2023-11-13T12:43:55-06:00 2022-12-31 161131146 BONADIO & CO LLP 171 SULLYS TRAIL PITTSFORD NY 14534 990 2022-01-01 150559686 CLAXTON-HEPBURN MEDICAL CENTER CLAX 3153938880 214 KING STREET OGDENSBURG NY 13669 RICHARD DUVALL PRESIDENT AND CEO 3153938880 2023-11-13 1 RICHARD DUVALL 999009999 0 JONATHAN MILLER P01322027 5853811000 2023-11-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z RICHARD DUVALL 214 KING STREET OGDENSBURG NY 13669 130349687 0 X WWW.CLAXTONHUPBURN.ORG X 1917 NY CLAXTON-HEPBURN MEDICAL CENTER (HOSPITAL) OPERATES ACUTE CARE AND PSYCHIATRIC FACILITIES IN OGDENSBURG, NY SERVICING PATIENTS PRIMARILY FROM ST. LAWRENCE COUNTY. 19 14 914 125 0 0 6425075 12765611 100152347 107614599 242581 -84144 4088688 3646316 110908691 123942382 0 0 0 0 52220066 55790712 0 0 83760 63925634 68074936 116145700 123865648 -5237009 76734 149795564 140540897 73437976 66049455 76357588 74491442 TO MEET OUR REGION'S HEALTHCARE NEEDS WITH COMPASSION AND EXCELLENCE. SIGNIFICANT ACTIVITIES: INPATIENT, OUTPATIENT, AND EMERGENCY CARE. 0 0 93747036 111260915 CLAXTON-HEPBURN MEDICAL CENTER IS LOCATED IN OGDENSBURG, NY AND IS A NOT-FOR-PROFIT HOSPITAL. THE HOSPITAL PROVIDES ACUTE INPATIENT, PRIMARY CARE, MEDICAL SURGICAL, INTENSIVE CARE, OBSTETRICS, NURSERY MAINTAINS AN EMERGENCY DEPT, AMBULATORY SURGERY, HOME HEMODIALYSIS AND MENTAL HEALTH CENTER. MED SURG DAYS EXCLUDING SWING WERE 6,640, ICU PATIENT DAYS WERE 2,285, MENTAL HEALTH PATIENT DAYS WERE 8,477, AND ER PATIENT VISITS WERE 14,397. 93747036 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 1 1 0 0 0 0 0 0 1 1 1 0 0 1 76 0 1 914 1 0 0 0 0 0 0 0 0 0 0 0 0 X 19 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X RICHARD DUVALL 3153938880 214 KING STREET OGDENSBURG NY 13669 MICHAEL OAKLEY MD DIRECTOR / PHYSICIAN 40.00 X 642667 0 36814 RICHARD DUVALL PRESIDENT AND CEO 3.00 X X 653946 0 36814 PHILIP COSMO DIRECTOR UNTIL MARCH 20221 3.00 X 0 0 0 CHRISTOPHER BRANDY DIRECTOR 3.00 X 1258992 0 0 DR ZVI SZAFRAN CHAIRPERSON 3.00 X X 0 0 0 CHET TRUSKOWSKI VICE-CHAIRPERSON 3.00 X X 0 0 0 SCOTT WILSON TREASURER UNTIL MAY 2022 3.00 X 0 0 0 MARK MASHAW TREASURER EFFECTIVE AUGUST 2022 3.00 X X 0 0 0 JAMES CROWLEY DIRECTOR 3.00 X 0 0 0 RITA CROWLEY DIRECTOR / NURSE PRACTITIONER 40.00 X 120176 0 29824 DIANE DAILEY DIRECTOR 3.00 X 0 0 0 BRYAN FELITTO DIRECTOR 3.00 X 0 0 0 DAVID HORNUNG DIRECTOR 3.00 X 0 0 0 TED LAWRENCE DIRECTOR 3.00 X 0 0 0 SANDRA LYONS DIRECTOR 3.00 X 0 0 0 DAWN MERZ DIRECTOR 3.00 X 0 0 0 MAUREEN MISSERT DIRECTOR 3.00 X 0 0 0 KOME OSEGHALE MD DIRECTOR / PHYSICIAN 40.00 X 192406 0 17132 JOHN PINKERTON DIRECTOR 3.00 X 0 0 0 DALLAS SUTTON DIRECTOR 3.00 X 0 0 0 JAMES THEW SECRETARY 3.00 X X 0 0 0 BRANDON BOWLINE COO 3.00 X 273785 0 8214 THOMAS HERZOG PHYSICIAN 40.00 X 674601 0 21297 MICHAEL SEIDMAN PHYSICIAN 40.00 X 529898 0 9150 NOAH ZUKER PHYSICIAN 40.00 X 638705 0 36814 MANASVI JAITLY PHYSICIAN 40.00 X 525660 0 36814 FRANCIS LEE PHYSICIAN 40.00 X 507841 0 36814 6018677 0 269687 99 0 1 0 QUORUM HEALTH RESOURCES LLC 1573 MALLORY LANE BRENTWOOD TN 37027 REVENUE CYCLE MANAGEMENT 2816567 DELPHI HOSPITALIST SERVICES 1160 CHILI AVENUE ROCHESTER NY 14624 STAFFING SERVICES 2041507 DR CHRISTOPHER BRANDY 305 MAIN STREET OGDENSBURG NY 13669 PHYSICIAN SERVICES 1258992 EMERGENCY PHYSICIAN ASSOCIATES PO BOX 634850 CINCINNATI OH 452634850 STAFFING SERVICES 486309 DR SYED RAHMATULLAH 214 KING STREET OGDENSBURG NY 13669 PHYSICIAN SERVICES 297493 14 12699054 66557 12765611 PATIENT SERVICE REVENUE 621990 106068702 106068702 340B REVENUE 621990 1545897 1545897 107614599 95709 95709 6227452 6407305 -179853 -179853 -179853 ALL OTHER REVENUE 900099 3109494 3109494 AUXILIARY 900099 339582 339582 CAFETERIA 900099 197240 197240 3646316 123942382 111260915 0 -84144 972758 972758 43585831 36610983 6891105 83743 1947634 1656990 290644 5889351 4990216 899135 3395138 2862961 532177 345158 8300 336858 308018 308018 194190 11546 182644 342198 316350 25848 1133014 209896 923118 127268 84468 42800 229918 203326 26592 4371028 3726356 644672 823362 86017 737345 MEDICAL SUPPLIES 23447311 21676211 1771100 PURCHASED SERVICES 18660852 8440358 10220494 RENTALS AND LEASES 7940338 5141318 2799020 PHYSICIAN FEES 6599948 6599948 3552333 1121792 2430524 17 123865648 93747036 30034852 83760 3322605 3049217 4021994 1902417 19669115 14999320 1739869 1787589 2002124 1791255 948541 1012627 134576268 103232968 37966780 31343300 80124536 84655172 149795564 140540897 23191037 33519755 4247366 9933988 3091329 1671138 4367662 38641813 20823343 73437976 66049455 X 73148157 71367048 3209431 3124394 76357588 74491442 149795564 140540897 X 76734 -225394 -1717486 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 21251 21251 0 PART II-B, LINE 1: A PORTION OF MEMBERSHIP DUES PAID TO AHA, IHA, AND HANYS ARE USED FOR LOBBYING PURPOSES. 0 0 3209431 188109 -139267 133879 3124394 3018895 273967 87457 170888 3209431 2857654 68386 -92855 3018895 2732558 -24492 -149588 2857654 2748073 20529 36044 2732558 0 0 526509 526509 71179824 43030460 28149364 556885 320498 236387 59722836 57588546 2134290 2590214 2293464 296750 31343300 OTHER ASSETS 2104998 RIGHT OF USE ASSET - FINANCING LEASES 2709120 INTEREST IN NET ASSETS OF CLAXTON-HEPBURN MEDICAL CENTER FOUNDATION, INC. 13372708 DUE FROM AFFILIATE 65043718 RIGHT OF USE ASSET - OPERATING LEASES 1121651 ASSETS LIMITED AS TO USE 82627 INTEREST RATE SWAP ASSET 13167 CASH ADVANCE DEPOSIT 71100 SELF INSURANCE ASSET 136083 84655172 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 4359712 ACCRUED PENSION LIABILITY 7035558 POSTRETIREMENT BENEFIT LIABILITY 1852836 OTHER LIABILITIES 1806018 LEASE LIABILITY - OPERATING LEASES 1108460 CASH OVERDRAFT 1353895 LEASE LIABILITY - FINANCING LEASES 3306864 20823343 PART V, LINE 4: DURING 2022, IT WAS DETERMINED THAT FUNDS THAT HAD PREVIOUSLY BEEN TREATED AS ENDOWED FUNDS WERE NOT ENDOWED BASED ON DONOR INTENT. THEREFORE, THE FUNDS WERE LIQUIDATED. 1 1 X 1 X 1 X 0 1 1 0 1 1 1353105 848576 504529 0.00410 28231754 12874592 15357162 0.12400 29584859 13723168 15861691 0.12810 53278384 34523559 18754825 0.15140 53278384 34523559 18754825 0.15140 82863243 48246727 34616516 0.27950 640 640 0.00000 10767 10767 0.00010 426 426 0.00000 6116 6116 0.00000 17949 17949 0.00010 1 6340186 3176684 19720003 25576930 -5856927 X 1 1 1 1 CLAXTON-HEPBURN MEDICAL CENTER 214 KING STREET OGDENSBURG NY 13669 WWW.CLAXTONHUPBURN.ORG X X X CLAXTON-HEPBURN MEDICAL CENTER 1 0 0 1 X X X X X X X X X 22 1 1 0 1 X HTTPS://WWW.CLAXTONHEPBURN.ORG/IMAGES/12.21.2022_CHIP_FINAL.PDF X 1 22 1 HTTPS://WWW.CLAXTONHEPBURN.ORG/ABOUT-US/COMMUNITY-OUTREACH/ 0 1 X 100.000000000000 300.000000000000 X 1 1 1 X WWW.CLAXTONHEPBURN.ORG X WWW.CLAXTONHEPBURN.ORG X WWW.CLAXTONHEPBURN.ORG X X X X X X 1 X 0 X X 1 X 0 1 CLAXTON-HEPBURN MEDICAL CENTER PART V, SECTION B, LINE 5: IN ACCORDANCE WITH THE IRS AND THE NEW YORK STATE DEPARTMENT OF HEALTH, CLAXTON-HEPBURN MEDICAL CENTER CONTINUES TO COLLABORATE WITH ITS PARTNERS THROUGH THE ST. LAWRENCE COUNTY BRIDGE TO WELLNESS COALITION WHICH CONSISTS OF THE ST. LAWRENCE COUNTY PUBLIC HEALTH DEPARTMENT, FIVE COUNTY HOSPITALS, MEMBERS FROM ACADEMIA, GOVERNMENT, HUMAN SERVICES AGENCIES, CIVIC GROUPS, AND THE PRIVATE SECTOR. ADDITIONALLY, CLAXTON-HEPBURN COLLABORATES REGIONALLY WITH THE FORT DRUM REGIONAL HEALTH PLANNING ORGANIZATION AND THE NORTH COUNTRY INITIATIVE AND ALL OF ITS PARTNERS. IN 2021, THE COLLABORATIONS CONDUCTED A REGIONAL COMMUNITY NEEDS ASSESSMENT AND DEVELOPED A COMMUNITY SERVICE PLAN TO ADDRESS THE DISPARITIES NOTED FROM THE ASSESSMENT, AND IN LINE WITH THE NEW YORK STATE DEPARTMENT OF HEALTH'S PREVENTION AGENDA. TWO PRIORITIES WERE CHOSEN WITHIN THE FIVER PRIORITY AREAS, ALONG WITH INTERVENTIONS AND GOALS TO ADDRESS THE SELECTED PRIORITIES.THE COMPLETED PLAN WAS SUBMITTED TO THE NEW YORK STATE DEPARTMENT OF HEALTH IN 2022 AND COPIES OF THE PLAN CAN BE FOUND ON CLAXTON-HEPBURN'S WEBSITE, ITS PARTNERING AGENCIES WEBSITES, AND IN PAPER COPY UPON REQUEST. A NEW COMMUNITY NEEDS ASSESSMENT WILL BE CONDUCTED IN 2024. CLAXTON-HEPBURN MEDICAL CENTER PART V, SECTION B, LINE 6A: CANTON-POTSDAM HOSPITALCLIFTON-FINE HOSPITALGOUVERNEUR HOSPITALMASSENA HOSPITAL CLAXTON-HEPBURN MEDICAL CENTER PART V, SECTION B, LINE 11: BETWEEN TWO REGIONAL GROUPS, AND ST. LAWRENCE COUNTY BRIDGE TO WELLNESS COALITION, THAT CLAXTON-HEPBURN IS COLLABORATING WITH, MOST NEEDS IDENTIFIED IN THE 2022 CHNA ARE BEING ADDRESSED WITH EVIDENCE-BASED MEASURABLE INTERVENTIONS. CLAXTON-HEPBURN MEDICAL CENTER PART V, SECTION B, LINE 24: GROSS CHARGES ARE BILLED TO PATIENTS WITH A NOTICE STATING IF THEY ARE ELIGIBLE FOR A DISCOUNT. ALSO, INSTRUCTIONS TO CONTACT OUR OFFICE AS TO HOW TO APPLY ARE PROVIDED. 9 1 - CANTON HEALTH CENTER 39 WEST MAIN STREET CANTON NY 13617 CLINIC 2 - CLAXTON-HEPBURN HEALTH CENTER 100 HORWOOD PLACE OGDENSBURG NY 13669 CLINIC 3 - WOUND HEALING CENTER 100 HORWOOD PLACE OGDENSBURG NY 13669 CLINIC 4 - WELLNESS CENTER 214 KING STREET OGDENSBURG NY 13669 CLINIC 5 - MADRID HEALTH CENTER 2263 STATE HIGHWAY 310 MADRID NY 13660 CLINIC 6 - HEUVELTON HEALTH CENTER 103 RENSSELAER STREET RENSSELAER NY 13654 CLINIC 7 - HAMMOND HEALTH CENTER 225 ST LAWRENCE AVE HAMMOND NY 13646 CLINIC 8 - LISBON HEALTH CENTER 7016 COUNTRY RT 10 LIBSON NY 13658 CLINIC 9 - WADDINGTON HEALTH CENTER 4 MONTGOMERY HEIGHTS WADDINGTON NY 13694 CLINIC PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS IN THE TABLE IS A COST-TO-CHARGE RATIO. THIS COST-TO-CHARGE RATIO WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST-TO-CHARGE RATIO. PART II, COMMUNITY BUILDING ACTIVITIES: WE DO HAVE AN OPEN MEDICAL STAFF, ALLOW OUTSIDE ORGANIZATIONS TO USE HOSPITAL SPACE WITHOUT COST, COMMUNITY-BASED BOARD, PROVIDE CHARITY CARE, WORK WITH LOCAL AGENCIES TO PROVIDE FREE OR REDUCED COST CANCER SCREENINGS AND PROVIDE FREE ON-SITE FACILITATED ENROLLMENT FOR THE UNINSURED. PART III, LINE 3: PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENT ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES PAST PAYMENT HISTORY AND INDENTIFIES TRENDS FOR EACH MAJOR PAYOR SOURCE OF REVENUE TO ESTIAMTE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE. THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS. IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS AND FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE REALIZATION OF THE AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE HOSPITAL ALSO ANALYZES AMOUNTS DUE AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR BAD DEBTS IN THE PRIOD OF SERVICE BASED ON PAST EXPERIENCE, INCLUDING CONSIDERATION OF CURRENT BUSINESS ANE ECONOMIC CONDITIONS. WHEN THE HOSPITAL ESTABLISHES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IT TAKES INTO CONSIDERATION THE FACT THAT MANY SELF-PAY-PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HABE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS WAS 51.05% AND 35.7% OF THE RELATED ACCOUNTS RECEIVABLE, NET OF CONTRACTUAL ALLOWANCES AT DECEMBER 31, 2022 AND 2021, RESPECTIVELY. PART III, LINE 8: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNT OF MEDICARE ALLOWABE COSTS IS A COST-TO-CHARGE RATIO. PART III, LINE 9B: CLAXTON-HEPBURN MEDICAL CENTER WILL PROVIDE CHARITY CARE TO PATIENTS WHO HAVE BEEN ESTABLISHED BY THE FINANCIAL ASSISTANCE POLICY. THE IDENTIFICATION OF INADEQUATE MEANS WILL BE BASED ON CRITERIA ESTABLISHED BY PATIENT FINANCIAL SERVICES AND APPROVED BY ADMINISTRATION. PART VI, LINE 2: CLAXTON-HEPBURN USES A VARIETY OF RESOURCES TO ASSESS THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES. WE USE LOCAL PUBLIC HEALTH DATA, NATIONAL RANKINGS DATA, AS WELL AS DATA FROM THE NEW YORK STATE DEPARTMENT OF HEALTH AND THE NEW YORK STATE HOSPITAL ASSOCIATION AND A RECENT COMMUNITY NEEDS ASSESSMENT. WE ALSO GATHER DATA ON OUR OWN THROUGH SURVEYS AND QUESTIONNAIRES UTILIZED AT COMMUNITY EVENTS THAT WE ATTEND. WE WORK WITH THE LOCAL HEALTH INITIATIVE AND COUNTY PUBLIC HEALTH TO ASSESS COMMUNITY HEALTH NEEDS. PART VI, LINE 3: ALL PATIENTS WITH A SELF PAY BALANCE RECEIVE A STATEMENT THAT INCLUDES INFORMATION REGARDING OUR FINANCIAL ASSISTANCE PROGRAM AND CONTACT INFORMATIONPATIENT FINANCIAL SERVICES STAFF VERBALLY COMMUNICATE WITH PATIENTS ABOUT CHARITY CARE AS THEY WORK ACCOUNTS. HEALTH CENTERS AND OTHER INTAKE AREAS HAVE CHARITY CARE INFORMATIONAL SHEETS TO HANDOUT TO PATIENTS IN NEED. CLAXTON-HEPBURN MEDICAL CENTER HAS CONTRACTED WITH A THIRD PARTY AGENCY WHO HAS AN INDIVIDUAL ON-SITE ON A FULL-TIME BASIS THAT SCREENS PATIENTS FOR MEDICAID OR AN ALTERNATE COVERAGE. THIS INDIVIDUAL IS ALSO ABLE TO ENROLL PATIENTS IN THE STATE-WIDE EXCHANGE PROGRAMS. SOCIAL WORKERS IN RENAL AND CANCER CARE SERVICES WORK CLOSELY WITH THE PATIENT FINANCIAL SERVICES STAFF WHEN SELF PAY PATIENTS ARE IN NEED OF SERVICES. PART VI, LINE 4: CLAXTON-HEPBURN MEDICAL CENTER IS A PRIVATE, NOT-FOR-PROFIT, 127 BED COMMUNITY HOSPITAL AND REGIONAL REFERRAL CENTER. CLAXTON-HEPBURN INCLUDES 67 ACUTE-CARE BEDS, A 10-BED INTENSIVE CARE UNIT, A 10-BED BIRTHING CENTER AND A 40-BED MENTAL HEALTH CENTER INCLUDING A SEPARATE CHILDREN'S UNIT. THE MEDICAL CENTER PROVIDES PRIMARY CARE TO NEARLY 40,000 RESIDENTS OF OGDENSBURG AND SURROUNDING COMMUNITIES AND REGIONAL SERVICES TO THE 108,000 PEOPLE OF ST. LAWRENCE COUNTY.CLAXTON-HEPBURN MEDICAL CENTER HAS AN ACTIVE MEDICAL STAFF OF MORE THAN 50 PHYSICIANS REPRESENTING MOST SPECIALTIES. REGINAL AND COUNTY WIDE SERVICES INCLUDE RADIATION AND MEDICAL ONCOLOGY PROVIDED BY THE RICHARD E. WINTER CANCER CENTER, DIALYSIS TREATMENT PROVIDED BY THE DR. RAVINDER N. AGARWAL RENAL CENTER, THE REV. THOMAS T. PATTERSON WOUND HEALING CENTER, AND A STATE-OF THE-ART DIAGNOSTIC IMAGING DEPARTMENT.ST. LAWRENCE COUNTY IS THE LARGEST COUNTY IN NEW YORK STATE BY SIZE AND THE MOST POPULOUS COUNTY IN NEW YORK STATE THAT LACKS DIRECT ACCESS TO AN INTERSTATE HIGHWAY WITHIN ITS BORDERS. ITS MAIN TRANSPORTATION LINKS ARE WITH JEFFERSON AND LEWIS COUNTIES TO ITS SOUTHWEST, FRANKLIN COUNTY TO ITS EAST, AND CANADA TO ITS NORTH. TO THE NORTH AND NORTHWEST, ST. LAWRENCE COUNTY IS BOUNDED BY THE ST. LAWRENCE RIVER, WHICH IS ALSO A MAJOR SHIPPING ROUTE AND INTERNATIONAL BORDER. TWO BRIDGES SPAN THE ST. LAWRENCE RIVER BETWEEN ST. LAWRENCE COUNTY AND CANADA: OGDENSBURG-PRESCOTT INTERNATIONAL BRIDGE BY OGDENSBURG AND MASSENA-CORNWALL INTERNATIONAL BRIDGE NEAR MASSENA. THE SOUTHERN THIRD OF THE COUNTY, WHICH IS LARGELY FORESTLAND, IS LOCATED WITHIN THE ADIRONDACK PARK. ST. LAWRENCE COUNTY IS A LARGE AND PREDOMINATELY RURAL COUNTY LOCATED BETWEEN THE ADIRONDACK MOUNTAINS AND THE ST. LAWRENCE RIVER IN NORTHERN NEW YORK. AS OF 2020, IT HAS AN ESTIMATED POPULATION OF 108,354. THE COUNTY'S LARGEST POPULATION HAS CHANGED VERY LITTLE SINCE 1970, AND CURRENT ESTIMATES ARE REFLECTIVE OF REGIONAL TRENDS.THE COUNTY COMPRISES 32 TOWNS AND A SINGLE CITY. NO COUNTY SUBDIVISION ACCOUNTS FOR MORE THAN 15% OF THE TOTAL COUNTY POPULATION, AND NONE OF THE COUNTY'S LARGEST POPULATED PLACES ARE CLOSER THAN 10 MILES FROM EACH OTHER WHEN MEASURED FROM CENTER TO CENTER. THE LARGEST COUNTY SUBDIVISIONS ARE THE CITY OF OGDENSBURG AND THE TOWNS OF POTSDAM, MASSENA, CANTON AND GOUVERNEUR. ABOUT HALF OF THE COUNTY'S POPULATION (52%) LIVE WITHIN THESE FIVE SUBDIVISIONS, WITH THE REMAINING HALF SPREAD ACROSS 28 OTHER TOWNS, WITH POPULATIONS RANGING FROM OVER FOUR THOUSAND (LIBSON, NORFOLK, AND OSWEGATCHIE) TO FEWER THAN FIVE HUNDRED RESIDENTS (CLARE AND PIERCEFIELD).THE MEDIAN AGE IN ST. LAWRENCE COUNTY IS 39 YEARS OLD. 18% OF RESIDENTS ARE OVER 65 YEARS OLD. THE COUNTY HAS AN ESPECIALLY LARGE NUMBER OF YOUNG ADULTS, ESPECIALLY IN THE VICINITY OF ITS FOUR-YEAR COLLEGES AND STATE PRISONS: 14% OF THE COUNTY'S RESIDENTS ARE 18 TO 24 YEARS OLD.ST. LAWRENCE COUNTY IS 92% NON-HISPANIC WHITE. THE LARGEST MINORITY GROUPS ARE HISPANICS OF ANY RACE (2%), BLACK NON-HISPANIC (2%), TWO OR MORE RACES AND NON-HISPANIC (1%), ASIAN NON-HISPANIC (1%), AND AMERICAN INDIAN NON-HISPANICS (1%), WITH OTHER GROUPS AMOUNTING TO LESS THAN 1% OF THE COUNTY'S POPULATION. THE RACIAL AND ETHNIC GEOGRAPHY OF THE COUNTY IS UNEVEN, WITH THE CITY OF OGDENSBURG AND MOST OF THE COUNTY'S LARGER VILLAGES (CANTON, POTSDAM, GOUVERNEUR) HAVING MORE DIVERSE POPULATIONS, AND THE SMALLER VILLAGES AND RURAL AREAS HAVE LESS DIVERSE POPULATIONS. MASSENA IS THE LEAST DIVERSE OF THE COUNTY'S LARGER VILLAGES, HOWEVER, MOST OF THE COUNTY'S AMERICAN INDIAN RESIDENTS LIVE IN ITS VICINITY.AMONG RESIDENTS 16 AND OVER, 53% ARE IN THE LABOR FORCE, WHICH IS LOWER THAN THE REGIONAL RATE (59%), THE STATEWIDE RATE (63%), AND THE NATIONAL RATE (63%). 49% OF THESE RESIDENTS ARE EMPLOYED WITHIN THE CIVILIAN LABOR FORCE AND LESS THAN 1% ARE IN THE ARMED FORCES. AMONG THOSE IN THE CIVILIAN LABOR FORCE, THE UNEMPLOYMENT RATE WAS 8.8%. MORE RECENT DATA FROM THE BUREAU OF LABOR STATISTICS SHOWS THAT THE AVERAGE UNEMPLOYMENT RATE IN 2018 IS 5.6%, WHICH IS HIGH COMPARED TO THE STATEWIDE AVERAGE OF 4.1% BUT NO HIGHER THAN NEIGHBORING COUNTIES. THIS IS 1.1% LOWER THAN THE PREVIOUS YEAR.10% OF HOUSEHOLDS IN ST. LAWRENCE COUNTY HAVE NO VEHICLE, 36% HAVE ONE VEHICLE, AND 55% HAVE TWO OR MORE VEHICLES. 77% OF WORKERS COMMUTE ALONE IN A CAR, TRUCK, OR VAN; 10% CARPOOL; 6% WALK; 5% WORK FROM HOME; AND ABOUT 2% UTILIZE PUBLIC TRANSPORTATION, TAXIS OR OTHER MEANS. ONE-QUARTER OF WORKERS WHO DRIVE ALONE HAVE A LONG COMMUTE OF MORE THAN 30 MINUTES.MEDIAN HOUSEHOLD INCOME FOR 2020 IN ST. LAWRENCE COUNTY IS ESTIMATED AT $52K- LOWER THAN THE NATIONAL VALUE OF $65K AND THE STATEWIDE VALUE OF $71K. THIS PATTERN HAS PERSISTED OVER HISTORY.89% OF ST. LAWRENCE COUNTY RESIDENTS 25 YEARS OF AGE AND OVER HAVE A HIGH SCHOOL LEVEL DIPLOMA OR EQUIVALENT. 24% HAVE A BACHELOR'S DEGREE OR HIGHER, THIS IS ON PAR WITH THE REGION BUT LOWER THAN NATIONAL AND STATE PERCENTAGES. WOMEN (38%) ARE MARKEDLY MORE LIKELY THAN MEN (30%) TO HAVE AT LEAST AN ASSOCIATES DEGREE, AND HAVE HIGHER EDUCATIONAL ATTAINMENT, ON AVERAGE. THERE IS A STRONG CORRELATIONS BETWEEN EDUCATIONAL ATTAINMENT AND POVERTY WITHIN THE COUNTY. 35% OF THOSE WITHOUT A HIGH SCHOOL DIPLOMA LIVE IN POVERTY, COMPARED TO 16% OF THOSE WITH A HIGH SCHOOL DIPLOMA, AND 6% OF THOSE WITH A FOUR-YEAR DEGREE.ST. LAWRENCE COUNTY IS SERVED BY FIVE HOSPITALS:-CANTON-POTSDAM HOSPITAL, A 94-BED NOT-FOR-PROFIT HOSPITAL IN POTSDAM-CLAXTON-HEPBURN MEDICAL CENTER, A 115-BED NOT-FOR-PROFIT HOSPITAL IN OGDENSBURG-CLIFTON-FINE HOSPITAL, A 20-BED NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL IN STAR LAKE-GOUVERNEUR HOSPITAL, A 25-BED NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL IN GOUVERNEUR-MASSENA MEMORIAL HOSPITAL, A 25-BED NOT-FOR-PROFIT HOSPITAL IN MASSENAAS OF 2018, CANTON-POTSDAM AND CLAXTON-HEPBURN WERE RESPONSIBLE FOR THE LARGEST NUMBER OF INPATIENT AND OUTPATIENT VISITS FOR RESIDENTS OF ST. LAWRENCE COUNTY.OUR MOST RECENT COMMUNITY NEEDS ASSESSMENT WAS CONDUCTED IN 2022.HEALTH SUMMARY:OVER THE MOST RECENT FIVE YEARS OF AVAILABLE DATA, ST. LAWRENCE COUNTY'S AGE-ADJUSTED MORTALITY RATE HAS DECREASED BY 8.4%, FALLING FROM 788 PER 100,000 STANDARD POPULATION IN 2013 TO 721 IN 2017.BY DISEASE CATEGORY, COMPARED TO STATEWIDE BENCHMARKS, ST. LAWRENCE COUNTY HAS LOWER RATES OF AGE-ADJUSTED MORTALITY DUE TO DISEASES OF THE NERVOUS SYSTEM, MENTAL AND BEHAVIORAL DISORDERS, AND INFECTIOUS DISEASE, BUT HIGHER RATES DUE TO CARDIOVASCULAR DISEASE, CANCER, RESPIRATORY DISEASE AND DIGESTIVE DISEASE, AND A SLIGHTLY HIGHER RATE FOR ALL OTHER DISEASE CATEGORIES. AMONG ALL DISEASES CATEGORIES, MORTALITY DUE TO CARDIOVASCULAR DISEASE, RESPIRATORY DISEASE, DIGESTIVE DISEASES, AND GENITOURINARY DISEASES ARE HIGHER COMPARED TO THE REGIONAL RATES.ST. LAWRENCE COUNTY HAS A HIGHER AGE-ADJUSTED MORTALITY RATE THAN NEW YORK STATE. THIS IS TRUE ACROSS AGE-ADJUSTED DEATH RATES FOR MOST MAJOR DISEASE CATEGORIES. IN TOTAL, THE AGE-ADJUSTED DEATH RATES FOR ST. LAWRENCE COUNTY AMONG THE LEADING CAUSES OF DEATH IS 92.1 DEATHS PER 100,000 HIGHER COMPARED TO THE STATE, A DIFFERENCE OF 14%. GENERALLY, ST. LAWRENCE COUNTY HAS SIMILAR AGE-ADJUSTED MORTALITY RATES WHEN COMPARED TO THE REGION.HEALTH STATUS:14% OF NON-INSTITUTIONALIZED CIVILIAN RESIDENTS MEET THE CENSUS DEFINITION FOR HAVING A DISABILITY, WHICH EXCEEDS THE STATEWIDE RATE OF 11%. THIS INCLUDES 7% OF CHILDREN 5% OR OLDER, 10% OF WORKING-AGE ADULTS (AGE 18-65), AND 38% OF ADULTS OVER THE AGE OF 65. AS OF 2016, 34% OF ST. LAWRENCE COUNTY ADULTS ARE OBESE WHICH IS NOT SIGNIFICANTLY DIFFERENT FROM PREVIOUS MEASURERS. THIS IS ABOVE THE STATEWIDE RATE OF 26%. WHEN OVERWEIGHT ADULTS ARE INCLUDED, THE RATE INCREASES TO 69%, ALSO ABOVE THE STATEWIDE RATE OF OBESE OR OVERWEIGHT ADULTS OF 61%. THE RATE OF OBESITY AMONG CHILDREN AND ADOLESCENTS IS 22%, EXCEEDING THE STATEWIDE-EXCLUDING NYC AVERAGE OF 17%. WHEN INCLUDING OVERWEIGHT CHILDREN AND ADOLESCENTS, THIS RATE INCREASES TO 38% WHICH IS ALSO ABOVE THE STATEWIDE-EXCLUDING NYC AVERAGE OF 34%AS OF 2016, 70% OF CHILDREN AGED 19-35 MONTHS IN ST. LAWRENCE COUNTY HAD THE NYS PREVENTION AGENDA-RECOMMEND 4:3:1:3:3:1:4 IMMUNIZATION SERIES. ST. LAWRENCE COUNTY RANKS WITHIN THE TOP HALF OF NEW YORK STATE COUNTIES FOR FLU VACCINATIONS AMONG ELDERLY ADULTS, WITH 67% OF ELDERLY ADULTS HAVING BEEN VACCINATED IN 2016.OPIOID MISUSE CONTINUES TO BE A BURDEN IN ST. LAWRENCE COUNTY. THE CRUDE RATE FOR THE OPIOID BURDEN (INCLUDING OUTPATIENT ED VISITS AND HOSPITAL DISCHARGES FOR NON-FATAL OPIOID OVERDOSE, ABUSE, DEPENDENCE, AND UNSPECIFIED USE; AND OPIOID OVERDOSE DEATHS) IS STAGGERINGLY HIGH AT 507.1 PER 100,000 POPULATION, AS COMPARED TO THE REGIONAL RATE OF 321.2 PER 100,000 POPULATION, AND THE STATEWIDE RATE EXCLUDING NYC RATE OF 300.3 PER 100,000 POPULATION. PART VI, LINE 7, REPORTS FILED WITH STATES NY X X X X X 0 0 0 0 0 0 0 0 0 CHRISTOPHER BRANDY DIRECTOR 1258992 0 0 0 0 0 0 0 0 0 1258992 0 0 0 THOMAS HERZOG PHYSICIAN 674601 0 0 0 0 0 9150 0 12147 0 695898 0 0 0 RICHARD DUVALL PRESIDENT AND CEO 653146 0 0 0 800 0 9150 0 27664 0 690760 0 0 0 MICHAEL OAKLEY MD DIRECTOR / PHYSICIAN 642667 0 0 0 0 0 9150 0 27664 0 679481 0 0 0 NOAH ZUKER PHYSICIAN 638705 0 0 0 0 0 9150 0 27664 0 675519 0 0 0 MANASVI JAITLY PHYSICIAN 525660 0 0 0 0 0 9150 0 27664 0 562474 0 0 0 FRANCIS LEE PHYSICIAN 507841 0 0 0 0 0 9150 0 27664 0 544655 0 0 0 MICHAEL SEIDMAN PHYSICIAN 529898 0 0 0 0 0 9150 0 0 0 539048 0 0 0 BRANDON BOWLINE COO 273785 0 0 0 0 0 8214 0 0 0 281999 0 0 0 KOME OSEGHALE MD DIRECTOR / PHYSICIAN 192406 0 0 0 0 0 6003 0 11129 0 209538 0 0 0 PART I, LINE 3 TTHE CHMC BOARD CONTRACTS WITH YAFFE AND COMPANY, AN INDEPENDENT SALARY COMPENSATION SPECIALIST TO ADVISE THE EXECUTIVE COMMITTEE TO ASSIST THE COMMITTEE IN SETTING ANNUAL SALARIES AND BENEFITS FOR SENIOR LEADERSHIP. YAFFE AND COMPANY IS USED IN COMBINATION WITH PULLING MULTIPLE COMPARABLE HOSPITAL'S EXECUTIVE OFFICER COMPENSATIONS FROM 990S. ALL DATA IS PRESENTED TO THE BOARD BY THE CFO FOR DETERMINATION OF APPROPRIATE EXECUTIVE SALARIES. CHET TRUSKOWSKI CHAIRPERSON 72200 CHET TRUSKOWSKI IS A DIRECTOR FOR THE HOSPITAL AND THE HOSPITAL EMPLOYS HIS DAUGHTER ELLEN PLUTA 0 DR CHRISTOPHER BRANDY BOARD MEMBER 1336440 PROFESSIONAL SERVICES AGREEMENT 0 RACHEL ZYSK SISTER-IN-LAW OF CEO 105840 SHE IS EMPLOYED BY CARTHAGE AREA HOSPITAL; RICH IS CONTRACTED CEO THERE AND A PORTION OF HER SALARY IS BILLED TO CLAXTON BASED ON TIME. 0 FORM 990, PART VI, SECTION A, LINE 6 NORTH STAR HEALTH ALLIANCE, INC. A NOT-FOR-PROFIT HOLDING COMPANY, IS THE SOLE CORPORATE MEMBER OF THE HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A NORTH STAR HEALTH ALLIANCE, INC. ELECTS THE MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF NORTH STAR HEALTH ALLIANCE, INC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PROVIDED TO CLAXTON-HEPBURN MEDICAL CENTER'S BOARD FOR REVIEW BEFORE FILING THE FORM. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS CONTRACTS WITH YAFFE AND COMPANY TO WORK WITH THE EXECUTIVE COMMITTEE TO ENSURE COMPLIANCE WITH IRC 4598 AND CONFLICT OF INTEREST DISCLOSURE, AND MAINTAINS MINUTES OF MEETINGS. BOARD MEMBERS DISCLOSE CONFLICTS OF INTEREST ANNUALLY IN WRITING, AFTER REVIEWING THE CORPORATE POLICY. THESE CONFLICTS ARE REVIEWED BY THE FULL BOARD ANNUALLY AND KEPT ON FILE FORM 990, PART VI, SECTION B, LINE 15 THE CHMC BOARD CONTRACTS WITH YAFFE AND COMPANY, AN INDEPENDENT SALARY COMPENSATION SPECIALIST TO ADVICE ON THE EXECUTIVE COMMITTEE TO ASST THE COMMITTEE IN SETTING ANNUAL SALARIES AND BENEIFTS FOR SENIOR LEADERSHIP. FORM 990, PART VI, SECTION C, LINE 18 CLAXTON-HEPBURN MEDICAL CENTER'S 990 IS AVAILABLE UPON WRITTEN REQUEST FORM 990, PART VI, SECTION C, LINE 19 CLAXTON-HEPBURN MEDICAL CENTER'S GOVERNING DOCUMENTS, FINANCIAL STATEMENT AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN CLAXTON-HEPBURN CENTER FOUNDATION, INC. -6,743,820. CHANGE IN FUNDED STATUS OF PENSION AND POSTRETIREMENT PLANS 5,041,298. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP LIABILITY 381,006. EQUITY IN OPERATION OF INVESTEE -137,857. OTHER COMPONENTS OF NET PERIODIC BENEFIT COST -78,344. OTHER NONOPERATING EXPENSES -179,769. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. NORTH STAR HEALTH ALLIANCE INC 214 KING STREET OGDENSBURG NY 13669 161449491 PARENT HOLDING COMPANY FOR CLAXTON-HEPBURN MEDICAL CENTER NY 501(C)(3) 12B N/A 0 CLAXTON-HEPBURN MEDICAL CENTER FOUNDATION INC 503 MANSION AVENUE OGDENSBURG NY 13669 222488389 PROVIDE FINANCIAL SUPPORT FOR CLAXTON HEPBURN MEDICAL CENTER NY 501(C)(3) 509(A)(3) NORTH STAR HEALTH ALLIANCE INC 0 CLAXTON MEDICAL PC 214 KING STREET OGDENSBURG NY 13669 264009395 ATTRACTING AND RETAINING SPECIALIZED MEDICAL PRACTICIONERS NY 501(C)(3) 509(A)(3) CLAXTON-HEPBURN MEDICAL CENTER 1 RIVER HOSPITAL INC 4 FULLER STREET ALEXANDRIA BAY NY 13607 810600548 HEALTHCARE SERVICES NY 501(C)(3) 509(A)(3) N/A 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 CLAXTON MEDICAL PC E 65043718 FMV CLAXTON-HEPBURN MEDICAL CENTER FOUNDATION INC E 3500000 FMV CLAXTON-HEPBURN MEDICAL CENTER FOUNDATION INC C 93628 FMV CLAXTON-HEPBURN MEDICAL CENTER FOUNDATION INC E 5261645 FMV