2025-11-17T14:50:00-06:00 2024-12-31 161131146 BONADIO & CO LLP 432 NORTH FRANKLIN STREET SYRACUSE NY 13204 990 2024-01-01 454102458 MEADOWBROOK TERRACE INC MEAD 3155191246 21957 COLE ROAD CARTHAGE NY 13619 ROB BLOOM CHIEF FINANCIAL OFFICER 3155191246 2025-11-17 1 0 TIMOTHY HAMMOND P01224809 3154227109 2025-11-17 2024 2025-03-06 01:10:19Z HEATHER SASKI 21957 COLE ROAD CARTHAGE NY 13619 2160012 0 X HTTPS://WWW.CARTHAGEHOSPITAL.COM/LOCATION/MEADOWB X 2011 NY TO PROVIDE A COMFORTABLE SETTING TO ASSIST RESIDENTS WITH LIVING COMFORTABLY AND MAINTAINING THE NORMALCY OF DAILY ACTIVITIES THAT THEY MAY NOT BE ABLE TO ACHIEVE ON THEIR OWN BY OFFERING RESIDENCE A SENSE OF INDEPENDENCE, FREEDOM, AND PRIVACY WITH SECURITY 24 HOURS PER DAY WHICH ALLOWS FOR A SAFE AND SECURE LIVING ENVIRONMENT. 4 3 0 6 0 0 0 91803 1829389 2031845 0 0 15260 36364 1844649 2160012 0 0 0 0 1876240 2264451 0 0 0 887113 887299 2763353 3151750 -918704 -991738 8103210 7876672 2862770 3627970 5240440 4248702 TO PROVIDE A COMFORTABLE SETTING TO ASSIST RESIDENTS WITH MAINTAINING THE NORMALCY OF DAILY ACTIVITIES THAT THEY MAY NOT BE ABLE TO ACHIEVE ON THEIR OWN BY PROVIDING SECURITY 24 HOURS PER DAY WHICH ALLOWS FOR A SAFE AND SECURE LIVING ENVIRONMENT. 0 0 2155445 2065386 MEADOWBROOK TERRACE, INC. OPERATES A 60 RESIDENT ASSISTED LIVING FACILITY THAT ALLOWS RESIDENTS TO LEAD AN UNINTERRUPTED LIFESTYLE. 2155445 1 1 0 0 0 0 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 4 3 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X ROB BLOOM 3155237632 1001 WEST STREET CARTHAGE NY 13619 DALE KLOCK BOARD CHAIR 1.00 X 0 0 0 ADAM FULLER TREASURER 1.00 X 0 0 0 ELIZABETH ELLIOT SECRETARY 1.00 X 0 0 0 JULIE WARD VICE PRESIDENT 1.00 X 0 0 0 MATTHEW CERVINI DIRECTOR 1.00 X 0 0 0 RICH DUVALL DIRECTOR, PRESIDENT AND CEO 1.00 41.00 X X 0 1015873 39663 JENNIFER PREMO DIRECTOR 1.00 X 0 0 0 ROB BLOOM CHIEF FINANCIAL OFFICER 1.00 39.00 X 0 0 0 HEATHER SASKI ADMINISTRATOR 40.00 X 0 161361 4231 0 1177234 43894 0 0 1 0 0 91803 91803 NET PATIENT SERVICE RE 623000 2031845 2031845 2031845 OTHER INCOME 420000 33541 33541 CAFE REVENUE AND MEALS 722514 2823 2823 36364 2160012 2065386 0 2823 1856107 1223535 632572 266352 175578 90774 141992 93600 48392 16890 16890 128879 28300 100579 14029 14029 179762 157426 22336 620 620 277675 277675 37663 37663 SUPPLIES 205146 199331 5815 OTHER EXPENSES 26635 26635 3151750 2155445 996305 0 69316 190199 33090 29833 160582 122565 40538 5175 10857228 3328328 7799684 7528900 8103210 7876672 68648 26798 57255 118354 34278 31021 2702589 3451797 2862770 3627970 X 0 0 0 0 0 -991738 5240440 4248702 8103210 7876672 -991738 0 X 0 0 0 X 53434 37530 33516 91803 216283 1987619 1861575 2100874 1876728 2031845 9858641 1987619 1915009 2138404 1910244 2123648 10074924 0 0 0 10074924 10153 11823 9178 13823 36364 81341 1997772 1926832 2147582 1924067 2160012 10156265 0.99200 0.00000 X PART III, SECTION B, LINE 12 MEADOWBROOK TERRACE INC'S OTHER INCOME IS COMPRISED OF FEES RELATED TO INITIAL MOVE IN, SALE OF MEALS, AND PROVIDING CABLE TO RESIDENTS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1066000 1066000 8815442 2710602 6104840 531089 263358 267731 444697 354368 90329 7528900 DUE TO CARTHAGE AREA HOSPITAL 3301357 DUE TO THIRD PARTY PAYORS 150440 3451797 PART IV, LINE 2B: MEADOWBROOK TERRACE, INC. MAINTAINS A SAVINGS ACCOUNT CONSISTING OF RESIDENTS' PERSONAL FUNDS. STAFF DEPOSIT AND WITHDRAW FUNDS AT THE REQUEST OF RESIDENTS TO PAY FOR PERSONAL PURCHASES. 0 0 0 0 0 0 0 0 0 RICH DUVALL DIRECTOR, PRESIDENT AND CEO 0 878491 0 137382 0 0 0 6900 0 32763 0 1055536 0 0 HEATHER SASKI ADMINISTRATOR 0 161361 0 0 0 0 0 4231 0 0 0 165592 0 0 PART I, LINE 3 THE BOARDS OF DIRECTORS OF CARTHAGE AREA HOSPITAL AND CLAXTON-HEPBURN MEDICAL CENTER CONTRACTS WITH AN INDEPENDENT SALARY COMPENSATION SPECIALIST TO ADVISE THEIR EXECUTIVE COMMITTEES ON SETTING COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF MEADOWBROOK TERRACE, INC. IS CARTHAGE AREA HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A AS SOLE MEMBER OF MEADOWBROOK TERRACE, INC., CARTHAGE AREA HOSPITAL HAS THE AUTHORITY TO ELECT, APPOINT, AND DISMISS MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B AS SOLE MEMBER OF MEADOWBROOK TERRACE, INC., CARTHAGE AREA HOSPITAL HAS THE AUTHORITY TO MAKE GOVERNANCE DECISIONS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS SHARED WITH THE FINANCE COMMITTEE OF NORTH STAR HEALTH ALLIANCE, INC., WHICH REVIEWS AND APPROVES AND THEN SHARES THE FINAL FORM 990 WITH THE BOARD OF DIRECTORS OF MEADOWBROOK TERRACE, INC. PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE BOARD OF DIRECTORS DISCLOSES ANY CONFLICTS OF INTEREST. IF A CONFLICT ARISES DURING ANY MEETING OF THE BOARD OF DIRECTORS, THE DIRECTOR WILL EXCUSE THEMSELVES FROM THE DISCUSSION AND THUS REFRAIN FROM ANY PERSUASION OF THE OTHER DIRECTORS ON THE SUBJECT. ADDITIONALLY, THE DIRECTOR WILL EXCUSE THEMSELVES FROM ANY VOTE WHICH TAKES PLACE ON THE SUBJECT. FORM 990, PART VI, SECTION B, LINE 15 OFFICIALS AND KEY EMPLOYEES' COMPENSATION IS REVIEWED ANNUALLY. COMPENSATION IS BASED ON COMPARABLE POSITIONS OF SIMILAR ORGANIZATIONS. NOTE THAT EMPLOYEES ARE COMPENSATED BY CARTHAGE AREA HOSPITAL; MEADOWBROOK THEN REIMBURSES CARTHAGE AREA HOSPITAL FOR THE EXPENSE. DUE TO THE EMPLOYEES BEING PAID UNDER CARTHAGE AREA HOSPITAL'S TAX IDENTIFICATION NUMBER, ALL COMPENSATION REVIEW IS COMPLETED BY CARTHAGE'S COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 ALL GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND TAX DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. CARTHAGE AREA HOSPITAL 1001 WEST STREET CARTHAGE NY 13619 150622079 HOSPITAL NY 501(C)(3) LINE 3 NORTH STAR HEALTH ALLIANCE INC 0 CARTHAGE AREA HOSPITAL FOUNDATION INC 3 BRIDGE STREET CARTHAGE NY 13619 161467023 FUNDRAISING NY 501(C)(3) LINE 7 CARTHAGE AREA HOSPITAL 1 CLAXTON-HEPBURN MEDICAL CENTER 214 KING STREET OGDENSBURG NY 13669 150559686 HEALTHCARE SERVICES NY 501(C)(3) LINE 3 NORTH STAR HEALTH ALLIANCE INC 0 NORTH STAR HEALTH ALLIANCE 214 KING STREET OGDENSBURG NY 13669 161449491 HOLDING COMPANY NY 501(C)(3) LINE 12B, II N/A 0 CLAXTON MEDICAL PC 214 KING STREET OGDENSBURG NY 13669 264009395 SPECIALITY HEALTHCARE SERVICES NY 501(C)(3) LINE 12B, II CLAXTON-HEPBURN MEDICAL CENTER 0 CLAXTON-HEPBURN MEDICAL CENTER FOUNDATION INC 503 MANSION AVENUE OGDENSBURG NY 13669 222488389 FUNDRAISING NY 501(C)(3) LINE 12B, II NORTH STAR HEALTH ALLIANCE INC 0 NORTH COUNTRY ORTHOPEDIC AMBULATORY SURGERY CENTER LLC 1571 WASHINGTON STREET SUITE 201 WATERTOWN NY 13601 731653922 SURGICAL SERVICES NY N/A 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0