2025-10-30T14:05:00-05:00 2024-12-31 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2024-01-01 461043637 SAMARITAN HOME HEALTH INC SAMA 3157854121 830 WASHINGTON STREET WATERTOWN NY 13601 MAXINE BRIGGS CFO 3157853605 2025-10-17 1 1 DESIREE M BENNETT P01263666 3154463600 2025-10-17 2024 2025-03-06 01:10:19Z MAXINE BRIGGS 830 WASHINGTON STREET WATERTOWN NY 13601 2531073 0 X WWW.SAMARITANHEALTH.COM X 2012 NY TO PROVIDE HIGH QUALITY, COMPREHENSIVE, SAFE AND COMPASSIONATE HEALTH CARE SERVICES TO MEET THE NEEDS OF OUR CIVILIAN AND MILITARY COMMUNITY. 3 1 26 3 0 0 0 0 2582314 2530389 0 103 0 581 2582314 2531073 0 0 0 0 2037114 2056637 0 0 0 472865 411633 2509979 2468270 72335 62803 869276 703396 809458 580775 59818 122621 TO PROVIDE HIGH QUALITY, COMPREHENSIVE, SAFE AND COMPASSIONATE HEALTHCARE SERVICE TO MEET THE NEEDS OF OUR CIVILIAN AND MILITARY COMMUNITY. 0 0 2440573 2530970 PROFESSIONAL CARE OF PATIENTS IN A HOME CARE SETTING PROVIDING 15,782 VISITS DURING 2024. 2440573 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 5 0 1 26 1 0 0 0 0 0 0 0 0 0 0 0 0 X 3 1 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X MAXINE BRIGGS 3157853605 830 WASHINGTON STREET WATERTOWN NY 13601 THOMAS CARMAN PRESIDENT & CEO 1.00 43.50 X X 0 1132728 62942 MAXINE BRIGGS CFO/TREASURER 1.00 2.50 X X 0 609760 52818 MELANIE PARKER-GEURSTSEN TRUSTEE 1.00 1.00 X 0 0 0 PATRICK CALLI VP OF LTC/SUPPORT SERVICES 1.00 40.00 X 0 370452 19342 0 2112940 135102 0 0 1 0 SIMITREE HEALTHCARE CONSULTING 4130 WHITNEY AVE HAMDEN CT 06518 BILLING SERVICE 107152 1 NET PATIENT REVENUE 621610 2530389 2530389 2530389 103 103 MISCELLANEOUS INCOME 541200 581 581 581 2531073 2530970 0 103 1714822 1714822 79911 79911 136154 136154 125750 125750 5765 5765 161360 139503 21857 82 82 15307 15307 78193 78193 28698 28698 81183 81183 45 45 460 460 17536 17536 SUPPLIES AND OTHER 12725 12650 75 NYS ASSESSMENT 10279 10279 2468270 2440573 27697 0 293950 58610 410876 496917 26006 9884 80407 78891 1975 1516 136469 136469 869276 703396 242037 232265 567421 348509 809458 580775 X 59818 122621 59818 122621 869276 703396 62803 0 X X 0 1 X 1 0 X 75653 30391 63950 0 0 169994 2210279 2757466 2277733 2582314 2530970 12358762 2285932 2787857 2341683 2582314 2530970 12528756 0 0 0 12528756 14 21 0 103 138 14 21 103 138 191 191 2286123 2787871 2341704 2582314 2531073 12529085 1.00000 1.00000 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: REFUND FROM VENDORS - 2020 AMOUNT: $ 10. MEDICAL RECORD FEES - 2020 AMOUNT: $ 181. 368 368 0 80039 78523 1516 1516 ACCOUNTS RECEIVABLE OTHER 114783 GOODWILL INVESTMENT 21686 136469 DUE TO/FROM AFFILIATES 308902 THIRD PARTY PAYABLE 39607 348509 X PART X, LINE 2: SAMARITAN HOME HEALTH QUALIFIES AS A TAX-EXEMPT, NOT-FOR-PROFIT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2024 AND 2023. SAMARITAN HOME HEALTH DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND NEW YORK STATE TAXING AUTHORITIES ARE 2021 THROUGH 2024. X X X X X 0 1 0 0 0 0 0 0 0 THOMAS CARMAN PRESIDENT & CEO 0 763173 0 364370 0 5185 0 13800 0 49142 0 1195670 0 0 MAXINE BRIGGS CFO/TREASURER 0 494062 0 92698 0 23000 0 20700 0 32118 0 662578 0 0 PATRICK CALLI VP OF LTC/SUPPORT SERVICES 0 317925 0 36657 0 15870 0 19066 0 276 0 389794 0 0 PART I, LINE 4B THE FOLLOWING INDIVIDUALS RECEIVED CONTRIBUTIONS TO AN IRC 457(B) PLAN DURING 2024: MAXINE BRIGGS - $23,000 FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF SAMARITAN HOME HEALTH INC IS THE SAMARITAN MEDICAL CENTER. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FORM 990 AND ACCOMPANYING SCHEDULES WERE REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD, PRIOR TO FILING. FORM 990 WAS PROVIDED TO EACH BOARD MEMBER PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ANNUAL DISCLOSURE STATEMENTS ARE REQUIRED BY ALL BOARD MEMBERS AND KEY PERSONS. WE HAVE MET 100% COMPIANCE WITH THIS REQUIREMENT EACH YEAR. RESPONSES ARE REVIEWED INITIALLY BY THE CHIEF EXECUTIVE OFFICER AND CHIEF COMPLIANCE OFFICER FOR ACCURACY AND COMPLETENESS. THIS INFORMATION IS DISCLOSED IN FULL REPORT TO THE BOARD OF TRUSTEES FOR REVIEW AND CONSIDERATION FOR FUTURE DECISION MAKING. BOARD MEMBERS AND KEY PERSONS AFFIRM THEIR UNDERSTANDING OF THEIR DUTY TO REPORT ANY ADDITIONAL OR NEW POTENTIAL CONFLICTS THROUGHOUT THE YEAR. BOARD MEMBERS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATION IN VOTING AND DECISION MAKING IN RELATED TRANSACTIONS. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION USES AN EXTERNAL CONSULTANT TO ANALYZE AND ESTABLISH COMPENSATION AND BENEFITS FOR ALL EXECUTIVE POSITIONS. AN EVALUATION IS PERFORMED ANNUALLY. THE ANALYSIS INCLUDES A REVIEW OF MARKET DATA BASED ON REGION, FACILITY SIZE, AND RESPECTIVE RESPONSIBILITIES. THIS INFORMATION IS PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES FOR REVIEW AND SUBSEQUENTLY PRESENTED TO THE FULL BOARD OF TRUSTEES FOR APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT AVAILABLE TO THE PUBLIC. THE FINANCIAL STATEMENTS ARE FILED AS PART OF THE ANNUAL NYS DEPARTMENT OF HEALTH INSTITUTIONAL COST REPORT, AND ARE AVAILABLE UPON REQUEST. FORM 990 PART XII LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. SCHEDULE A PART 3 SAMARITAN HOME HEALTH, INC. IS A HOME HEALTH CARE ENTITY WHICH HAS AS ITS MAIN PURPOSE THE PROVISION OF HEALTH CARE SERVICES, IT APPROPRIATELY NOTED ON FORM 1023 THAT IT IS A HOSPITAL. THE STATE OF NEW YORK DOES NOT REQUIRE CAPTIVE PHYSICIAN PRACTICES TO BE LICENSED AS A HOSPITAL. AS A HOME HEALTH CARE ENTITY, SAMARITAN HOME HEALTH, INC. HAS AS ITS PRINCIPAL PURPOSE THE PROVISION OF HEALTH CARE SERVICES. ACCORDINGLY, IT WAS (I) PROPERLY IDENTIFIED AS A "HOSPITAL" ON FORM 1023; (II) PROPERLY IDENTIFIED AS A "HOSPITAL" ON FORM 990 SCHEDULE A; AND (III) SHOULD NOT BE DESIGNATED AS A "HOSPITAL/HOSPITAL FACILITY" ON FORM 990 SCHEDULE H. SAMARITAN MEDICAL CENTER 830 WASHINGTON STREET WATERTOWN NY 13601 150533577 HOSPITAL NY 501 (C) 3 SCHED A, PART 1, LN3 N/A 0 SAMARITAN MEDICAL CENTER FOUNDATION OF NORTHERN NEW YORK 830 WASHINGTON STREET WATERTOWN NY 13601 161490523 PROVIDES FUNDS FOR SAMARITAN MEDICAL CENTER & AFFILIATES NY 501 (C) 3 SCHED A, PART 1, LN7 SAMARITAN MEDICAL CENTER 0 SAMARITAN KEEP NURSING HOME INC 133 PRATT STREET WATERTOWN NY 13601 160969838 SKILLED NURSING FACILITY NY 501 (C) 3 SCHED A, PART 1, LN3 SAMARITAN MEDICAL CENTER 0 SAMARITAN SENIOR VILLAGE INC 22691 CAMPUS DRIVE WATERTOWN NY 13601 454913668 SKILLED NURSING FACILITY/ASSISTED LIVING NY 501 (C) 3 SCHED A, PART 1, LN3 SAMARITAN MEDICAL CENTER 0 SAMARITAN MEDICAL PRACTICE PC 830 WASHINGTON STREET WATERTOWN NY 13601 261528342 PHYSICIAN MEDICAL PRACTICE NY 501 (C) 3 SCHED A, PART 1, LN3 SAMARITAN MEDICAL CENTER 0 EDWARD J NOBLE HOSPITAL - SAMARITAN 104 PADDOCK STREET WATERTOWN NY 13601 237227989 HOSPITAL NY 501 (C) 3 SCHED A, PART 1, LN3 SAMARITAN MEDICAL CENTER 0 CLIFTON-FINE HEALTH CARE CORPORATION 1014 OSWEGATCHIE TRAIL STAR LAKE NY 13690 900909506 HOSPITAL NY 501 (C) 3 SAMARITAN MEDICAL CENTER 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0