GOOD SHEPHERD HOSPICE: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- GOOD SHEPHERD HOSPICE (EIN 11-2958438)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201603199349303145
- Schema version
- 2015v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T11:26:29-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 Madison Avenue | AddressLine1Txt |
| City | New York | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10017 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 112958438 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOOD SHEPHERD HOSPICE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % GOOD SHEPHERD HOSPICE | InCareOfNm |
| Business Name Control | GOOD | BusinessNameControlTxt |
| Phone | 6314656300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 BI-COUNTY BLVD SUITE 114 | AddressLine1Txt |
| City | FARMINGDALE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11735 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARY ELLEN POLIT | PersonNm |
| Person Title | EXECUTIVE VP, CAO | PersonTitleTxt |
| Phone | 6318287411 | PhoneNum |
| Signature | 2016-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAURA J PARELLO | PreparerPersonNm |
| PTIN | P01080295 | PTIN |
| Phone | 6464713000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARY ELLEN POLIT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 BI-COUNTY BLVD SUITE 114 | AddressLine1Txt |
| City | FARMINGDALE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11735 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $36,422,774 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP//GOODSHEPHERDHOSPICE.CHSLI.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 316 | TotalEmployeeCnt |
| Total Volunteers | 103 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $377,874 | PYContributionsGrantsAmt |
| CY Contributions Grants | $305,017 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,127,660 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $35,910,385 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,521 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,669 | CYInvestmentIncomeAmt |
| PY Other Revenue | $203,685 | PYOtherRevenueAmt |
| CY Other Revenue | $202,703 | CYOtherRevenueAmt |
| PY Total Revenue | $36,712,740 | PYTotalRevenueAmt |
| CY Total Revenue | $36,422,774 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $29,355 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $6,708 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $18,848,776 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,569,537 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,920,790 | PYOtherExpensesAmt |
| CY Other Expenses | $15,423,245 | CYOtherExpensesAmt |
| PY Total Expenses | $35,798,921 | PYTotalExpensesAmt |
| CY Total Expenses | $36,999,490 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $913,819 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$576,716 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,043,261 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,788,309 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,707,268 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,029,032 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,335,993 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,759,277 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | GOOD SHEPHERD HOSPICE, 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. CHS 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. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $27,074,602 | ExpenseAmt |
| Grant | $6,708 | GrantAmt |
| Revenue | $32,228,870 | RevenueAmt |
| Desc | HOSPICE CARE-FOCUSED ON PATIENT COMFORT IN AN ENVIRONMENT THAT AFFIRMS LIFE AND DIGNITY, INCLUDING A NETWORK OF PROFESSIONAL CAREGIVERS WORKING IN CONJUNCTION WITH THE PATIENT'S PRIMARY CARE PHYSICIAN. THE MULTIDISCIPLINARY APPROACH ENSURES THE DELIVERY OF HIGH QUALITY PHYSICAL, PSYCHOLOGICAL AND SPIRITUAL CARE THROUGHOUT THE PROCESS. HOSPICE SERVED A TOTAL OF 3,344 PATIENTS IN 2015 AND OUR DAILY CENSUS WAS 374. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,714,622 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,884,218 | RevenueAmt |
| Desc | INPATIENT UNIT SERVICES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $31,789,224 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | 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 |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| 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 | 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 | Yes (true) | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | 46 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 316 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | GOOD SHEPHERD HOSPICE | PersonNm |
| Phone | 6318287411 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 BI-COUNTY BLVD SUITE 114 | AddressLine1Txt |
| City | FARMINGDALE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11735 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
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 | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS CHRISTMAN | ||||||||||
| CHAIRPERSON | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JENNIFER HOFFMAN | ||||||||||
| VICE CHAIRPERSON | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| SISTER DOLORES WISNIEWSKI CIJ | ||||||||||
| SECRETARY | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| C JUSTIN MCCARTHY | ||||||||||
| TREASURER | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| BRIAN P KERLY ESQ | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| DIANE SWEENEY | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| DOUGLAS CELIBERTI | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN O'BRIEN | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL LAMBERT | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| PETER DAGHER | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| PETER WRIGHT | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| REV STEPHEN PIETROWSKI | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| SISTER AUDREY HARSEN | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| DR DONATO BALSAMO | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| CALVIN SULLIVAN | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| MARY ELLEN POLIT | ||||||||||
| EVP & CAO | 50.0 | 0.0 | Yes (X) | $0 | $349,334 | $103,068 | ||||
| DANIELLE STEIN | ||||||||||
| VP FINANCE | 0.0 | 50.0 | Yes (X) | $0 | $144,401 | $40,238 | ||||
| KERIANNE PAGE | ||||||||||
| CHIEF MEDICAL OFFICER | 50.0 | 0.0 | $285,190 | $0 | $33,402 | Yes (X) | ||||
| PEDRO CALVES | ||||||||||
| SR ASSOC MED DIRECTOR | 50.0 | 0.0 | $230,443 | $0 | $45,202 | Yes (X) | ||||
| LINDA CARMOSINO | ||||||||||
| MEDICAL DIRECTOR | 30.0 | 0.0 | $192,861 | $0 | $17,370 | Yes (X) | ||||
| GINA ZARRILLI | ||||||||||
| PHYSICIAN | 50.0 | 0.0 | $227,345 | $0 | $28,584 | Yes (X) | ||||
| GENINE FRANCIS | ||||||||||
| ASSOC MD | 28.0 | 0.0 | $162,829 | $0 | $41,476 | Yes (X) | ||||
| EILEEN ROBERTO | ||||||||||
| DIR PALLIATIVE CARE | 37.5 | 0.0 | $137,178 | $0 | $21,578 | Yes (X) | ||||
| JOSEPH TOMAINO | ||||||||||
| FORMER EVP CONTINUING CARE | 0.0 | 0.0 | $0 | $314,959 | $7,541 | Yes (X) | ||||
| KAREN ESTRADA | ||||||||||
| FMR SVP/CFO | 0.0 | 35.0 | $0 | $181,604 | $44,919 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,235,846 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $990,298 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $383,378 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 20 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| GURWIN JEWISH GERIATRIC CTR | |||||
| 68 HAUPPAUGE RD | COMMACK | NY | 11725 | NURSING HOME FEES | $1,860,622 |
| LI STATE VETERANS HOME | |||||
| 100 PATRIOT RD | STONYBROOK | NY | 11790 | NURSING HOME FEES | $952,017 |
| ABLE HEALTHCARE SERVICES | |||||
| 1240 BROADCAST PLAZA | MERRICK | NY | 11566 | HOME HEALTH AIDE SVS | $390,223 |
| MARIA REGINA RESIDENCE | |||||
| 1725 BRENTWOOD ROAD | BRENTWOOD | NY | 11717 | NURSING HOME FEES | $390,172 |
| NESCONSET ACQUISITION LLC | |||||
| 100 SOUTHERN BLVD | NESCONSET | NY | 11767 | NURSING HOME FEES | $337,257 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 13 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $305,017 | AllOtherContributionsAmt |
| Total Contributions | $305,017 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET OUTPATIENT SERVICES | 621610 | $30,071,311 | $30,071,311 |
| NET INPATIENT SERVICES | 623000 | $5,839,074 | $5,839,074 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $35,910,385 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,669 | TotalRevenueColumnAmt |
| Exclusion | $4,669 | 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 |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PALLIATIVE CARE STIPEND - RELATED PARTY | 900099 | $200,000 | $200,000 |
| PURCHASE DISCOUNTS | 900099 | $44 | $44 |
| MEDICAL RECORD COPIES | 900099 | $2,659 | $2,659 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $202,703 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,422,774 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $36,113,088 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $4,669 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,708 | TotalAmt |
| Program Services | $6,708 | 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 | $318,592 | TotalAmt |
| Program Services | $318,592 | ProgramServicesAmt |
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 | $14,792,244 | TotalAmt |
| Program Services | $12,037,793 | ProgramServicesAmt |
| Management And General | $2,754,451 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,105,100 | TotalAmt |
| Program Services | $903,659 | ProgramServicesAmt |
| Management And General | $201,441 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,285,546 | TotalAmt |
| Program Services | $3,241,920 | ProgramServicesAmt |
| Management And General | $1,043,626 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,068,055 | TotalAmt |
| Program Services | $873,367 | ProgramServicesAmt |
| Management And General | $194,688 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,120 | TotalAmt |
| Program Services | $59,910 | ProgramServicesAmt |
| Management And General | $210 | ManagementAndGeneralAmt |
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 | $8,004 | TotalAmt |
| Management And General | $8,004 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,398 | TotalAmt |
| Management And General | $2,398 | ManagementAndGeneralAmt |
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 | $1,599,218 | TotalAmt |
| Program Services | $1,567,337 | ProgramServicesAmt |
| Management And General | $31,881 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,036 | TotalAmt |
| Program Services | $21,743 | ProgramServicesAmt |
| Management And General | $28,293 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,184 | TotalAmt |
| Program Services | $287,397 | ProgramServicesAmt |
| Management And General | $66,787 | ManagementAndGeneralAmt |
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 | $873,322 | TotalAmt |
| Program Services | $508,561 | ProgramServicesAmt |
| Management And General | $364,761 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $687,011 | TotalAmt |
| Program Services | $666,104 | ProgramServicesAmt |
| Management And General | $20,907 | ManagementAndGeneralAmt |
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 | $15,984 | TotalAmt |
| Management And General | $15,984 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $426,242 | TotalAmt |
| Program Services | $426,242 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,435 | TotalAmt |
| Program Services | $170,237 | ProgramServicesAmt |
| Management And General | $4,198 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| NURSING HOME EXPENSES | $6,259,538 | $6,259,538 | |
| PATIENT DME & MEDICAL SUPPLIES | $2,502,359 | $2,502,359 | |
| HOSPITAL EXPENSES | $1,282,965 | $1,282,965 | |
| CHS SERVICES | $455,746 | $177,053 | $278,693 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $671,683 | TotalAmt |
| Program Services | $477,739 | ProgramServicesAmt |
| Management And General | $193,944 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,999,490 | TotalAmt |
| Program Services | $31,789,224 | ProgramServicesAmt |
| Management And General | $5,210,266 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $759,520 | BOYAmt |
| EOY | $311,289 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,120,352 | BOYAmt |
| EOY | $5,726,052 | 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 | $4,996,090 | BOYAmt |
| EOY | $4,148,409 | 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 | $125,709 | BOYAmt |
| EOY | $146,554 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,615,051 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,021,493 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,801,498 | BOYAmt |
| EOY | $3,593,558 | 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 | $1,240,092 | BOYAmt |
| EOY | $1,862,447 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,043,261 | BOYAmt |
| EOY | $15,788,309 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,671,538 | BOYAmt |
| EOY | $6,003,950 | 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 | $3,035,730 | BOYAmt |
| EOY | $4,025,082 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,707,268 | BOYAmt |
| EOY | $10,029,032 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,215,901 | BOYAmt |
| EOY | $5,691,830 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,092 | BOYAmt |
| EOY | $49,447 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,000 | BOYAmt |
| EOY | $18,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,335,993 | BOYAmt |
| EOY | $5,759,277 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,043,261 | BOYAmt |
| EOY | $15,788,309 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$576,716 | 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $132,751 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $340,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $290,607 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $377,874 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $305,017 | CurrentTaxYearAmt |
| Total | $1,446,249 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,676,105 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $34,408,509 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $35,018,619 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $36,127,660 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $35,910,385 | CurrentTaxYearAmt |
| Total | $174,141,278 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,808,856 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $34,748,509 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $35,309,226 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $36,505,534 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $36,215,402 | CurrentTaxYearAmt |
| Total | $175,587,527 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $47,123 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $974,925 | CurrentTaxYearAmt |
| Total | $1,022,048 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $47,123 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $974,925 | CurrentTaxYearAmt |
| Total | $1,022,048 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $174,565,479 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,592 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,563 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,367 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,521 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,669 | CurrentTaxYearAmt |
| Total | $26,712 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,592 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,563 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,367 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,521 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,669 | CurrentTaxYearAmt |
| Total | $26,712 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,234 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,471 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $51,792 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $203,685 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $202,703 | CurrentTaxYearAmt |
| Total | $477,885 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $32,828,682 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $34,761,543 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $35,366,385 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $36,712,740 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $36,422,774 | CurrentTaxYearAmt |
| Total | $176,092,124 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99133 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99789 | PublicSupportPY509Pct |
| Investment Income CY | 0.00015 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00020 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $2,398 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $2,398 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1 - OTHER LOBBYING ACTIVITIES | FormAndLineReferenceDesc |
| Explanation | Good Shepherd Hospice paid membership dues to Hospice & Palliative Care Association of NYS, of which 10.9% was used for lobbying. The total dues payment for 2015 was $22,000, amounting to the expense of $2,398. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,000 | BeginningYearBalanceAmt |
| Contributions | $10,000 | ContributionsAmt |
| Investment Earnings Or Losses | $150 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $150 | OtherExpendituresAmt |
| End Year Balance | $18,000 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $8,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $72 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $72 | OtherExpendituresAmt |
| End Year Balance | $8,000 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $0 | BeginningYearBalanceAmt |
| Contributions | $8,000 | ContributionsAmt |
| Investment Earnings Or Losses | $38 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $38 | OtherExpendituresAmt |
| End Year Balance | $8,000 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Land | LandGrp | |
| Buildings | BuildingsGrp |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,870,176 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,712,001 | DepreciationAmt |
| Book Value | $3,158,175 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,736,484 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,309,492 | DepreciationAmt |
| Book Value | $426,992 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,391 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $8,391 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,593,558 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM RELATED PARTIES | $1,795,000 |
| FUNDS RESTRICTED USE | $67,447 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,862,447 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTIES | $3,933,441 |
| OTHER NON CURRENT LIABS-PENSION | $91,641 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,025,082 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, ENDOWMENT FUNDS - LINE 4, ORGANIZATION'S INTENDED USE | ENDOWMENT IS TO BE HELD IN PERPETUITY, WITH INCOME TO BE USED FOR THE OPERATIONS OF THE INPATIENT UNIT. |
| 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 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. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CATHOLIC HEALTH SERVICES OF LONG ISLAND | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 992 N VILLAGE AVE | AddressLine1Txt |
| City | ROCKVILLE CENTRE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11570 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 113403968 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $6,708 | CashGrantAmt |
| Valuation Method Used | NONE | ValuationMethodUsedDesc |
| Non Cash Assistance | NONE | NonCashAssistanceDesc |
| Purpose Of Grant | OUTPATIENT CENTERS | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE | CHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR GOOD SHEPHERD HOSPICE 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 OUTPATIENT CENTERS AND GRANTS FOR THE UNDERSERVED COMMUNITIES. |
| PART II, LINE 1, COLUMN (H) | NAME OF ORGANIZATION OR GOVERNMENT: CATHOLIC HEALTH SYSTEM OF LONG ISLAND (H) PURPOSE OF GRANT: 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; 2) PROVIDE SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND TO FUND OUTPATIENT CENTERS THAT PROVIDE CHARITY CARE TO THOSE CENTERS COMMUNITIES; AND 3) 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. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARY ELLEN POLIT | ||||||||||||||
| EVP & CAO | $0 | $292,360 | $0 | $55,000 | $0 | $1,974 | $0 | $71,372 | $0 | $31,696 | $0 | $452,402 | $0 | $0 |
| KERIANNE PAGE | ||||||||||||||
| CHIEF MEDICAL OFFICER | $264,824 | $0 | $20,000 | $0 | $366 | $0 | $23,432 | $0 | $9,970 | $0 | $318,592 | $0 | $0 | $0 |
| PEDRO CALVES | ||||||||||||||
| SR ASSOC MED DIRECTOR | $211,188 | $0 | $18,450 | $0 | $805 | $0 | $19,140 | $0 | $26,062 | $0 | $275,645 | $0 | $0 | $0 |
| LINDA CARMOSINO | ||||||||||||||
| MEDICAL DIRECTOR | $191,793 | $0 | $0 | $0 | $1,068 | $0 | $17,136 | $0 | $234 | $0 | $210,231 | $0 | $0 | $0 |
| GINA ZARRILLI | ||||||||||||||
| PHYSICIAN | $207,151 | $0 | $19,000 | $0 | $1,194 | $0 | $18,653 | $0 | $9,931 | $0 | $255,929 | $0 | $0 | $0 |
| GENINE FRANCIS | ||||||||||||||
| ASSOC MD | $162,481 | $0 | $0 | $0 | $348 | $0 | $14,475 | $0 | $27,001 | $0 | $204,305 | $0 | $0 | $0 |
| EILEEN ROBERTO | ||||||||||||||
| DIR PALLIATIVE CARE | $136,518 | $0 | $0 | $0 | $660 | $0 | $12,311 | $0 | $9,267 | $0 | $158,756 | $0 | $0 | $0 |
| DANIELLE STEIN | ||||||||||||||
| VP FINANCE | $0 | $144,143 | $0 | $0 | $0 | $258 | $0 | $12,153 | $0 | $28,085 | $0 | $184,639 | $0 | $0 |
| JOSEPH TOMAINO | ||||||||||||||
| FORMER EVP CONTINUING CARE | $0 | $0 | $0 | $0 | $0 | $314,959 | $0 | $0 | $0 | $7,541 | $0 | $322,500 | $0 | $316,239 |
| KAREN ESTRADA | ||||||||||||||
| FMR SVP/CFO | $0 | $174,812 | $0 | $0 | $0 | $6,792 | $0 | $12,819 | $0 | $32,100 | $0 | $226,523 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 - METHODS TO ESTABLISH COMPENSATION BY RELATED ORGANIZATION | THE FOLLOWING METHODS ARE USED BY A RELATED ORGANIZATION TO ESTABLISH COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4A - SEVERANCE | JOSEPH TOMAINO, FORMER EXECUTIVE VP OF CONTINUING CARE, RECEIVED PAYMENT OF SEVERANCE OF $316,239. MEDICAL BENEFITS WERE ALSO PROVIDED DURING 2015. |
| 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. MARY ELLEN POLIT - $50,000 PARTICIPATION IN THE PLAN THE DEFERRED COMPENSATION IN COLUMN C FOR THESE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NON-QUALIFIED RETIREMENT PLANS. |
| PART II - FORMER OFFICERS AND KEY EMPLOYEES | EFFECTIVE 12/25/13, KAREN ESTRADA WAS TRANSFERRED TO MARYHAVEN CENTER OF HOPE AS THE VP OF FINANCE, A RELATED ENTITY. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION | THE SOLE MEMBER OF GOOD SHEPHERD HOSPICE IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS). CHS IS A NEW YORK NOT-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 GOOD SHEPHERD HOSPICE AND AS SUCH HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF GOOD SHEPHERD HOSPICE. |
| FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY | CHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF GOOD SHEPHERD HOSPICE, IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERING BODY OF GOOD SHEPHERD HOSPICE. |
| FORM 990, PART VI, LINE 11B - REVIEW PROCESS OF 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 DISCLOSURES 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 IF 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 A WRITTEN REQUEST TO THE CHAIR OF 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 SIMILAR SERVICES FROM AN ORGANZIATION 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 (OF CHS, A RELATED ORG) | THE CHIEF ADMINISTRATIVE 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 | GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND. |
| 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. MARY ELLEN POLIT, EVP & CAO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SHEPHERD HOSPICE (11-2958438); GOOD SHEPHERD HOSPICE FOUNDATION (26-3169427); CHS HOME SUPPORT SERVICES (11-3594561)AND CATHOLIC HOME CARE (11-2126736). DANIELLE STEIN, VP FINANCE - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: NURSING SISTERS HOME CARE, INC. (11-2126736); GOOD SHEPHERD HOSPICE (11-2958438) AND CHS HOME SUPPORT SERVICES, INC. (11-3594561). |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (36 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| CATHOLIC HEALTH SYSTEM OF LONG ISLAND | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 113403968 | SUPPORT ORG | NY | 501(C)(3) | 11A- I | NA | false |
| CHS SERVICES INC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 113555766 | SUPPORT ORG | NY | 501(C)(3) | 11A- 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) | 11A- I | GOOD SAMARTN | false |
| MARYHAVEN TRANSPORTATION SERVICES | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 113434776 | TRANSPORTATIO | NY | 501(C)(3) | 11A- I | MARYHAVENCTR | Yes (true) |
| MARYHAVEN CENTER OF HOPE | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 112861698 | Prgm-disabled | NY | 501(C)(3) | 9 | CHSLI | Yes (true) |
| MARYHAVEN SCHOOL CORPORATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 112861690 | Schl-disabled | NY | 501(C)(3) | 2 | MARYHAVENCTR | Yes (true) |
| THE CENTER OF HOPE FOUNDATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 113638367 | SUPPORT ORG | NY | 501(C)(3) | 11A- I | MARYHAVENCTR | false |
| 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) | 9 | CHSLI | Yes (true) |
| OUR LADY OF CONSOLATION GERIATRIC CARE | ||||||||||
| 111 BEACH DRIVE | WEST ISLIP | NY | 11795 | 113284066 | LT NURSE CARE | NY | 501(C)(3) | 9 | CHSLI | Yes (true) |
| RIVERHEAD HOSTEL HOLDING CORPORATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 112499790 | RENTING | NY | 501(C)(2) | MARYHAVENCTR | Yes (true) | |
| SIENA VILLAGE INC | ||||||||||
| 2000 BISHOPS ROAD | SMITHTOWN | NY | 11787 | 061569129 | SR HOUSING | NY | 501(C)(3) | 9 | 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 DIVE | HAUPPAUGE | NY | 11788 | 113594561 | RESP THERAPY | NY | 501(C)(3) | 9 | CATHHOMECARE | Yes (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) | 11A- I | ST FRANCIS | false |
| ST FRANCIS HOSPITAL RESEARCH & EDUCATIO | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113090867 | RESEARCH ORG | NY | 501(C)(3) | 11A- 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) | 11A- I | CHSLI | false |
| THE SAMARITAN CORPORATION | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 112716640 | SUPPORT ORG | NY | 501(C)(3) | 11A- I | CHSLI | false |
| WISDOM GARDENS HOUSING DEVELOPMENT FUND | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 113559713 | SR HOUSING | NY | 501(C)(3) | 9 | MARYHAVENCTR | Yes (true) |
| ST CHARLES HOSPITAL FOUNDATION | ||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 412076312 | SUPPORT ORG | NY | 501(C)(3) | 11A- I | ST CHARLES | false |
| GOOD SAMARITAN HOSPITAL FOUNDATION | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 770611240 | SUPPORT ORG | NY | 501(C)(3) | 11A- I | GOOD SAMARTN | false |
| MERCY MEDICAL CENTER FOUNDATION | ||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 550813603 | SUPPORT ORG | NY | 501(C)(3) | 11A- I | MERCY MEDCTR | false |
| ST CATHERINE OF SIENA MEDICAL CTR FDN | ||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 271459941 | SUPPORT ORG | NY | 501(C)(3) | 11A- 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) | 11A- I | CATHHOMECARE | Yes (true) |
| GOOD SHEPHERD HOSPICE FOUNDATION | ||||||||||
| 110 Bi-County Blvd Suite 114 | FARMINGDALE | NY | 11735 | 263169427 | SUPPORT ORG | NY | 501(C)(3) | 11A- I | GOODSHEPHERD | Yes (true) |
| OUR LADY OF CONSOLATION FOUNDATION | ||||||||||
| 111 BEACH DRIVE | WEST ISLIP | NY | 11795 | 450517566 | SUPPORT ORG | NY | 501(C)(3) | 11A- I | OURLADYOFC | false |
| RVC SUPPORT | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 271531084 | REAL ESTATE | NY | 501(C)(3) | 11A- I | CHSLI | false |
| ST FRANCIS CARDIOVASCULAR PHYSICIANS P | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113613997 | HEALTHCARESVC | NY | 501(C)(3) | 11A- I | ST FRANCIS | false |
| RVC INSURANCE COMPANYINC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 208067039 | CAPTIVE INS | NY | 501(C)(3) | 11A- 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 AVENUE | ROCKVILLE CENTRE | NY | 11570 | 472353387 | SUPPORT ORG | NY | 501(C)(3) | 11A- I | WSNCHS NORTH | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|
| BIPO HOLDINGS LLC | ||||||||
| 1600 STEWART AVE WESTBURY NY | WESTBURY | NY | 11590 | 464763720 | PHYSICIAN ASSN | NY | NA | N/A |
| IDHC LLC | ||||||||
| 2500 YORK RD JAMISONPA 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 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (15 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 |
|---|---|---|---|---|---|---|---|---|---|
| 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 |
| FAIRVIEW HILL MANAGEMENT CO INC | |||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 112798383 | HOLDING CO | 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 |
| HEALTH CARE TEMP SERVICES INC | |||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 112801136 | EMPLOYMENT AGENCY | NY | FAIRVIEW HILL | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| 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 | false | 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 | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CATHOLIC HOME CARE | ||
| NOPQ | $1,157,085 | COST |
| CHS HOME SUPPORT SERVICES INC | ||
| NOPQ | $232,383 | COST |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART IV | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
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