAMPUS IS COMPLETE, WHICH IS PROJECTED FOR DECEMBER 2025(2) CONTINUED WORK WITH OUR ED PEER NAVIGATOR PROGRAM TO PROVIDE SOCIAL SUPPORT SERVICES TO PATIENTS ENTERING THE EMERGENCY DEPARTMENT AS IDENTIFIED THROUGH SDOH SCREENING MECHANISMS (TRANSPORTATION, FOOD, HOUSING, HEAT, HEALTH INSURANCE ENROLLMENT, ETC). A CRISIS CLINICIAN HAS BEEN ADDED TO THE ED STAFFING MODEL TO CONNECT PATIENTS IN NEED WITH CRITICALLY IMPORTANT SERVICES.(3) 28 TRAININGS FOR A TOTAL OF 615 INDIVIDUALS WERE COMPLETED IN THE SIMULATION LAB FOR ACLS, EKG TRAINING, PATIENT ROUNDING, IMMINENT BIRTH SITUATION, MOCK CODE AND EMS SKILLS. THE TRAININGS WERE AVAILABLE TO COMMUNITY HEALTH AGENCY STAFF AND INTERNAL HOSPITAL STAFF.(4) IN RESPONSE TO THE UPTICK IN VIOLENT SITUATIONS IN THE HEALTHCARE ENVIRONMENT, MENTAL HEALTH TRAINING CONTINUES TO BE A PRIORITY FOR STAFF AT ALICE HYDE. AHMC HAS IMPLEMENTED THE RIES TRAINING PROGRAM (RESPONDING TO INTENSE EMOTIONAL SITUATIONS) TO PROVIDE A SAFER ENVIRONMENT FOR EMPLOYEES, PATIENTS AND FAMILIES. 123 EMPLOYEES (17.7%) WERE TRAINED IN DE-ESCALATION TECHNIQUES AND PROVIDED NECESSARY SKILLS FOR RESPONDING TO NON-VIOLENT AND VIOLENT HEALTHCARE INCIDENCES.(5) AHMC BECOMES CRITICAL ACCESS HOSPITAL WITH SWING BED PROGRAM, PROVIDING AN AVENUE FOR PATIENTS TO TRANSITION FROM ACUTE INPATIENT CARE TO SKILLED NURSING AND/OR REHABILITATIVE CARE WITHOUT LEAVING THE HOSPITAL TO ENSURE A SEAMLESS RECOVERY AND TRANSITION HOME.(6) ALL PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE AND REFERRED FOR INTERVENTION SERVICES DURING ANNUAL PHYSICAL APPOINTMENT(7) AHMC IS CURRENTLY IMPLEMENTING A NUMBER OF HIGH VALUE CARE INITIATIVES IN THE PRIMARY CARE PRACTICES. TRACKING AND TRENDING OF DIABETES HBA1C POOR CONTROL, INCREASING COLORECTAL SCREENING RATES AND BREAST CANCER SCREENING RATES, HYPERTENSION BLOOD PRESSURE CONTROL, DEPRESSION SCREENING AND FOLLOW UP, AND MEDICARE ANNUAL WELLNESS VISITS. SUBSTANTIAL PROGRESS IS BEING MADE WITH THESE MEASURES, AND THE GOAL IS TO IDENTIFY CARE GAPS AND IMPROVE THE HEALTH AND WELL-BEING OF OUR PATIENTS.FUTURE PLANS: ALICE HYDE WILL CONTINUE TO PARTNER WITH THE ADIRONDACK RURAL HEALTH NETWORK OF THE ADIRONDACK HEALTH INSTITUTE (AHI-ARHN) AND FRANKLIN COUNTY PARTNERS TO IMPLEMENT THE 2025-2027 CHNA AND CHIP. OUR PATH FORWARD WILL ALIGN WITH THE NEW YORK STATE PREVENTION AGENDA, AND ADDRESS RESULTS OF COUNTY HEALTH INDICATORS FOR FRANKLIN COUNTY RESIDENTS IN ORDER TO IMPROVE HEALTH STATUS AND ADDRESS DISPARITIES IDENTIFIED. THIS WORK IS SET TO KICK OFF MARCH 1, 2025. AHMC WILL FINALIZE ITS PARTNERSHIP WITH HUDSON HEADWATERS AS THEY COMPLETE CONSTRUCTION OF THEIR NEW BUILDING NEAR ALICE HYDE'S CAMPUS. ALICE HYDE WILL CONTINUE TO WORK ON AGE FRIENDLY STRATEGIES OF CARE AND CONTINUE PARTNERING WITH THE CHRONIC DISEASE CARE COORDINATION NETWORK TO ENHANCE CHRONIC DISEASE PREVENTION STRATEGIES AND PROVIDE FREE HEALTH IMPROVEMENT PROGRAMS FOR OUR PATIENTS AND COMMUNITY. AHMC WILL WORK TO MEET AND/OR EXCEED BENCHMARKS IDENTIFIED FOR CANCER SCREENING RATES, ANNUAL WELLNESS VISITS AND A1C THRESHOLD RATES OF THE PATIENTS IN AHMC PRIMARY CARE PANELS IN 2025. A NUMBER OF HIGH VALUE CARE INITIATIVES WILL BE IMPLEMENTED IN 2025-2027 WITH THE GOAL OF IDENTIFYING CARE GAPS TO IMPROVE THE HEALTH AND WELLBEING OF OUR PATIENTS. AHMC WILL PARTNER WITH COMMUNITY AGENCIES TO ADDRESS THE SOCIAL DETERMINANTS OF HEALTH OF OUR PATIENT POPULATION, WITH A FOCUS ON HEALTH EQUITY, INCREASING CHRONIC DISEASE SELF-MANAGEMENT, REDUCING HEALTH DISPARITIES AND INCREASING OUR APTITUDE IN YOUTH AND ADULT MENTAL HEALTH INTERVENTION STRATEGIES AND WELLBEING TRAINING.
PART V, LINE 16A, FAP WEBSITE	HTTPS://WWW.ALICEHYDE.COM/PATIENTS-AND-VISITORS/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE-PROGRAM
PART V, LINE 16B, FAP APPLICATION WEBSITE:	HTTPS://WWW.ALICEHYDE.COM/PATIENTS-AND-VISITORS/PATIENT-FINANCIAL-SERVICES/FINANCIAL-ASSISTANCE-PROGRAM
PART V, SECTION B, LINE 20A:	ALICE HYDE MEDICAL CENTER DOES NOT PURSUE LEGAL ACTION IN ORDER TO COLLECT A DEBT, INCLUDING NOT SELLING DEBT INFORMATION TO ANOTHER PARTY FOR COLLECTIONS, REPORTING TO INDIVIDUAL CREDIT AGENCIES REGARDING PAYMENT STATUS, NOR DOES ALICE HYDE MEDICAL CENTER REFUSE TREATMENT FORPAST DEBT OBLIGATIONS.

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?9
Name and address		Type of Facility (describe)
1	1 - THE ALICE CENTER 45 SIXTH STREET MALONE,NY12953	SKILLED NURSING FACILITY
2	2 - REDDY CANCER TREATMENT CENTER 23 FOURTH STREET STE 1 2 MALONE,NY12953	ONCOLOGY TREATMENT
3	3 - HASTINGS HEMODIALYSIS UNIT 20 FOURTH STREET MALONE,NY12901	OUTPATIENT DIALYSIS
4	4 - BESSETT HEALTH CENTER 6087 STATE ROUTE 11 CHATEAUGAY,NY12920	PRIMARY CARE CLINIC
5	5 - DWYER HEALTH CENTER 969 STATE ROUTE 11 MORIA,NY12957	PRIMARY CARE CLINIC
6	6 - THE MARTIN J LEROUX HEALTH CENTER 577 COUNTY ROUTE 1 FORT COVINGTON,NY12937	PRIMARY CARE CLINIC
7	7 - TOWER HEALTH CENTER 76 NORTH MAIN STREET SAINT REGIS FALLS,NY12980	PRIMARY CARE CLINIC
8	8 - ALICE HYDE WALK-IN CLINIC 134 PARK STREET MALONE,NY12953	URGENT CARE
9	9 - DENTAL CARE CENTER 134 PARK STREET MALONE,NY12953	DENTAL CARE
10

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
PART I, LINE 7:	UTILIZED IS WORKSHEETS FOR SCHEDULE H AND RATIO OF COST TO CHARGES.
PART I, LINE 7, COLUMN (F):	THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,281,441.
PART III, LINE 2:	OUR BAD DEBT METHODOLOGY IS BASED ON HISTORICAL AMOUNTS WHICH WERE TYPICALLY, 3.2% OF NET REVENUE.
PART III, LINE 3:	WE USE THE BAD DEBT EXPENSE AND ALLOCATE BASED ON THE ACTUAL WRITE-OFFS. FY2043 MARKS THE SECOND FULL YEAR OF A NEW ELECTRONIC HEALTH RECORD THAT HELPED REFINE THE METHODOLOGY.
PART III, LINE 4:	SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE. BAD DEBT EXPENSE FOR THE YEARS ENDED SEPTEMBER 30, 2024, AND 2023, WAS NOT SIGNIFICANT. THE ORGANIZATION'S BAD DEBT EXPENSE IS ADDRESSED ON PAGE 22IN FOOTNOTE 4 OF ITS MOST RECENT AUDITED FINANCIAL STATEMENTS.
PART III, LINE 8:	THE MEDICARE BENEFICIARIES WHO ALICE HYDE PROVIDES SERVICES TO ARE PART OF OUR COMMUNITY OF MALONE, NEW YORK, AND THEREFORE, SHOULD BE TREATED AS A COMMUNITY BENEFIT. THE SOURCE FOR THE COST METHODOLOGY IS THE 2024 MEDICARE COST REPORT.THE MEDICAL CENTER EXPERIENCED A SHORTFALL IN MEDICARE REVENUE OVER COSTS. DESPITE THIS SHORTFALL, THE MEDICAL CENTER CONTINUES TO PROVIDE QUALITY CARE TO THE COMMUNITY OF MALONE, NEW YORK.
PART III, LINE 9B:	THE CENTER PROVIDES CARE TO CLIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CENTER'S POLICY IS NOT TO PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE; THEREFORE, THESE AMOUNTS ARE NOT REPORTED IN NET OPERATING REVENUES OR IN PROVISIONS FOR DOUBTFUL ACCOUNTS.
PART VI, LINE 3:	THE ALICE HYDE MEDICAL CENTER (AHMC) BELIEVES THAT FEAR OF A MEDICAL BILL SHOULD NOT PRECLUDE A RESIDENT OF ITS COMMUNITY FROM SEEKING OR OBTAINING ESSENTIAL HEALTH CARE SERVICES. TO HELP THOSE WHO ARE UNINSURED, AHMC PARTNERS WITH VARIOUS ORGANIZATIONS, INCLUDING THE FRANKLIN COUNTY DEPARTMENT OF SOCIAL SERVICES, PUBLIC HEALTH, FIDELIS, AND EXCELLUS, TO ENSURE ACCURATE INFORMATION AND RESOURCES ARE AVAILABLE THROUGHOUT THE COMMUNITY, INCLUDING A FACILITATED ENROLLMENT PROGRAM FOR ITS UNINSURED.THIS PROGRAM ASSISTS THE INDIVIDUAL IN APPLYING FOR STATE SPONSORED HEALTH INSURANCE, INCLUDING MEDICAID AND CHILD HEALTH PLUS. THE GOAL OF THIS INITIATIVE IS TO PROVIDE CONVENIENT LOCATION FOR PATIENTS AND COMMUNITY MEMBERS TO ACCESS THE PROGRAM AND TO PROVIDE ASSISTANCE IN COMPLETING HEALTH INSURANCE APPLICATIONS. THESE GOALS ARE MET THROUGH A PARTNERSHIP BETWEEN AHMC AND ADIRONDACK HEALTH INSTITUTE. AHMC HAS AN EMPLOYEE DEDICATED TO FINANCIAL COUNSELING AND ASSISTANCE.
PART VI, LINE 4:	ALICE HYDE MEDICAL CENTER (AHMC) PRIMARILY SERVES TOWNS, VILLAGES, AND THE NATIVE AMERICAN RESERVATION IN FRANKLIN COUNTY. AHMC'S PRIMARY SERVICE AREA COVERS THE FOLLOWING TOWNS (BY ZIP CODE) - MALONE (12953), NORTH BANGOR (12966), CHATEAUGAY (12920), CONSTABLE (12926), BRUSHTON (12916), MOIRA (12957), BURKE (12917), FORT COVINGTON (12937), HOGANSBURG (13655), SAINT REGIS FALLS (12980), BOMBAY (12914), OWLS HEAD (12969), DICKINSON CENTER (12930). THE SECONDARY SERVICE AREAS SERVED BY AHMC INCLUDE CHURUBUSCO (12923), ELLENBURG CENTER (12934), NORTH LAWRENCE (12967), LYON MOUNTAIN (12955), NICHOLVILLE (12965). IN ADDITION, AHMC PROVIDES SERVICESTO THE INMATE POPULATION FOR THE FRANKLIN COUNTY JAIL AND THE CLINTON, FRANKLIN, UPSTATE, BAREHILL AND ALTONA CORRECTIONAL FACILITIES.
PART VI, LINE 5:	ALICE HYDE MEDICAL CENTER IDENTIFIED TWO NYS PREVENTION AGENDA PRIORITY AREAS FOR THE 2022-2024 COMMUNITY SERVICE PLAN CYCLE: (1) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS AND (2) PREVENT CHRONIC DISEASE. FROM THESE TWO PRIORITY AREAS, ALICE HYDE MEDICAL CENTER DEVELOPED A COMPREHENSIVE ACTION PLAN IN RELATION TO ALICE HYDE MEDICALCENTER.THE TWO PRIORITIES SELECTED FOCUS AREAS, GOALS, OBJECTIVES, AND INTERVENTIONS, AS FOLLOWS:PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: PROMOTE WELL BEINGACTION PLAN:INVESTIGATE AND IMPLEMENT COMMUNITY PARTNERSHIPS FOR EXPANDED PRIMARY CARE OFFERINGS IN THE MALONE COMMUNITY TO IMPROVE ACCESS TO CARE. ACHIEVE GERIATRIC EMERGENCY DEPARTMENT (GEDA) ACCREDITATION IN 2022 TO SUPPORT THE NEEDS OF OUR AGING POPULATION. DEVELOP AND PLAN FOR AN ENHANCED/MODERNIZED/REIMAGINED HOSPITAL CAMPUS THROUGH NYS TRANSFORMATION IV GRANT FUNDING. CONTINUE THE ED PEER NAVIGATOR PROGRAM IMPLEMENTED IN AHMC EMERGENCY DEPARTMENT TO PROVIDE ACCESS TO AND COORDINATION OF COMMUNITY BASED RESOURCES FOR PATIENTS FREQUENTING THE ED, WHO NEED ADDITIONAL SERVICES TO MANAGE THEIR HEALTH AND WELL-BEING.PROMOTE WELL BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: MENTAL AND SUBSTANCE USE DISORDER PREVENTIONACTION PLAN:BUILD SUPPORT SYSTEMS TO CARE FOR OPIOID USERS OR AT RISK OF AN OVERDOSE. INTEGRATE TRAUMA INFORMED APPROACHES IN TRAINING STAFF AND IMPLEMENTING PROGRAM AND POLICY. STRENGTHENING RESOURCES FOR FAMILIES AND CAREGIVERS. CONTINUED COORDINATION/COLLABORATION BETWEEN AHMC ED AND THE CITIZEN ADVOCATES' CRISIS INTERVENTION CENTER TO ENSURE PATIENTS PRESENTING TO THEAHMC ED RECEIVE THE APPROPRIATE LEVEL OF CARE. CREATION OF FULLY TRAINED AHMC CISM TEAM (CRITICAL INCIDENT STRESS MANAGEMENT TEAM) IN 2022 TO SUPPORT STAFF, PATIENTS AND FAMILIES EXPERIENCING CRISIS EVENTS. UTILIZE THE EXPERTISE OF THE UVMHN COMMUNICATIONS AND ENGAGEMENT STRATEGIES TEAM TO EDUCATE PROVIDERS, STAFF AND THE BROADER COMMUNITY ON MENTAL AND SUBSTANCE USE DISORDERS AND PREVENTION/EARLY INTERVENTION STRATEGIES. PREVENT CHRONIC DISEASE: HEALTHY EATING AND FOOD SECURITYACTION PLAN:ESTABLISHMENT AND CONTINUED ENHANCEMENT OF EMPLOYEE WELLNESS COMMITTEE (EWC) TO PROMOTE HEALTH AND WELL-BEING FOR ALL EMPLOYEES. COLLABORATE WITH JCEO FOR ONSITE MOBILE FOOD MARKET PROVIDING ACCESS TO HEALTHY FRUITS AND VEGETABLES WEEKLY DURING THE GROWING SEASON.PARTNER WITH LOCAL ORCHARD FOR ONSITE ACCESS TO LOCAL APPLES, HONEY, AND OTHER NATURALLY GROWN PRODUCTSUTILIZE THE EXPERTISE OF THE UMVHN COMMUNICATION AND ENGAGEMENT STRATEGIES TO CREATE AND PROMOTE MEDIA PIECES SPOTLIGHTING AND EDUCATING STAFF, PATIENTS AND THE COMMUNITY ABOUT THE HEALTH BENEFITS ASSOCIATED WITH HEALTHY EATING.PREVENT CHRONIC DISEASE PHYSICAL ACTIVITYACTION PLAN:IMPLEMENT A COMBINATION OF WORKSITE-BASED PHYSICAL ACTIVITY POLICIES, PROGRAMS, OR BEST PRACTICES THROUGH MULTI-COMPONENT WORKSITE PHYSICAL ACTIVITY AND/OR NUTRITION PROGRAMS; ENVIRONMENTAL SUPPORTS OR PROMPTS TO ENCOURAGE WALKING AND/OR TAKING THE STAIRS; OR STRUCTURED WALKING-BASED PROGRAMS FOCUSING ON OVERALL PHYSICAL ACTIVITY THAT INCLUDE GOAL-SETTING, ACTIVITY MONITORING, SOCIAL SUPPORT, COUNSELING, AND HEALTH PROMOTION ANDINFORMATION MESSAGING. IMPLEMENT AND/OR PROMOTE A COMBINATION OF COMMUNITY WALKING, WHEELING, OR BIKING PROGRAMS.AHMC SPONSORED EVENTS, PROGRAMS AND ENVIRONMENTS THAT SUPPORT THE PROMOTION OF WORKSITE PHYSICAL ACTIVITY AND HEALTHY BEHAVIOR. INVESTIGATE THE ABILITY TO CREATE EMPLOYEE FITNESS CENTER ON CAMPUS.PREVENT CHRONIC DISEASE TOBACCO PREVENTIONACTION PLAN:IMPLEMENT WORKFLOW TO ENSURE ALL PRIMARY CARE PATIENTS ARE SCREENED AND TRACKED FOR TOBACCO USE (ALL FORMS) AND REFERRED FOR INTERVENTION SERVICES WITH ONSITE CTCS OR NYS QUITLINE.UTILIZE AHMC COMMUNICATIONS AND ENGAGEMENT STRATEGIES DIVISION TO CREATE CONTENT TO PROMOTE AND EDUCATE SMOKERS ABOUT THE BENEFITS OF EVIDENCE-BASED QUITTING APPROACHESPROMOTE THE GREAT AMERICAN SMOKEOUT INITIATIVEWORK WITH PRIMARY CARE LEADERSHIP AND PROVIDERS TO PROMOTE THE DELIVERY OF EVIDENCE-BASED CESSATION SERVICES BY HEALTH CARE PROVIDERS TO PATIENTS, INCLUDING ACCESS TO CERTIFIED TOBACCO CESSATION SPECIALISTS AS NEEDED AND ALSO COLLABORATE WITH NORTH COUNTRY HEALTHY HEART NETWORK TO CREATE AND PROVIDE EDUCATION OPPORTUNITIES AND TOBACCO CESSATION INTERVENTION MATERIALS FOR HEALTH CARE PROVIDERS AND PATIENTS.PREVENT CHRONIC DISEASE - CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENTACTION PLAN:WORK WITH HEALTH CARE PROVIDERS/CLINICS TO PUT SYSTEMS IN PLACE FOR PATIENT AND PROVIDER SCREENING REMINDERS (E.G., LETTER, POSTCARDS, EMAILS, RECORDED PHONE MESSAGES, ELECTRONIC HEALTH RECORDS [EHR] ALERTS). PROMOTE THE USE OF HEALTH INFORMATION TECHNOLOGY FOR: MEASUREMENT, REGISTRY DEVELOPMENT, PATIENT ALERTS, BI-DIRECTIONAL REFERRALS, REPORTING. EXPAND ACCESS TO EVIDENCE-BASED SELF-MANAGEMENT INTERVENTIONS FOR INDIVIDUALS WITH CHRONIC DISEASE (ARTHRITIS, ASTHMA, CARDIOVASCULAR DISEASE, DIABETES, PREDIABETES, AND OBESITY) WHOSE CONDITION(S) IS NOT WELL-CONTROLLED WITH GUIDELINES-BASED MEDICAL MANAGEMENT ALONE.CONTINUE TO OPTIMIZE THE EPIC EMR SYSTEM TO ENHANCE PATIENT CARE DELIVERY, MEASUREMENT AND REPORTING. UTILIZE THE EPIC EMR REMINDER SYSTEM IN PRIMARY CARE TO ENSURE COMPLETION OF ANNUAL PATIENT SCREENINGS, INCLUDING MANAGEMENT OF PATIENT ALERTS AND REMINDERS. IMPLEMENT CANCER SCREENING PARTNERSHIP OPPORTUNITIES INCLUDING EDUCATION FOR PROVIDERS. CONTINUE TODELIVER THE CHRONIC DISEASE SELF-MANAGEMENT PROGRAM TO EXISTING PATIENTS (INPATIENTS AS IDENTIFIED) TO EDUCATE PATIENTS ON BEST PRACTICE STRATEGIES FOR MANAGING THEIR CHRONIC CONDITION SPECIFICALLY WITH THE FOCUS ON CHF, COPD AND DIABETES, WITH THE GOAL OF REDUCING AVOIDABLE READMISSIONS AND IMPROVING THE HEALTH OF OUR PATIENT POPULATION LIVING WITH CHRONIC DISEASE.ALICE HYDE MEDICAL CENTER'S PRIMARY SERVICE AREA IS IDENTIFIED AS THE THIRTEEN NORTHERN NEW YORK TOWNSHIPS OF: BOMBAY 12914, BRUSHTON 12916, BURKE 12917, CHATEAUGAY 12920, CHURUBUSCO 12923, CONSTABLE 12926, DICKINSON CENTER 12930, LYON MOUNTAIN 12955, MALONE 12953, MOIRA 12957, NORTH BANGOR 12966, OWLS HEAD 12969, AND ST. REGIS FALLS 12980. ALICE HYDE MEDICAL CENTER'S SECONDARY SERVICE AREA IS IDENTIFIED AS THE EIGHT TOWNSHIPS IN THE NORTHWEST PORTION OF THE FRANKLIN COUNTY BORDER INTO ST. LAWRENCE COUNTY, INCLUDING BRASHER FALLS 13613, CHASE MILLS 13621, HOGANSBURG 13655, MADRID 13660, MASSENA 13662, NORFOLK 13667, NORTH LAWRENCE 12967, AND WINTHROP 13697. THESE TWO SERVICE AREAS COMPRISE 95% OF AHMC'S PATIENT ORIGIN AS OF THE LATEST AVAILABLE DATA.
PART VI, LINE 7, REPORTS FILED WITH STATES	NY

Schedule H (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ALICE HYDE MEDICAL CENTER

Employer identification number

15-0346515

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

Yes

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1MICHELLE LEBEAU PRESIDENT & COO	(i) (ii)	0 ------------- 503,752	0 ------------- 64,499	0 ------------- 42,432	0 ------------- 84,670	0 ------------- 28,496	0 ------------- 723,849	0 ------------- 0
2DR JASON SANDERS UVMMG PRESIDENT & CEO	(i) (ii)	0 ------------- 407,420	0 ------------- 89,269	0 ------------- 11,986	0 ------------- 58,037	0 ------------- 37,514	0 ------------- 604,226	0 ------------- 0
3DR LISA MARK CHIEF MEDICAL OFFICER	(i) (ii)	0 ------------- 428,756	0 ------------- 32,267	0 ------------- 1,473	0 ------------- 19,800	0 ------------- 30,810	0 ------------- 513,106	0 ------------- 0
4LISA L GOODRICH VP MEDICAL GROUP NTWK DEPTS	(i) (ii)	0 ------------- 379,299	0 ------------- 28,723	0 ------------- 8,422	0 ------------- 39,600	0 ------------- 34,435	0 ------------- 490,479	0 ------------- 0
5MARINA MEDVED BOARD MEMBER	(i) (ii)	0 ------------- 325,124	0 ------------- 0	0 ------------- 26,759	0 ------------- 19,800	0 ------------- 7,082	0 ------------- 378,765	0 ------------- 0
6MATEJ KOLLAR VP/CFO	(i) (ii)	0 ------------- 277,133	0 ------------- 23,695	0 ------------- 23,109	0 ------------- 19,737	0 ------------- 33,568	0 ------------- 377,242	0 ------------- 0
7DEBRA PIERCEY ANESTHETIST NURSE	(i) (ii)	248,827 ------------- 0	0 ------------- 0	3,580 ------------- 0	0 ------------- 0	11,557 ------------- 0	263,964 ------------- 0	0 ------------- 0
8CHRISTOPHER HICKEY FORMER SVP/CFO	(i) (ii)	0 ------------- 201,211	0 ------------- 0	0 ------------- 11,145	0 ------------- 11,124	0 ------------- 25,648	0 ------------- 249,128	0 ------------- 0
9DUYEN NGUYEN DENTIST	(i) (ii)	228,579 ------------- 0	0 ------------- 0	955 ------------- 0	6,752 ------------- 0	10,526 ------------- 0	246,812 ------------- 0	0 ------------- 0
10ROBERT STOUT PHYSICIAN ASSISTANT (TIL 04/24)	(i) (ii)	235,443 ------------- 0	0 ------------- 0	966 ------------- 0	6,905 ------------- 0	1,598 ------------- 0	244,912 ------------- 0	0 ------------- 0
11MATT JONES CVPH AVP/ FORMER AHMC COO	(i) (ii)	204,794 ------------- 0	12,508 ------------- 0	437 ------------- 0	6,208 ------------- 0	12,638 ------------- 0	236,585 ------------- 0	0 ------------- 0
12JOHN REMILLARD DEVELOPMENT CONSULTANT	(i) (ii)	227,250 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	227,250 ------------- 0	0 ------------- 0
13SUSAN BIONDOLILLO AVP OF LONG TERM CARE	(i) (ii)	176,613 ------------- 0	9,934 ------------- 0	2,039 ------------- 0	5,299 ------------- 0	824 ------------- 0	194,709 ------------- 0	0 ------------- 0
14EMILE BENARDOT MD FORMER DIRECTOR	(i) (ii)	111,000 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	111,000 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 3	ALICE HYDE MEDICAL CENTER RELIED ON THE UNIVERSITY OF VERMONT HEALTH NETWORK ("UVM HEALTH NETWORK"), THE PARENT ORGANIZATION, TO ESTABLISH SENIOR EXECUTIVE COMPENSATION. UVM HEALTH NETWORK UTILIZED THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE
PART I, LINE 4B	THE UNIVERSITY OF VERMONT HEALTH NETWORK, BY AND THROUGH ITS AFFILIATED SUBSIDIARIES, MAINTAINS A SUPPLEMENTAL RETIREMENT BENEFIT PLAN (SRP) UNDER CONTRACTUAL ARRANGEMENTS WITH SEVERAL PERSONS LISTED ON FORM 990, PART VII, SECTION A, LINE 1A. PURSUANT TO THE TERMS OF THE SRP, ANNUAL CREDITS WERE MADE EQUAL TO A FIXED PERCENTAGE OF BASE SALARY. THE FOLLOWING PERSONS PARTICIPATED IN THE SRP IN CALENDAR YEAR 2023, AND THEIR RESPECTIVE FIXED PERCENTAGE IS DESIGNATED IN PARENTHESES: JASON SANDERS (8.68); MICHELLE LEBEAU (10.04%). DEFERRED AMOUNTS VEST ON THE EARLIER OF: (I) JANUARY 1 OF THE THIRD PLAN YEAR AFTER THE PLAN YEAR FOR WHICH THE ACCOUNT WAS CREATED; OR (II) THE PARTICIPANT'S 65TH BIRTHDAY. SRP DISTRIBUTIONS REFLECTED IN SCH J, PART II, COLS (B)(III) AND (F). FOR THE PLANS NOTED ABOVE, AMOUNTS DEFERRED DURING CALENDAR YEAR 2023 ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. AMOUNTS DEFERRED REMAIN SUBJECT TO FORFEITURE IF CERTAIN CONDITIONS ARE NOT MET.
PART I, LINE 7	ALICE HYDE MEDICAL CENTER PAID AWARDS TO CERTAIN MEMBERS OF UPPER MANAGEMENT (DIRECTORS, VICE PRESIDENTS, PHYSICIAN CHAIRS AND SENIOR EXECUTIVES) THROUGH ITS ANNUAL VARIABLE PAY PLAN AS THE PLAN'S PERFORMANCE MEASURES WERE MET. THE MEASURES WERE REVIEWED AND APPROVED BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THESE MEASURES INCLUDED FINANCIAL, POPULATION HEALTH & QUALITY, AND OPERATIONAL RELATED METRICS.
PART I, LINE 8	SALARIES AND OTHER FIXED AMOUNTS PAYABLE TO EXECUTIVES SUCH AS OFFICERS AND CERTAIN KEY EMPLOYEES ARE SET BY CONTRACTS THAT ARE NEGOTIATED AND ENTERED INTO PRIOR TO THE COMMENCEMENT OF EACH EXECUTIVES' EMPLOYMENT. THE TERMS OF SUCH CONTRACTS ARE APPROVED IN ADVANCE BY THE APPROPRIATE COMPENSATION COMMITTEE OR OTHER BOARD-AUTHORIZED BODY, WHICH OBTAINS AND RELIES ON APPROPRIATE DATA AS TO COMPARABILITY PRIOR TO MAKING SUCH OFFER, AND CONCURRENTLY DOCUMENTS ITS BASIS FOR DETERMINATION.

Schedule J (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ALICE HYDE MEDICAL CENTER

Employer identification number

15-0346515

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No




Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50056A

Schedule L (Form 990) 2023

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) KRISTIN ELLIS-WOOD	SIBLING OF BOARD MEMBER	212,724	KRISTIN ELLIS-WOOD, SISTER TO BOARD MEMBER JASON ELLIS, IS THE AVP OF SUPPORT & PROFESSIONAL SERVICES		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

ALICE HYDE MEDICAL CENTER

Employer identification number

15-0346515

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	MICHELLE LEBEAU, DR. LISA MARK, AND MATEJ KOLLAR WERE EMPLOYED BY CHAMPLAIN VALLEY PHYSICIAN'S HOSPITAL MEDICAL CENTER, A RELATED ORGANIZATION AT WHICH THESE INDIVIDUALS ALSO SERVED AS OFFICERS.
FORM 990, PART VI, SECTION A, LINE 4	EFFECTIVE JANUARY 1, 2024, THE BYLAWS FOR THE ALICE HYDE MEDICAL CENTER ("AHMC") WERE AMENDED IN CONNECTION WITH A NETWORK-WIDE EFFORT TO PROMOTE EFFICIENCY AND STANDARDIZATION IN THE DELIVERY OF MEDICAL SERVICES THROUGH THE CREATION OF A SINGLE, UNIFIED MEDICAL STAFF (THE "MEDICAL STAFF"). THE AMENDMENTS REMOVE PROVISIONS IN THE BYLAWS RELATING TO THE ADMINISTRATION OF A SEPARATE MEDICAL STAFF, INCLUDING PROVISIONS GRANTING THE BOARD OF TRUSTEES AUTHORITY TO APPROVE MEDICAL STAFF AND CREDENTIALS. IN THE PLACE OF THESE PROVISIONS, ADDITIONAL PROVISIONS WERE ADDED RELATING TO THE ADMINISTRATION OF A CAMPUS ADVISORY COMMITTEE OF THE MEDICAL STAFF. THE CHAIR OF THE CAMPUS ADVISORY COMMITTEE SHALL SERVE EX OFFICIO, WITHOUT VOTE, ON THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 6	THE UNIVERSITY OF VERMONT HEALTH NETWORK, INC. (UVMHN) IS THE SOLE MEMBER OF THE ORGANIZATION.
FORM 990, PART VI, SECTION A, LINE 7A	UVM HEALTH NETWORK HAS POWERS TO ELECT ALICE HYDE MEDICAL CENTER'S BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION A, LINE 7B	UVM HEALTH NETWORK HAS THE POWER TO APPROVE SIGNIFICANT CORPORATE ACTIONS, INCLUDING ANNUAL OPERATING AND CAPITAL BUDGETS, STRATEGIC PLANS, THE APPOINTMENT OF THE CEO, THE INCURRENCE OF LONG-TERM INDEBTEDNESS, AMENDMENTS TO ALICE HYDE MEDICAL CENTER'S BYLAWS AND ARTICLES OF THE ORGANIZATION, AND APPROVAL OF MAJOR FINANCIAL DECISIONS INCLUDING MERGERS, BANKRUPTCIES, AND THE DEVELOPMENT OR TERMINATION OF PROGRAM SERVICES. UVM HEALTH NETWORK IS A NON-PROFIT CORPORATION WHICH HAS BEEN RECOGNIZED BY THE IRS AS A 501(C)(3) ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 IS PREPARED BY AN INDEPENDENT OUTSIDE ACCOUNTING FIRM. IT IS PROVIDED TO THE FULL BOARD OF DIRECTORS FOR REVIEW PRIOR TO SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12C	THE ORGANIZATION REGULARLY MONITORS AND ENFORCES COMPLIANCE WITH THE UVM HEALTH NETWORK'S CONFLICT OF INTEREST POLICY, WHICH IT HAS ADOPTED. IN ACCORDANCE WITH THE POLICY, TRUSTEES, OFFICERS, KEY EMPLOYEES AND PHYSICIANS ARE REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE AND CERTIFICATION UPON HIRING, AT LEAST ANNUALLY, PRIOR TO PARTICIPATING IN ANY DECISION THAT MAY BE AFFECTED BY A PERSONAL INTEREST, AND WHENEVER A POTENTIALLY CONFLICTING INTEREST FIRST ARISES. CONFLICT OF INTEREST DISCLOSURES AND CERTIFICATIONS MAY BE MADE ONLINE OR IN WRITING AND ARE REGULARLY REVIEWED BY THE GENERAL COUNSEL. THE CONFLICT OF INTEREST POLICY IS ENFORCED BY THE OFFICE OF GENERAL COUNSEL AND OVERSEEN BY A FIVE-PERSON CONFLICT OF INTEREST COMMITTEE. THE GENERAL COUNSEL REPORTS AT LEAST QUARTERLY ON CONFLICT OF INTEREST ISSUES TO THE AUDIT COMMITTEE OF THE BOARD OF TRUSTEES. CONFLICTS OF INTEREST ARE MANAGED IN ACCORDANCE WITH THE POLICY, WHICH PROVIDES FOR A VARIETY OF REMEDIES TO ADDRESS CONFLICTS OF INTEREST. IN ADDITION, "DISQUALIFIED PERSONS", CONSISTING OF TRUSTEES, OFFICERS AND KEY EMPLOYEES ARE SUBJECT TO SPECIAL PROCEDURES TO COMPLY WITH THE INTERMEDIATE SANCTION RULES, AS OUTLINED IN THE CONFLICT OF INTEREST POLICY. REMEDIES TO ADDRESS CONFLICTS OF INTEREST MAY INCLUDE THE FOLLOWING: RECUSAL FROM DECISION MAKING, DISCLOSURE TO APPROPRIATE PARTIES, COMMITTEE PARTICIPATION LIMITS AND REQUESTED DIVESTITURE. AN APPEALS PROCESS EXISTS SHOULD THE INDIVIDUAL REQUEST A SECONDARY REVIEW BE PERFORMED.
FORM 990, PART VI, SECTION B, LINE 15	ALICE HYDE MEDICAL CENTER DELEGATES THE SETTING OF EXECUTIVE COMPENSATION TO THE UVM HEALTH NETWORK COMPENSATION COMMITTEE, AN INDEPENDENT COMMITTEE, UNDER PRINCIPLES DESCRIBED IN ITS CHARTER. THE HEALTH NETWORK HAS ADOPTED A COMPENSATION PHILOSOPHY WHICH PROVIDES A FRAMEWORK FOR SETTING COMPENSATION FOR THE EXECUTIVES OF UVM HEALTH NETWORK, ITS AFFILIATED HOSPITALS, AND ITS MEDICAL GROUP. THE PARAMETERS OF THIS PHILOSOPHY INCLUDE UTILIZING APPROPRIATE NATIONAL AND REGIONAL PEER GROUPS. SALARIES ARE TARGETED AT THE 50TH PERCENTILE OF THE NATIONAL PEER GROUP, WITH PERFORMANCE BASED VARIABLE PAY OPPORTUNITIES TO ACHIEVE UP TO THE 65TH PERCENTILE, DEPENDING ON ORGANIZATION AND INDIVIDUAL RESULTS. COMPENSATION LEVELS ARE APPROVED BY THE NETWORK COMPENSATION COMMITTEE FOR THE UVM HEALTH NETWORK/DIRECT REPORTS AND THE AFFILIATE HOSPITAL CEOS. CALCULATIONS ARE PERFORMED USING THE SAME PHILOSPHY FOR THE THIRD TIER OF LEADERSHIP. ALL ACTIONS TAKEN REGARDING EXECUTIVE COMPENSATION ARE CONTEMPORANEOUSLY DOCUMENTED BY THE APPROPRIATE ORGANIZATION. THIS REVIEW IS PERFORMED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 18	THE COMPLETED FORMS 1023, 990, AND 5500 FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION C, LINE 19	THE GOVERNING DOCUMENTS, THE CONFLICT OF INTEREST POLICY, AND THE FINANCIAL STATEMENTS FOR THE MEDICAL CENTER ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11G	PURCHASED SERVICES : PROGRAM SERVICE EXPENSES 2,947,279. MANAGEMENT AND GENERAL EXPENSES 6,723,868. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,671,147. TRAVELER/AGENCY FEES: PROGRAM SERVICE EXPENSES 3,495,371. MANAGEMENT AND GENERAL EXPENSES 582,471. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,077,842.
FORM 990, PART XI, LINE 9:	TRANSFER OF NET ASSETS 1,872,400.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ALICE HYDE MEDICAL CENTER

Employer identification number

15-0346515

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)UVM HEALTH NETWORK MEDICAL GROUP 111 COLCHESTER AVE BURLINGTON,VT05401 03-0225105	PHYSICIAN SERVICES	VT	501(C)(3)	LINE 12B, II	UVMHN	Yes
(2)UNIV OF VT MED CTR FOUNDATION INC 111 COLCHESTER AVE BURLINGTON,VT05401 26-3159849	FUNDRAISING	VT	501(C)(3)	LINE 12B, II	UVMMC	Yes
(3)UNIV OF VT MED CTR AUXILLIARY INC 111 COLCHESTER AVE BURLINGTON,VT05401 20-8022004	SERVICE	VT	501(C)(3)	LINE 12D, III-O	N/A		No
(4)UNIV OF VT HEALTH NETWORK 111 COLCHESTER AVE BURLINGTON,VT05401 45-2880726	HOLDING COMPANY	VT	501(C)(3)	LINE 12B, II	N/A		No
(5)CENTRAL VT MEDICAL CENTER 111 COLCHESTER AVE BURLINGTON,VT05401 22-2547186	HOSPITAL	VT	501(C)(3)	LINE 3	UVMHN	Yes
(6)UNIVERSITY HEALTH CENTER 111 COLCHESTER AVE BURLINGTON,VT05401 03-0229931	HOSPITAL	VT	501(C)(3)	LINE 12D, III-O	UVMHNMG	Yes
(7)COMMUNITY PROVIDERS INC 75 BEEKMAN STREET PLATTSBURGH,NY12901 22-2544844	HLTH SVC COORD	NY	501(C)(3)	LINE 12B, II	UVMHN	Yes
(8)CHAMPLAIN VALLEY PHYSICIANS HOSPITAL 75 BEEKMAN STREET PLATTSBURGH,NY12901 14-1338471	HOSPITAL	NY	501(C)(3)	LINE 3	UVMHN	Yes
(9)ELIZABETHTOWN COMMUNITY HOSPITAL 75 PARK STREET ELIZABETHTOWN,NY12901 14-1364513	HOSPITAL	NY	501(C)(3)	LINE 3	UVMHN	Yes
(10)EMERGENCY MEDICAL TRANSPORT OF CVPH INC 75 BEEKMAN STREET PLATTSBURGH,NY12901 06-1718419	AMBULANCE SVC	NY	501(C)(3)	LINE 12C, III-FI	UVMHN	Yes
(11)CVPH MEDICAL CENTER FOUNDATION 75 BEEKMAN STREET PLATTSBURGH,NY12901 14-1727048	HLTH SVC COORD	NY	501(C)(3)	LINE 12C, III-FI	CVPH	Yes
(12)LAKE CHAMPLAIN PHYSICIAN SERVICES PC 75 BEEKMAN STREET PLATTSBURGH,NY12901 27-3785445	PHYSICIAN SERVICES	NY	501(C)(3)	LINE 12B, II	CVPH	Yes
(13)UNIVERSITY MEDICAL EDUCATION ASSOCIATES 89 BEAUMONT AVENUE BURLINGTON,VT05401 23-7107832	EDUCATIONAL	VT	501(C)(3)	LINE 11	UVMHNMG	Yes
(14)PORTER MEDICAL CENTER INC 115 PORTER DRIVE MIDDLEBURY,VT05753 03-0310862	SUPPORTING ORG	VT	501(C)(3)	LINE 12B, II	UVMHN	Yes
(15)HELEN PORTER NURSING HOME 37 PORTER DRIVE MIDDLEBURY,VT05753 03-0306549	NURSING HOME	VT	501(C)(3)	LINE 3	PMC	Yes
(16)AUXILIARY OF PORTER MEDICAL CENTER 37 PORTER DRIVE MIDDLEBURY,VT05753 23-7363227	SUPPORTING ORG	VT	501(C)(3)	LINE 12B, II	PMC	Yes
(17)PORTER HOSPITAL INC 37 PORTER DRIVE MIDDLEBURY,VT05753 03-0181058	HOSPITAL	VT	501(C)(3)	LINE 3	PMC	Yes
(18)VMC INDEMNITY COMPANY INC 95 ST PAUL ST BURLINGTON,VT05401 83-1102018	INSURANCE	VT	501(C)(3)	LINE 12B, II	UVMHN	Yes
(19)UVMHN HOME HEALTH AND HOSPICE 1110 PRIM ROAD COLCHESTER,VT05446 03-0179603	HOME HEALTHCARE	VT	501(C)(3)	LINE 11	UVMHN	Yes

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) UVM HEALTH VENTURES INC 111 COLCHESTER AVE BURLINGTON,VT05401 04-3380045	HOLDING COMPANY	VT	UVMHN	C					No
(2) UVMHN NETWORK CREDENTIALING & ENROLLMENT 111 COLCHESTER AVE BURLINGTON,VT05401 03-0333056	ADMIN SVC	VT	UVMHN VENTURES	C					No
(3) CHARITABLE REMAINDER TRUST (6)	SUPPORT	VT	UVMMCCVMC	T					No
(4) PERPETUAL TRUST (10)	SUPPORT	VT	UVMMC	T					No
(5) CHARITABLE IRREVOCABLE TRUST (8)	SUPPORT	VT	UVMMCCVMC	T					No
(6) CHAMPLAIN VALLEY HEALTH NETWORK 75 BEEKMAN STREET PLATTSBURGH,NY12901 16-1586102	ADMIN SVC	NY	N/A	C					No
(7) MEDIQUEST INC PO BOX 1656 PLATTSBURGH,NY12901 14-1663061	MED OFFICE LEASE	NY	N/A	C					No

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

Yes

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) THE UNIVERSITY OF VERMONT MEDICAL CENTER INC	P	25,795,917	FMV
(2) THE UNIVERSITY OF VERMONT HEALTH NETWORK	P	3,211,457	FMV
(3) VMCIC INC	M	787,456	FMV
(4) CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER	Q	1,858,088	FMV
(5) THE UNIVERSITY OF VERMONT MEDICAL CENTER INC	I	73,881	FMV
(6) THE UNIVERSITY OF VERMONT MEDICAL CENTER INC	Q	1,851,239	FMV

Schedule R (Form 990) 2023

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: TO SERVE THE COMMUNITY THROUGH ACUTE, LONG TERM AND PRIMARY HEALTHCARE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	11
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	898
6	Total number of volunteers (estimate if necessary) .............	6	22
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,138,318	3,131,647
9	Program service revenue (Part VIII, line 2g) .........	89,624,346	108,194,275
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-58,579	96,170
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	2,657,116	3,030,673
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	94,361,201	114,452,765
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	70,829,693	72,472,230
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	34,491,678	43,868,628
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	105,321,371	116,340,858
19	Revenue less expenses. Subtract line 18 from line 12.......	-10,960,170	-1,888,093
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	59,902,936	67,372,089
21	Total liabilities (Part X, line 26).............	56,241,267	63,345,265
22	Net assets or fund balances. Subtract line 21 from line 20.....	3,661,669	4,026,824

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 93,585,078 including grants of $ ) (Revenue $ 110,951,644 )
	ALICE HYDE MEDICAL CENTER PROVIDES PATIENT CARE AS A CRITICAL ACCESS HOSPITAL, GENERAL MEDICAL/SURGICAL HOSPITAL AND SKILLED NURSING FACILITY. ALICE HYDE MEDICAL CENTER PROVIDED INPATIENT SERVICES FOR 856 PATIENTS, PROVIDED 412,350 OUTPATIENT ANCILLARY PROCEDURES, PROVIDED 77,575 PHYSICIAN OFFICE VISITS, AND PROVIDED 43,790 DAYS OF SKILLED NURSING FACILITY CARE, AND 10,704 DAYS OF ASSISTED LIVING FACILITY CARE DURING THE PERIOD.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses93,585,078

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) MATT JONES........................................................................ CVPH AVP/ FORMER AHMC COO	0.00 .......................40.00	X		217,739	0	18,846
(19) ROBERT STOUT........................................................................ PHYSICIAN ASSISTANT (TIL 04/24)	40.00 .......................0.00	X		236,409	0	8,503
(20) DUYEN NGUYEN........................................................................ DENTIST	40.00 .......................0.00	X		229,534	0	17,278
(21) DEBRA PIERCEY........................................................................ ANESTHETIST NURSE	40.00 .......................0.00	X		252,407	0	11,557
(22) JOHN REMILLARD........................................................................ DEVELOPMENT CONSULTANT	40.00 .......................0.00	X		227,250	0	0
(23) CHRISTOPHER HICKEY........................................................................ FORMER SVP/CFO	5.00 .......................5.00		X	0	212,356	36,772
(24) EMILE BENARDOT MD........................................................................ FORMER DIRECTOR	0.00 .......................		X	111,000	0	0

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	1,462,925	2,886,474	512,628

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	13,860
d	Related organizations		1d
e	Government grants (contributions)		1e	2,051,115

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,066,672

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		3,131,647

		Business Code
2a	PATIENT CARE	622000	105,077,498	105,077,498
b	340B REVENUE	900099	3,104,005	3,104,005
c	RETAIL PHARMACY REVENUE	900099	12,772	12,772
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		108,194,275

3 Investment income (including dividends, interest, and othersimilar amounts) ......			88,601			88,601
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	736,111
b	Less: rental expenses	6b	465,160
c	Rental income or (loss)	6c	270,951
d	Net rental income or (loss).......			270,951			270,951
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a	215,721
b	Less: cost or other basis and sales expenses	7b	208,152
c	Gain or (loss)	7c	7,569
d	Net gain or (loss).........			7,569			7,569
8a	Gross income from fundraising events (not including $ 13,860of contributions reported on line 1c). See Part IV, line 18 ....
			8a	6,871
b	Less: direct expenses ...		8b	4,518
c	Net income or (loss) from fundraising events..			2,353			2,353
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	CAFETERIA REVENUE		900099	496,813	496,813
b
c
d	All other revenue ....			2,260,556	2,260,556
e	Total. Add lines 11a–11d ......			2,757,369
12	Total revenue. See instructions.....			114,452,765	110,951,644	0	369,474

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	194,709		194,709
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	212,723		212,723
7	Other salaries and wages........	59,314,803	50,902,474	8,412,329
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	1,944,552	1,690,933	253,619
9	Other employee benefits .......	6,646,461	5,713,687	932,774
10	Payroll taxes ...........	4,158,982	3,564,922	594,060
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	161,190		161,190
c	Accounting ...........	31,818		31,818
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	2,289		2,289
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	13,748,989	6,442,650	7,306,339
12	Advertising and promotion ....
13	Office expenses .......	251,336	134,116	117,220
14	Information technology ......	211,443	884	210,559
15	Royalties ..
16	Occupancy ...........	1,424,488	200,175	1,224,313
17	Travel ............	407,921	363,410	44,511
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	957,004	914,705	42,299
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	3,491,006	2,868,909	622,097
23	Insurance ...	1,281,746	397,296	884,450
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES & PHAR	13,228,367	13,078,499	149,868
b	BAD DEBT EXPENSE	3,281,441	3,281,441
c	REPAIRS AND MAINTENANCE	2,503,372	1,796,201	707,171
d	PROVIDER TAX EXPENSE	1,127,826	1,127,826
e	All other expenses	1,758,392	1,106,950	651,442
25	Total functional expenses. Add lines 1 through 24e	116,340,858	93,585,078	22,755,780	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			1,363,354	1	5,531,921
2	Savings and temporary cash investments .........			3,869,180	2	2,551,049
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			10,853,008	4	11,036,176
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				93,923	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			1,170,888	8	1,198,516
9	Prepaid expenses and deferred charges ......			1,599,183	9	3,665,468
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	64,275,789
b	Less: accumulated depreciation	10b	33,542,041	32,848,327	10c	30,733,748
11	Investments—publicly traded securities .			3,605,330	11	4,492,282
12	Investments—other securities. See Part IV, line 11 .....			16,283	12	16,283
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			4,483,460	15	8,146,646
16	Total assets. Add lines 1 through 15 (must equal line 33)...			59,902,936	16	67,372,089

17	Accounts payable and accrued expenses .....	10,886,995	17	8,060,339
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	27,628,545	23	25,732,848
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	17,725,727	25	29,552,078
26	Total liabilities. Add lines 17 through 25..	56,241,267	26	63,345,265

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	2,484,263	27	3,202,812
28	Net assets with donor restrictions ...........	1,177,406	28	824,012
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	3,661,669	32	4,026,824
33	Total liabilities and net assets/fund balances ........	59,902,936	33	67,372,089