2023-11-13T15:04:34-06:00 2022-12-31 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2022-01-01 161528554 ADIRONDACK MEDICAL CENTER FOUNDATION ADIR 5188972370 2233 STATE ROUTE 86 PO BOX 120 SARANAC LAKE NY 12983 DANIEL KELLEHER CHAIR OF THE BOARD 5188972370 2023-11-06 1 DANIEL KELLEHER 999009999 1 DESIREE M BENNETT P01263666 3154463600 2023-11-06 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z DANIEL KELLEHER 2233 STATE ROUTE 86 PO BOX 120 SARANAC LAKE NY 12983 53493167 0 X WWW.ADIRONDACKHEALTH.ORG X 1997 NY TO SUPPORT AND ASSIST ADIRONDACK MEDICAL CENTER, AN EXEMPT HEALTHCARE ORGANIZATION 23 20 3 0 0 0 4030215 1839329 0 0 1185386 1852372 0 0 5215601 3691701 2186244 679038 0 0 275850 283226 0 0 270212 338754 199124 2800848 1161388 2414753 2530313 22163364 20838777 2500 17347 22160864 20821430 X TO SUPPORT AND ASSIST ADIRONDACK MEDICAL CENTER, AN EXEMPT HEALTHCARE ORGANIZATION 0 0 369384 369384 FUTURE OF CARE CAMPAIGN - FUNDS WILL BE USED BY THE ADIRONDACK MEDICAL CENTER FOR TWO MAJOR CAPITAL PROJECTS. IN SARANAC LAKE, FUNDS WILL BE USED TOWARDS A RENOVATION AND EXPANSION OF THE SURGICAL SERVICES DEPARTMENT. IN LAKE PLACID, FUNDS WILL BE USED TO BUILD THE ADIRONDACK HEALTH - LAKE PLACID HEALTH AND MEDICAL FITNESS CENTER.COVID RELIEF FUND - FUNDS RAISED TO ASSIST ADIRONDACK HEALTH WITH EXPENSES RELATED TO COVID-19.INFECTIOUS DISEASE TESTING LAB - FUNDS RAISED TO RENOVATE LABORATORY SPACE AND TO PURCHASE 2 RHEONIX AND A ROCHE MACHINE TO PROCESS PCR TESTS IN-HOUSE IN A TIMELY MANNER. 292854 292854 OTHER GRANTS TO AMC - FUNDS PROVIDED TO DEPARTMENTS FOR GRANTS OF UP TO $5,000 THAT ENHANCE THE PATIENT OR RESIDENT EXPERIENCE OR ENHANCE THE HEALING ENVIRONMENT. 16801 16801 COMMUNITY HEALTH, EDUCATION ETC. - THE ADIRONDACK MEDICAL CENTER FOUNDATION PROVIDED SCHOLARSHIPS TO NON-TRADITIONAL AND TRADITIONAL STUDENTS PURSUING A DEGREE IN REGISTERED NURSING AND RADIOLOGIC TECHNOLOGY PROGRAMS. COMMUNITY HEALTH OUTREACH INCLUDED A HEALTH MAGAZINE PUBLISHED TWICE/YEAR. 65390 COSTS INCURRED WHILE PERFORMING ACTIVITIES IN ACCORDANCE WITH THE MISSION OF THE FOUNDATION. 65390 744429 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 0 0 3 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 23 20 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X ROBERT LABA 5188914141 PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 SYLVIA GETMAN EX-OFFICIO 1.00 X 0 100000 0 AARON KRAMER EX-OFFICIO 1.00 X 0 355932 13438 DANIEL F KELLEHER CHAIR 1.00 X X 0 0 0 HEATHER BUMSTED VICE CHAIR 0.50 X X 0 0 0 ERIN PERKINS SECRETARY 0.50 X X 0 0 0 ROBERT J BEIER TREASURER 1.00 X X 0 0 0 JOE BECK TRUSTEE 0.50 X 0 0 0 EDWARD BICKFORD TRUSTEE 0.50 X 0 0 0 KEVIN BRADY TRUSTEE 0.50 X 0 0 0 EVE BURNS DO TRUSTEE 0.50 X 0 672422 64652 WOODROW GANDY MD TRUSTEE 0.50 X 0 0 0 JOAN H GRABE TRUSTEE 0.50 X 0 0 0 MAGGIE HO DO TRUSTEE 0.50 X 0 0 0 KELLY LARKIN MD TRUSTEE 0.50 X 0 0 0 NINA MERRILL TRUSTEE 0.50 X 0 0 0 MATTHEW D NORFOLK ESQ TRUSTEE 0.50 X 0 0 0 NICK POLITI TRUSTEE 0.50 X 0 0 0 NOELLE SHORT TRUSTEE 0.50 X 0 0 0 EDWARD UGHETTA TRUSTEE 0.50 X 0 0 0 PETER VAN ETTEN TRUSTEE 0.50 X 0 0 0 SARAH WILSON TRUSTEE 0.50 X 0 0 0 SUSAN DELEHANTY EX-OFFICIO 1.00 X 0 0 0 JOHN HUWILER TRUSTEE 0.50 X 0 0 0 HANNAH HANFORD EXECUTIVE DIRECTOR 40.00 X 135112 0 17621 135112 1128354 95711 1 0 1 0 0 107090 1732239 206503 1839329 248771 248771 51375398 49771797 1603601 1603601 1603601 29669 107090 29669 0 3691701 0 0 1852372 679038 679038 152734 30547 30547 91640 93296 18659 18659 55978 2196 439 439 1318 17526 3505 3505 10516 17474 3495 3495 10484 714 714 2790 2790 66218 66218 27317 5317 22000 7864 7864 3440 688 688 2064 6317 6317 FUNDRAISING 50695 50695 DUES AND SUBSCRIPTIONS 14129 2826 2826 8477 ALL OTHER EXPENSES 10464 5232 5232 RESTRICTED GIFTS PAYOUT 9176 9176 1161388 744429 146747 270212 478332 363132 948730 89249 2290609 1368465 18442117 19017931 3576 0 22163364 20838777 2500 2500 0 14847 2500 17347 X 18928255 16425193 3232609 4396237 22160864 20821430 22163364 20838777 2530313 -3869747 0 X X 0 1 X 1 0 X X 1 ADIRONDACK MEDICAL CENTER 141731786 3 1 622238 0 1 622238 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3232609 1163279 349 4396237 69038 3163543 28 3232609 69513 -475 69038 7447394 825 7378706 69513 7036690 398116 13088 500 7447394 0.01050 0.98950 0 0 0 DUE TO AFFILIATE 14847 14847 X PART V, LINE 4: 2022 CONTRIBUTIONS TO THE ENDOWMENT FUNDS ARE CORNERSTONE CAMPAIGN PLEDGES AND CONTRIBUTIONS. PART X, LINE 2: ADIRONDACK HEALTH (PREVIOUSLY DEFINED AS THE COLLECTIVE ENTITY) QUALIFIES AS NOT-FOR-PROFIT CORPORATIONS AND ARE EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ADIRONDACK HEALTH AND THE FOUNDATION HAVE BEEN CLASSIFIED BY THE INTERNAL REVENUE SERVICE (IRS) AS ENTITIES THAT ARE NOT PRIVATE FOUNDATIONS. AS OF DECEMBER 31, 2022 AND 2021, ADIRONDACK HEALTH DID NOT HAVE ANY UNRECOGNIZED TAX BENEFITS OR LIABILITIES OR ANY RELATED ACCRUED INTEREST OR PENALTIES. ADIRONDACK HEALTH DOES NOT ANTICIPATE THAT THE TOTAL UNRECOGNIZED TAX BENEFITS OR LIABILITIES WILL CHANGE IN THE NEXT TWELVE MONTHS. THE TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2019 THROUGH 2022. GALA 136759 107090 29669 225 8965 20479 136759 107090 29669 225 8965 20479 29669 0 1 ADIRONDACK MEDICAL CENTER PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 141731786 501(C)(3) 0 369384 FMV GRANT FOR FUTURE CAPITAL PROJECTS ADIRONDACK MEDICAL CENTER PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 141731786 501(C)(3) 0 292854 FMV OTHER GRANTS & ASSISTANCE PART I, LINE 2: PROTOCOL CALLS FOR A GRANT RECIPIENT TO SUBMIT A PURCHASE ORDER OR RECEIPT TO THE EXECUTIVE DIRECTOR OF THE FOUNDATION FOR APPROVAL TO SHOW THE GRANT WILL BE USED APPROPRIATELY, PRIOR TO RECEIVING THE GRANT CHECK. GRANT RECIPIENTS ARE ASKED TO MAKE A PRESENTATION AT A FOUNDATION BOARD MEETING TO DISCUSS THEIR USE OF THE GRANT. 0 0 0 0 0 0 0 0 0 EVE BURNS DO TRUSTEE 0 672422 0 0 0 0 0 64472 0 180 0 737074 0 0 AARON KRAMER EX-OFFICIO 0 326842 0 29090 0 0 0 13258 0 180 0 369370 0 0 HANNAH HANFORD EXECUTIVE DIRECTOR 135112 0 0 0 0 0 6600 0 11021 0 152733 0 0 0 X 7 206503 FMV 0 0 0 FORM 990, PART VI, SECTION A, LINE 6 ADIRONDACK MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF THE FOUNDATION. FORM 990, PART VI, SECTION A, LINE 7A ADIRONDACK MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF THE ADIRONDACK MEDICAL CENTER FOUNDATION. AS SUCH, ADIRONDACK MEDICAL CENTER APPROVES MEMBERS OF THE ADIRONDACK MEDICAL CENTER FOUNDATION'S BOARD OF TRUSTEES, BYLAWS AND ANNUAL BUDGET. FORM 990, PART VI, SECTION A, LINE 7B CERTAIN DECISIONS MADE BY THE ADIRONDACK MEDICAL CENTER FOUNDATION'S BOARD OF TRUSTEES ARE SUBJECT TO APPROVAL BY THE BOARD OF TRUSTEES OF THE ADIRONDACK MEDICAL CENTER. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PRESENTED FOR REVIEW AND APPROVAL BY THE BOARD OF TRUSTEES PRIOR TO FILING THE 990. FORM 990, PART VI, SECTION B, LINE 12C STATEMENTS ARE REQUIRED ANNUALLY BY THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 15 THE SALARY OF THE EXECUTIVE DIRECTOR IS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES WORKING IN CONJUNCTION WITH THE PRESIDENT/CEO OF ADIRONDACK MEDICAL CENTER BASED UPON THE RECOMMENDATION OF THE CHIEF HR OFFICER (CHRO). THE CHRO USES INDUSTRY SURVEYS SUCH AS THE IROQUOIS SURVEY, COMP DATA SURVEY AND ASSOCIATION OF HEALTHCARE PHILANTHROPY SALARY AND BENEFIT SURVEY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR. ADIRONDACK MEDICAL CENTER PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 141731786 ACUTE, SKILLED NURSING AND OUTPATIENT SERVICES NY 501(C)(3) LINE 3 ADIRONDACK MEDICAL CENTER 0 ADIRONDACK HEALTH REGIONAL MEDICAL PC PO BOX 471 2233 STATE ROUTE 86 SARANAC LAKE NY 12983 475676016 SUPPORT AND ASSIST ADIRONDACK MEDICAL CENTER NY 501(C)(3) BOX 11 ADIRONDACK MEDICAL CENTER 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 1 0 0 0