HUDSON VISTA MEDICAL PC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- HUDSON VISTA MEDICAL PC (EIN 45-2526738)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-05
- IRS object ID
- 202043109349302779
- Schema version
- 2019v5.1
- 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 | 2020-11-05T16:59:25-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5 TIMES SQUARE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452526738 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUDSON VISTA MEDICAL PC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % THOMAS J GIBNEY CPA | InCareOfNm |
| Business Name Control | HUDS | BusinessNameControlTxt |
| Phone | 8455614400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 DUBOIS STREET | AddressLine1Txt |
| City | NEWBURGH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 125504851 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS J GIBNEY CPA | PersonNm |
| Person Title | Secretary | PersonTitleTxt |
| Phone | 8455682881 | PhoneNum |
| Signature | 2020-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NICOLE M SOKOLOWSKI | PreparerPersonNm |
| PTIN | P01683199 | PTIN |
| Phone | 2127733000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 108.206.163.59 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 26308520203105000013 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-11-05 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 24558E047A149CE0743DDA4F89040DC2FD5B7974 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 770194AAF055F9EA87E64CA02E08FE540289067F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GINA DEL SAVIO MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 DUBOIS STREET | AddressLine1Txt |
| City | NEWBURGH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 125504851 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,390,405 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MONTEFIORESLC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MULTI-SPECIALTY HEALTHCARE SERVICES TO ST. LUKE'S CORNWALL HOSPITAL PATIENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 1 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 27 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $917,735 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,123,165 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,198,764 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,266,716 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,603 | PYOtherRevenueAmt |
| CY Other Revenue | $524 | CYOtherRevenueAmt |
| PY Total Revenue | $3,119,102 | PYTotalRevenueAmt |
| CY Total Revenue | $3,390,405 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,416,112 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,698,025 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $702,990 | PYOtherExpensesAmt |
| CY Other Expenses | $692,380 | CYOtherExpensesAmt |
| PY Total Expenses | $3,119,102 | PYTotalExpensesAmt |
| CY Total Expenses | $3,390,405 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $0 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $338,531 | TotalAssetsBOYAmt |
| Total Assets EOY | $351,693 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $338,531 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $351,693 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $0 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE MULTI-SPECIALTY HEALTHCARE SERVICES TO ST. LUKE'S CORNWALL HOSPITAL PATIENTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $2,943,921 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,266,716 | RevenueAmt |
| Desc | Hudson Vista Medical, P.C. is a supporting organization of Montefiore St Luke's Cornwall Hospital, a member of the Montefiore Health System. Hudson Vista Medical provides MULTI-SPECIALTY HEALTHCARE SERVICES TO ST. LUKE'S CORNWALL HOSPITAL PATIENTS. The corporation operates in furtherance and support of the charitable, healthcare, educational and scientific mission of Montefiore St Luke's Cornwall Hospital and the patient populations and communities served by Montefiore St Luke's Cornwall Hospital. The organization's objective is to enhance and improve the accessibility, quality and cost efficiency of healthcare services in the community, increase access to quality healthcare services for the medically underserved residents within the community and advance, promote and support the medical research activities at St Luke's hospital for the improvement of the physical, mental and environmental health of the community. | Desc |
| Total Program Service Expenses | $2,943,921 | 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 | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | 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 | false | 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 | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 27 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| 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 | 1 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | 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 | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS J GIBNEY CPA | PersonNm |
| Phone | 8455682881 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 DUBOIS STREET | AddressLine1Txt |
| City | NEWBURGH | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 125504851 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| GINA DEL SAVIO MD | ||||||||
| DIRECTOR/PRESIDENT | 12.0 | 43.0 | Yes (X) | Yes (X) | $0 | $650,609 | $33,952 | |
| JOAN CUSACK-MCGUIRK | ||||||||
| ASSISTANT SECRETARY | 1.0 | 54.0 | Yes (X) | $0 | $630,222 | $24,322 | ||
| THOMAS J GIBNEY CPA | ||||||||
| SECRETARY | 1.0 | 54.0 | Yes (X) | $0 | $473,273 | $45,442 | ||
| UTICIA M BELFIELD M | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $256,419 | $0 | $38,384 | Yes (X) | ||
| Manita Sawhney MD | ||||||||
| Physician | 39.0 | 1.0 | $256,849 | $0 | $4,281 | Yes (X) | ||
| MARGARITA KOGAN MD | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $216,188 | $0 | $43,187 | Yes (X) | ||
| NICHOLAS G BAMBINO M | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $173,038 | $0 | $6,803 | Yes (X) | ||
| Diana Linetskaya MD | ||||||||
| Physician | 40.0 | 0.0 | $160,698 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,063,192 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,754,104 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $196,371 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Change Healthcare LLC | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 742526 | AddressLine1Txt |
| City | ALTANTIC | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 303742526 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | billing services | ServicesDesc |
| Compensation | $141,885 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,123,165 | RelatedOrganizationsAmt |
| Total Contributions | $1,123,165 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621111 | $2,161,898 | $2,161,898 | $0 | $0 |
| OTHER HEALTHCARE RELATED REVENUE | 621999 | $104,818 | $104,818 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,266,716 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
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 |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| 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 | PURCHASE DISCOUNTS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $524 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $524 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $524 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,390,405 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,266,716 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $524 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $2,287,306 | TotalAmt |
| Program Services | $2,060,376 | ProgramServicesAmt |
| Management And General | $226,930 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,895 | TotalAmt |
| Program Services | $42,242 | ProgramServicesAmt |
| Management And General | $4,653 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $213,822 | TotalAmt |
| Program Services | $192,608 | ProgramServicesAmt |
| Management And General | $21,214 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,002 | TotalAmt |
| Program Services | $135,120 | ProgramServicesAmt |
| Management And General | $14,882 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
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 | $0 | TotalAmt |
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 | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,586 | TotalAmt |
| Program Services | $129,473 | ProgramServicesAmt |
| Management And General | $159,113 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,417 | TotalAmt |
| Program Services | $26,272 | ProgramServicesAmt |
| Management And General | $15,145 | ManagementAndGeneralAmt |
| Fundraising | $0 | 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 | $186,151 | TotalAmt |
| Program Services | $186,151 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | 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 | $8,174 | TotalAmt |
| Program Services | $8,174 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,700 | TotalAmt |
| Program Services | $41,700 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $110,924 | $110,924 | $0 | $0 |
| LICENSE FEES | $4,884 | $4,884 | $0 | $0 |
| COLLECTION FEES | $4,547 | $0 | $4,547 | $0 |
| EDUCATION & TRAINING | $3,524 | $3,524 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,473 | TotalAmt |
| Program Services | $2,473 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,390,405 | TotalAmt |
| Program Services | $2,943,921 | ProgramServicesAmt |
| Management And General | $446,484 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $350 | BOYAmt |
| EOY | $250 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,040 | BOYAmt |
| EOY | $39,770 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $291,246 | BOYAmt |
| EOY | $248,214 | 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 | $2,200 | BOYAmt |
| EOY | $2,200 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $127,536 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $104,015 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,695 | BOYAmt |
| EOY | $23,521 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $0 | BOYAmt |
| EOY | $37,738 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,531 | BOYAmt |
| EOY | $351,693 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $269,288 | BOYAmt |
| EOY | $351,693 | 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 | $69,243 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,531 | BOYAmt |
| EOY | $351,693 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,531 | BOYAmt |
| EOY | $351,693 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $0 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST LUKE'S CORNWALL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141340054 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (true) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | false | OperateBenefitNonSuprtOrgInd |
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 | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $127,536 | OtherCostOrOtherBasisAmt |
| Depreciation | $104,015 | DepreciationAmt |
| Book Value | $23,521 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $23,521 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE FROM AFFILIATES | Desc |
| Book Value | $37,738 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $37,738 | TotalBookValueOtherAssetsAmt |
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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS J GIBNEY CPA | ||||||||||||||
| SECRETARY | $0 | $427,149 | $0 | $38,600 | $0 | $7,524 | $0 | $13,114 | $0 | $32,328 | $0 | $518,715 | $0 | $0 |
| NICHOLAS G BAMBINO MD | ||||||||||||||
| PHYSICIAN | $170,059 | $0 | $0 | $0 | $2,979 | $0 | $6,803 | $0 | $0 | $0 | $179,841 | $0 | $0 | $0 |
| UTICIA M BELFIELD MD | ||||||||||||||
| PHYSICIAN | $196,654 | $0 | $59,345 | $0 | $420 | $0 | $4,100 | $0 | $34,284 | $0 | $294,803 | $0 | $0 | $0 |
| MARGARITA KOGAN MD | ||||||||||||||
| PHYSICIAN | $172,697 | $0 | $43,128 | $0 | $363 | $0 | $7,968 | $0 | $35,219 | $0 | $259,375 | $0 | $0 | $0 |
| JOAN CUSACK-MCGUIRK | ||||||||||||||
| ASSISTANT SECRETARY | $0 | $557,830 | $0 | $61,700 | $0 | $10,692 | $0 | $10,563 | $0 | $13,759 | $0 | $654,544 | $0 | $0 |
| GINA DEL SAVIO MD | ||||||||||||||
| DIRECTOR/PRESIDENT | $0 | $344,911 | $0 | $22,300 | $0 | $283,398 | $0 | $12,375 | $0 | $21,577 | $0 | $684,561 | $0 | $0 |
| Manita Sawhney MD | ||||||||||||||
| Physician | $145,500 | $0 | $111,089 | $0 | $260 | $0 | $4,281 | $0 | $0 | $0 | $261,130 | $0 | $0 | $0 |
| Diana Linetskaya MD | ||||||||||||||
| Physician | $160,645 | $0 | $0 | $0 | $53 | $0 | $0 | $0 | $0 | $0 | $160,698 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 | Hudson Vista Medical, PC top management official is employed by Montefiore St Luke's Cornwall Hospital. THE Hospital's COMPENSATION COMMITTEE REVIEWS AND APPROVES ALL FORMS OF COMPENSATION AND BENEFITS PROVIDED TO its top level EXECUTIVEs WITH THE ASSISTANCE OF A NATIONAL INDEPENDENT COMPENSATION CONSULTING FIRM. THE CONSULTING FIRM ASSISTS THE COMPENSATION COMMITTEE WITH ITS DECISION-MAKING PROCESS TO ENSURE EXECUTIVE COMPENSATION LEVELS ARE REASONABLE AND APPROPRIATE RELATIVE TO THOSE OF OTHER SIMILAR ORGANIZATIONS. BASE SALARIES are DETERMINED BASED ON COMPETITIVE MARKET PRACTICES FOR COMPARABLE POSITIONS WITH SIMILAR SIZE ORGANIZATIONS AND SCOPE OF RESPNSIBILITIES. BONUS AND INCENTIVE COMPENSATION IS BASED ON THE ACHIEVEMENT OF PERFORMANCE GOALS. THE EXECUTIVES' COMPENSATION PROGRAM HAS A SIGNIFICANT PAY-AT-RISK COMPONENT TO ENSURE THE ALIGNMENT OF PAY AND ORGANIZATIONAL PERFORMANCE. GOALS ARE SET IN ADVANCE IN AREAS SUCH AS QUALITY OF CARE, PATIENT SATISFACTION, COMMUNITY SERVICES AND FINANCIAL PERFORMANCE. COMPENSATION IS AT RISK IF THE GOALS ESTABLISHED BY THE COMPENSATION COMMITTEE ARE NOT MET. |
| Schedule J, Part I, Line 7 | Certain Physicians reported as the five highest compensated by the organization received PAYMENTS RELATED TO THE SATISFATION OF CERTAIN METRICS ASSOCIATED WITH CLINICAL CODING AND OTHER ADMINISTRATIVE FACTORS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, lines 6 & 7 | The organization has a sole shareholder appointed by MONTEFIORE St Luke's Cornwall Hospital who has the authority to elect and remove any director from the organization's Board. The sole shareholder is required to obtain the express written approval of the Hospital before taking any material action relating to the ownership, existence and operation of the organization. |
| Form 990, PART VI, SECTION B, line 11 | The Form 990 was prepared by the Montefiore's tax Department working closely with St Luke's Finance team and assisted by various departments throughout the Health System. The Form 990 was reviewed and approved by the Vice-President-Finance and the Montefiore ST LUKE'S CORNWALL HOSPITAL senior leadership including the Chief Financial Officer. In addition, an independent accounting firm was engaged to review the Form 990. Upon completion of the various reviews, the Form 990 was presented to the Board of trustees for review and approval prior to filing. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION has adopted the conflict of interest policy maintained by Montefiore ST. LUKE'S CORNWALL HOSPITAL, the parent organization. All moitoring and enforcement of the conflict of interest policy is performed by the hospital. All officers, directors and key employees of the St Luke's organization are required to complete an annual conflict of interest questionnaire, in their capacity as an employee of the organization or as a Board Member. Completed questionnaires are returned and reviewed by the Secretary of the Board of trustees and concerns presented by the responses are disclosed to the system's compliance officer. Any potential conflicts are disclosed and reported to the system's President/CEO and the organization's Finance committee for discussion and alleviation of the conflict. Documentation of the existence and resolution of the conflict, including any meeting minutes, IS maintained by the Secretary of the Board. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION IS AN AFFILIATE WITHIN Montefiore Health System, Inc., A tax-exempt INTEGRATED HEALTHCARE DELIVERY SYSTEM ("SYSTEM") WHICH includes Montefiore ST. LUKE'S CORNWALL HOSPITAL ("HOSPITAL"). The officers of the organization are employees of Montefiore St Luke's Cornwall Hospital. The St Luke's Board of Trustees has charged the Compensation Committee of the Board (which is comprised of independent Board members with no conflicts of interest in regards to executive compensation) with making all decisions related to compensation for certain officers and key employees. All decisions made by the Compensation Committee are appropriately and timely documented in meeting minutes. The compensation committee's review process follows the Intermediate Sanctions guidelines for qualifying for the rebuttable presumption of reasonableness. The Committee retains an independent compensation consultant to assist it with this process. Compensation levels are established considering data for comparble organizations, an assessment of management performance (including the services provided to the community), and other business judgement factors, consistent with St Luke's executive compensation philosophy. The Committee's decisions are made in the best interest of St Luke's, and are intended to ensure the recruitment and retention of key executive talent, consistent with the market practices of other not-for profit healthcare organizations of comparable scope, mission and complexity. On an annual basis, the Committee provides the full Board of Trustees with a description of the committee's review and approval process and its decisions. All decisions made by the Compensation Comittee are appropriately and timely documented in meeting minutes. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE available UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ST LUKE'S CORNWALL HOSPITAL | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 141340054 | Hospital | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| ST LUKE'S CORNWALL HEALTH SYSTEM INC | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 223026261 | HOLDING COMP | NY | 501(C)(3) | 12A TYPE I | MHS | Yes (true) |
| ST LUKE'S CORNWALL HEALTH SYSTEM FDN | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 223026263 | FUNDRAISING | NY | 501(C)(3) | 7 | SLCHS | Yes (true) |
| AMOS & SARAH HOLDEN HOME AGED WOMEN | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 141365995 | ASST LIVING | NY | 501(C)(3) | PF | SLCHS | Yes (true) |
| HUDSON VISTA PHYSICIANS SERVICES PC | ||||||||||
| 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 272020746 | HEALTHCARE | NY | 501(C)(3) | 12A TYPE I | SLCH | Yes (true) |
| MONTEFIORE HEALTH SYSTEM INC | ||||||||||
| 555 SOUTH BROADWAY | TARRYTOWN | NY | 10591 | 201615393 | SUPPORT SERV | NY | 501(C)(3) | 12B TYPE II | MMAHS | Yes (true) |
| MONTEFIORE MEDICAL CENTER | ||||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 131740114 | ACD MED CTR | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| MMC CORPORATION | ||||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 133430322 | REAL ESTATE | NY | 501(C)(3) | 12A TYPE I | MMC | Yes (true) |
| MMC RESIDENTIAL CORP I INC | ||||||||||
| 3411 WAYNE AVENUE | BRONX | NY | 10467 | 911943271 | STAFF HOUSING | NY | 501(C)(2) | MMC | Yes (true) | |
| MONTEFIORE HOSP HOUSING SECTION II INC | ||||||||||
| 3450 WAYNE AVENUE | BRONX | NY | 10467 | 237160641 | STAFF HOUSING | NY | 501(C)(2) | MMC | Yes (true) | |
| MOSHOLU PRESERVATION CORPORATION | ||||||||||
| 3400 RESEVOIR OVAL EAST | BRONX | NY | 10467 | 133109387 | COMMUNITY SER | NY | 501(C)(3) | 12A TYPE I | MMC | Yes (true) |
| GUN HILL MRI PC | ||||||||||
| 200 EAST GUN HILL ROAD | BRONX | NY | 10467 | 133734486 | DIAG SERVICES | NY | 501(C)(3) | 12A TYPE I | MMC | Yes (true) |
| MONTEFIORE NEW ROCHELLE HOSPITAL | ||||||||||
| 16 GUION PLACE | NEW ROCHELLE | NY | 10801 | 462931956 | HOSPITAL | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| MONTEFIORE MOUNT VERNON HOSPITAL | ||||||||||
| 12 NORTH SEVENTH AVENUE | MOUNT VERNON | NY | 10550 | 462916938 | HOSPITAL | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| SCHAFFER EXTENDED CARE CENTER | ||||||||||
| 16 GUION PLACE | NEW ROCHELLE | NY | 10801 | 462929888 | NURSING HOME | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| MONTEFIORE FOUNDATION INC | ||||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 471600439 | INACTIVE | NY | 501(C)(3) | 7 | MMAHS | Yes (true) |
| ALBERT EINSTEIN COLLEGE OF MEDICINE INC | ||||||||||
| 1300 MORRIS PARK AVENUE | BRONX | NY | 10461 | 472209056 | MED COLLEGE | NY | 501(C)(3) | 2 | MMAHS | Yes (true) |
| MONTEFIORE MEDICINE ACAD HLTH SYST INC | ||||||||||
| 555 SOUTH BROADWAY | TARRYTOWN | NY | 10591 | 471582973 | SYSTEM PARENT | NY | 501(C)(3) | 12B TYPE II | NA | Yes (true) |
| MONTEFIORE NYACK HOSPITAL | ||||||||||
| 160 NORTH MIDLAND AVENUE | NYACK | NY | 10960 | 131740119 | HOSPITAL | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| WHITE PLAINS HOSPITAL MEDICAL CENTER | ||||||||||
| 41 EAST POST ROAD | WHITE PLAINS | NY | 10601 | 131740130 | HOSPITAL | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| AECOM STUDENT HOUSING CO INC | ||||||||||
| 1300 MORRIS PARK AVENUE | BRONX | NY | 10461 | 237075620 | STUDENT HOUS | NY | 501(C)(2) | AECOM | Yes (true) | |
| MONTEFIORE CERC OPERATION INC | ||||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 474853506 | REHAB CENTER | NY | 501(c)(3) | 3 | MMC | Yes (true) |
| WHITE PLAINS HOSPITAL CTR FOUNDATIONINC | ||||||||||
| 41 EAST POST ROAD DAVIS AVE | WHITE PLAINS | NY | 10601 | 133281507 | FUNDRAISING | NY | 501(C)(3) | 12A TYPE I | WPHMC | Yes (true) |
| MONTEFIORE NYACK HOSPITAL FOUNDATION | ||||||||||
| 160 NORTH MIDLAND AVENUE | NYACK | NY | 10960 | 133245804 | FUNDRAISING | NY | 501(C)(3) | 7 | NYACK HOSP | Yes (true) |
| THE WINIFRED MASTERSON BURKE REHAB HOSP | ||||||||||
| 785 MAMARONECK AVENUE | WHITE PLAINS | NY | 10605 | 131739937 | REHAB HOSP | NY | 501(C)(3) | 3 | MHS | Yes (true) |
| Hudson Vista Corporation | ||||||||||
| 70 Dubois Street | Newburgh | NY | 12550 | 202286782 | Healthcare | NY | 501(c)(3) | 12A Type I | NA | false |
| MONTEFIORE MED ACAD HLTH SYS SELF INS TR | ||||||||||
| 555 SOUTH BROADWAY | TARRYTOWN | NY | 10591 | 824019223 | INS TRUST | NY | 501(c)(3) | 12A TYPE I | MMAHS | Yes (true) |
| ALBERT EINSTEIN COLLEGE OF MEDICINE | ||||||||||
| 1300 MORRIS PARK AVENUE | BRONX | NY | 10461 | 830621846 | MED COLLEGE | NY | 501(C)(3) | 2 | MMAHS | Yes (true) |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (28 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| UNIVERSITY BEHAVIORAL ASSOCIATES INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 133877781 | MGMT SERVICES | NY | NA | C CORP | Yes (true) |
| THE MONTEFIORE IPA INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 134114915 | INTEG PROVR ASSOC | NY | NA | C CORP | Yes (true) |
| MMC GI HOLDINGS EAST INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 721610013 | HOLDING COMPANY | NY | NA | C CORP | Yes (true) |
| MMC GI HOLDINGS WEST INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 721610015 | HOLDING COMPANY | NY | NA | C CORP | Yes (true) |
| MONTEFIORE BEHAVIORAL CARE IPA NO 1 INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 133952750 | INTEG PROVR ASSOC | NY | NA | C CORP | Yes (true) |
| BRONX ACCOUNTABLE CARE NETWORK IPA INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 300689571 | INTEG PROVR ASSOC | NY | NA | C CORP | Yes (true) |
| MONTEFIORE CONSOLIDATED VENTURES INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 611728539 | HOLDING COMPANY | NY | NA | C CORP | Yes (true) |
| MONTEFIORE INSURANCE COMPANY INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 320436594 | INACTIVE | NY | NA | C CORP | Yes (true) |
| HUDSON VALLEY IPA INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 383978087 | INTEG PROVR ASSOC | NY | NA | C CORP | Yes (true) |
| MONTEFIORE INNOVTIONS INC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 475106910 | HOLDING COMPANY | NY | NA | C CORP | Yes (true) |
| HIGHLAND MEDICAL PC | |||||||||
| 160 NORTH MIDLAND AVENUE | NYACK | NY | 10960 | 134034481 | HEALTHCARE SERV | NY | NA | C CORP | Yes (true) |
| 8 LONGVIEW DEVELOPMENT CORP | |||||||||
| DAVIS AVENUE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 263321278 | HOUSING | NY | NA | C CORP | Yes (true) |
| WHITE PLAINS MEDICAL DIAGNOSTIC SVCS PC | |||||||||
| 41 EAST POST ROAD | WHITE PLAINS | NY | 10601 | 453164626 | HEALTHCARE SERV | NY | NA | C CORP | Yes (true) |
| CANCER AND BLOOD MEDICAL SERVS OF NY PC | |||||||||
| 41 EAST POST ROAD | WHITE PLAINS | NY | 10601 | 462021804 | HEALTHCARE SERV | NY | NA | C CORP | Yes (true) |
| DAVIS AVENUE CORP | |||||||||
| DAVIS AVENUE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 133331643 | Property Holding | NY | NA | C CORP | Yes (true) |
| WHITE PLAINS MANAGEMENT CO INC | |||||||||
| 41 EAST POST ROAD | WHITE PLAINS | NY | 10601 | 133331641 | Propoerty holding | NY | NA | C CORP | Yes (true) |
| WPHC BUILDING CORP | |||||||||
| 41 EAST POST ROAD | WHITE PLAINS | NY | 10601 | 133676932 | Property Holding | NY | NA | C CORP | Yes (true) |
| WHITE PLAINS MEDICAL SERVICES PC | |||||||||
| DAVIS AVENUE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 815369152 | HEALTHCARE SERV | NY | NA | C CORP | Yes (true) |
| WHITE PLAINS PHYSICIAN SERVICES PC | |||||||||
| DAVIS AVENUE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 815309615 | HEALTHCARE SERV | NY | NA | C CORP | Yes (true) |
| CHARITABLE REMAINDER TRUST (4) | |||||||||
| CHARIT REMR TRUST | NY | NA | Trust | Yes (true) | |||||
| WHITE PLAINS PHYSICIAN MEDICAL SERV PC | |||||||||
| DAVIS AVE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 830519787 | INACTIVE | NY | NA | C CORP | Yes (true) |
| EAST POST ROAD MEDICAL SERVICES PC | |||||||||
| DAVIS AVE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 830535258 | HEALTHCRE SERV | NY | NA | C CORP | Yes (true) |
| EAST POST ROAD PHYSICIAN SERVICES PC | |||||||||
| DAVIS AVE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 830563325 | INACTIVE | NY | NA | C CORP | Yes (true) |
| DAVIS AVENUE MEDICAL SERVICES PC | |||||||||
| DAVIS AVENUE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 830579310 | INACTIVE | NY | NA | C CORP | Yes (true) |
| WPH HOLDINGS INC | |||||||||
| DAVIS AVE AT EAST POST ROAD | WHITE PLAINS | NY | 10601 | 833893119 | HOLDING COMPANY | NY | NA | C CORP | Yes (true) |
| CRHT ACQUISITION INC | |||||||||
| 555 SOUTH BROADWAY | TARRYTOWN | NY | 10591 | 815220651 | HOLDING COMPANY | NY | NA | C CORP | Yes (true) |
| QUANTUM BIOTHERAPEUTICS LLC | |||||||||
| 111 EAST 210TH STREET | BRONX | NY | 10467 | 611793667 | INACTIVE | NY | NA | C CORP | Yes (true) |
| Innovator Acqusition Corp | |||||||||
| 111 East 210th Street | Bronx | NY | 104672401 | 833394059 | Holding Compay | NY | NA | C Corp | 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 | false | 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 | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | 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 | ST LUKE'S CORNWALL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionTypeTxt |
| Involved | $1,123,165 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |