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THE BERTRAND CHAFFEE HOSPITAL

Company Details

Name: THE BERTRAND CHAFFEE HOSPITAL
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 28 Jan 1946 (79 years ago)
Entity Number: 46580
County: Erie
Place of Formation: New York

Contact Details

Phone +1 716-592-8140

Phone +1 716-794-3309

Phone +1 716-592-2871

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
YFBYPFBVD1C8 2024-12-01 224 E MAIN ST, SPRINGVILLE, NY, 14141, 1443, USA 244 EAST MAIN STREET, SPRINGVILLE, NY, 14141, 1443, USA

Business Information
URL http://bertrandchaffee.com/About
Congressional District 23
State/Country of Incorporation NY, USA
Activation Date 2023-12-05
Initial Registration Date 2012-06-26
Entity Start Date 1958-07-25
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name TERESA DONOHUE
Role CEO
Address 224 EAST MAIN STREET, SPRINGVILLE, NY, 14141, USA
Title ALTERNATE POC
Name TERESA DONOHUE
Address 244 EAST MAIN STREET, SPRINGVILLE, NY, 14141, USA
Government Business
Title PRIMARY POC
Name TERESA DONOHUE
Role CEO
Address 224 EAST MAIN STREET, SPRINGVILLE, NY, 14141, USA
Title ALTERNATE POC
Name TERESA DONOHUE
Address 244 EAST MAIN STREET, SPRINGVILLE, NY, 14141, USA
Past Performance Information not Available

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
6S8T7 Obsolete Non-Manufacturer 2012-06-27 2024-03-12 No data 2024-12-01

Contact Information
POC TERESA DONOHUE
Phone +1 716-592-2871
Fax +1 716-592-8105
Address 224 E MAIN ST, SPRINGVILLE, NY, 14141 1443, 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
LIFE ADD LTD PLAN 2023 160743921 2024-10-08 BERTRAND CHAFFEE HOSPITAL 215
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2019-07-01
Business code 622000
Sponsor’s telephone number 7165922871
Plan sponsor’s DBA name BERTRAND CHAFFEE HOSPITAL
Plan sponsor’s mailing address 224 E MAIN ST, SPRINGVILLE, NY, 141411443
Plan sponsor’s address 224 E MAIN ST, SPRINGVILLE, NY, 141411443

Number of participants as of the end of the plan year
Active participants 214

Signature of
Role Plan administrator
Date 2024-10-08
Name of individual signing TERESA DONOHUE
Valid signature Filed with authorized/valid electronic signature
BERTRAND CHAFFEE HOSPITAL CAFETERIA AND MEDICAL INSURANCE PREMIUM PLAN 2023 160743921 2024-10-08 BERTRAND CHAFFEE HOSPITAL 118
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2014-01-01
Business code 622000
Sponsor’s telephone number 7165922871
Plan sponsor’s mailing address 224 E MAIN ST, SPRINGVILLE, NY, 141411443
Plan sponsor’s address 224 E MAIN ST, SPRINGVILLE, NY, 141411443

Number of participants as of the end of the plan year
Active participants 124

Signature of
Role Plan administrator
Date 2024-10-08
Name of individual signing TERESA DONOHUE
Valid signature Filed with authorized/valid electronic signature
LIFE ADD LTD PLAN 2022 160743921 2023-10-09 BERTRAND CHAFFEE HOSPITAL 215
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2019-07-01
Business code 622000
Sponsor’s telephone number 7165922871
Plan sponsor’s DBA name BERTRAND CHAFFEE HOSPITAL
Plan sponsor’s mailing address 224 E MAIN ST, SPRINGVILLE, NY, 141411443
Plan sponsor’s address 224 E MAIN ST, SPRINGVILLE, NY, 141411443

Number of participants as of the end of the plan year
Active participants 214

Signature of
Role Plan administrator
Date 2023-10-09
Name of individual signing TERESA DONOHUE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-09
Name of individual signing TERESA DONOHUE
Valid signature Filed with authorized/valid electronic signature
BERTRAND CHAFFEE HOSPITAL CAFETERIA AND MEDICAL INSURANCE PREMIUM PLAN 2022 160743921 2023-10-09 BERTRAND CHAFFEE HOSPITAL 120
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2014-01-01
Business code 622000
Sponsor’s telephone number 7165922871
Plan sponsor’s mailing address 224 E MAIN ST, SPRINGVILLE, NY, 141411443
Plan sponsor’s address 224 E MAIN ST, SPRINGVILLE, NY, 141411443

Number of participants as of the end of the plan year
Active participants 118

Signature of
Role Plan administrator
Date 2023-10-09
Name of individual signing TERESA DONOHUE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-09
Name of individual signing TERESA DONOHUE
Valid signature Filed with authorized/valid electronic signature
BERTRAND CHAFFEE HOSPITAL CAFETERIA AND MEDICAL INSURANCE PREMIUM PLAN 2021 160743921 2022-09-16 BERTRAND CHAFFEE HOSPITAL 133
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2014-01-01
Business code 622000
Sponsor’s telephone number 7165922871
Plan sponsor’s mailing address 224 E MAIN ST, SPRINGVILLE, NY, 141411443
Plan sponsor’s address 224 E MAIN ST, SPRINGVILLE, NY, 141411443

Number of participants as of the end of the plan year
Active participants 119
Retired or separated participants receiving benefits 1

Signature of
Role Plan administrator
Date 2022-09-15
Name of individual signing NILS GUNNERSEN
Valid signature Filed with authorized/valid electronic signature
LIFE ADD LTD PLAN 2021 160743921 2022-09-16 BERTRAND CHAFFEE HOSPITAL 253
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2019-07-01
Business code 622000
Sponsor’s telephone number 7165922871
Plan sponsor’s DBA name BERTRAND CHAFFEE HOSPITAL
Plan sponsor’s mailing address 224 E MAIN ST, SPRINGVILLE, NY, 141411443
Plan sponsor’s address 224 E MAIN ST, SPRINGVILLE, NY, 141411443

Number of participants as of the end of the plan year
Active participants 224

Signature of
Role Plan administrator
Date 2022-09-15
Name of individual signing NILS GUNNERSEN
Valid signature Filed with authorized/valid electronic signature
LIFE ADD LTD PLAN 2020 160743921 2021-10-12 BERTRAND CHAFFEE HOSPITAL 232
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2019-07-01
Business code 622000
Sponsor’s telephone number 7165922871
Plan sponsor’s DBA name BERTRAND CHAFFEE HOSPITAL
Plan sponsor’s mailing address 224 E MAIN ST, SPRINGVILLE, NY, 141411443
Plan sponsor’s address 224 E MAIN ST, SPRINGVILLE, NY, 141411443

Number of participants as of the end of the plan year
Active participants 226

Signature of
Role Plan administrator
Date 2021-10-12
Name of individual signing NILS GUNNERSEN
Valid signature Filed with authorized/valid electronic signature
BERTRAND CHAFFEE HOSPITAL CAFETERIA AND MEDICAL INSURANCE PREMIUM PLAN 2020 160743921 2021-10-12 BERTRAND CHAFFEE HOSPITAL 131
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2014-01-01
Business code 622000
Sponsor’s telephone number 7165922871
Plan sponsor’s mailing address 224 E MAIN ST, SPRINGVILLE, NY, 141411443
Plan sponsor’s address 224 E MAIN ST, SPRINGVILLE, NY, 141411443

Number of participants as of the end of the plan year
Active participants 130

Signature of
Role Plan administrator
Date 2021-10-12
Name of individual signing NILS GUNNERSEN
Valid signature Filed with authorized/valid electronic signature
BERTRAND CHAFFEE HOSPITAL CAFETERIA AND MEDICAL INSURANCE PREMIUM PLAN 2020 160743921 2021-10-12 BERTRAND CHAFFEE HOSPITAL 126
Three-digit plan number (PN) 501
Effective date of plan 2014-01-01
Business code 622000
Sponsor’s telephone number 7165922871
Plan sponsor’s mailing address 224 E MAIN ST, SPRINGVILLE, NY, 141411443
Plan sponsor’s address 224 E MAIN ST, SPRINGVILLE, NY, 141411443

Number of participants as of the end of the plan year
Active participants 126

Signature of
Role Plan administrator
Date 2021-10-12
Name of individual signing NILS GUNNERSEN
Valid signature Filed with authorized/valid electronic signature
LIFE ADD LTD PLAN 2018 160743921 2019-10-09 BERTRAND CHAFFEE HOSPITAL 239
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2018-06-01
Business code 622000
Sponsor’s telephone number 7165922871
Plan sponsor’s DBA name BERTRAND CHAFFEE HOSPITAL
Plan sponsor’s mailing address 224 E MAIN ST, SPRINGVILLE, NY, 141411443
Plan sponsor’s address 224 E MAIN ST, SPRINGVILLE, NY, 141411443

Number of participants as of the end of the plan year
Active participants 239

Signature of
Role Plan administrator
Date 2019-10-09
Name of individual signing NILS GUNNERSEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
THE BERTRAND CHAFFEE HOSPITAL Agent 224 E. MAIN ST., SPRINGVILLE, NY

Filings

Filing Number Date Filed Type Effective Date
Z003531-2 1979-04-19 ASSUMED NAME CORP INITIAL FILING 1979-04-19
A167901-2 1974-07-09 CERTIFICATE OF AMENDMENT 1974-07-09
33EX-340 1952-02-05 CERTIFICATE OF AMENDMENT 1952-02-05
462Q-39 1946-01-28 CERTIFICATE OF INCORPORATION 1946-01-28

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
306047226 0213600 2003-01-14 224 EAST MAIN STREET, SPRINGVILLE, NY, 14141
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 2003-02-14
Case Closed 2003-05-14

Related Activity
Type Complaint
Activity Nr 203730023
Health Yes

Violation Items
Citation ID 01001A
Citaton Type Serious
Standard Cited 19100134 E01
Issuance Date 2003-02-21
Abatement Due Date 2003-03-26
Current Penalty 892.0
Initial Penalty 1275.0
Nr Instances 1
Nr Exposed 1
Gravity 01
Citation ID 01001B
Citaton Type Serious
Standard Cited 19100134 F02
Issuance Date 2003-02-21
Abatement Due Date 2003-03-26
Nr Instances 1
Nr Exposed 1
Gravity 01
Citation ID 01001C
Citaton Type Serious
Standard Cited 19261101 G09 V
Issuance Date 2003-02-21
Abatement Due Date 2003-03-26
Nr Instances 1
Nr Exposed 1
Gravity 01
Citation ID 02001
Citaton Type Other
Standard Cited 19261101 K08 I
Issuance Date 2003-02-21
Abatement Due Date 2003-02-26
Nr Instances 1
Nr Exposed 1
Gravity 01
305056178 0213600 2002-01-25 224 EAST MAIN STREET, SPRINGVILLE, NY, 14141
Inspection Type Prog Related
Scope Partial
Safety/Health Safety
Close Conference 2002-01-28
Case Closed 2002-05-31

Violation Items
Citation ID 01001A
Citaton Type Serious
Standard Cited 19100147 C04 I
Issuance Date 2002-03-01
Abatement Due Date 2002-04-03
Current Penalty 900.0
Initial Penalty 1500.0
Nr Instances 1
Nr Exposed 6
Gravity 02
Citation ID 01001B
Citaton Type Serious
Standard Cited 19100147 C05 II
Issuance Date 2002-03-01
Abatement Due Date 2002-03-18
Nr Instances 1
Nr Exposed 6
Gravity 02
Citation ID 01001C
Citaton Type Serious
Standard Cited 19100147 C06 I
Issuance Date 2002-03-01
Abatement Due Date 2002-03-18
Nr Instances 1
Nr Exposed 6
Gravity 02
Citation ID 01001D
Citaton Type Serious
Standard Cited 19100147 C07 IV
Issuance Date 2002-03-01
Abatement Due Date 2002-03-18
Nr Instances 1
Nr Exposed 6
Gravity 02
Citation ID 01002
Citaton Type Serious
Standard Cited 19100305 B01
Issuance Date 2002-03-01
Abatement Due Date 2002-03-06
Current Penalty 900.0
Initial Penalty 1500.0
Nr Instances 1
Nr Exposed 3
Gravity 02
Citation ID 01003A
Citaton Type Serious
Standard Cited 19101001 J01 III
Issuance Date 2002-03-01
Abatement Due Date 2002-04-03
Current Penalty 1125.0
Initial Penalty 1875.0
Nr Instances 1
Nr Exposed 4
Gravity 03
Citation ID 01003B
Citaton Type Serious
Standard Cited 19101001 J05 II
Issuance Date 2002-03-01
Abatement Due Date 2002-04-03
Nr Instances 2
Nr Exposed 9
Gravity 03
Citation ID 01003C
Citaton Type Serious
Standard Cited 19101001 J07 IV
Issuance Date 2002-03-01
Abatement Due Date 2002-04-03
Nr Instances 1
Nr Exposed 9
Gravity 03
Citation ID 01003D
Citaton Type Serious
Standard Cited 19261101 K02 II
Issuance Date 2002-03-01
Abatement Due Date 2002-04-03
Nr Instances 1
Nr Exposed 9
Gravity 03
Citation ID 01003E
Citaton Type Serious
Standard Cited 19261101 K09 I
Issuance Date 2002-03-01
Abatement Due Date 2002-04-03
Nr Instances 1
Nr Exposed 9
Gravity 03
Citation ID 02001
Citaton Type Other
Standard Cited 19040002 A
Issuance Date 2002-03-01
Abatement Due Date 2002-03-18
Nr Instances 3
Nr Exposed 10
Gravity 00
Citation ID 02002
Citaton Type Other
Standard Cited 19100132 D02
Issuance Date 2002-03-01
Abatement Due Date 2002-04-03
Nr Instances 1
Nr Exposed 6
Gravity 01
Citation ID 02003
Citaton Type Other
Standard Cited 19100134 A02
Issuance Date 2002-03-01
Abatement Due Date 2002-04-03
Nr Instances 1
Nr Exposed 6
Gravity 01

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
16-0743921 Corporation Unconditional Exemption 224 E MAIN ST, SPRINGVILLE, NY, 14141-1443 1952-07
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 Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2023-12
Asset 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 21863385
Income Amount 28671541
Form 990 Revenue Amount 28671541
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 BERTRAND CHAFFEE HOSPITAL
EIN 16-0743921
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name BERTRAND CHAFFEE HOSPITAL
EIN 16-0743921
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name BERTRAND CHAFFEE HOSPITAL
EIN 16-0743921
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name BERTRAND CHAFFEE HOSPITAL
EIN 16-0743921
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name BERTRAND CHAFFEE HOSPITAL
EIN 16-0743921
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name BERTRAND CHAFFEE HOSPITAL
EIN 16-0743921
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name BERTRAND CHAFFEE HOSPITAL
EIN 16-0743921
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name BERTRAND CHAFFEE HOSPITAL
EIN 16-0743921
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
8351607006 2020-04-08 0296 PPP 224 East Main Street, SPRINGVILLE, NY, 14141-1443
Loan Status Date 2021-07-16
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 2455678
Loan Approval Amount (current) 2455678
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 U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address SPRINGVILLE, ERIE, NY, 14141-1443
Project Congressional District NY-23
Number of Employees 257
NAICS code 622110
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 2180305.88
Forgiveness Paid Date 2021-06-09

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 19 Mar 2025

Sources: New York Secretary of State

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