2011-11-14T18:09:05-06:00 2010-12-31 FUST CHARLES CHAMBERS LLP 5784 WIDEWATERS PARKWAY SYRACUSE NY 13214 990 2010-01-01 810600548 RIVER HOSPITAL INC RIVE 3154822511 4 FULLER STREET ALEXANDRIA BAY NY 13607 BEN MOORE 3154822511 2011-11-11 1 JOSEPH J SCHLEGEL 3154463600 2010 2016-02-24 21:20:13Z BEN MOORE 4 FULLER STREET ALEXANDRIA BAY NY 13607 14923718 0 X WWW.RIVERHOSPITAL.ORG X 2003 NY IT IS THE MISSION OF RIVER HOSPITAL TO PROVIDE COMPASSIONATE, COST EFFECTIVE AND ACCESSIBLE PRIMARY HEALTH CARE TO THE YEAR ROUND AND SEASONAL RESIDENTS, AND VISITORS OF THE RIVER COMMUNITIES. THE HOSPITAL PRIDES ITSELF ON HIGH QUALITY OUTPATIENT, INPATIENT AND LONG-TERM CARE WHILE MEETING INDIVIDUAL AND COMMUNITY NEEDS THROUGH PARTNERSHIPS WITH OUR PATIENTS AND COMMUNITIES WE SERVE. 14 14 241 0 0 0 2029030 2042292 12735939 12049130 -59848 164590 53031 56341 14758152 14312353 0 0 0 0 8422605 8327847 0 0 0 5393189 5340683 13815794 13668530 942358 643823 11186139 12111985 5916584 6149584 5269555 5962401 X IT IS THE MISSION OF RIVER HOSPITAL TO PROVIDE COMPASSIONATE, COST EFFECTIVE AND ACCESSIBLE PRIMARY HEALTH CARE TO THE YEAR ROUND AND SEASONAL RESIDENTS, AND VISITORS OF THE RIVER COMMUNITIES. THE HOSPITAL PRIDES ITSELF ON HIGH QUALITY OUTPATIENT, INPATIENT AND LONG-TERM CARE WHILE MEETING INDIVIDUAL AND COMMUNITY NEEDS THROUGH PARTNERSHIPS WITH OUR PATIENTS AND COMMUNITIES WE SERVE. 1 1 10841591 12105471 RIVER HOSPITAL, INC. PROVIDED GENERAL INPATIENT, OUTPATIENT, EMERGENCY, ADULT DAY CARE AND SKILLED NURSING SERVICES TO RESIDENTS IN THE NORTHERN NEW YORK AREA. DURING 2010, THE HOSPITAL PROVIDED 1,019 DAYS OF SKILLED NURSING CARE TO THE ELDERLY, 1,366 SWING BED DAYS AND 513 DAYS OF CRITICAL ACCESS CARE TO THE SICK AND INJURED. RIVER HOSPITAL STRIVES TO IDENTIFY AND UPDATE SERVICES BASED ON THE COMMUNITY NEEDS. OVERALL, OUTPATIENT VISITS INCREASED 2% FROM 2009 TO 2010. CLINIC UTILIZATION INCREASED 10% FROM 2009 TO 2010, RESPIRATORY THERAPY UTILIZATION INCREASED 61%, EKG UTILIZATION INCREASED 10%, LABORATORY SERVICES INCREASED 7%, AND THE IMAGING UNIT UTILIZATION INCREASED 5%. THE HOSPITAL SERVES A COMMUNITY PAYOR MIX CONSISTING OF 44% MEDICARE, 13% MEDICAID, 37% PRIVATELY INSURED, AND 6% UNINSURED. RIVER HOSPITAL EMPLOYED 241 INDIVIDUALS DURING 2010. 10841591 1 1 0 0 0 0 0 0 1 1 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 63 0 1 241 1 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X TRACI MINTONYE 3154822511 4 FULLER STREET ALEXANDRIA BAY NY 13607 JOSEPH RUSSELL 2.00 X X 0 0 0 ROBERT TOOLE 2.00 X X 0 0 0 LAURA COLES 2.00 X 0 0 0 JEANNE SNOW 2.00 X X 0 0 0 PATRICIA CHALK 2.00 X X 0 0 0 ROBERT TAGUE DDS 2.00 X 0 0 0 FRANCES BROWN 2.00 X 0 0 0 CRAIG GARLOCK 2.00 X 0 0 0 RICHARD BENNETT 2.00 X 0 0 0 NORMAN SNYDER 2.00 X 0 0 0 RONALD MILLER 2.00 X 0 0 0 ROBERT NELSON 2.00 X 0 0 0 RICHARD MACSHERRY 2.00 X 0 0 0 RONALD RANDALL 2.00 X 0 0 0 BEN MOORE 40.00 X 240000 0 0 TRACI MINTONYE 40.00 X 105700 0 10486 WILLIAM H CONNOR 40.00 X 100922 0 0 HARRIET BURRIS 40.00 X 166685 0 4523 WAYNE JACKSON 40.00 X 123569 0 10486 FREDERICK TONTARSKI 40.00 X 122539 0 7881 CHRISTOPHER SYMENOW 40.00 X 127961 0 1908 AARON HUIZENGA 40.00 X 168197 0 10486 MAHREEN RAZZAQ 40.00 X 171029 0 4523 REBECCA ALBERTO-TAN 40.00 X 249019 0 10486 JENIFFER ALBERRY 40.00 X 100045 0 0 CYNTHIA SIMPSON 40.00 X 105696 0 4523 1781362 0 65302 12 0 1 0 JEFFERSON EYE SURGEONS 826 WASHINGTON STREET SUITE 102 WATERTOWN NY 13601 SURGERY 549443 1 72662 191771 1777859 2042292 PROGRAM SERVICE REVENU 623000 12049130 12049130 12049130 55504 55504 61965 60974 991 991 991 647948 11529 550391 97557 11529 109086 109086 OTHER OPERATING REVENU 623000 38094 38094 CAFETERIA REVENUE 623000 8734 8734 OTHER NON-OPERATING RE 623000 5471 5471 3051 3051 55350 14312353 12105471 0 164590 7094561 5495508 1599053 746277 578073 168204 487009 373222 113787 43458 43458 110865 110865 713465 618824 94641 48124 738 47386 22406 13298 9108 249579 237115 12464 776435 656682 119753 284551 270189 14362 SUPPLIES 934343 882976 51367 BAD DEBT 698699 698699 OUTSIDE SERVICES 689005 483493 205512 UTILITIES 308604 259227 49377 NYS ASSESSMENT 58221 58221 402928 215326 187602 13668530 10841591 2826939 0 109468 409280 166992 147715 2012160 1750245 264742 257880 81782 107276 8538828 4037107 4525606 4501721 2586020 2920113 514737 546793 924632 1470962 11186139 12111985 1580225 2082480 4336359 4067104 5916584 6149584 X 2358891 2229289 2405299 3227747 505365 505365 5269555 5962401 11186139 12111985 X 643823 49023 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2910665 2020137 37447 1235136 3733113 1338898 -4542 -1567225 2910665 1393497 -4223 58822 1338898 0.13540 0.86460 0 0 11000 11000 3203736 1164528 2039208 5001913 2872579 2129334 322179 322179 4501721 ESTIMATED THIRD PARTY PAYMENT SETTLEMENTS 940249 DUE FROM FOUNDATION 15476 DEBT ISSUANCE COST 53526 RESTRICTED CASH 461711 1470962 14312353 13668530 643823 16967 32056 49023 692846 14373327 0 14373327 -60974 -60974 14312353 13729504 0 13729504 -60974 -60974 13668530 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: PERMANENT ENDOWMENT FUNDS ARE TO BE HELD IN PERPETUITY WITH THE INCOME TO BE USED TO SUPPORT HEALTHCARE SERVICES. TEMPORARY ENDOWMENT FUNDS ARE TO BE USED TO PURCHASE CAPITAL EQUIPMENT FOR HEALTHCARE SERVICES, HOSPITAL OPERATIONS AND SCHOLARSHIPS. DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE STANDARDS FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES ESTABLISH A RECOGNITION THRESHOLD AND MEASUREMENT FOR INCOME TAX POSITIONS RECOGNIZED IN A HOSPITAL'S FINANCIAL STATEMENTS. THESE STANDARDS HAD NO IMPACT ON THE ACCOMPANYING FINANCIAL STATEMENTS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2007 THROUGH 2010. PART XI, LINE 8 - OTHER ADJUSTMENTS: CHANGE IN INTEREST IN FOUNDATION 32,056. PART XII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -60,974. PART XIII, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -60,974. 1 1 1 X 1 X 1 1 1 0 1 1 210043 210043 1787994 1112315 675679 0.04940 1998037 1322358 675679 0.04940 1011 1011 1011 1011 1999048 1323369 675679 0.04940 1 491515 0 3566656 3541339 25317 X 1 1 1 1 RIVER HOSPITAL

4 FULLER STREET ALEXANDRIA BAY NY 13607

X X X X RIVER HOSPITAL INC 1 PART I, LINE 7: WORKSHEETS 1, 2 & 3 WERE USED TO COMPLETE LINES 7A, 7B AND 7C. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES CONSIST OF PSA SCREENINGS AND MAMMOGRAPHY SCREENINGS GIVEN TO UNINSURED PATIENTS DURING 2010 PART III, LINE 4: AN ALLOWANCE FOR DOUBTFUL ACCOUNTS RECEIVABLE IS ESTIMATED BY MANAGEMENT BASED ON PERIODIC REVIEWS OF THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE CONSIDERING HISTORICAL EXPERIENCE AND PREVAILING ECONOMIC CONDITIONS. CHARITY CARE DISCOUNTS ARE DETERMINED BASED UPON THE CURRENTLY PUBLISHED POVERTY GUIDELINES UNDER OUR "RIVER CARE" PROGRAM. PART III, LINE 9B: UNDER OUR CHARITY CARE PROGRAM, PATIENTS MAY APPLY FOR ASSISTANCE WITHIN 90 DAYS OF DISCHARGE OR DATE OF SERVICE. ONCE THE APPLICATION IS REQUESTED AND RECEIVED BY THE APPLICANT, THE APPLICATION MUST BE RETURNED TO RIVER HOSPITAL WITHIN 20 DAYS. RIVER HOSPITAL DOES NOT PURSUE FURTHER COLLECTION ACTION WHILE THIS APPLICATION IS IN PROCESS PROVIDING THAT THE APPLICATION IS COMPLETED IN A TIMELY FASHION. RIVER HOSPITAL PROCESSES THIS APPLICATION WITHIN 30 DAYS OF RECEIPT. APPLICANTS ARE NOTIFIED IN WRITING OF OUR DECISION. AN INSTALLMENT AGREEMENT IS THEN SENT TO THE APPLICANT, AN INTEREST FREE AGREEMENT, TO BE SIGNED AND RETURNED. PART VI, LINE 2: DURING JULY AND AUGUST 2007 RIVER HOSPITAL SECURED FUNDING TO CONDUCT A SURVEY WITH THE ASSISTANCE OF THE CENTER FOR COMMUNITY STUDIES LOCATED AT JEFFERSON COMMUNITY COLLEGE, WATERTOWN, NEW YORK. THE PURPOSE OF THE SURVEY WAS TO OBTAIN A BETTER UNDERSTANDING OF THE NEEDS OF COMMUNITY MEMBERS SERVED BY THIS FACILITY. RIVER HOSPITAL CONTINUES TO DRAW INFORMATION FROM THIS SURVEY. IN ADDITION, RIVER HOSPITAL IS WORKING WITH A MARKETING FIRM TO DETERMINE COMMUNITY PERCEPTION FOLLOWING THE CLOSING OF THE LONG TERM CARE UNIT. IN ADDITION, THE ADMINISTRATIVE STAFF IS WORKING CLOSELY WITH THE BOARD OF DIRECTORS TO DEVELOP A LONG TERM STRATEGIC PLAN AND LOOKING FOR IMPROVING THE PHYSICAL PLANT AND DEVELOPING MORE OUTPATIENT SERVICES FOR THE COMMUNITIES SERVED BY THIS FACILITY. PART VI, LINE 3: RIVER HOSPITAL PROVIDES FACILITATED ENROLLMENT AS AN INTEGRAL PART OF OUR COLLECTION PROCESS. ADDITIONALLY, APPLICATIONS ARE AVAILABLE TO PATIENTS IN THE REGISTRATION AREAS. PART VI, LINE 4: RIVER HOSPITAL PROVIDES HEALTH CARE SERVICES TO THE SURROUNDING COMMUNITIES INCLUDING THE TOWNS OF ALEXANDRIA, ORLEANS, THERESA, HAMMOND, CLAYTON, AND CAPE VINCENT, AS WELL AS A PORTION OF THE FORT DRUM MILITARY INSTALLATION. IN ADDITION TO THE FULL TIME RESIDENTS OF THESE COMMUNITIES, RIVER HOSPITAL SERVES A LARGE POPULATION OF SEASONAL RESIDENTS AND VISITORS AS A TOURIST AREA. PART VI, LINE 6: SINCE THE SUBMISSION OF THE LAST COMMUNITY SERVICE PLAN, RIVER HOSPITAL IS CONTINUING TO WORK WITH THE JEFFERSON AND LEWIS COUNTY PUBLIC HEALTH DEPARTMENTS AND OTHER AREA AGENCIES IN THE HEALTH PLANNING INITIATIVE. THROUGH THE JOINT EFFORTS OF THE AGENCIES INVOLVED IN THE HEAL NY PHASE 9 WORK PLAN SOUND PUBLIC INPUT HAS BEEN USED IN IDENTIFYING AND ADDRESSING HEALTH NEEDS OF THE ENCOMPASSING COMMUNITIES. THE COMMUNITY SURVEY CONDUCTED IN JEFFERSON AND LEWIS COUNTY COMMUNITIES WAS THE METHOD OF COLLECTION DATA AND IT WAS DETERMINED THAT PREVENTION STRATEGIES WOULD FOCUS ON DIABETES PREVENTION AND AWARENESS. PART VI, LINE 7: RIVER HOSPITAL PARTICIPATED IN HEALTH & WELLNESS FAIRS WHERE WE DISTRIBUTED OF HEALTH INFORMATION AND INFORMATION ABOUT RIVER HOSPITAL INCLUDING "READY, SET, FUN", PBS FAMILY DAY,:"WOMEN'S DAY HEALTH DAY."RIVER HOSPITAL HOSTED AREA STUDENTS IN THE MASH CAMP IN THE SUMMER OF 2010. MASH CAMP, HELD ALSO AT OTHER NORTH COUNTRY HOSPITALS THIS SUMMER, IS SPONSORED BY THE NORTHERN NEW YORK RURAL HEALTH CARE ALLIANCE. THE CAMP ENCOMPASSES A CURRICULUM BASE AND IS DIVIDED INTO THREE LEVELS. THE FIRST IS FOR FIRST-YEAR STUDENTS WHO WILL EXPLORE CAREERS IN HEALTH CARE AND RECEIVE CARDIOPULMONARY RESUSCITATION CERTIFICATION, WHILE LEVEL 2 STUDENTS WILL LEARN HOW TO PROVIDE BASIC FIRST AID AND SURVIVAL SKILLS AND TO APPLY SCIENCES TO HEALTH PROBLEMS. LEVEL 3 STUDENTS LEARN BASIC ASSESSMENT SKILLS AND EXPLORE ILLNESS THROUGH CASE STUDIES, MINI LECTURES AND DIAGNOSTIC PROCEDURES. EVENTUALLY, THE PROGRAM WILL BE ABLE TO TRACK STUDENTS' PARTICIPATING IN MASH CAMP, SET UP "JOB SHADOWS" THROUGH THE FORT DRUM REGIONAL HEALTH PLANNING ORGANIZATION AND THEN SEE WHAT UNIVERSITIES AND PROGRAM OF STUDY EACH STUDENT CHOOSES.OUR REGISTERED DIETICIAN, NICOLE GARNSEY RD, CDE, HOSTED DIABETIC SUPPORT GROUP FOR DIABETICS AND THEIR CAREGIVERS TO DISCUSS THE DISEASE AND HOW TO LIVE WITH IT AN CONTROL IT. THE GROUP WAS SCHEDULED TO MEET MONTHLY AT RIVER HOSPITAL.THE HOSPITAL HELD "LEARN TO BREATHE EASIER" MEETINGS WERE SCHEDULED MONTHLY FOR INDIVIDUALS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE, COPD TO TAKE STEPS TO LEARN HOW TO IMPROVE THEIR ABILITY TO BREATH.THE 'BUILDING HEALTHY COMMUNITIES COALITION IN ALEXANDRIA' WAS ESTABLISHED THROUGH A GRANT THAT JEFFERSON COUNTY PUBLIC HEALTH SERVICE RECEIVED TO BRING TOGETHER A GROUP OF COMMUNITY LEADERS IN ORDER TO ADDRESS THE PHYSICAL ACTIVITY AND NUTRITION NEEDS IN THE TOWN OF ALEXANDRIA. THE COALITION CURRENTLY CONSISTS OF ACTIVE REPRESENTATIVES FROM RIVER HOSPITAL, ALEXANDRIA CENTRAL SCHOOL, THE REDWOOD NEIGHBORHOOD ASSOCIATION, HEARTS FOR YOUTH, CORNELL COOPERATIVE EXTENSION OF JEFFERSON COUNTY, AND JEFFERSON COUNTY PUBLIC HEALTH SERVICE. THE COALITION SEEKS TO ADD ADDITIONAL MEMBERS WITH LEADERSHIP CAPABILITIES WITHIN THE COMMUNITY AND/OR A COMMON INTEREST IN CURBING CHRONIC DISEASE AND CREATING A HEALTHIER ENVIRONMENT FOR THE RESIDENTS OF ALEXANDRIA.THE GROUP BEGAN BY CONDUCTING AN ASSESSMENT OF LOCAL OPPORTUNITIES AND BARRIERS TO HEALTHY BEHAVIORS THAT EXIST WITHIN ALEXANDRIA AND CHOOSING AREAS OF FOCUS FOR THE GRANT. A TEAM OF FIVE PEOPLE FROM THE COALITION THEN ATTENDED AN ACTION INSTITUTE ON FEBRUARY 25-26, 2010 AND DEVELOPED AN INITIAL ACTION PLAN FOR THE COMMUNITY. FUNDING WAS THEN USED TO IMPLEMENT THREE IDENTIFIED PRIORITY STRATEGIES BASED ON THE ACTION PLAN. THE STRATEGIES INCLUDED INCREASING PHYSICAL ACTIVITY OPPORTUNITIES IN THE TOWN OF ALEXANDRIA, INCREASING ACCESS TO FRUITS AND VEGETABLES IN THE TOWN OF ALEXANDRIA, AND PROMOTING THE IMPORTANCE OF WELLNESS WITHIN THE COMMUNITY. RIVER HOSPITAL REACHED OUT TO FORT DRUM REGIONAL HEALTHCARE PLANNING ORGANIZATION TO ASSIST IN THE COORDINATION OF THE FIRST TRAINING DAY FOR EMS ENTITLED "BATTLEFIELD EMERGENCY CARE: WHAT CAN COMBAT MEDICINE TEACH US FROM THE SCENE TO THE ER?" THIS DAY INCLUDED CLASSROOM TRAINING AS WELL AS HANDS-ON TRAINING AT THE FORT DRUM MILITARY INSTALLATION'S SIMULATION CENTER. IT WAS VERY WELL RECEIVED. IN ADDITION, SOME OF THE FUNDING COVERED THE COST OF EQUIPMENT FOR OUR EMERGENCY DEPARTMENT AND EMS SQUADS IN RIVER HOSPITAL'S SERVICE AREA WHO PARTICIPATED IN THE TRAINING DAY.SEVERAL HOSPITAL DEPARTMENTS PARTICIPATED IN THE CROWLEY'S ANNUAL HEALTH DAY FOR EMPLOYEES AND OFFERED SCREENING SERVICES AND PROPER LIFTING AND STRETCHING TECHNIQUES AT THEIR PLANT. SCREENINGS INCLUDED BLOOD PRESSURE CHECKS, SPIROMETRY, CHOLESTEROL, ALONG WITH DISTRIBUTING HEALTH INFORMATION FOR AGE APPROPRIATE SCREENING AND SMOKING CESSATION.IN COOPERATION WITH CANCER SERVICE PROGRAM, RIVER HOSPITAL PARTICIPATED IN THE "LOVE YOURSELF" CAMPAIGN TO INCREASE AWARENESS FOR THE IMPORTANCE OF WOMEN OVER THE AGE OF 40 TO BE SCREENED ANNUALLY FOR BREAST CANCER.THROUGH HEAL 9 GRANT FUNDING WITH JEFFERSON COUNTY PUBLIC HEALTH, RIVER HOSPITAL WAS ABLE TO DEVELOP AND EXECUTE A WORK PLAN WITH A FOCUS ON THE CHRONIC DISEASE OF DIABETES. THIS INCLUDED PARTICIPATION FOR OUR CLINICAL PROVIDERS TO WORK WITH ALEXANDRIA CENTRAL SCHOOL'S 5TH GRADE STUDENTS AND HEALTH INSTRUCTOR TO IMPROVE ACTIVITY AND HEALTH NUTRITION HABITS THROUGH "PLANET HEALTH" CURRICULUM. INCLUDED IN THIS WORK PLAN WAS DISTRIBUTION OF "PREVENTION KITS" FOR 10 PATIENTS 'AT RISK' AND 10 PATIENTS 'DIAGNOSED' WITH DIABETES, ALONG WITH 8 'SCHOLARSHIPS' FOR PT EVALUATIONS, CONSULTATION AND 2 MONTH GYM MEMBERSHIP FOR CLINIC PATIENTS WHO DO NOT HAVE ADEQUATE RESOURCES TO AFFORD THIS SERVICE. IN ADDITION TO THESE ACTIVITIES, WE HAVE BEEN ABLE TO COVER THE EXPENSES FOR ONE OF OUR RN'S TO RECEIVE DIABETES EDUCATION AND TRAINING, AND EXAM FEES. REPORTS FILED WITH STATES PART VI, LINE 7 NY X X X 0 0 0 0 0 0 0 0 0 BEN MOORE 240000 0 0 0 0 0 0 0 0 0 240000 0 0 0 HARRIET BURRIS 166685 0 0 0 0 0 0 0 4523 0 171208 0 0 0 AARON HUIZENGA 168197 0 0 0 0 0 0 0 10486 0 178683 0 0 0 MAHREEN RAZZAQ 171029 0 0 0 0 0 0 0 4523 0 175552 0 0 0 REBECCA ALBERTO-TAN 249019 0 0 0 0 0 0 0 10486 0 259505 0 0 0 NEW PROGRAM SERVICES FORM 990, PART III, LINE 2 THERE WERE SIGNIFICANT RADIOLOGY UPDATES. WE ADDED DIGITAL X-RAY SERVICES AND UPGRADED OUR CT SCANNER TO 16 SLICE IMAGERY. CHANGES IN PROGRAM SERVICES FORM 990, PART III, LINE 3 THE NURSING HOME CLOSED IN MAY 2010 DUE TO CONTINUED OPERATING DEFICIT AND LOW LEVELS OF REIMBURSEMENT RATES FROM GOVERNMENT AGENCIES. FORM 990, PART VI, SECTION A, LINE 7A THE DIRECTORS OF THE ORGANIZATION MAY ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS MADE AVAILABLE TO THE BOARD MEMBERS PRIOR TO ITS FILING. FORM 990, PART VI, SECTION B, LINE 12C EACH MEMBER OF THE BOARD IS REQUIRED TO COMPLETE AND SIGN A CONFLICT OF INTEREST POLICY ANNUALLY. IF A CONFLICT ARISES IN BETWEEN ANNUAL REVIEW OF THE POLICY, THE BOARD MEMBER IS REQUIRED TO AND RESPONSIBLE FOR REPORTING THE CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE CEO'S WAGES ARE REVIEWED AND APPROVED BY THE BOARD OF TRUSTEES AND COMPARABLE REGIONAL WAGE DATA PROVIDED BY PAYSCALE AND IROQUOIS SURVEY WAGE DATA ARE USED TO DETERMINE COMPETITIVE WAGES. THE CEO IS MONITORED AND EVALUATED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS. THE EXECUTIVE DIRECTOR, AND OTHER TOP MANAGEMENT OFFICERS ARE MONITORED AND REVIEWED ON AN ANNUAL BASIS BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE COMPANY'S WEBSITE. THE FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC THROUGH THE PUBLIC CHARITY WEBSITE. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 16,967. CHANGE IN INTEREST IN FOUNDATION 32,056. TOTAL TO FORM 990, PART XI, LINE 5: 49,023. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. RIVER HOSPITAL FOUNDATION PO BOX 567 ALEXANDRIA BAY NY 13607 421585479 RAISES FUNDS FOR HOSPITAL CONSTRUCTION, REMODELING AND MEDICAL EQUIPMENT. NY 501 (C) 3 11C RIVER HOSPITAL INC 0 0 0 1 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0