FORT HUDSON HEALTH SYSTEM INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
FORT HUDSON HEALTH SYSTEM INC (EIN 20-0928661)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-06-20
IRS object ID
201911719349300706
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-06-20T07:19:35-05:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN161131146PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BONADIO & CO LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line16 WEMBLEY CTAddressLine1Txt
CityALBANYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12205ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN200928661EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FORT HUDSON HEALTH SYSTEM INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFORTBusinessNameControlTxt
Phone5187472811PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1319 BROADWAYAddressLine1Txt
CityFORT EDWARDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12828ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN COBURNPersonNm
Person TitleCFOPersonTitleTxt
Phone5187472811PhoneNum
Signature2019-06-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonARIEL F AMMIRATOPreparerPersonNm
PTINP01346991PTIN
Phone5184644080PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address24.194.166.226IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-06-12IPDt
IP Tm10:01:17IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id6F0B485C3B3761609EF88A1BD8C31F03C074873AAtSubmissionCreationDeviceId
At Submission Filing Device Id83DCA7CB572579BC2F7670A58B2B8A6B85EBC27AAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerANDREW CRUIKSHANKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1319 BROADWAYAddressLine1Txt
CityFORT EDWARDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12828ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$755,356GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FORTHUDSON.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionSERVES AS PASSIVE PARENT, SOLE CORPORATE MEMBER AND SUPPORTING ORGANIZATION FOR AFFILIATED NOT-FOR-PROFIT ENTITIES.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers13TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$748,130PYProgramServiceRevenueAmt
CY Program Service Revenue$755,356CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$748,130PYTotalRevenueAmt
CY Total Revenue$755,356CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$683,259PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$684,655CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$66,510PYOtherExpensesAmt
CY Other Expenses$69,177CYOtherExpensesAmt
PY Total Expenses$749,769PYTotalExpensesAmt
CY Total Expenses$753,832CYTotalExpensesAmt
PY Revenues Less Expenses-$1,639PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,524CYRevenuesLessExpensesAmt
Total Assets BOY$63,772TotalAssetsBOYAmt
Total Assets EOY$69,450TotalAssetsEOYAmt
Total Liabilities BOY$57,191TotalLiabilitiesBOYAmt
Total Liabilities EOY$61,345TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,581NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,105NetAssetsOrFundBalancesEOYAmt
MissionSERVES AS PASSIVE PARENT, SOLE CORPORATE MEMBER AND SUPPORTING ORGANIZATION FOR AFFILIATED NOT-FOR-PROFIT ENTITIES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$697,573ExpenseAmt
Revenue$755,356RevenueAmt
DescEXECUTIVE MANAGEMENT OF SIX RELATED HEALTH SERVICE AND HOUSING PROVIDERS.Desc
Total Program Service Expenses$697,573TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN COBURNBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5187472811PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1319 BROADWAYAddressLine1Txt
CityFORT EDWARDCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12828ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
KEITH LAAKE
PRESIDENT0.400.00Yes (X)Yes (X)$0$0$0
DEAN REALI
VICE PRESIDENT0.400.00Yes (X)Yes (X)$0$0$0
KEVIN HAYES
SECRETARY0.400.00Yes (X)Yes (X)$0$0$0
G NEIL ROBERTS
TREASURER0.400.00Yes (X)Yes (X)$0$0$0
JOHN BRODT
DIRECTOR0.400.00Yes (X)$0$0$0
JUDITH BULOVA
DIRECTOR0.400.00Yes (X)$0$0$0
CARMEN DELLA BELLA
DIRECTOR0.400.00Yes (X)$0$0$0
JOAN GRISHKOT
DIRECTOR0.400.00Yes (X)$0$0$0
ROBERT MILES
DIRECTOR0.400.00Yes (X)$0$0$0
CLAIRE MURPHY
DIRECTOR0.400.00Yes (X)$0$0$0
CHRIS NELSON
DIRECTOR0.400.00Yes (X)$0$0$0
TORI J RILEY
DIRECTOR0.400.00Yes (X)$0$0$0
GRETCHEN STEFFAN
DIRECTOR0.400.00Yes (X)$0$0$0
ANDREW CRUIKSHANK
CEO0.4040.00Yes (X)$336,660$0$61,791
JOHN COBURN
CFO0.4040.00Yes (X)$191,003$0$35,057
FieldValueIRS element (for citing)
Total Reportable Comp From Org$527,663TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$96,848TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescMANAGEMENT FEE REVENUEDesc
Business551112BusinessCd
Total Revenue Column$755,356TotalRevenueColumnAmt
Related Or Exempt Func Income$755,356RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$755,356TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$755,356TotalRevenueColumnAmt
Related Or Exempt Func Income$755,356RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$524,277TotalAmt
Program Services$524,277ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$160,378TotalAmt
Program Services$160,378ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$56,259TotalAmt
Management And General$56,259ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$12,918TotalAmt
Program Services$12,918ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$753,832TotalAmt
Program Services$697,573ProgramServicesAmt
Management And General$56,259ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$512BOYAmt
EOY$512EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$63,260BOYAmt
EOY$68,938EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$63,772BOYAmt
EOY$69,450EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$57,191BOYAmt
EOY$61,345EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$57,191BOYAmt
EOY$61,345EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,581BOYAmt
EOY$8,105EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,581BOYAmt
EOY$8,105EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$63,772BOYAmt
EOY$69,450EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,524ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations6SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp (6 entries)

EINEINOrganization TypeOrganizationTypeCdGoverning Document ListedGoverningDocumentListedIndSupportSupportAmtOther SupportOtherSupportAmt
FORT HUDSON NURSING CENTER INC
20048158330$331,598$0
FORT HUDSON HOME CARE INC
208166870100$176,874$0
FORT HUDSON PROPERTY MANAGEMENT CORP
141810104100$7,554$0
FORT HUDSON FOUNDATION CORPORATION
223368083100$17,870$0
FORT HUDSON RESIDENCES INC
311655779100$44,586$0
FORT HUDSON CERTIFIED HOME HEALTH AGENCY
463241378100$176,874$0
FieldValueIRS element (for citing)
Supported Organizations Total6SupportedOrganizationsTotalCnt
Support Sum$755,356SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported OrgYes (1)MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, SECTION C, LINE 1:FormAndLineReferenceDesc
ExplanationSEE SCHEDULE R FOR 6 SUPPORTED ORGANIZATIONS.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM AFFILIATESDesc
Book Value$68,938BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$68,938TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFLIATESDesc
Amt$61,345Amt
FieldValueIRS element (for citing)
Total Liability$61,345TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANDREW CRUIKSHANK
CEO$336,660$0$0$0$0$0$0$0$61,791$0$398,451$0$0$0
JOHN COBURN
CFO$191,003$0$0$0$0$0$0$0$35,057$0$226,060$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationINDUSTRY DATA FROM TRADE ASSOCIATION USED BY THE BOARD TO SET PARAMETERS FOR SALARY AND BENEFIT LEVELS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BRETURNS ARE PRESENTED TO THE FULL BOARD FOR REVIEW AND APPROVAL PRIOR TO SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12CANNUAL REVIEW OF DISCLOSURES AND REQUIREMENT TO INFORM OF NEW DEVELOPMENT.
FORM 990, PART VI, SECTION B, LINE 15INDUSTRY DATA FROM TRADE ASSOCIATIONS IS USED BY THE BOARD TO SET PARAMETERS FOR SALARY AND BENEFIT LEVELS.
FORM 990, PART VI, SECTION C, LINE 18UPON WRITTEN REQUEST BASED ON STATUTORY AND REGULATORY REQUIREMENTS
FORM 990, PART VI, SECTION C, LINE 19UPON WRITTEN REQUEST BASED ON STATUTORY AND REGULATORY REQUIREMENTS
FORM 990, PART VII - COMPENSATION EXPLANATIONANDREW CRUIKSHANK NON TAXABLE FRINGE BENEFITS ORGANIZATIONAL AVERAGE 18.35% GROSS WAGES. JOHN COBURN NON TAXABLE FRINGE BENEFITS ORGANIZATIONAL AVERAGE 18.35% GROSS WAGES.
FORM 990, PART XII, LINE 2C:PROCESS HAS NOT BEEN CHANGED FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
FORT HUDSON NURSING CENTER INC
319 BROADWAYFORT EDWARDNY12828200481583SKILLED NURSING FACILITY AND DAY SERVICENY501(C)(3)170(B)(1)(A)(III)FORT HUDSON HEALTH SYSTEM INCYes (1)
FORT HUDSON HOME CARE INC
319 BROADWAYFORT EDWARDNY12828208166870HOMECARE AND DAY SERVICESNY501(C)(3)509(A)(2)FORT HUDSON HEALTH SYSTEM INCYes (1)
FORT HUDSON PROPERTY MANAGEMENT CORPORATION
319 BROADWAYFORT EDWARDNY12828141810104REAL ESTATE HOLDING COMPANYNY501(C)(2)FORT HUDSON HEALTH SYSTEM INCYes (1)
FORT HUDSON FOUNDATION CORPORATION
319 BROADWAYFORT EDWARDNY12828223368083FUNDRAISINGNY501(C)(3)509(A)(2)FORT HUDSON HEALTH SYSTEM INCYes (1)
FORT HUDSON RESIDENCES INC
319 BROADWAYFORT EDWARDNY12828311655779HOUSING FOR THE ELDERLYNY501(C)(3)509(A)(2)FORT HUDSON HEALTH SYSTEM INCYes (1)
FORT HUDSON CERTIFIED HOME HEALTH AGENCY
319 BROADWAYFORT EDWARDNY12828463241378HOME HEALTH CARENY501(C)(3)509(A)(2)FORT HUDSON HEALTH SYSTEM INCYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (6 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmt
FORT HUDSON NURSING CENTER INC
D$2,690,318
FORT HUDSON RESIDENCES INC
D$131,861
FORT HUDSON CERTIFIED HOME HEALTH AGENCY INC
D$393,413
FORT HUDSON HOME CARE INC
O$176,874
FORT HUDSON CERTIFIED HOME HEALTH AGENCY INC
O$176,874
FORT HUDSON NURSING CENTER INC
O$331,598

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