Liabilities / Assets
51st percentile
Higher debt load relative to assets than 51% of similar nonprofits.
Siviq Scores
Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.
0.11x
Liabilities / Revenue
28th percentile
Higher debt load relative to revenue than 28% of similar nonprofits.
Net Margin
4th percentile
Higher net margin than 4% of similar nonprofits.
Top Officer Pay
95th percentile
Higher top officer pay than 95% of similar nonprofits.
Top officer pay equals 8.6% of source-year revenue.
Asset Growth
15th percentile
Faster asset growth than 15% of similar nonprofits.
Revenue Growth
75th percentile
Faster revenue growth than 75% of similar nonprofits.
Balance Sheet
Assets
Down$1,021,400
Down $87,017 (-7.9%) from 2015
Net Assets
Down$910,053
Down $171,010 (-16%) from 2015
Liabilities
Up$111,347
Up $83,993 (+307%) from 2015
Revenue And Expenses
Revenue
Up$3,891,066
Up $595,772 (+18%) from 2015
Expenses
Up$7,053,845
Up $1,516,819 (+27%) from 2015
Net Income
Down-$3,162,779
Down $921,047 (-41%) from 2015
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- Jan 1, 2016 to Dec 31, 2016
- Signed
- Sep 1, 2017
- Return Version
- 2016v3.0
- Gross Receipts
- $3,891,066
Mission and Program Overview
Mission
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.
Balance Sheet Detail
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Accounts Receivable | $527,216 | $502,081 | ▼ $25,135 |
| Land, Buildings, and Equipment, Net | $403,029 | $460,727 | ▲ $57,698 |
| Cash and Non-Interest-Bearing Accounts | $131,365 | $26,110 | ▼ $105,255 |
| Prepaid Expenses and Deferred Charges | $19,103 | $22,131 | ▲ $3,028 |
| Inventories for Sale or Use | $7,142 | $3,999 | ▼ $3,143 |
| Total Assets | $1,108,417 | $1,021,400 | ▼ $87,017 |
| Other Assets Total | $20,562 | $6,352 | ▼ $14,210 |
| Liabilities | |||
| Accounts Payable and Accrued Expenses | $27,354 | $111,347 | ▲ $83,993 |
| Total Liabilities | $27,354 | $111,347 | ▲ $83,993 |
| Net Assets / Fund Balance | |||
| Unrestricted Net Assets | $1,081,063 | $910,053 | ▼ $171,010 |
| Total Net Assets Fund Balance | $1,081,063 | $910,053 | ▼ $171,010 |
| Total Liabilities and Net Assets / Fund Balance | $1,108,417 | $1,021,400 | ▼ $87,017 |
Asset Categories
| Asset | Book Value | Depreciation | Basis |
|---|---|---|---|
| Equipment | $452,477 | $359,455 | $811,932 |
| Leasehold Improvements | $8,250 | $10,728 | $18,978 |
Compensation and Service Providers
Board Members and Trustees
| Name | Title |
|---|---|
| Robert T Rogersii Md | Director |
| Richard D Jacobs | Finance |
Highest Paid Contractors
| Contractor | Services | Location | Compensation |
|---|---|---|---|
| Eclinical Works LLC | Elec. Med. Rec. | PO BOX 847950, Boston, MA 02284-7950 | $107,042 |
Revenue and Support
Revenue Composition
- Contributions and Grants
- $0
- Program Service Revenue
- $3,879,270
- Investment Income
- $0
- Other Revenue
- $11,796
- Change in Net Assets
- $-3,162,779
Expenses and Functional Allocation
Major Expense Lines
| Line Item | Amount |
|---|---|
| Salaries, Compensation, and Employee Benefits | $5,785,313 |
| Other Expenses | $1,268,532 |
| Grants and Similar Amounts Paid | $0 |
| Professional Fundraising Fees | $0 |
| Total Fundraising Expense | $0 |
Functional Expense Allocation
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Other Salaries and Wages | $4,726,184 | $230,364 | - | $4,956,548 |
| Other Employee Benefits | $790,247 | $38,518 | - | $828,765 |
| Occupancy | $228,599 | $11,142 | - | $239,741 |
| Fees for Services Management | - | $196,177 | - | $196,177 |
| Insurance | $162,671 | $3,475 | - | $166,146 |
| Depreciation Depletion | $141,079 | $6,876 | - | $147,955 |
| Other Expenses | $33,613 | $1,638 | - | $35,251 |
| Conferences and Meetings | $18,386 | $896 | - | $19,282 |
| Travel | $10,403 | $507 | - | $10,910 |
| All Other Expenses | $1,697 | $83 | - | $1,780 |
| Interest | $10 | - | - | $10 |
| Total Functional Expenses | $6,552,866 | $500,979 | $0 | $7,053,845 |
Fundraising, Events, and Gaming
- Fundraising activities
- No
- Gaming activities
- No
- Professional fundraiser used
- No
Fundraising and Gaming Totals
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
Political and Lobbying Activity
- Political campaign activity
- No
- Lobbying activity
- No
- Subject to proxy tax
- No
Governance and Compliance
Governance Checklist
- Compiled or reviewed by an accountant
- No
- Annual disclosure for covered persons
- Yes
- Audit committee
- Yes
- Backup withholding compliance
- Yes
- Business relationship with family members
- No
- Business relationship with organization members
- No
- Material changes to governing documents
- No
- Compensation from other sources disclosed
- No
- CEO compensation reviewed
- Yes
- Other officer compensation reviewed
- Yes
- Conflict-of-interest policy
- Yes
- Audited financial statements prepared
- Yes
- Key decisions subject to board approval
- No
- Management duties delegated
- Yes
Governance Explanations
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-potdam 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, richard jacobs, 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 canton-potsdam hospital's finance department staff members. Upon completion, a copy with supporting documentation is reviewed by the vice president for finance and the controller. Furthermore, the form was provided to the canton-potsdam medical practice advisory committee for further review and comment. After review, any changes are made and a copy is presented to the sole member of canton-potsdam medical practice, robert t. Rogers, ii, md for his review and approval.”
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 the work of the human resource department, the recommendation of the vice president of human resources (hr), and by information gathered from independent survey data of national and surrounding markets. The vice president of human resources will review the survey data to estimate salary ranges and compensation packages. The vp of hr makes the recommendation to the ceo. The ceo will bring the information to the compensation committee. After deliberations and considerations, the 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.”
Filing and Contact Details
Filer
- Filer Name
- Canton-potsdam Med Practice Pllc
- EIN
- 46-0714367
- Phone
- 3152615100
- Address
- 50 LEROY STREET, POTSDAM, NY 13676
Signing Officer
- Name
- Robert T Rogersii Md
- Title
- Director
- Phone
- 3152615100
- Signed
- 2017-09-01
- Discuss with paid preparer
- Yes
Organization Details
- Principal Officer
- Robert T Rogersii Md
- Formed
- 2012
- Legal Domicile
- Ny
- Voting Board Members
- 1
- Independent Board Members
- 0
- Employees
- 0
Preparer
- Firm
- Gray & Gray and Associates Cpas Pc
- Address
- 1 MAIN STREET SUITE 101, CANTON, NY 13617-1277
- Preparer
- John J Gray Jr CPA
- Phone
- 3153862925
Supplemental Narrative
Additional Explanations
Form 990, Page 2, Part III, Line 4D
“Canton-potsdam medical practice operates other outpatient clinic locations including the following: ent: located in potsdam, ny, this clinic served approximately 3,138 patients in 2016. Gastro: located in massena, ny, this clinic served approximately 3,460 patients in 2016. Family practice: located in colton, ny, this clinic served approximately 2,561 patients in 2016. Canton general surgery: located in canton, ny, this clinic opened in january 2016 and served approximately 936 patients in 2016.”
Form 990, Part XI, Line 9
“Transfer from affiliate (canton-potsdam hospital) 2,991,769”
Financial Statement Notes
Schedule D, Page 3, Part X
“Income taxes of the consolidated audited financial statements: the hospital and cpmp are not-for-profit corporations as described in section 501(c)(3) of the internal revenue code (the code) and are exempt from the federal income taxes on related income pursuant to section 501(a) of the code. The hospital and cpmp 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 judgement occurs. The hospital and cpmp did not recognize the effect of any uncertain income tax positions in either 2016 or 2015.”
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| IRS990/ProgSrvcAccomActy3Grp/RevenueAmt | 0 | 1117471 |
| IRS990/ProgSrvcAccomActyOtherGrp/Desc | 0 | CANTON-POTSDAM MEDICAL PRACTICE OPERATES OTHER OUTPATIENT CLINIC LOCATIONS INCLUDING THE FOLLOWING: ENT: LOCATED IN POTSDAM, NY, THIS CLINIC SERVED APPROXIMATELY 3,138 PATIENTS IN 2016. GASTRO: LOCATED IN MASSENA, NY, THIS CLINIC SERVED APPROXIMATELY 3,460 PATIENTS IN 2016. FAMILY PRACTICE: LOCATED IN COLTON, NY, THIS CLINIC SERVED APPROXIMATELY 2,561 PATIENTS IN 2016. CANTON GENERAL SURGERY: LOCATED IN CANTON, NY, THIS CLINIC OPENED IN JANUARY 2016 AND SERVED APPROXIMATELY 936 PATIENTS IN 2016. |
| IRS990/ProgSrvcAccomActyOtherGrp/ExpenseAmt | 0 | 3382997 |
| IRS990/ProgSrvcAccomActyOtherGrp/RevenueAmt | 0 | 6275588 |
| IRS990/ProhibitedTaxShelterTransInd | 0 | false |
| IRS990/PYExcessBenefitTransInd | 0 | false |
| IRS990/PYOtherExpensesAmt | 0 | 1474576 |
| IRS990/PYOtherRevenueAmt | 0 | 31 |
| IRS990/PYProgramServiceRevenueAmt | 0 | 3295263 |
| IRS990/PYRevenuesLessExpensesAmt | 0 | -2241732 |
| IRS990/PYSalariesCompEmpBnftPaidAmt | 0 | 4062450 |
| IRS990/PYTotalExpensesAmt | 0 | 5537026 |
| IRS990/PYTotalRevenueAmt | 0 | 3295294 |
| IRS990/ReconcilationRevenueExpnssAmt | 0 | -3162779 |
| IRS990/RegularMonitoringEnfrcInd | 0 | true |
| IRS990/RelatedEntityInd | 0 | true |
| IRS990/RelatedOrganizationCtrlEntInd | 0 | false |
| IRS990/ReportInvestmentsOtherSecInd | 0 | false |
| IRS990/ReportLandBuildingEquipmentInd | 0 | true |
| IRS990/ReportOtherAssetsInd | 0 | false |
| IRS990/ReportOtherLiabilitiesInd | 0 | false |
| IRS990/ReportProgramRelatedInvstInd | 0 | false |
| IRS990/RevenueAmt | 0 | 1076350 |
| IRS990ScheduleA/First5Years509Ind | 0 | X |
| IRS990ScheduleA/Form990ScheduleAPartVIGrp/ExplanationTxt | 0 | MISCELLANEOUS INCOME 13,565 |
| IRS990ScheduleA/Form990ScheduleAPartVIGrp/FormAndLineReferenceDesc | 0 | PART III, LINE 12 |
| IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearAmt | 0 | 11044644 |
| IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus1YearAmt | 0 | 9222226 |
| IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus2YearsAmt | 0 | 5518479 |
| IRS990ScheduleA/GrossReceiptsAdmissionsGrp/CurrentTaxYearMinus3YearsAmt | 0 | 102962 |
| IRS990ScheduleA/GrossReceiptsAdmissionsGrp/TotalAmt | 0 | 25888311 |
| IRS990ScheduleA/OtherIncome509Grp/CurrentTaxYearAmt | 0 | 11796 |
| IRS990ScheduleA/OtherIncome509Grp/CurrentTaxYearMinus1YearAmt | 0 | 31 |
| IRS990ScheduleA/OtherIncome509Grp/CurrentTaxYearMinus2YearsAmt | 0 | 1698 |
| IRS990ScheduleA/OtherIncome509Grp/CurrentTaxYearMinus3YearsAmt | 0 | 40 |
| IRS990ScheduleA/OtherIncome509Grp/TotalAmt | 0 | 13565 |
| IRS990ScheduleA/PubliclySupportedOrg509a2Ind | 0 | X |
| IRS990ScheduleA/PublicSupportTotal509Amt | 0 | 25888311 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearAmt | 0 | 11044644 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus1YearAmt | 0 | 9222226 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus2YearsAmt | 0 | 5518479 |
| IRS990ScheduleA/Total509Grp/CurrentTaxYearMinus3YearsAmt | 0 | 102962 |
| IRS990ScheduleA/Total509Grp/TotalAmt | 0 | 25888311 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearAmt | 0 | 11056440 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus1YearAmt | 0 | 9222257 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus2YearsAmt | 0 | 5520177 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/CurrentTaxYearMinus3YearsAmt | 0 | 103002 |
| IRS990ScheduleA/TotalSupportCalendarYearGrp/TotalAmt | 0 | 25901876 |
| IRS990/ScheduleBRequiredInd | 0 | false |
| IRS990ScheduleD/EquipmentGrp/BookValueAmt | 0 | 452477 |
| IRS990ScheduleD/EquipmentGrp/DepreciationAmt | 0 | 359455 |
| IRS990ScheduleD/EquipmentGrp/OtherCostOrOtherBasisAmt | 0 | 811932 |
| IRS990ScheduleD/FootnoteTextInd | 0 | X |
| IRS990ScheduleD/LeaseholdImprovementsGrp/BookValueAmt | 0 | 8250 |
| IRS990ScheduleD/LeaseholdImprovementsGrp/DepreciationAmt | 0 | 10728 |
| IRS990ScheduleD/LeaseholdImprovementsGrp/OtherCostOrOtherBasisAmt | 0 | 18978 |
| IRS990ScheduleD/SupplementalInformationDetail/ExplanationTxt | 0 | INCOME TAXES OF THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS: THE HOSPITAL AND CPMP ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM THE FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. THE HOSPITAL AND CPMP 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 JUDGEMENT OCCURS. THE HOSPITAL AND CPMP DID NOT RECOGNIZE THE EFFECT OF ANY UNCERTAIN INCOME TAX POSITIONS IN EITHER 2016 OR 2015. |
| IRS990ScheduleD/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | SCHEDULE D, PAGE 3, PART X |
| IRS990ScheduleD/TotalBookValueLandBuildingsAmt | 0 | 460727 |
| IRS990ScheduleJ/AnyNonFixedPaymentsInd | 0 | false |
| IRS990ScheduleJ/CompBasedOnRevenueOfFlngOrgInd | 0 | false |
| IRS990ScheduleJ/CompBsdNetEarnsFlngOrgInd | 0 | false |
| IRS990ScheduleJ/CompBsdNetEarnsRltdOrgsInd | 0 | false |
| IRS990ScheduleJ/CompBsdOnRevRelatedOrgsInd | 0 | false |
| IRS990ScheduleJ/EquityBasedCompArrngmInd | 0 | false |
| IRS990ScheduleJ/InitialContractExceptionInd | 0 | false |
| IRS990/ScheduleJRequiredInd | 0 | true |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt | 0 | 316146 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/CompensationBasedOnRltdOrgsAmt | 1 | 272822 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt | 0 | 5300 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/DeferredCompRltdOrgsAmt | 1 | 18383 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt | 0 | 11720 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/NontaxableBenefitsRltdOrgsAmt | 1 | 12321 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm | 0 | ROBERT T ROGERSII MD |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm | 1 | RICHARD D JACOBS |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt | 0 | DIRECTOR |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TitleTxt | 1 | FINANCE |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt | 0 | 333166 |
| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/TotalCompensationRltdOrgsAmt | 1 | 303526 |
| IRS990ScheduleJ/SeverancePaymentInd | 0 | false |
| IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt | 0 | 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. 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 COMMITTEE WILL THEN MAKE RECOMMENDATION TO THE FULL BOARD. THE FULL BOARD WILL THEN VOTE ON THE TOP OFFICIAL'S COMPENSATION PACKAGE. |
| IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | SCHEDULE J, PART III |
| IRS990ScheduleJ/SupplementalNonqualRtrPlanInd | 0 | false |
| IRS990/ScheduleORequiredInd | 0 | true |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | CANTON-POTSDAM MEDICAL PRACTICE OPERATES OTHER OUTPATIENT CLINIC LOCATIONS INCLUDING THE FOLLOWING: ENT: LOCATED IN POTSDAM, NY, THIS CLINIC SERVED APPROXIMATELY 3,138 PATIENTS IN 2016. GASTRO: LOCATED IN MASSENA, NY, THIS CLINIC SERVED APPROXIMATELY 3,460 PATIENTS IN 2016. FAMILY PRACTICE: LOCATED IN COLTON, NY, THIS CLINIC SERVED APPROXIMATELY 2,561 PATIENTS IN 2016. CANTON GENERAL SURGERY: LOCATED IN CANTON, NY, THIS CLINIC OPENED IN JANUARY 2016 AND SERVED APPROXIMATELY 936 PATIENTS IN 2016. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | 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-POTDAM 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, RICHARD JACOBS, 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. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | 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. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | THE FORM 990 IS PREPARED BY CANTON-POTSDAM HOSPITAL'S FINANCE DEPARTMENT STAFF MEMBERS. UPON COMPLETION, A COPY WITH SUPPORTING DOCUMENTATION IS REVIEWED BY THE VICE PRESIDENT FOR FINANCE AND THE CONTROLLER. FURTHERMORE, THE FORM WAS PROVIDED TO THE CANTON-POTSDAM MEDICAL PRACTICE ADVISORY COMMITTEE FOR FURTHER REVIEW AND COMMENT. AFTER REVIEW, ANY CHANGES ARE MADE AND A COPY IS PRESENTED TO THE SOLE MEMBER OF CANTON-POTSDAM MEDICAL PRACTICE, ROBERT T. ROGERS, II, MD FOR HIS REVIEW AND APPROVAL. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | 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. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 5 | 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. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 6 | 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 THE WORK OF THE HUMAN RESOURCE DEPARTMENT, THE RECOMMENDATION OF THE VICE PRESIDENT OF HUMAN RESOURCES (HR), AND BY INFORMATION GATHERED FROM INDEPENDENT SURVEY DATA OF NATIONAL AND SURROUNDING MARKETS. THE VICE PRESIDENT OF HUMAN RESOURCES WILL REVIEW THE SURVEY DATA TO ESTIMATE SALARY RANGES AND COMPENSATION PACKAGES. THE VP OF HR MAKES THE RECOMMENDATION TO THE CEO. THE CEO WILL BRING THE INFORMATION TO THE COMPENSATION COMMITTEE. AFTER DELIBERATIONS AND CONSIDERATIONS, THE COMPENSATION COMMITTEE WILL THEN BRING THEIR RECOMMENDATION TO THE FULL BOARD FOR THEIR FINAL APPROVAL. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 7 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 8 | TRANSFER FROM AFFILIATE (CANTON-POTSDAM HOSPITAL) 2,991,769 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | FORM 990, PAGE 2, PART III, LINE 4D |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | FORM 990, PAGE 6, PART VI, LINE 3 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | FORM 990, PAGE 6, PART VI, LINE 8B |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | FORM 990, PAGE 6, PART VI, LINE 11B |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | FORM 990, PAGE 6, PART VI, LINE 12C |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 5 | FORM 990, PAGE 6, PART VI, LINE 15A |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 6 | FORM 990, PAGE 6, PART VI, LINE 15B |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 7 | FORM 990, PAGE 6, PART VI, LINE 19 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 8 | FORM 990, PART XI, LINE 9 |
| IRS990ScheduleR/AssetExchangeInd | 0 | false |
| IRS990ScheduleR/AssetPurchaseFromOtherOrgInd | 0 | false |
| IRS990ScheduleR/AssetSaleToOtherOrgInd | 0 | false |
| IRS990ScheduleR/DivRelatedOrganizationInd | 0 | false |
| IRS990ScheduleR/GiftGrntCapContriFromOthOrgInd | 0 | false |
| IRS990ScheduleR/GiftGrntOrCapContriToOthOrgInd | 0 | false |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd | 0 | false |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd | 1 | true |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ControlledOrganizationInd | 2 | true |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt | 0 | NA |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt | 1 | SLHS |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DirectControllingEntityName/BusinessNameLine1Txt | 2 | SLHS |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 0 | ST LAWRENCE HEALTH SYSTEM INC |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 1 | CANTON-POTSDAM HOSPITAL |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 2 | GOUVERNEUR HOSPITAL INC |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN | 0 | 464259168 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN | 1 | 161012691 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/EIN | 2 | 464249555 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt | 0 | 501C3 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt | 1 | 501C3 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt | 2 | 501C3 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd | 0 | NY |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd | 1 | NY |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/LegalDomicileStateCd | 2 | NY |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt | 0 | SEE VII |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt | 1 | HOSPITAL |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/PrimaryActivitiesTxt | 2 | HOSPITAL |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt | 0 | 50 LEROY STREET |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt | 1 | 50 LEROY STREET |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/AddressLine1Txt | 2 | 77 WEST BARNEY STREET |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm | 0 | POTSDAM |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm | 1 | POTSDAM |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/CityNm | 2 | GOUVERNEUR |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd | 0 | NY |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd | 1 | NY |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/StateAbbreviationCd | 2 | NY |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd | 0 | 13676 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd | 1 | 13676 |
| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/USAddress/ZIPCd | 2 | 13642 |
| IRS990ScheduleR/LoansOrGuaranteesFromOthOrgInd | 0 | false |
| IRS990ScheduleR/LoansOrGuaranteesToOtherOrgInd | 0 | false |
| IRS990ScheduleR/PaidEmployeesSharingInd | 0 | false |
| IRS990ScheduleR/PerformOfServicesByOtherOrgInd | 0 | false |
| IRS990ScheduleR/PerformOfServicesForOthOrgInd | 0 | false |
| IRS990ScheduleR/ReceiptOfIntAnntsRntsRyltsInd | 0 | false |
| IRS990ScheduleR/ReimbursementPaidByOtherOrgInd | 0 | false |
| IRS990ScheduleR/ReimbursementPaidToOtherOrgInd | 0 | false |
| IRS990ScheduleR/RentalOfFacilitiesToOthOrgInd | 0 | false |
| IRS990ScheduleR/RentalOfFcltsFromOthOrgInd | 0 | true |
| IRS990ScheduleR/SharingOfFacilitiesInd | 0 | false |
| IRS990ScheduleR/SupplementalInformationDetail/ExplanationTxt | 0 | ST. LAWRENCE HEALTH SYSTEM, INC. (SLHS) IS OPERATED EXCLUSIVELY FOR THE SOLE CHARITABLE PURPOSE OF BENEFITING AND SUPPORTING CANTON-POTSDAM HOSPITAL, GOUVERNEUR HOSPITAL AND OTHER CORPORATIONS OF WHICH THE CORPORATION IS THE SOLE CORPORATE MEMBER INCLUDING THE CANTON-POTSDAM MEDICAL PRACTICE, PLLC. |
| IRS990ScheduleR/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | SCHEDULE R |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt | 0 | 5992491 |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/InvolvedAmt | 1 | 141850 |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/MethodOfAmountDeterminationTxt | 0 | FMV |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/MethodOfAmountDeterminationTxt | 1 | FMV |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt | 0 | CANTON-POTSDAM HOSPITAL |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/OtherOrganizationName/BusinessNameLine1Txt | 1 | CANTON-POTSDAM HOSPITAL |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/TransactionTypeTxt | 0 | K |
| IRS990ScheduleR/TransactionsRelatedOrgGrp/TransactionTypeTxt | 1 | K |
| IRS990ScheduleR/TransferFromOtherOrgInd | 0 | false |
| IRS990ScheduleR/TransferToOtherOrgInd | 0 | false |
| IRS990/SchoolOperatingInd | 0 | false |
| IRS990/SignificantChangeInd | 0 | false |
| IRS990/SignificantNewProgramSrvcInd | 0 | false |
| IRS990/SubjectToProxyTaxInd | 0 | false |
| IRS990/TaxablePartyNotificationInd | 0 | false |
| IRS990/TaxExemptBondsInd | 0 | false |
| IRS990/TempOrPermanentEndowmentsInd | 0 | false |
| IRS990/TerminateOperationsInd | 0 | false |
| IRS990/TotalAssetsBOYAmt | 0 | 1108417 |
| IRS990/TotalAssetsEOYAmt | 0 | 1021400 |
| IRS990/TotalAssetsGrp/BOYAmt | 0 | 1108417 |
| IRS990/TotalAssetsGrp/EOYAmt | 0 | 1021400 |
| IRS990/TotalCompGreaterThan150KInd | 0 | true |
| IRS990/TotalEmployeeCnt | 0 | 0 |
| IRS990/TotalFunctionalExpensesGrp/FundraisingAmt | 0 | 0 |
| IRS990/TotalFunctionalExpensesGrp/ManagementAndGeneralAmt | 0 | 500979 |
| IRS990/TotalFunctionalExpensesGrp/ProgramServicesAmt | 0 | 6552866 |
| IRS990/TotalFunctionalExpensesGrp/TotalAmt | 0 | 7053845 |
| IRS990/TotalGrossUBIAmt | 0 | 0 |
| IRS990/TotalLiabilitiesBOYAmt | 0 | 27354 |
| IRS990/TotalLiabilitiesEOYAmt | 0 | 111347 |
| IRS990/TotalLiabilitiesGrp/BOYAmt | 0 | 27354 |
| IRS990/TotalLiabilitiesGrp/EOYAmt | 0 | 111347 |
| IRS990/TotalNetAssetsFundBalanceGrp/BOYAmt | 0 | 1081063 |
| IRS990/TotalNetAssetsFundBalanceGrp/EOYAmt | 0 | 910053 |
| IRS990/TotalOtherCompensationAmt | 0 | 47724 |
| IRS990/TotalOtherProgSrvcExpenseAmt | 0 | 3382997 |
| IRS990/TotalOtherProgSrvcRevenueAmt | 0 | 6275588 |
| IRS990/TotalProgramServiceExpensesAmt | 0 | 6552866 |
| IRS990/TotalProgramServiceRevenueAmt | 0 | 3879270 |
| IRS990/TotalRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 3891066 |
| IRS990/TotalRevenueGrp/TotalRevenueColumnAmt | 0 | 3891066 |
| IRS990/TotLiabNetAssetsFundBalanceGrp/BOYAmt | 0 | 1108417 |
| IRS990/TotLiabNetAssetsFundBalanceGrp/EOYAmt | 0 | 1021400 |
| IRS990/TotReportableCompRltdOrgAmt | 0 | 588968 |
| IRS990/TravelGrp/ManagementAndGeneralAmt | 0 | 507 |
| IRS990/TravelGrp/ProgramServicesAmt | 0 | 10403 |
| IRS990/TravelGrp/TotalAmt | 0 | 10910 |
Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2016 • Form 990Detailed filing. Detailed filing data is available for this year.
- Assets
- $1,021,400
- Liabilities
- $111,347
- Net assets
- $910,053
- Revenue
- $3,891,066
- Expenses
- $7,053,845
- Net income
- -$3,162,779