2021-11-15T16:35:04-06:00 2020-12-31 822624857 GRAY & GRAY AND ASSOCIATES CPAS PC 1 MAIN STREET SUITE 101 CANTON NY 136171277 990 2020-01-01 460714367 CANTON-POTSDAM MED PRACTICE PLLC CANT 3152615100 50 LEROY STREET POTSDAM NY 13676 ROBERT T ROGERSII MD MEDICAL DIRECTOR 3152615100 2021-10-21 true ROBERT ROGERS 999009999 JOHN J GRAY JR CPA P00076464 3153862925 2021-11-15 2020 2022-09-23 18:48:47Z ROBERT T ROGERSII MD 50 LEROY STREET POTSDAM NY 13676 1486639 false X N/A X PLLC 2012 NY CANTON-POTSDAM MEDICAL PRACTICE'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE PHYSICIAN SERVICES, IN AN OUTPATIENT CLINIC SETTING, THAT PROVIDE PUBLIC BENEFIT TO THE COMMUNITY AND CANTON-POTSDAM HOSPITAL. 1 0 0 0 0 1964831 1448197 0 38442 1964831 1486639 0 0 2753247 2487566 0 0 642005 655069 3395252 3142635 -1430421 -1655996 372357 209847 1651790 3145376 -1279433 -2935529 X CANTON-POTSDAM MEDICAL PRACTICE'S PRIMARY EXEMPT PURPOSE IS TO PROVIDE PHYSICIAN SERVICES, IN AN OUTPATIENT CLINIC SETTING, THAT PROVIDE PUBLIC BENEFIT TO THE COMMUNITY AND CANTON-POTSDAM HOSPITAL. false false 807986 1291440 CANTON-POTSDAM MEDICAL PRACTICE OPERATED A GASTROENTEROLOGY CLINIC IN 2020. PATIENT VISITS TOTALED APPROXIMATELY 2,225. THE GASTROENTEROLOGY CLINIC OPENED IN OCTOBER OF 2014 AND SERVES THE SURROUNDING NORTH COUNTRY COMMUNITIES OF (AND INCLUDING) POTSDAM, NEW YORK. 656441 761159 CANTON-POTSDAM MEDICAL PRACTICE OPERATED A GENERAL SURGERY CLINIC IN 2020. PATIENT VISITS TOTALED APPROXIMATELY 1,193. THIS CLINIC OPENED IN AUGUST OF 2014 AND SERVES THE SURROUNDING NORTH COUNTRY COMMUNITIES OF (AND INCLUDING) POTSDAM, NEW YORK. 944498 1645247 CANTON-POTSDAM MEDICAL PRACTICE OPERATED A DERMATOLOGY PRACTICE IN 2020. PATIENT VISITS TOTALED APPROXIMATELY 5,701. THIS CLINIC OPENED IN 2019 AND SERVES THE SURROUNDING NORTH COUNTRY COMMUNITIES OF (AND INCLUDING) POTSDAM, NEW YORK. 656210 542259 CANTON-POTSDAM MEDICAL PRACTICE OPERATES A FAMILY HEALTH CLINIC LOCATED IN COLTON NY. THIS CLINIC HAD APPROXIMATELY 2,834 VISITS IN 2020 WITH OPERATING EXPENSES OF 409K. CANTON-POTSDAM MEDICAL PRACTICE ADDITIONALLY OPERATES OTHER PROGRAM SERVICES WITH 246K IN EXPENSES. 656210 542259 3065135 true false false false false false false false false false true false false true true true false true false false false false false false false false false false false true false false false false false true false false false false false false false true false false false true 4 0 true 0 false false false false false false false false X 1 0 false true false false true false false true false false false true true true true true true true true false X DONNA MCGREGOR 3152615451 50 LEROY STREET POTSDAM NY 13676 RICHARD D JACOBS FINANCE 8.00 50.00 X 0 389565 33225 ROBERT T ROGERSII MD MEDICAL DIRE 1.00 50.00 X 0 222009 12606 DONNA MCGREGOR FINANCE 8.00 50.00 X 0 184769 16191 796343 62022 false true false KOPP BILLING AGENCY INC PO BOX 2337 SYRACUSE NY 13220 BILLING/COLLECT 137937 1 PROGRAM SERVICE REVENUE 621400 1448197 1448197 1448197 OTHER OPERATING REVENUE 621400 38442 38442 38442 1486639 1486639 2125178 2125178 362388 362388 30108 30108 2650 2650 170229 170229 71 71 1477 1477 7 7 13230 12342 888 68418 68150 268 PURCHASED SERVICES 237699 237699 SUPPLIES 73708 73708 OTHER 26313 327 25986 ALL OTHER EXPENSES 19781 3729 16052 11378 11378 3142635 3065135 77500 0 54015 38912 256359 122022 1086 1518 6267 6586 199574 174226 54630 25348 15461 372357 209847 47838 58367 1603952 3087009 1651790 3145376 X -1279433 -2935529 -1279433 -2935529 372357 209847 -1655996 -100 X false true X true false X 11044644 6051657 3724091 5867052 4240105 30927549 11044644 6051657 3724091 5867052 4240105 30927549 30927549 11796 2 2205 38442 52445 11056440 6051659 3726296 5867052 4278547 30979994 0.99830 0.99960 0.00000 0.00000 X PART III, LINE 12 VENDOR PURCHASE DISCOUNT 14,009 STIMULUS GRANT FUNDS 38,436 13024 9673 3351 186550 164553 21997 25348 OTHER RECEIVABLES 15461 15461 DUE TO AFFILIATES 3087009 3087009 X 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. false false false false false false false false false RICHARD D JACOBS FINANCE 389565 19950 13275 422790 ROBERT T ROGERSII MD MEDICAL DIRECTOR 222009 12606 234615 DONNA MCGREGOR FINANCE 184769 3273 12918 200960 SCHEDULE J, PART III CANTON-POTSDAM MEDICAL PRACTICE DOES NOT HAVE ANY EMPLOYEES ON ITS PAYROLL AND ALL "EMPLOYEES" ARE CONTRACTED THROUGH CANTON-POTSDAM HOSPITAL, RELATED TAX EXEMPT ORGANIZATION. AS SUCH, THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF CANTON-POTSDAM HOSPITAL SEEKS INPUT OF A CONSULTING FIRM WITH NATIONAL EXPERIENCE TO REVIEW COMPENSATION PACKAGES OFFERED TO TOP MANAGEMENT AND THE REGULATORY COMPLIANCE ISSUES OF NON-FOR-PROFITS. UPON THE FINDINGS OF THE CONSULTANT AND DELIBERATIONS OF THE COMPENSATION COMMITTEE, THE COMMITTEEE WILL THEN MAKE RECOMMENDATION TO THE FULL BOARD. THE FULL BOARD WILL THEN VOTE ON THE TOP OFFICIALS COMPENSATION PACKAGE. ROBERT T ROGERS II MD MEDICAL DIRECTO 234615 COMPENSATION false SCHEDULE L, PART V CANTON-POTSDAM HOSPITAL, RELATED ORGANIZATION, HAS BUSINESS TRANSACTIONS INVOLVING ROBERT T. ROGERS, II, MD, AN EMPLOYEE AT CANTON-POTSDAM HOSPITAL AND MEDICAL DIRECTOR OF CANTON-POTSDAM HOSPITAL. CANTON-POTSDAM HOSPITAL REMITTED APPROXIMATELY 234,615 TO ROBERT T. ROGERS, II, MD FOR COMPENSATION. FORM 990, PAGE 2, PART III, LINE 4D CANTON-POTSDAM MEDICAL PRACTICE OPERATES A FAMILY HEALTH CLINIC LOCATED IN COLTON NY. THIS CLINIC HAD APPROXIMATELY 2,834 VISITS IN 2020 WITH OPERATING EXPENSES OF 409K. CANTON-POTSDAM MEDICAL PRACTICE ADDITIONALLY OPERATES OTHER PROGRAM SERVICES WITH 246K IN EXPENSES. FORM 990, PAGE 6, PART VI, LINE 3 CANTON-POTSDAM MEDICAL PRACTICE DOES NOT HAVE ANY EMPLOYEES ON ITS PAYROLL. ALL "EMPLOYEES", INCLUDING THOSE THAT PERFORM MANAGEMENT FUNCTIONS, ARE CONTRACTED THROUGH CANTON-POTSDAM HOSPITAL, RELATED TAX EXEMPT ORGANIZATION. EMPLOYEES OF CANTON-POTSDAM HOSPITAL ARE LEASED TO CANTON- POTSDAM MEDICAL PRACTICE TO PROVIDE ALL MEDICAL STAFF AND MANAGEMENT SERVICES. SERVICE AGREEMENTS ARE IN PLACE BETWEEN THE TWO RELATED ORGANIZATIONS. CANTON-POTSDAM HOSPITAL INVOICES CANTON-POTSDAM MEDICAL PRACTICE FOR THESE SERVICES. KEY EMPLOYEE, DONNA MCGREGOR, IS AN EMPLOYEE OF CANTON-POTSDAM HOSPITAL WHO IS RESPONSIBLE FOR THE FINANCIAL REPORTING OF CANTON-POTSDAM MEDICAL PRACTICE. ROBERT T. ROGERS, II, MD, IS AN EMPLOYEE OF CANTON-POTSDAM HOSPITAL WHO IS THE SOLE MEMBER MANAGER OF THE PLLC. FORM 990, PAGE 6, PART VI, LINE 8B CANTON-POTSDAM MEDICAL PRACTICE DID NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY, AND THUS NO COMMITTEE MEETINGS WERE HELD. 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 REVIEW AND 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 CANTON-POTSDAM MEDICAL PRACTICE ADVISORY COMMITTEE AND TO THE SOLE MEMBER OF CANTON-POTSDAM MEDICAL PRACTICE, ROBERT T. ROGERS, II, MD FOR FURTHER REVIEW AND COMMENT (PRIOR TO IRS SUBMISSION). FORM 990, PAGE 6, PART VI, LINE 12C THE KEY EMPLOYEE AND SOLE MEMBER OF CANTON-POTSDAM MEDICAL PRACTICE ARE EMPLOYEES OF CANTON-POTSDAM HOSPITAL, RELATED ORGANIZATION. ALL EMPLOYEES ADHERE TO CANTON-POTSDAM HOSPITAL'S WRITTEN CONFLICT OF INTEREST POLICY. DISCLOSURE STATEMENTS ARE REVIEWED ANNUALLY. FORM 990, PAGE 6, PART VI, LINE 15A LINE 15A: AS STATED ABOVE IN THIS SCHEDULE O, CANTON-POTSDAM MEDICAL PRACTICE DOES NOT HAVE ANY EMPLOYEES ON ITS PAYROLL AND ALL "EMPLOYEES" ARE CONTRACTED THROUGH CANTON-POTSDAM HOSPITAL, RELATED TAX EXEMPT ORGANIZATION. AS SUCH, THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF CANTON-POTSDAM HOSPITAL 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 THE 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 OFFICIALS COMPENSATION PACKAGE. FORM 990, PAGE 6, PART VI, LINE 15B THE KEY EMPLOYEE AND SOLE MEMBER OF CANTON-POTSDAM MEDICAL PRACTICE ARE EMPLOYEES OF CANTON-POTSDAM HOSPITAL, RELATED ORGANIZATION. COMPENSATION OF EMPLOYEES IS DETERMINED BY CANTON-POTSDAM HOSPITAL'S PROCESSES FOR DETERMINING COMPENSATION. THEY ARE AS FOLLOWS: 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. ST LAWRENCE HEALTH SYSTEM INC 50 LEROY STREET POTSDAM NY 13676 464259168 SEE VII NY 501C3 12A NA false CANTON-POTSDAM HOSPITAL 50 LEROY STREET POTSDAM NY 13676 161012691 HOSPITAL NY 501C3 3 SLHS true GOUVERNEUR HOSPITAL INC 77 WEST BARNEY STREET GOUVERNEUR NY 13642 464249555 HOSPITAL NY 501C3 3 SLHS true MASSENA HOSPITAL INC 1 HOSPITAL DRIVE MASSENA NY 13662 843134268 HOSPITAL NY 501C3 3 SLHS true false false false false false false false false false false true false false false false false false false false CANTON-POTSDAM HOSPITAL K 2538697 FMV CANTON-POTSDAM HOSPITAL K 30330 FMV SCHEDULE R ST. LAWRENCE HEALTH SYSTEM, INC. (SLHS) IS OPERATED EXCLUSIVELY FOR THE SOLE CHARITABLE PURPOSE OF BENEFITING AND SUPPORTING CANTON-POTSDAM HOSPITAL, GOUVERNEUR HOSPITAL, MESSENA HOSPITAL AND OTHER CORPORATIONS OF WHICH THE CORPORATION IS THE SOLE CORPORATE MEMBER, INCLUDING THE CANTON- POTSDAM MEDICAL PRACTICE, PLLC.