TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) EDWARD MUCENSKI...................................................................... CHAIR OF THE BOARD	1.00 ................. 1.00	X	X	0	0	0
(2) MICHAEL TULLOCH MD...................................................................... DIRECTOR	1.00 ................. 40.00	X		0	237,360	1,939
(3) JAMES THEODORE...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(4) ANNE RICHEY...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(5) LORETTA PEREZ...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(6) KATHRYN MULLANEY...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(7) MICHAEL GRIFFIN...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(8) ANDREW LEONARD...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(9) ERIN DRAPER...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(10) REAL FRENCHIE COUPAL...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(11) FLORENCE BERO MD...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(12) RICHARD DAVIS PHD...................................................................... CEO	5.00 ................. 50.00	X	X	280,201	2,802,008	54,880
(13) KELLY CICCHINELLI...................................................................... ASSISTANT TREASURER	40.00 .................	X	X	262,325	0	7,785
(14) AMY IRISH-BICKNELL...................................................................... ASSISTANT SECRETARY	40.00 .................	X	X	76,034	0	2,800
(15) DONALD DANGREMOND...................................................................... SECRETARY	1.00 ................. 1.00	X	X	0	0	0
(16) MARK BRACKETT...................................................................... TREASURER	1.00 ................. 1.00	X	X	0	0	0
(17) MARK CORNETT...................................................................... VICE CHAIR	1.00 ................. 1.00	X	X	0	0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(18) BRIAN GARDAM........................................................................ DIRECTOR	1.00 .......................1.00	X			0	0	0
(19) THOMAS ADAMS........................................................................ DIRECTOR	1.00 .......................1.00	X			0	0	0
(20) ANNE MARIE SNELL........................................................................ DIRECTOR	1.00 .......................1.00	X			0	0	0
(21) HUGH THOMAS........................................................................ CAO	5.00 .......................50.00		X		157,309	1,573,082	9,101
(22) THOMAS CRILLY........................................................................ CFO	5.00 .......................50.00		X		129,493	1,294,926	154,600
(23) DONNA MCGREGOR........................................................................ PRESIDENT, SLHS	55.00 .......................1.00		X		689,457	0	10,525
(24) CHRISTIAN CASINI........................................................................ ASSISTANT SECRETARY	0.00 .......................55.00		X		0	337,568	34,153
(25) JENNIFER ESLINGER........................................................................ MEMBER APPOINTMENT, COO	7.00 .......................48.00		X		164,693	1,129,321	11,368
(26) LISA LOUGHEED........................................................................ CHIEF NURSING OFFICER, SLH	40.00 .......................			X	370,924	0	1,602
(27) DAVID BENDER........................................................................ CEO, MASSENA HOSPITAL	40.00 .......................			X	382,955	0	2,349
(28) BRENT BISHOP........................................................................ ASSOCIATE CHIEF OPERATING	40.00 .......................			X	351,343	0	5,365
(29) KATHERINE SCHLEIDER........................................................................ CHIEF CLINICAL INTEGRATION	40.00 .......................			X	471,303	0	9,526
(30) LYNDON ALLEN........................................................................ CHIEF INFORMATION OFFICER	40.00 .......................			X	307,906	0	2,349

(A) Name and business address	(B) Description of services	(C) Compensation
CHANGE HEALTHCARE 5995 WINDWARD PARKWAY ALPHARETTA,GA30005	REVENUE CYCLE MANAGEMENT	517,871
CROTHALL HEALTHCARE INC 13028 COLLECTION CENTER DRIVE CHICAGO,IL60693	HEALTHCARE ENVIRONMENT SERVICES	510,665
AVOCA SEARCH 8045 BIKNG BEND BLVD STE 104 WEBSTER GROVES,MO63119	EXECUTIVE SEARCH	239,250
MCDERMOTT WILL AND EMERY PO BOX 1675 CAROL STREAM,IL601321675	LEGAL SERVICES	222,642
MANATT PHELPS AND PHILLIPS 2049 CENTURY PARK EAST SUITE 1700 LOS ANGELES,CA900673101	CONSULTING SERVICES	190,000
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 13

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

ST LAWRENCE HEALTH SYSTEM INC

Employer identification number

46-4259168

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ............................... 3

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 10 above (see instructions))	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) GOUVERNEUR HOSPITAL	464249555	3	Yes		0	0
(B) CANTON-POTSDAM HOSPITAL	161012691	3	Yes		0	0
(C) MASSENA HOSPITAL INC	843134268	3	Yes		0	0
Total 3					0	0

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Yes

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Yes

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
PART IV, SECTION C, LINE 1:	WHILE THERE ARE SOME COMMON BOARD MEMBERS AMONGST ST. LAWRENCE HEALTH SYSTEM AND ITS AFFILIATES, THE MAJORITY OF DIRECTORS ARE INDEPENDENT OF EACH ORGANIZATION. MANAGEMENT OF THE SUPPORTING ORGANIZATIONS IS VESTED THROUGH ITS SHARED OVERSIGHT OF THE CORPORATE BY-LAWS WITH EACH AFFILIATED ORGANIZATION.

Schedule A (Form 990) 2023

Additional Data

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SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

ST LAWRENCE HEALTH SYSTEM INC

Employer identification number

46-4259168

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	1,020,920		1,020,920
b	Buildings ....	24,954,452	3,985,577	20,968,875
c	Leasehold improvements
d	Equipment ....	4,900,783	2,459,264	2,441,519
e	Other .....	360,336	8,101	352,235
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				24,783,549

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)DUE FROM AFFILIATES				2,930,544
(2)SECURITY DEPOSITS				2,240
(3)OPERATING LEASE ASSET				12,089
(4)OTHER ASSETS				580,000
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				3,524,873

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
OPERATING LEASE LIABILITY	12,089
DUE TO AFFILIATES	9,818,039







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	9,830,128
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART XIII - SUPPLEMENTAL FINANCIAL INFORMATION	REVENUE AND EXPENSES RELATED TO INTERCORPORATE TRANSACTIONS BETWEEN SLHS AND RELATED ENTITIES CPH, GH, AND MH ARE EXCLUDED FROM REVENUE AND EXPENSES. THESE ARE FOR CHARGES BILLED TO THE ENTITIES CPH, GH, AND MH (RECORDED AS BILLABLE EXPENSES) AND THEN CASH IS COLLECTED FOR THESE (RECORDED AS BILLABLE REVENUE).

Schedule D (Form 990) 2022

Additional Data

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ST LAWRENCE HEALTH SYSTEM INC

Employer identification number

46-4259168

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1RICHARD DAVIS PHD CEO	(i) (ii)	152,044 ------------- 1,520,439	128,157 ------------- 1,281,569	0 ------------- 0	4,197 ------------- 41,971	792 ------------- 7,920	285,190 ------------- 2,851,899	0 ------------- 0
2HUGH THOMAS CAO	(i) (ii)	42,484 ------------- 424,839	43,142 ------------- 431,416	71,683 ------------- 716,827	0 ------------- 0	827 ------------- 8,274	158,136 ------------- 1,581,356	0 ------------- 0
3THOMAS CRILLY CFO	(i) (ii)	63,323 ------------- 633,232	66,041 ------------- 660,409	129 ------------- 1,285	13,237 ------------- 132,373	817 ------------- 8,173	143,547 ------------- 1,435,472	0 ------------- 0
4JENNIFER ESLINGER MEMBER APPOINTMENT, COO	(i) (ii)	95,228 ------------- 652,991	69,465 ------------- 476,330	0 ------------- 0	0 ------------- 0	1,447 ------------- 9,921	166,140 ------------- 1,139,242	0 ------------- 0
5DONNA MCGREGOR PRESIDENT, SLHS	(i) (ii)	525,846 ------------- 0	163,611 ------------- 0	0 ------------- 0	0 ------------- 0	10,525 ------------- 0	699,982 ------------- 0	0 ------------- 0
6KATHERINE SCHLEIDER CHIEF CLINICAL INTEGRATION	(i) (ii)	355,802 ------------- 0	115,501 ------------- 0	0 ------------- 0	0 ------------- 0	9,526 ------------- 0	480,829 ------------- 0	0 ------------- 0
7DAVID BENDER CEO, MASSENA HOSPITAL	(i) (ii)	305,454 ------------- 0	77,501 ------------- 0	0 ------------- 0	0 ------------- 0	2,349 ------------- 0	385,304 ------------- 0	0 ------------- 0
8LISA LOUGHEED CHIEF NURSING OFFICER, SLH	(i) (ii)	299,674 ------------- 0	71,250 ------------- 0	0 ------------- 0	0 ------------- 0	1,602 ------------- 0	372,526 ------------- 0	0 ------------- 0
9CHRISTIAN CASINI ASSISTANT SECRETARY	(i) (ii)	0 ------------- 321,343	0 ------------- 16,225	0 ------------- 0	0 ------------- 30,027	0 ------------- 4,126	0 ------------- 371,721	0 ------------- 0
10BRENT BISHOP ASSOCIATE CHIEF OPERATING	(i) (ii)	263,844 ------------- 0	87,499 ------------- 0	0 ------------- 0	0 ------------- 0	5,365 ------------- 0	356,708 ------------- 0	0 ------------- 0
11LYNDON ALLEN CHIEF INFORMATION OFFICER	(i) (ii)	248,414 ------------- 0	59,492 ------------- 0	0 ------------- 0	0 ------------- 0	2,349 ------------- 0	310,255 ------------- 0	0 ------------- 0
12KELLY CICCHINELLI ASSISTANT TREASURER	(i) (ii)	231,886 ------------- 0	30,439 ------------- 0	0 ------------- 0	0 ------------- 0	7,785 ------------- 0	270,110 ------------- 0	0 ------------- 0
13MICHAEL TULLOCH MD DIRECTOR	(i) (ii)	0 ------------- 237,360	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 1,939	0 ------------- 239,299	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 3	THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS SEEKS THE INPUT OF A CONSULTING FIRM WITH NATIONAL EXPERIENCE TO REVIEW THE COMPENSATION PACKAGES OFFERED TO TOP MANAGEMENT AND THE REGULATORY COMPLIANCE ISSUES OF NOT FOR PROFITS. UPON FINDINGS OF THE CONSULTANT AND DELIBERATIONS OF THE COMPENSATION COMMITTEE, THE COMMITTEE WILL THEN MAKE A RECOMMENDATION TO THE FULL BOARD. THE FULL BOARD WILL THEN VOTE ON THE TOP OFFICIAL'S COMPENSATION PACKAGE.
PART I, LINES 4A-B	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. THERE WERE NO DISTRIBUTIONS FROM THE PLAN IN 2023.
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.

Schedule J (Form 990) 2023

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
ST LAWRENCE HEALTH SYSTEM INC

Employer identification number
46-4259168

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	THE GENESEE COUNTY FUNDING CORPORATION	16-1139027	371669AW2	05-15-2022	30,653,122	FINANCE CAPITAL IMPROVEMENT PROJECTS		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	995,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	30,653,122
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	631,438
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............
11 Other spent proceeds .............	30,021,684
12 Other unspent proceeds .............
13 Year of substantial completion .............	2022
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........	X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X
b Exception to rebate? ........		X
c No rebate due? .........		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part Ⅴ

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation

Schedule K (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

ST LAWRENCE HEALTH SYSTEM INC

Employer identification number

46-4259168

Return Reference	Explanation
FORM 990, PART III, LINE 4	ROCHESTER REGIONAL HEALTH (ROCHESTER REGIONAL/RRH) (I.E. THE PARENT ORGANIZATION AND ITS RELATED AFFILIATES) IS AN INTEGRATED HEALTH SYSTEM ROOTED IN COMMUNITY, SERVING TOGETHER TO UPLIFT HUMANITY THROUGH COMPASSIONATE CARE FOR THE PEOPLE OF ROCHESTER, THE FINGER LAKES REGION, AND NEW YORK STATE'S NORTH COUNTRY. THROUGH ROBUST INVESTMENTS IN PEOPLE, FACILITIES, AND TECHNOLOGY IN EACH COMMUNITY WE SERVE, ROCHESTER REGIONAL STANDS OUT FOR ITS ABILITY TO BRING THE HIGHEST QUALITY CARE CLOSE TO HOME. ACROSS WESTERN NEW YORK, THE FINGER LAKES, ST. LAWRENCE COUNTY AND BEYOND, RRH PROUDLY SERVES THE COMMUNITY THROUGH ITS NINE HOSPITALS PROVIDING INPATIENT, ADVANCED AND CRITICAL CARE; HUNDREDS OF OUTPATIENT SPECIALTY, URGENT CARE AND PRIMARY CARE PRACTICES; BEHAVIORAL HEALTH AND CHEMICAL DEPENDENCY TREATMENT CENTERS; INNOVATIVE AND COMFORTING SENIOR SERVICES; COMPASSIONATE HOME CARE AND HOSPICE CARE PROGRAMS; AND LABORATORIES, INCLUDING SPECIALIZED CLINICAL TRIAL AND TOXICOLOGY TESTING FACILITIES. ROCHESTER REGIONAL HAS A NATIONALLY RECOGNIZED HEART PROGRAM AND A NATIONALLY ACCREDITED CANCER CENTER, AND OFFERS PATIENTS MANY OF THE SAME LEADING EDGE TREATMENT OPTIONS FOUND AT THE COUNTRY'S FINEST MEDICAL CENTERS. FROM SURGERY TO ORTHOPEDICS, WOMEN'S HEALTH TO EMERGENCY CARE, PEOPLE ALL ACROSS WESTERN NY AND NYS'S NORTH COUNTRY TURN TO ROCHESTER REGIONAL FOR THEIR EXPERIENCE, COMPASSION AND EXPERTISE IN HELPING THEM GET BACK TO LIVING THEIR LIVES. POVERTY TRENDS, COMMUNITY HEALTH RESEARCH AND NEEDS ASSESSMENTS ARE REVIEWED ON A REGULAR BASIS WHILE PLANNING COMMUNITY HEALTH PROGRAMS. ROCHESTER REGIONAL REPRESENTATIVES ARE ACTIVELY ENGAGED IN VARIOUS COMMUNITY HEALTH COLLABORATIONS WITH THE LOCAL HEALTH DEPARTMENTS, STATE HEALTH DEPARTMENT, AND LOCAL NOT-FOR-PROFIT HEALTH AND HUMAN SERVICE AGENCIES, AND ACTIVELY WORK TO RESPOND TO COMMUNITY PRIORITIES AND DEVELOP PROGRAMS AND SERVICES THAT FILL A GAP OR SUPPLEMENT AN EXISTING PROGRAM. MOST ROCHESTER REGIONAL COMMUNITY HEALTH OUTREACH PROGRAMS ARE OFFERED IN PARTNERSHIP WITH OTHER COMMUNITY ORGANIZATIONS OR GOVERNMENTAL AGENCIES, IN ORDER TO LEVERAGE RESOURCES TO MEET COMMUNITY NEEDS. INFORMATION REGARDING THE AVAILABILITY OF COMMUNITY HEALTH PROGRAMS, ASSISTANCE WITH HEALTH INSURANCE ENROLLMENT AND FINANCIAL ASSISTANCE FOR MEDICAL CARE RECEIVED AT ROCHESTER REGIONAL HOSPITALS, EMERGENCY DEPARTMENTS, OUTPATIENT DEPARTMENTS OR LONG-TERM CARE FACILITIES IS DISSEMINATED TO THE PUBLIC IN ELECTRONIC FORM ON THE ORGANIZATION'S WEBSITE. AT ROCHESTER REGIONAL HEALTH, DIVERSITY, EQUITY, INCLUSION AND SOCIAL JUSTICE ARE WOVEN INTO THE TAPESTRY OF OUR CULTURE AND HEALTH EQUITY IS OUR TRUE NORTH. RRH IS COMMITTED TO FOSTERING A DIVERSE AND INCLUSIVE ENVIRONMENT WHERE PEOPLE FROM ALL BACKGROUNDS ARE INCLUDED, VALUED, AND RESPECTED. BY ESTABLISHING AND MAINTAINING COMMUNITY PARTNERSHIPS, RRH IS LEADING EFFORTS TO CULTIVATE AN EQUITABLE AND INCLUSIVE ENVIRONMENT AND DELIVER HIGH-QUALITY PATIENT OUTCOMES AND EXPERIENCES. WE BELIEVE OUR WORKFORCE AND PATIENT CARE ARE DIRECTLY CONNECTED AND ARE COMMITTED TO ENSURING THAT OUR TEAMS AND EACH PATIENT WE CARE FOR ENJOYS BETTER, HEALTHIER LIVES. AS PART OF THEIR HEALTHY PEOPLE 2030 INITIATIVE, AIMED AT ELIMINATING DISPARITIES AND IMPROVING THE HEALTH AND WELL-BEING OF ALL, THE UNITED STATES GOVERNMENT HAS DEEMED HEALTH LITERACY A "CENTRAL FOCUS." HEALTHY PEOPLE 2030 DEFINES PERSONAL HEALTH LITERACY AS, "THE DEGREE TO WHICH INDIVIDUALS HAVE THE ABILITY TO FIND, UNDERSTAND, AND USE INFORMATION AND SERVICES TO INFORM HEALTH-RELATED DECISIONS AND ACTIONS FOR THEMSELVES AND OTHERS." SIMILARLY, THEY DEFINE ORGANIZATIONAL HEALTH LITERACY AS, "THE DEGREE TO WHICH ORGANIZATIONS EQUITABLY ENABLE INDIVIDUALS TO FIND, UNDERSTAND, AND USE INFORMATION AND SERVICES TO INFORM HEALTH-RELATED DECISIONS AND ACTIONS FOR THEMSELVES AND OTHERS." IN ORDER TO PROMOTE HEALTH LITERACY, IN DECEMBER OF 2020, RRH SERVED AS LEADERS IN CREATING A WAY OF COMMUNICATING IMPORTANT INFORMATION ABOUT COVID-19 AND VACCINE INFORMATION TO GROUPS WHO ARE HISTORICALLY MARGINALIZED. THE RRH TEAM HELD OVER 30 PRESENTATIONS FOR UNDERSERVED POPULATIONS REACHING ALMOST 5,000 PARTICIPANTS AND VIEWERS; PROVIDING THEM WITH ACCURATE, UP-TO-DATE INFORMATION ABOUT THE VIRUS AND VACCINE OPTIONS TO SUPPORT INFORMED DECISIONS FOR THEMSELVES, THEIR FAMILIES, AND THEIR COMMUNITIES. OUR TEAM WAS THE FIRST TO BE IN THIS SPACE AND CREATED A WELCOMING ENVIRONMENT FOR ALL QUESTIONS TO BE ASKED. TWO OF THE KEYS TO REDUCING HEALTH DISPARITIES AND BUILDING HEALTH LITERACY ARE COMMUNITY OUTREACH AND EDUCATION. TO THIS END, RRH HAS DEVELOPED TARGETED INTERVENTIONS, COMMUNITY OUTREACH AND EDUCATION PROGRAMS. RRH IS COMMITTED TO PROVIDING A RELAXED AND WELCOMING ENVIRONMENT TO ASK QUESTIONS, AND HAD MEDICAL EXPERTS THAT PROVIDED SOLID, RELEVANT AND TIMELY INFORMATION SO THAT PEOPLE COULD MAKE INFORMED HEALTHCARE DECISIONS. THE RRH COMMUNITY CONVERSATIONS ARE HOSTED IN PARTNERSHIP WITH A WIDE RANGE OF LEADERS THROUGHOUT THE COMMUNITY. RRH HAS PARTNERED WITH VARIOUS COMMUNITIES SUCH AS THE LATINX COMMUNITY, RURAL MIGRANT FARMERS, FAITH COMMUNITIES, DEAF AND HARD OF HEARING, LGBTQ+, VETERANS, PEOPLE LIVING WITH DISABILITIES, ELDERS AND THEIR CAREGIVERS, ADOLESCENTS AND PARENTS. WITH THESE PARTNERSHIPS RRH HAS BEEN ABLE TO FORM STRONG COMMUNITY BONDS. WITH THE COVID INFORMATION NOW WIDELY AVAILABLE, RRH IS PIVOTING ITS COMMUNITY CONVERSATIONS TO FOCUS ON HEALTH AND WELLNESS. RRH PLANS TO CONTINUALLY EVALUATE AND ADJUST THE FOCUS OF ITS COMMUNITY CONVERSATIONS TO ENSURE OTHER PRESSING TOPICS, SUCH AS HEALTH SCREENINGS AS A PREVENTIVE MEASURE, ARE ALWAYS AT THE FOREFRONT AND CONTINUED EDUCATION IS ALWAYS AVAILABLE TO THE COMMUNITY. AS A RESULT OF THESE EFFORTS, RRH WAS RECOGNIZED AMONG THE NATION'S TOP DEI ADVOCATES. CITING RRH'S "FANTASTIC" DIVERSITY, EQUITY & INCLUSION (DEI) OFFICE, THE HEALTHCARE DIVERSITY COUNCIL HAS GRANTED RRH A TOP 3 HEALTHCARE DIVERSITY ORGANIZATIONS AWARD. THE COUNCIL COMMENDED RRH DEI INITIATIVES TO REDUCE HEALTHCARE DISPARITIES IN UNDERSERVED COMMUNITIES; RECRUIT AND RETAIN A DIVERSE WORKFORCE; AND IMPLEMENT COMMUNITY CONVERSATIONS SURROUNDING COVID-19. RRH'S ACTIVE PURSUIT OF DIVERSITY IN OUR WORK ENVIRONMENT AND COMMUNITY PROGRAMS MAKES IT A "PERFECT" AWARD RECIPIENT, THE COUNCIL STATED. THE HEALTHCARE DIVERSITY COUNCIL IS AN ORGANIZATION DEVOTED TO PROMOTING AN INCLUSIVE ENVIRONMENT OF CARE AT MEDICAL INSTITUTIONS NATIONWIDE. ROCHESTER REGIONAL HEALTH IS ALSO LEADING THE INDUSTRY WITH ITS SUSTAINABILITY EFFORTS. RRH BELIEVES IN THE CLOSE RELATIONSHIP BETWEEN THE WELL-BEING OF OUR COMMUNITY, ENVIRONMENT, AND OUR FINANCIAL HEALTH. GUIDED BY THIS BELIEF, RRH MANAGES ITS RESOURCES CONSCIENTIOUSLY, AIMING TO LIMIT OUR ENVIRONMENTAL FOOTPRINT AND SPEARHEAD SUSTAINABILITY INITIATIVES IN THE REGION. THOUGH IT IS KNOWN THAT HOSPITALS CONSUME MORE THAN DOUBLE THE ENERGY THAN TYPICAL COMMERCIAL BUILDINGS AND GENERATE SIGNIFICANT WASTE PER PATIENT, ROCHESTER REGIONAL HEALTH IS STEADFAST IN BREAKING THIS NORM. THE RRH SUSTAINABILITY DEPARTMENT IS DEVOTED TO REFINING THE HEALTHCARE EXPERIENCE, PRESERVING A ROBUST ENVIRONMENT, AND CURBING HEALTHCARE COSTS. THEY ACTIVELY MANAGE WASTE, ELIMINATING HARMFUL SUBSTANCES, AND FOSTERING A SUSTAINABLE COMMUNITY FOR NOW AND FUTURE GENERATIONS. QUALITY AND SAFETY ARE AT THE CORE OF ROCHESTER REGIONAL HEALTH'S PURPOSE TO HEAL, COMFORT, PROMOTE HEALTH AND DELIVER CARE THAT ENHANCES LIVES. BY TAKING A PROACTIVE APPROACH, RRH DESIGNS PATIENT-CENTERED SYSTEMS THAT DELIVER HIGH-QUALITY CARE, SAFELY. THROUGH SYSTEM-WIDE PROGRAMS WE ARE CONSISTENTLY IMPROVING THE SAFETY AND QUALITY OF THE CARE WE PROVIDE; ENSURING REGULATORY COMPLIANCE AND COORDINATING ACCREDITATIONS OF LOCATIONS AND PROGRAMS; PREVENTING ERRORS AND WORKING TO ENHANCE THE CARE DELIVERED IN OUR REGION AND ACROSS THE COUNTRY; AND PROVIDING EDUCATION AND TRAINING FOR EMPLOYEES, PATIENTS AND VISITORS. A CORNERSTONE OF ROCHESTER REGIONAL HEALTH'S STRATEGIC PLAN IS TO INVEST IN A SUSTAINABLE BUSINESS MODELTHAT IS, TO PRIORITIZE INVESTMENTS IN GROWTH AND SERVICES THAT CREATE LONG-TERM VALUE. DESPITE THE CHALLENGES WITHIN THE HEALTHCARE INDUSTRY, ROCHESTER REGIONAL CONTINUES TO CELEBRATE PROGRESS ON INITIATIVES ESSENTIAL TO THE FUTURE OF THE INSTITUTION AND THE HEALTH OF THE NEW YORK STATE COMMUNITIES IT SERVES. EXAMPLES INCLUDE: ROCHESTER REGIONAL'S DESTINATION CAMPUS STRATEGY BRINGS RURAL PATIENTS EASY, LOCAL ACCESS TO A WIDE RANGE OF HIGH QUALITY, COORDINATED PRIMARY AND SPECIALTY CARE SERVICES CLOSE TO WHERE THEY LIVE. RRH OPENED A NEW 95,000 SQ. FT. BATAVIA MEDICAL CAMPUS IN SEPTEMBER 2023 WHICH BRINGS MORE THAN A DOZEN SPECIALTY SERVICES UNDER ONE ROOF. THE BRIGHT, MODERN BUILDING CLEARLY VISIBLE OFF THE I-90 NEW YORK STATE THRUWAY, INCLUDES PRIMARY CARE, PEDIATRICS, ORTHOPAEDICS, OTOLARYNGOLOGY, PLASTIC SURGERY, VASCULAR SURGERY, NEUROSCIENCES,
FORM 990, PART III, LINE 4 (CONTINUED)	SANDS-CONSTELLATION HEART INSTITUTE CARDIOLOGISTS, LAB, IMAGING AND AN URGENT CARE. URGENT CARE CENTERS IN WEBSTER AND CHILI WERE REOPENED AS PART OF A STRATEGY TO REACH PATIENTS WHO NEED MEDICAL CARE FOR MINOR ILLNESSES AND INJURIES. PROVIDERS AND STAFF TRAINED TO PROVIDE APPROPRIATE TREATMENT FOR ACUTE INJURIES OR ILLNESSES THAT ARE URGENT BUT NOT SEVERE ENOUGH TO REQUIRE AN EMERGENCY ROOM VISIT ARE AVAILABLE FOR CONVENIENT SAME-DAY WALK-IN APPOINTMENTS. VIRTUAL URGENT CARE IS ALSO AVAILABLE 7 DAYS A WEEK FOR MINOR INJURIES AND COMMON ILLNESSES FROM THE COMFORT OF THE PATIENT'S HOME, OR WHEREVER THEY MAY BE. ROCHESTER REGIONAL IS FORGING AHEAD ON ALL FRONTS OF A STRATEGIC PLAN WHOSE PURPOSE IS TO UPLIFT HUMANITY THROUGH CARE FOR THE COMMUNITY WITH A VISION TO BECOME A NATIONAL MODEL OF HEALTH AND HEALING. THE FOUR PILLARS OF THE STRATEGIC PLAN ARE AS FOLLOWS: STRENGTHEN OUR COMMUNITIES COMMUNITY PARTNERSHIP WILL GROW TRUST WITH THOSE WE SERVE SOLIDIFY RRH'S POSITION AS A CORNERSTONE OF COMMUNITY HEALTH. RELENTLESS FOCUS ON QUALITY AND SAFETY IMPROVED QUALITY AND SAFETY WILL POSITION US AS THE PROVIDER OF CHOICE FOR PATIENTS BUILD AND CONTINUALLY FOCUS ON A CULTURE OF QUALITY AND SAFETY. UNLEASH THE POWER OF OUR PEOPLE EMPOWERED PEOPLE WILL ALLOW US TO TAKE OUR ORGANIZATION TO THE NEXT LEVEL ENGAGE PEOPLE TO COMMIT, BELONG AND GROW AT RRH. GROWTH AN EVOLVED HEALTH CARE DELIVERY MODEL WILL BETTER SERVE PATIENTS BECOME THE MOST ACCESSIBLE AND CONVENIENT SYSTEM IN THE COMMUNITIES WE SERVE AND INNOVATE TO TRANSFORM CARE DELIVERY OPERATIONS. RRH CONTINUES TO GROW THROUGH THE ADDITION OF MEDICAL PRACTICES STRENGTHENING THE SERVICE OFFERINGS TO THOSE THROUGHOUT THE COMMUNITIES SERVED. NEW AND EXPANDED SERVICE OFFERINGS INCLUDE: IN JULY 2023, THE STRUCTURAL HEART TEAM PERFORMED THEIR 2000TH TRASCATHETER AORTIC VALVE REPLACEMENT (TAVR) PROCEDURE AT ROCHESTER REGIONAL HEALTH'S SANDS-CONSTELLATION HEART INSTITUTE. THE 2000TH TAVR PROCEDURE PUTS RRH IN THE TOP 5 PERCENT OF HEALTH SYSTEMS NATIONWIDE THAT HAVE COMPLETED TAVRS OF THAT VOLUME. THE PROCEDURE IS MOST OFTEN USED TO TREAT AORTIC STENOSIS. A NEW RRH LABORATORY IN GREECE, NY WAS OPENED. THIS NEW SITE OFFERS SIX DEDICATED DRAW ROOMS, TWO PEDIATRIC ROOMS, AND A CONVENIENT SELF-CHECK-IN SYSTEM. WITH A FULL RANGE OF HEALTH SCREENING OPTIONS, EXPERTS ARE READY TO PROVIDE THE COMMUNITY WITH CONVENIENT AND ACCURATE TESTING AND RESULTS. ROCHESTER REGIONAL HEALTH IS MAKING STRIDES IN USING VIRTUAL TECHNOLOGY AS A PATH FORWARD IN HEALTH CARE. DURING TELEHEALTH AWARENESS WEEK, RRH HIGHLIGHTED THE WAYS IT IS TAKING PATIENT-CENTERED CARE A STEP FURTHER AND MEETING COMMUNITY MEMBERS WHERE THEY ARE. IN 2023, RRH'S VIRTUAL CARE SERVICE USING TYTOCLINIC EXPANDED TO INCLUDE MORE COVERAGE THROUGH THE ROCHESTER CITY SCHOOL DISTRICT, SERVICES AT THE IBERO EARLY CHILDCARE CENTER, AND THE GREECE CENTRAL SCHOOL DISTRICT. RRH ALSO OFFERS OTHER TELEHEALTH-RELATED PROGRAMS, INCLUDING: A PARTNERSHIP WITH REGIONAL HEALTH REACH TO PROVIDE VIRTUAL HEALTHCARE FOR PEOPLE EXPERIENCING HOMELESSNESS IN SHELTERS AND ON THE STREET; A CONGESTIVE HEART FAILURE PROGRAM APPLYING THE MAYO CLINIC'S CARE COMPANION MODULE AND REMOTE MONITORING; VIRTUAL WOUND CARE SERVICES AT ELDERONE; TELENEUROLOGY TELEMEDICINE CARTS TO ASSIST WITH REMOTELY ASSESSING STROKE PATIENTS; AND SUPPORT FOR GERIATRIC SURGERY VERIFICATION. THE RRH VASCULAR TEAM SUCCESSFULLY COMPLETED ITS FIRST TRANSCAROTID ARTERY REVASCULARIZATION (TCAR) PROCEDURE, WHICH IS A CUTTING-EDGE, MINIMALLY INVASIVE PROCEDURE SPECIFICALLY DESIGNED TO TREAT CAROTID ARTERY DISEASE, A CONDITION THAT, IF LEFT UNTREATED, CAN LEAD TO SEVERE COMPLICATIONS SUCH AS STROKE. RRH IS NOW OFFERING TRANSCRANIAL MAGNETIC STIMULATION (TMS), A GROUNDBREAKING TREATMENT PROVIDING NEW HOPE TO PATIENTS WITH SEVERE DEPRESSION WHO HAVE NOT RESPONDED TO TRADITIONAL THERAPIES. TMS UTILIZES MAGNETIC PULSES TO STIMULATE SPECIFIC AREAS OF THE BRAIN, OFFERING A NON-INVASIVE AND POTENTIALLY LIFE-CHANGING OPTION FOR THOSE BATTLING TREATMENT-RESISTANT DEPRESSION. 2023 CONTINUED TO BE A CHALLENGING YEAR FOR THE HEALTHCARE INDUSTRY. IN RESPONSE TO THESE CHALLENGES RRH RESPONDED BY TAKING MEASURES TO ENSURE THE SAFETY OF PATIENTS, TEAM MEMBERS AND THE BROADER COMMUNITY. THE ACTIONS CONTINUED INTO 2023 AND INCLUDED: ROCHESTER REGIONAL CONTINUED TO PROVIDE HEALTH AND WELLNESS EDUCATION ON MULTIPLE PLATFORMS INCLUDING: SOCIAL MEDIA, WEBSITE, MYCARE PATIENT PORTAL, PHONE MESSAGING, AND E-NEWSLETTER. MORE SPECIFICALLY: O RRH'S "HEALTH HIVE," AN ONLINE PORTAL OF ARTICLES AND HELPFUL HINTS IN DEALING WITH A HOST OF HEALTH RELATED TOPICS. DURING 2023, MORE THAN 115 ARTICLES WERE PUBLISHED. O RRH PARTICIPATED IN OVER 300 NEWS ARTICLES, SPECIAL REPORTS, AND INTERVIEWS OVER A VARIETY OF MEDIUMS INCLUDING TV, RADIO AND PRINTED NEWS ARTICLES. ADDITIONALLY, RRH MADE OVER 2,500 SOCIAL MEDIA POSTS ACROSS MULTIPLE PLATFORMS INCLUDING FACEBOOK, INSTAGRAM, TWITTER AND LINKEDIN. O THE ROCHESTER REGIONAL HEALTH DIVERSITY, EQUITY, INCLUSION AND JUSTICE OFFICE HOSTED COMMUNITY CONVERSATIONS WITH VARIOUS COMMUNITY AND CHURCH GROUPS. ATTENDEES HAVE JOINED FROM ROCHESTER AND ALSO THROUGHOUT OTHER PARTS OF THE US. RRH ESTABLISHED AND CONTINUES TO MAINTAIN COLLABORATIVE PARTNERSHIPS TO ENSURE THOSE MOST VULNERABLE IN THE COMMUNITY ARE WELL SERVED, INCLUDING: O ROCHESTER REGIONAL HEALTH HAS ENTERED INTO A FIVE-YEAR PARTNERSHIP WITH TRIMEDX, ONE OF THE NATION'S LARGEST AND MOST ADVANCED CLINICAL ENGINEERING AND ASSET MANAGEMENT ORGANIZATIONS. TRIMEDX BRINGS A WEALTH OF ADVANCED SUPPORT SYSTEMS, INCLUDING A CALL CENTER, SERVICE SOFTWARE, CYBER SECURITY, CAPITAL PLANNING, AND SUPPLY CHAIN AND QUALITY EXPERT. THE NEW PARTNERSHIP WILL HELP TRANSFORM ROCHESTER REGIONAL HEALTH TO MEET THE ECONOMIC AND OPERATIONAL CHALLENGES AHEAD AND ALLOW US TO CONTINUE TO PROVIDE OUR PATIENTS AND CAREGIVERS WITH THE HIGHEST QUALITY SERVICE. O RRH PARTNERED WITH THE LOCAL AHL TEAM, THE ROCHESTER AMERICANS, TO SPREAD THE WORD ABOUT HEART HEALTH. AT HOME GAMES IN FEBRUARY 2023 ATTENDEES PARTICIPATED IN THE "HEART MONTH MINUTE" CHALLENGE, WHERE A FEW LUCKY FANS WENT HEAD-TO-HEAD FOR A SPECIAL HEART-HEALTHY PRIZE. O RRH, THE RIT ALLIANCE, AND THE RIT SIMONE CENTER FOR INNOVATIONS PARTNERED TO SOLICIT PROJECTS FOR THE 2023 RIT FALL IDEALAB. THIS COLLABORATIVE TEAM IDENTIFIES UNIQUE HEALTHCARE CHALLENGES THAT REQUIRES AN INNOVATIVE SOLUTION AND THE PROGRAM EMPLOYS RIT STUDENT TEAMS WITH MULTIDISCIPLINARY EXPERTISE TO SOLVE UNIQUE PROBLEMS FACED BY RRH. STUDENTS DESIGN INNOVATIVE SOLUTIONS WITH THE GUIDANCE OF AN RIT FACULTY MEMBER AND SPONSORING RRH ADMINISTRATOR OR CLINICIAN; SUCCESSFUL PROJECTS MAY LEAD TO PRODUCT DEVELOPMENT OR PROTOTYPES. RRH AND ITS EMPLOYEES HAVE AN INCREDIBLY STRONG COMMITMENT TO THE COMMUNITIES THEY SERVE. IN 2023 EVENTS SPONSORED AND HELD BY RRH INCLUDE: IN APRIL 2023, RRH CELEBRATED NATIONAL MINORITY HEALTH MONTH. THIS MONTH WAS ESTABLISHED BY CIVIL RIGHTS LEADER BOOKER T. WASHINGTON IN 1915. MR. WASHINGTON PROVIDED US WITH AN OPPORTUNITY TO SHARE RESOURCES AND INFORMATION TO GET ACTIVE AND STAY HEALTHY AND BRING AWARENESS TO THE HEALTH DISPARITIES STILL AFFECTING COMMUNITIES OF COLOR. BETTER HEALTH THROUGH BETTER UNDERSTANDING WAS THE THEME FOR NATIONAL MINORITY HEALTH MONTH IN 2023. IT CHALLENGED US TO BE INTENTIONAL ABOUT COMMUNITY OUTREACH, HEALTH LITERACY EFFORTS, AND LINGUISTIC DIVERSITY. IN SO DOING, WE EQUIP OUR COMMUNITIES WITH THE INFORMATION THEY NEED, THE WAY THEY NEED IT, TO MAKE INFORMED DECISIONS. THROUGHOUT THE MONTH, RRH PROVIDED SHARED COMMUNITY RESOURCES, LANGUAGE ASSISTANCE, AND INTERPRETATION FACTS, AS WELL AS CULTURAL WELLNESS TIPS. RRH SPONSORED A SPECIAL MARTIN LUTHER KING JR. EVENT. THIS EVENT WAS OPEN TO STAFF AND THE COMMUNITY AND CONSISTED OF A KEYNOTE SPEAKER, ROCHESTER CITY SCHOOL DISTRICT CHOIR, PERFORMANCES BY MEMBERS OF SCHOOL FOR THE ARTS, AND SEVERAL OTHER SPEAKERS. RRH'S CELEBRATION OF BLACK HISTORY MONTH IN FEBRUARY CONTINUED TO RECOGNIZE THE IMPORTANCE OF REPRESENTATION IN HEALTHCARE. ACCORDING TO RESEARCH, THE LACK OF REPRESENTATION BETWEEN HEALTHCARE ORGANIZATIONS AND THE COMMUNITIES THEY SERVE CAN IMPACT PATIENT CARE. A STRATEGIC COMMITMENT TO DIVERSITY IS A MEANS OF PROMOTING HEALTH EQUITY AND REDUCING HEALTH DISPARITIES. REPRESENTATION IN HEALTHCARE ALSO HAS OTHER MEASURABLE BENEFITS FOR BOTH HEALTHCARE PROFESSIONALS AND THE COMMUNITIES THEY SERVE, INCLUDING: ENHANCED UNDERSTANDING OF VALUE SETS; IMPROVED COMMUNICATION; AND INCREASED PATIENT TRUST. AT THE RRH WELLNESS: RUNNING AT ANY AGE EVENT, PHYSICAL THERAPISTS SHARED TIPS, TRICKS, AND EVIDENCE-BASED RESEARCH STRATEGIES TO RETURN TO RUNNING AT ANY AGE. IN ADDITION TO COMMON RUNNING INJURIES, THEY PROVIDED A BRIEF OVERVIEW OF INJURY PREVENTION TECHNIQUES. RRH HELD A VIRTUAL STROKE SYMPOSIUM A DAY OF INSIGHT AND ENGAGING
FORM 990, PART III, LINE 4 (CONTINUED)	DISCUSSIONS THAT FOCUSED ON THE INTERDISCIPLINARY CLINICAL CARE AND MANAGEMENT OF STROKE AND CEREBROVASCULAR DISEASE. REGIONAL STROKE EXPERTS DISCUSSED THE LATEST ADVANCES IN THE CARE AND MANAGEMENT OF ACUTE, ISCHEMIC, AND HEMORRHAGIC STROKE, AS WELL AS OTHER CEREBROVASCULAR DISEASES, FROM INITIAL PRESENTATION TO REHABILITATION. MARCH IS COLORECTAL CANCER AWARENESS MONTH. ACCORDING TO THE COLORECTAL CANCER ALLIANCE, COLORECTAL CANCER (CRC), IS THE SECOND DEADLIEST CANCER IN THE US, BUT IT IS HIGHLY PREVENTABLE AND TREATABLE WHEN DETECTED EARLY WITH REGULAR SCREENING. RRH'S COLORECTAL CANCER SCREENING AND PREVENTION PROGRAM IS DESIGNED TO EDUCATE AND HELP PREVENT COLORECTAL CANCER IN MEN AND WOMEN. THE HOSPITALS WERE LIT UP BLUE TO HELP RAISE AWARENESS FOR COLORECTAL CANCER DURING PAINT RRH BLUE WEEK. RRH HIGHLIGHTED THAT MARCH IS BRAIN INJURY AWARENESS MONTH, RECOGNIZING THAT BRAIN INJURY IS THE SECOND MOST PREVALENT INJURY AND DISABILITY IN THE US. THE GOLISANO RESTORATIVE NEUROLOGY & REHABILITATION CENTER IS THE LARGEST INPATIENT PROGRAM OF ITS KIND IN THE FINGER LAKES REGION. THE CENTER HELPS THOSE RECOVERING FROM A SEVERE BRAIN INJURY RESTORE AS MUCH OF THEIR INDEPENDENCE AS POSSIBLE. ACCREDITED FOR CHILDREN, ADOLESCENTS, AND ADULTS BY THE COMMISSION ON ACCREDITATION OF REHABILITATION FACILITIES (CARF), THE PROGRAM PRODUCES EXCELLENT PATIENT OUTCOMES AND SATISFACTION. RRH CELEBRATED WOMEN WHO TELL OUR STORIES IN RECOGNITION OF WOMEN'S HISTORY MONTH. THE THEME HONORS WOMEN THROUGHOUT HISTORY AND WOMEN IN THE HISTORY OF RRH WHO HAVE DEVOTED THEIR LIVES AND TALENTS TO IMPROVING THE HUMAN CONDITION. A SERIES OF EDUCATION SESSIONS WERE HELD DURING BLACK MATERNAL HEALTH WEEK. THIS WEEK-LONG CAMPAIGN WAS INSPIRED BY THE BLACK MAMAS MATTER ALLIANCE (BMMA), A COLLECTIVE OF MULTI-DISCIPLINARY PROFESSIONALS WORKING TO ENSURE THAT "ALL BLACK MAMAS HAVE THE RIGHTS, RESPECT, AND RESOURCES TO THRIVE BEFORE, DURING, AND AFTER PREGNANCY." RRH PARTICIPATED IN THE IMAGINE RIT: CREATIVITY & INNOVATION FESTIVAL FEATURING 350+ EXHIBITS AND 2,200+ EXHIBITORS. VISITORS OF ALL AGES EXPERIENCED INTERACTIVE PRESENTATIONS, HANDS-ON DEMONSTRATIONS, EXHIBITIONS, PERFORMING ARTS, AND RESEARCH PROJECTS. IN CELEBRATION OF EARTH DAY 2023, RRH SPONSORED SPECIAL ACTIVITIES ACROSS ITS LOCATIONS, INCLUDING TREE SAPLING GIVEAWAYS AT EACH OF THE HOSPITALS AND AN E-WASTE DROP-OFF. MAY IS MENTAL HEALTH AWARENESS MONTH, A NATIONAL MOVEMENT TO RAISE AWARENESS ABOUT MENTAL HEALTH. EVERY YEAR MILLIONS OF AMERICANS 1 IN 5 ADULTS, 1 IN 6 CHILDREN FACE THE REALITY OF LIVING WITH A MENTAL ILLNESS. ROCHESTER REGIONAL OFFERS A COMPREHENSIVE RANGE OF MENTAL HEALTH SERVICES, INCLUDING ADULT MENTAL HEALTH, YOUTH, AND FAMILY, BEHAVIORAL HEALTH ACCESS & CRISIS CENTER, COMPREHENSIVE PSYCHIATRIC EMERGENCY PROGRAM, HEALTH CARE MANAGEMENT, AND PERSONALIZED RECOVERY ORIENTED SERVICES. STROKE AWARENESS: ROCHESTER REGIONAL HEALTH AND THE ROCHESTER RED WINGS BASEBALL TEAM CAME TOGETHER TO RAISE AWARENESS OF THE IMPORTANCE OF PREVENTION, RECOGNITION, AND RAPID STROKE TREATMENT. RRH SPONSORED THE HAIR & HEALTH SYMPOSIUM IN JUNE 2023. THE FREE EVENT WAS HELD AT LOCAL SCHOOLS AND WAS OPEN TO THE PUBLIC. IF PERFORMED IMMEDIATELY, CARDIOPULMONARY RESUSCITATION (CPR) CAN DOUBLE, OR EVEN TRIPLE, THE CHANCES OF SURVIVAL FROM AN OUT-OF-HOSPITAL CARDIAC ARREST. RRH HOSTED A SERIES OF FREE CPR TRAINING EVENTS FOR ANYONE WANTING TO LEARN HOW TO PERFORM CPR AND OTHER LIFE-SAVING MEASURES IN CASE OF AN EMERGENCY. RRH JOINED THE AMERICAN HOSPITAL ASSOCIATION TO RECOGNIZE THE 7TH "NATIONAL DAY OF AWARENESS TO END VIOLENCE." THIS ANNUAL RECOGNITION USES A PUBLIC HEALTH LENS TO DRAW ATTENTION TO THE AREAS OF VIOLENCE WE SEE WITHIN THE HEALTHCARE SYSTEM AND WITHIN THE COMMUNITIES WE SERVE. AS A SYSTEM, RRH IS ALSO WORKING TO UPDATE AND SIMPLIFY SIGNAGE RELATED TO AGGRESSIVE BEHAVIOR IN OUR FACILITIES. THE GOAL OF THE EFFORT IS TO CLEARLY COMMUNICATE OUR EXPECTATIONS FOR RESPECTFUL PATIENT AND VISITOR BEHAVIOR WHILE EXPLAINING CLEAR CONSEQUENCES FOR VIOLATIONS OF THOSE EXPECTATIONS. THESE NEW INITIATIVES ARE IN ADDITION TO MAJOR INVESTMENTS RRH HAS MADE TO SECURITY ACROSS THE ENTIRE SYSTEM INCLUDING THE INSTALLATION AND REPAIR OF BLUE LIGHT EMERGENCY CALL BOXES, NEW SECURITY CAMERAS, IMPROVED LIGHTING AND INCREASED PATROLS BY UNIFORMED SECURITY WHICH NOT ONLY FACILITATE FASTER RESPONSES TO INCIDENTS BUT AIM TO PREVENT INCIDENTS BEFORE THEY HAPPEN. DURING PRIDE MONTH IN JUNE 2023, THE DIVERSITY, EQUITY & INCLUSION (DEI) TEAM LED EFFORTS TO RAISE AWARENESS AND CELEBRATE LESBIAN, GAY, BISEXUAL, TRANSGENDER, QUEER, OR QUESTIONING (LGBTQ+) PATIENTS, COLLEAGUES, AND OUR COMMUNITIES. RRH WAS A TOP SPONSOR OF THE 2023 ROC PRIDE PARADE. OVER 100 WALKERS AND VOLUNTEERS DEMONSTRATED RRH'S COMMITMENT TO DIVERSITY, EQUITY, AND INCLUSION. THOUSANDS OF ROCHESTERIANS ATTENDED THE EVENTS TO CELEBRATE AND SUPPORT SAFE AND INCLUSIVE SPACES FOR THE LGBTQ+ COMMUNITY. RRH WAS A SPONSOR OF THE 2023 AHA HEART WALK - BY COMING TOGETHER AS A COMMUNITY, RRH HOPES TO RAISE AWARENESS ABOUT HEART HEALTH, SUPPORT LIFE-SAVING RESEARCH, AND MAKE A POSITIVE IMPACT ON THE LIVES OF INDIVIDUALS AFFECTED BY CARDIOVASCULAR DISEASES. AT THE ROCHESTER INTERNATIONAL JAZZ FESTIVAL, RRH SPONSORED THE FIRST AID TENT THROUGHOUT THE FESTIVAL FOR GIVEAWAYS AND BASIC FIRST AID NEEDS. RRH STEPPING UP FOR LUNG CANCER RRH ENCOURAGED TEAM MEMBERS TO PARTICIPATE IN THE SUMMER RAISE, GO2 FOR LUNG CANCER'S GLOBAL FUNDRAISING EVENT BY OFFERING A FREE 40-DAY VIRTUAL STEP-TRACKING CHALLENGE TO RAISE AWARENESS FOR LUNG CANCER. RRH HEALTHY MOMS HOSTED A FAMILY RESOURCE FAIR TO SUPPORT FAMILIES IN NEED IN THE COMMUNITY. STUDIES SHOW THAT AN EDUCATION IS KEY TO OVERCOMING POVERTY, BUT MANY FAMILIES ARE UNABLE TO PROVIDE THE BASIC SCHOOL SUPPLIES THEIR CHILDREN NEED TO BE EFFECTIVE. RRH'S FEDERALLY QUALIFIED HEALTH CENTERS (FQHCS) ARE PART OF A NATIONWIDE NETWORK THAT PROVIDES CARE TO PATIENTS, REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES. IN HONOR OF NATIONAL HEALTH CENTER WEEK (AUGUST 6 12), RRH RECOGNIZED THE 400+ DEDICATED FQHC STAFF MEMBERS FOR THEIR COMMITMENT TO PROVIDING QUALITY SERVICES EACH AND EVERY DAY. RRH HOSTED A FREE SCHOOL-BASED HEALTH CENTERS INFORMATION SESSION INFORMING PARENTS AND THE COMMUNITY ABOUT THE SERVICES AVAILABLE TO STUDENTS ENROLLED IN THE ROCHESTER CITY SCHOOL DISTRICT. THE EVENT INCLUDED: ENROLLMENT SERVICES FOR CHILDREN IN FREE MEDICAL AND MENTAL HEALTH SERVICES; MEET AND PET THERAPY DOGS AND SCHOOL SUPPLY GIVEAWAYS. RRH CELEBRATED NATIONAL MINORITY DONOR AWARENESS MONTH (NMDAM) WHICH BEGAN AS NATIONAL MINORITY DONOR AWARENESS WEEK, FOUNDED IN 1996 BY THE NATIONAL MINORITY ORGAN TISSUE TRANSPLANT EDUCATION PROGRAM TO RAISE AWARENESS OF DONATIONS AND TRANSPLANTATIONS IN COMMUNITIES OF COLOR. ON AVERAGE, AFRICAN AMERICAN/BLACK TRANSPLANT CANDIDATES WAIT LONGER THAN WHITE TRANSPLANT CANDIDATES FOR KIDNEY, HEART, AND LUNG TRANSPLANTS. THESE HEALTH CARE DISPARITIES ARE PART OF THE NEED FOR NMDAM EDUCATION AND OUTREACH TO HELP HEAL AND SAVE LIVES IN OUR COMMUNITIES. WE CELEBRATED NATIONAL HEALTH CENTER WEEK WITH A CALENDAR FULL OF EVENTS, INCLUDING A PATIENT APPRECIATION DAY WITH FREE HEALTH SCREENINGS FOR ALL, AS WELL AS A "HEALTH CARE FOR THE HOMELESS" DAY, WHERE UNHOUSED INDIVIDUALS WERE OFFERED MOBILE HEALTH SERVICES, FREE HAIRCUTS, AND MORE. THE RRH AFFIRMING CARE CHEMICAL DEPENDENCY TEAM PARTICIPATED IN THE 8TH ANNUAL SCOTT B OVERDOSE AWARENESS DAY BY DISTRIBUTING NARCAN AND TEST STRIPS TO TEST FOR FENTANYL AND XYLAZINE. THE TEAM ALSO EDUCATED ATTENDEES ON THE DANGERS OF FENTANYL AND XYLAZINE AND INSTRUCTED THEM ON HOW TO IDENTIFY THESE SUBSTANCES WITHIN OTHER DRUGS. DURING NATIONAL REHABILITATION AWARENESS WEEK, RRH BROUGHT AWARENESS TO THE VARIOUS REHABILITATION PROGRAMS THAT SUPPORT COMMUNITY MEMBERS AND RECOGNIZED THE TEAM MEMBERS WHO PROVIDE THESE ESSENTIAL SERVICES TO PATIENTS. DURING GYNECOLOGICAL CANCER AWARENESS MONTH, RRH EDUCATED, RAISED AWARENESS, AND PROVIDED RESOURCES ON GYNECOLOGIC CANCERS. ROCHESTER REGIONAL HEALTH AND AENON MISSIONARY BAPTIST CHURCH JOINTLY HOSTED A COMMUNITY HEALTH FAIR. THE ONGOING COLLABORATION BETWEEN THE CHURCH AND THE HOSPITAL SEEKS TO PROMOTE BOTH PHYSICAL AND SPIRITUAL WELL-BEING WITHIN THE COMMUNITY. THE EVENT PROVIDED FREE MAMMOGRAMS, BEHAVIORAL HEALTH INFORMATION & WELLNESS, BLOOD PRESSURE CHECKS, DIABETES EDUCATION, CHOLESTEROL SCREENING, BMI SCREENING, AND INFORMATION ON CANCER PREVENTION, SCREENING, AND DETECTION. THE SANDS-CONSTELLATION HEART INSTITUTE HELD A VIRTUAL CARDIOVASCULAR DISEASE PREVENTION SYMPOSIUM INCLUDING PRESENTATIONS AND ENGAGING DISCUSSIONS DESIGNED FOR CARDIOLOGISTS, PRIMARY CARE PHYSICIANS, AND OTHER HEALTH CARE PROVIDERS INTERESTED IN THE PREVENTION OF CARDIOVASCULAR DISEASE. THE FOCUS WAS ON CARDIOVASCULAR DISEASE RISK FACTORS, PREVENTATIVE STRATEGIES, AND
FORM 990, PART III, LINE 4 (CONTINUED)	PRACTICES FOR HELPING PATIENTS LIVE LONGER, HAPPIER LIVES. ROCHESTER REGIONAL HOSTED A HEALTH OBESITY, WEIGHT LOSS & METABOLIC SURGERY SYMPOSIUM - A DAY OF INSIGHT AND ENGAGING DISCUSSIONS ON THE MULTIDISCIPLINARY CARE AND MANAGEMENT OF OBESITY, METABOLIC DISEASES, AND RELATED COMORBIDITIES. ESTEEMED NATIONAL EXPERTS SHARED THE LATEST ADVANCES, GUIDELINES, AND EVIDENCE-BASED TREATMENT OPTIONS THAT ARE SHAPING THE FUTURE OF OBESITY-RELATED CARE AND METABOLIC SURGERY. THE SANDS-CONSTELLATION HEART INSTITUTE HOSTED ITS ANNUAL CARDIOVASCULAR SYMPOSIUM. AS CARDIOVASCULAR MEDICINE CONTINUES TO EVOLVE, RRH IS COMMITTED TO PROVIDING THE VERY BEST CARDIAC CARE TO OUR COMMUNITY. PRESENTATIONS WERE DESIGNED TO HELP EACH PARTICIPANT GAIN UP-TO-DATE MEDICAL KNOWLEDGE THAT APPLIES TO THEIR DAILY PRACTICE. TOPICS INCLUDED A REVIEW OF ADVANCED STRATEGIES, CURRENT KNOWLEDGE, AND SPECIALIZED TREATMENTS TO GIVE EVERY PATIENT THE BEST POSSIBLE RESULT. THE RRH BEHAVIORAL HEALTH TEAM PARTICIPATED IN THE OUT OF THE DARKNESS WALK, WHERE FRIENDS, FAMILY MEMBERS, NEIGHBORS, AND COWORKERS WALKED SIDE-BY-SIDE, SUPPORTING EACH OTHER IN MEMORY OF THOSE LOST TO SUICIDE. THE OUT OF THE DARKNESS WALK GIVES PEOPLE THE COURAGE TO OPEN UP ABOUT THEIR CONNECTIONS TO THE CAUSE AND A PLATFORM TO CREATE A SMARTER MENTAL HEALTH CULTURE. DURING BREAST CANCER AWARENESS MONTH, ROCHESTER REGIONAL HEALTH BROUGHT AWARENESS TO BREAST CANCER THROUGH EDUCATION AND EVENTS, SUCH AS THE MAKING STRIDES ROCHESTER WALK. THIS EVENT BRINGS TOGETHER WOMEN LIVING WITH BREAST CANCER SURVIVORS, ALONG WITH THEIR FAMILIES, FRIENDS, AND SUPPORTERS. THROUGH A PARTNERSHIP WITH THE AMERICAN CANCER SOCIETY, ROCHESTER REGIONAL IS COMMITTED TO HELPING FUND GROUNDBREAKING BREAST CANCER RESEARCH PROVIDING PATIENT SERVICE SUCH AS FREE RIDES TO CHEMO, FREE PLACES TO STAY NEAR TREATMENT, AND A LIVE, 24/7 CANCER HELPLINE. RRH CELEBRATED INTERNATIONAL INFECTION PREVENTION WEEK AND SPOTLIGHTED THE INFECTION PREVENTION (IP) TEAM'S WORK AND ITS POSITIVE IMPACT ON TEAM MEMBERS, PATIENTS, VISITORS, AND THE WIDER COMMUNITY. IP WORK WITHIN RRH INCLUDES: HAND HYGIENE CAMPAIGN, HEALTHCARE-ASSOCIATED INFECTIONS TASK FORCE WORK AND PREVENTION EFFORTS, SURGICAL SITE INFECTION REDUCTION WORK, ENVIRONMENTAL ROUNDS, CONSULTING WITH FACILITIES/CONTRACTORS REGARDING MITIGATING INFECTION RISKS FROM CONSTRUCTION AND REMODELING, ANSWERING QUESTIONS ABOUT COVID-19, EXPOSURES, ISOLATION, DISINFECTION AND STERILIZATION, AND MORE. DURING SPIRITUAL CARE WEEK RRH ACKNOWLEDGED THE SPIRITUAL CARE PROVIDERS OR CHAPLAINS THROUGHOUT THE SYSTEM WHO OFFER PERSONALIZED CARE AND PSYCHO-SPIRITUAL-SOCIAL SUPPORT TO PATIENTS, FAMILIES, AND STAFF WHEN PEOPLE HAVE THINGS TO CELEBRATE OR ARE GOING THROUGH A DIFFICULT TIME. AS PART OF LUNG CANCER AWARENESS MONTH, ROCHESTER REGIONAL HEALTH BROUGHT ATTENTION TO THE IMPORTANCE OF EARLY DETECTION. THE LUNG CANCER SCREENING PROGRAM OFFERS QUICK, NON-INVASIVE SCANS AT NO OUT-OF-POCKET COST TO THOSE ELIGIBLE. PROVIDERS WORK WITH EACH PATIENT TO DETECT AND TREAT LUNG CANCER AS EARLY AS POSSIBLE. ON VETERANS DAY AND EVERY DAY, WE ARE GRATEFUL FOR THE VETERANS THROUGHOUT OUR SYSTEM AND OUR COMMUNITY. ALL RRH EMPLOYEES AND VOLUNTEERS WHO ARE VETERANS OR ACTIVE-DUTY MILITARY MEMBERS CAN RECEIVE A COMPLIMENTARY MEAL AT RRH CAFETERIAS AND COFFEE BARS. RRH HOSTED "WELLNESS WEDNESDAYS" IN CONJUNCTION WITH A LOCAL COMMUNITY CENTER. TOPICS DURING THE 2023 SESSIONS INCLUDED THE FOLLOWING: O SYMPATHETIC NERVOUS SYSTEM AND DEPRESSION AND THE ROLE OF THIS STRESS ON EMOTIONS AND MENTAL HEALTH. O HEALTH BENEFITS OF YOGA - EVIDENCE-BASED RESEARCH ON THE HEALTH BENEFITS OF YOGA INCLUDING IMPROVING BALANCE AND STRENGTH TO MENTAL CLARITY AND FOCUS. O MINDFULNESS AND MEDITATION INSTRUCTORS WILL LEAD A FULL BODY SCAN AND A GUIDED MEDITATION. O HEARING AND AGING O BASIC FUNDAMENTALS OF SPEECH, VOICE, AND LANGUAGE SKILLS. HOW THE EFFECTS OF AGING IMPACT THESE AREAS AND OUR OVERALL COMMUNICATION SKILLS. O MINDFUL SELF-COMPASSION - EXTENDING COMPASSION TO THE SELF FOR ONE'S PERCEIVED FAILINGS, INADEQUACIES, AND EXPERIENCES OF SUFFERING. O HOW TO MANAGE INJURIES TO THE HANDS, FINGERS, WRISTS AND ELBOWS. O SEASONAL DEPRESSION/SEASONAL AFFECTIVE DISORDER (SAD) - LEARN ABOUT SEASONAL DEPRESSION AND HOW TO RECOGNIZE IT. O LEARN ABOUT THE OUTLOOK/PERSPECTIVE ON AGING, "AGE FRIENDLY" HEALTH CARE, AND HOW THIS PROGRAM SPECIFICALLY MEETS THE NEEDS OF THE GERIATRIC COMMUNITY. O LEARN SOME COMMON MYTHS ABOUT ENVIRONMENTAL ALLERGIES AND WHAT THE DATA SAYS ON HOW TO BEST TREAT THEM. O SMOOTHIES & MOVIES & PLANT-BASED WHOLE FOOD POT-LUCK THE BENEFITS OF DRINKING SMOOTHIES, SECRET POWERHOUSE INGREDIENTS AND AN ACTUAL DEMONSTRATION ON HOW TO MAKE THEM. DURING THE POT-LUCK WE WILL BE SHOWING THE DOCUMENTARY FORKS OVER KNIVES TO HELP EDUCATE MEMBERS AND THE COMMUNITY ON THE HEALING BENEFITS OF CONSUMING PLANTS. O THE LATEST UP TO DATE PRACTICES REGARDING PHYSICAL THERAPY. O LIFESTYLE MEDICINE AND HOW IT RELATES TO OUR PHYSICAL HEALTH, STRESS MANAGEMENT. O CHOLESTEROL EVALUATION AND MANAGEMENT O EDUCATION ON PRE-DRIVING SCREENING ASSESSMENTS. SEVERAL MEDICAL CONDITIONS MAY AFFECT DRIVING INCLUDING HEART DISEASE, STROKE, DIABETES, DEMENTIA, BRAIN INJURY AND MANY MORE. LICENSED OCCUPATIONAL THERAPISTS CAN CONDUCT ASSESSMENTS ON PHYSICAL PERFORMANCE, REACTION TIME, ABILITY TO READ SIGNS, PROBLEM SOLVING TECHNIQUES AND MORE. O PRESENTATION ON HOW THE COST OF MEDICATIONS CAN BE A MAJOR BARRIER TO MEDICATION ACCESSIBILITY. NEARLY FOUR IN TEN OF THOSE TAKING FOUR OR MORE PRESCRIPTION DRUGS SAY THEY HAVE DIFFICULTY AFFORDING THEIR PRESCRIPTIONS. WHAT CAN BE DONE TO HELP REDUCE COST RELATED MEDICATION NON-ADHERENCE AND IMPROVE MEDICATION AFFORDABILITY. O CLIMATE CHANGE & KEEPING HEALTHY - THE SCIENCE OF CLIMATE CHANGE, THE MULTIPLE IMPACTS CLIMATE CHANGE CAN HAVE ON OUR HEALTH, AND MOST IMPORTANTLY, WHAT WE CAN DO INDIVIDUALLY AND COLLECTIVELY TO HELP PROTECT OUR HEALTH AND BE PART OF THE SOLUTION. O BREAST CANCER AWARENESS DISCUSSIONS RELATING TO TAKING CHARGE OF YOUR BREAST, BREAST CANCER SCREENING RECOMMENDATIONS, SIGNS AND SYMPTOMS OF BREAST CANCER AND HOW TO REDUCE YOUR BREAST CANCER RISK FROM A BREAST SURGEON PERSPECTIVE. O COGNITIVE HEALTH O RRH'S MOBILE MAMMOGRAPHY CENTER WILL BE ON SITE FOR MAMMOGRAM SCREENINGS. THE MAMMOGRAM MACHINE ON THE BUS IS THE EXACT SAME AS THE MACHINE USED IN THE HOSPITAL, AS IS THE QUALITY. O BREAK DOWN THE COMPLICATED INFORMATION REGARDING LUNG CANCER AND SHED SOME LIGHT AS TO WHAT RESEARCHERS ARE DOING TO DECREASE LUNG CANCER RATES AND IMPROVE OUTCOMES. O EFFECTS OF LONELINESS AND STRATEGIES FOR STAYING CONNECTED - THE EPIDEMIC OF LONELINESS IN THE UNITED STATES HAS REACHED AN ALL-TIME HIGH IN RECENT YEARS. THE PHYSICAL AND MENTAL EFFECTS OF LONELINESS CAN INCREASE THE RISK FOR HEART DISEASE, STROKE, DEMENTIA AND EVEN PREMATURE DEATH. LEARN STRATEGIES FOR STAYING CONNECTED. O URINARY HEALTH AND INCONTINENCE - DISCUSSING THE TYPES OF URINARY INCONTINENCE, HOW URINARY INCONTINENCE OFTEN HAS A MUSCULOSKELETAL ORIGIN, AND HOW YOU CAN TREAT AND EVEN CURE WITH SIMPLE INTERVENTIONS. O LIVE TO 100: SECRETS OF THE BLUE ZONES - SCIENTISTS FOUND OTHER LONGEVITY HOTSPOTS WORLDWIDE AND THEY ARE KNOWN AS THE BLUE ZONES. THE RESEARCHERS FOUND THAT ALL BLUE ZONES AREAS SHARE NINE SPECIFIC LIFESTYLE HABITS THAT ARE CALLED THE POWER 9. O LEARN ABOUT EATING FOR KIDNEY HEALTH. DURING 2023 ROCHESTER REGIONAL HEALTH WAS RECOGNIZED AS FOLLOWS: THE RRH CHEMICAL DEPENDENCY PROGRAM BECAME ONE OF THE FIRST IN NEW YORK STATE TO BE ENDORSED AS AN LGBTQ-AFFIRMING PROGRAM BY THE NEW YORK STATE OFFICE OF ADDICTION SERVICES AND SUPPORTS (OASAS). LIVING WITH SUBSTANCE USE DISORDER IS A SIGNIFICANT LIFE HARDSHIP. YET, CULTURALLY RESPONSIVE CARE HAS NOT ALWAYS BEEN AVAILABLE TO PEOPLE IDENTIFYING AS LESBIAN, GAY, BISEXUAL, TRANSGENDER, QUEER/QUESTIONINGOR ANY PART OF THE LGBTQ COMMUNITY. RRH CHEMICAL DEPENDENCY PROVIDES A SAFE, WELCOMING SPACE FOR PERSON-CENTERED CARE. AS THE REGION'S MOST EXTENSIVE CHEMICAL DEPENDENCY TREATMENT PROVIDER AND ONE OF THE FIRST TO OFFER CHEMICAL DEPENDENCY PROGRAMS AND SERVICES TAILORED TO LGBTQ PATIENT NEEDS. OUR FLEXIBLE OFFERINGS INCLUDE INPATIENT REHABILITATION, OUTPATIENT SERVICES, AND INTEGRATED MEDICATION-ASSISTED TREATMENT. TO ADDRESS THE UNIQUE NEEDS OF LGBTQ CLIENTS, WE OFFER AFFIRMATIVE CARE TO SUPPORT RECOVERY IN INDIVIDUAL SESSIONS, GROUP SESSIONS, AND PEER RECOVERY SERVICES. THE LGBTQ-AFFIRMING PROGRAM ENDORSEMENT FROM OASAS IS AN OPERATING DESIGNATION FOR CERTIFIED PROGRAMS THAT HAVE CREATED AN LGBTQ-AFFIRMING ADDICTION TREATMENT SPACE. ROCHESTER REGIONAL HEALTH WAS NAMED A PRACTICE GREENHEALTH SYSTEM FOR CHANGE AWARD WINNER FOR THE SIXTH YEAR IN A ROW IN RECOGNITION OF THE SYSTEM'S ONGOING COMMITMENT TO SUSTAINABILITY. ADDITIONALLY, OUR FIVE ROCHESTER-ADJACENT HOSPITALS HAVE BEEN NAMED AS PARTNERS FOR CHANGE AWARD
FORM 990, PART III, LINE 4 (CONTINUED)	RECIPIENTS. THE SYSTEM FOR CHANGE AWARD RECOGNIZES HEALTH SYSTEMS THAT ARE WORKING COHESIVELY TO SET SYSTEM-WIDE SUSTAINABILITY GOALS, TRACK PERFORMANCE DATA, AND SUPPORT INTRA-ORGANIZATIONAL LEARNING AND IMPLEMENTATION WITHIN THEIR INSTITUTIONS. THE ASSOCIATION OF COMMUNITY CANCER CENTERS (ACCC) NATIONAL ONCOLOGY CONFERENCE TASKFORCE CHOSE THE LIPSON CANCER INSTITUTE'S "A COLLABORATIVE CARE MODEL" AS A 2023 ACCC INNOVATOR AWARD WINNER. THE ACCC INNOVATOR AWARD RECOGNIZES INNOVATIONS THAT SUPPORT ADVANCEMENTS TO ACCESS, QUALITY, AND VALUE IN CANCER CARE DELIVERY. AS PART OF THE COLLABORATIVE CARE MODEL, THE LIPSON CANCER INSTITUTE EMBEDDED COUNSELING SERVICES INTO ONCOLOGY AND PALLIATIVE CARE ACROSS SIX CLINIC LOCATIONS. THE MODEL ALLOWS PATIENTS TO RECEIVE COUNSELING FOR DEPRESSION, ANXIETY, OR OTHER PSYCHO-SOCIAL CONCERNS WHILE IN ACTIVE TREATMENT AND SURVIVORSHIP, ELIMINATING MANY BARRIERS TO CARE. COUNSELING IS PROVIDED IN-PERSON OR VIRTUALLY, ENSURING THAT CRITICAL SUPPORT AND MENTAL HEALTH CARE ARE ACCESSIBLE TO ALL, INCLUDING PATIENTS IN RURAL AREAS AND THOSE WHO ARE HOMEBOUND. THE ROCHESTER REGIONAL HEALTH CARDIAC AND PULMONARY REHABILITATION PROGRAM TEAM MAINTAINED THEIR AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION (AACVPR) CERTIFICATIONS. AS THE ONLY PEER-REVIEW ACCREDITATION PROCESS, AACVPR PROGRAM CERTIFICATION IS DESIGNED TO REVIEW INDIVIDUAL PROGRAMS FOR ADHERENCE TO THE HIGHEST STANDARDS AND GUIDELINES DEVELOPED AND PUBLISHED BY A GROUP OF PROFESSIONAL SOCIETIES IN THE FIELD. CERTIFICATION IS VALID FOR THREE YEARS. TO EARN ACCREDITATION, THE CARDIAC AND PULMONARY REHAB PROGRAM PARTICIPATED IN AN APPLICATION PROCESS THAT REQUIRED EXTENSIVE DOCUMENTATION OF PRACTICES. ROCHESTER REGIONAL HEALTH AMONG TOP 100 HOSPITALS & HEALTH SYSTEMS WITH HIGH-ACHIEVING ORTHOPEDIC PROGRAMS RRH WAS ANNOUNCED AS PART OF THE BECKER'S HEALTHCARE LIST OF "HOSPITALS AND HEALTH SYSTEMS WITH GREAT ORTHOPEDIC PROGRAMS" FOR 2023. AS BECKER'S CITES IN ITS LIST, RRH PERFORMS ABOUT 18,000 ORTHOPEDIC SURGERIES AND HAS MORE THAN 160,000 OUTPATIENT ORTHOPEDIC VISITS YEARLY. RRH IS THE REGIONAL LEADER IN JOINT REPLACEMENT, PERFORMING THOUSANDS OF HIP, KNEE, SHOULDER, ELBOW, ANKLE, AND CERVICAL SPINE PROCEDURES ANNUALLY AT RRH HOSPITALS THAT DNV HEALTHCARE REPEATEDLY RECOGNIZES AS ORTHOPEDIC CENTERS OF EXCELLENCE. RRH IS AMONG ONLY A FEW HEALTH SYSTEMS IN THE COUNTRY OFFERING A VERIFIED GERIATRIC SURGICAL PROGRAM THAT PROVIDES OLDER ADULT PATIENTS PERSONALIZED SURGICAL PLANS, INCLUDING COMPREHENSIVE PRE-OP EVALUATIONS BEFORE THEY ARRIVE IN THE OPERATING SUITE. RRH SURGEONS ALSO UTILIZE STATE-OF-THE-ART TOOLS, SUCH AS ROBOTIC SURGICAL ASSISTANT, ALLOWING JOINT REPLACEMENTS TO BE DONE WITH GREATER ACCURACY AND EFFICIENCY. IN ADDITION, RRH IS ALSO HELPING SOME OF OUR COMMUNITY'S YOUNGEST ORTHOPEDIC PATIENTS THROUGH OUR SPORTS MEDICINE PROGRAMS, HELPING YOUNG ATHLETES TRAIN WITHOUT INJURY AND STANDING READY FOR ANY EMERGENCY ALONG THE SIDELINES WHEN THOSE ATHLETES ARE ON THE FIELD FOR A GAME. FIVE RRH EMERGENCY DEPARTMENT PHYSICIANS WERE RECOGNIZED BY THE NEW YORK AMERICAN COLLEGE OF EMERGENCY PHYSICIANS (NY ACEP) AS RECIPIENTS OF THEIR 2023 "UNSUNG HEROES" AWARD. THESE PHYSICIANS WERE AMONG JUST 33 RECOGNIZED ACROSS ALL OF NYS FOR THEIR INCREDIBLE CONTRIBUTIONS TO THEIR COLLEAGUES AND THE PATIENTS AND COMMUNITIES THEY SERVE. ST. LAWRENCE HEALTH SYSTEM (SLH), A NORTH COUNTRY HEALTH SYSTEM INCLUDING THREE HOSPITALS (CANTON-POTSDAM HOSPITAL, GOUVERNEUR HOSPITAL AND MASSENA HOSPITAL) AND A NETWORK OF PRIMARY AND SPECIALTY CARE PRACTICES JOINED RRH IN 2021 ALLOWING RRH TO EXPAND ITS REGIONAL REACH WHILE ENABLING ST. LAWRENCE TO ELEVATE AND GROW ITS MEDICAL SERVICES. BOTH RRH AND SLH HAVE TRADITIONS OF PROVIDING HIGH QUALITY, COMPASSIONATE CAREAND TOGETHER, IN 2023 THEY CONTINUED TO BRING ABOUT IMPORTANT TECHNOLOGICAL INTEGRATION MILESTONES. ACCOLADES AND ACTIVITY OF THE ST. LAWRENCE HEALTH TEAM IN 2023 INCLUDED THE FOLLOWING: CANTON-POTSDAM HOSPITAL, GOUVERNEUR HOSPITAL AND MASSENA HOSPITAL RECEIVED THE INSTITUTE FOR HEALTHCARE IMPROVEMENT'S (IHI) AGE-FRIENDLY HEALTH SYSTEMS- COMMITTED TO CARE EXCELLENCE (LEVEL 2) DESIGNATION. IHI RECOGNIZES HEALTHCARE FACILITIES WORKING TOWARDS EVIDENCE-BASED INTERVENTIONS FOR OLDER ADULTS IN THEIR CARE FOLLOWING THE 4MS: WHAT MATTERS, MEDICATION, MENTATION, AND MOBILITY. THE COMMITTED TO CARE EXCELLENCE DESIGNATION IS THE HIGHEST RECOGNITION IN THE AGE-FRIENDLY HEALTH SYSTEMS MOVEMENT AND ACKNOWLEDGES THAT THESE PRACTICES HAVE BEEN IMPLEMENTED WITH PROVEN DATA FOR AT LEAST THREE MONTHS. THE SLH DIVERSITY, EQUITY, AND INCLUSION COMMITTEE ORGANIZED A SOCK DRIVE TO BENEFIT RENEWAL HOUSE, AN AGENCY THAT HELPS VICTIMS OF FAMILY VIOLENCE; AND NORTH COUNTRY FREEDOM HOMES, WHICH PROVIDES SAFE AND SUPPORTIVE RESIDENTIAL CARE FOR COMMUNITY MEMBERS RECOVERING FROM SUBSTANCE USE DISORDER. ST. LAWRENCE HEALTH DONATED TO THE FRIENDS OF HIGLEY FLOW STATE PARK'S SLED SHED CAMPAIGN TO HELP BUILD A NEW STRUCTURE TO STORE THE EQUIPMENT USED TO KEEP THE TRAILS ACCESSIBLE FOR THE COMMUNITY. ST. LAWRENCE HEALTH WAS A MAIN SPONSOR OF THE NORTH COUNTRY KIDS EXPO HELD IN CANTON IN MARCH 2023. SLH COVERED THE COST OF ADMISSION FOR ALL CHILDREN AGES 12 AND UNDER WHO ATTENDED THE EVENT. DURING SUNY POTSDAM'S HEALTH, WELLNESS AND SAFETY EXPO THE NUTRITION SERVICES TEAM PROVIDED EDUCATIONAL MATERIALS, THE CLINICAL RESEARCH TEAM PROVIDED INFORMATION ON CLINICAL TRIALS ACTIVITY, AND MARKETING & COMMUNICATIONS TEAM HAD GIVEAWAYS FROM DONATE LIFE. THE EVENT WAS HELD ON SEXUAL ASSAULT AWARENESS DAY, AND SLH REPRESENTATIVES PARTICIPATED IN WEARING TEAL TO RAISE AWARENESS. ST. LAWRENCE HEALTH (SLH) AND COMMUNITY PARTNERS INVITED HEALTHCARE WORKERS AND THE GENERAL PUBLIC TO RECOGNIZE MENTAL HEALTH AWARENESS MONTH DURING MAY BY ATTENDING ANY OF THEIR THREE BEHAVIORAL HEALTH FAIRS. NARCAN TRAINING WAS AMONG THE MANY EVENTS SCHEDULED FOR THE DAY. ST. LAWRENCE HEALTH WAS A PROUD SPONSOR OF THE POTSDAM SNACK PACK PROGRAM'S 5TH ANNUAL BACK TO SCHOOL FAIR IN AUGUST 2023, AT THE NEW HOPE COMMUNITY CHURCH IN POTSDAM. SLH TEAM MEMBERS CONNECTED WITH FAMILIES WITH SHARED INFORMATIONAL HANDOUTS AND GIVEAWAYS. SLH HELD A "WALK WITH A DOC" EVENT IN POTSDAM, NY ALONG THE RAQUETTE RIVER ON AN EASY TRAIL WHILE MEETING LOCAL HEALTHCARE PROVIDERS. PARTICIPANTS JOINED VARIOUS STAFF MEMBERS AS WELL AS MEMBERS OF THE SLH DIVERSITY, EQUITY, AND INCLUSION COMMITTEE IN CELEBRATION OF PRIDE MONTH TO LEARN ABOUT OUR COMMITMENT TO PROVIDING QUALITY AND COMPASSIONATE CARE TO ALL COMMUNITY MEMBERS. THE TRINITY CATHOLIC SCHOOL IN MASSENA INVITED SLH TO ITS FIRST EVER HEALTH AND FITNESS FAIR, WHERE THE BEHAVIORAL HEALTH CARE COORDINATOR PROVIDED BLOOD PRESSURE AND PULSE SCREENINGS AND HAD A SELECTION OF HANDOUTS AND GIVEAWAYS FOR THOSE IN ATTENDANCE. DURING 2023, SLH, FOCUSED ON CONTINUED GROWTH, FINALIZED THE PROCESS OF ACQUIRING SEAWAY VALLEY AMBULANCE SERVICE. THE MASSENA-BASED SEAWAY VALLEY AMBULANCE SERVICE, A DEDICATED EMS, INTER-FACILITY TRANSPORT, AND AMBULATE SERVICE PRESENTLY SERVICING THE MASSENA-AREA MARKET IS EXPECTED TO FURTHER IMPROVE TRANSPORT ACCESS IN MASSENA AND ITS SURROUNDING COMMUNITIES. CANTON-POTSDAM HOSPITAL (CPH) IS A NOT-FOR-PROFIT COMMUNITY HEALTHCARE FACILITY CERTIFIED FOR 94 BEDS. ITS CORE PROGRAMS IN EMERGENCY MEDICINE, ACUTE CARE, HOSPITALIST MEDICINE, AND CRITICAL CARE ARE SUPPLEMENTED BY OUTPATIENT HEALTH SERVICES IN BRASHER FALLS, CANTON, COLTON, GOUVERNEUR, MASSENA, NORFOLK, AND POTSDAM, NY. FURTHERMORE, CARE IS PROVIDED IN OVER 25 DIFFERENT SPECIALTIES, INCLUDING A ROBUST ORTHOPEDIC SURGERY AND SPORTS MEDICINE PROGRAM, AND THE CENTER FOR CANCER CARE. CPH OFFERS LEVEL III TRAUMA CARE AND A CRITICAL CARE UNIT, AND IS A CERTIFIED PRIMARY STROKE CENTER. CPH HOUSES THE BIRTHPLACE CENTER WHICH OFFERS OPTIONS FOR PRENATAL CARE, DELIVERY--INCLUDING MIDWIFERY--POST-PARTUM CARE, AND EDUCATION. THE COMBINATION LABOR, DELIVERY, RECOVERY AND POSTPARTUM ROOMS (LDRPS) OFFER FAMILIES A SPACIOUS AND COMFORTABLE AREA DURING THE BIRTHING EXPERIENCE. THE BIRTHPLACE PARTICIPATES IN THE NEW YORK STATE BREASTFEEDING QUALITY IMPROVEMENT IN HOSPITALS PROGRAM. A CERTIFIED LACTATION SPECIALIST PROVIDES BEDSIDE EDUCATION AND ADVICE. THE FIRST SURGERY IN ST. LAWRENCE COUNTY USING THE DA VINCI XI ROBOTIC SURGICAL SYSTEM WAS COMPLETED IN THE CPH OPERATING ROOM IN APRIL 2023 MARKING A SIGNIFICANT MILESTONE FOR THE COMMUNITY. CANTON-POTSDAM HOSPITAL ALSO RECEIVED DNV CERTIFICATION AS A PRIMARY STROKE CENTER, AFFIRMING THE HOSPITAL'S READINESS TO HANDLE A FULL RANGE OF STROKE-RELATED MEDICAL CONCERNS, POSITIVELY IMPACTING THE OVERALL HEALTH AND WELL-BEING OF THE LOCAL COMMUNITY. GOUVERNEUR HOSPITAL (GH) IS A NOT-FOR-PROFIT CRITICAL ACCESS HOSPITAL FOUNDED IN 2013, AND IS CERTIFIED FOR 25 BEDS. SERVICES INCLUDE INPATIENT DETOX, SUBSTANCE USE DISORDER REHABILITATION, EMERGENCY CARE,
FORM 990, PART III, LINE 4 (CONTINUED)	IMAGING AND EKG'S, PHYSICAL THERAPY, AND RESPIRATORY THERAPY AS WELL AS OUTPATIENT HEALTH SERVICES TO NEIGHBORING COMMUNITIES. MASSENA HOSPITAL (MH) IS A NOT-FOR-PROFIT CRITICAL ACCESS 25-BED HOSPITAL. IT PROVIDES INPATIENT MEDICAL, SURGICAL, AND PEDIATRIC SERVICES, IN ADDITION TO EMERGENCY CARE. NUTRITIONAL COUNSELING, RESPIRATORY CARE, PHYSICAL, AND SPEECH THERAPIES ARE ALSO OFFERED AT THE MAIN CAMPUS. NUMEROUS OUTREACH PRIMARY AND SPECIALTY CARE CENTERS OFFER THE COMMUNITY CARDIOLOGY, INFUSION, NEPHROLOGY, NEUROLOGY, OBSTETRICS/GYNECOLOGY AND WOMEN'S HEALTH, PEDIATRICS, AND SURGICAL CARE.
FORM 990, PART VI, SECTION A, LINE 6	THE ORGANIZATION IS A MEMBERSHIP (NOT A STOCK) CORPORATION UNDER NEW YORK STATE LAW. THE SOLE CORPORATE MEMBER OF ST. LAWRENCE HEALTH SYSTEM, INC. IS ROCHESTER REGIONAL HEALTH, A RELATED NOT-FOR-PROFIT CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11B	PRIOR TO FILING, A COPY OF THE FORM 990 IS PROVIDED TO, AND REVIEWED WITH, ALL MEMBERS OF THE AUDIT AND COMPLIANCE COMMITTEE. THIS REVIEW IS PERFORMED IN CONSULTATION WITH THE ORGANIZATION'S TAX ADVISORS, AND IS BASED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AND OTHER RELEVANT INFORMATION FOR THE APPROPRIATE TIME PERIOD.
FORM 990, PART VI, SECTION B, LINE 12C	BOARD MEMBER CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED AND REVIEWED BY THE BOARD ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION PROCESS FOR TOP OFFICIAL - THE AUDIT, COMPLIANCE AND COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS UTILIZES THE INPUT OF A NATIONAL CONSULTING FIRM WITH EXPERTISE IN EXECUTIVE COMPENSATION TO REVIEW THE COMPENSATION PACKAGES OFFERED TO TOP MANAGEMENT AS WELL AS OUR COMPLIANCE WITH REGULATORY REQUIREMENTS FOR EXECUTIVE COMPENSATION FOR NOT-FOR-PROFIT HOSPITALS. UPON THE FINDINGS OF THE CONSULTANT AND DELIBERATIONS OF THE AUDIT, COMPLIANCE, AND COMPENSATION COMMITTEE, THE COMMITTEE WILL THEN MAKE A RECOMMENDATION TO THE FULL BOARD. THE FULL BOARD WILL THEN VOTE ON THE TOP OFFICIAL'S COMPENSATION PACKAGE. COMPENSATION PROCESS FOR OFFICERS - THE COMPENSATION OF OTHER KEY EMPLOYEES IS DETERMINED PRIMARILY BY INFORMATION GATHERED FROM INDEPENDENT SURVEY DATA FROM NATIONAL AND SURROUNDING MARKETS COORDINATED BY THE HUMAN RESOURCE DEPARTMENT. THE CEO AND VICE PRESIDENT OF HUMAN RESOURCES REVIEW THE SURVEY DATA TO DETERMINE SALARY RANGES AND COMPENSATION PACKAGES. THE CEO BRINGS THE INFORMATION AND FINDINGS TO THE AUDIT, COMPLIANCE, AND COMPENSATION COMMITTEE OF THE BOARD FOR THEIR DELIBERATION AND CONSIDERATION. THE AUDIT, COMPLIANCE, AND COMPENSATION COMMITTEE WILL THEN BRING THEIR RECOMMENDATION TO THE FULL BOARD FOR THEIR FINAL APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE ADMINISTRATIVE OFFICES OF THE AFFILIATED HEALTH SYSTEM AT 100 KINGS HIGHWAY SOUTH, ROCHESTER, NY 14617. A NOMINAL FEE IS CHARGED IF COPIES ARE REQUESTED.
FORM 990, PART VII, SECTION A, COLUMN (F):	ESTIMATED AMOUNT OF OTHER COMPENSATION FROM THE ORGANIZATION AND RELATED ORGANIZATIONS - THIS COLUMN IS REFLECTIVE OF (1) THE ACTUARIAL CHANGE IN DEFINED BENEFIT PENSION PLAN AND POST-RETIREMENT BENEFITS FOR THE TAX YEAR AND (2) NON-TAXABLE BENEFITS.
FORM 990, PART XI, LINE 9:	ACO ADJUSTMENT 587,144.
FORM 990, PART XII, LINE 2C	THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ST LAWRENCE HEALTH SYSTEM INC

Employer identification number

46-4259168

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) ACCOUNTABLE CARE ORGANIZATION OF THE NORTH COUNTRY LLC 100 KINGS HIGHWAY S ROCHESTER,NY14617 45-4106154	MEDICAL CARE	NY	23,781	74,356	ST LAWRENCE HEALTH SYSTEM

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)BEHAVIORAL HEALTH NETWORK INC 490 EAST RIDGE ROAD ROCHESTER,NY14621 16-6069131	MENTAL HEALTH	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(2)CANTON-POTSDAM HOSPITAL 50 LEROY STREET POTSDAM,NY13676 16-1012691	HOSPITAL	NY	501(C)(3)	LINE 3	ST LAWRENCE HEALTH SYSTEM INC	Yes
(3)CANTON-POTSDAM MEDICAL PRACTICE PLLC 50 LEROY STREET POTSDAM,NY13676 46-0714367	OUT PATIENT CLINIC	NY	501(C)(3)	LINE 10	ST LAWRENCE HEALTH SYSTEM INC	Yes
(4)CLIFTON SPRINGS HOSPITAL & CLINIC FOUNDATION 2 COULTER ROAD CLIFTON SPRINGS,NY14432 16-1560033	FUNDRAISING	NY	501(C)(3)	LINE 12B, II	ROCHESTER REGIONAL HEALTH	Yes
(5)CLIFTON SPRINGS HOSPITAL AND CLINIC 2 COULTER ROAD CLIFTON SPRINGS,NY14432 16-0743966	HOSPITAL	NY	501(C)(3)	LINE 3	ROCHESTER REGIONAL HEALTH	Yes
(6)CONTINUING CARE NETWORK INC (CCN) 100 KINGS HIGHWAY SOUTH ROCHESTER,NY14617 22-2963016	SUPPORT RGH	NY	501(C)(3)	LINE 12B, II	ROCHESTER REGIONAL HEALTH	Yes
(7)GENESEE REGION HOME CARE ASSOCIATION ONTARIO COUNTY INC 100 KINGS HIGHWAY ROCHESTER,NY14617 22-3257719	HOME HEALTH	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(8)GENESEE REGION HOME CARE ASSOCIATION INC 100 KINGS HIGHWAY ROCHESTER,NY14617 16-0844109	HOME HEALTH	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(9)GOVEURNEUR HOSPITAL 77 WEST BARNEY STREET GOUVERNEUR,NY13642 46-4249555	HOSPITAL	NY	501(C)(3)	LINE 3	ST LAWRENCE HEALTH SYSTEM INC	Yes
(10)GRHS FOUNDATION 100 KINGS HIGHWAY SOUTH ROCHESTER,NY14617 22-3378111	R/E INV MGMT	NY	501(C)(3)	LINE 12B, II	ROCHESTER REGIONAL HEALTH	Yes
(11)INDEPENDENT LIVING FOR SENIORS 2066 HUDSON AVENUE ROCHESTER,NY14617 16-1491059	ADULT DAY HC	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(12)MASSENA HOSPITAL INC 1 HOSPITAL DRIVE MASSENA,NY13662 84-3134268	HOSPITAL	NY	501(C)(3)	LINE 3	ST LAWRENCE HEALTH SYSTEM INC	Yes
(13)NEWARK WAYNE COMMUNITY HOSPITAL DRIVING PARK AVENUE NEWARK,NY14513 15-0584188	HOSPITAL	NY	501(C)(3)	LINE 3	ROCHESTER REGIONAL HEALTH	Yes
(14)NEWARK WAYNE COMMUNITY HOSPITAL FOUNDATION DRIVING PARK AVENUE NEWARK,NY14513 22-2963015	FUNDRAISING	NY	501(C)(3)	LINE 12B, II	ROCHESTER REGIONAL HEALTH	Yes
(15)NORTH PARK NURSING HOME INC 1555 LONG POND RD ROCHESTER,NY14626 22-3159644	LONG TERM CARE FACILITY	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(16)PARK RIDGE CHILD CARE CENTER INC 1555 LONG POND ROAD ROCHESTER,NY14626 22-2918126	CHILD DAY CARE SERVICES	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(17)PARK RIDGE HOUSING DEVELOPMENT FUND 1555 LONG POND RD ROCHESTER,NY14626 22-2608311	LOW INCOME HOUSING PROJECT FOR ELDERLY	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(18)PARK RIDGE NURSING HOME INC 1555 LONG POND RD ROCHESTER,NY14626 16-0978184	LONG TERM CARE FACILITY	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(19)PARKWAY COMMONS HOUSING DEVELOPMENT 1555 LONG POND RD ROCHESTER,NY14626 22-3130818	LOW INCOME HOUSING FOR ELDERLY/HANDICAPPED	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(20)PARMA HOUSING DEVELOPMENT FUND CORP 89 GENESEE STREET ROCHESTER,NY14611 81-0671685	LOW INCOME HOUSING FOR ELDERLY/HANDICAPPED	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(21)PRCD INC 1555 LONG POND RD ROCHESTER,NY14626 16-1311581	SUBSTANCE ABUSE TREATMENT & REHAB.	NY	501(C)(3)	LINE 7	ROCHESTER REGIONAL HEALTH	Yes
(22)RGHS WORKERS' COMPENSATION TRUST 1425 PORTLAND AVENUE ROCHESTER,NY14621 16-6429300	SEE PART VII	NY	501(C)(3)	LINE 12B, II	ROCHESTER REGIONAL HEALTH	Yes
(23)ROCHESTER GENERAL COLLEGE OF HEALTH CAREERS 470 SKYVIEW CENTRE PKWY ROCHESTER,NY14622 86-2935462	EDUCATION	NY	501(C)(3)	LINE 2	THE ROCHESTER GENERAL HOSPITAL	Yes
(24)ROCHESTER GENERAL HEALTH SYSTEM 100 KINGS HIGHWAY SOUTH ROCHESTER,NY14617 22-2551509	SYSTEM SUPPORT	NY	501(C)(3)	LINE 12B, II	ROCHESTER REGIONAL HEALTH	Yes
(25)ROCHESTER GENERAL HOSPITAL 1425 PORTLAND AVENUE ROCHESTER,NY14621 16-0743134	HOSPITAL	NY	501(C)(3)	LINE 3	ROCHESTER REGIONAL HEALTH	Yes
(26)ROCHESTER GENERAL HUDSON HOUSING 2066 HUDSON AVENUE ROCHESTER,NY14621 22-3210351	LOW INC HOUSING	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(27)ROCHESTER GENERAL LONG TERM CARE 1550 EMPIRE BLVD WEBSTER,NY14580 22-3187140	NH & REHAB	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(28)ROCHESTER REGIONAL HEALTH 100 KINGS HIGHWAY SOUTH ROCHESTER,NY14617 47-1234999	SYSTEM PARENT	NY	501(C)(3)	LINE 12B, II	N/A	Yes
(29)ROCHESTER REGIONAL HEALTH FOUNDATION 100 KINGS HIGHWAY SOUTH ROCHESTER,NY14617 22-2229425	FUNDRAISING	NY	501(C)(3)	LINE 12B, II	ROCHESTER REGIONAL HEALTH	Yes
(30)THE UNITY HOSPITAL OF ROCHESTER 1555 LONG POND RD ROCHESTER,NY14626 23-7221763	HOSPITAL	NY	501(C)(3)	LINE 3	ROCHESTER REGIONAL HEALTH	Yes
(31)UNITED MEMORIAL MEDICAL CENTER 127 NORTH STREET BATAVIA,NY14020 16-0743029	HOSPITAL	NY	501(C)(3)	LINE 3	ROCHESTER REGIONAL HEALTH	Yes
(32)UNITED MEMORIAL MEDICAL CENTER FOUNDATION 127 NORTH STREET BATAVIA,NY14020 22-2611543	FUNDRAISING	NY	501(C)(3)	LINE 12B, II	UNITED MEMORIAL MEDICAL CENTER	Yes
(33)UNITY AGING SERVICES INC 1555 LONG POND RD ROCHESTER,NY14626 84-1684195	MANAGEMENT AND DEVELOPMENT CO	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(34)UNITY AMBULATORY SURGERY CENTER INC 1555 LONG POND RD ROCHESTER,NY14626 38-3871383	OUTPATIENT SURGERY	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(35)UNITY HEALTH SYSTEM INC 1555 LONG POND ROAD ROCHESTER,NY14626 22-2572873	SYSTEM SUPPORT	NY	501(C)(3)	LINE 12B, II	ROCHESTER REGIONAL HEALTH	Yes
(36)UNITY HOUSING DEVELOPMENT FUND CORP 1555 LONG POND RD ROCHESTER,NY14626 30-0068596	RECEIPT AND DISBURSEMENTS OF SUBSIDIES	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(37)VIA HEALTH HOME CARE I 100 KINGS HIGHWAY SOUTH ROCHESTER,NY14617 16-1504370	HOME HEALTH	NY	501(C)(3)	LINE 10	CCN	Yes
(38)VIA HEALTH HOMECARE II 100 KINGS HIGHWAY SOUTH ROCHESTER,NY14617 16-1538727	HOME HEALTH	NY	501(C)(3)	LINE 10	CCN	Yes
(39)WESTERN NEW YORK MEDICAL PRACTICE PC 1425 PORTLAND AVENUE ROCHESTER,NY14621 61-1654232	PHYS PRAC	NY	501(C)(3)	LINE 10	ROCHESTER REGIONAL HEALTH	Yes
(40)ADIRONDACK HEALTH INSTITUTE 101 RIDGE STREET GLENS FALLS,NY12801 14-1698269	CONSORTIUM	NY	501(C)(3)	LINE 3	N/A		No
(41)ST LAWRENCE HEALTH FOUNDATION 29 GROVE STREET POTSDAM,NY13676 16-1279472	FUNDRAISING	NY	501(C)(3)	LINE 12A, I	CANTON POTSDAM HOSPITAL		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) NW ASSOCIATES LP PO BOX 111 DRIVING PARK AVENUE NEWARK,NY14513 14-1674119	R/E LEASING	NY	NWCH	RELATED				No			No	73.610 %
(2) PARMA SENIOR HOUSING 1555 LONG POND RD ROCHESTER,NY14626 43-2082116	HILTON PROJ	NY	N/A					No			No
(3) UNITY SENIOR HOUSING ASSOCIATES LP 1555 LONG POND RD ROCHESTER,NY14626 06-1709927	MOORE PK	NY	N/A					No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) ACM MEDICAL LABORATORY INC 160 ELMGROVE PARK ROCHESTER,NY14624 16-1059691	CLINICAL LAB	NY	PRH INC	C					No
(2) GRACO RISK RETENTION GROUP INC 1425 PORTLAND AVENUE ROCHESTER,NY14621 71-0933967	INSURANCE	SC	RGH	C			100.000 %		No
(3) GREATER ROCHESTER ASSURANCE COMPANY LTD GEORGE TOWN GRAND CAYMAN CJ	INSURANCE	CJ	N/A	C			100.000 %		No
(4) GREATER ROCHESTER INDEPENDENT PRACTICE ASSOCIATION INC 100 KINGS HWY S SUITE 2500 ROCHESTER,NY14617 16-1507171	INDEPENDENT PRACTICE ASSOCIATION	NY	N/A	C			50.000 %		No
(5) NWA INC DRIVING PARK AVENUE NEWARK,NY14513 14-1667339	R/E LEASING	NY	NWCH	C			100.000 %		No
(6) PARMA SENIOR HOUSING LLC 1555 LONG POND ROAD ROCHESTER,NY14626 81-0671687	SENIOR HOUSING	NY	ROCHESTER REGIONAL HEALTH	C					No
(7) PRH INC 1555 LONG POND ROAD ROCHESTER,NY14626 16-1329632	MEDICAL LAB	NY	ROCHESTER REGIONAL HEALTH	C					No
(8) ROCHESTER GENERAL HEALTH SYSTEM DIALYSIS INC 1425 PORTLAND AVENUE ROCHESTER,NY14621 38-3912199	DIALYSIS	NY	RGHS	C			100.000 %		No
(9) UNITY HEALTH SYSTEM PURCHASING GROUP LLC 1555 LONG POND ROAD ROCHESTER,NY14626 22-2572873	SENIOR HOUSING	NY	ROCHESTER REGIONAL HEALTH	C					No
(10) UNITY SENIOR HOUSING CORP 1555 LONG POND ROAD ROCHESTER,NY14624 06-1709925	SENIOR HOUSING	NY	ROCHESTER REGIONAL HEALTH	C					No
(11) PHILLGREY INC 202 N MAIN STREET MASSENA,NY136621121 16-1556443	AMBULANCE SERVICES	NY	ST LAWRENCE HEALTH SYSTEM	S			100.000 %		No
(12) ACCOUNTABLE CARE ORGANIZATION OF THE NORTH COUNTRY 555 WEST GRANADA BLVD 555 ORMOND BEACH,FL32174 45-4106154	SERVICE COORDINATION	FL							No

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

Yes

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) CANTON-POTSDAM HOSPITAL	S	259,477	FMV
(2) GOUVERNEUR HOSPITAL INC	S	99,250	FMV
(3) CANTON-POTSDAM HOSPITAL	J	1,452,552	FMV

Schedule R (Form 990) 2023

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference

Explanation

SCHEDULE R, PART II, COLUMN (B):

RELATED TAX-EXEMPT ORGANIZATION - PRIMARY ACTIVITY: RGHS WORKER'S COMPENSATION TRUST SUPPORTS THE ROCHESTER GENERAL HOSPITAL, NEWARK WAYNE COMMUNITY HOSPITAL, ROCHESTER GENERAL LONG TERM CARE, INDEPENDENT LIVING FOR SENIORS, BEHAVIORAL HEALTH NETWORK, INC., CLIFTON SPRINGS HOSPITAL & CLINIC, UNITED MEMORIAL MEDICAL CENTER, UNITY HOSPITAL OF ROCHESTER, GENESEE REGION HOME CARE ASSOCIATION AND GENESEE REGIONAL HOME CARE OF ONTARIO COUNTY.

Schedule R (Form 990) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: ST. LAWRENCE HEALTH SYSTEM'S MISSION IS TO IMPROVE HEALTH, DELIVER BETTER CARE AND CONSUMER EXPERIENCE, AND LOWER COSTS IN ST. LAWRENCE COUNTY THROUGH COORDINATION AND INTEGRATION OF SERVICES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	20
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	16
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	252
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	0	0
9	Program service revenue (Part VIII, line 2g) .........	407,344	246,987
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	321,916	181,862
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	1,317,984	1,476,333
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	2,047,244	1,905,182
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	455,141	529,346
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	3,057,964	4,236,939
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	3,513,105	4,766,285
19	Revenue less expenses. Subtract line 18 from line 12.......	-1,465,861	-2,861,103
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	105,606,405	36,296,223
21	Total liabilities (Part X, line 26).............	109,749,982	42,713,759
22	Net assets or fund balances. Subtract line 21 from line 20.....	-4,143,577	-6,417,536

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 604,919 including grants of $ ) (Revenue $ 246,987 )
	CLINICAL RESEARCH - IN 2023, THE CLINICAL RESEARCH PROGRAM CONDUCTED 16 STUDIES AND HAD 15 ENROLLED PARTICIPANTS.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ 1,452,552 )
	RENTAL - LEASE OF MEDICAL OFFICE BUILDING AND OTHER OFFICE SPACE TO A RELATED PARTY.

4c	(Code: ) (Expenses $ 462,454 including grants of $ ) (Revenue $ 23,781 )
	ACCOUNTABLE CARE OF THE NORTH COUNTRY - PROVIDING MEDICAL SERVICES

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses1,067,373

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	3,643,943	7,374,265	308,342

1a	Federated campaigns..	1a
b	Membership dues..	1b
c	Fundraising events..	1c
d	Related organizations	1d
e	Government grants (contributions)	1e

f	All other contributions, gifts, grants, and similar amounts not included above	1f

g	Noncash contributions included in lines 1a - 1f:$	1g

h Total. Add lines 1a-1f.......

		Business Code
2a	CLINICAL RESEARCH	541700	246,987	246,987
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		246,987

3 Investment income (including dividends, interest, and othersimilar amounts) ......			181,862			181,862
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a	1,452,552
b	Less: rental expenses	6b	0
c	Rental income or (loss)	6c	1,452,552
d	Net rental income or (loss).......			1,452,552	1,452,552
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a
b	Less: cost or other basis and sales expenses	7b
c	Gain or (loss)	7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	MISC INCOME - ACO		900099	23,781	23,781
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			23,781
12	Total revenue. See instructions.....			1,905,182	1,723,320	0	181,862

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	478,455	478,455
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......	50,891	50,891
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......	104,078	7,775	96,303
b	Legal .........	156,091	10,135	145,956
c	Accounting ...........	5,333	5,333
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	374,766	374,766
12	Advertising and promotion ....	2,296	2,296
13	Office expenses .......	26,807	26,807
14	Information technology ......	20,359	20,359
15	Royalties ..
16	Occupancy ...........	23,482	23,482
17	Travel ............	4,058	4,058
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	14,185	14,185
20	Interest ...........	1,401,250		1,401,250
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	1,631,335		1,631,335
23	Insurance ...	45,928	45,928
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	ACO	424,068		424,068
b	MEMBERSHIP & DUES	600	600
c
d
e	All other expenses	2,303	2,303
25	Total functional expenses. Add lines 1 through 24e	4,766,285	1,067,373	3,698,912	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			3,669,019	1	5,526,984
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			197,193	4	202,434
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			13,310	9	171,383
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	31,236,491
b	Less: accumulated depreciation	10b	6,452,942	25,982,520	10c	24,783,549
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14	2,087,000
15	Other assets. See Part IV, line 11 ...........			75,744,363	15	3,524,873
16	Total assets. Add lines 1 through 15 (must equal line 33)...			105,606,405	16	36,296,223

17	Accounts payable and accrued expenses .....	4,085,724	17	4,956,273
18	Grants payable ...		18
19	Deferred revenue .........	-22,500	19	-6,459
20	Tax-exempt bond liabilities .........	28,991,537	20	27,933,817
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	76,695,221	25	9,830,128
26	Total liabilities. Add lines 17 through 25..	109,749,982	26	42,713,759

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	-4,143,577	27	-6,417,536
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	-4,143,577	32	-6,417,536
33	Total liabilities and net assets/fund balances ........	105,606,405	33	36,296,223