2024-11-14T11:40:31-06:00 2023-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL ROCHESTER NY 14534 990 2023-01-01 161279472 ST LAWRENCE HEALTH FOUNDATION INC CANT 3152615410 29 GROVE STREET POTSDAM NY 136762051 KELLY J CICCHINELLI MBA SLH VP OF FINANCE 3152615410 2024-11-12 1 1 CHELSEY WYANT P01336644 5853811000 2024-11-12 2023 2024-10-15 13:58:12Z APRIL GRANT 29 GROVE STREET POTSDAM NY 136762051 9805607 0 X WWW.STLAWRENCEHEALTHSYSTEM.ORG X 1985 NY THE FOUNDATION'S PRIMARY PURPOSE IS TO SOLICIT, RECEIVE AND ADMINISTER GIFTS AND BEQUESTS MADE ON BEHALF OF CANTON-POTSDAM HOSPITAL, GOUVERNEUR HOSPITAL, AND MASSENA HOSPITAL. 17 16 0 5 0 0 376194 1270258 0 0 1058792 953890 228699 328783 1663685 2552931 46495 241937 0 0 0 0 0 0 344128 571643 625627 618138 867564 1045547 1685367 30633797 34229630 2539948 2371684 28093849 31857946 THE FOUNDATION'S PRIMARY PURPOSE IS TO SOLICIT, RECEIVE AND ADMINISTER GIFTS AND BEQUESTS MADE ON BEHALF OF CANTON-POTSDAM HOSPITAL, GOUVERNEUR HOSPITAL, AND MASSENA HOSPITAL. 0 0 255148 241937 ADMINISTRATION OF GIFTS MADE TO THE ST. LAWRENCE HEALTH FOUNDATION FOR THE BENEFIT OF THE AFFILIATED HOSPITALS. 255148 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 21 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 17 16 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X KELLY CICCHINELLI 3152615102 50 LEROY STREET POTSDAM NY 13676 X JOSEPH FITZSIMONNS CHAIR OF THE BOARD 1.00 0.00 X X 0 0 0 BROOKS WASHBURN VICE CHAIR 1.00 0.00 X X 0 0 0 ANGELA GRAY TREASURER 1.00 0.00 X X 0 0 0 RYAN NILES DIRECTOR 1.00 0.00 X 0 0 0 MARY ANN HEALEY SECRETARY 1.00 0.00 X X 0 0 0 RICHARD BURNS DIRECTOR 1.00 0.00 X 0 0 0 SHELBY CONNELLY DIRECTOR 1.00 0.00 X 0 0 0 STEPHEN EASTER DIRECTOR 1.00 0.00 X 0 0 0 MARK GOODNOW DIRECTOR 1.00 0.00 X 0 0 0 STACEY HOWLETT DIRECTOR 1.00 0.00 X 0 0 0 SUSAN KIRWAN DIRECTOR 1.00 0.00 X 0 0 0 WILLIAM MELCHOIR DIRECTOR 1.00 0.00 X 0 0 0 JAY SCHECHTER DIRECTOR 1.00 40.00 X 0 22609 0 THOMAS ADAMS DIRECTOR 1.00 1.00 X 0 0 0 SHAWN BURNS DIRECTOR 1.00 1.00 X 0 0 0 JODI CANFIELD DIRECTOR 1.00 1.00 X 0 0 0 PENELOPE RATTAN DIRECTOR 1.00 1.00 X 0 0 0 JENNIFER ESLINGER MEMBER APPOINTMENT 0.00 55.00 X 0 1294014 11368 KELLY MCCORMICK-SULLIVAN PRESIDENT, RRH FOUNDATIONS 0.00 55.00 X 0 314344 11176 KELLY GAGAN PRESIDENT, RRH FOUNDATIONS 0.00 55.00 X 0 229849 51 0 1860816 22595 0 0 1 0 0 9600 1260658 1270258 547434 547434 532395 299150 233245 233245 233245 7348684 6942228 406456 406456 406456 106836 9600 11298 95538 95538 2552931 0 0 1282673 X 241937 241937 398313 13211 213359 171743 5830 5830 162836 162836 6735 6735 1738 1738 536 536 7728 5747 1981 DONOR RECOGNITION AND C 24759 24759 BAD DEBT 15226 15226 1926 1926 867564 255148 268288 344128 1352022 1278808 721343 273181 18829 71 9768974 2975813 7047782 6793161 22210189 25091143 4975 71923 30633797 34229630 119628 47180 1870000 1690000 550320 634504 2539948 2371684 X 27963849 30570690 130000 1287256 28093849 31857946 30633797 34229630 1685367 2078730 0 X X 0 1 X 1 0 X X X 3 CANTON-POTSDAM HOSPITAL 161012691 3 1 241937 0 GOUVERNEUR HOSPITAL 464249555 3 1 0 0 MASSENA HOSPITAL 843134268 3 1 0 0 3 241937 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 130000 1249193 91937 1287256 130000 130000 0.00000 0.00000 1.00000 0 0 9761923 2970369 6791554 7051 5444 1607 6793161 DUE TO AFFILIATES 634504 634504 X 4930811 2078730 299150 2377880 2552931 0 2552931 1166714 299150 299150 867564 0 867564 PART X, LINE 2: THE FOUNDATION IS A NOT-FOR-PROFIT ORGANIZATION EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS CLASSIFIED BY THE INTERNAL REVENUE SERVICE AS A PRIVATE FOUNDATION. THE FOUNDATION HAS CONSIDERED THE RECOGNITION REQUIREMENTS FOR UNCERTAIN INCOME TAX POSITIONS. THE FOUNDATION BELIEVES THAT ITS INCOME TAX FILING POSITIONS WOULD BE SUSTAINED UPON EXAMINATION AND DOES NOT ANTICIPATE ANY ADJUSTMENTS THAT WOULD RESULT IN A MATERIAL ADVERSE EFFECT ON THE FOUNDATION'S FINANCIAL CONDITION. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 299,150. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 299,150. GALA 116436 9600 106836 400 8060 2838 116436 9600 106836 400 8060 2838 11298 95538 1 CANTON POTSDAM HOSPITAL 50 LEROY ST POTSDAM NY 13676 161012691 501C3 241937 0 PROJECT FUNDING 1 PART I, LINE 2: PART II - ALL CONTRIBUTIONS ARE GIVEN SOLELY TO RELATED EXEMPT ORGANIZATIONS. 0 0 0 0 0 0 0 0 0 JENNIFER ESLINGER MEMBER APPOINTMENT 0 748219 0 545795 0 0 0 0 0 11368 0 1305382 0 0 KELLY MCCORMICK-SULLIVAN PRESIDENT, RRH FOUNDATIONS 0 106627 0 70616 0 137101 0 0 0 11176 0 325520 0 0 KELLY GAGAN PRESIDENT, RRH FOUNDATIONS 0 229849 0 0 0 0 0 0 0 51 0 229900 0 0 PART I, LINE 3: PAY RANGE DATA FOR THE PRESIDENT IS DETERMINED BASED ON COMPARABILITY DATA PROVIDED BY THE HOSPITAL'S HUMAN RESOURCES DEPARTMENT. PAY WITHIN THAT RANGE IS DETERMINED BASED ON LONGEVITY AND QUANTIFIED BASED ON PERFORMANCE REVIEW COMPLETED BY THE VICE PRESIDENT, WITH INPUT FROM THE BOARD. PART II, COLUMN C: RETIREMENT AND OTHER DEFERRED COMPENSATION - THIS COLUMN IS REFLECTIVE OF THE ACTUARIAL CHANGE IN DEFINED BENEFIT PENSION PLAN AND POST-RETIREMENT BENEFITS FOR THE TAX YEAR. A ST LAWRENCE COUNTY IDC 272614310 2010-08-30 3585000 SEE PART VI 0 1 0 A 1895000 3585000 3585000 1 0 0 1 A 0 0 0 0 0 0 1 A 0 0 0 0 1 0 0 0 1 A 1 PART I, LINE A - PROCEEDS OF THE FOUNDATION BONDS WERE ISSUED TO FINANCE THE ACQUISITION, CONSTRUCTION AND EQUIPPING OF MEDICAL FACILITIES OWNED BY CANTON-POTSDAM HOSPITAL FOUNDATION, INC. (THE "FOUNDATION") WHICH ARE LEASED TO CANTON-POTSDAM HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING, A COPY OF THE FORM 990 IS PROVIDED TO, AND REVIEWED WITH, ALL MEMBERS OF THE AUDIT AND COMPLIANCE COMMITTEE. THIS REVIEW IS PREFORMED IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AND OTHER RELEVANT INFORMATION FOR THE APPROPRIATE TIME PERIOD. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS ANNUALLY RENEW THE CODE OF CONDUCT AND CONFLICT OF INTEREST DISCLOSURE STATEMENTS. FORM 990, PART VI, SECTION B, LINE 15 PAY RANGE DATA FOR THE EXECUTIVE DIRECTOR IS DETERMINED BASED ON COMPARABILITY DATA PROVIDED BY THE HOSPITAL'S HUMAN RESOURCES DEPARTMENT. PAY WITHIN THAT RANGE IS DETERMINED BASED ON LONGEVITY AND QUANTIFIED PERFORMANCE REVIEW COMPLETED BY THE VICE PRESIDENT, WITH INPUT FROM THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATIVE OFFICES OF THE AFFILIATED HEALTH SYSTEM AT 100 KING HIGHWAY SOUTH, ROCHESTER, NY 14617. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED. FORM 990, PART VII, SECTION A, COLUMN (F): ESTIMATED AMOUNT OF OTHER COMPENSATION FROM THE ORGANIZATION AND RELATED ORGANIZATIONS - THIS COLUMN IS REFLECTIVE OF (1) THE ACTUARIAL CHANGE IN DEFINED BENEFIT PENSION PLAN AND POST-RETIREMENT BENEFITS FOR THE TAX YEAR AND (2) NON-TAXABLE BENEFITS. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 13,211. MANAGEMENT AND GENERAL EXPENSES 191,025. FUNDRAISING EXPENSES 171,743. TOTAL EXPENSES 375,979. REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 22,334. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,334. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CANTON-POTSDAM HOSPITAL 50 LEROY STREET POTSDAM NY 13676 161012691 HOSPITAL NY 501(C)(3) LINE 3 ST LAWRENCE HEALTH SYSTEM INC 1 GOVEURNEUR HOSPITAL 77 WEST BARNEY STREET GOUVERNEUR NY 13642 464249555 HOSPITAL NY 501(C)(3) LINE 3 ST LAWRENCE HEALTH SYSTEM INC 1 MASSENA HOSPITAL INC 1 HOSPITAL DRIVE MASSENA NY 13662 843134268 HOSPITAL NY 501(C)(3) LINE 3 ST LAWRENCE HEALTH SYSTEM INC 1 0 1 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 CANTON-POTSDAM HOSPITAL B 241937 FMV CANTON-POTSDAM HOSPITAL L 94076 FMV CANTON-POTSDAM HOSPITAL J 532395 FMV