2021-11-15T16:31:29-06:00 2020-12-31 822624857 GRAY & GRAY AND ASSOCIATES CPAS PC 1 MAIN STREET SUITE 101 CANTON NY 136171277 990 2020-01-01 464259168 ST LAWRENCE HEALTH SYSTEM INC STLA 3152615100 50 LEROY STREET POTSDAM NY 13676 DONNA MCGREGOR CFO/VP OF FINANCE 3152615100 2021-10-19 DONNA MCGREGOR 999009999 JOHN J GRAY JR CPA P00076464 3153862925 2021-11-15 2020 2022-09-23 18:48:47Z DONNA MCGREGOR 50 LEROY STREET POTSDAM NY 13676 2368203 false X WWW.STLAWRENCEHEALTHSYSTEM.ORG X 2013 NY ST. LAWRENCE HEALTH SYSTEM'S MISSION IS TO IMPROVE HEALTH, DELIVER BETTER CARE AND CONSUMER EXPERIENCE, AND LOWER COSTS IN ST. LAWRENCE COUNTY THROUGH COORDINATION AND INTEGRATION OF SERVICES. 17 4 123 97 0 0 251928 505523 0 1931557 1862680 2183485 2368203 0 0 241567 275057 0 0 4166863 4174039 4408430 4449096 -2224945 -2080893 51183877 40562629 44007521 43531124 7176356 -2968495 X ST. LAWRENCE HEALTH SYSTEM'S MISSION IS TO IMPROVE HEALTH, DELIVER BETTER CARE AND CONSUMER EXPERIENCE, AND LOWER COSTS IN ST. LAWRENCE COUNTY THROUGH COORDINATION AND INTEGRATION OF SERVICES. false false 452088 505523 DURING 2020, THE CLINICAL RESEARCH PROGRAM INCLUDED 16 STUDIES CONDUCTED AND INCLUDED 34 ENROLLED PARTICIPANTS. DURING 2020, THE CLINICAL RESEARCH PROGRAM INCLUDED 16 STUDIES CONDUCTED AND INCLUDED 34 ENROLLED PARTICIPANTS. 452088 true false false false false false false false false false true false false false true true false true false false false false false false false false false false false true true false false false false false false false true false true false false false false false true true true false false true 53 0 123 true false false false false false false false false false false false false false false X 17 4 false false false false false false false true true false false true true true true true false true true false NY X ST LAWRENCE HEALTH SYSTEM 3152615451 50 LEROY STREET POTSDAM NY 13676 DAVID ACKER PRESIDENT/CE 5.00 50.00 X 785218 0 39570 KATHERINE SCHLEIDER COO 50.00 0.00 X 426331 0 45398 RICHARD JACOBS PROJECT SPEC 5.00 50.00 X 389565 0 33225 DAVID BENDER VP STRATEGIC 50.00 0.00 X 353769 0 26139 ERIC BURCH CEO 50.00 0.00 X 338872 0 23868 JANET SCHAPIRO VP NURSING 50.00 0.00 X 306209 0 24216 SUSAN HODGSON VP COMPLIANC 50.00 0.00 X 276773 0 23062 MICHAEL TULLOCH MD DIRECTOR 5.00 2.00 X 0 218432 34538 DONNA MCGREGOR CFO/VP OF FI 5.00 50.00 X 184769 0 16191 AMY IRISH-BICKNELL ASSISTANT SE 5.00 40.00 X 69965 0 20515 RONALD BERRY DIRECTOR 5.00 2.00 X 0 0 0 MARK BRACKETT TREASURER 5.00 1.00 X X 0 0 0 MARK J CORNETT VICE CHAIR 5.00 4.00 X X 0 0 0 REAL FRENCHIE COUPAL DIRECTOR 5.00 0.00 X 0 0 0 DONALD R DANGREMOND DIRECTOR 5.00 2.00 X 0 0 0 ERIN DRAPER DIRECTOR 5.00 2.00 X 0 0 0 BRIAN D GARDAM DIRECTOR 5.00 2.00 X 0 0 0 MICHAEL GRIFFIN DIRECTOR 5.00 4.00 X 0 0 0 STEPHEN KNIGHT DIRECTOR 5.00 0.00 X 0 0 0 ANDREW LEONARD DIRECTOR 5.00 0.00 X 0 0 0 FLORENCE BERO MD DIRECTOR 5.00 2.00 X 0 0 0 EDWARD S MUCENSKI CHAIR 5.00 2.00 X X 0 0 0 KATHRYN MULLANEY DIRECTOR 5.00 2.00 X 0 0 0 LORETTA PEREZ DIRECTOR 5.00 2.00 X 0 0 0 ANNE RICHEY DIRECTOR 5.00 0.00 X 0 0 0 JAMES C THEODORE DIRECTOR 5.00 2.00 X 0 0 0 3131471 218432 286722 24 false true false MCDERMOTT WILL & EMERY LLP 500 N CAPITOL ST NW MCDERMOTT BUILDING WASHINGTON DC 200011531 CONSULTING 1403418 EISENBERG VITAL & RYZE ADVERTISING 155 DOW STREET SUITE 300 MANCHESTER NH 03101 ADVERTISING 337625 KPMG LLP DEPT 0511 PO BOX 120511 DALLAS TX 753120511 FINANCIAL SERVI 181499 NEWPORT CREDENTIALING SOLUTIONS 15 GRUMMAN RD W 1400 BETHPAGE NY 11714 PROVIDER CONTRA 160921 BENEFIT TECHNOLOGY RESOURCES LLC PO BOX 26622 TAMPA FL 33623 HR CONSULTING 157751 5 CLINICAL RESEARCH 621110 505523 505523 505523 RENTAL INCOME 621110 1454733 1454733 INTEREST INCOME 621110 407947 407947 1862680 2368203 2368203 260832 260832 14225 14225 1263909 11200 1252709 69992 55962 14030 75370 75370 22397 20262 2135 1962 1962 421 421 1298212 1298212 978086 978086 225 225 ACO 450612 450612 SUPPLIES 7821 6822 999 OTHER DIRECT EXPENSE 5032 5032 4449096 452088 3997008 0 2537760 2189674 126674 205432 11072684 12526565 1600 27673462 3143519 24927584 24529943 12519175 1109415 51183877 40562629 197460 2495343 26152670 25255670 17657391 15780111 44007521 43531124 X 7176356 -2968495 7176356 -2968495 51183877 40562629 X -2080893 -8063958 X false true X true false X X 3 GOUVERNEUR HOSPITAL GOUVERNEUR HOSPITAL 464249555 3 true 0 0 CANTON-POTSDAM HOSPITAL CANTON-POTSDAM HOSPITAL 161012691 3 true 0 0 MASSENA HOSPITAL INC MASSENA HOSPITAL INC 843134268 3 true 0 0 3 0 true false false false true false false false false false false false false false false false false false PART IV, SECTION A, LINE 5A IN JULY 2019, SLHS EXECUTED AN ASSET PURCHASE AGREEMENT (APA) WITH THE TOWN OF MASSENA AND ITS HOSPITAL, MASSENA MEMORIAL HOSPITAL (MMH), SUBJECT TO VARIOUS APPROVALS AND CONDITIONS, TO ACQUIRE SUBSTANTIALLY ALL OF THE ASSETS OF MMH AND ASSUME CERTAIN OUTSTANDING LIABILITIES. THE TRANSACTION WAS OVERSEEN BY THE DOH IN RECOGNITION OF MMH'S PAST OPERATING PERFORMANCE. THE NECESSARY APPROVALS WERE GRANTED AND REQUIRED CONDITIONS MET AND LEGALLY BINDING ON JANUARY 1, 2020. PART IV, SECTION C, LINE 1 CANTON-POTSDAM HOSPITAL'S (CPH) BOARD CONSISTS OF 17 DIRECTORS. SEVEN (7) OF THESE DIRECTORS ARE MEMBERS OF THE ST. LAWRENCE HEALTH SYSTEM (SLHS) BOARD. THE BYLAWS OF THE SLHS BOARD PROVIDE THAT SLHS, AS SOLE MEMBER OF CPH, HAS THE FOLLOWING POWERS REGARDING CPH: A)APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS; B)APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER; C)APPROVE THE ADOPTION AND AMENDMENT OF BYLAWS; D)APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS; E)APPROVE STRATEGIC PLANS; F)APPROVE AND MAY INITIATE THE FILING OF CERTIFICATE OF NEED APPLICATIONS; AND G)APPROVE THE DISSOLUTION OF CPH. GOUVERNEUR HOSPITAL'S (GH) BOARD CONSISTS OF 9 DIRECTORS. ONE (1) DIRECTOR IS A MEMBER OF THE SLHS BOARD. THE BYLAWS OF THE SLHS BOARD PROVIDE THAT SLHS, AS SOLE MEMBER OF GH, HAS THE FOLLOWING POWERS REGARDING GH: A)APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS; B)APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER; C)APPROVE THE ADOPTION AND AMENDMENT OF BYLAWS; D)APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS; E)APPROVE STRATEGIC PLANS; F)APPROVE AND MAY INITIATE THE FILING OF CERTIFICATE OF NEED APPLICATIONS; G)APPROVE THE DISSOLUTION OF GH; H)APPROVE THE SALE, LEASE, MORTGAGE OR ENCUMBRANCE OF ANY ASSET OTHER THAN ANY SALE, LEASE OR MORTGAGE WHICH IS PART OF AN APPROVED BUDGET; I)APPROVE ANY MERGER, BUSINESS CONSOLIDATION, ACQUISITION OR JOINT VENTURE; J)APPROVE THE PURCHASE OR SALE OF PHYSICIAN PRACTICES OTHER THAN ANY PURCHASE OR SALE WHICH IS PART OF AN APPROVED BUDGET; K)APPROVE AND MAY INITIATE THE COMMENCEMENT AND SETTLEMENT OF LITIGATION; L)APPROVE ANY FILING OF A BANKRUPTCY PETITION; M)APPROVE THE INCURRENCE OF ANY DEBT OTHER THAN DEBT WHICH IS INCURRED IN THE ORDINARY COURSE OF BUSINESS AND WHICH IS NOT INCONSISTENT WITH AN APPROVED BUDGET; N)APPROVE NEW CLINICAL PROGRAMS OR THE TERMINATIONS OF EXISTING CLINICAL PROGRAMS OTHER THAN ANY ACTION WHICH IS PART OF AN APPROVED BUDGET; O)APPROVE ANY OF THE FOLLOWING AGREEMENTS: (A) MANAGEMENT SERVICES AGREEMENT OTHER THAN ANY AGREEMENT WHICH IS PART OF AN APPROVED BUDGET; (B) CONTRACTS WITH A PHYSICIAN OR PHYSICIAN GROUP; (C) AGREEMENTS FOR THE OUTSOURCING OF A HOSPITAL SERVICE OR FUNCTION; (D) COLLECTIVE BARGAINING AGREEMENTS; AND (E) ANY AGREEMENTS TO PARTICIPATE IN RISK BEARING ARRANGEMENT SUCH AS AN ACCOUNTABLE CARE ORGANIZATION OR A BUNDLED PAYMENT ARRANGEMENT. P)INITIATE, NEGOTIATE AND APPROVE MANAGED CARE AGREEMENTS WITH MANAGED CARE ORGANIZATIONS AND OTHER PAYORS OTHER THAN AGREEMENT WHICH IS PART OF AN APPROVED BUDGET; Q)DEVELOP INTEGRATED SERVICES AND MANDATE PARTICIPATION IN SUCH SERVICES (E.G., FINANCIAL MANAGEMENT, STRATEGIC PLANNING, HUMAN RESOURCES, INFORMATION TECHNOLOGY, LEGAL, QUALITY ASSURANCE, RISK MANAGEMENT, CONTRACTING AND RECRUITMENT); AND R)REQUIRE THE GUARANTEE OF LOANS THROUGH AN OBLIGATED GROUP STRUCTURE THAT WILL SUPPORT ACCESS TO CAPITAL AND MAY INCLUDE DEBT SERVICES. MASSENA HOSPITAL'S (MH) BOARD CONSISTS OF 9 DIRECTORS. NONE OF THESE DIRECTORS ARE MEMBERS OF THE ST. LAWRENCE HEALTH SYSTEM (SLHS) BOARD. THE BYLAWS OF THE SLHS BOARD PROVIDE THAT SLHS, AS SOLE MEMBER OF MH, HAS THE FOLLOWING POWERS REGARDING MH: A)APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS; B)APPOINT AND REMOVE THE CHIEF EXECUTIVE OFFICER; C)APPROVE THE ADOPTION AND AMENDMENT OF BYLAWS; D)APPROVE THE ANNUAL OPERATING AND CAPITAL BUDGETS; E)APPROVE STRATEGIC PLANS; F)APPROVE AND MAY INITIATE THE FILING OF CERTIFICATE OF NEED APPLICATIONS; AND G)APPROVE THE DISSOLUTION OF MH. 1046545 1046545 24973396 2467752 22505644 1492114 675767 816347 161407 161407 24529943 DUE TO AFFILIATES 5982463 TAXABLE BOND LIABILITY 5899000 NOTE-LT 3594613 OTHER LT LIAB-PAYROLL 304035 15780111 X 21667516 19299313 19299313 2368203 2368203 25212253 20763157 20763157 4449096 4449096 SCHEDULE D, PAGE 3, PART X THE SYSTEM AND ITS AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE SYSTEM AND AFFILIATES RECOGNIZE THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN FIFTY PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE SYSTEM AND AFFILIATES DID NOT RECOGNIZE THE EFFECT OF ANY UNCERTAIN INCOME TAX POSITIONS IN EITHER 2020 OR 2019. SCHEDULE D, PAGE 4, PART XI, LINE 2D OTHER 19,299,313 SCHEDULE D, PAGE 4, PART XII, LINE 2D OTHER 20,763,157 SCHEDULE D, PAGE 4, PART XIII THE SYSTEM AND ITS AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE SYSTEM AND AFFILIATES RECOGNIZE THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED. RECOGNIZED INCOME TAX POSITIONS ARE MEASURED AT THE LARGEST AMOUNT THAT IS GREATER THAN FIFTY PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT. CHANGES IN RECOGNITION IN MEASUREMENT ARE REFLECTED IN THE PERIOD IN WHICH THE CHANGE IN JUDGMENT OCCURS. THE SYSTEM AND AFFILIATES DID NOT RECOGNIZE THE EFFECT OF ANY UNCERTAIN INCOME TAX POSITIONS IN EITHER 2020 OR 2019. REVENUE AND EXPENSES RELATED TO INTERCORPORATE TRANSACTIONS BETWEEN SLHS AND RELATED ENTITIES CPH, GH, AND MH ARE EXCLUDED FROM REVENUE AND EXPENSES. THESE ARE FOR CHARGES BILLED TO THE ENTITIES CPH, GH, AND MH (RECORDED AS BILLABLE EXPENSES) AND THEN CASH IS COLLECTED FOR THESE (RECORDED AS BILLABLE REVENUE). X X X X X false false false false false false false false false DAVID ACKER PRESIDENT/CEO 785218 19950 19620 824788 KATHERINE SCHLEIDER COO 426331 12121 33277 471729 RICHARD JACOBS PROJECT SPECIALIST 389565 19950 13275 422790 DAVID BENDER VP STRATEGIC PLANNIN 353769 14100 12039 379908 ERIC BURCH CEO 338872 13100 10768 362740 JANET SCHAPIRO VP NURSING 306209 12175 12041 330425 SUSAN HODGSON VP COMPLIANCE 276773 12135 10927 299835 MICHAEL TULLOCH MD DIRECTOR 218432 13234 21304 252970 DONNA MCGREGOR CFO/VP OF FINANCE 184769 3273 12918 200960 SCHEDULE J, PART III THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS SEEKS THE INPUT OF A CONSULTING FIRM WITH NATIONAL EXPERIENCE TO REVIEW THE COMPENSATION PACKAGES OFFERED TO TOP MANAGEMENT AND THE REGULATORY COMPLIANCE ISSUES OF NOT FOR PROFITS. UPON FINDINGS OF THE CONSULTANT AND DELIBERATIONS OF THE COMPENSATION COMMITTEE, THE COMMITTEE WILL THEN MAKE A RECOMMENDATION TO THE FULL BOARD. THE FULL BOARD WILL THEN VOTE ON THE TOP OFFICIAL'S COMPENSATION PACKAGE. A ST LAWRENCE COUNTY IDA CIVIC DEVEL 272614310 2016-04-01 28500000 THE BOND ISSUANCE OF 28,500,000 IS TO FINANCE A PROJECT FOR THE BENEFIT OF ST. LAWRENCE HEALTH SYSTE false false false A 3244000 28500000 733875 130346 27635779 2017 false false false true A false false false false false false true A false true false false true false false false true A true PURPOSE OF ISSUE DESCRIPTION ST. LAWRENCE COUNTY IDA CIVIC DEVEL THE BOND ISSUANCE OF 28,500,000 IS TO FINANCE A PROJECT FOR THE BENEFIT OF ST. LAWRENCE HEALTH SYSTEM AND CANTON-POTSDAM HOSPITAL CONSISTING OF (1) THE CONSTRUCTION OF AN APPROXIMATELY 60,000 SQ. FT., THREE-LEVEL MEDICAL OFFICE BUILDING LOCATED AT 6119 US HIGHWAY 11, IN THE TOWN OF CANTON, NEW YORK; (2) THE ACQUISITION AND INSTALLATION IN THE MEDICAL OFFICE BUILDING OF FURNITURE, MACHINERY AND EQUIPMENT; (3) THE RENOVATION AND IMPROVEMENT OF THE EXISTING HOPSITAL BUILDING LOCATED AT 50 LEROY STREET, IN THE VILLAGE OF POTSDAM, NEW YORK; (4) THE ACQUISITION AND INSTALLATION AT THE HOSPITAL OF FURNITURE, MACHINERY AND EQUIPMENT; AND (5) PAYING COSTS INCEDENTAL TO THE FINANCING THEREOF. SEE PART V ADDITIONAL INFORMATION false SCHEDULE L, PART V DUE TO OUR BOARD MEMBERS' AFFILIATIONS WITH RELATED HOSPITALS CANTON- POTSDAM HOSPITAL (CPH) AND GOUVERNEUR HOSPITAL (GH) (AS DISCLOSED ON SCHEDULE R), WE ARE DISCLOSING THE FOLLOWING: 1. DONALD DANGREMOND, SLHS BOARD SECRETARY AND CPH BOARD MEMBER, RETIRED AS AN EMPLOYEE OF CLARKSON UNIVERSITY (CU). CPH PROVIDES HEALTHCARE SERVICES AND STAFFS A CLINIC ON THE CU CAMPUS. THE OPERATION COSTS OF THAT CLINIC IN 2020 WERE APPROXIMATELY 557,077 WHICH WERE REIMBURSED BY CU ON A PASS THROUGH BASIS. 2. BRIAN GARDAM, SLHS AND CPH BOARD MEMBER, WAS THE FORMER EXECUTIVE DIRECTOR OF HOSPICE OF PALLIATIVE CARE OF ST. LAWRENCE VALLEY (HOSPICE). BRIAN IS ALSO A BOARD MEMBER FOR NORTHERN LIGHTS HEALTH CARE. HOSPICE CONTRACTS WITH CPH FOR INPATIENT HOSPICE SERVICES FOR SYMPTOM MANAGEMENT AND PAIN CONTROL. 3. JAMES THEODORE, SLHS AND CPH BOARD MEMBER, IS ALSO THE MORGAN STANLEY SMITH BARNEY LLC FINANCIAL ADVISOR FOR AN ACCOUNT HELD IN THE NAME OF CANTON-POTSDAM HOSPITAL FOUNDATION, INC. (A RELATED TAX-EXEMPT ORGANIZATION TO CPH). THIS FOUNDATION ACCOUNT IS USED AS A PASS-THROUGH FOR DONATIONS OF STOCK. THE BALANCE IN THIS ACCOUNT AS OF DECEMBER 31, 2020 WAS 0. 4. DURING 2010, BOND ISSUES WERE OBTAINED FOR CPH FROM COMMUNITY BANK, NA AND KEY BANK, AS DISCLOSED IN SCHEDULE K OF CPH'S FORM 990. THE COMMUNITY BANK, NA PORTION OF THESE BOND ISSUES WERE IN THE AMOUNT OF 3,585,000. IN 2011, CPH WAS ISSUED A MORTGAGE BY COMMUNITY BANK, NA FOR CONSTRUCTION OF THE E.J. NOBEL ANNEX BUILDING, IN THE AMOUNT OF 2,200,000. EDWARD MUCENSKI, SLHS CHAIR AND CPH BOARD MEMBER, WAS A SHAREHOLDER AND A BOARD MEMBER OF COMMUNITY BANK, NA UNTIL DECEMBER 31, 2017. AS OF DECEMBER 31, 2020 CPH WAS CURRENT ON ANY OBLIGATIONS DUE TO THE BANK. 5. SLHS VICE CHAIR AND CPH BOARD MEMBER, MARK CORNETT, WAS A CONSULTANT FORMERLY EMPLOYED BY SLIC NETWORK SOLUTIONS. SLIC RENTS OFFICE SPACE AT CPH'S MEDICAL OFFICE BUILDING IN CANTON, NEW YORK. CPH REMITTED APPROXIMATELY 276,425 TO SLIC IN 2020 FOR TELECOMMUNICATION SERVICES. 6. MARK BRACKETT, SLHS BOARD TREASURER AND GH BOARD MEMBER, WAS PRESIDENT OF KINNEY DRUGS FOUNDATION FROM JANUARY 1, 2014 UNTIL JUNE 30, 2014. HE REMAINS ON THE KINNEY DRUGS FOUNDATION BOARD OF DIRECTORS. KINNEY DRUGS FOUNDATION IS UNDER THE PARENT ORGANIZATION, KPH HEALTHCARE SERVICES. CPH AND GH PARTICIPATED WITH ONE OR MORE OF THE KPH HEALTHCARE CORPORATE DIVISIONS IN THE HOSPITALS' 340B PROGRAMS. 7. ANNE RICHEY, SLHS BOARD DIRECTOR, IS EXECUTIVE DIRECTOR OF UNITED CEREBRAL PALSY ASSOCIATION OF THE NORTH COUNTRY, INC., DBA COMMUNITY HEALTH CENTER OF THE NORTH COUNTRY. IN 2020, THE UNITED CEREBRAL PALSY ASSOCIATION RENTED OUTPATIENT CLINIC SPACE FROM GH, FOR APPROXIMATELY 9,843 PER MONTH FOR THE COMMUNITY HEALTH CENTER OF THE NORTH COUNTRY. 8. MICHAEL GRIFFIN, SLHS AND CPH (RELATED ORGANIZATION) BOARD MEMBER, RETIRED AS AN EMPLOYEE OF CLARKSON UNIVERSITY (CU) IN 2017. MICHAEL GRIFFIN SERVES AS A PAID CONSULTANT TO CLARKSON UNIVERSITY. CPH PROVIDES HEALTHCARE SERVICES AND STAFFS A CLINIC ON THE CU CAMPUS. THE OPERATION COSTS OF THAT CLINIC IN 2020 WERE 557,077 WHICH WERE REIMBURSED BY CU ON A PASS THROUGH BASIS. 9. DR. MICHAEL TULLOCH, BOARD MEMBER OF SLHS IS A CPH HOSPITALIST. DR. TULLOCH WAS COMPENSATED 252,971 FOR HIS SERVICES TO CPH. SLHS CLINICAL RESEARCH LEASES OFFICE SPACE FROM GAIL AND DR. MICHAEL TULLOCH IN POTSDAM, NEW YORK. SLHS REMITTED 19,200 TO GAIL AND DR. MICHAEL TULLOCH IN 2020 FOR RENT. 10. ANDREW LEONARD, BOARD MEMBER, IS ALSO THE PRESIDENT OF EMPIRE NORTHEAST MECHANICAL CONTRACTOR (ENI MECHANICAL, INC.). CANTON-POTSDAM HOSPITAL AND MASSENA HOSPITAL CONTRACT WITH ENI MECHANICAL, INC. FOR VARIOUS MECHANICAL PROJECTS. CPH AND MH REMITTED APPROXIMATELY A TOTAL OF 401,494 TO ENI MECHANICAL, INC. IN 2020 FOR MECHANICAL SERVICES. FORM 990, PAGE 2, PART III, LINE 4D DURING 2020, THE CLINICAL RESEARCH PROGRAM INCLUDED 16 STUDIES CONDUCTED AND INCLUDED 34 ENROLLED PARTICIPANTS. FORM 990, PAGE 6, PART VI, LINE 11B THE FORM 990 IS PREPARED BY THE FINANCE DEPARTMENT STAFF MEMBERS. UPON COMPLETION, THE FORM IS SUBMITTED TO A CPA FIRM FOR REVIEW AND PREPARED FOR FILING. A COPY OF THE DRAFT RETURN IS THEN REVIEWED BY THE SYSTEM CFO AND SYSTEM CONTROLLER. AFTER REVIEW, ANY CHANGES ARE MADE AND A COPY IS PRESENTED TO THE BOARD OF DIRECTORS FOR THEIR REVIEW, COMMENTS AND APPROVAL (PRIOR TO IRS SUBMISSION). FORM 990, PAGE 6, PART VI, LINE 12C BOARD MEMBER CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED AND REVIEWED BY THE BOARD ANNUALLY. FORM 990, PAGE 6, PART VI, LINE 15A THE AUDIT, COMPLIANCE AND COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS UTILIZES THE INPUT OF A NATIONAL CONSULTING FIRM WITH EXPERTISE IN EXECUTIVE COMPENSATION TO REVIEW THE COMPENSATION PACKAGES OFFERED TO TOP MANAGEMENT AS WELL AS OUR COMPLIANCE WITH REGULATORY REQUIREMENTS FOR EXECUTIVE COMPENSATION FOR NOT-FOR-PROFIT HOSPITALS. UPON THE FINDINGS OF THE CONSULTANT AND DELIBERATIONS OF THE AUDIT, COMPLIANCE, AND COMPENSATION COMMITTEE, THE COMMITTEE WILL THEN MAKE A RECOMMENDATION TO THE FULL BOARD. THE FULL BOARD WILL THEN VOTE ON THE TOP OFFICIAL'S COMPENSATION PACKAGE. FORM 990, PAGE 6, PART VI, LINE 15B THE COMPENSATION OF OTHER KEY EMPLOYEES IS DETERMINED PRIMARILY BY INFORMATION GATHERED FROM INDEPENDENT SURVEY DATA FROM NATIONAL AND SURROUNDING MARKETS COORDINATED BY THE HUMAN RESOURCE DEPARTMENT. THE CEO AND VICE PRESIDENT OF HUMAN RESOURCES REVIEW THE SURVEY DATA TO DETERMINE SALARY RANGES AND COMPENSATION PACKAGES. THE CEO BRINGS THE INFORMATION AND FINDINGS TO THE AUDIT, COMPLIANCE, AND COMPENSATION COMMITTEE OF THE BOARD FOR THEIR DELIBERATION AND CONSIDERATION. THE AUDIT, COMPLIANCE, AND COMPENSATION COMMITTEE WILL THEN BRING THEIR RECOMMENDATION TO THE FULL BOARD FOR THEIR FINAL APPROVAL. FORM 990, PAGE 6, PART VI, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 TRANSFER TO MMH -7,200,000 TRANSFER FROM CPH ACO 449,887 REV/EXP ADJ -1,463,845 TRANSFER FROM ROCHESTER RH 150,000 TOTAL -8,063,958 CANTON-POTSDAM HOSPITAL INC 50 LEROY STREET POTSDAM NY 13676 161012691 HOSPITAL NY 501C 3 SLHS true GOUVERNEUR HOSPITAL INC 77 WEST BARNEY STREET GOUVERNEUR NY 13642 464249555 HOSPITAL NY 501C 3 SLHS true CANTON-POTSDAM HOSPITAL FOUNDATION 29 GROVE STREET POTSDAM NY 13676 161279472 FUNDRAISG NY 501C 12A SLHS true CANTON-POTSDAM MEDICAL PRACTICEPLLC 50 LEROY STREET POTSDAM NY 13676 460714367 OUT PATIEN NY 501C 3 SLHS true ADIRONDACK HEALTH INSTITUTE 101 RIDGE STREET GLENS FALLS NY 12801 141698269 CONSORTIUM NY 501C 3 N/A false MASSENA MEMORIAL HOSPITAL 1 HOSPITAL DRIVE MASSENA NY 13662 843134268 HOSPITAL NY 501C 3 NA true ACCOUNTABLE CARE ORGANIZATION OF THE NORTH COUNTRY LLC 555 WEST GRANADA BLVD 555 ORMOND BEACH FL 32174 454106154 SERV COORD FL NA RELATED -585521 55609 false false 0.25500 false true true false false false false false false true false false false false false true true false false GOUVERNEUR HOSPITAL INC Q 713547 FMV CANTON-POTSDAM HOSPITAL S 449887 CASH EXCHANGED