Keuka Health Care Foundation Inc

“Neil Fagan - 31 Morris St. Bath, NY 14810; Michael Page - 10996 W. Lake Rd. Hammondsport, NY 14840; Rod Pederson - 9025 S. Lake Rd. Hammondsport, NY 14840; Sam Pennise, DMD - PO Box 386, Hammondsport, NY 14840; Marc Shuart - 6779 State Route 415, Bath, NY 14810; Scott Sprague - PO Box 522, Hammondsport, NY 14840; John Walton - 9323 Spruce Rd. Hammondsport, NY 14840; Jerry Keeler - 5555 Oregon Rd. Bath, NY 14810”

“The Keuka Healthcare Foundation 990 is prepared by the accounting department of the supported organization. Once completed, a draft is provided to the executive committee of the Keuka Healthcare Foundation for approval to move forward with filing the 990 electronically. A copy is made available to the board members for review and discussion.”

“All members if the board of managers, officers, and management employees shall be required annually to file a disclosure statement setting forth any respect in which such person, or any person associated with such person, has or may have any interest in any transaction which there may be, or appear to be, a conflict of interest of such person and the IRA Davenport Memorial Hospital. An associate includes (1) spouse, a descendant or an ancestor, or a source of a descendant or ancestor; (2) an organization in which the person or an associate is a partner or an employee, or such person or an associate holds more than 10% beneficial interest; (3) a trust in which such person is a trustee, or such person or an associate holds more than 10% beneficial interest; and (4) a corporation in which such person or an associate is an officer or director or employee, or such person or an associate is an owner of more than 10% of any class of securities.”

“Although the foundation itself has no employees, the director of the Keuka Healthcare Foundation's salary is determined by the hospital's human resources department with hospital executive approval.”

“The organization makes their tax form 990, governing documents, conflicts of interest policy, and financial statements available to the public upon request.”

“Unrestricted donations were originally misclassified as gross income from fundraising events. The amended return reclassifies $483,089 from Part VIII, Line 8a to Line 1f.”