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 990-EZ or to provide any additional information.
MediumBullet Attach to Form 990 or 990-EZ.
MediumBullet Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.
OMB No. 1545-0047
2016
Open to Public
Inspection
Name of the organization
HUDSON HEADWATERS HEALTH NETWORK INC
 
Employer identification number

14-1628237
Return Reference Explanation
Form 990, Part VI, Section B, line 11b An independent accountant prepares the 990. After preparation, a copy of the draft return is provided to the Board Members via email or at a Board meeting prior to submission with the IRS.
Form 990, Part VI, Section B, line 12c The organization regularly and consistently monitors its' conflict of interest policy with an annual update of all interest that could potentially lead to a conflict of interest for all employees. If a conflict of interest potential is recognized the board shall determine whether a conflict exists and whether such director should abstain from voting.
Form 990, Part VI, Section B, line 15a the board of directors sets compensation for the CEO. the ceo sets the compensation for members of senior management. the organization also uses a survey where possible, comparable positions within the region, compensation consultants and board review. Compensation is determined by a combination of senior management, finance and human resources to ensure fairness and consistency in setting pay rate and benefit levels.
Form 990, Part VI, Section C, line 19 Documents are Available upon written request. They are made available at our administrative office at 9 Carey Road, Queensbury, NY.
Form 990, Part XII, Line 2C: The selection and oversight Process did not change from the prior year.
Form 990, Part IV, question 20a: The organization is licensed under article 28 of New York State Public Health Law. However, subsection 10 of article 28 excludes certain healthcare facilities from the definition of general hospital. Therefore, the organization is not including schedule H in the current year form 990 as they do not meet this definition.
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.
Cat. No. 51056K
Schedule O (Form 990 or 990-EZ) 2016


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