2023-11-15T09:47:05-06:00 2022-12-31 454051133 FREED MAXICK CPAS PC 424 MAIN STREET SUITE 800 BUFFALO NY 142023508 990 2022-01-01 161035427 CROUSE HEALTH FOUNDATION INC CROU 3154707702 736 IRVING AVENUE SYRACUSE NY 132101687 KATHLEEN MILLER-MURPHY INTERIM EXECUTIVE DIRECTOR 3154702655 2023-11-13 1 KATHLEEN MILLER-MURPHY XXX-XX-XXXX 0 MARY MADONIA P00405803 7168472651 2023-11-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z KATHLEEN MILLER-MURPHY 736 IRVING AVENUE SYRACUSE NY 132101687 3983238 0 X WWW.CROUSE.ORG X 1974 NY THE MISSION OF CROUSE HEALTH FOUNDATION, INC IS TO SUPPORT CROUSE HOSPITAL INC IN PROVIDING THE BEST IN PATIENT CARE AND PROMOTING COMMUNITY HEALTH. 36 28 0 100 0 0 2023533 730417 0 0 1465249 761639 69947 492407 3558729 1984463 1561185 2130404 0 0 681635 496679 0 0 526707 166355 1062515 2409175 3689598 1149554 -1705135 36778618 28371180 812122 240117 35966496 28131063 THE MISSION OF CROUSE HEALTH FOUNDATION, INC IS TO SUPPORT CROUSE HOSPITAL INC IN PROVIDING THE BEST IN PATIENT CARE AND PROMOTING COMMUNITY HEALTH. 0 0 2130404 2130404 CONTRIBUTIONS TO CROUSE HEALTH HOSPITAL INC FOR PURPOSES OF EQUIPMENT ACQUISTION, EDUCATION, AND SCHOLARSHIP FUNDING. IN ADDITION, CONTRIBUTIONS TO THE HOSPITAL ARE MADE FOR PURPOSES OF UNDERWRITING EXPENSES ASSOCIATED WITH PATIENT AND GUEST RELATIONS, GRANT ADMINISTRATION AND OTHER PURPOSES. 2130404 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 5 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 36 28 0 0 0 0 0 0 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X THE ORGANIZATION 3154707702 736 IRVING AVENUE SYRACUSE NY 132101687 VINCENT SPINA TRUSTEE, BOARD CHAIR 1.00 X X 0 0 0 JOYCE MAWHINNEY MACKNIGHT TRUSTEE, BOARD VICE CHAIR 1.00 X X 0 0 0 THOMAS R CURRAN JR MD TRUSTEE, BOARD VICE CHAIR 1.00 X X 0 0 0 KIMBERLY BOYNTON TRUSTEE, BOARD VICE CHAIR 1.00 42.00 X X 0 1036936 84906 LISA BETHMANN TRUSTEE, BOARD SECRETARY 1.00 X X 0 0 0 JOHN O'CONNOR TRUSTEE, BOARD TREASURER 1.00 X X 0 0 0 KEVIN RANDALL TRUSTEE, BOARD ASST TREASURER 1.00 42.00 X X 0 347191 57608 ANTHONY FIORITO TRUSTEE, BOARD ASST SECRETARY 1.00 X X 0 0 0 CHRISTINE O'CONNELL MORE TRUSTEE 1.00 X 0 0 0 CARLENE LACEY TRUSTEE 1.00 X 0 0 0 DOUGLAS LOGAN TRUSTEE 1.00 X 0 0 0 FRANK SMITH MD TRUSTEE 1.00 X 0 20000 0 JEFFREY ASCENZO MD TRUSTEE 1.00 40.00 X 0 609563 46339 JOAN O DADEY TRUSTEE 1.00 40.00 X 0 89616 44171 JOHN GAAL TRUSTEE 1.00 X 0 0 0 TOLANI AJAGBE MD TRUSTEE 1.00 30.00 X 0 272755 44288 ANITA LOMBARDI TRUSTEE 1.00 X 0 0 0 MARK WORDEN TRUSTEE 1.00 X 0 0 0 PATRICIA DEFERIO TRUSTEE 1.00 X 0 0 0 MARK RE TRUSTEE 1.00 X 0 0 0 MELVIN T STITH TRUSTEE 1.00 X 0 0 0 SALVATORE J BELLAVIA TRUSTEE 1.00 X 0 0 0 LAURENCE G BOUSQUET TRUSTEE 1.00 X 0 0 0 TIMOTHY ATSEFF TRUSTEE 1.00 X 0 0 0 ZACHARY ZUCKERMAN TRUSTEE 1.00 X 0 0 0 PETER DERRENBACKER TRUSTEE 1.00 X 0 0 0 JUDY COWDEN TRUSTEE 1.00 X 0 0 0 SCOTT KINGSLEY TRUSTEE 1.00 X 0 0 0 EDWARD BARNO TRUSTEE 1.00 X 0 0 0 MICHELLE BODE MD TRUSTEE 1.00 40.00 X 0 260950 45678 ROCHELLE CUMMINGS TRUSTEE 1.00 X 0 0 0 PAUL SOLOMON TRUSTEE 1.00 X 0 0 0 JENNIFER JACKSON DONAHOE TRUSTEE 1.00 X 0 0 0 MEGAN GRANT TRUSTEE 1.00 X 0 0 0 JEFFREY PAWLOWSKI TRUSTEE 1.00 X 0 0 0 JOHN BARSANTI TRUSTEE, INTERIM EXE DIRECTOR 40.00 X X 124000 0 0 STEVEN ST AMOUR TRUSTEE (TO JUNE 2022) 1.00 X 0 0 0 SANDRA POMEROY TRUSTEE / VICE CHAIR (TO JUNE 2022) 1.00 X 0 0 0 LINDSEY HAZELTON TRUSTEE (TO JUNE 2022) 1.00 X 0 0 0 MICHELE JOHNSON TRUSTEE (TO JUNE 2022) 1.00 X 0 0 0 PAMELA REILLY TRUSTEE (TO JUNE 2022) 1.00 X 0 0 0 JEREMY THURSTON TRUSTEE (TO JUNE 2022) 1.00 X 0 0 0 GREGORY BAUM TRUSTEE (TO JUNE 2022) 1.00 X 0 0 0 PHYLLIS DEVLIN TRUSTEE, INTERIM EXE DIRECTOR (TO JUNE 2022) 40.00 X 70209 0 14992 194209 2637011 337982 1 0 1 0 CROUSE HEALTH HOSPITAL INC 736 IRVING AVE SYRACUSE NY 13210 STAFF SERVICES 496679 THE ONCENTER 760 S STATE STREET SYRACUSE NY 13202 EVENT SERVICES 176364 2 119730 610687 730417 581257 581257 1787338 1606956 180382 180382 180382 884226 119730 391819 492407 492407 1984463 0 0 1254046 2130404 2130404 396645 79329 317316 100034 20007 80027 5728 5728 13100 13100 39022 39022 153100 30620 122480 19601 19601 53964 53964 27210 27210 626 626 11333 11333 BAD DEBT 715897 715897 OTHER EXPENSES 9047 9047 DUES & SUBSCRIPTIONS 7003 7003 CREDIT CARD FEES 6884 6884 3689598 2130404 1032487 526707 763362 972376 3239509 1699419 54990 61228 43722 43722 626 0 32093620 25023594 497663 490804 128848 123759 36778618 28371180 220419 238216 586758 0 4945 1901 812122 240117 X 10376522 8032460 25589974 20098603 35966496 28131063 36778618 28371180 -1705135 -6130298 0 X X 0 1 X 1 0 X 3077650 2851596 1718657 2023533 730417 10401853 3077650 2851596 1718657 2023533 730417 10401853 1578384 8823469 537875 655506 732062 706317 581257 3213017 13614870 3398445 0.64810 0.61260 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 35726515 83575 -9694110 2353703 23762277 33210738 984073 2243853 712149 35726515 29916900 318485 3701292 725939 33210738 26074042 270273 4294127 721542 29916900 27601980 690564 -1306174 912328 26074042 0.35376 0.64624 0.00000 1 0 43722 43722 0 0 LIABILITIES UNDER SPLIT-INTEREST AGREEMENT 1901 1901 X -3754016 -6130298 391819 -5738479 1984463 0 1984463 4081417 391819 391819 3689598 0 3689598 PART V, LINE 4: THE PURPOSE OF THE FOUNDATION'S ENDOWMENT FUND IS TO GIVE ANNUAL GRANTS TO CROUSE HOSPITAL TO UNDERWRITE HIGH-PRIORITY EQUIPMENT AND PROGRAM NEEDS. ALL DONOR RESTRICTIONS FOR ENDOWMENT FUNDS ARE HONORED. PART X, LINE 2: THE FOUNDATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(1). THE FOUNDATION FOLLOWS US GAAP PERTAINING TO UNCERTAIN TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE FOUNDATION FILES ITS RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX IN THE U.S. FEDERAL JURISDICTION AND THE ANNUAL FILING OF CHARITABLE ORGANIZATION IN NEW YORK STATE. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NETTED AGAINST REVENUE 391,819. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES NETTED AGAINST REVENUE 391,819. TRIBUTE EVENING 693536 91800 601736 255713 CROUSE CLASSIC GOLF EVENT 196676 27930 168746 74668 2 113744 113744 61438 1003956 119730 884226 391819 391819 492407 1 CROUSE HEALTH HOSPITAL INC 736 IRVING AVE SYRACUSE NY 13210 160960470 501(C)(3) 2130404 0 EQUIPMENT ACQUISTION, SCHOLARSHIPS & PROGRAM EXPENSES 1 PART I, LINE 2: THE FOUNDATION REIMBURSES CROUSE HEALTH HOSPITAL, INC. ONCE DOCUMENTATION IS PROVIDED. DOCUMENTATION CONSISTS OF INVOICE COPY AND PROOF OF PAYMENT SUPPORTED BY CHECK COPY. 0 0 0 0 0 0 0 0 0 KIMBERLY BOYNTON TRUSTEE, BOARD VICE CHAIR 0 925027 0 108642 0 3267 0 26823 0 58083 0 1121842 0 0 JEFFREY ASCENZO MD TRUSTEE 0 509563 0 100000 0 0 0 11993 0 34346 0 655902 0 0 KEVIN RANDALL TRUSTEE, BOARD ASST TREASURER 0 337191 0 10000 0 0 0 9938 0 47670 0 404799 0 0 TOLANI AJAGBE MD TRUSTEE 0 272755 0 0 0 0 0 7288 0 37000 0 317043 0 0 MICHELLE BODE MD TRUSTEE 0 235900 0 25050 0 0 0 6385 0 39293 0 306628 0 0 FORM 990, PART VI, SECTION A, LINE 7B THE ELECTION OF OFFICERS AND TRUSTEES OF CROUSE HEALTH FOUNDATION BY THE BOARD OF TRUSTEES OF THE FOUNDATION IS RATIFIED AND APPROVED BY CROUSE HEALTH SYSTEMS. CROUSE HEALTH FOUNDATION BY-LAWS REQUIRE CROUSE HEALTH SYSTEMS TO APPROVE ANY AMENDMENTS TO THE FOUNDATION'S BY-LAWS OR CERTIFICATE OF INCORPORATION BEFORE THE AMENDMENT CAN BE EFFECTIVE. FORM 990, PART VI, SECTION B, LINE 11B INFORMATION IS PROVIDED TO AN INDEPENDENT ACCOUNTING FIRM THAT PREPARES THE 990 AND ALL REQUIRED SCHEDULES. THE FOUNDATION PRESIDENT AND LEGAL FOR THE FOUNDATION WILL REVIEW THE 990 AND ALL REQUIRED SCHEDULES BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST DISCLOSURE STATEMENTS ARE COMPLETED ANNUALLY BY THE BOARD OF TRUSTEES, OFFICERS, AND KEY EMPLOYEES OF CROUSE HEALTH FOUNDATION. THE STATEMENTS ARE REVIEWED BY SENIOR STAFF. THE STATEMENTS ARE ALSO AVAILABLE FOR REVIEW BY AN INDEPENDENT AUDITOR AS PART OF THE ANNUAL FINANCIAL AUDIT. ALL POTENTIAL CONFLICTS OF INTEREST ARE EVALUATED, REPORTED TO THE AUDIT COMMITTEE, AND THEN DISCUSSED AMONG THE PARTIES. A REPORT IS THEN PROVIDED TO THE BOARD OF TRUSTEES UPON COMPLETION OF THE COMPLIANCE REVIEW. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION FOR ALL KEY EMPLOYEES, OFFICERS, CEO AND THE REST OF SENIOR MANAGEMENT OF CROUSE HEALTH HOSPITAL IS DONE BASED ON ANNUAL BOARD OF DIRECTOR REVIEW IN CONJUNCTION WITH HUMAN RESOURCES. CURRENT COMPENSATION IS COMPARED TO NATIONAL SALARY SURVEYS FOR COMPARABLE ORGANIZATIONS AND ANY NECESSARY ADJUSTMENTS ARE DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF CROUSE HEALTH HOSPITAL FOLLOWING REQUIREMENTS OF 26 C.F.R SECTION 53.4958-6(C). FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS OF CROUSE HEALTH FOUNDATION ARE AVAILABLE TO THE PUBLIC UPON REQUEST. CROUSE HEALTH FOUNDATION HAS THE SAME CONFLICT OF INTEREST POLICY AS ITS AFFILIATED ORGANIZATION, CROUSE HEALTH HOSPITAL. THE CONFLICT OF INTEREST POLICY CAN BE FOUND ON THE HOSPITAL'S WEBSITE WWW.CROUSE.ORG UNDER "CORPORATE COMPLIANCE PROGRAM HANDBOOK". THE FOUNDATION DOES NOT MAKE ITS GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 2C THE ORGANIZATION HAS AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. CROUSE HEALTH HOSPITAL INC 736 IRVING AVE SYRACUSE NY 13210 160960470 HEALTH CARE SERVICES NY 501(C)(3) LINE 3 CROUSE HEALTH SYSTEM INC 0 CROUSE HEALTH SYSTEM INC 736 IRVING AVE SYRACUSE NY 13210 161560473 PROVIDE OFF SITE SPACE AND SECURE CAPITAL FOR CROUSE HEALTH HOSPITAL, INC. NY 501(C)(3) LINE 12B, II N/A 0 CROUSE MEDICAL PRACTICE PLLC 736 IRVING AVE SYRACUSE NY 13210 800548096 FURTHER CROUSE HOSPITAL'S PURPOSE BY PROVIDING PROFESSIONAL MEDICAL SERVICES NY 501(C)(3) LINE 10 N/A 0 CROUSE HEALTH NETWORK LLC 736 IRVING AVE SYRACUSE NY 13210 472918011 ESTABLISH/OPERATE ACCTABLE CARE ORG OF CLINICALLY INTEGR HLTHCARE PROVIDERS NY 501(C)(3) LINE 3 CROUSE HEALTH HOSPITAL INC 0 0 1 0 1 0 0 0 0 0 0 1 1 0 0 0 1 0 0 0