﻿<?xml version="1.0" encoding="utf-8"?>
<Return returnVersion="2022v5.0" xmlns="http://www.irs.gov/efile" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
  <ReturnHeader binaryAttachmentCnt="0">
    <ReturnTs>2023-10-25T15:30:22-07:00</ReturnTs>
    <TaxPeriodEndDt>2022-12-31</TaxPeriodEndDt>
    <ReturnTypeCd>990</ReturnTypeCd>
    <TaxPeriodBeginDt>2022-01-01</TaxPeriodBeginDt>
    <Filer>
      <EIN>161072414</EIN>
      <BusinessName>
        <BusinessNameLine1Txt>CAYUGA MEDICAL CENTER FOUNDATION</BusinessNameLine1Txt>
      </BusinessName>
      <BusinessNameControlTxt>CAYU</BusinessNameControlTxt>
      <PhoneNum>6072744443</PhoneNum>
      <USAddress>
        <AddressLine1Txt>101 Dates Drive</AddressLine1Txt>
        <CityNm>Ithaca</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>14850</ZIPCd>
      </USAddress>
    </Filer>
    <BusinessOfficerGrp>
      <PersonNm>Rebecca Gould</PersonNm>
      <PersonTitleTxt>Chief Financial Officer</PersonTitleTxt>
      <PhoneNum>6072744136</PhoneNum>
      <SignatureDt>2023-09-06</SignatureDt>
    </BusinessOfficerGrp>
    <IRSResponsiblePrtyInfoCurrInd>1</IRSResponsiblePrtyInfoCurrInd>
    <AdditionalFilerInformation>
      <TrustedCustomerGrp>
        <TrustedCustomerCd>1</TrustedCustomerCd>
        <OOBSecurityVerificationCd>11</OOBSecurityVerificationCd>
        <LastSubmissionRqrOOBCd>1</LastSubmissionRqrOOBCd>
        <AuthenticationAssuranceLevelCd>AAL2</AuthenticationAssuranceLevelCd>
        <ProfilePasswordChangeInd>X</ProfilePasswordChangeInd>
        <ProfileEmailAddressChangeInd>X</ProfileEmailAddressChangeInd>
      </TrustedCustomerGrp>
    </AdditionalFilerInformation>
    <TaxYr>2022</TaxYr>
    <BuildTS>2023-04-26 12:10:37Z</BuildTS>
  </ReturnHeader>
  <ReturnData documentCnt="9">
    <IRS990 documentId="R000001" referenceDocumentId="R000007 R000009" softwareId="22015720" softwareVersionNum="v1.00">
      <PrincipalOfficerNm>Brian Wilbur</PrincipalOfficerNm>
      <USAddress>
        <AddressLine1Txt>101 Dates Drive</AddressLine1Txt>
        <CityNm>Ithaca</CityNm>
        <StateAbbreviationCd>NY</StateAbbreviationCd>
        <ZIPCd>14850</ZIPCd>
      </USAddress>
      <GrossReceiptsAmt>1328670</GrossReceiptsAmt>
      <GroupReturnForAffiliatesInd>0</GroupReturnForAffiliatesInd>
      <Organization501c3Ind>X</Organization501c3Ind>
      <TypeOfOrganizationCorpInd>X</TypeOfOrganizationCorpInd>
      <FormationYr>1889</FormationYr>
      <LegalDomicileStateCd>NY</LegalDomicileStateCd>
      <ActivityOrMissionDesc>To provide assistance to Cayuga Medical Center so as to provide health and welfare mainly through fund raising, investment activities, funding for capital equipment and providing education scholarships relating to the healthcare field.</ActivityOrMissionDesc>
      <VotingMembersGoverningBodyCnt>8</VotingMembersGoverningBodyCnt>
      <VotingMembersIndependentCnt>8</VotingMembersIndependentCnt>
      <TotalEmployeeCnt>0</TotalEmployeeCnt>
      <TotalVolunteersCnt>20</TotalVolunteersCnt>
      <TotalGrossUBIAmt>0</TotalGrossUBIAmt>
      <NetUnrelatedBusTxblIncmAmt>0</NetUnrelatedBusTxblIncmAmt>
      <PYContributionsGrantsAmt>307035</PYContributionsGrantsAmt>
      <CYContributionsGrantsAmt>275442</CYContributionsGrantsAmt>
      <PYProgramServiceRevenueAmt>0</PYProgramServiceRevenueAmt>
      <CYProgramServiceRevenueAmt>0</CYProgramServiceRevenueAmt>
      <PYInvestmentIncomeAmt>377960</PYInvestmentIncomeAmt>
      <CYInvestmentIncomeAmt>-5255</CYInvestmentIncomeAmt>
      <PYOtherRevenueAmt>0</PYOtherRevenueAmt>
      <CYOtherRevenueAmt>0</CYOtherRevenueAmt>
      <PYTotalRevenueAmt>684995</PYTotalRevenueAmt>
      <CYTotalRevenueAmt>270187</CYTotalRevenueAmt>
      <PYGrantsAndSimilarPaidAmt>74476</PYGrantsAndSimilarPaidAmt>
      <CYGrantsAndSimilarPaidAmt>99741</CYGrantsAndSimilarPaidAmt>
      <PYBenefitsPaidToMembersAmt>0</PYBenefitsPaidToMembersAmt>
      <CYBenefitsPaidToMembersAmt>0</CYBenefitsPaidToMembersAmt>
      <PYSalariesCompEmpBnftPaidAmt>0</PYSalariesCompEmpBnftPaidAmt>
      <CYSalariesCompEmpBnftPaidAmt>0</CYSalariesCompEmpBnftPaidAmt>
      <PYTotalProfFndrsngExpnsAmt>431961</PYTotalProfFndrsngExpnsAmt>
      <CYTotalProfFndrsngExpnsAmt>427630</CYTotalProfFndrsngExpnsAmt>
      <CYTotalFundraisingExpenseAmt>427630</CYTotalFundraisingExpenseAmt>
      <PYOtherExpensesAmt>79125</PYOtherExpensesAmt>
      <CYOtherExpensesAmt>67804</CYOtherExpensesAmt>
      <PYTotalExpensesAmt>585562</PYTotalExpensesAmt>
      <CYTotalExpensesAmt>595175</CYTotalExpensesAmt>
      <PYRevenuesLessExpensesAmt>99433</PYRevenuesLessExpensesAmt>
      <CYRevenuesLessExpensesAmt>-324988</CYRevenuesLessExpensesAmt>
      <TotalAssetsBOYAmt>19696395</TotalAssetsBOYAmt>
      <TotalAssetsEOYAmt>17601450</TotalAssetsEOYAmt>
      <TotalLiabilitiesBOYAmt>14312119</TotalLiabilitiesBOYAmt>
      <TotalLiabilitiesEOYAmt>13642914</TotalLiabilitiesEOYAmt>
      <NetAssetsOrFundBalancesBOYAmt>5384276</NetAssetsOrFundBalancesBOYAmt>
      <NetAssetsOrFundBalancesEOYAmt>3958536</NetAssetsOrFundBalancesEOYAmt>
      <MissionDesc>To provide funds to or for the benefit of Cayuga Medical Center at Ithaca, so as to promote the health and welfare of the community by soliciting, accepting, holding, investing and reinvesting gifts, grants, contributions, devices, benefits or trusts, endowments and property of any kind without limitations as to the amount or value.</MissionDesc>
      <SignificantNewProgramSrvcInd>0</SignificantNewProgramSrvcInd>
      <SignificantChangeInd>0</SignificantChangeInd>
      <ExpenseAmt>101778</ExpenseAmt>
      <GrantAmt>99741</GrantAmt>
      <RevenueAmt>0</RevenueAmt>
      <Desc>Health education assistance provides funds to assist individuals to obtain education in the heathcare field.</Desc>
      <TotalOtherProgSrvcExpenseAmt>0</TotalOtherProgSrvcExpenseAmt>
      <TotalOtherProgSrvcGrantAmt>0</TotalOtherProgSrvcGrantAmt>
      <TotalOtherProgSrvcRevenueAmt>0</TotalOtherProgSrvcRevenueAmt>
      <TotalProgramServiceExpensesAmt>101778</TotalProgramServiceExpensesAmt>
      <DescribedInSection501c3Ind referenceDocumentId="R000002">1</DescribedInSection501c3Ind>
      <ScheduleBRequiredInd referenceDocumentId="R000003">1</ScheduleBRequiredInd>
      <PoliticalCampaignActyInd>0</PoliticalCampaignActyInd>
      <LobbyingActivitiesInd>0</LobbyingActivitiesInd>
      <SubjectToProxyTaxInd>0</SubjectToProxyTaxInd>
      <DonorAdvisedFundInd>0</DonorAdvisedFundInd>
      <ConservationEasementsInd>0</ConservationEasementsInd>
      <CollectionsOfArtInd>0</CollectionsOfArtInd>
      <CreditCounselingInd>0</CreditCounselingInd>
      <DonorRstrOrQuasiEndowmentsInd referenceDocumentId="R000004">1</DonorRstrOrQuasiEndowmentsInd>
      <ReportLandBuildingEquipmentInd>0</ReportLandBuildingEquipmentInd>
      <ReportInvestmentsOtherSecInd referenceDocumentId="R000004">1</ReportInvestmentsOtherSecInd>
      <ReportProgramRelatedInvstInd>0</ReportProgramRelatedInvstInd>
      <ReportOtherAssetsInd referenceDocumentId="R000004">0</ReportOtherAssetsInd>
      <ReportOtherLiabilitiesInd referenceDocumentId="R000004">1</ReportOtherLiabilitiesInd>
      <IncludeFIN48FootnoteInd>0</IncludeFIN48FootnoteInd>
      <IndependentAuditFinclStmtInd referenceDocumentId="R000004">0</IndependentAuditFinclStmtInd>
      <ConsolidatedAuditFinclStmtInd referenceDocumentId="R000004">0</ConsolidatedAuditFinclStmtInd>
      <SchoolOperatingInd>0</SchoolOperatingInd>
      <ForeignOfficeInd>0</ForeignOfficeInd>
      <ForeignActivitiesInd>0</ForeignActivitiesInd>
      <MoreThan5000KToOrgInd>0</MoreThan5000KToOrgInd>
      <MoreThan5000KToIndividualsInd>0</MoreThan5000KToIndividualsInd>
      <ProfessionalFundraisingInd referenceDocumentId="R000005">1</ProfessionalFundraisingInd>
      <FundraisingActivitiesInd>0</FundraisingActivitiesInd>
      <GamingActivitiesInd>0</GamingActivitiesInd>
      <OperateHospitalInd>0</OperateHospitalInd>
      <GrantsToOrganizationsInd>0</GrantsToOrganizationsInd>
      <GrantsToIndividualsInd referenceDocumentId="R000006">1</GrantsToIndividualsInd>
      <ScheduleJRequiredInd>0</ScheduleJRequiredInd>
      <TaxExemptBondsInd>0</TaxExemptBondsInd>
      <EngagedInExcessBenefitTransInd>0</EngagedInExcessBenefitTransInd>
      <PYExcessBenefitTransInd>0</PYExcessBenefitTransInd>
      <LoanOutstandingInd>0</LoanOutstandingInd>
      <GrantToRelatedPersonInd>0</GrantToRelatedPersonInd>
      <BusinessRlnWithOrgMemInd>0</BusinessRlnWithOrgMemInd>
      <BusinessRlnWithFamMemInd>0</BusinessRlnWithFamMemInd>
      <BusinessRlnWith35CtrlEntInd>0</BusinessRlnWith35CtrlEntInd>
      <DeductibleNonCashContriInd>0</DeductibleNonCashContriInd>
      <DeductibleArtContributionInd>0</DeductibleArtContributionInd>
      <TerminateOperationsInd>0</TerminateOperationsInd>
      <PartialLiquidationInd>0</PartialLiquidationInd>
      <DisregardedEntityInd>0</DisregardedEntityInd>
      <RelatedEntityInd referenceDocumentId="R000008">1</RelatedEntityInd>
      <RelatedOrganizationCtrlEntInd>0</RelatedOrganizationCtrlEntInd>
      <TrnsfrExmptNonChrtblRltdOrgInd>0</TrnsfrExmptNonChrtblRltdOrgInd>
      <ActivitiesConductedPrtshpInd>0</ActivitiesConductedPrtshpInd>
      <ScheduleORequiredInd>1</ScheduleORequiredInd>
      <IRPDocumentCnt>2</IRPDocumentCnt>
      <IRPDocumentW2GCnt>0</IRPDocumentW2GCnt>
      <BackupWthldComplianceInd>0</BackupWthldComplianceInd>
      <EmployeeCnt>0</EmployeeCnt>
      <UnrelatedBusIncmOverLimitInd>0</UnrelatedBusIncmOverLimitInd>
      <ForeignFinancialAccountInd>0</ForeignFinancialAccountInd>
      <ProhibitedTaxShelterTransInd>0</ProhibitedTaxShelterTransInd>
      <TaxablePartyNotificationInd>0</TaxablePartyNotificationInd>
      <NondeductibleContributionsInd>0</NondeductibleContributionsInd>
      <IndoorTanningServicesInd>0</IndoorTanningServicesInd>
      <SubjToTaxRmnrtnExPrchtPymtInd>0</SubjToTaxRmnrtnExPrchtPymtInd>
      <SubjectToExcsTaxNetInvstIncInd>0</SubjectToExcsTaxNetInvstIncInd>
      <InfoInScheduleOPartVIInd>X</InfoInScheduleOPartVIInd>
      <GoverningBodyVotingMembersCnt>8</GoverningBodyVotingMembersCnt>
      <IndependentVotingMemberCnt>8</IndependentVotingMemberCnt>
      <FamilyOrBusinessRlnInd>0</FamilyOrBusinessRlnInd>
      <DelegationOfMgmtDutiesInd>0</DelegationOfMgmtDutiesInd>
      <ChangeToOrgDocumentsInd>0</ChangeToOrgDocumentsInd>
      <MaterialDiversionOrMisuseInd>0</MaterialDiversionOrMisuseInd>
      <MembersOrStockholdersInd>0</MembersOrStockholdersInd>
      <ElectionOfBoardMembersInd>0</ElectionOfBoardMembersInd>
      <DecisionsSubjectToApprovaInd>0</DecisionsSubjectToApprovaInd>
      <MinutesOfGoverningBodyInd>1</MinutesOfGoverningBodyInd>
      <MinutesOfCommitteesInd>1</MinutesOfCommitteesInd>
      <OfficerMailingAddressInd>0</OfficerMailingAddressInd>
      <LocalChaptersInd>0</LocalChaptersInd>
      <Form990ProvidedToGvrnBodyInd>1</Form990ProvidedToGvrnBodyInd>
      <ConflictOfInterestPolicyInd>1</ConflictOfInterestPolicyInd>
      <AnnualDisclosureCoveredPrsnInd>1</AnnualDisclosureCoveredPrsnInd>
      <RegularMonitoringEnfrcInd>1</RegularMonitoringEnfrcInd>
      <WhistleblowerPolicyInd>1</WhistleblowerPolicyInd>
      <DocumentRetentionPolicyInd>1</DocumentRetentionPolicyInd>
      <CompensationProcessCEOInd>0</CompensationProcessCEOInd>
      <CompensationProcessOtherInd>0</CompensationProcessOtherInd>
      <InvestmentInJointVentureInd>0</InvestmentInJointVentureInd>
      <StatesWhereCopyOfReturnIsFldCd>NY</StatesWhereCopyOfReturnIsFldCd>
      <UponRequestInd>X</UponRequestInd>
      <BooksInCareOfDetail>
        <PersonNm>Mikhail O'Laughlin</PersonNm>
        <PhoneNum>6072744136</PhoneNum>
        <USAddress>
          <AddressLine1Txt>101 Dates Drive</AddressLine1Txt>
          <CityNm>Ithaca</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14850</ZIPCd>
        </USAddress>
      </BooksInCareOfDetail>
      <Form990PartVIISectionAGrp>
        <PersonNm>Julie Crowley</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.5</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Mark Kreydt</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.5</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Andy Sciarabba</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.5</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Lisa Seyfried</PersonNm>
        <TitleTxt>Trustee</TitleTxt>
        <AverageHoursPerWeekRt>0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.5</AverageHoursPerWeekRltdOrgRt>
        <IndividualTrusteeOrDirectorInd>X</IndividualTrusteeOrDirectorInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Brian Wilbur</PersonNm>
        <TitleTxt>President</TitleTxt>
        <AverageHoursPerWeekRt>0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>1</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Thomas Evans</PersonNm>
        <TitleTxt>Vice President</TitleTxt>
        <AverageHoursPerWeekRt>0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.5</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Markeisha Miner</PersonNm>
        <TitleTxt>Secretary</TitleTxt>
        <AverageHoursPerWeekRt>0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.5</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <Form990PartVIISectionAGrp>
        <PersonNm>Jerry Mickelson</PersonNm>
        <TitleTxt>Treasurer</TitleTxt>
        <AverageHoursPerWeekRt>0</AverageHoursPerWeekRt>
        <AverageHoursPerWeekRltdOrgRt>0.5</AverageHoursPerWeekRltdOrgRt>
        <OfficerInd>X</OfficerInd>
        <ReportableCompFromOrgAmt>0</ReportableCompFromOrgAmt>
        <ReportableCompFromRltdOrgAmt>0</ReportableCompFromRltdOrgAmt>
        <OtherCompensationAmt>0</OtherCompensationAmt>
      </Form990PartVIISectionAGrp>
      <TotalReportableCompFromOrgAmt>0</TotalReportableCompFromOrgAmt>
      <TotReportableCompRltdOrgAmt>0</TotReportableCompRltdOrgAmt>
      <TotalOtherCompensationAmt>0</TotalOtherCompensationAmt>
      <IndivRcvdGreaterThan100KCnt>0</IndivRcvdGreaterThan100KCnt>
      <FormerOfcrEmployeesListedInd>0</FormerOfcrEmployeesListedInd>
      <TotalCompGreaterThan150KInd>0</TotalCompGreaterThan150KInd>
      <CompensationFromOtherSrcsInd>0</CompensationFromOtherSrcsInd>
      <CntrctRcvdGreaterThan100KCnt>0</CntrctRcvdGreaterThan100KCnt>
      <FederatedCampaignsAmt>0</FederatedCampaignsAmt>
      <MembershipDuesAmt>0</MembershipDuesAmt>
      <FundraisingAmt>0</FundraisingAmt>
      <RelatedOrganizationsAmt>0</RelatedOrganizationsAmt>
      <GovernmentGrantsAmt>0</GovernmentGrantsAmt>
      <AllOtherContributionsAmt>275442</AllOtherContributionsAmt>
      <NoncashContributionsAmt>0</NoncashContributionsAmt>
      <TotalContributionsAmt>275442</TotalContributionsAmt>
      <TotalProgramServiceRevenueAmt>0</TotalProgramServiceRevenueAmt>
      <InvestmentIncomeGrp>
        <TotalRevenueColumnAmt>22902</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>22902</ExclusionAmt>
      </InvestmentIncomeGrp>
      <IncmFromInvestBondProceedsGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </IncmFromInvestBondProceedsGrp>
      <RoyaltiesRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </RoyaltiesRevenueGrp>
      <RentalIncomeOrLossGrp>
        <RealAmt>0</RealAmt>
        <PersonalAmt>0</PersonalAmt>
      </RentalIncomeOrLossGrp>
      <GrossAmountSalesAssetsGrp>
        <SecuritiesAmt>1030326</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GrossAmountSalesAssetsGrp>
      <LessCostOthBasisSalesExpnssGrp>
        <SecuritiesAmt>1058483</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </LessCostOthBasisSalesExpnssGrp>
      <GainOrLossGrp>
        <SecuritiesAmt>-28157</SecuritiesAmt>
        <OtherAmt>0</OtherAmt>
      </GainOrLossGrp>
      <NetGainOrLossInvestmentsGrp>
        <TotalRevenueColumnAmt>-28157</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-28157</ExclusionAmt>
      </NetGainOrLossInvestmentsGrp>
      <ContriRptFundraisingEventAmt>0</ContriRptFundraisingEventAmt>
      <GrossSalesOfInventoryAmt>0</GrossSalesOfInventoryAmt>
      <CostOfGoodsSoldAmt>0</CostOfGoodsSoldAmt>
      <NetIncomeOrLossGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </NetIncomeOrLossGrp>
      <MiscellaneousRevenueGrp>
        <TotalRevenueColumnAmt>0</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>0</ExclusionAmt>
      </MiscellaneousRevenueGrp>
      <OtherRevenueTotalAmt>0</OtherRevenueTotalAmt>
      <TotalRevenueGrp>
        <TotalRevenueColumnAmt>270187</TotalRevenueColumnAmt>
        <RelatedOrExemptFuncIncomeAmt>0</RelatedOrExemptFuncIncomeAmt>
        <UnrelatedBusinessRevenueAmt>0</UnrelatedBusinessRevenueAmt>
        <ExclusionAmt>-5255</ExclusionAmt>
      </TotalRevenueGrp>
      <GrantsToDomesticOrgsGrp>
        <TotalAmt>0</TotalAmt>
      </GrantsToDomesticOrgsGrp>
      <GrantsToDomesticIndividualsGrp>
        <TotalAmt>99741</TotalAmt>
        <ProgramServicesAmt>99741</ProgramServicesAmt>
      </GrantsToDomesticIndividualsGrp>
      <FeesForServicesManagementGrp>
        <TotalAmt>52800</TotalAmt>
        <ManagementAndGeneralAmt>52800</ManagementAndGeneralAmt>
      </FeesForServicesManagementGrp>
      <FeesForServicesAccountingGrp>
        <TotalAmt>7729</TotalAmt>
        <ManagementAndGeneralAmt>7729</ManagementAndGeneralAmt>
      </FeesForServicesAccountingGrp>
      <FeesForServicesProfFundraising>
        <TotalAmt>427630</TotalAmt>
        <FundraisingAmt>427630</FundraisingAmt>
      </FeesForServicesProfFundraising>
      <FeesForServicesOtherGrp>
        <TotalAmt>393</TotalAmt>
        <ManagementAndGeneralAmt>393</ManagementAndGeneralAmt>
      </FeesForServicesOtherGrp>
      <InformationTechnologyGrp>
        <TotalAmt>4710</TotalAmt>
        <ManagementAndGeneralAmt>4710</ManagementAndGeneralAmt>
      </InformationTechnologyGrp>
      <InsuranceGrp>
        <TotalAmt>135</TotalAmt>
        <ManagementAndGeneralAmt>135</ManagementAndGeneralAmt>
      </InsuranceGrp>
      <AllOtherExpensesGrp>
        <TotalAmt>2037</TotalAmt>
        <ProgramServicesAmt>2037</ProgramServicesAmt>
      </AllOtherExpensesGrp>
      <TotalFunctionalExpensesGrp>
        <TotalAmt>595175</TotalAmt>
        <ProgramServicesAmt>101778</ProgramServicesAmt>
        <ManagementAndGeneralAmt>65767</ManagementAndGeneralAmt>
        <FundraisingAmt>427630</FundraisingAmt>
      </TotalFunctionalExpensesGrp>
      <CashNonInterestBearingGrp>
        <BOYAmt>663451</BOYAmt>
        <EOYAmt>533612</EOYAmt>
      </CashNonInterestBearingGrp>
      <SavingsAndTempCashInvstGrp>
        <BOYAmt>753450</BOYAmt>
        <EOYAmt>1450237</EOYAmt>
      </SavingsAndTempCashInvstGrp>
      <PledgesAndGrantsReceivableGrp>
        <BOYAmt>7125</BOYAmt>
        <EOYAmt>485782</EOYAmt>
      </PledgesAndGrantsReceivableGrp>
      <AccountsReceivableGrp>
        <BOYAmt>99702</BOYAmt>
        <EOYAmt>139662</EOYAmt>
      </AccountsReceivableGrp>
      <PrepaidExpensesDefrdChargesGrp>
        <BOYAmt>405</BOYAmt>
      </PrepaidExpensesDefrdChargesGrp>
      <InvestmentsPubTradedSecGrp>
        <BOYAmt>1027535</BOYAmt>
        <EOYAmt>997777</EOYAmt>
      </InvestmentsPubTradedSecGrp>
      <InvestmentsOtherSecuritiesGrp>
        <BOYAmt>17144727</BOYAmt>
        <EOYAmt>13994110</EOYAmt>
      </InvestmentsOtherSecuritiesGrp>
      <OtherAssetsTotalGrp>
        <EOYAmt>270</EOYAmt>
      </OtherAssetsTotalGrp>
      <TotalAssetsGrp>
        <BOYAmt>19696395</BOYAmt>
        <EOYAmt>17601450</EOYAmt>
      </TotalAssetsGrp>
      <AccountsPayableAccrExpnssGrp>
        <BOYAmt>671744</BOYAmt>
        <EOYAmt>1136982</EOYAmt>
      </AccountsPayableAccrExpnssGrp>
      <OtherLiabilitiesGrp>
        <BOYAmt>13640375</BOYAmt>
        <EOYAmt>12505932</EOYAmt>
      </OtherLiabilitiesGrp>
      <TotalLiabilitiesGrp>
        <BOYAmt>14312119</BOYAmt>
        <EOYAmt>13642914</EOYAmt>
      </TotalLiabilitiesGrp>
      <OrganizationFollowsFASB117Ind>X</OrganizationFollowsFASB117Ind>
      <NoDonorRestrictionNetAssetsGrp>
        <BOYAmt>553408</BOYAmt>
        <EOYAmt>153057</EOYAmt>
      </NoDonorRestrictionNetAssetsGrp>
      <DonorRestrictionNetAssetsGrp>
        <BOYAmt>4830868</BOYAmt>
        <EOYAmt>3805479</EOYAmt>
      </DonorRestrictionNetAssetsGrp>
      <TotalNetAssetsFundBalanceGrp>
        <BOYAmt>5384276</BOYAmt>
        <EOYAmt>3958536</EOYAmt>
      </TotalNetAssetsFundBalanceGrp>
      <TotLiabNetAssetsFundBalanceGrp>
        <BOYAmt>19696395</BOYAmt>
        <EOYAmt>17601450</EOYAmt>
      </TotLiabNetAssetsFundBalanceGrp>
      <ReconcilationRevenueExpnssAmt>-324988</ReconcilationRevenueExpnssAmt>
      <NetUnrlzdGainsLossesInvstAmt>-1100752</NetUnrlzdGainsLossesInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <InvestmentExpenseAmt>0</InvestmentExpenseAmt>
      <PriorPeriodAdjustmentsAmt>0</PriorPeriodAdjustmentsAmt>
      <OtherChangesInNetAssetsAmt>0</OtherChangesInNetAssetsAmt>
      <MethodOfAccountingAccrualInd>X</MethodOfAccountingAccrualInd>
      <AccountantCompileOrReviewInd>1</AccountantCompileOrReviewInd>
      <AcctCompileOrReviewBasisGrp>
        <SeparateBasisFinclStmtInd>X</SeparateBasisFinclStmtInd>
      </AcctCompileOrReviewBasisGrp>
      <FSAuditedInd>0</FSAuditedInd>
      <AuditCommitteeInd>1</AuditCommitteeInd>
      <FederalGrantAuditRequiredInd>0</FederalGrantAuditRequiredInd>
    </IRS990>
    <IRS990ScheduleA documentId="R000002" softwareId="22015720" softwareVersionNum="v1.00">
      <SupportingOrganization509a3Ind>X</SupportingOrganization509a3Ind>
      <SupportingOrgType3FuncIntInd>X</SupportingOrgType3FuncIntInd>
      <SupportedOrganizationsCnt>1</SupportedOrganizationsCnt>
      <SupportedOrgInformationGrp>
        <SupportedOrganizationName>
          <BusinessNameLine1Txt>Cayuga Medical Center at Ithaca</BusinessNameLine1Txt>
        </SupportedOrganizationName>
        <EIN>222325405</EIN>
        <OrganizationTypeCd>3</OrganizationTypeCd>
        <GoverningDocumentListedInd>1</GoverningDocumentListedInd>
        <SupportAmt>99741</SupportAmt>
        <OtherSupportAmt>454118</OtherSupportAmt>
      </SupportedOrgInformationGrp>
      <SupportedOrganizationsTotalCnt>1</SupportedOrganizationsTotalCnt>
      <SupportSumAmt>99741</SupportSumAmt>
      <OtherSupportSumAmt>454118</OtherSupportSumAmt>
      <Form990SchASupportingOrgGrp>
        <ListedByNameGoverningDocInd>1</ListedByNameGoverningDocInd>
        <SuprtOrgNoIRSDeterminationInd>0</SuprtOrgNoIRSDeterminationInd>
        <SupportedOrgSectionC456Ind>0</SupportedOrgSectionC456Ind>
        <SupportedOrgNotOrganizedUSInd>0</SupportedOrgNotOrganizedUSInd>
        <OrganizationChangeSuprtOrgInd>0</OrganizationChangeSuprtOrgInd>
        <SupportNonSupportedOrgInd>1</SupportNonSupportedOrgInd>
        <PaymentSubstantialContribtrInd>0</PaymentSubstantialContribtrInd>
        <LoanDisqualifiedPersonInd>0</LoanDisqualifiedPersonInd>
        <ControlledDisqualifiedPrsnInd>0</ControlledDisqualifiedPrsnInd>
        <DisqualifiedPrsnControllIntInd>0</DisqualifiedPrsnControllIntInd>
        <DisqualifiedPrsnOwnrIntInd>0</DisqualifiedPrsnOwnrIntInd>
        <ExcessBusinessHoldingsRulesInd>0</ExcessBusinessHoldingsRulesInd>
        <ContributionControllerInd>0</ContributionControllerInd>
        <ContributionFamilyInd>0</ContributionFamilyInd>
        <Contribution35ControlledInd>0</Contribution35ControlledInd>
      </Form990SchASupportingOrgGrp>
      <Form990SchAType3SprtOrgAllGrp>
        <TimelyProvidedDocumentsInd>1</TimelyProvidedDocumentsInd>
        <OfficersCloseRelationshipInd>1</OfficersCloseRelationshipInd>
        <SupportedOrgVoiceInvestmentInd>0</SupportedOrgVoiceInvestmentInd>
      </Form990SchAType3SprtOrgAllGrp>
      <Form990SchAType3FuncIntGrp>
        <ActivitiesTestInd>X</ActivitiesTestInd>
        <ActivitiesFurtherExemptPrpsInd>1</ActivitiesFurtherExemptPrpsInd>
        <ActivitiesEngagedOrgInvlmntInd>1</ActivitiesEngagedOrgInvlmntInd>
      </Form990SchAType3FuncIntGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part IV, Section A, Line 6</FormAndLineReferenceDesc>
        <ExplanationTxt>Scholarships were provided to individuals to further their education in the healthcare field, which would benefit the supported organization in its need for qualified healthcare employees.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part IV, Section E, Line 2a</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization's activities during the year, consisting of providing scholarships, directly furthered the exempt purpose of the supported organization.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
      <Form990ScheduleAPartVIGrp>
        <FormAndLineReferenceDesc>Schedule A, Part IV, Section E, Line 2b</FormAndLineReferenceDesc>
        <ExplanationTxt>If the organization had not solicited donations for the supported organization, then the supported organization would have been left to solicit funds for itself. The supported organization has a program that provides funds to its employees for continuing education. The scholarships assisted the supported organization in that it helped to provide health care related education to both current and prospective employees. If the organization did not offer scholarships, then the supported organization, cognizant of the need for a base of highly educated personnel from which to draw employees, would expand its continuing education program for its purpose.</ExplanationTxt>
      </Form990ScheduleAPartVIGrp>
    </IRS990ScheduleA>
    <IRS990ScheduleB documentId="R000003" softwareId="22015720" softwareVersionNum="v1.00">
      <ContributorInformationGrp>
        <ContributorNum>RESTRICTED</ContributorNum>
        <ContributorBusinessName>
          <BusinessNameLine1>RESTRICTED</BusinessNameLine1>
        </ContributorBusinessName>
        <ContributorUSAddress>
          <AddressLine1>RESTRICTED</AddressLine1>
          <AddressLine2>RESTRICTED</AddressLine2>
          <City>RESTRICTED</City>
          <State>RESTRICTED</State>
          <ZIPCode>RESTRICTED</ZIPCode>
        </ContributorUSAddress>
        <TotalContributionsAmt>RESTRICTED</TotalContributionsAmt>
      </ContributorInformationGrp>
    </IRS990ScheduleB>
    <IRS990ScheduleD documentId="R000004" softwareId="22015720" softwareVersionNum="v1.00">
      <CYEndwmtFundGrp>
        <BeginningYearBalanceAmt>4830868</BeginningYearBalanceAmt>
        <ContributionsAmt>7274</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-1032663</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>0</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>3805479</EndYearBalanceAmt>
      </CYEndwmtFundGrp>
      <CYMinus1YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>4456388</BeginningYearBalanceAmt>
        <ContributionsAmt>12593</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>466381</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>104497</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>4830865</EndYearBalanceAmt>
      </CYMinus1YrEndwmtFundGrp>
      <CYMinus2YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>4206886</BeginningYearBalanceAmt>
        <ContributionsAmt>31626</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>301244</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>83368</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>4456388</EndYearBalanceAmt>
      </CYMinus2YrEndwmtFundGrp>
      <CYMinus3YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>3756082</BeginningYearBalanceAmt>
        <ContributionsAmt>9609</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>517921</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>76726</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>4206886</EndYearBalanceAmt>
      </CYMinus3YrEndwmtFundGrp>
      <CYMinus4YrEndwmtFundGrp>
        <BeginningYearBalanceAmt>4010477</BeginningYearBalanceAmt>
        <ContributionsAmt>58069</ContributionsAmt>
        <InvestmentEarningsOrLossesAmt>-233117</InvestmentEarningsOrLossesAmt>
        <GrantsOrScholarshipsAmt>0</GrantsOrScholarshipsAmt>
        <OtherExpendituresAmt>79347</OtherExpendituresAmt>
        <AdministrativeExpensesAmt>0</AdministrativeExpensesAmt>
        <EndYearBalanceAmt>3756082</EndYearBalanceAmt>
      </CYMinus4YrEndwmtFundGrp>
      <BoardDesignatedBalanceEOYPct>0</BoardDesignatedBalanceEOYPct>
      <PrmnntEndowmentBalanceEOYPct>0.96</PrmnntEndowmentBalanceEOYPct>
      <TermEndowmentBalanceEOYPct>0.04</TermEndowmentBalanceEOYPct>
      <EndowmentsHeldUnrelatedOrgInd>1</EndowmentsHeldUnrelatedOrgInd>
      <EndowmentsHeldRelatedOrgInd>0</EndowmentsHeldRelatedOrgInd>
      <FinancialDerivativesGrp>
        <BookValueAmt>0</BookValueAmt>
      </FinancialDerivativesGrp>
      <CloselyHeldEquityInterestsGrp>
        <BookValueAmt>0</BookValueAmt>
      </CloselyHeldEquityInterestsGrp>
      <OtherSecuritiesGrp>
        <Desc>Mutual Funds</Desc>
        <BookValueAmt>9101028</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <OtherSecuritiesGrp>
        <Desc>Funds Held in Trust by Others</Desc>
        <BookValueAmt>4893082</BookValueAmt>
        <MethodValuationCd>F</MethodValuationCd>
      </OtherSecuritiesGrp>
      <TotalBookValueSecuritiesAmt>13994110</TotalBookValueSecuritiesAmt>
      <OtherAssetsOrgGrp>
        <Desc>Various</Desc>
        <BookValueAmt>270</BookValueAmt>
      </OtherAssetsOrgGrp>
      <TotalBookValueOtherAssetsAmt>270</TotalBookValueOtherAssetsAmt>
      <FederalIncomeTaxLiabilityAmt>0</FederalIncomeTaxLiabilityAmt>
      <OtherLiabilitiesOrgGrp>
        <Desc>Payable to Durham Trust</Desc>
        <Amt>2935066</Amt>
      </OtherLiabilitiesOrgGrp>
      <OtherLiabilitiesOrgGrp>
        <Desc>Payable to CMC</Desc>
        <Amt>9570866</Amt>
      </OtherLiabilitiesOrgGrp>
      <TotalLiabilityAmt>12505932</TotalLiabilityAmt>
      <TotalRevEtcAuditedFinclStmtAmt>-830565</TotalRevEtcAuditedFinclStmtAmt>
      <NetUnrealizedGainsInvstAmt>-1100752</NetUnrealizedGainsInvstAmt>
      <DonatedServicesAndUseFcltsAmt>0</DonatedServicesAndUseFcltsAmt>
      <RecoveriesPriorYearGrantsAmt>0</RecoveriesPriorYearGrantsAmt>
      <OtherRevenueAmt>0</OtherRevenueAmt>
      <RevenueNotReportedAmt>-1100752</RevenueNotReportedAmt>
      <RevenueSubtotalAmt>270187</RevenueSubtotalAmt>
      <InvestmentExpensesNotIncldAmt>0</InvestmentExpensesNotIncldAmt>
      <OtherRevenuesNotIncludedAmt>0</OtherRevenuesNotIncludedAmt>
      <RevenueNotReportedFinclStmtAmt>0</RevenueNotReportedFinclStmtAmt>
      <TotalRevenuePerForm990Amt>270187</TotalRevenuePerForm990Amt>
      <TotExpnsEtcAuditedFinclStmtAmt>595175</TotExpnsEtcAuditedFinclStmtAmt>
      <DonatedServicesUseFcltsAmt>0</DonatedServicesUseFcltsAmt>
      <PriorYearAdjustmentsAmt>0</PriorYearAdjustmentsAmt>
      <LossesReportedAmt>0</LossesReportedAmt>
      <OtherExpensesIncludedAmt>0</OtherExpensesIncludedAmt>
      <ExpensesNotReportedAmt>0</ExpensesNotReportedAmt>
      <ExpensesSubtotalAmt>595175</ExpensesSubtotalAmt>
      <InvestmentExpensesNotIncld2Amt>0</InvestmentExpensesNotIncld2Amt>
      <OtherExpensesNotIncludedAmt>0</OtherExpensesNotIncludedAmt>
      <ExpensesNotRptFinclStmtAmt>0</ExpensesNotRptFinclStmtAmt>
      <TotalExpensesPerForm990Amt>595175</TotalExpensesPerForm990Amt>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule D, Part V, Line 4</FormAndLineReferenceDesc>
        <ExplanationTxt>There are 5 permanent endowments. One is intended to generate income for Cayuga Medical Center. One is intended to generate income for and to provide funds for the education of young women in the healthcare field. One is intended to generate income for health education scholarships. Two are intended to generate income for charity care.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleD>
    <IRS990ScheduleG documentId="R000005" softwareId="22015720" softwareVersionNum="v1.00">
      <MailSolicitationsInd>X</MailSolicitationsInd>
      <EmailSolicitationsInd>X</EmailSolicitationsInd>
      <PhoneSolicitationsInd>X</PhoneSolicitationsInd>
      <InPersonSolicitationsInd>X</InPersonSolicitationsInd>
      <AgrmtProfFundraisingActyInd>0</AgrmtProfFundraisingActyInd>
      <LicensedStatesCd>NY</LicensedStatesCd>
    </IRS990ScheduleG>
    <IRS990ScheduleI documentId="R000006" softwareId="22015720" softwareVersionNum="v1.00">
      <GrantRecordsMaintainedInd>1</GrantRecordsMaintainedInd>
      <GrantsOtherAsstToIndivInUSGrp>
        <GrantTypeTxt>Scholarship.</GrantTypeTxt>
        <RecipientCnt>50</RecipientCnt>
        <CashGrantAmt>99741</CashGrantAmt>
        <NonCashAssistanceAmt>0</NonCashAssistanceAmt>
        <NonCashAssistanceDesc>Health education assistance provides funds to assist individuals to obtain education in the healthcare field.</NonCashAssistanceDesc>
      </GrantsOtherAsstToIndivInUSGrp>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Schedule I, Part I, Line 2</FormAndLineReferenceDesc>
        <ExplanationTxt>Scholarships to employees of Cayuga Medical Center: The funding is initiated as a loan of up to $4,250 a year, maximum of $21,250 over a five-year span. Each year of the loan, or part thereof, will be repaid by service to Cayuga Medical center for a total of 3,400 hours. Upon satisfying the service agreement, the loan is converted into a scholarship.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleI>
    <IRS990ScheduleO documentId="R000007" softwareId="22015720" softwareVersionNum="v1.00">
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section A, Line 8a</FormAndLineReferenceDesc>
        <ExplanationTxt>Board minutes are taken and state who is in attendance, who presided at the meeting, when the meeting started and ended, and what actions (motions) were taken. The minutes typically materials, power point slide and narrative, that explain the results of the accounting period and may also include the "why" of a decision being made.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 11b</FormAndLineReferenceDesc>
        <ExplanationTxt>After completion by the staff accountant the Form 990 is reviewed by the independent auditing firm, and then it is presented to the Board of Directors for review and approval before submission to the IRS.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section B, Line 12c</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization requires each officer, director, and trustee to complete and sign a new conflict of interest form each year.</ExplanationTxt>
      </SupplementalInformationDetail>
      <SupplementalInformationDetail>
        <FormAndLineReferenceDesc>Form 990, Part VI, Section C, Line 19</FormAndLineReferenceDesc>
        <ExplanationTxt>The organization makes its governing documents, conflicts of interest policy, and financial statements available to the public upon written request.</ExplanationTxt>
      </SupplementalInformationDetail>
    </IRS990ScheduleO>
    <IRS990ScheduleR documentId="R000008" softwareId="22015720" softwareVersionNum="v1.00">
      <IdRelatedTaxExemptOrgGrp>
        <DisregardedEntityName>
          <BusinessNameLine1Txt>Cayuga Medical Center at Ithaca</BusinessNameLine1Txt>
        </DisregardedEntityName>
        <USAddress>
          <AddressLine1Txt>101 Dates Drive</AddressLine1Txt>
          <CityNm>Ithaca</CityNm>
          <StateAbbreviationCd>NY</StateAbbreviationCd>
          <ZIPCd>14850</ZIPCd>
        </USAddress>
        <EIN>222325405</EIN>
        <PrimaryActivitiesTxt>Hospital</PrimaryActivitiesTxt>
        <LegalDomicileStateCd>NY</LegalDomicileStateCd>
        <ExemptCodeSectionTxt>501(c)(3)</ExemptCodeSectionTxt>
        <PublicCharityStatusTxt>170(b)(1)(A)(iii)</PublicCharityStatusTxt>
        <DirectControllingNACd>N/A</DirectControllingNACd>
        <ControlledOrganizationInd>0</ControlledOrganizationInd>
      </IdRelatedTaxExemptOrgGrp>
      <ReceiptOfIntAnntsRntsRyltsInd>0</ReceiptOfIntAnntsRntsRyltsInd>
      <GiftGrntOrCapContriToOthOrgInd>0</GiftGrntOrCapContriToOthOrgInd>
      <GiftGrntCapContriFromOthOrgInd>0</GiftGrntCapContriFromOthOrgInd>
      <LoansOrGuaranteesToOtherOrgInd>0</LoansOrGuaranteesToOtherOrgInd>
      <LoansOrGuaranteesFromOthOrgInd>0</LoansOrGuaranteesFromOthOrgInd>
      <DivRelatedOrganizationInd>0</DivRelatedOrganizationInd>
      <AssetSaleToOtherOrgInd>0</AssetSaleToOtherOrgInd>
      <AssetPurchaseFromOtherOrgInd>0</AssetPurchaseFromOtherOrgInd>
      <AssetExchangeInd>0</AssetExchangeInd>
      <RentalOfFacilitiesToOthOrgInd>0</RentalOfFacilitiesToOthOrgInd>
      <RentalOfFcltsFromOthOrgInd>0</RentalOfFcltsFromOthOrgInd>
      <PerformOfServicesForOthOrgInd>1</PerformOfServicesForOthOrgInd>
      <PerformOfServicesByOtherOrgInd>0</PerformOfServicesByOtherOrgInd>
      <SharingOfFacilitiesInd>0</SharingOfFacilitiesInd>
      <PaidEmployeesSharingInd>0</PaidEmployeesSharingInd>
      <ReimbursementPaidToOtherOrgInd>1</ReimbursementPaidToOtherOrgInd>
      <ReimbursementPaidByOtherOrgInd>0</ReimbursementPaidByOtherOrgInd>
      <TransferToOtherOrgInd>0</TransferToOtherOrgInd>
      <TransferFromOtherOrgInd>0</TransferFromOtherOrgInd>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Cayuga Medical Center at Ithaca</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>p</TransactionTypeTxt>
        <InvolvedAmt>52800</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Contract</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
      <TransactionsRelatedOrgGrp>
        <OtherOrganizationName>
          <BusinessNameLine1Txt>Cayuga Medical Center at Ithaca</BusinessNameLine1Txt>
        </OtherOrganizationName>
        <TransactionTypeTxt>l</TransactionTypeTxt>
        <InvolvedAmt>427630</InvolvedAmt>
        <MethodOfAmountDeterminationTxt>Fundraising services provided.</MethodOfAmountDeterminationTxt>
      </TransactionsRelatedOrgGrp>
    </IRS990ScheduleR>
    <ReasonableCauseExplanation documentId="R000009" softwareId="22015720" softwareVersionNum="v1.00">
      <ExplanationTxt>Due to staffing shortages 990 prep was delayed.</ExplanationTxt>
    </ReasonableCauseExplanation>
  </ReturnData>
</Return>