Civic Intelligence

Gouverneur Hospital

990 • Fiscal year 2019 • EIN 46-4249555

Jan 01, 2019 to Dec 31, 2019 • Filed on Nov 13, 2020

Organization ProfileWWW.GVNRHOSPITAL.ORG

View Organization Page

77 West Barney StreetGouverneur, NY 13642

(315) 287-1000

Siviq Scores

Precomputed percentiles for this filing year versus similar nonprofits in the same peer cohort.

Liabilities / Assets

66th percentile

0.54x

Higher debt load relative to assets than 66% of similar nonprofits.

2019 filings • NTEE E • $25M-$50M nonprofits • Source year 2019

Liabilities / Revenue

56th percentile

0.34x

Higher debt load relative to revenue than 56% of similar nonprofits.

2019 filings • NTEE E • $25M-$50M nonprofits • Source year 2019

Net Margin

68th percentile

6.4%

Higher net margin than 68% of similar nonprofits.

2019 filings • NTEE E • $25M-$50M nonprofits • Source year 2019

Top Officer Pay

35th percentile

$355,487

Higher top officer pay than 35% of similar nonprofits.

Top officer pay equals 1.4% of source-year revenue.

2019 filings • NTEE E • $25M-$50M nonprofits • Source year 2019

Asset Growth

68th percentile

11%

Faster asset growth than 68% of similar nonprofits.

2019 filings • NTEE E • $25M-$50M nonprofits • Annualized from 2018 to 2019

Revenue Growth

72nd percentile

8.5%

Faster revenue growth than 72% of similar nonprofits.

2019 filings • NTEE E • $25M-$50M nonprofits • Annualized from 2018 to 2019

Balance Sheet
Liabilities / Assets66th percentile

Assets

Up

$16,154,381

Up $1,639,302 (+11%) from 2018

Net Assets

Up

$7,376,850

Up $1,783,362 (+32%) from 2018

Liabilities

Down

$8,777,531

Down $144,060 (-1.6%) from 2018

Revenue And Expenses
Liabilities / Revenue56th percentileNet Margin68th percentile

Revenue

Up

$25,517,703

Up $2,006,638 (+8.5%) from 2018

Expenses

Up

$23,892,821

Up $1,360,935 (+6.0%) from 2018

Net Income

Up

$1,624,882

Up $645,703 (+66%) from 2018

Historical Trend

Balance Sheet Trend

Asset Growth68th percentile

The highlighted filing sits inside the broader history for assets, liabilities, and net assets.

$60M$40M$20M$0-$20MAssets 2013: $6,880,748Liabilities 2013: $9,009,753Net Assets 2013: -$2,129,0052013Assets 2014: $9,074,063Liabilities 2014: $8,593,646Net Assets 2014: $480,4172014Assets 2015: $9,880,241Liabilities 2015: $8,662,398Net Assets 2015: $1,217,8432015Assets 2016: $11,697,963Liabilities 2016: $9,267,108Net Assets 2016: $2,430,8552016Assets 2017: $12,847,542Liabilities 2017: $8,795,533Net Assets 2017: $4,052,0092017Assets 2018: $14,515,079Liabilities 2018: $8,921,591Net Assets 2018: $5,593,4882018Assets 2019: $16,154,381Liabilities 2019: $8,777,531Net Assets 2019: $7,376,8502019Assets 2020: $21,451,302Liabilities 2020: $8,974,904Net Assets 2020: $12,476,3982020Assets 2021: $22,324,244Liabilities 2021: $8,777,528Net Assets 2021: $13,546,7162021Assets 2022: $41,545,414Liabilities 2022: $27,314,511Net Assets 2022: $14,230,9032022Assets 2023: $32,251,939Liabilities 2023: $10,645,337Net Assets 2023: $21,606,6022023Assets 2024: $31,323,692Liabilities 2024: $8,292,612Net Assets 2024: $23,031,0802024

Highlighted filing

2019

Assets$16,154,381
Liabilities$8,777,531
Net Assets$7,376,850
Open 2019 Filing

Operations Trend

Revenue Growth72nd percentile

Revenue, expenses, and net income across loaded years, with this filing highlighted.

$40M$30M$20M$10M$0-$10MRevenue 2013: $0Expenses 2013: $0Net Income 2013: $02013Revenue 2014: $20,538,727Expenses 2014: $18,389,474Net Income 2014: $2,149,2532014Revenue 2015: $17,585,466Expenses 2015: $18,445,024Net Income 2015: -$859,5582015Revenue 2016: $19,182,104Expenses 2016: $18,726,338Net Income 2016: $455,7662016Revenue 2017: $20,417,624Expenses 2017: $20,573,267Net Income 2017: -$155,6432017Revenue 2018: $23,511,065Expenses 2018: $22,531,886Net Income 2018: $979,1792018Revenue 2019: $25,517,703Expenses 2019: $23,892,821Net Income 2019: $1,624,8822019Revenue 2020: $30,316,998Expenses 2020: $25,603,599Net Income 2020: $4,713,3992020Revenue 2021: $28,105,337Expenses 2021: $27,081,312Net Income 2021: $1,024,0252021Revenue 2022: $30,436,096Expenses 2022: $29,588,845Net Income 2022: $847,2512022Revenue 2023: $37,980,965Expenses 2023: $30,631,278Net Income 2023: $7,349,6872023Revenue 2024: $36,021,916Expenses 2024: $34,666,503Net Income 2024: $1,355,4132024

Highlighted filing

2019

Revenue$25,517,703
Expenses$23,892,821
Net Income$1,624,882
Open 2019 Filing
Jump To
Filing Snapshot
Filing Period
Jan 1, 2019 to Dec 31, 2019
Signed
Nov 13, 2020
Return Version
2019v5.0
Gross Receipts
$25,874,309
Mission and Program Overview

Mission

Our mission is to provide skilled, compassionate, cost-effective care that promotes wellness and meets the community's healthcare needs.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$7,230,929$7,407,059▲ $176,130
Accounts Receivable$2,489,308$3,285,137▲ $795,829
Cash and Non-Interest-Bearing Accounts$926,842$2,255,748▲ $1,328,906
Investments Other Securities$546,506$624,786▲ $78,280
Inventories for Sale or Use$427,859$445,053▲ $17,194
Prepaid Expenses and Deferred Charges$186,714$108,231▼ $78,483
Pledges and Grants Receivable$1,026,775$42,911▼ $983,864
Total Assets$14,515,079$16,154,381▲ $1,639,302
Other Assets Total$1,680,146$1,985,456▲ $305,310
Liabilities
Other Liabilities$7,095,405$6,538,004▼ $557,401
Accounts Payable and Accrued Expenses$1,421,980$1,843,962▲ $421,982
Unsecured Notes Loans Payable$404,206$395,565▼ $8,641
Total Liabilities$8,921,591$8,777,531▼ $144,060
Net Assets / Fund Balance
Net Assets Without Donor Restrictions$4,047,126$5,483,175▲ $1,436,049
Net Assets With Donor Restrictions$1,546,362$1,893,675▲ $347,313
Total Net Assets Fund Balance$5,593,488$7,376,850▲ $1,783,362
Total Liabilities and Net Assets / Fund Balance$14,515,079$16,154,381▲ $1,639,302

Asset Categories

AssetBook ValueDepreciationBasis
Equipment$2,446,331$3,820,365$6,266,696
Buildings$4,084,513$1,237,571$5,322,084
Land$647,398-$647,398
Other Land Buildings$228,817-$228,817
Other Assets Org$409,819--

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2019$1,908,169-▼ $14,494-$1,893,675
2018$2,534,689-▼ $626,520-$1,908,169
2017$2,412,779-▲ $121,910-$2,534,689
2016$1,637,555$1,806,389▲ $38,244$1,069,409$2,412,779
2015$1,672,801$61,715▼ $35,323$61,638$1,637,555
Compensation and Service Providers
Top Officer Pay35th percentile

Employees

NameTitleFull / Part TimeBaseOtherTotal
Alice Loving MdAnesthesioloFT$325,810$29,677$355,487
Alice Loving MdAnesthesiologist-$325,810$29,677$355,487
Eric BurchCEOPT$265,810$22,084$287,894
Ismene N Maravegias MdPhysicianFT$148,174$23,869$172,043
Richard Corcoran RpaPhysician asFT$148,174$23,869$172,043
Richard Corcoran RpaPhysician Assistant-$157,444$3,171$160,615
Kelly CicchinelliControllerPT-$139,478$139,478
Amanda HanceNurse PractiFT$121,254$15,117$136,371

Board Members and Trustees

NameTitle
Michael BurgessChairperson
Andrew LeonardVice Chair
Andrew Williams MdTrustee
Carolyn PistolesiTrustee
Christine BetrusTrustee
Kurt HallidayTrustee
Lauren FrenchTrustee
Roger Cook DvmTrustee
Ryan SchermerhornTrustee
Nicole L Weber MdPhysician
Mark BrackettSecretary/tr

Highest Paid Contractors

ContractorServicesLocationCompensation
Canton-potsdam HospitalStaffing50 LEROY STREET, Potsdam, NY 13676$2,554,544
Delphi Hospitalist Services LLCHospitalist1160 CHILI AVE SUITE 200, Rochester, NY 14624$1,062,807
St Lawrence Health SystemStaffing50 LEROY STREET, Potsdam, NY 13676$840,453
Eni Mechanical INCContractor39 SOUTH GORDON STREET, Gouverneur, NY 13642$306,014
Morrison Management SpecialistsStaffingPO BOX 102289, Atlanta, GA 30368-2289$130,531
Revenue and Support

Revenue Composition

Contributions and Grants
$83,371
Program Service Revenue
$22,898,581
Investment Income
$72,371
Other Revenue
$2,463,380
All Other Contributions
$83,371
Change in Net Assets
$1,624,882

Audited Revenue Reconciliation

Revenue per Audited Statements
$25,254,977
Revenue Not Reported on Financial Statements
$262,726
Revenue Not Reported on Form 990
$329,959
Other Revenue Adjustments
$262,726
Total Revenue per Audited Statements
$25,584,936
Total Revenue per Form 990
$25,517,703
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Salaries, Compensation, and Employee Benefits$14,049,641
Other Expenses$9,843,180
Grants and Similar Amounts Paid$0
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$7,925,327$2,641,776-$10,567,103
Other Employee Benefits$1,635,772$545,257-$2,181,029
Depreciation Depletion$976,677$183,015-$1,159,692
Payroll Taxes$576,620$192,207-$768,827
Pension Plan Contributions$310,338$103,446-$413,784
Occupancy$314,894$59,007-$373,901
Other Expenses$242,298$80,766-$323,064
All Other Expenses$165,459$149,057-$314,516
Insurance$236,001$44,223-$280,224
Interest$113,015$37,672-$150,687
Current Officers, Directors, Trustees, and Key Employees$89,174$29,724-$118,898
Fees for Services Accounting-$115,140-$115,140
Advertising$54,355$18,119-$72,474
Fees for Services Legal-$51,763-$51,763
Conferences and Meetings$31,903$10,634-$42,537
Travel$30,998$10,332-$41,330
Fees for Services Lobbying-$4,495-$4,495
Total Functional Expenses$17,960,721$5,932,100$0$23,892,821

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Audited Statements$24,222,780
Expenses per Audited Statements$23,892,821
Total Expenses per Form 990$23,892,821
Expenses Not Reported on Form 990$329,959
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Interested-Person Transactions

Interested PartyRelationshipDescriptionShared RevenueAmount
See Part V Below--No-
Debt and Bond Financing

Other Reported Liabilities

LiabilityAmount
Asset Retirement Obligation$3,841,675
Due to Affiliates$1,932,531
Est Third-party Payor Settlements$763,798
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 35% controlled entity
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
Yes
Management duties delegated
No

Governance Explanations

Form 990, Page 6, Part VI, Line 6

“St. Lawrence health system, inc. Is a sole member.”

Form 990, Page 6, Part VI, Line 7A

“St. Lawrence health system, inc. Is a sole member, and has the ability to appoint members of the board of directors.”

Form 990, Page 6, Part VI, Line 7B

“The members shall have the following powers with regard to the corporation: -appoint the members of the board of directors. -appoint and remove the chief executive officer. -approve the adoption and amendment of bylaws. -approve the annual operating and capital budgets. -approve strategic plans. -approve and initiate the filing of certificate of need applications. -review and approve the annual audit of the corporation and any subsidiary corporations. -approve the dissolution of the corporation. -approve the sale, lease, mortgage or encumbrance of any asset other than any sale, lease or mortgage which is part of an approved budget. -approve the sale or transfer of all or substantially all of the assets of the corporations. -approve any merger, business consolidation, acquisition or joint venture. -approve the purchase or sale of physician practices other than any purchase or sale which is part of an approved budget. -approve and may initiate the commencement and settlement of litigation. -approve any filing of bankruptcy petition. -approve the incurrence of any debt other than debt which is incurred in the ordinary course of business and which is not inconsistent with an approved budget. -approve new clinical programs or the termination of existing clinical programs other than any action which is part of an approved budget. -approve any of the following agreements: (i) management services agreements other than any agreement which is part of an approved budget. (ii) contracts with a physician or a physician group. (iii) agreements for the outsourcing of a gouverneur hospital service or function. (iv) collective bargaining agreements, and (v) any agreements to participate in a risk bearing arrangement such as an accountable care organization or a bundled payment arrangement. -initiate, negotiate, and approve managed care agreements with managed care organizations and other payors other than any agreement which is part of an approved budget. -develop integrated services and mandate participation in such services (e.g., financial management, legal, quality assurance, risk management, contracting, and recruitment) -require the guarantee of loans through an obligated group structure that will support access to capital and include debt services.”

Form 990, Page 6, Part VI, Line 11B

“The form 990 is prepared by the finance department staff members. Upon completion, the form is submitted to a cpa firm for review and prepared for filing. A copy of the draft return is then reviewed by the system cfo and system controller. After review, any changes are made and a copy is presented to the board of directors for their review, comments and approval (prior to irs submission).”

Form 990, Page 6, Part VI, Line 12C

“On an annual basis, officers, directors, and key employees are required to complete a conflict of interest statement. Compliance with this requirement is monitored by the hospital administration.”

Form 990, Page 6, Part VI, Line 15A

“The chief executive officer is evaluated by the st. Lawrence health system ceo. Hospital senior leadership is evaluated by the hospital's ceo. Yaffe and company provides executive compensation data for critical access hospitals which is utilized by the st. Lawrence health system ceo to determine appropriate compensation for the hospital's ceo. The same data is utilized by the hospital's ceo to determine appropriate compensation for the hospital's senior leadership.”

Form 990, Page 6, Part VI, Line 15B

“The chief executive officer is evaluated by the st. Lawrence health system ceo. Hospital senior leadership is evaluated by the hospital's ceo. Yaffe and company provides executive compensation data for critical access hospitals which is utilized by the st. Lawrence health system ceo to determine appropriate compensation for the hospital's ceo. The same data is utilized by the hospital's ceo to determine appropriate compensation for the hospital's senior leadership.”

Form 990, Page 6, Part VI, Line 19

“The hospital makes its governing documents, conflict of interest policy and financial statement available to the public upon request.”

Filing and Contact Details

Filer

Filer Name
Gouverneur Hospital
EIN
46-4249555
Phone
3152871000
Address
77 WEST BARNEY STREET, GOUVERNEUR, NY 13642

Signing Officer

Name
Eric Burch
Title
CEO
Phone
3152871000
Signed
2020-11-13

Organization Details

Principal Officer
Eric Burch
Formed
2013
Legal Domicile
Ny
Voting Board Members
10
Independent Board Members
6
Employees
264
Volunteers
4

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 2

“The hospital added an outpatient substance use clinic in 2019.”

Form 990, Page 2, Part III, Line 4D

“There was decrease in surgeries performed in 2019. There were 617 surgeries in 2019, compared to 704 in 2018, roughly an 12% decrease.”

Form 990, Part XI, Line 9

“Contributions for capital acquisitions 172,974 net assets realeased from restrictions for capital -108,469 restricted contributions - net -14,494 change in fair value of funds held in trust by oth 108,469 change in net unrealized gain on investments 0 transfer to st.lawrence health system 0 total 158,480”

Financial Statement Notes

Schedule D, Page 2, Part V, Line 4

“The organization uses the income from the endowment funds for general operating purposes and lawful purposes at the discretion of the board of directors.”

Schedule D, Page 3, Part X

“The system and its affiliates are not for profit corporations as described in section 501(c)(3) of the internal revenue code (the code)and are exempt from federal income tax on related income pursuant to section 501(a) of the code.the system and affiliates recognize the effect of income tax positions only if those positions are more likely then 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 recognization in measurement are reflected in the period in which the change in judgement occurs. The system and affiliates did not recognize the effect of any uncertain income tax positions in either 2019 or 2018.”

Schedule D, Page 4, Part XI, Line 2D

“RENT EXPENSES 329,959”

Schedule D, Page 4, Part XI, Line 4B

“Non operating gains/losses 262,726”

Schedule D, Page 4, Part XII, Line 2D

“RENT EXPENSES 329,959”

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This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.

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Document Assets

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Filings

Displayed year

2019 • Form 990Detailed filing. Detailed filing data is available for this year.

Open filing
Assets
$16,154,381
Liabilities
$8,777,531
Net assets
$7,376,850
Revenue
$25,517,703
Expenses
$23,892,821
Net income
$1,624,882
Balance SheetOperations
YearAssetsLiabilitiesNet AssetsRevenueExpensesNet Income
2024Detailed filing. Detailed filing data is available for this year.$31.3$8.29$23.0$36.0$34.7$1.36
2023Detailed filing. Detailed filing data is available for this year.$32.3$10.6$21.6$38.0$30.6$7.35
2022Detailed filing. Detailed filing data is available for this year.$41.5$27.3$14.2$30.4$29.6$0.85
2021Detailed filing. Detailed filing data is available for this year.$22.3$8.78$13.5$28.1$27.1$1.02
2020Detailed filing. Detailed filing data is available for this year.$21.5$8.97$12.5$30.3$25.6$4.71
2019Detailed filing. Detailed filing data is available for this year.$16.2$8.78$7.38$25.5$23.9$1.62
2018Detailed filing. Detailed filing data is available for this year.$14.5$8.92$5.59$23.5$22.5$0.98
2017Detailed filing. Detailed filing data is available for this year.$12.8$8.80$4.05$20.4$20.6$0.16
2016Detailed filing. Detailed filing data is available for this year.$11.7$9.27$2.43$19.2$18.7$0.46
2015Detailed filing. Detailed filing data is available for this year.$9.88$8.66$1.22$17.6$18.4$0.86
2014Detailed filing. Detailed filing data is available for this year.$9.07$8.59$0.48$20.5$18.4$2.15
2013Detailed filing. Detailed filing data is available for this year.$6.88$9.01$2.13$0.00$0.00$0.00