2023-11-14T14:07:56-06:00 2022-12-31 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2022-01-01 161603283 COMMUNITY MEMORIAL HOSPITAL FOUNDATION INC COMM 3158246081 150 BROAD STREET HAMILTON NY 13346 JEFF COAKLEY CEO 3158246551 2023-11-02 1 JEFF COAKLEY 999009999 0 THOMAS J GIUFRE P00841958 3154463600 2023-11-02 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z JEFF COAKLEY 150 BROAD STREET HAMILTON NY 13346 552436 0 X HTTP://WWW.COMMUNITYMEMORIAL.ORG/ABOUT-CMH/GIVING X 1993 NY COMMUNITY MEMORIAL HOSPITAL FOUNDATION IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO SOLICIT, RECEIVE, INVEST AND ADMINISTER CONTRIBUTIONS, GIFTS, DEVICES AND BEQUESTS TO OR ON BEHALF OF COMMUNITY MEMORIAL HOSPITAL, INC AND TO PAY MONIES TO THE HOSPITAL FOR ITS CORPORATE PURPOSES. 10 9 0 60 0 0 770365 477080 0 0 54115 54113 -12395 -15778 812085 515415 593 0 0 0 0 0 81150 43000 43000 109440 178413 191183 221413 620902 294002 2553257 2638889 239691 222637 2313566 2416252 X COMMUNITY MEMORIAL HOSPITAL FOUNDATION IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO SOLICIT, RECEIVE, INVEST AND ADMINISTER CONTRIBUTIONS, GIFTS, DEVICES AND BEQUESTS TO OR ON BEHALF OF COMMUNITY MEMORIAL HOSPITAL, INC AND TO PAY MONIES TO THE HOSPITAL FOR ITS CORPORATE PURPOSES. 0 0 117594 515415 COMMUNITY MEMORIAL HOSPITAL FOUNDATION IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO SOLICIT, RECEIVE, INVEST AND ADMINISTER CONTRIBUTIONS, GIFTS, DEVICES AND BEQUESTS TO OR ON BEHALF OF COMMUNITY MEMORIAL HOSPITAL, INC AND TO PAY MONIES TO THE HOSPITAL FOR ITS CORPORATE PURPOSES. 117594 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 X 10 9 1 0 0 0 0 0 1 1 1 0 0 1 1 1 1 0 0 0 0 0 NY X COMMUNITY MEMORIAL HOSPITAL 3158246081 150 BROAD STREET HAMILTON NY 13346 PATRICIA CAPRIO TRUSTEE - EMERITUS 1.00 X 0 0 0 MARY BRUNDAGE SECRETARY 1.00 X X 0 0 0 MICHAEL WOLTMAN TRUSTEE 1.00 X 0 0 0 ROBERT TENNEY CHAIR 1.00 X X 0 0 0 TIMOTHY TRUEWORTHY TRUSTEE 1.00 X 0 0 0 LAWRENCE BAKER TRUSTEE - EMERITUS 1.00 X 0 0 0 LEE WOLTMAN TRUSTEE - EMERITUS 1.00 X 0 0 0 THERESA KEVORKIAN VICE CHAIR 1.00 X X 0 0 0 ROBERT TYBURSKI TRSUTEE 1.00 X 0 0 0 BRAD WHELER TRUSTEE 1.00 X 0 0 0 AMY WILES TREASURER 1.00 X X 0 0 0 ANDREW FAGON TRUSTEE 1.00 X 0 0 0 JENNIFER MEYERS MD TRUSTEE 1.00 X 0 227317 30202 JEFFERY COAKLEY PRESIDENT AND CEO 1.00 X 0 400884 2200 MEGHAN DOUGHERTY DIRECTOR OF MARKETING AND FOUNDATION 40.00 X 0 75107 13918 JASON LIEBEL CONTROLLER 0.00 40.00 X 0 79544 14692 KEARA CONNORS DIRECTOR OF COMMUNITY RELATIONS 0.00 40.00 X 0 93415 12405 ROBERT DELORME FORMER TRUSTEE 1.00 X 0 142999 29213 DIANE CHASE FORMER TRUSTEE 1.00 X 0 96540 26681 0 1115806 129311 0 1 1 0 0 86912 390168 477080 51838 51838 13513 11238 2275 2275 2275 10005 86912 25783 -15778 -15778 515415 0 0 38335 X 43000 43000 13609 13609 103246 79514 23732 35870 28434 7436 9646 9646 16042 16042 221413 117594 60819 43000 2190004 2341349 363253 297540 2553257 2638889 239691 222637 239691 222637 X 2313566 2416252 2313566 2416252 2553257 2638889 X 294002 -350743 159427 X X 0 1 X 1 0 X X 1 COMMUNITY MEMORIAL HOSPITAL 150548010 3 1 0 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PART IV, SECTION B, LINE 1 BOARD MEMBERS ARE ULTIMATELY APPROVED BY COMMUNITY MEMORIAL HOSPITAL RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2313566 4284117 -310013 3875056 -3638 2416252 1380696 5061726 178688 4292091 15453 2313566 654422 3452732 92692 2803202 15948 1380696 2248442 619793 160605 2366777 7641 654422 2029066 320927 -78937 14421 8193 2248442 0.22113 0.77887 0 1 1 0 DUE TO AFFILIATE 222637 222637 X PART V, LINE 4: THE FOUNDATION SUPPORTS COMMUNITY MEMORIAL HOSPITAL'S CAPITAL PROJECTS AND HEALTH RELATED EDUCATION. PART X, LINE 2: THE HOSPITAL AND FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AND HAS BEEN RECOGNIZED AS TAX-EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS OF DECEMBER 31, 2022 AND 2021, THE HOSPITAL AND FOUNDATION DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR ANY RELATED ACCRUED INTEREST OR PENALTIES. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2019 THROUGH 2022. THE HOSPITAL AND FOUNDATION DO NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS WILL CHANGE IN THE NEXT TWELVE MONTHS. X 1 GEORGE FUND DEVELOPMENT GROUP LLC PO BOX 417 CAZENOVIA NY 13035 FUNDRAISING SERVICES 0 0 43000 -43000 43000 -43000 SPECIAL EVENT 96917 86912 10005 1100 5720 10051 8912 96917 86912 10005 1100 5720 10051 8912 25783 -15778 0 0 0 0 0 0 0 0 0 JEFFERY COAKLEY PRESIDENT AND CEO 0 370608 0 30000 0 276 0 2200 0 0 0 403084 0 0 JENNIFER MEYERS MD TRUSTEE 0 199716 0 27475 0 126 0 4765 0 25437 0 257519 0 0 ROBERT DELORME FORMER TRUSTEE 0 125207 0 1350 0 16442 0 1276 0 27937 0 172212 0 0 DIANE CHASE FORMER TRUSTEE 0 95880 0 0 0 660 0 7871 0 18810 0 123221 0 0 FORM 990, PART VI, SECTION A, LINE 2 LEE WOLTMAN IS MICHAEL WOLTMAN'S FATHER. LEE WOLTMAN HAS NO VOTING RIGHTS. FORM 990, PART VI, SECTION A, LINE 7B VACANCIES FILLED ON THE FOUNDATION BOARD ARE SUBJECT TO RATIFICATION BY COMMUNITY MEMORIAL HOSPITAL'S BOARD. FORM 990, PART VI, SECTION B, LINE 11B THE CEO AND THE CFO EMAIL THE 990 TO ALL BOARD OF DIRECTORS, WITH THE REQUEST TO REVIEW AND COMMENT PRIOR TO THE SUBMISSION OF THE 990 TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE FINANCE COMMITTEE OF THE BOARD INVITES ALL BOARD MEMBERS TO THE FINANCE COMMITTEE MEETING AT WHICH THE 990 IS PRESENTED. THE 990 IS REVIEWED BY FINANCE COMMITTEE, AND ALL COMMENTS AND QUESTION OF THE FULL BOARD ARE REVIEWED AT THE MEETING, AND CHANGES ARE COMMUNICATED AND THE 990 IS UPDATED AND SUBMITTED. FORM 990, PART VI, SECTION B, LINE 12C THE CEO AND THE PRESIDENT OF THE BOARD OF DIRECTORS REVIEW THE CONFLICT OF INTEREST POLICIES ANNUALLY WITH THE FULL BOARD. ANY POSSIBLE CONFLICTS ARE REVIEWED AND APPROPRIATE ACTION TAKEN. FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS FOR COMMUNITY MEMORIAL HOSPITAL, INC. ARE FILED WITH THE CHARITIES BUREAU AND ARE PART OF THE PUBLIC RECORD. IN ADDITION, THE ORGANIZATION PROVIDES ALL DOCUMENTS REQUIRED BY THE INTERNAL REVENUE CODE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G FOUNDATION PROGRAM SERVICE EXPENSES PAID BY RELATED ORGANIZATIONS: PROGRAM SERVICE EXPENSES 79,514. MANAGEMENT AND GENERAL EXPENSES 23,732. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 103,246. FORM 990, PART XI, LINE 9: EXPENSES PAID BY RELATED ORGANIZATIONS 159,427. FORM 990, PART VII, SECTION A: THE ORGANIZATION'S PRESIDENT, JEFFREY COAKLEY, IS ALSO THE PRESIDENT/CEO OF COMMUNITY MEMORIAL HOSPITAL, A RELATED ORGANIZATION. COMMUNITY MEMORIAL HOSPITAL 150 BROAD STREET HAMILTON NY 13346 150548010 TO PROVIDE EMERGENCY AND INPATIENT CARE TO THE GENERAL POPULATION NY 501(C)(3) 3 NONE 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0