2017-11-13T15:40:18-06:00 2016-12-31 PricewaterhouseCoopers LLP 300 Madison Avenue New York NY 10017 990 2016-01-01 112861698 MARYHAVEN CENTER OF HOPE % LAURA PEPPER MARY 6314744120 51 TERRYVILLE RD PORT JEFFERSON NY 117763097 LEWIS GROSSMAN EXECUTIVE VP, CEO 6314744120 2017-11-06 true LAURA J PARELLO P01080295 6464713000 155.201.188.12 13049920173175000051 2017-11-13 P A47FF8DD5715699DF48307C25ACEE32075633D08 061919171EF570F7EF91D6556883685BED3C11EB 2016 2017-02-10 21:41:12Z LEWIS GROSSMAN 51 TERRYVILLE ROAD PORT JEFFERSON NY 117763097 69587673 false 0928 X http://MARYHAVEN.CHSLI.ORG/ X 1987 NY CHSLI AND ITS MEMBERS, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUE CHRIST'S HEALING MISSION, BY PROMOTING EXCELLENCE IN CARE AND COMMITTING ITSELF TO THOSE IN NEED. 15 15 1332 18 0 0 5606221 8344486 58915052 61132312 25280 44520 34602 30836 64581155 69552154 8870 220061 0 0 49722867 52091763 0 0 227587 12416601 12354779 62148338 64666603 2432817 4885551 37609123 37981562 32298101 27784242 5311022 10197320 X MARYHAVEN CENTER OF HOPE, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED. THE ORGANIZATION AFFIRMS THE SANCTITY OF LIFE, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. false false 31911031 220061 38960099 RESIDENTIAL CARE PROGRAMS: RESIDENTIAL AND HOME BASED SERVICES FOR ADULTS AND CHILDREN WITH DISABILITIES. (401 INDIVIDUALS SERVED) 21975547 0 16977386 Day programs for the developmentally disabled: provides community integrated educational, recreational, and clinical services to adults with disabilities. (1,000 INDIVIDUALS SERVED) 4440176 0 3988168 Vocational rehabilitation programs: Job placement, training, and workshop for adults with disabilities. (482 INDIVIDUALS SERVED) 1119877 0 1165031 CARE MANAGEMENT (472 INDIVIDUALS SERVED) 63206 0 41628 MAINTENANCE SERVICES FOR PHYSICIAN OFFICES 1183083 0 1206659 59509837 true true false false false false false false false false true false false true true true false true false false false false false false true false false true false true false false false false false false false false false false false false true true true true false false true 80 0 true 1332 true false false false false false true true false false false false X 15 15 false false false false true true true true true false false true true true true true true true true false X LAURA PEPPER 6314744120 51 TERRYVILLE ROAD PORT JEFFERSON NY 117763097 X THOMAS CHRISTMAN CHAIRPERSON 2.0 0.0 X X 0 0 0 JENNIFER HOFFMAN VICE CHAIRPERSON 2.0 0.0 X X 0 0 0 C JUSTIN MCCARTHY TREASURER 2.0 0.0 X X 0 0 0 SISTER DOLORES WISNIEWSKI CIJ SECRETARY 2.0 0.0 X X 0 0 0 BRIAN P KERLY ESQ TRUSTEE 2.0 0.0 X 0 0 0 DIANE SWEENEY TRUSTEE 2.0 0.0 X 0 0 0 DOUGLAS CELIBERTI TRUSTEE 2.0 0.0 X 0 0 0 JOHN O'BRIEN TRUSTEE 2.0 0.0 X 0 0 0 MICHAEL LAMBERT TRUSTEE 2.0 0.0 X 0 0 0 PETER DAGHER TRUSTEE 2.0 0.0 X 0 0 0 PETER WRIGHT TRUSTEE 2.0 0.0 X 0 0 0 REV STEPHEN PIETROWSKI TRUSTEE 2.0 0.0 X 0 0 0 S AUDREY HARSEN TRUSTEE 2.0 0.0 X 0 0 0 DR DONATO BALSAMO TRUSTEE 2.0 0.0 X 0 0 0 CALVIN SULLIVAN TRUSTEE 2.0 0.0 X 0 0 0 LEWIS GROSSMAN CHIEF EXECUTIVE OFFICER 30.0 0.0 X 447045 0 47316 LAURA PEPPER VP OF FINANCE 35.0 0.0 X 156168 0 31590 KAREN ESTRADA VP OF FINANCE UNTIL 2/11/16 35.0 0.0 X 22253 151388 51771 ROBIN DWYER DIR EDUC & RESIDENTIAL 35.0 0.0 X 169469 0 42020 EVA TARANTINO DIR HUMAN RESOURCES 35.0 0.0 X 164946 0 32323 PATRICIA FOGARTY EXEC DIR ADULT SERVICES 35.0 0.0 X 147982 0 36321 ARTHUR KURTZ MED COORDINATOR-CHILDREN SVC 35.0 0.0 X 150561 0 22458 CHARLES VANEK III ASST DIV DIRECTOR 35.0 0.0 X 128713 0 35739 1387137 151388 299538 14 false true false SINKOFF REALTY CO PO BOX 309 YAPHANK NY 11980 RENT 455643 MEDFORD HAMLETT LLC 1529 N OCEAN AVE MEDFORD NY 11763 RENT 238519 55 MEDFORD AVENUE LLC 55 MEDFORD AVENUE PATCHAGUE NY 11772 RENT 180269 KURUVILLA MANJUMMELKUDIYIL PC 15 CEDAR RIDGE LANE DIX HILLS NY 11746 PSYCHIATRY 175121 HEATHERWOOD HOUSE 39 PIEDMONT DR PORT JEFFERSON NY 11776 RENT 148592 9 224352 8000000 50000 70134 8344486 COMMUNITY RESIDENTIAL SERVICES 623000 38960099 38960099 DAY PROGRAMS 624100 16977386 16977386 VOCATIONAL 624310 3988168 3988168 CARE MANAGEMENT 624100 1165031 1165031 MAINTENANCE SERVICES 900099 41628 41628 61132312 28173 28173 0 0 36867 953 35914 0 35914 35914 16347 16347 16347 16347 29488 224352 34566 -5078 -5078 0 0 0 0 0 0 0 69552154 61132312 75356 220061 220061 0 0 0 712171 712171 0 34540759 32700792 1755936 84031 2453025 2333330 107454 12241 11734070 11161508 514005 58557 2651738 2522347 116158 13233 0 0 2782 2782 0 0 0 977347 841019 125583 10745 0 163244 123590 39654 81957 73147 8810 0 5605991 5226747 379244 745073 734542 10531 0 69799 46917 22882 124367 120044 4323 972480 972480 1341905 1276398 65507 298602 297770 832 PROGRAM SUPPLIES 676159 675876 283 CLIENT CARE 774766 770513 4253 SPECIAL EVENTS 26522 1025 25497 FOOD/MISCELLANEOUS 493785 384211 86291 23283 64666603 59509837 4929179 227587 3040638 4788324 730943 744364 0 0 8456636 8218924 0 0 0 0 0 0 319294 203660 2451760 2559766 35887295 25137746 10529461 10749549 0 0 674160 693045 0 0 0 0 11406231 10023930 37609123 37981562 4402101 4206063 0 0 8620581 3534117 185875 102275 0 0 0 0 677506 714028 0 0 18412038 19227759 32298101 27784242 X 5311022 10197320 0 0 0 0 5311022 10197320 37609123 37981562 4885551 747 X false true X true true true X 227035 246700 777113 5606221 8344486 15201555 56907891 60059987 58545365 58915052 61132312 295560607 0 0 0 57134926 60306687 59322478 64521273 69476798 310762162 5269837 8000000 13269837 0 5269837 8000000 13269837 297492325 80302 77660 58578 56318 65040 337898 2201 2201 82503 77660 58578 56318 65040 340099 0 0 0 4689 0 0 4689 57217429 60384347 59385745 64577591 69541838 311106950 0.95624 0.99878 0.00109 0.00120 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1953364 1953364 14639983 12169309 2470674 4527469 1702846 2824623 3109584 2415319 694265 11656895 8850272 2806623 10749549 DUE FROM RELATED COMPANIES 6026370 INSURANCE CLAIMS RECEIVABLE 3997560 10023930 0 DUE TO RELATED COMPANIES 4014710 RELATED PARTY LOAN 2426865 SELF INSURANCE LIABILITIES 4633938 OTHER LIABILITIES 8152246 19227759 X PART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTE CHS AND MOST OF ITS SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CHS ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE ACCOUNTING STANDARDS CODIFICATION TOPIC 740, INCOME TAXES. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS, USING A THRESHOLD OF MORE LIKELY THAN NOT OF BEING SUSTAINED. GARDEN PARTY 146466 136666 9800 1000 11203 FRIENDS OF MHC 107374 87686 19688 2450 19913 0 253840 224352 29488 3450 31116 34566 -5078 true CATHOLIC HEALTH SERVICE OF LONG ISLAND 992 N VILLAGE AVEROCKVILLE CENTRE ROCKVILLE CENTRE NY 11570 113403968 501(C)(3) 220061 NONE NONE OUTPATIENT CENTERS 1 PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE CHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR MARYHAVEN CENTER OF HOPE AND CATHOLIC HEALTH SERVICES OF LONG ISLAND AND IS THEREFORE ABLE TO MONITOR THAT CATHOLIC HEALTH SERVICES OF LONG ISLAND USES THE GRANT FUNDS FOR MISSION SUPPORT, OUTPATIENT CENTERS, GRANTS FOR THE UNDERSERVED COMMUNITIES, AND CAPITAL SUPPORT. PART II, LINE 1, COLUMN (H) NAME OF ORGANIZATION OR GOVERNMENT: CATHOLIC HEALTH SYSTEM OF LONG ISLAND (H) PURPOSE OF GRANT OR ASSISTANCE: 1) SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND AS A PASS THROUGH TO PROVIDE GENERAL SUPPORT TO THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD; AND 2) PROVIDE SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND TO FUND OUTPATIENT CENTERS THAT PROVIDE CHARITY CARE TO THOSE CENTERS' COMMUNITIES. IN ADDITION THE GRANTS PROVIDED TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND ARE USED TO FUND SUPPORT PROVIDED THROUGH THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CAREGIVERS FUND. THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CAREGIVERS FUND WAS FORMED WITH THE MISSION TO ASSIST OUR FELLOW CAREGIVERS ON THE FRONT LINES, HERE AND ABROAD, WHO STRUGGLE JUST TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. X X X X X X false true false false false false false false false LEWIS GROSSMAN CHIEF EXECUTIVE OFFICER 357520 0 65000 0 24525 0 26822 0 20494 0 494361 0 0 0 LAURA PEPPER VP OF FINANCE 149899 0 0 0 6269 0 11619 0 19971 0 187758 0 0 0 KAREN ESTRADA VP OF FINANCE UNTIL 2/11/16 22138 141929 0 9000 115 459 1829 12342 5970 31630 30052 195360 0 0 ROBIN DWYER DIR EDUC & RESIDENTIAL 152637 0 10000 0 6832 0 11833 0 30187 0 211489 0 0 0 EVA TARANTINO DIR HUMAN RESOURCES 147626 0 10000 0 7320 0 11380 0 20943 0 197269 0 0 0 PATRICIA FOGARTY EXEC DIR ADULT SERVICES 130324 0 11000 0 6658 0 10007 0 26314 0 184303 0 0 0 ARTHUR KURTZ MED COORDINATOR-CHILDREN SVC 149741 0 0 0 820 0 11543 0 10915 0 173019 0 0 0 CHARLES VANEK III ASST DIV DIRECTOR 122506 0 0 0 6207 0 9336 0 26403 0 164452 0 0 0 PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. LEWIS GROSSMAN $7,000 PARTICIPATION IN THE PLAN THE DEFERRED COMPENSATION IN COLUMN C FOR THESE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NON-QUALIFIED RETIREMENT PLANS. CURRENT OFFICERS AND DIRECTORS EFFECTIVE 2/11/16, KAREN ESTRADA TRANSFERRED OUT OF HER ROLE AS VP OF FINANCE TO A NON-OFFICER ROLE AT CHS SERVICES, INC, A RELATED ENTITY. FORM 990, PART III, LINE 4D - OTHER PROGRAM SERVICES CARE MANAGEMENT PROGRAMS: PROVIDES INDIVIDUAL SERVICE COORDINATION AND PASTORAL CARE TO INDIVIDUALS WITH SPECIAL NEEDS. (472 INDIVIDUALS SERVED) FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION THE SOLE MEMBER OF MARYHAVEN CENTER OF HOPE IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND DBA CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS). CHS IS A NY NON-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER (DIOCESE). FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODY CHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF MARYHAVEN CENTER OF HOPE AND AS SUCH, HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF MARYHAVEN CENTER OF HOPE. FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY CHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF MARYHAVEN CENTER OF HOPE IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY MARYHAVEN'S GOVERNING BODY. FORM 990, PART VI, LINE 11B - REVIEW PROCESS FOR FORM 990 THE FORM 990 AND APPROPRIATE SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF TRUSTEES (THE BOARD), WHICH HAS BEEN DELEGATED THE REVIEW FUNCTION BY THE BOARD. UPON APPROVAL OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO ALL VOTING MEMBERS OF THE BOARD. ONCE APPROVED BY THE BOARD (OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE), THE ORGANIZATION'S BOARD CHAIR AND CHIEF EXECUTIVE OFFICER COMMUNICATES, IN WRITING TO THE CHS COMPLIANCE AND AUDIT COMMITTEE AND CHS BOARD CHAIR. AFTER REVIEW OF ANY APPLICABLE COMMENTS FROM THE BOARD, THE COMPLIANCE AND AUDIT COMMITTEE WILL THEN RECOMMEND THE APPROVAL OF THE FORM 990 TO THE CHS BOARD OF DIRECTORS WHO WILL THEN REVIEW THE RECOMMENDATIONS AND PROVIDE THE FINAL APPROVAL OF THE FORM 990. THE FORM 990 IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST POLICY DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE BY THE ORGANIZATION'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFERRED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILIAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIMSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, LINE 15 - COMPENSATION POLICY THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE SYSTEM CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE POLICY. THE POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER, AND CHIEF OPERATING OFFICERS OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS; D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AN OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE DONE BY AN INDEPENDENT CONSULTANT ANNUALLY. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE BOARD OF TRUSTEES. FORM 990, PART VI, LINE 19 - DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VII, SECTION A - LINE 1A HOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. LEWIS GROSSMAN, CHIEF EXECUTIVE OFFICER - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: MARYHAVEN CENTER OF HOPE (11-2861698); MARYHAVEN SCHOOL (11-2861690); MARYHAVEN TRANSPORTATION SERVICES INC (11-3434776); RIVERHEAD HOSTEL HOLDING CORP (11-2499790); CENTER OF HOPE FOUNDATION INC (11-3638367). KAREN ESTRADA, VP OF FINANCE - THE TOTAL HOURS WORKED REPORTED (35.0) REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: MARYHAVEN CENTER OF HOPE (11-2861698); MARYHAVEN SCHOOL (11-2861690); MARYHAVEN TRANSPORTATION SERVICES INC (11-3434776); RIVERHEAD HOSTEL HOLDING CORP (11-2499790); CENTER OF HOPE FOUNDATION INC (11-3638367). LAURA PEPPER, VP OF FINANCE - THE TOTAL HOURS REPORTED (35.0) REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: MARYHAVEN CENTER OF HOPE (11-2861698); MARYHAVEN SCHOOL (11-2861690); MARYHAVEN TRANSPORTATION SERVICES INC (11-3434776); RIVERHEAD HOSTEL HOLDING CORP (11-2499790); CENTER OF HOPE FOUNDATION INC (11-3638367). MCH-WISDOM LLC 51 TERRYVILLE RD PORT JEFFERSON NY 11776 SR HOUSING NY 2510 21246 MARYHAVENCTR CATHOLIC HEALTH SYSTEM OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113403968 SUPPORT ORG NY 501(C)(3) 12A- I NA false CHS SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113555766 SUPPORT ORG NY 501(C)(3) 12B- II CHSLI false CHS AMBULANCE SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 141801961 DORMANT NY 501(C)(3) 3 CHSLI false GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 111888924 HOSPITAL NY 501(C)(3) 3 CHSLI false GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112537396 SELF INSURANC NY 501(C)(3) 12A- I GOOD SAMARTN false MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113434776 TRANSPORTATIO NY 501(C)(3) 12A- I MARYHAVENCTR true MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861690 Schl-disabled NY 501(C)(3) 2 MARYHAVENCTR true THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113638367 SUPPORT ORG NY 501(C)(3) 12A- I MARYHAVENCTR true MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CTR NY 11570 111635088 HOSPITAL NY 501(C)(3) 3 CHSLI false CATHOLIC HOME CARE 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 112126736 HOME CARE NY 501(C)(3) 10 CHSLI true OUR LADY OF CONSOLATION GERIATRIC CARE 111 BEACH DRIVE WEST ISLIP NY 11795 113284066 LT NURSE CARE NY 501(C)(3) 10 CHSLI true RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112499790 RENTING NY 501(C)(2) MARYHAVENCTR true SIENA VILLAGE INC 2000 BISHOPS ROAD SMITHTOWN NY 11787 061569129 SR HOUSING NY 501(C)(3) 10 STCATHERINE false ST CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN NY 11787 061562701 HOSPITAL NY 501(C)(3) 3 CHSLI false ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 111871039 HOSPITAL NY 501(C)(3) 3 CHSLI false CHS HOME SUPPORT SERVICES INC 15 POWER DRIVE HAUPPAUGE NY 11788 113594561 RESP THERAPY NY 501(C)(3) 10 CATHHOMECARE true ST FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112050523 HOSPITAL NY 501(C)(3) 3 CHSLI false ST FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112916033 SUPPORT ORG NY 501(C)(3) 12A- I ST FRANCIS false ST FRANCIS HOSPITAL RESEARCH & EDUCATIO 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113090867 RESEARCH ORG NY 501(C)(3) 12A- I ST FRANCIS false WSNCHS NORTH INC 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 113438973 HOSPITAL NY 501(C)(3) 3 CHSLI false THE ST CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 112983148 SUPPORT ORG NY 501(C)(3) 12A- I CHSLI false THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112716640 SUPPORT ORG NY 501(C)(3) 12A- I CHSLI false WISDOM GARDENS HOUSING DEVELOPMENT FUND 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113559713 SR HOUSING NY 501(C)(3) 10 MARYHAVENCTR true GOOD SHEPHERD HOSPICE 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 112958438 HOSPICE SVC NY 501(C)(3) 10 CHSLI true ST CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 412076312 SUPPORT ORG NY 501(C)(3) 12A- I ST CHARLES false GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 770611240 SUPPORT ORG NY 501(C)(3) 12A- I GOOD SAMARTN false MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 550813603 SUPPORT ORG NY 501(C)(3) 12A- I MERCY MEDCTR false ST CATHERINE OF SIENA MEDICAL CTR FDN 50 ROUTE 25A SMITHTOWN NY 11787 271459941 SUPPORT ORG NY 501(C)(3) 12A- I STCATHERINE false CHS HOME CARE AND HOSPICE FOUNDATION 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 452907761 SUPPORT ORG NY 501(C)(3) 12A- I CATHHOMECARE false GOOD SHEPHERD HOSPICE FOUNDATION 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 263169427 SUPPORT ORG NY 501(C)(3) 12A- I GOODSHEPHERD false OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP NY 11795 450517566 SUPPORT ORG NY 501(C)(3) 12A- I OURLADYOFC false RVC SUPPORT 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 271531084 REAL ESTATE NY 501(C)(3) 12A- I CHSLI false ST FRANCIS CARDIOVASCULAR PHYSICIANS P 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113613997 HEALTHCARESVC NY 501(C)(3) 12A- I ST FRANCIS false RVC INSURANCE COMPANYINC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 208067039 CAPTIVE INS NY 501(C)(3) 12B- II CHSLI false SAMARITAN EMERGENCY MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208243412 HEALTHCARESVC NY 501(C)(4) GOOD SAMARTN false ST JOSEPH HOSPITAL FOUNDATION 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 472353387 SUPPORT ORG NY 501(C)(3) 12A- I WSNCHS NORTH false BIPO HOLDINGS LLC 1600 STEWART AVE WESTBURY NY WESTBURY NY 11590 464763720 PHYSICIAN ASSN NY NA N/A IDHC LLC 2500 YORK RDJAMISONPA 18929 JAMISON PA 18929 452411095 HEALTH SERVICES PA NA N/A BEACON HEALTH PTNRS 1600 STEWART AVE WESTBURY NY WESTBURY NY 11590 454229842 HEALTHCARE NY NA N/A WISDOM GARDENS LP 51 TERRYVILLE RD PORT JEFFERSON NY 11776 113567947 SR HOUSING NY MCH-WISDOM LLC RELATED -10343 3626471 false 0 false 0.99991 RADIOLOGY CONSULTING OF LONG ISLANDPLLC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 421646134 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN PEDIATRIC SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208180263 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208088453 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SOUTHWEST SUFFOLK MEDICAL PC 580 UNION BOULEVARD WEST ISLIP NY 11795 061603195 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false CARDIAC EKG INTERPRETATION PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112924518 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208964140 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112838185 HEALTHCARE SVC NY CHSLI C-CORP false ADVANCED REHABILIATION MEDICINE PLLC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 113640709 HEALTHCARE SVC NY STCHARLES HOSP C-CORP false ST FRANCIS CARDIAC PREVENTION SERVICES 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113224885 HEALTHCARE SVC NY STFRANCIS HOSP C-CORP false SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113307977 HEALTHCARE SVC NY SAMARITAN MGMT C-CORP false SAMARITAN HOME CARE AMERICA 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113319259 HEALTHCARE SVC NY SAMARITAN MGMT C-CORP false MERCY INTERNAL MEDICINE PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 510639649 HEALTHCARE SVC NY MERCY MED CTR C-CORP false LONG ISLAND EMERGENCY CARE PC 1000 N VILLAGE AVE ROCKVILLE NY 11571 113633515 PHYSICIAN SVC NY MERCY MED CTR S-CORP false false true true true true false false false true false false true true false true true true false true MARYHAVEN SCHOOL CORPORATION MOQ 353712 COST MARYHAVEN TRANSPORTATION SERVICES INC MOQ 222278 COST CATHOLIC HOME CARE PQ 105250 GOOD SHEPHERD HOSPICE PQ 100497 SCHEDULE R, PART IV FOR ALL PROFESSIONAL CORPORATIONS REPORTED ON SCHEDULE R, PART IV, THE PHYSICIAN IS THE SOLE SHAREHOLDER OF THE ENTITY AND THE DIRECT CONTROLLING ENTITY REPORTED IN COLUMN (D) IS THE BENEFICIAL OWNER. THIS STRUCTURE IS CONSISTENT WITH THE NEW YORK CORPORATE PRACTICE OF MEDICINE.