BROOKHAVEN HEALTH CARE SERVICES CORPORATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- BROOKHAVEN HEALTH CARE SERVICES CORPORATION (EIN 11-2950196)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-03
- IRS object ID
- 202233079349301713
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-03T10:14:31-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 PARK AVENUE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 100175001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 112950196 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROOKHAVEN HEALTH CARE SERVICES CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % R T MARGULIS CEO | InCareOfNm |
| Business Name Control | BROO | BusinessNameControlTxt |
| Phone | 6316547100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL ROAD | AddressLine1Txt |
| City | PATCHOGUE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11772 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Richard MARGULIS | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 6316547100 | PhoneNum |
| Signature | 2022-11-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Richard | PersonFirstNm |
| Person Last | MARGULIS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kristin Ruffini | PreparerPersonNm |
| PTIN | P00741491 | PTIN |
| Phone | 2128858000 | PhoneNum |
| Preparation | 2022-11-01 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LI COMM HOSP HEALTH CARE SVCS FD | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | R T MARGULIS CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL ROAD | AddressLine1Txt |
| City | PATCHOGUE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11772 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,616,578 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.licommunityhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO SEEK PHILANTHROPIC SUPP. & GRANT FUNDS TO LONG ISLAND COMMUNITY HOSPITAL (BMHMC) & OTHER NOT-FOR-PROFIT ORGS. UNDER THE DIRECTION OF THE ORGANIZATION'S BOARD OF DIRECTORS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 22 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $477,180 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,942,352 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $987,539 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,208,482 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $10,666 | CYOtherRevenueAmt |
| PY Total Revenue | $1,464,719 | PYTotalRevenueAmt |
| CY Total Revenue | $4,161,500 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $184,523 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $10,925 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $57,539 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $882,541 | PYOtherExpensesAmt |
| CY Other Expenses | $1,076,929 | CYOtherExpensesAmt |
| PY Total Expenses | $1,067,064 | PYTotalExpensesAmt |
| CY Total Expenses | $1,087,854 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $397,655 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,073,646 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,841,897 | TotalAssetsBOYAmt |
| Total Assets EOY | $51,123,644 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,529 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,818,218 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,830,368 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $46,305,426 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SEEK PHILANTHROPIC SUPPORT ON THE BEHALF OF BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER (D/B/A LONG ISLAND COMMUNITY HOSPITAL) AND OTHER NOT-FOR-PROFIT ORGANIZATIONS AND TO GRANT FUNDS TO BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER AND OTHER NOT-FOR-PROFIT ORGANIZATIONS UNDER THE DIRECTION OF THE ORGANIZATION'S BOARD OF DIRECTORS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $803,635 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | THE ORGANIZATION SEEKS PHILANTHROPIC SUPPORT AND GRANTS FUNDS TO LONG ISLAND COMMUNITY HOSPITAL (BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER), A NOT-FOR-PROFIT ACUTE CARE HOSPITAL, PROVIDING INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,925 | ExpenseAmt |
| Grant | $10,925 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | SPONSORSHIPS TO VARIOUS NOT-FOR-PROFIT ORGANIZATIONS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $814,560 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | R T MARGULIS CEO | PersonNm |
| Phone | 6316547100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL ROAD | AddressLine1Txt |
| City | PATCHOGUE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11772 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| R T MARGULIS | |||||||
| PRESIDENT & CEO/DIRECTOR | 0.5 | 40.0 | Yes (X) | Yes (X) | $0 | $842,974 | $64,276 |
| N Kiridly MD | |||||||
| DIRECTOR AS OF 6/24/21 | 0.5 | 0.5 | Yes (X) | $0 | $18,333 | $0 | |
| E KORMYLO DPM | |||||||
| Director, Secretary | 0.5 | 7.5 | Yes (X) | Yes (X) | $0 | $13,785 | $0 |
| W Kruger MD as of 51121 | |||||||
| DIRECTOR/PRES. OF MED. STAFF | 0.5 | 0.5 | Yes (X) | $0 | $5,833 | $0 | |
| E P SMITH | |||||||
| CHAIRMAN | 0.5 | 0.5 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| P MOLONEY | |||||||
| 1ST VICE CHAIR | 0.5 | 0.5 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| F GRUCCI JR | |||||||
| 2ND VICE CHAIR | 0.5 | 0.5 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| M KNAPP | |||||||
| TREASURER | 0.5 | 0.5 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| F C BRAUN III | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| G BROWN | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| T CULLEN | |||||||
| DIRECTOR THRU 1/28/21 | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| W LADICK | |||||||
| DIRECTOR THRU 1/28/21 | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| J MAIORINO | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| J MAYER | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| M MENNELLA | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| M MULHOLLAND | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| C PARKER | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| S NORTON REMMER | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| R ROCHE MD | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| L ROSE | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| C ROTHBERG MD thru 052021 | |||||||
| DIRECTOR/PRES. OF MED. STAFF | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| E RUSSO | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| R W SCHWARZ | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| J SULLIVAN | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| S TAITZ | |||||||
| DIRECTOR | 0.5 | 0.5 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $880,925 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $64,276 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,504,611 | RelatedOrganizationsAmt |
| All Other Contributions | $437,741 | AllOtherContributionsAmt |
| Total Contributions | $1,942,352 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $897,630 | TotalRevenueColumnAmt |
| Exclusion | $897,630 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,460,931 | SecuritiesAmt |
| Other | $305,000 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4,208,008 | SecuritiesAmt |
| Other | $247,070 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,252,923 | SecuritiesAmt |
| Other | $57,930 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,310,852 | TotalRevenueColumnAmt |
| Exclusion | $1,310,852 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $10,666 | TotalRevenueColumnAmt |
| Exclusion | $10,666 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $10,666 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,161,500 | TotalRevenueColumnAmt |
| Exclusion | $2,219,148 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,925 | TotalAmt |
| Program Services | $10,925 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,480 | TotalAmt |
| Management And General | $51,480 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,700 | TotalAmt |
| Management And General | $157,700 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,977 | TotalAmt |
| Program Services | $2,977 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,207 | TotalAmt |
| Program Services | $155 | ProgramServicesAmt |
| Management And General | $6,575 | ManagementAndGeneralAmt |
| Fundraising | $3,477 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,101 | TotalAmt |
| Program Services | $91,203 | ProgramServicesAmt |
| Fundraising | $25,898 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,451 | TotalAmt |
| Program Services | $186,451 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|
| LEASED EMPLOYEES | $521,848 | $521,848 | |
| MISCELLANEOUS EXPENSES | $29,165 | $1,001 | $28,164 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,087,854 | TotalAmt |
| Program Services | $814,560 | ProgramServicesAmt |
| Management And General | $215,755 | ManagementAndGeneralAmt |
| Fundraising | $57,539 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,475,312 | BOYAmt |
| EOY | $1,024,287 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $731,473 | BOYAmt |
| EOY | $3,058,938 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,101 | BOYAmt |
| EOY | $26,413 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,028 | BOYAmt |
| EOY | $29,862 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,562 | BOYAmt |
| EOY | $1,562 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $21,525,680 | LandBldgEquipCostOrOtherBssAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $21,525,680 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,294,421 | BOYAmt |
| EOY | $23,456,902 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,000,000 | BOYAmt |
| EOY | $2,000,000 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $235,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,841,897 | BOYAmt |
| EOY | $51,123,644 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,529 | BOYAmt |
| EOY | $4,818,218 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,529 | BOYAmt |
| EOY | $4,818,218 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,743,190 | BOYAmt |
| EOY | $46,227,872 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,178 | BOYAmt |
| EOY | $77,554 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,830,368 | BOYAmt |
| EOY | $46,305,426 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,841,897 | BOYAmt |
| EOY | $51,123,644 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,073,646 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,906,023 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $15,495,389 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,789,092 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,014,196 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $696,445 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $477,180 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,942,352 | CurrentTaxYearAmt |
| Total | $5,919,265 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,789,092 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,014,196 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $696,445 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $477,180 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,942,352 | CurrentTaxYearAmt |
| Total | $5,919,265 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $295,728 | SubstantialContributorsTotAmt |
| Public Support Total170 | $5,623,537 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $568,755 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $522,087 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $532,120 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $708,932 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $897,630 | CurrentTaxYearAmt |
| Total | $3,229,524 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $88 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $88,764 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,466 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,666 | CurrentTaxYearAmt |
| Total | $106,984 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $9,255,773 | TotalSupportAmt |
| Public Support CY170 | 0.60757 | PublicSupportCY170Pct |
| Public Support PY170 | 0.56095 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $21,525,680 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $21,525,680 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,525,680 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HOSPITAL, A RELATED ORG. | Desc |
| Amt | $4,818,218 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,818,218 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS NOT TAKEN AN UNSUBSTANTIATED TAX POSITION THAT WOULD REQUIRE PROVISION OF A LIABILITY UNDER ASC 740, INCOME TAXES. UNDER ASC 740, AN ORGANIZATION MUST RECOGNIZE THE TAX BENEFIT ASSOCIATED WITH TAX POSITIONS TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED. THE ORGANIZATION DOES NOT BELIEVE THERE ARE ANY MATERIAL UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, HAS NOT RECOGNIZED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. THE ORGANIZATION FILED IRS FORM 990, AS REQUIRED, AND ALL OTHER APPLICABLE RETURNS IN JURISDICTIONS WHERE IT IS REQUIRED. FOR THE YEAR ENDED DECEMBER 31, 2021, THERE WERE NO INTEREST OR PENALTIES RECORDED OR INCLUDED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO 2017, WHICH IS THE STATUTE OF LIMITATION LOOK-BACK PERIOD. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | R T MARGULIS | PersonNm |
| Title | PRESIDENT & CEO/DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $830,386 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $12,588 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $40,150 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $24,126 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $907,250 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3: | FormAndLineReferenceDesc |
| Explanation | Brookhaven Memorial Hospital Medical Center, an affiliate of the reporting organization paid compensation to the reporting organization's top management official. Brookhaven Memorial Hospital Medical Center has established the compensation of the top management official using compensation committee, independent compensation consultant, compensation survey and study done by consultants, and approval by the board. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B: | DESCRIPTION OF THE PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW THE FORM 990: 1. THE FINANCE DEPARTMENT DRAFTS THE FORM 990 AND THE ACCOMPANYING SCHEDULES BASED ON THE CALENDAR YEAR'S FINANCIAL ACTIVITY. 2. THE DRAFT IS PROVIDED TO THE ORGANIZATION'S EXTERNAL TAX ADVISOR FOR REVIEW. 3. THE DRAFT IS THEN REVIEWED BY MANAGEMENT FOR COMPLETENESS AND ACCURACY. THIS IS AN ITERATIVE PROCESS WHICH MAY INVOLVE MORE THAN ONE REVIEW BY THE ORGANIZATION'S EXTERNAL TAX ADVISOR. 4. THE REVIEWED DRAFT IS PRESENTED TO THE BOARD OF TRUSTEES' FNANCE AND AUDIT COMMITTEE FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINES 12-14: | ALL OF THE DIRECTORS, OFFICERS, AND EMPLOYEES OF THE ORGANIZATION ARE ALSO DIRECTORS, OFFICERS, AND EMPLOYEES OF LONG ISLAND COMMUNITY HOSPITAL ("HOSPITAL"), A RELATED ORGANIZATION. ALL OF THESE INDIVIDUALS ARE GOVERNED BY AND SUBJECT TO THE POLICIES OF THE HOSPITAL INCLUDING ITS CONFLICT OF INTEREST AND WHISTLE BLOWER POLICIES. THESE AND OTHER HOSPITAL POLICIES ARE RECOGNIZED BY THE ORGANIZATION AS APPLICABLE TO IT. |
| FORM 990, PART VI, SECTION B, LINE 12C: | MEMBERS OF THE BOARD OF DIRECTORS, ADMINISTRATORS, DEPARTMENT HEADS AND MEDICAL STAFF WORKING FOR OR ON BEHALF OF LONG ISLAND COMMUNITY HOSPITAL AND ITS RELATED PARTIES, INCLUDING BUT NOT LIMITED TO BROOKHAVEN HEALTH CARE SERVICES CORPORATION, D/B/A LONG ISLAND COMMUNITY HOSPITAL HEALTH CARE SERVICES FOUNDATION, ARE REQUIRED TO COMPLETE AND SIGN THE CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY AND WHENEVER NEW INFORMATION OR CHANGES ARISE THAT MAY REQUIRE DIFFERENT RESPONSES FROM THOSE INCLUDED IN THE PREVIOUS CONFLICT OF INTEREST DISCLOSURE STATEMENT. INDIVIDUALS ARE REQUIRED TO NOTIFY THE COMPLIANCE OFFICE WHEN THEY BELIEVE CHANGES IN THE RESPONSES MAY BE NECESSARY OR WHEN THEY BELIEVE A TRANSACTION MAY INVOLVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST. THE HOSPITAL BY-LAWS REQUIRE THAT ANYONE WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST IMMEDIATELY DISCLOSE THIS FACT TO THE BOARD OF DIRECTORS OR TO A DESIGNATED BOARD COMMITTEE FOR THEIR REVIEW AND EVALUATION. FURTHER, THE BY-LAWS PROHIBIT ANY INDIVIDUAL OR ENTITY DEEMED TO HAVE AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST FROM PARTICIPATING IN ANY EVALUATION OR DECISION MAKING PROCESS REGARDING PRODUCTS OR SERVICES PROVIDED BY OR THROUGH THAT INDIVIDUAL OR ENTITY OR FROM USING THIS RELATIONSHIP TO OBTAIN GOODS OR SERVICES ON TERMS THAT ARE NOT AVAILABLE TO INDIVIDUALS WHO ARE NOT AFFILIATED WITH THE HOSPITAL. THE BOARD OF DIRECTORS IS RESPONSIBLE FOR ENFORCEMENT OF THE AFOREMENTIONED POLICY AND REPORT ANY CONDUCT THAT IT BELIEVES IN GOOD FAITH TO BE A VIOLATION OF THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINES 15A AND 15B: | OFFICERS AND DIRECTORS OF THE ORGANIZATION ARE COMPENSATED BY LONG ISLAND COMMUNITY HOSPITAL, A RELATED 501(C)(3) ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19: | UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE ONLY THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 14 GLOVER LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL ROAD | AddressLine1Txt |
| City | PATCHOGUE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11772 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 814169801 | EIN |
| Primary Activities | LEASING | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Total Income | $1,504,611 | TotalIncomeAmt |
| End Of Year Assets | $21,527,420 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BHCSC | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CTR | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 HOSPITAL ROAD | AddressLine1Txt |
| City | PATCHOGUE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11772 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 111704595 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BHCSC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Brookhaven Physician Services | |||||||||||
| 100 HOSPITAL ROAD | PATCHOGUE | NY | 11772 | 260628913 | PHYSICIAN OFF | NY | BHCSC | C | $3,916,857 | $985,010 | Yes (true) |
| Brookhaven Surgical Services PC | |||||||||||
| 100 Hospital ROAD | Patchogue | NY | 11772 | 260885844 | PHYSICIAN OFF | NY | BHCSC | C | $1,613,842 | $174,736 | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Brookhaven Memorial Hospital Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $1,504,611 | InvolvedAmt |
| Method Of Amount Determination | Cost | MethodOfAmountDeterminationTxt |
Comments