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Nonprofiteer
← CANTON-POTSDAM MEDICAL PRACTICE PLLC

Form 990 for tax year 2022

Filed by CANTON-POTSDAM MEDICAL PRACTICE PLLC.

Totals

Total revenue
$1,207,631
Total expenses
$3,135,398
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$1,128,088
Investment income
$0
Other revenue
$79,543
Total assets, end of year
$432,578
Total liabilities, end of year
$6,089,411
Net assets or fund balances, end of year
-$5,656,833
Program services expenses (Part IX)
$3,027,991
Management and general expenses
$107,407
Fundraising expenses
$0
Program service expenses (Part III)
$3,027,991

Program services were 96.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • ROBERT T ROGERS II MD

    MEDICAL DIRECTOR

    Total calculated
    $252,996
    From this org
    $0
    From related orgs
    $250,647
    Other
    $2,349
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $2,291 related
    Bonus
    $0 + $248,356 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $2,349 related
    Filer's total
    $0 + $252,996 related

  • RICHARD DAVIS PHD

    CEO

    Total calculated
    $1,305,226
    From this org
    $0
    From related orgs
    $1,294,014
    Other
    $11,212
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,044,014 related
    Bonus
    $0 + $250,000 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $11,212 related
    Filer's total
    $0 + $1,305,226 related

  • THOMAS CRILLY

    CFO

    Total calculated
    $1,101,091
    From this org
    $0
    From related orgs
    $1,333,009
    Other
    -$231,918
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $632,120 related
    Bonus
    $0 + $650,433 related
    Other
    $0 + $50,456 related
    Deferred
    $0 + -$244,610 related
    Nontaxable benefits
    $0 + $12,692 related
    Filer's total
    $0 + $1,101,091 related

  • HUGH THOMAS

    CAO

    Total calculated
    $1,269,539
    From this org
    $0
    From related orgs
    $1,464,024
    Other
    -$194,485
    Hours/week
    0 + 55 related

    Schedule J breakdown matched by us

    Base
    $0 + $895,878 related
    Bonus
    $0 + $568,146 related
    Other
    $0
    Deferred
    $0 + -$207,017 related
    Nontaxable benefits
    $0 + $12,532 related
    Filer's total
    $0 + $1,269,539 related

  • ERIC BIEBER MD

    FORMER CEO

    Total calculated
    $47,654
    From this org
    $0
    From related orgs
    $47,360
    Other
    $294
    Hours/week
    0

    Schedule J breakdown matched by us

    Base
    $0 + $47,360 related
    Bonus
    $0
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $294 related
    Filer's total
    $0 + $47,654 related

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

  • 4b · Supplemental nonqualified retirement plan

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
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 3
COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS IS ESTABLISHED USING THE FOLLOWING: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - FORM 990 OF OTHER ORGANIZATIONS - WRITTEN EMPLOYMENT CONTRACTS - COMPENSATION SURVEYS AND STUDIES - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE ON AN ANNUAL BASIS, THE ORGANIZATION USES AN INDEPENDENT COMPENSATION CONSULTANT TO REVIEW THE SALARIES FOR ALL EXECUTIVES TO ENSURE SUCH SALARIES ARE CONSISTENT WITH MARKET SALARIES PAID TO SIMILARLY SITUATED EXECUTIVES. IN ADDITION, A COMPENSATION COMMITTEE REVIEWS THIS INFORMATION ANNUALLY AND IT IS THEN APPROVED BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD. FINALLY, EXECUTIVES RECEIVE A WRITTEN LETTER OUTLINING THE SPECIFICS OF THE COMPENSATION AGREEMENT AND THEIR EXPECTED PERFORMANCE.
PART I, LINE 4B
SUPPLEMENTAL EXECUTIVE RETIREMENT PLANS PROVIDE BENEFITS TO CERTAIN KEY EXECUTIVE EMPLOYEES OF ROCHESTER REGIONAL HEALTH. THE ORGANIZATION MAINTAINS A SECTION 457(F) PLAN WHICH WOULD BE CONSIDERED A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. DURING 2022 THE CFO OF ROCHESTER REGIONAL HEALTH RECEIVED A DISTRIBUTION TOTALING $49,054.
OTHER ADDITIONAL INFORMATION:
CANTON-POTSDAM MEDICAL PRACTICE DOES NOT HAVE ANY EMPLOYEES ON ITS PAYROLL AND ALL "EMPLOYEES" ARE CONTRACTED THROUGH CANTON-POTSDAM HOSPITAL, RELATED TAX EXEMPT ORGANIZATION. AS SUCH, THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS OF CANTON-POTSDAM HOSPITAL SEEKS INPUT OF A CONSULTING FIRM WITH NATIONAL EXPERIENCE TO REVIEW COMPENSATION PACKAGES OFFERED TO TOP MANAGEMENT AND THE REGULATORY COMPLIANCE ISSUES OF NOT-FOR-PROFITS. UPON THE FINDINGS OF THE CONSULTANT AND DELIVERATIONS OF THE COMPENSATION COMMITTEE, THE COMMITTEE WILL THEN MAKE RECOMENDATION TO THE FULL BOARD. THE FULL BOARD WILL THEN VOTE ON THE TOP OFFICIAL'S COMPENSATION PACKAGE.
PART II, COLUMN C:
RETIREMENT AND OTHER DEFERRED COMPENSATION - THIS COLUMN IS REFLECTIVE OF THE ACTUARIAL CHANGE IN DEFINED BENEFIT PENSION PLAN AND POST-RETIREMENT BENEFITS FOR THE TAX YEAR.

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 partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

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

Provenance

Return type
form_990
Tax year
2022
Filed
8 November 2023
IRS schema version
2022v5.0
Source object
202313179349304666

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