2025-11-05T10:06:20-07:00 2024-12-31 990 2024-01-01 141338465 NATHAN LITTAUER HOSPITAL ASSOCIATION NATH 5187258621 99 East State Street Gloversville NY 12078 Mike Ostrander Vice President of Finance & CFO 5187735480 2025-11-14 1 2024 2025-03-06 01:10:19Z Nathan Littauer Hospital and Nursing Home Sean Fadale East State Street Gloversville NY 12078 147206995 0 X www.nlh.org X 1894 NY Nathan Littauer Hospital & Nursing Home and its family of health services is committed to providing safe high quality health and wellness services and improving the health of our communities in a caring, contemporary environment. 14 12 1223 97 1445775 0 5323993 2505325 107015721 113094659 1840268 3397349 2883701 3491373 117063683 122488706 0 0 0 0 81165526 84477559 0 0 376737 50884775 50503054 132050301 134980613 -14986618 -12491907 111820193 104497640 39364927 40413007 72455266 64084633 Nathan Littauer Hospital & Nursing Home and its family of health services is committed to providing safe high quality health and wellness services and improving the health of our communities in a caring, contemporary environment. 0 0 64321724 0 88732173 74 bed general medical surgical hospital providing inpatient and outpatient services with the following service statistics for 2024; 7,681 inpatient days, 931 observation visits, 574 new born days, 2,026 admissions, 292 nursery admissions, 19,665 emergency room visits, 94,644 outpatient visits and 4,364 day surgery visits. 50442776 0 19832491 The Nathan Littauer Hospital and Specialty Care Centers provide care for the whole family. Our twelve conveniently located centers offer a range of services and specialties that include urology, obstetrics, gynecology, podiatry, pulmonology, gastroenterology, pediatrics, and neurology along with direct access to state-of-the-art technology available at Nathan Littauer Hospital. Several Centers are located in remote rural parts of our service area. The Centers employ 45 physicians and over 50 other healthcare professionals. During 2024, the Centers collectively incurred 134,435 patient visits. 10517042 0 4314024 The Nathan Littauer Nursing Home located on the Nathan Littauer Hospital campus is a short and long-term residential healthcare facility that provides a wide range of medical services with 84 beds. In 2024, the facility had a total of 18,416 patient days. 420545 0 2334998 Lifeline is a personal emergency response system providing immediate assistance 24 hours a day 7 days a week. Over 400 subscribers are members of NLHs Lifeline Program. Other community services include community health fairs, speakers bureau, organ donation program and New Visions Program for high school students. Health Insurance Counseling: Nathan Littauer Hospital was awarded and continues to be the Lead Agency for the grant entitled: "Consumer Assistant for the NYS of Health Benefit Exchange" covering Fulton and Montgomery County. During the year of 2024 Nathan Littauer Hospital as Lead Agency the program's was able to enroll a total of 2,596 individuals with the following breakdown: Children's Medicaid - 539, Child Health Plus Program - 309, Adult Medicaid - 804, Adult Quality Health Plan - 323, Essential Plans - 621. Also included here is other operating revenue of $2,334,998. 420545 0 2334998 125702087 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 25 0 1 1223 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 0 0 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X Michael Redcross 5187735481 99 East State Street Gloversville NY 12078 Shri Verma MD Physician 40 0 X 695302 0 37849 Paul Husson MD Member/Employed Physician 40 0 X 679976 0 37849 Hadi Minhas MD Physician 40 0 X 674643 0 38278 David Cohen MD Physician 40 0 X 672899 0 19138 Sean Fadale President and CEO 40 0.25 X X 565368 0 96738 Zainul Syed MD Physician 40 0 X 637481 0 13800 Stephen Little MD Employed Physician 40 0 X 581309 0 38278 Mike Ostrander Vice President of Finance and CFO 40 0.25 X 346908 0 13800 G Jeremiah Ryan PhD Member 0.5 0.25 X 0 0 0 Gregory Truckenmiller PhD Member 0.5 0.25 X 0 0 0 Peter Kiernan Member 0.5 0 X 0 0 0 Susan Johnson Esq Treasurer 0.5 0.25 X 0 0 0 Holly Chamberlin Esq Secretary 0.5 0.25 X 0 0 0 Polly Hoye Member 0.5 0.25 X 0 0 0 John Fox DDS Member 0.5 0.25 X 0 0 0 Tobin Cash Member 0.5 0.25 X 0 0 0 Amy Pedrick Chair 0.5 0.25 X 0 0 0 Diana Marshall Member 0.5 0.25 X 0 0 0 Paul Naslund Vice Chair 0.5 0.25 X 0 0 0 Audrey Kline Member 0.50 0.25 X 0 0 0 Stephen Tomlinson Member 0.5 0.25 X 0 0 0 4853886 0 295730 175 0 1 0 Sodexo Operations PO Box 905374 Charlotte NC 28290 Dietary Services 2424832 Davin Healthcare Workforce 18 Division Street Saratoga Springs NY 12866 Contracted Nursing Services 1175914 Alliance Health Services PO BOX 96485 Chicago IL 60693 Imaging Services 1042245 Health Advocates Network 1875 Corporate Blvd Boca Raton FL 33431 Contract labor 2447144 Gloversville Physician Services PO BOX 82368 Lafayette LA 70598 Physician Services 963998 28 0 0 0 903455 1598921 2949 0 2505325 Inpatient and Outpatient Services 622110 88802768 88732173 70595 0 Primary Care Centers 621400 19832491 19832491 0 0 Nursing Home 623000 4314024 4314024 0 0 Lifeline 621990 145376 145376 0 0 0 0 0 0 113094659 1539043 0 2834 1536209 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 26576095 500 24718289 0 1857806 500 1858306 0 0 1858306 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Retail Pharmacy 459990 1372346 0 1372346 0 340b Pharmacy 900099 1057868 1057868 0 0 Cafeteria Sales 722514 415545 415545 0 0 645614 645614 0 0 3491373 122488706 115143091 1445775 3394515 0 0 0 0 0 0 0 0 1592252 0 1592252 0 0 0 0 0 66147533 62630898 3216049 300586 3226387 3130890 83474 12023 8982452 8368135 574396 39921 4528935 4161100 344840 22995 568549 568549 0 0 193849 0 193849 0 174091 0 174091 0 22251 0 22251 0 0 0 0 0 0 0 8456688 7984439 472249 0 177146 0 177146 0 5649928 5122266 527662 0 0 0 0 0 0 0 0 0 1419580 1418723 857 0 230322 199994 30328 0 0 0 0 0 0 0 0 0 589849 589849 0 0 0 0 0 0 7562438 7230114 332324 0 1921315 1921315 0 0 Medical Supplies 12172422 12172229 193 0 Non-Medical Supplies 1337156 1330225 6931 0 Purchased Services 7453203 6787988 665215 0 Food 937537 937537 0 0 1636730 1147836 487682 1212 134980613 125702087 8901789 376737 2753068 3297257 2194184 1032966 532406 451547 11783543 11017032 0 0 0 0 0 0 804799 762211 1108312 466563 127584966 99585050 32250122 27999916 47632553 45750698 0 0 0 0 0 0 12761206 13719450 111820193 104497640 15184966 15334263 0 0 483570 451345 0 0 0 0 0 0 0 0 0 0 23696391 24627399 39364927 40413007 X 68194703 60408660 4260563 3675973 72455266 64084633 111820193 104497640 X -12491907 1145677 0 0 0 2975597 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 22251 22251 0 Schedule C, Part II-B, Line 1 A portion of the organizations dues for the American Hospital Association, Healthcare Association of New York State and the Iroquois Healthcare Consortium is used for Lobbying purposes. 632500 0 88165 0 0 1353 719312 537821 0 95809 0 0 1130 632500 655081 0 -116139 0 0 1121 537821 560097 0 96200 0 0 1216 655081 481564 0 79449 0 0 946 560067 0 1 0 0 0 0 1103543 1103543 0 58675587 39893309 18782278 0 2106131 1832896 273235 0 61317469 54379086 6938383 0 4382236 3479759 902477 27999916 AWUIL by Board Designation 272685 Agency Funds 68885 Other Assets 1545317 Deferred Finance Costs 10336 Right of Use Assets-Operating Lease 6369792 Deferred Asset 457 Plans 2945861 Prepaid Pension Asset 2506574 13719450 0 Due to Third Parties 4303042 Section 457 Plans 2945861 EHR Reserve 445944 Promissory Notes 10486328 Obligations under Operating Leases 6446224 24627399 X 126609980 1145677 0 0 2975597 4121274 122488706 0 0 0 122488706 134980613 0 0 0 0 0 134980613 0 0 0 134980613 Schedule D, Part V, Line 4 The principle donation is permanently restricted, income generated by the fund can be used toward operations of the hospital. Schedule D, Part X, Line 2 The Hospital is a not-for-profit organization, as described in Section 501c 3 of the Internal Revenue Code (the Code) and is exempt from federal income taxes on related income pursuant to Section 501 (a) of the Code. The Hospital recognizes income tax positions when its more-likely than not that position will be sustainable based on the merits of the position. Recognized tax liabilities are not material to the financial statements as of December 31, 2024 or 2023. Schedule D, Part XI, Line 2d Changes include increases of $2,656,732 for pension related changes other than net periodic pension cost, contributions of capital assets of $903,455, a decrease of $503,731 for changes in net assets for capital grant awards, and a decrease of $80,859 for changes in net assets of the Nathan Littauer Hospital Foundation. 1 1 1 X 1 X 1 1 0 1 1 0 489 156558 8606 147952 0.0011 0 62525 30562140 13655591 16459623 0.1219 0 0 0 0 0 0 0 63014 30718698 13664197 16607575 0.1230 0 0 0 0 0 0 0 0 0 0 0 0 1 134435 30269728 15370571 14889157 0.1103 0 0 0 0 0 0 0 0 0 0 0 0 1 134435 30269728 15370571 14889157 0.1103 1 197449 60988426 29034768 31496732 0.2333 1 0 0 11327228 11550001 -222773 X 1 1 1 1 Nathan Littauer Hospital Association 99 East State Street Gloversville NY 12078 www.nlh.org 1701000H X X X Nathan Littauer Hospital Association 1 0 0 1 X X X X X X X X X 22 1 1 1 1 X https://www.nlh.org/wp-content/uploads/2023/04/CHNA-draft-for-Dec-2022-ver1.pdf X 1 22 1 https://www.nlh.org/wp-content/uploads/2023/04/2022_25_chip_workplan-Fulton-County.pdf 0 0 1 X 200 400 1 1 X X X X 1 X https://www.nlh.org/wp-content/uploads/2024/01/2024-Financial-Assistance-Policy-website.pdf X https://www.nlh.org/wp-content/uploads/2024/01/2024-Financial-Assistance-Application.pdf X https://www.nlh.org/wp-content/uploads/2024/01/2024-Financial-Assistance-Summary.pdf X X X X X X 1 X 0 X X X 1 X 0 0 Schedule H, Part V, Section B, Line 5-Nathan Littauer Hospital Association The Ad Hoc Data Sub-Committee of the Adirondack Rural Health Network (ARHN) drafted a survey to obtain input from the community. ARHN surveyed key informants in the seven county service area, to provide the CHA Committee with input on regional health care needs and priorities. At the June 4, 2021, CHA meeting, it was decided that an Ad Hoc Data Sub-Committee would be created to review tools and processes used by CHA Committee members to develop their Community Health Assessments (CHA) and Community Health Improvement Plans (CHIP), as well as identify ways to enhance the CHA/CHIP process. A primary activity of the Ad Hoc Data Sub-Committee was to collaboratively develop a stakeholder survey. The data subcommittee met four times from mid-July through mid-November 2021. Meetings were held via Webex/Zoom. Attendance ranged from 6 to 10 subcommittee members per meeting, with Fulton County Public Health participating in all. Meetings were also attended by AHI staff from the Adirondack Rural Health Network. The survey was developed through SurveyMonkey and included 14 community health questions as well as several demographic questions. The CHA Committee provided a list of health care, social service, education, government, and service providers (hereafter referred to as community stakeholders) by county to be surveyed. The collected distribution list totaled 806 community stakeholders. An initial email was sent to the community stakeholders in early January 2022 by the CHA Committee partners, introducing and providing a web-based link to the survey. CHA Committee partners released a follow-up email approximately two weeks later after the initial reach out. CHA Committee members were provided the names of all non-respondents for additional follow-up, at partner discretion. To analyze the chosen priority areas, responses were totaled by ARHN and the priority area that received the most responses is listed as the First Choice, followed by the second most responses listed as Second Choice. Fulton County survey participants' first choice was Promote Well-Being and Prevent Mental and Substance Use Disorders and the second choice was Prevent Chronic Disease. After reviewing the survey results and determining their ability to impact the focus areas, Nathan Littauer Hospital and Fulton County Public Health Department selected the priority areas of Prevent Chronic Diseases, with a focus area of Healthy Eating and Food Security and a focus area of Physical Activity for their 2022-2024 service plans. Schedule H, Part V, Section B, Line 6a-Nathan Littauer Hospital Association The Community Health Assessment (CHA) Committee, facilitated by ARHN, is made up of hospitals including; University of Vermont Health Network - Alice Hyde Medical Center, University of Vermont Health Network - Elizabethtown Community Hospital, Glens Falls Hospital, Nathan Littauer Hospital, University of Vermont Health Network - Champlain Valley Physicians Hospital. Schedule H, Part V, Section B, Line 6b-Nathan Littauer Hospital Association The Community Health Assessment Committee is comprised of representatives from organizations other than hospital facilities including; Adirondack Health, Clinton County Health Department, Essex County Public Health, Franklin County Public Health, Fulton County Public Health, Warren County Health Service and Washington County Health Services. Schedule H, Part V, Section B, Line 11-Nathan Littauer Hospital Association After reviewing the survey results and determining their ability to impact the focus areas, Nathan Littauer Hospital and Fulton County Public Health Department selected the priority areas of Prevent Chronic Diseases, with a focus area of #1 Health Eating and Food Security and a focus area of #2 Physical Activity for their 2022-2024 service plans. Concerning focus area #1: Healthy Eating and Food Security, Nathan Littauer Hospital & Nursing Home's goal is to Increase skills and knowledge to support healthy food and beverage choices with an objective of by December 31, 2024. In addition, decrease the percentage of adults ages 18 years and older with obesity (among all adults); and Decrease the percentage of adults who consume less than one fruit and less than one vegetable per day (among all adults). Nathan Littauer Hospital & Nursing Home plans to move HealthLink to NLH main campus and recruit medical staff to re-launch its community service programs. NLH will expand food collection efforts to assist re-stocking local food pantries. NLH will collaborate with FCPH, local organizations, and local media to promote food drive campaigns, such as a "Holiday Food Drive" as well as others during the year. To promote education and awareness NLH will explore video programming led by trained nutritionist/NLH staff advocating affordable, convenient, and nutritional ideas and recipes. The goal is to broadcast programming at healthcare and health-related facilities servicing underserved or low-income members of the community. Continuing an already existing program, NLH will offer a vehicle-service voucher program to address patients with significantly limited transportation access who may need rides to appointments and other necessary locations like food stores. Concerning Priority #2: Physical Activity, the goal is to promote school, child care and worksite environments that increase physical activity. Nathan Littauer Hospital plans to increase physical activity through implementing a combination of worksite-based physical activity policies, programs, or best practices; through multi-component worksite physical activity 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 promotions and information messaging. Specifically Nathan Littauer Hospital & Nursing Home plans to explore physical fitness and exercise programs under the HealthLink service led by activity trainers. Explore or expand counseling services by NLH staff to promote physical activity benefits and (at minimum) annual wellness visits. Lastly, NLH will continue their Walking Challenge program in the main campus grounds and track participation metrics. Schedule H, Part V, Section B, Line 20d-Nathan Littauer Hospital Association The Hospital does not have adequate resources to accurately predict those who would qualify for its Financial Assistance Program. 13 Nathan Littauer Hospital Nursing Home 99 East State Street Gloverville NY 12078 84 Bed Nursing Home. Nathan Littauer Hospital Primary Care 99 East State Street Gloversville NY 12078 Primary/Specialty Care Center (Clinic) Perth Primary Care Center 4100 State Highway 30 Amsterdam NY 12110 Primary/Specialty Care Center (Clinic). Johnstown Primary Care Center 23 South Perry Street Johnstown NY 12095 Primary/Specialty Care Center (Clinic). Mayfield Primary Care Center 2497 State Highway 30 Mayfield NY 12117 Primary/Specialty Care Center (Clinic). Kingsboro GI Center 434 South Kingsboro Ave Extension Johnstown NY 12095 Primary/Specialty Care Center (Clinic). Decker Drive Primary Care Center 9 Decker Drive Johnstown NY 12095 Primary/Specialty Care Center (Clinic). Steele Avenue Primary Care Center 182 Steele Avenue Gloversville NY 12078 Primary/Specialty Care Center (Clinic). Speculator Primary Care Center Route 8 Speculator NY 12164 Primary/Specialty Care Center (Clinic). Caroga Lake Primary Care Center 1840 State Highway 10 Caroga Lake NY 12032 Primary/Specialty Care Center (Clinic). Fonda Primary Care Center 46 East Main Street Fonda NY 12068 Primary/Specialty Care Center (Clinic). Broadalbin Primary Care Center 103 County Highway 138 Broadalbin NY 12025 Primary/Specialty Care Center (Clinic) Amsterdam Primary & Urgent Care Center 375 Golf Course Road Amsterdam NY 12010 Amsterdam Primary/Urgent Care Center: Schedule H, Part I, Line 7 The costing methodology used to calculate the amounts reported in the Table for Line 7 is the ratio of patient cost to patient charges. Schedule H, Part I, Line 7, Column f Bad Debt Expense was not included in Form 990, Part IX, line 25, Column (A), and not subtracted for purpose of calculating the percentage in Schedule H Part I, Line 7 column (f). Schedule H, Part I, Line 7g Subsidized health services reported included details from the Primary/Specialty Care Centers and licensed clinics. The Centers operate despite financial losses to the Organization for at least the last fifteen years. The Hospital is committed to operate the Clinics as a benefit to the community in order address an identified need and to improve access to healthcare, including our remote rural communities. Schedule H, Part III, Section A, Line 2 Due to the adoption of ASU No. 2014-09- Revenue from contracts with Customers (Topic 606) bad debt expense is no longer reported on the audited financial statements. Rather, it is treated as a price concession. Revenue from Contracts with Customers (Topic 606), which outlines a single comprehensive model for entities to use in accounting for revenue arising from contracts with customers and supersedes most current revenue recognition guidance, including industry specific guidance, and requires significantly expanded disclosures about revenue recognition. The core principle of the revenue model is that an entity recognizes revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. Schedule H, Part III, Section A, Line 3 Due to the adoption of ASU No. 2014-09- Revenue from contracts with Customers (Topic 606) bad debt expense is no longer reported on the audited financial statements. Rather, it is treated as a price concession. Revenue from Contracts with Customers (Topic 606), which outlines a single comprehensive model for entities to use in accounting for revenue arising from contracts with customers and supersedes most current revenue recognition guidance, including industry specific guidance, and requires significantly expanded disclosures about revenue recognition. The core principle of the revenue model is that an entity recognizes revenue to depict the transfer of promised goods or services to customers in an amount that reflects the consideration to which the entity expects to be entitled in exchange for those goods or services. Schedule H, Part III, Section A, Line 4 The Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The Hospital maintains records to identify and monitor the level of charity care it provides. Those records include the amount of charges for services and supplies furnished to patients at no charge. The level of charity care, measured on the basis of cost, is approximately $156,558 and $245,905 for 2024 and 2023, respectively. The cost of charity care provided was determined based on the application of the ratio of the Hospital's overall cost to patient charges. Included in net patient service revenue for 2024 and 2023 is approximately $28,000 and $0, respectively in net uncompensated care distributions received from New York State to support the cost of charity care. The Hospital annually conducts a comprehensive assessment of the community and charitable benefits it provides. A copy of the Nathan Littauer Hospital Community Service Report is available on the Hospital's website. Schedule H, Part III, Section B, Line 8 Medicare allowable costs were calculated using a cost to charge ratio based upon the cost finding methodology in the Medicare 2252-10 Cost Report. Community Benefit rationale: The Medicare shortfall should be considered a community benefit because our mission is to promote health in the community and we do not limit the care available to any patient, including those covered by Medicare. We are relieving a government burden by providing care to Medicare patients even though costs exceed reimbursements by $222,773. Tax exempt hospital are expected to participate in the Medicare program. For many of the medical services provided by the Hospital, Medicare does not provide sufficient reimbursement to cover the cost of providing care to our patients, forcing the Hospital to use other funds to cover the deficit. Medicare Cost Reports that hospitals are required to file do not include the costs required to treat all Medicare patients. Therefore, the amount reflected on the Medicare Cost Report differs from actual losses. In 2024, the Hospital realized an additional shortfall of $846,419 resulting from Medicare Advantage and non-PPS Medicare patients. The total shortfall for all types of Medicare patients was $1,069,192. Schedule H, Part III, Section C, Line 9b Requests for Financial Assistance may be made at any point before, during or after the provision of care. Anyone seeking Financial Assistance will be given an application. Financial Assistance requests may be proposed by sources other than the patient, such as patient's physician, family members, social services or hospital personnel. Pending final eligibility determination, Nathan Littauer Hospital will not initiate collection efforts or requests for deposits provided that the responsible party is cooperative with Nathan Littauer Hospital's efforts to get payment from other sources. If initial screening does not disqualify someone for Financial Assistance they will be given an application, which includes instructions on how to apply. Schedule H, Part VI, Line 2 Fulton County Public Health Department and Nathan Littauer Hospital and Nursing Home collaborated to complete their 2022-2024 Community Health Needs Assessment utilizing key informant survey data compiled by Adirondack Rural Health Network. The key informants represent a broad range of sectors, and community interests, and include organizations that represent the medically underserved, low-income, and minority populations. In addition to the key informant responses, the assessment includes quantitative data sources collected and published by New York State, as well as health indicators included on NYS Prevention Agenda Dashboard. The site includes a comprehensive dashboard of community indicators covering over 20 topics in the areas of health, social determinants of health, and quality of life from public secondary data sources. Schedule H, Part VI, Line 3 NLH educates our patient population for our Financial Assistance policy in the following ways: NLH has provided a "Frequently Asked Question" section on our website (www.nlh.org) to answer questions our patients may have. We have posted the complete Charity/Financial assistance policy on our website (www.nlh.org). NLH posts in their registration areas the availability of Financial Assistance and the appropriate contact information to obtain and complete the application process. NLH also provides pamphlets in all of our inpatient and outpatient registration areas literature providing information on insurances and again, providing information on our Financial Assistance program and contact information. NLH has four facilitated enrollers available to assist patients with their application for Medicaid, Quality Health Plan and Child Health Plus. They will also assist patients in completing our charity care application. Our staff has been trained in assisting our patients with obtaining application and providing direction and contact information for the completion of same. Our in-patient statements and our billing agency provides information advising patients to contact our offices to request the application and assistance in its completion. Schedule H, Part VI, Line 4 Nathan Littauer Hospital and Nursing Home is located in a rural area in Upstate New York. Our primary service area is Fulton County with additional services in neighboring Hamilton and Montgomery counties. Within our main service area, Fulton County, 2024 data shows a population of 52,073 a 0.3% decrease since 2023. Of those reporting one race, 91.05% of those residents identified themselves as white. 50.2% of our population are women. Over 22.1% of the population has median age of 65 or older. The median household income in Fulton County is $60,557. Our county has 13.9% of its residents living below the poverty level. 79.65% of the population has a high school degree or higher. The leading industries remain: Educational services, health care and social assistance. Unemployment rates for 2024 are about 4.2%. Major health issues for our region remain, respiratory diseases/childhood asthma, cancers of the lung and colon, lack of physical fitness and nutrition, unintentional injuries, tobacco use, lead poisoning and chronic diseases of the lung and the heart. Of particular note is our aging population and poverty levels, which are much higher than the state average. Our mission is in keeping with the community need as we strive to provide care that is effective, clinically astute, safe and accessible. Schedule H, Part VI, Line 5 The Board of Directors of Nathan Littauer Hospital and Nursing Home is made up of medical and business professionals, all of whom reside in our primary service area. These volunteers give countless hours to the organization in their oversight role. They are involved in the community needs assessment process, in fundraising and in general stewardship. Littauer utilizes excess funds to reinvest in our technology, computerization and facilities to keep our organization safe, efficient and accessible as well as to ensure quality patient care. For example, we used excess funds to support free and low cost education programs offered by Healthlink Littauer. Built a new a Primary Care Center in Fonda NY, added a new Interventional Radiology department among other capital equipment acquisitions and projects in 2017. Most of the funds needed for these projects and purchases were made with operational gains. Schedule H, Part VI, Line 7 New York State. X 1 1 X X X X 0 1 0 0 0 0 0 0 0 Sean Fadale President and CEO 539423 0 0 0 25945 0 72260 0 24478 0 662106 0 0 0 Mike Ostrander Vice President of Finance and CFO 345618 0 0 0 1290 0 13800 0 0 0 360708 0 0 0 Shri Verma MD Physician 691492 0 0 0 3810 0 13800 0 24049 0 733151 0 0 0 David Cohen MD Physician 670919 0 0 0 1980 0 13800 0 5338 0 692037 0 0 0 Paul Husson MD Employed Physician 679527 0 0 0 450 0 13800 0 24049 0 717826 0 0 0 Hadi Minhas MD Physician 674403 0 0 0 240 0 13800 0 24478 0 712921 0 0 0 Zainul Syed MD Physician 633818 0 0 0 3663 0 13800 0 0 0 651281 0 0 0 Stephen Little MD Employed Physician 581039 0 0 0 270 0 13800 0 24478 0 619587 0 0 0 Schedule J, Part I, Line 1a A tax gross-up payment was made to the CEO, Sean Fadale. This amount was treated as taxable compensation, and is reported on Schedule J, Part II, Column (B)(iii). Schedule J, Part I, Line 4 Payments of $58,460 were made on behalf of the CEO, Sean Fadale to a 457(f) plan in 2024, and is included in Schedule J, Part II, Column (C) as Deferred Compensation. Form 990, Part VI, Section A, Line 6 The sole member of the Nathan Littauer Hospital Association is Colonial Healthcare Corp. which shall be represented at all meetings of the Association by the President of the Board of Directors of Colonial Healthcare Corp. or such person designated by the President in writing. Form 990, Part VI, Section A, Line 7b Colonial Healthcare Corp. the sole member of the Nathan Littauer Hospital Association must consent to any changes to the Hospital's bylaws. Form 990, Part VI, Section B, Line 11b The form 990 was presented at a regular meeting of the Board of Directors on October 28, 2025 by Mike Redcross, Director of Finance and Sean Fadale, President and CEO prior to the filing of the form. Form 990, Part VI, Section B, Line 12c The Hospital's Conflict of Interest policy requires the filing of an annual disclosure statement by covered persons. Covered persons are defined as "Any director, officer, member of a committee with governing board delegated powers, or any member of the Capital Acquisition Committee, Pharmacy & Therapeutics Committee. Value Analysis Committee and Hospital employees who have a position which involves the acquisition of equipment and supplies or who authorize payments for such material. The Board or Committee is informed annually of any possible conflicts. The covered person has a duty to disclose the possible conflict when a matter is brought before or the Board or Committee and Board or Committee makes the determination if a conflict actually exists. The conflicted party will not participate in the discussion of the matter at hand and will leave the meeting which a vote of the disinterested parties takes place. The Corporate Compliance Officer and the Chairman of the Board or Committee are responsible for compliance with policy. Form 990, Part VI, Section B, Line 15 The Hospital's Compensation Committee is composed of the Chairman, Vice Chairman and immediate past Chairman of the Board of Directors. All members are independent directors. The Committee utilizes comparable compensation data in its determinations. The compensation of the President (CEO) of the hospital is in the form of a recommendation to the full Board of Directors in an Executive Session of the meeting. Only independent directors are present at the meeting. The Compensation committee also advises and assists the President (CEO) in determining the compensation for senior management of the Hospital using comparative compensation data. Form 990, Part VI, Section C, Line 19 The Hospital publishes an annual report distributed by mail and made available for distribution through a number of public outlets such as civic and social organizations. The report includes condensed financial statements and various statistical data relative to services provided to the community including free clinics, education programs, health fairs, etc. The form 990 is available to the public upon request. The Hospital's governing documents, conflict of interest policy and internal financial statements are not available to the public. Form 990, Part XI, Line 9 Changes include increases of $2,656,732 for pension related changes other than net periodic pension cost, contribution of capital assets of $903,455, a decrease of $503,731 for changes in net assets for capital grant awards and a decrease of $80,859 for changes in net assets of the Nathan Littauer Hospital Foundation. Gloversville Extended Care & Nursing Home Co Inc 99 East State Street Gloversville NY 12078 237065255 Leasing a 84 bed Skilled Nursing Facility NY 501(c)3 Schedule A Line 3 Nathan Littauer Hospital Association 1 NLH Realty Corp 99 East State Street Gloversville NY 12078 141641020 Realty Holding Company NY 501(c)2 Nathan Littauer Foundation 0 Nathan Littauer Foundation 99 East State Street Gloversville NY 12078 141638991 Support the Hospital and promote healthcare NY 501(c)3 Schedule A Line 7 Colonial Healthcare Corporation 0 Nathan Littauer Hospital Auxiliary 99 East State Street Gloversville NY 12078 146086641 Assisting Hospital in promoting healthcare NY 501(c)3 Schedule A Line 12 N/A 0 Colonial Healthcare Corporation PO Box 586 Gloversville NY 12078 141670605 Support & Supplement the activities and goals NY 501(c)3 Schedule A Line 7 N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 Nathan Littauer Foundation c 903455 Payment made to Hospital.