TY 2013 Form 990 Schedule O

efile Public Visual Render ObjectId: 201402209349301240 - Submission: 2014-08-08 TIN: 16-1528554

SCHEDULE O
(Form 990 or 990-EZ)

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 to provide any additional information.
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Attach to Form 990 or 990-EZ.
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Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2013

Open to Public
Inspection

Name of the organization

ADIRONDACK MEDICAL CENTER FOUNDATION

Employer identification number

16-1528554

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 4	THE ORGANIZATION MADE SEVERAL CHANGES TO THE BYLAWS, IN THE FOLLOWING AREAS: (1) THE SECTION REGARDING THE BOARD OF TRUSTEES HAS BEEN MODIFIED IN THE TENURE AND ELECTION SECTIONS, (2) VERBIAGE WAS ADDED TO THE SECTION RELATED TO INTERESTED TRUSTEE TRANSACTIONS TO ADDRESS THE CONFLICTS OF INTEREST POLICY, (3) "QUORUM" WAS MODIFIED, (4) THE DESCRIPTION FOR THE DEVELOPMENT COMMITTEE WAS MODIFIED, (5) A NEW SECTION WAS ADDED FOR THE AUDIT COMMITTEE, WHICH IDENTIFIES THE MEMBERS OF SUCH COMMITTEE, IN ADDITION TO THE FUNCTIONS OF THE COMMITTEE, AND (6) SEVERAL SECTIONS UNDER THE "MISCELLANEOUS" ARTICLE WERE REMOVED.
FORM 990, PART VI, SECTION A, LINE 6	ADIRONDACK MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF THE FOUNDATION.
FORM 990, PART VI, SECTION A, LINE 7A	ADIRONDACK MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF THE ADIRONDACK MEDICAL CENTER FOUNDATION. AS SUCH, ADIRONDACK MEDICAL CENTER APPROVES MEMBERS OF THE ADIRONDACK MEDICAL CENTER FOUNDATION'S BOARD OF TRUSTEES, BYLAWS AND ANNUAL BUDGET.
FORM 990, PART VI, SECTION A, LINE 7B	CERTAIN DECISIONS MADE BY THE ADIRONDACK MEDICAL CENTER FOUNDATION'S BOARD OF TRUSTEES ARE SUBJECT TO APPROVAL BY THE BOARD OF TRUSTEES OF THE ADIRONDACK MEDICAL CENTER.
FORM 990, PART VI, SECTION B, LINE 11	THE 990 IS PRESENTED FOR REVIEW AND APPROVAL BY THE BOARD OF TRUSTEES PRIOR TO FILING THE 990.
FORM 990, PART VI, SECTION B, LINE 12C	STATEMENTS ARE REQUIRED ANNUALLY BY THE BOARD OF TRUSTEES.
FORM 990, PART VI, SECTION B, LINE 15	THE SALARY OF THE EXECUTIVE DIRECTOR IS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES WORKING IN CONJUNCTION WITH THE PRESIDENT/CEO OF ADIRONDACK MEDICAL CENTER BASED UPON THE RECOMMENDATION OF THE CHIEF HR OFFICER (CHRO). THE CHRO USES INDUSTRY SURVEYS SUCH AS THE IROQUOIS SURVEY, COMP DATA SURVEY AND ASSOCIATION OF HEALTHCARE PHILANTHROPY SALARY AND BENEFIT SURVEY.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST.

Return Reference

Explanation

FORM 990, PART VI, SECTION A, LINE 4

THE ORGANIZATION MADE SEVERAL CHANGES TO THE BYLAWS, IN THE FOLLOWING AREAS: (1) THE SECTION REGARDING THE BOARD OF TRUSTEES HAS BEEN MODIFIED IN THE TENURE AND ELECTION SECTIONS, (2) VERBIAGE WAS ADDED TO THE SECTION RELATED TO INTERESTED TRUSTEE TRANSACTIONS TO ADDRESS THE CONFLICTS OF INTEREST POLICY, (3) "QUORUM" WAS MODIFIED, (4) THE DESCRIPTION FOR THE DEVELOPMENT COMMITTEE WAS MODIFIED, (5) A NEW SECTION WAS ADDED FOR THE AUDIT COMMITTEE, WHICH IDENTIFIES THE MEMBERS OF SUCH COMMITTEE, IN ADDITION TO THE FUNCTIONS OF THE COMMITTEE, AND (6) SEVERAL SECTIONS UNDER THE "MISCELLANEOUS" ARTICLE WERE REMOVED.

FORM 990, PART VI, SECTION A, LINE 6

ADIRONDACK MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF THE FOUNDATION.

FORM 990, PART VI, SECTION A, LINE 7A

ADIRONDACK MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF THE ADIRONDACK MEDICAL CENTER FOUNDATION. AS SUCH, ADIRONDACK MEDICAL CENTER APPROVES MEMBERS OF THE ADIRONDACK MEDICAL CENTER FOUNDATION'S BOARD OF TRUSTEES, BYLAWS AND ANNUAL BUDGET.

FORM 990, PART VI, SECTION A, LINE 7B

CERTAIN DECISIONS MADE BY THE ADIRONDACK MEDICAL CENTER FOUNDATION'S BOARD OF TRUSTEES ARE SUBJECT TO APPROVAL BY THE BOARD OF TRUSTEES OF THE ADIRONDACK MEDICAL CENTER.

FORM 990, PART VI, SECTION B, LINE 11

THE 990 IS PRESENTED FOR REVIEW AND APPROVAL BY THE BOARD OF TRUSTEES PRIOR TO FILING THE 990.

FORM 990, PART VI, SECTION B, LINE 12C

STATEMENTS ARE REQUIRED ANNUALLY BY THE BOARD OF TRUSTEES.

FORM 990, PART VI, SECTION B, LINE 15

THE SALARY OF THE EXECUTIVE DIRECTOR IS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES WORKING IN CONJUNCTION WITH THE PRESIDENT/CEO OF ADIRONDACK MEDICAL CENTER BASED UPON THE RECOMMENDATION OF THE CHIEF HR OFFICER (CHRO). THE CHRO USES INDUSTRY SURVEYS SUCH AS THE IROQUOIS SURVEY, COMP DATA SURVEY AND ASSOCIATION OF HEALTHCARE PHILANTHROPY SALARY AND BENEFIT SURVEY.

FORM 990, PART VI, SECTION C, LINE 19

THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST.

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

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2013

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