2024-11-15T14:31:13-06:00 2023-12-31 161131146 BONADIO & CO LLP 432 NORTH FRANKLIN STREET SYRACUSE NY 13204 990 2023-01-01 150559686 CLAXTON-HEPBURN MEDICAL CENTER CLAX 3153938880 214 KING STREET OGDENSBURG NY 13669 RICHARD DUVALL PRESIDENT AND CHIEF EXECUTIVE OFFIC 3153938880 2024-11-15 1 0 TIMOTHY HAMMOND P01224809 3154227109 2024-11-15 2023 2024-10-15 13:58:12Z RICHARD DUVALL 214 KING STREET OGDENSBURG NY 13669 145001371 0 X HTTPS://WWW.CLAXTONHEPBURN.ORG/ X 1917 NY CLAXTON-HEPBURN MEDICAL CENTER OPERATES ACUTE CARE AND PSYCHIATRIC FACILITIES IN OGDENSBURG, NY SERVICING PATIENTS PRIMARILY FROM ST. LAWRENCE COUNTY. 19 14 897 120 0 0 12765611 22195104 107614599 116678829 -84144 25610 3646316 4167136 123942382 143066679 0 0 0 0 55790712 54274018 0 0 0 68074936 74508201 123865648 128782219 76734 14284460 140540897 161254905 66049455 70779431 74491442 90475474 TO MEET OUR REGION'S HEALTHCARE NEEDS WITH COMPASSION AND EXCELLENCE. SIGNIFICANT ACTIVITIES: INPATIENT, OUTPATIENT, AND EMERGENCY CARE. 0 0 98229170 120845965 CLAXTON-HEPBURN MEDICAL CENTER IS LOCATED IN OGDENSBURG, NY AND IS A NOT-FOR-PROFIT HOSPITAL. THE HOSPITAL PROVIDES ACUTE INPATIENT SERVICES, PRIMARY CARE, MEDICAL SURGICAL, INTENSIVE CARE, OBSTETRICS SERVICES AND NURSERY SERVICES AS WELL AS MAINTAINS AN EMERGENCY DEPT, AMBULATORY SURGERY, HOME HEMODIALYSIS AND MENTAL HEALTH CENTER. MED SURG DAYS EXCLUDING SWING WERE 6,336, ICU PATIENT DAYS WERE 1,661, MENTAL HEALTH PATIENT DAYS WERE 12,302, AND ER PATIENT VISITS WERE 13,858 IN 2023. 98229170 1 1 0 1 0 0 0 0 0 0 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 83 0 1 897 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 EMILY GAZDA 3154931000 40 FRANKLIN STREET CARTHAGE NY 13619 MICHAEL OAKLEY MD DIRECTOR / PHYSICIAN UNTIL APRIL 2023 40.00 1.00 X 88492 0 3821 RICHARD DUVALL PRESIDENT AND CHIEF EXECUTIVE OFFICER 20.00 22.00 X X 649370 0 37353 CHRISTOPHER BRANDY DIRECTOR 3.00 1.00 X 1884750 0 0 DR ZVI SZAFRAN CHAIRPERSON 3.00 X X 0 0 0 CHET TRUSKOWSKI VICE-CHAIRPERSON 3.00 1.00 X X 0 0 0 MARK MASHAW DIRECTOR 3.00 1.00 X 0 0 0 JAMES CROWLEY DIRECTOR 3.00 X 0 0 0 RITA CROWLEY DIRECTOR / NURSE PRACTITIONER UNTIL APRIL 2023 40.00 X 122881 0 30082 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 (THRU FEB 2023) 3.00 X 0 0 0 SANDRA LYONS DIRECTOR (THRU MAR 2023) 3.00 1.00 X 0 0 0 DAWN MERZ DIRECTOR 3.00 X 0 0 0 MAUREEN MISSERT DIRECTOR 3.00 1.00 X 0 0 0 KOME OSEGHALE MD PHYSICIAN / DIRECTOR (THRU APR 2023) 40.00 X 180379 0 16692 JOHN PINKERTON DIRECTOR 3.00 X 0 0 0 DALLAS SUTTON SECRETARY 3.00 X X 0 0 0 JAMES THEW TREASURER 3.00 1.00 X X 0 0 0 PATRICIA MAHONEY DIRECTOR 3.00 X 0 0 0 SHEILA MEHAFFY DIRECTOR 3.00 X 0 0 0 DHRUV MODI DIRECTOR 3.00 X 343815 0 35620 CRYSTAL SIMMONS DIRECTOR 3.00 X 127304 0 31701 ALKA SRIVASTAVA DIRECTOR 3.00 X 406095 0 20669 MICHAEL SEIDMAN DIRECTOR 40.00 1.00 X 543436 0 9900 BRANDON BOWLINE CHIEF OPERATING OFFICER 3.00 37.00 X X 301793 0 9074 DAVID BOYCE PHYSICIAN 40.00 X 790867 0 37353 THOMAS HERZOG PHYSICIAN 40.00 X 648038 0 21992 MANASVI JAITLY PHYSICIAN 40.00 X 569220 0 37353 FRANCIS LEE PHYSICIAN 40.00 X 519484 0 37353 JOHN SCHAEFER PHYSICIAN 40.00 X 464553 0 37353 7640477 0 366316 123 0 1 0 QUORUM HEALTH RESOURCES LLC 1573 MALLORY LANE BRENTWOOD TN 37027 REVENUE CYCLE MANAGEMENT 13087660 DAVIN HEALTHCARE WORKFORCE SOLUTIONS 18 DIVISION STREET SARATOGA SPRINGS NY 12866 STAFFING SERVICES 3964142 DELPHI HOSPITALIST SERVICES 1160 CHILI AVENUE ROCHESTER NY 14624 STAFFING SERVICES 3438582 CARTHAGE AREA HOSPITAL 1001 WEST STREET CARTHAGE NY 13619 SHARED SERVICES 3070008 DR CHRISTOPHER BRANDY 305 MAIN STREET OGDENSBURG NY 13669 PHYSICIAN SERVICES 1878298 42 22145576 49528 22195104 PATIENT SERVICE REVENUE 621990 115403818 115403818 340B REVENUE 621990 1275011 1275011 116678829 14094 14094 1946208 1934692 11516 11516 11516 ALL OTHER REVENUE 900099 3720541 3720541 CAFETERIA 900099 187001 187001 AUXILIARY 900099 186260 186260 73334 73334 4167136 143066679 120845965 0 25610 997590 997590 43408042 37843035 5565007 2677476 2300353 377123 3630330 3120471 509859 3560580 3037547 523033 380384 10850 369534 450196 450196 181451 181451 261489 236228 25261 1276593 272812 1003781 439936 389545 50391 238506 210921 27585 3505356 2988359 516997 875937 98979 776958 PURCHASED SERVICES 28273940 13584301 14689639 MEDICAL SUPPLIES 22967469 20748746 2218723 PHYSICIAN FEES 12145652 12103445 42207 OTHER EXPENSES 2185621 457931 1727690 0 1325671 825647 500024 128782219 98229170 30553049 0 3049217 8233270 1902417 12142 14999320 24579480 1787589 820728 1791255 1740275 1012627 1138213 135222094 106176612 31343300 29045482 13167 3402 84642005 95681913 140540897 161254905 33519755 44363741 4247366 0 3091329 2194891 4367662 4604931 20823343 19615868 66049455 70779431 X 71367048 86791359 3124394 3684115 74491442 90475474 140540897 161254905 X 14284460 15875 1683697 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 9742 9742 0 PART II-B, LINE 1: A PORTION OF MEMBERSHIP DUES PAID TO IHA ARE USED FOR LOBBYING PURPOSES. 3209431 188109 -139267 133879 3124394 3018895 273967 87457 170888 3209431 2857654 68386 -92855 3018895 2732558 -24492 -149588 2857654 526509 526509 68688037 44823848 23864189 556885 341356 215529 62717568 58175172 4542396 2733095 2836236 -103141 29045482 OTHER ASSETS 1425883 RIGHT OF USE ASSET - FINANCING LEASES 2147411 INTEREST IN NET ASSETS OF CLAXTON-HEPBURN MEDICAL CENTER FOUNDATION, INC. 15195432 DUE FROM AFFILIATE 75966709 RIGHT OF USE ASSET - OPERATING LEASES 671117 ASSETS LIMITED AS TO USE 68178 CASH ADVANCE DEPOSIT 71100 SELF INSURANCE ASSET 136083 95681913 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 7389423 ACCRUED PENSION LIABILITY 5132576 POSTRETIREMENT BENEFIT LIABILITY 1795270 OTHER LIABILITIES 978673 LEASE LIABILITY - OPERATING LEASES 657928 CASH OVERDRAFT 1483554 LEASE LIABILITY - FINANCING LEASES 2178444 19615868 1 1 X 1 X 1 X 0 1 1 0 1 1 1368110 1797343 0 0.00000 30814473 19623795 11190678 0.08690 32182583 21421138 11190678 0.08690 77718375 52089555 25628820 0.19900 77718375 52089555 25628820 0.19900 109900958 73510693 36819498 0.28590 1621 1621 0.00000 15376 15376 0.00010 5386 5386 0.00000 22383 22383 0.00010 7411935 3936579 18434266 23693313 -5259047 X 1 1 1 1 CLAXTON-HEPBURN MEDICAL CENTER 214 KING STREET OGDENSBURG NY 13669 HTTPS://WWW.CLAXTONHEPBURN.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 HTTPS://WWW.CLAXTONHEPBURN.ORG/IMAGES/-1-WEBSITE-FA-POLICY.PDF X HTTPS://WWW.CLAXTONHEPBURN.ORG/DOCUMENTS/FAP-WEBSITE-APP_08.2023.PDF X HTTPS://WWW.CLAXTONHEPBURN.ORG/IMAGES/PLAIN-LANGUAGE-SUMMARY-WEBSITE.PDF 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 FEDERAL AND STATE LAW AND NEW YORK STATE DEPARTMENT OF HEALTH REGULATIONS, THE HOSPITAL 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 AREA HOSPITALS, MEMBERS FROM ACADEMIA, GOVERNMENT, HUMAN SERVICES AGENCIES, CIVIC GROUPS, AND THE PRIVATE SECTOR. ADDITIONALLY, THE HOSPITAL 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 THE HOSPITAL'S WEBSITE, ITS PARTNERING AGENCIES WEBSITES, AND IN PAPER COPY UPON REQUEST. 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 THE ST. LAWRENCE COUNTY BRIDGE TO WELLNESS COALITION THAT THE HOSPITAL 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: THE HOSPITAL HAS AN OPEN MEDICAL STAFF, ALLOWS OUTSIDE ORGANIZATIONS TO USE HOSPITAL SPACE WITHOUT COST, HAS AN INDEPENDENT COMMUNITY-BASED BOARD, PROVIDED CHARITY CARE, WORKS WITH LOCAL AGENCIES TO PROVIDE FREE OR REDUCED COST CANCER SCREENINGS, AND PROVIDES FREE ON-SITE FACILITATED ENROLLMENT FOR THE UNINSURED. PART III, LINE 3: PATIENT ACCOUNTS RECEIVABLE ARE REDUCED BY AN IMPLICIT PRICE CONCESSION. 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 ESTIMATE THE APPROPRIATE PRICE CONCESSIONS. FOR RECEIVABLES ASSOCIATED WITH PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS, 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 RECOGNIZES PRICE CONCESSIONS IN THE PRIOD OF SERVICE BASED ON PAST EXPERIENCE, INCLUDING CONSIDERATION OF CURRENT BUSINESS ANE ECONOMIC CONDITIONS. WHEN THE HOSPITAL ESTABLISHES PRICE CONCESSIONS 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 HAVE BEEN EXHAUSTED.THE HOSPITAL'S ALLOWANCE FOR IMPLICIT PRICE CONCESSIONS WAS 56.33% AND 50.60% OF THE RELATED ACCOUNTS RECEIVABLE AT DECEMBER 31, 2023 AND 2022, 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: THE HOSPITAL 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: THE HOSPITAL 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 HOSPITAL ASSOCIATION OF NEW YORK STATE 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 INFORMATION PATIENT 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. THE HOSPITAL 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: THE HOSPITAL IS A PRIVATE, NOT-FOR-PROFIT, 127 BED COMMUNITY HOSPITAL AND REGIONAL REFERRAL CENTER. THE HOSPITAL 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 HOSPITAL PROVIDES PRIMARY CARE TO NEARLY 40,000 RESIDENTS OF OGDENSBURG AND SURROUNDING COMMUNITIES AND REGIONAL SERVICES TO THE 107,000 PEOPLE OF ST. LAWRENCE COUNTY.THE HOSPITAL HAS AN ACTIVE MEDICAL STAFF OF MORE THAN 50 PHYSICIANS REPRESENTING MOST SPECIALTIES. REGIONAL 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 IN OGDENSBURG AND MASSENA-CORNWALL INTERNATIONAL BRIDGE NEAR MASSENA. THE SOUTHEASTERN THIRD OF THE COUNTY, 953 SQUARE MILES, IS WITHIN THE HEAVILY FORESTED ADIRONDACK REGION.ST. LAWRENCE COUNTY IS PREDOMINATELY RURAL, LOCATED BETWEEN THE ADIRONDACK MOUNTAINS AND THE ST. LAWRENCE RIVER IN NORTHERN NEW YORK. THE COUNTY IS COMPRISED OF 32 TOWNS AND A SINGLE CITY. THE LARGEST COUNTY SUBDIVISIONS ARE THE CITY OF OGDENSBURG AND THE TOWNS OF POTSDAM, MASSENA, CANTON AND GOUVERNEUR. AS OF 2023, THE COUNTY HAD AN ESTIMATED POPULATION OF 106,940. NEARLY 19% OF RESIDENTS ARE OVER 65 YEARS OLD. AMONG RESIDENTS 16 AND OVER, 53% ARE IN THE CIVILIAN LABOR FORCE, WHICH IS LOWER THAN THE STATEWIDE RATE (63%), AND THE NATIONAL RATE (63%). THE UNEMPLOYMENT RATE WAS REPORTED BY THE USDA ECONOMIC RESEARCH SERVICE TO BE AT 4.2% IN 2022. NEARLY 13% OF THOSE 65 AND UNDER ARE LIVING WITH A DISABILITY, MARKEDLY HIGHER THAN THE STATEWIDE AND NATIONAL AVERAGES AT 8% AND 9% RESPECTIVELY.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, WHICH IS COMPARABLE WITH THE REGION BUT LOWER THAN NATIONAL AND STATE PERCENTAGES. MEDIAN HOUSEHOLD INCOME FOR 2021 IN ST. LAWRENCE COUNTY IS ESTIMATED AT $55,500 - 25% LOWER THAN THE STATEWIDE VALUE OF $74,000. THIS PATTERN HAS PERSISTED OVER HISTORY.ST. LAWRENCE COUNTY IS 92% NON-HISPANIC WHITE. THE LARGEST MINORITY GROUPS ARE HISPANIC OR LATINO (2.6%), BLACK NON-HISPANIC (2.1%), TWO OR MORE RACES (1.6%), 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 HAVING LESS DIVERSE POPULATIONS. 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 HOSPITAL AND CLAXTON-HEPBURN MEDICAL CENTER WERE RESPONSIBLE FOR THE LARGEST NUMBER OF INPATIENT AND OUTPATIENT VISITS FOR RESIDENTS OF ST. LAWRENCE COUNTY.THE 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 OVERWEIGHTADULTS 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 1884750 0 0 0 0 0 0 0 0 0 1884750 0 0 0 DAVID BOYCE PHYSICIAN 790867 0 0 0 0 0 9900 0 27453 0 828220 0 0 0 RICHARD DUVALL PRESIDENT AND CHIEF EXECUTIVE OFFICE 649370 0 0 0 0 0 9900 0 27453 0 686723 0 0 0 THOMAS HERZOG PHYSICIAN 648038 0 0 0 0 0 9900 0 12092 0 670030 0 0 0 MANASVI JAITLY PHYSICIAN 569220 0 0 0 0 0 9900 0 27453 0 606573 0 0 0 FRANCIS LEE PHYSICIAN 519484 0 0 0 0 0 9900 0 27453 0 556837 0 0 0 MICHAEL SEIDMAN DIRECTOR 543436 0 0 0 0 0 9900 0 0 0 553336 0 0 0 JOHN SCHAEFER PHYSICIAN 464553 0 0 0 0 0 9900 0 27453 0 501906 0 0 0 ALKA SRIVASTAVA DIRECTOR 406095 0 0 0 0 0 9900 0 10769 0 426764 0 0 0 DHRUV MODI DIRECTOR 343815 0 0 0 0 0 9900 0 25720 0 379435 0 0 0 BRANDON BOWLINE CHIEF OPERATING OFFICER 301793 0 0 0 0 0 9074 0 0 0 310867 0 0 0 KOME OSEGHALE MD PHYSICIAN / DIRECTOR (THRU APR 2023) 180379 0 0 0 0 0 5563 0 11129 0 197071 0 0 0 CRYSTAL SIMMONS DIRECTOR 127304 0 0 0 0 0 4248 0 27453 0 159005 0 0 0 RITA CROWLEY DIRECTOR / NURSE PRACTITIONER UNTIL 122881 0 0 0 0 0 4002 0 26080 0 152963 0 0 0 ELLEN PLUTA FAMILY MEMBER OF CHET TRUSKOWSKI, OFFICER 86628 EMPLOYEE COMPENSATION 0 RITA CROWLEY DIRECTOR AND FAMILY MEMBER OF JAMES CROWLEY, DIRECTOR 133400 EMPLOYEE COMPENSATION 0 RACHEL ZYSK FAMILY MEMBER OF RICHARD DUVALL, OFFICER 183750 EMPLOYEE COMPENSATION 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 OF DIRECTORS FOR REVIEW BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS CONTRACTS WITH AN EXTERNAL CONSULTING FIRM TO WORK WITH THE EXECUTIVE COMMITTEE TO ENSURE COMPLIANCE WITH IRC 4598 AND CONFLICT OF INTEREST DISCLOSURE. THROUGH THIS PROCESS, DIRECTORS DISCLOSE CONFLICTS OF INTEREST ANNUALLY IN WRITING, AFTER REVIEWING THE CORPORATE POLICY. THESE CONFLICTS ARE REVIEWED BY THE FULL BOARD OF DIRECTORS ANNUALLY AND ARE KEPT ON FILE. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS OF CONTRACTS WITH AN INDEPENDENT SALARY COMPENSATION SPECIALIST TO ADVISE ITS EXECUTIVE COMMITTEE ON SETTING COMPENSATION FOR THE CHIEF EXECUTIVE OFFICER AND OTHER OFFICERS AND KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FUNDED STATUS OF PENSION AND POSTRETIREMENT PLANS 720,800. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP LIABILITY -9,765. CHANGE IN INTEREST IN CLAXTON-HEPBURN MEDICAL CENTER FOUNDATION, INC. 1,822,724. EQUITY IN OPERATION OF INVESTEE -107,020. OTHER COMPONENTS OF NET PERIODIC BENEFIT COST -743,042. NORTH STAR HEALTH ALLIANCE INC 214 KING STREET OGDENSBURG NY 13669 161449491 HOLDING COMPANY NY 501(C)(3) LINE 12B, II N/A 0 CLAXTON-HEPBURN MEDICAL CENTER FOUNDATION INC 125 NEW YORK AVENUE OGDENSBURG NY 13669 222488389 FUNDRAISING NY 501(C)(3) LINE 12B, II NORTH STAR HEALTH ALLIANCE INC 0 CLAXTON MEDICAL PC 214 KING STREET OGDENSBURG NY 13669 264009395 SPECIALTY HEALTHCARE SERVICES NY 501(C)(3) LINE 12B, II CLAXTON-HEPBURN MEDICAL CENTER 1 CARTHAGE AREA HOSPITAL 1001 WEST STREET CARTHAGE NY 13619 150622079 HEALTHCARE SERVICES NY 501(C)(3) LINE 3 NORTH STAR HEALTH ALLIANCE INC 0 MEADOWBROOK TERRACE INC 21957 COLE ROAD CARTHAGE NY 13619 454102458 ASSISTED LIVING NY 501(C)(3) LINE 10 CARTHAGE AREA HOSPITAL 0 CARTHAGE AREA HOSPITAL FOUNDATION INC 3 BRIDGE STREET CARTHAGE NY 13619 161467023 FUNDRAISING NY 501(C)(3) LINE 7 CARTHAGE AREA HOSPITAL 0 NORTH COUNTRY ORTHOPEDIC AMBULATORY SURGERY CENTER LLC 1571 WASHINGTON STREET SUITE 201 WATERTOWN NY 13601 731653922 SURGICAL SERVICES NY N/A 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 CLAXTON MEDICAL PC E 75966709 BOOK VALUE