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  5. SOUTHERN TIER HEALTH CARE SYSTEM INC.

SOUTHERN TIER HEALTH CARE SYSTEM INC.

Company Details

Name: SOUTHERN TIER HEALTH CARE SYSTEM INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 13 Oct 1994 (30 years ago)
Entity Number: 1859499
ZIP code: 14760
County: Cattaraugus
Place of Formation: New York
Address: ONE BLUE BIRD SQUARE, OLEAN, NY, United States, 14760

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
V7BCVZ2ZMBF2 2025-01-08 150 N UNION ST, OLEAN, NY, 14760, 2735, USA 150 N UNION ST, OLEAN, NY, 14760, 2735, USA

Business Information
URL http://www.sthcs.org
Congressional District 23
State/Country of Incorporation NY, USA
Activation Date 2024-01-11
Initial Registration Date 2006-01-10
Entity Start Date 1994-08-02
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name DONNA L. KAHM
Role PRESIDENT AND CEO
Address SOUTHERN TIER HEALTH CARE SYSTEM INC., 150 NORTH UNION STREET, OLEAN, NY, 14760, 2500, USA
Title ALTERNATE POC
Name ALICIA N. BROADBENT
Role DIRECTOR OF PLANNING AND DEVELOPMENT
Address 150 NORTH UNION STREET, 150 NORTH UNION STREET, OLEAN, NY, 14760, USA
Government Business
Title PRIMARY POC
Name DONNA L. KAHM
Role PRESIDENT AND CEO
Address SOUTHERN TIER HEALTH CARE SYSTEM INC., 150 NORTH UNION STREET, OLEAN, NY, 14760, USA
Title ALTERNATE POC
Name DONNA KAHM
Role PRESIDENT AND CEO
Address SOUTHERN TIER HEALTH CARE SYSTEM INC., 150 NORTH UNION STREET, OLEAN, NY, 14760, USA
Past Performance Information not Available

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
49BH3 Obsolete Non-Manufacturer 2006-01-11 2024-03-10 No data 2025-01-08

Contact Information
POC DONNA L.. KAHM
Phone +1 716-372-0614
Fax +1 716-372-5217
Address 150 N UNION ST, OLEAN, NY, 14760 2735, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHERN TIER HEALTH CARE SYSTEM, INC. TAX SHELTERED ANNUITY PROGRAM 2023 161469489 2024-06-24 SOUTHERN TIER HEALTH CARE SYSTEM, INC. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 813000
Sponsor’s telephone number 7163720614
Plan sponsor’s address 150 NORTH UNION STREET, OLEAN, NY, 147602500

Signature of
Role Plan administrator
Date 2024-06-24
Name of individual signing DONNA KAHM
SOUTHERN TIER HEALTH CARE SYSTEM, INC. TAX SHELTERED ANNUITY PROGRAM 2022 161469489 2023-05-16 SOUTHERN TIER HEALTH CARE SYSTEM, INC. 28
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 813000
Sponsor’s telephone number 7163720614
Plan sponsor’s address 150 NORTH UNION STREET, OLEAN, NY, 147602500

Signature of
Role Plan administrator
Date 2023-05-16
Name of individual signing DONNA KAHM
SOUTHERN TIER HEALTH CARE SYSTEM, INC. TAX SHELTERED ANNUITY PROGRAM 2021 161469489 2022-06-22 SOUTHERN TIER HEALTH CARE SYSTEM, INC. 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 813000
Sponsor’s telephone number 7163720614
Plan sponsor’s address 150 NORTH UNION STREET, OLEAN, NY, 147602500

Signature of
Role Plan administrator
Date 2022-06-22
Name of individual signing DONNA KAHM
SOUTHERN TIER HEALTH CARE SYSTEM, INC. TAX SHELTERED ANNUITY PROGRAM 2020 161469489 2021-07-28 SOUTHERN TIER HEALTH CARE SYSTEM, INC. 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 813000
Sponsor’s telephone number 7163720614
Plan sponsor’s address 150 NORTH UNION STREET, OLEAN, NY, 147602500

Signature of
Role Plan administrator
Date 2021-07-28
Name of individual signing DONNA KAHM
SOUTHERN TIER HEALTH CARE SYSTEM, INC. TAX SHELTERED ANNUITY PROGRAM 2019 161469489 2020-07-23 SOUTHERN TIER HEALTH CARE SYSTEM, INC. 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 813000
Sponsor’s telephone number 7163720614
Plan sponsor’s address 150 NORTH UNION STREET, OLEAN, NY, 147602500

Signature of
Role Plan administrator
Date 2020-07-23
Name of individual signing DONNA KAHM
SOUTHERN TIER HEALTH CARE SYSTEM, INC. TAX SHELTERED ANNUITY PROGRAM 2018 161469489 2019-08-06 SOUTHERN TIER HEALTH CARE SYSTEM, INC. 33
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 813000
Sponsor’s telephone number 7163720614
Plan sponsor’s address 150 NORTH UNION STREET, OLEAN, NY, 147602500

Signature of
Role Plan administrator
Date 2019-08-06
Name of individual signing DONNA KAHM
SOUTHERN TIER HEALTH CARE SYSTEM, INC. TAX SHELTERED ANNUITY PROGRAM 2017 161469489 2018-10-04 SOUTHERN TIER HEALTH CARE SYSTEM, INC. 33
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 813000
Sponsor’s telephone number 7163720614
Plan sponsor’s address 150 NORTH UNION STREET, OLEAN, NY, 147602500

Signature of
Role Plan administrator
Date 2018-10-04
Name of individual signing DONNA KAHM
SOUTHERN TIER HEALTH CARE SYSTEM, INC. TAX SHELTERED ANNUITY PROGRAM 2016 161469489 2017-07-13 SOUTHERN TIER HEALTH CARE SYSTEM, INC. 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 813000
Sponsor’s telephone number 7163720614
Plan sponsor’s address ONE BLUE BIRD SQUARE, OLEAN, NY, 147602500

Signature of
Role Plan administrator
Date 2017-07-13
Name of individual signing DONNA KAHM
SOUTHERN TIER HEALTH CARE SYSTEM, INC. TAX SHELTERED ANNUITY PROGRAM 2015 161469489 2016-10-14 SOUTHERN TIER HEALTH CARE SYSTEM, INC. 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 813000
Sponsor’s telephone number 7163720614
Plan sponsor’s address ONE BLUE BIRD SQUARE, OLEAN, NY, 147602500

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing DONNA KAHM
SOUTHERN TIER HEALTH CARE SYSTEM, INC. TAX SHELTERED ANNUITY PROGRAM 2014 161469489 2015-09-14 SOUTHERN TIER HEALTH CARE SYSTEM, INC. 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1997-10-01
Business code 813000
Sponsor’s telephone number 7163720614
Plan sponsor’s address ONE BLUE BIRD SQUARE, OLEAN, NY, 147602500

Signature of
Role Plan administrator
Date 2015-09-14
Name of individual signing DONNA KAHM

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent ONE BLUE BIRD SQUARE, OLEAN, NY, United States, 14760

History

Start date End date Type Value
1996-08-08 2002-07-19 Address C/O OLEAN GENERAL HOSPITAL, 515 MAIN STREET, OLEAN, NY, 14760, USA (Type of address: Service of Process)
1994-10-13 1996-08-08 Address C/O OLEAN GENERAL HOSPITAL, 515 MAIN STREET, OLEAN, NY, 14760, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
020719000113 2002-07-19 CERTIFICATE OF CHANGE 2002-07-19
960808000222 1996-08-08 CERTIFICATE OF AMENDMENT 1996-08-08
941013000335 1994-10-13 CERTIFICATE OF INCORPORATION 1994-10-13

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
16-1469489 Corporation Unconditional Exemption 150 N UNION ST, OLEAN, NY, 14760-2735 1997-01
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2023-12
Asset 1,000,000 to 4,999,999
Income 1,000,000 to 4,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 3184383
Income Amount 1481214
Form 990 Revenue Amount 1481214
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name SOUTHERN TIER HEALTH CARE SYSTEM INC
EIN 16-1469489
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name SOUTHERN TIER HEALTH CARE SYSTEM INC
EIN 16-1469489
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name SOUTHERN TIER HEALTH CARE SYSTEM INC
EIN 16-1469489
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name SOUTHERN TIER HEALTH CARE SYSTEM INC
EIN 16-1469489
Tax Period 201912
Filing Type P
Return Type 990
File View File
Organization Name SOUTHERN TIER HEALTH CARE SYSTEM INC
EIN 16-1469489
Tax Period 201912
Filing Type P
Return Type 990
File View File
Organization Name SOUTHERN TIER HEALTH CARE SYSTEM INC
EIN 16-1469489
Tax Period 201812
Filing Type P
Return Type 990
File View File
Organization Name SOUTHERN TIER HEALTH CARE SYSTEM INC
EIN 16-1469489
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name SOUTHERN TIER HEALTH CARE SYSTEM INC
EIN 16-1469489
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name SOUTHERN TIER HEALTH CARE SYSTEM INC
EIN 16-1469489
Tax Period 201512
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7430638309 2021-01-28 0296 PPS 150 N Union St, Olean, NY, 14760-2735
Loan Status Date 2021-12-17
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 66431
Loan Approval Amount (current) 66431
Undisbursed Amount 0
Franchise Name -
Lender Location ID 47029
Servicing Lender Name Community Bank, National Association
Servicing Lender Address 45-49 Court St, CANTON, NY, 13617-1118
Rural or Urban Indicator R
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Olean, CATTARAUGUS, NY, 14760-2735
Project Congressional District NY-23
Number of Employees 7
NAICS code 813319
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 47029
Originating Lender Name Community Bank, National Association
Originating Lender Address CANTON, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 66955.17
Forgiveness Paid Date 2021-11-17
3787667207 2020-04-27 0296 PPP 150 N Union Street, OLEAN, NY, 14760-2735
Loan Status Date 2021-02-24
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 73077
Loan Approval Amount (current) 73077
Undisbursed Amount 0
Franchise Name -
Lender Location ID 47029
Servicing Lender Name Community Bank, National Association
Servicing Lender Address 45-49 Court St, CANTON, NY, 13617-1118
Rural or Urban Indicator R
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address OLEAN, CATTARAUGUS, NY, 14760-2735
Project Congressional District NY-23
Number of Employees 8
NAICS code 923120
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 47029
Originating Lender Name Community Bank, National Association
Originating Lender Address CANTON, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 73597.55
Forgiveness Paid Date 2021-01-14

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Date of last update: 15 Mar 2025

Sources: New York Secretary of State

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