2011-11-15T14:03:54-08:00 2010-12-31 Gray & Gray CPAs P C 1 Main St Suite 101 Canton NY 13617 990 2010-01-01 161012691 Canton-Potsdam Hospital CANT 3152615103 50 Leroy Street Potsdam NY 13676 Richard Jacobs 2011-11-15 John J Gray Jr CPA 3153862925 2010 2016-03-07 17:11:31Z David Acker Canton-Potsdam Hospital Potsdam NY 13676 90431117 false false X www.cphospital.org X NY Canton-Potsdam Hospital is a voluntary, private, not-for-profit, general acute-care community health care organization. We provide health care to the people of St. Lawrence County and to areas beyond for speciality services. We work cooperatively to provide or coordinate health care. 21 14 974 149 0 153690 148665 78070151 88047748 100071 -21078 3190633 1667248 81514545 89842583 0 0 43331065 49578322 0 0 35162890 38615112 78493955 88193434 3020590 1649149 56155831 66411160 26591329 33228871 29564502 33182289 X Canton-Potsdam Hospital is a voluntary, private, not-for-profit, general acute-care community health care organization. We provide health care to the people of St. Lawrence County and to areas beyond for speciality services. We work cooperatively to provide or coordinate health care. false false 49001050 104689613 In addition to the three programs listed on lines 4a-4c, Canton-Potsdam Hospital also has the following services available:Acute Care - Canton-Potsdam Hospital has 70 licensed beds to care for Medical-Surgical, Intensive Care and Obstetric patients. In 2010, there were 3,731 discharges, 13,296 patient days with 71% of the patients either Medicare, Medicaid or uninsured. The Hospitalist program which was initiated prior to 2010 has expanded to include weekend and daily coverage to 16 hours per day which provides continuity of medical professional care to the patients we serve.Chemical Dependency Program - Canton-Potsdam Hospital operates a 7 bed detoxification and a 17 bed rehabilitation program. A psychiatrist was added which enhanced the benefits of the rehabilitation program. Growth continues in both programs. This program provides a highly needed service to residents of St. Lawrence County and immediate surrounding counties.Emergency Department - Total visits were 24,603 for the year. 8105359 14361628 The Hospital opened four new hospital based clinics, including a new Medical Oncology clinic. Significant growth was seen in the Primary care, Obstetrics, Opthalmology and Sports and Orthopedic clinics.The Hospital remains focused on providing new services to our community and continues to make investments into the infrastructure of buildings, technology, and physician recruiting.There was a total of nearly 65,000 visits in 2010 compared to 47,000 in 2009.In 2010, 51% of the total revenue generated for the clinics was Medicaid, Medicare, or Uninsured. This is an increase from 45% in 2009. 6736372 7817541 In 2010, the Operating Room cases grew by 536 cases or nearly 10% over 2009.The increase in cases were predominately driven by our Opthalmology, Pain, and Sports and Orthopedic clinics which matured in 2010 as well as services provided by a new general surgeon recruited in 2009. In 2010, 49% of the total revenue generated for the Operating Room was Medicaid, Medicare, or Uninsured. This is an increasefrom 43% in 2009. 4686440 40635936 68529221 true false false true false false false false false true true false false true true false true false false false false false false false false false true true false false true true false false true false false false false true true true false false false false false true false true false false true 159 0 true 974 true false false false false false false false false false false false 0 false false false false false false false false false false false X 21 14 false false false false false false false true true false false false true true true true true true true true false false X Richard Jacobs 3152615100 Canton Potsdam Hospital 50 Leroy St Potsdam NY 13676 Spence Thew 2.00 X 0 0 0 Ron Berry 2.00 X 0 0 0 Robert Nordberg MD 2.00 X 0 0 0 Richard Jacobs 50.00 X X 174539 0 8349 Penelope Rattan 2.00 X 0 0 0 Paul Cole DVM 2.00 X 0 0 0 Michael Tulloch MD 2.00 X 32770 0 0 Michael Griffin 2.00 X 0 0 0 Mary Anne Healey 2.00 X 0 0 0 Marlinda LaValley 50.00 X X 125636 0 8328 Margaret Madden 4.00 X X 0 0 0 Laurie Maki 2.00 X 0 0 0 Kris Vanwagner MD 0.00 X 386289 0 8278 Kathryn Mullaney 2.00 X X 0 0 0 June Peoples 2.00 X 0 0 0 Judy Chittenden 2.00 X X 0 0 0 Judy Chase 2.00 X X 0 0 0 John Savage MD 50.00 X 677490 0 8403 John Kaplan 2.00 X 0 0 0 John Dewar MD 2.00 X 159657 0 0 James Theodore 2.00 X 0 0 0 James Dalton 2.00 X 0 0 0 Howard Gold MD 50.00 X 416827 0 8291 Edward Mucenski 4.00 X X 0 0 0 Duane Pelkey 2.00 X 0 0 0 David Patterson 2.00 X 0 0 0 David Acker 50.00 X X 316116 0 8409 Ayaz Khan MD 50.00 X 397307 0 8283 Alexander Clark MD 50.00 X 1039831 0 8559 3726462 66900 30 false true false Resources on Call PO Box 3918 Hickory NC 28603 Temporary Staffing 288050 Potsdam Anesthesia Associates Canton-Potsdam Hospital Potsdam NY 13676 Anesthesiology 334880 Northstar Emergency Physicians Canton-Potsdam Hospital Potsdam NY 13669 Emergency Dept Phys 938301 Labcorp PO Box 12140 Burlington NC 27216 Reference Lab 606412 Continuum Professional Services Inc 2401 burnett Avenue East Syracuse NY 130570176 Dictation 292705 10 35032 113633 148665 Net Patient Revenue 900099 88047748 88047748 88047748 -22886 -22886 1 1 0 319338 429438 -110100 -110100 -110100 151779 9124 159096 -7317 9124 1807 1807 0 0 0 Student Health Services 900099 883930 883930 Other 900099 529255 529255 Cafeteria Revenue 900099 241163 241163 123000 123000 1777348 89842583 88047748 1646170 0 0 0 0 992764 264907 727857 0 37819379 29257456 8561923 1972617 1500466 472151 6113065 4649888 1463177 2680497 2038914 641583 0 93262 93262 167750 167750 111976 111976 0 0 0 0 0 0 0 1836041 341050 1494991 252025 100290 151735 0 134422 73484 60938 576658 397894 178764 0 4332874 2989683 1343191 858042 779862 78180 Supplies 10648025 9720912 927113 Purchased Services 3028871 2423097 605774 Other 6126163 4900930 1225233 Equipment Rental 2729836 1732890 996946 Bad Debt 4637763 4637763 3081404 2719735 361669 88193434 68529221 19664213 0 -128726 261791 1733166 4715447 0 12144853 12529468 0 0 0 1193774 1147148 769703 836631 79517692 48614753 26805412 30902939 813308 831307 0 0 0 12824341 15186429 56155831 66411160 8792528 11889327 9945000 11368046 1640495 1571205 6213306 8400293 26591329 33228871 X 28844744 32198687 263844 719758 719758 29564502 33182289 56155831 66411160 X 1649149 1968638 X false true true X false false X false false false false false false false false false false true 172741 172741 false false Part II-B, Line 1i Part II-B, Line 1i - Other Activities Description Canton-Potsdam Hospital through its membership or fees paid to the following organizations incurred $172,741 in lobbying expenses for 2010. 85,600 Wilson, Elser and Moskowitz-Federal and State lobbying and representation 29,320 Health Association on New York State-Federal and State advocacy 28,100 North Country Healthcare Providers-State advocacy 10,733 Iroquois Health Alliance-Federal and State advocacy 18,988 American Hospital Association-Federal and State advocacy 813308 17999 831307 778337 34971 813308 884504 -106167 778337 false false false 713734 713734 35172956 13948286 21224670 2025802 855065 1170737 41605200 33811402 7793798 30902939 Physician Agreements 1340954 Other Notes & Loans Receivable (Net) 1322534 Interest in Canton-Pots Hospital Foundat 10573256 Due From Affiliate 155706 Deferred Financing Costs 297129 Assets Whose Useful Life is Limited 1496850 15186429 Estimated Third Party Payor Settlements 2465702 Change in Interest Rate Swap 1398085 Asset Retirement Obligation 533914 Accrued Pension 4002592 8400293 89842583 88193434 1649149 1968638 1968638 3617787 89842583 89842583 89842583 88193434 88193434 88193434 Part XI, Line 8 Part XI, Line 8: Other Changes in Net Assets or Fund Balances Capital Campaign Gifts $263844 Change in Net Assets of CPH Foundation $1304153 Grants For Capital Acquisitions $822173 Unrealized Gain on Investments $29889 Resticted Money Spent For Capital $213558 Change in funded status of employee benefit plan $ -553301 Resticted Money Spent For Operation $ -111678 true true true X true X true true true false true true 464991 35575 429416 0.00490 6073069 1136995 4936074 0.05600 6538060 1172570 5365490 0.06090 199006 199006 0.00230 5000 5000 0.00010 1637079 1637079 0.01860 18970 18970 0.00020 1860055 1860055 0.02120 8398115 1172570 7225545 0.08210 658275 658275 0.00750 658275 658275 0.00750 true 2075687 846676 19300233 20114918 -814685 X true true 1 0 Canton-Potsdam Hospital

50 Leroy Street Potsdam NY 13676

X X X Canton-Potsdam Hospital 1 false true true 100.0000 true 300.0000 true X X true true X X X X true X true X X X X X X true false true Part V - Explanation of Number of Facility Type SEE ATTACHED EXPLANATION Number of Hospital Faciltiy - 0 Part V, Line 21 - Charge Patients Amount Equal Gross Charge for Services SEE ATTACHED EXPLANATION X X X X false false false false false false false false false false Richard Jacobs 174539 8349 182888 150346 Kris Vanwagner MD 386289 8278 394567 John Savage MD 677490 8403 685893 John Dewar MD 159657 159657 Howard Gold MD 416827 8291 425118 David Acker 316116 8409 324525 288373 Ayaz Khan MD 397307 8283 405590 Alexander Clark MD 1039831 8559 1048390 St Lawrence County CDC 272614310 2010-08-30 21305000 See Part V false true false 80000 21305000 3436256 9590000 8278744 2011 true false false true false false true false true 0.02990 0.02990 true false true false false false true See Attachment To Form 990, Schedule K, Part V-Supplemental Information SEE ATTACHMENT FOR SCHED L true Form 990, Part VI, Line 19 Form 990, Part VI, Line 19: Other Organization Documents Publicly Available Available upon request. Form 990, Part VI, Line 15b Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees Line 15a: The Audit and Compensation Committee of the Board of Directors will ultimately be responsible for the compensation of the top management at Canton-Potsdam Hospital. They will seek the input of consulting firms 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 consultants, the Audit and Compensation Committee will offer its recommendation to the full board.Line 15b: The compensation of other key employees is determined by the input of recruiting firms, if used, but primarily by the work of the Human Resource Department who will review the surrounding market and use data from various hospital organizations to establish salary ranges. Form 990, Part VI, Line 12c Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts We annually review disclosure statements and have reporting mechanisms, including a confidential hot line, that are regularly monitored by the Compliance Officer. The Compliance Officer attends all board committee meetings and provides a monthly report to the board Form 990, Part VI, Line 11 Form 990, Part VI, Line 11: Form 990 Review Process The form 990 is prepared by various staff members of the finance department. Upon completion, a copy with supporting documentation is reviewed by a team made up of the Vice-President For Finance, the Controller and senior staff member. After review, any changes are made and a copy is presented to the Finance Committee. After review, comments are solicited and barring any changes, the Finance Committee will approve and submit to the full Board of Directors for their review, comments and approval. Form 990, Part III, Line 4d Form 990, Part III, Line 4d : Other Program Services Description OTHER PROGRAM SERVICES 4: In addition to the three programs listed on lines 4a-4c, Canton-Potsdam Hospital also has the following services available:Acute Care - Canton-Potsdam Hospital has 70 licensed beds to care for Medical-Surgical, Intensive Care and Obstetric patients. In 2010, there were 3,731 discharges, 13,296 patient days with 71% of the patients either Medicare, Medicaid or uninsured. The Hospitalist program which was initiated prior to 2010 has expanded to include weekend and daily coverage to 16 hours per day which provides continuity of medical professional care to the patients we serve.Chemical Dependency Program - Canton-Potsdam Hospital operates a 7 bed detoxification and a 17 bed rehabilitation program. A psychiatrist was added which enhanced the benefits of the rehabilitation program. Growth continues in both programs. This program provides a highly needed service to residents of St. Lawrence County and immediate surrounding counties.Emergency Department - Total visits were 24,603 for the year. Canton-Potsdam Hospital Foundation 29 Grove Street Potsdam NY 13676 161279472 Raising, investing and managing funds for the hospital NY 501(c)(3) 11a N/A false N/A false false false false false false false false false false true true false false false false true true false false Canton-Potsdam Hospital Foundation p 114224 Cash Exchanged Canton-Potsdam Hospital Foundation o 136900 Cash Exchanged Canton-Potsdam Hospital Foundation j 7635 Cash Exchanged Canton-Potsdam Hospital Foundation i 226326 Cash Exchanged