Skip to content
Nonprofiteer
← CHENANGO MEMORIAL HOSPITAL INC

Form 990 for tax year 2022

Filed by CHENANGO MEMORIAL HOSPITAL INC.

Totals

Total revenue
$90,798,708
Total expenses
$87,686,631
Contributions and grants received
$6,127,988
Grants paid
$0
Program service revenue
$83,132,744
Investment income
$158,369
Other revenue
$1,379,607
Total assets, end of year
$91,116,827
Total liabilities, end of year
$39,316,179
Net assets or fund balances, end of year
$51,800,648
Program services expenses (Part IX)
$76,266,988
Management and general expenses
$11,419,643
Fundraising expenses
$0
Program service expenses (Part III)
$76,266,988

Program services were 87.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1b · Membership dues

    $1,150

  • 1e · Government grants (contributions)

    $5,149,246

  • 1f · All other contributions, gifts and grants

    $977,592

  • 2a · Program service revenue: OUTPATIENT AND AMBULATORY SERVICE

    total $55,560,988 · related or exempt $55,560,988

  • 2b · Program service revenue: INPATIENT, ACUTE AND LONG TERM SK

    total $18,068,948 · related or exempt $18,068,948

  • 2c · Program service revenue: CLINICS

    total $9,502,808 · related or exempt $9,502,808

  • 3 · Investment income

    total $369,057 · excluded $369,057

  • 6a · Gross rents

    real property $3,600

  • 6b · Less rental expenses

    real property $0

  • 6c · Rental income or loss

    real property $3,600

  • 6d · Net rental income or loss

    total $3,600 · unrelated business $3,600

  • 7b · Less cost or other basis and sales expenses

    other assets $210,688

  • 7c · Gain or loss

    other assets -$210,688

  • 7d · Net gain or loss

    total -$210,688 · excluded -$210,688

  • 11a · Other revenue: NON OPERATING REVENUE

    total $697,419 · related or exempt $697,419

  • 11b · Other revenue: OTHER OPERATING REVENUE

    total $651,532 · related or exempt $651,532

  • 11c · Other revenue: CAFETERIA REVENUE

    total $7,999 · related or exempt $7,999

  • 11d · All other revenue

    total $19,057 · excluded $19,057

  • 11e · Other revenue, total

    $1,376,007

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $2,686,627 · program services $2,686,627

  • 7 · Other salaries and wages

    total $21,785,483 · program services $18,971,370 · management and general $2,814,113

  • 8 · Pension plan contributions

    total $871,544 · program services $758,243 · management and general $113,301

  • 9 · Other employee benefits

    total $3,015,836 · program services $2,641,434 · management and general $374,402

  • 10 · Payroll taxes

    total $1,653,226 · program services $1,438,307 · management and general $214,919

  • 11a · Fees: management

    total $844,393 · management and general $844,393

  • 11b · Fees: legal

    total $55,419 · management and general $55,419

  • 11c · Fees: accounting

    total $89,516 · management and general $89,516

  • 11d · Fees: lobbying

    total $12,431 · management and general $12,431

  • 11g · Fees: other

    total $16,824,078 · program services $14,636,948 · management and general $2,187,130

  • 12 · Advertising and promotion

    total $76,331 · program services $1,698 · management and general $74,633

  • 13 · Office expenses

    total $229,833 · program services $120,024 · management and general $109,809

  • 14 · Information technology

    total $225,981 · program services $223,241 · management and general $2,740

  • 16 · Occupancy

    total $1,528,061 · program services $1,327,849 · management and general $200,212

  • 17 · Travel

    total $75,522 · program services $39,616 · management and general $35,906

  • 20 · Interest

    total $574,404 · program services $574,404

  • 22 · Depreciation, depletion and amortization

    total $4,094,366 · program services $4,094,366

  • 23 · Insurance

    total $680,149 · program services $680,149

  • 24a · Other expenses: SUPPLIES

    total $27,263,070 · program services $23,661,413 · management and general $3,601,657

  • 24b · Other expenses: BAD DEBTS

    total $2,304,237 · program services $2,304,237

  • 24c · Other expenses: NEW YORK STATE CASH REC

    total $443,182 · program services $443,182

  • 24d · Other expenses: MISCELLANEOUS AUXILLARY

    total $7,361 · program services $7,361

  • 24e · All other expenses

    total $2,345,581 · program services $1,656,519 · management and general $689,062

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $15,433,504 · end of year $12,488,629

  • 3 · Pledges and grants receivable

    beginning of year $7,440,372 · end of year $6,119,022

  • 4 · Accounts receivable

    beginning of year $8,045,908 · end of year $8,544,100

  • 8 · Inventories for sale or use

    beginning of year $708,498 · end of year $803,083

  • 9 · Prepaid expenses and deferred charges

    beginning of year $669,872 · end of year $1,501,243

  • 10a · Land, buildings and equipment: cost or other basis

    $117,024,356

  • 10b · Land, buildings and equipment: accumulated depreciation

    $66,935,615

  • 10c · Land, buildings and equipment, net

    beginning of year $46,169,200 · end of year $50,088,741

  • 12 · Investments: other securities

    beginning of year $148,033 · end of year $125,605

  • 15 · Other assets

    beginning of year $12,463,162 · end of year $11,446,404

  • 17 · Accounts payable and accrued expenses

    beginning of year $7,074,816 · end of year $7,694,607

  • 23 · Secured mortgages and notes payable

    beginning of year $9,599,087 · end of year $13,100,895

  • 25 · Other liabilities

    beginning of year $27,052,548 · end of year $18,520,677

  • 27 · Net assets without donor restrictions

    beginning of year $24,645,677 · end of year $44,052,620

  • 28 · Net assets with donor restrictions

    beginning of year $22,706,421 · end of year $7,748,028

Mission and programs · 2022

Mission

(SEE SCHEDULE O)CHENANGO MEMORIAL HOSPITAL, INC. (THE HOSPITAL) IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO OPERATE ACUTE AND SKILLED NURSING FACILITIES IN NORWICH, NEW YORK. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF CHENANGO AND SURROUNDING COUNTIES.

Activities or mission (Part I)

(SEE SCHUDULE O)CHENANGO MEMORIAL HOSPITAL, INC. (THE HOSPITAL) IS A NOT-FOR-PROFIT CORPORATION ORGANIZED TO OPERATE ACUTE AND SKILLED NURSING FACILITIES IN NORWICH, NEW YORK. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF CHENANGO AND SURROUNDING COUNTIES.

  • INPATIENT, ACUTE AND LONG TERM SKILLED NURSING SERVICES- CHENANGO MEMORIAL HOSPITAL FULFILLS ITS MISSION BY WORKING TOGETHER WITH THE COMMUNITY, PHYSICIANS AND OTHER HEALTH CARE PROVIDERS TO CONTINUOUSLY IMPROVE THE AVAILABILITY AND QUALITY OF SERVICES AND THE ABILITY TO PROVIDE A COMPREHENSIVE RANGE OF SHORT-TERM INPATIENT ACUTE SERVICES AND LONG-TERM SKILLED NURSING CARE. CHENANGO MEMORIAL HOSPITAL PROVIDES A WIDE RANGE OF MEDICAL-SURGICAL SERVICES, INCLUDING: OPHTHALMOLOGY, EMERGENCY MEDICINE, MATERNITY CARE, PULMONARY MEDICINE, AND PEDIATRICS. TOTAL INPATIENT DAYS FOR THE YEAR ENDED DECEMBER 31, 2022 WAS 4,685. DISCHARGES WERE 1,273, AND AVERAGE LENGTH OF STAY WAS 3.68 DAYS. LONG TERM SKILLED NURSING DAYS WERE 10,834. THERE WERE 201 BIRTHS AND 199 INPATIENT SURGERIES PERFORMED AT CHENANGO MEMORIAL HOSPITAL IN 2022. IN 2022, CHENANGO MEMORIAL HOSPITAL GAVE FINANCIAL ASSISTANCE TO 59 INDIVIDUALS FOR WHICH $558,551 OF INPATIENT CARE (AT CHARGES) WAS PROVIDED.

    Expenses $21,481,407 · Revenue $18,068,948

  • OUTPATIENT AND AMBULATORY SERVICES- CHENANGO MEMORIAL HOSPITAL ALSO PROVIDES A WIDE RANGE OF OUTPATIENT DIAGNOSTIC AND TREATMENT SERVICES, INCLUDING EMERGENCY DEPARTMENT, AMBULATORY SURGERY, FULL-SERVICE LABORATORY, COMPREHENSIVE IMAGING AND OTHER PROCEDURAL OUTPATIENT SERVICES. TOTAL PATIENT VISITS FOR OUTPATIENT SERVICES FOR YEAR-ENDED 2022 WAS 185,396. INCLUDED IN THE 185,396 VISITS WERE 15,372 EMERGENCY ROOM VISITS, 860 EMERGENCY ROOM TREATED AND ADMITTED AS ACUTE CARE PATIENTS, 3,699 VARIOUS OUTPATIENT SURGICAL CASES, AND 165,465 OTHER OUTPATIENT DEPARTMENT VISITS. IN 2022, CHENANGO MEMORIAL HOSPITAL GAVE FINANCIAL ASSISTANCE TO 2,153 INDIVIDUALS FOR WHICH $1,422,889 OF OUTPATIENT CARE (AT CHARGES) WAS PROVIDED.

    Expenses $36,941,035 · Revenue $55,560,988

  • CLINICS- CHENANGO MEMORIAL HOSPITAL PROVIDES A WIDE RANGE OF PRIMARY CARE AND SPECIALTY CARE CLINICS. PRIMARY CARE SERVICES ARE THE FOUNDATION FOR SERVING THE COMMUNITY WITH A COORDINATED SYSTEM OF CARE, WITH SPECIAL ATTENTION TO UNDER-SERVED AREAS. CMH OFFERS FIVE FAMILY HEALTH CENTERS LOCATED THROUGHOUT A MULTI-COUNTY SERVICE AREA: 1) NORWICH FAMILY HEALTH CENTER 2) INTERNAL MEDICINE 3) OXFORD FAMILY HEALTH CENTER 4) SHERBURNE FAMILY HEALTH CENTER AND 5) SIDNEY FAMILY HEALTH CENTER. OTHER OUTPATIENT SERVICES INCLUDE: GERIATRICS, WOMEN'S HEALTH CENTER, GENERAL SURGERY, HEART CENTER, GI, ORTHOPEDICS, PODIATRY, ONCOLOGY AND PAIN MANAGEMENT CLINIC. TOTAL PATIENT VISITS FOR THE CMH CLINICS AT YEAR-ENDED 2022 WAS 72,906.

    Expenses $17,844,546 · Revenue $9,502,808

  • Revenue $1,356,950

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • John M Carrigg

    BOARD MEMBER 2ND V CHAIR

    Total calculated
    $1,673,716
    From this org
    $0
    From related orgs
    $1,579,359
    Other
    $94,357
    Hours/week
    2 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $981,834 related
    Bonus
    $0 + $50,000 related
    Other
    $0 + $547,525 related
    Deferred
    $0 + $71,251 related
    Nontaxable benefits
    $0 + $23,106 related
    Filer's total
    $0 + $1,673,716 related

  • Elizabeth K Boland

    BOARD MEMBER

    Total calculated
    $824,331
    From this org
    $0
    From related orgs
    $724,570
    Other
    $99,761
    Hours/week
    2 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $629,157 related
    Bonus
    $0 + $95,000 related
    Other
    $0 + $413 related
    Deferred
    $0 + $83,984 related
    Nontaxable benefits
    $0 + $15,777 related
    Filer's total
    $0 + $824,331 related

  • Drake Lamen MD

    BOARD MEMBER/PRES/CEO/CMO

    Total calculated
    $376,040
    From this org
    $352,377
    From related orgs
    $0
    Other
    $23,663
    Hours/week
    57

    Schedule J breakdown matched by us

    Base
    $352,377
    Bonus
    $0
    Other
    $0
    Deferred
    $6,100
    Nontaxable benefits
    $17,563
    Filer's total
    $376,040

  • Catherine M Scarlett

    BOARD MEMBER/CHAIR TO 5/31/22

    Total calculated
    $0
    Hours/week
    2

  • Joseph R Stagliano

    BOARD MEMBER/CHAIR

    Total calculated
    $0
    Hours/week
    2

  • Heather Ferrarese

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Ric Festarini

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Eric G Larsen

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Denise Reppert

    BOARD MEMBER/PRES OF AUX

    Total calculated
    $0
    Hours/week
    2

  • Robert W Nassar

    BOARD MEMBER SECRETARY

    Total calculated
    $0
    Hours/week
    2

  • Julie Oehlbeck

    BOARD MEMBER TREASURER

    Total calculated
    $0
    Hours/week
    2

  • Bruce S Erath

    BOARD MEMBER 1ST VICE CHAIR

    Total calculated
    $0
    Hours/week
    2

  • Jay Smith

    BOARD MEMBER

    Total calculated
    $418,752
    From this org
    $0
    From related orgs
    $391,900
    Other
    $26,852
    Hours/week
    2 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $386,900 related
    Bonus
    $0 + $5,000 related
    Other
    $0
    Deferred
    $0 + $12,200 related
    Nontaxable benefits
    $0 + $14,652 related
    Filer's total
    $0 + $418,752 related

  • Carlos Santa Ines Jr MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Dominic Shea

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Martin Masarech MD

    BOARD MEMBER

    Total calculated
    $236,551
    From this org
    $0
    From related orgs
    $193,271
    Other
    $43,280
    Hours/week
    2 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $193,271 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $20,800 related
    Nontaxable benefits
    $0 + $22,480 related
    Filer's total
    $0 + $236,551 related

  • Kathleen Miratbito Voss

    BOARD MEMBER TO 5/31/22

    Total calculated
    $0
    Hours/week
    2

  • Shauna Hyle

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Kristina K Hummer

    VP OF MEDICAL

    Total calculated
    $206,056
    From this org
    $175,894
    From related orgs
    $0
    Other
    $30,162
    Hours/week
    1 + 55 related

    Schedule J breakdown matched by us

    Base
    $175,894
    Bonus
    $0
    Other
    $0
    Deferred
    $1,875
    Nontaxable benefits
    $28,287
    Filer's total
    $206,056

  • Desiree Axley

    VP FINANCE AND CFO

    Total calculated
    $214,155
    From this org
    $208,710
    From related orgs
    $0
    Other
    $5,445
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $208,710
    Bonus
    $0
    Other
    $0
    Deferred
    $4,237
    Nontaxable benefits
    $1,208
    Filer's total
    $214,155

  • David Finney

    VP, NURSING

    Total calculated
    $200,333
    From this org
    $0
    From related orgs
    $161,481
    Other
    $38,852
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $0 + $161,481 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0 + $10,958 related
    Nontaxable benefits
    $0 + $27,894 related
    Filer's total
    $0 + $200,333 related

  • Christina Kisacky

    VP OF OPERATIONS

    Total calculated
    $197,192
    From this org
    $173,540
    From related orgs
    $0
    Other
    $23,652
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $173,540
    Bonus
    $0
    Other
    $0
    Deferred
    $3,609
    Nontaxable benefits
    $20,043
    Filer's total
    $197,192

  • Wendy Surdoval

    VP OF QUALITY MGMT

    Total calculated
    $139,536
    From this org
    $135,189
    From related orgs
    $0
    Other
    $4,347
    Hours/week
    55

  • Phyllis Sheriff-White

    PRES OF MED STAFF

    Total calculated
    $350,651
    From this org
    $325,977
    From related orgs
    $0
    Other
    $24,674
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $325,977
    Bonus
    $0
    Other
    $0
    Deferred
    $3,050
    Nontaxable benefits
    $21,624
    Filer's total
    $350,651

  • Margaret Swartwood

    CONTROLLER

    Total calculated
    $178,745
    From this org
    $162,675
    From related orgs
    $0
    Other
    $16,070
    Hours/week
    55

    Schedule J breakdown matched by us

    Base
    $162,675
    Bonus
    $0
    Other
    $0
    Deferred
    $3,284
    Nontaxable benefits
    $12,786
    Filer's total
    $178,745

  • Richard Stone

    DIRECTOR OF SUPP SERV-FAC

    Total calculated
    $149,016
    From this org
    $118,107
    From related orgs
    $0
    Other
    $30,909
    Hours/week
    55

  • Braxton Tomsic

    CARDIAC CARE MGR

    Total calculated
    $118,965
    From this org
    $104,374
    From related orgs
    $0
    Other
    $14,591
    Hours/week
    55

  • Melissa Stagnaro

    EXEC DIR FOUNDATION

    Total calculated
    $133,080
    From this org
    $102,551
    From related orgs
    $0
    Other
    $30,529
    Hours/week
    55

  • Leia Tracy

    STAFF NURSE

    Total calculated
    $140,248
    From this org
    $128,479
    From related orgs
    $0
    Other
    $11,769
    Hours/week
    55

  • Patricia Adams

    NURSING SUPERVISOR

    Total calculated
    $132,538
    From this org
    $129,528
    From related orgs
    $0
    Other
    $3,010
    Hours/week
    55

  • Matthew Salanger To 53118

    FORMER 2ND VICE CHAIR

    Total calculated
    $253,307
    From this org
    $0
    From related orgs
    $253,227
    Other
    $80
    Hours/week
    0 + 20 related

    Schedule J breakdown matched by us

    Base
    $0 + $253,227 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $80 related
    Filer's total
    $0 + $253,307 related

  • Rohan Jayasena

    FORMER PRES OF MED STAFF TO 12/31/17

    Total calculated
    $438,862
    From this org
    $387,239
    From related orgs
    $0
    Other
    $51,623
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $386,939
    Bonus
    $300
    Other
    $0
    Deferred
    $27,000
    Nontaxable benefits
    $24,623
    Filer's total
    $438,862

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 4B
PAYMENT IN 2022 FROM A NON-QUALIFIED PLAN: JOHN CARRIGG $540,006 RE: SCHEDULE J, PART II, LINE 1, BIII - OTHER REPORTABLE COMPENSATION IN THE AMOUNT OF $540,006 INCLUDES NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). EARLY SERP DISTRIBUTIONS WERE RELATED TO INCOME TAX PAYMENTS; THE REMAINING AMOUNTS ARE DEFERRED UNTIL SUBSEQUENT TRIGGERING EVENTS.
PART I, LINE 6
THE EXECUTIVE COMPENSATION INCENTIVE PLAN HAS VARIOUS PERFORMANCE MEASURES WHICH INCLUDE ONES FOR CLINICAL EXCELLENCE, MARKET GROWTH, AND FINANCIAL STRENGTH. ONE MEASURE UNDER THE FINANCIAL STRENGTH HEADING IS THE COMBINED NET INCOME OF THE UNITED HEALTH SERVICES SYSTEM. A PORTION OF THE 2022 INCENTIVE COMPENSATION PAYMENTS WERE ATTRIBUTABLE TO MEETING THE COMBINED NET INCOME, PATIENT SAFETY, AND QUALITY GOALS.
FORM 990, PART VII, SECTION A, LINE 5:
INDIVIDUAL: KRISTINA HUMMER, D.O. UNRELATED ORGANIZATION: UNITED MEDICAL ASSOCIATES, INC. TYPE AND AMOUNT OF COMPENSATION: $175,894
FORM 990, PART VII, SECTION A, LINE 5:
INDIVIDUAL: PHYLLIS SHERIFF-WHITE, M.D. UNRELATED ORGANIZATION: UNITED MEDICAL ASSOCIATES, INC. TYPE AND AMOUNT OF COMPENSATION: $325,977
FORM 990, PART VII, SECTION A, LINE 5:
INDIVIDUAL: ROHAN JAYASENA, M.D. UNRELATED ORGANIZATION: UNITED MEDICAL ASSOCIATES, INC. TYPE AND AMOUNT OF COMPENSATION: $387,239

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • PATHWAY HEALTH MANAGEMENT INC

    C · WINDING DOWN OF MANAGEMENT SERVICES TO SUSQUEHANNA MEDICAL ASSOCIATES · NY

  • CHENANGO MADA INC

    C · INACTIVE · NY · 100% owned · controlled entity

    Directly controlled by CMH FUND INC

Provenance

Return type
form_990
Tax year
2022
Filed
2 November 2023
IRS schema version
2022v5.0
Source object
202333129349303388

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

The source document this was parsed from is served over the API, which is where bulk and document access live.