GOOD SAMARITAN UNIVERSITY HOSPITAL: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: GOOD SAMARITAN UNIVERSITY HOSPITAL (EIN 11-1888924)
Tax period: 2015-01-01 to 2015-12-31
Filed: 2016-11-14
IRS object ID: 201623199349307657
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 H
Schedule I
Schedule J
Schedule L
Schedule M
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-11-14T14:17:45-06:00	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	111888924	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GOOD SAMARITAN HOSPITAL MEDICAL CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% CHS SERVICES	InCareOfNm
Business Name Control	GOOD	BusinessNameControlTxt
Phone	6313763000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1000 MONTAUK HIGHWAY	AddressLine1Txt
City	WEST ISLIP	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	11795	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	THOMAS OCKERS	PersonNm
Person Title	CAO	PersonTitleTxt
Phone	5167051919	PhoneNum
Signature	2016-11-10	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	ALAN D GUERCI MD	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1000 MONTAUK HIGHWAY	AddressLine1Txt
City	WEST ISLIP	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	11795	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$597,838,069	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	HTTP://GOODSAMARITAN.CHSLI.ORG/	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1959	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	23	VotingMembersGoverningBodyCnt
Voting Members Independent	22	VotingMembersIndependentCnt
Total Employee	4049	TotalEmployeeCnt
Total Volunteers	514	TotalVolunteersCnt
Total Gross UBI	$1,689,482	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	-$703,888	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$8,672,802	PYContributionsGrantsAmt
CY Contributions Grants	$2,818,750	CYContributionsGrantsAmt
PY Program Service Revenue	$531,407,743	PYProgramServiceRevenueAmt
CY Program Service Revenue	$542,429,871	CYProgramServiceRevenueAmt
PY Investment Income	$16,055,525	PYInvestmentIncomeAmt
CY Investment Income	$1,877,578	CYInvestmentIncomeAmt
PY Other Revenue	$35,224,352	PYOtherRevenueAmt
CY Other Revenue	$18,280,426	CYOtherRevenueAmt
PY Total Revenue	$591,360,422	PYTotalRevenueAmt
CY Total Revenue	$565,406,625	CYTotalRevenueAmt
PY Grants And Similar Paid	$753,469	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$304,839	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$319,247,606	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$303,833,255	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$237,180,313	PYOtherExpensesAmt
CY Other Expenses	$250,129,041	CYOtherExpensesAmt
PY Total Expenses	$557,181,388	PYTotalExpensesAmt
CY Total Expenses	$554,267,135	CYTotalExpensesAmt
PY Revenues Less Expenses	$34,179,034	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$11,139,490	CYRevenuesLessExpensesAmt
Total Assets BOY	$450,690,630	TotalAssetsBOYAmt
Total Assets EOY	$465,129,473	TotalAssetsEOYAmt
Total Liabilities BOY	$245,571,810	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$250,686,968	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$205,118,820	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$214,442,505	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	GOOD SAMARITAN HOSPITAL MEDICAL CENTER, 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	$482,322,267	ExpenseAmt
Grant	$304,839	GrantAmt
Revenue	$534,331,775	RevenueAmt
Desc	GOOD SAMARITAN HOSPITAL MEDICAL CENTER IS A 437 BED MEDICAL CENTER LOCATED ON THE SOUTH SHORE OF LONG ISLAND IN WEST ISLIP, NEW YORK. A PREMIER HEALTHCARE FACILITY, PROVIDING QUALITY AND COST EFFECTIVE HEALTH CARE SERVICES EXTENDING ACROSS THE CONTINUUM OF CARE TO ALL DISCIPLINES, BOTH FOR INPATIENTS AND OUTPATIENTS. IN 2015 THE MEDICAL CENTER PROVIDED INPATIENT SERVICES FOR 26,856 DISCHARGED INDIVIDUALS, MANAGED 87,731 EMERGENCY DEPARTMENT VISITS AND 24,148 CLINIC VISITS. THE MEDICAL CENTER PROVIDES CARE REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY AND ALONG WITH COMMUNITY SERVICE AND CHARITABLE ACTIVITIES.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$10,643,012	ExpenseAmt
Revenue	$10,002,231	RevenueAmt
Desc	GOOD SAMARITAN NURSING HOME IS LOCATED ON THE SOUTH SHORE OF LONG ISLAND IN SAYVILLE, NEW YORK. THE 100 BED FACILITY HAS BEEN PART OF GOOD SAMARITAN HOSPITAL MEDICAL CENTER SINCE 1980. THE RESIDENT POPULATION OF THE NURSING HOME IS MEDICALLY COMPLEX AND REQUIRES FULL-TIME CARE. SKILLED NURSING CARE AT THE FACILITY PROVIDES ONGOING MEDICALLY COMPLEX CARE ALONG WITH GERIATRIC CARE, REHABILITATIVE CARE, AND DEMENTIA DISEASE CARE. 2015 PATIENT DAYS FOR THE NURSING HOME TOTALED 35,206.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$492,965,279	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	false	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	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
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	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	Yes (true)	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	254	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	4049	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
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	23	GoverningBodyVotingMembersCnt
Independent Voting Member	22	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	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	Yes (true)	InvestmentInJointVentureInd
Written Policy Or Procedure	Yes (true)	WrittenPolicyOrProcedureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	CHS SERVICES	PersonNm
Phone	5167051919	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	992 NORTH VILLAGE AVE	AddressLine1Txt
City	ROCKVILLE CENTRE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	11570	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 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
SALVATORE SODANO
CHAIRMAN	2.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
BRIAN MCGUIRE
VICE CHAIR	2.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
JOSEPH TANTILLO
SECRETARY	2.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
CHRIS PASCUCCI
TREASURER	2.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
BARBARA ELLEN BLACK
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
VIRGINIA EWEN
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
SISTER AUDREY HARSEN
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
FRANK L KURRE
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
REV MSGR ROBERT MORRISEY
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
DANIEL T ROWE
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
JOHN WAGNER
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
REV JAMES VLAUN
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
KEVIN J CONWAY
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
PETER D'ANGELO
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
REV PETER DUGANDZIC
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
BRIAN P HEHIR
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
HON ANTHONY MARANO
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
STEPHEN F MCLOUGHLIN
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
JEROME POLLER
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
JOHN FRANCFORT MD
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
ALEXANDER HAZELTON
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
WILLIAM WARD
TRUSTEE	2.0	0.0	Yes (X)		$0	$0	$0
ALAN D GUERCI MD
PRESIDENT & CEO	50.0	0.0	Yes (X)	Yes (X)	$0	$2,376,352	$367,629
NANCY SIMMONS
CAO	50.0	0.0		Yes (X)	$611,352	$0	$122,440
WILLIAM C ARMSTRONG
SVP FINANCE	50.0	0.0		Yes (X)	$0	$870,087	$193,066
JEROME WEINER
CMO THRU DECEMBER 2015	50.0	0.0			$674,196	$0	$584,256	Yes (X)
DONALD TEPLITZ
CHIEF MEDICAL OFFICER	50.0	0.0			$544,994	$0	$48,661	Yes (X)
NEIL LOBO
PHYSICIAN	50.0	0.0			$1,097,709	$0	$50,811		Yes (X)
KOUROSH ADHAMI
PHYSICIAN	50.0	0.0			$1,097,906	$0	$50,614		Yes (X)
JAMES KOHLROSER
PHYSICIAN	50.0	0.0			$1,064,727	$0	$53,361		Yes (X)
BABAK DANESH
PHYSICIAN	50.0	0.0			$1,061,390	$0	$23,175		Yes (X)
KENNETH GOLD
PHYSICIAN	50.0	0.0			$786,749	$0	$50,837		Yes (X)
JAMES CALDAS
FORMER PRESIDENT & CEO	0.0	0.0			$0	$346,651	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$6,939,023	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$3,593,090	TotReportableCompRltdOrgAmt
Total Other Compensation	$1,544,850	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	559	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
PROGRESSIVE EMERGENCY PHYSICIANS PL
1236 RXR PLAZA	UNIONDALE	NY	11556	PHYSICIAN SERVICES	$16,924,280
MEDICAL SOLUTIONS
9101 WESTERN AVENUE SUITE 101	OMAHA	NE	68114	NURSING SERVICES	$1,806,896
TOTAL HEALTHCARE STAFFING LI
PO BOX 823461	PHILADELPHIA	PA	19182	NURSING SERVICES	$1,711,449
MAJESTIC PROP MGT AAF CAPTREE
60 CUTTERMILL RD	GREAT NECK	NY	11021	RENT	$902,286
COLUMBIA PARTNERS LLC
161 STILLWELL LA	LAUREL HOLLOW	NY	11792	RENT	$760,788

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	36	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$50	FederatedCampaignsAmt
Related Organizations	$1,770,854	RelatedOrganizationsAmt
Government Grants	$945,697	GovernmentGrantsAmt
All Other Contributions	$102,149	AllOtherContributionsAmt
Noncash Contributions	$552,709	NoncashContributionsAmt
Total Contributions	$2,818,750	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE - HOSPITAL	623990	$532,427,640	$532,427,640
NET PATIENT SERVICE REV. - NURSING HOME	623000	$10,002,231	$10,002,231

Field	Value	IRS element (for citing)
Total Program Service Revenue	$542,429,871	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,732,745	TotalRevenueColumnAmt
Exclusion	$1,732,745	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

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$1,722,144	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$1,722,144	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,722,144	TotalRevenueColumnAmt
Exclusion	$1,722,144	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$32,576,277	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$32,431,444	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$144,833	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$144,833	TotalRevenueColumnAmt
Exclusion	$144,833	ExclusionAmt

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	ExclusionExclusionAmt
PHYSICAN SERVICES REVENUE	621110	$1,904,135	$1,904,135
MARTIN L KING HEALTH CENTER	621400	$299,813		$299,813
CONTRACTED SERVICES	900099	$2,963,720		$2,963,720

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,390,614	TotalRevenueColumnAmt
Unrelated Business Revenue	$1,689,482	UnrelatedBusinessRevenueAmt
Exclusion	$9,701,132	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$16,558,282	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$565,406,625	TotalRevenueColumnAmt
Related Or Exempt Func Income	$544,334,006	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$1,689,482	UnrelatedBusinessRevenueAmt
Exclusion	$16,564,387	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$304,839	TotalAmt
Program Services	$304,839	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	$2,585,899	TotalAmt
Program Services	$1,852,107	ProgramServicesAmt
Management And General	$733,792	ManagementAndGeneralAmt

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	$224,535,439	TotalAmt
Program Services	$211,638,981	ProgramServicesAmt
Management And General	$12,896,458	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$15,481,436	TotalAmt
Program Services	$14,552,347	ProgramServicesAmt
Management And General	$929,089	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$43,437,941	TotalAmt
Program Services	$40,537,174	ProgramServicesAmt
Management And General	$2,900,767	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$17,792,540	TotalAmt
Program Services	$16,724,755	ProgramServicesAmt
Management And General	$1,067,785	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$311,764	TotalAmt
Program Services	$124,171	ProgramServicesAmt
Management And General	$187,593	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$33,064	TotalAmt
Management And General	$33,064	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$29,820	TotalAmt
Management And General	$29,820	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$101,173	TotalAmt
Management And General	$101,173	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	$32,121,324	TotalAmt
Program Services	$29,063,565	ProgramServicesAmt
Management And General	$3,057,759	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,561,376	TotalAmt
Program Services	$193,892	ProgramServicesAmt
Management And General	$1,367,484	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,993,929	TotalAmt
Program Services	$6,156,145	ProgramServicesAmt
Management And General	$2,837,784	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	$7,518,545	TotalAmt
Program Services	$6,701,495	ProgramServicesAmt
Management And General	$817,050	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$285,651	TotalAmt
Program Services	$262,051	ProgramServicesAmt
Management And General	$23,600	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	$402,197	TotalAmt
Program Services	$402,197	ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$21,321,864	TotalAmt
Program Services	$21,321,864	ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$21,423,733	TotalAmt
Program Services	$18,301,919	ProgramServicesAmt
Management And General	$3,121,814	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$14,880,064	TotalAmt
Program Services	$14,880,064	ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES EXPENSE	$78,098,459	$78,098,459
CHS SERVICES	$37,057,719	$14,396,583	$22,661,136
EQUIPMENT SERVICE CONTRACTS	$6,459,182	$6,459,182
HOME OFFICE ALLOCATION	$7,915,980		$7,915,980

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,613,197	TotalAmt
Program Services	$10,993,489	ProgramServicesAmt
Management And General	$619,708	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$554,267,135	TotalAmt
Program Services	$492,965,279	ProgramServicesAmt
Management And General	$61,301,856	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$35,161,032	BOYAmt
EOY	$30,148,709	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$28,471,866	BOYAmt
EOY	$46,859,396	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	$56,801,362	BOYAmt
EOY	$60,784,217	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	$6,486,045	BOYAmt
EOY	$6,881,966	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$4,662,565	BOYAmt
EOY	$4,161,119	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$468,379,702	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$299,769,342	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$172,805,952	BOYAmt
EOY	$168,610,360	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$44,601,172	BOYAmt
EOY	$45,179,748	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	$101,700,636	BOYAmt
EOY	$102,503,958	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$450,690,630	BOYAmt
EOY	$465,129,473	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$64,461,384	BOYAmt
EOY	$66,543,006	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	$5,430,931	BOYAmt
EOY	$5,290,025	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	$1,995,376	BOYAmt
EOY	$1,990,155	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	$173,684,119	BOYAmt
EOY	$176,863,782	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$245,571,810	BOYAmt
EOY	$250,686,968	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$203,474,388	BOYAmt
EOY	$212,820,473	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$1,644,432	BOYAmt
EOY	$1,622,032	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$205,118,820	BOYAmt
EOY	$214,442,505	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$450,690,630	BOYAmt
EOY	$465,129,473	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$11,139,490	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$2,102,805	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$287,000	OtherChangesInNetAssetsAmt
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	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

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	$101,173	OtherActivitiesAmt
Total Lobbying Expenditures	$101,173	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	AMOUNT REFLECTS PORTION OF TRADE ASSOCIATION DUES WHICH WERE USED FOR LEGISLATIVE LOBBYING ON THE BEHALF OF THE HEALTHCARE INDUSTRY THOSE TRADE ASSOCIATIONS REPRESENT.	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$5,039,490	OtherCostOrOtherBasisAmt
Book Value	$5,039,490	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$240,978,203	OtherCostOrOtherBasisAmt
Depreciation	$130,741,520	DepreciationAmt
Book Value	$110,236,683	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$11,134,857	OtherCostOrOtherBasisAmt
Depreciation	$9,197,829	DepreciationAmt
Book Value	$1,937,028	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$208,886,219	OtherCostOrOtherBasisAmt
Depreciation	$159,829,993	DepreciationAmt
Book Value	$49,056,226	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,340,933	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$2,340,933	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$168,610,360	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDesc	Book ValueBookValueAmt
OTHER RECEIVABLES	$4,930,016
DUE FROM RELATED PARTIES	$18,146,349
INSURANCE CLAIMS RECEIVABLE	$78,083,363
GOODWILL ISLAND DIGESTIVE	$1,344,230

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$102,503,958	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
THIRD PARTY PAYOR LIABILITY	$26,697,708
SELF INSURANCE RESERVE-MALPRACTICE	$81,422,449
SELF INSURANCE RESERVE-LIABILITIES	$47,510,419
OTHER NON-CURRENT LIABILITIES	$10,767,124
DUE TO RELATED PARTIES	$10,466,082

Field	Value	IRS element (for citing)
Total Liability	$176,863,782	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTE	FormAndLineReferenceDesc
Explanation	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.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	300.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,374,307	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,762,938	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,611,369	NetCommunityBenefitExpnsAmt
Total Expense	0.00290	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$71,933,279	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$51,481,591	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$20,451,688	NetCommunityBenefitExpnsAmt
Total Expense	0.03690	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,893,810	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$9,575,730	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,318,081	NetCommunityBenefitExpnsAmt
Total Expense	0.00240	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$91,201,396	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$67,820,259	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$23,381,138	NetCommunityBenefitExpnsAmt
Total Expense	0.04220	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$954,660	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$954,660	NetCommunityBenefitExpnsAmt
Total Expense	0.00170	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$9,535,633	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,997,747	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,537,887	NetCommunityBenefitExpnsAmt
Total Expense	0.00820	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$213,029	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$213,029	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,703,322	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,997,747	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,705,576	NetCommunityBenefitExpnsAmt
Total Expense	0.01030	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$101,904,718	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$72,818,006	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$29,086,714	NetCommunityBenefitExpnsAmt
Total Expense	0.05250	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$17,779,000	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$120,829,008	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$136,970,442	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$16,141,434	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GOOD SAMARITAN HOSPITAL MEDICAL CTR	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1000 MONTAUK HIGHWAY	AddressLine1Txt
City	WEST ISLIP	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	11795	ZIPCd

Field	Value	IRS element (for citing)
Website Address	HTTP://GOODSAMARITAN.CHSLI.ORG/	WebsiteAddressTxt
State License	5154001H	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Teaching Hospital	Yes (X)	TeachingHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd
Other	HOSPITAL	OtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	GOOD SAMARITAN HOSPITAL MED CTR	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	goodsamaritan.chsli.org/	OwnWebsiteURLTxt
Other Website	Yes (X)	OtherWebsiteInd
Other Website URL	www.chsli.org	OtherWebsiteURLTxt
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	13	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	www.chsli.org	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	300.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	www.chsli.org	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	www.chsli.org	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	www.chsli.org	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified Upon Admission	Yes (X)	FAPNotifiedUponAdmissionInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Medicare Rates	Yes (X)	MedicareRatesInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART V, SECTION B, LINE 5	GOOD SAMARITAN HOSPITAL PARTNERED WITH SUFFOLK COUNTY'S OTHER NOT-FOR-PROFIT HOSPITALS AND THE SUFFOLK COUNTY DEPARTMENT OF HEALTH, UNDER THE AUSPICES OF THE NASSAU-SUFFOLK HOSPITAL COUNCIL, TO SURVEY COMMUNITY-BASED ORGANIZATIONS THROUGHOUT LONG ISLAND. AN ONLINE SURVEY WAS COMPLETED BY 102 REPRESENTATIVES OF COMMUNITY-BASED HEALTH, HUMAN SERVICE, GOVERNMENT, CIVIC, EDUCATIONAL AND BUSINESS AGENCIES WHO SHARED THEIR VIEWS ON THE UNMET HEALTH CARE NEEDS AND BARRIERS TO ACCESSING HEALTH CARE SERVICES IN BOTH NASSAU AND SUFFOLK COUNTIES. IN-DEPTH INTERVIEWS WERE CONDUCTED BY MEMBERS OF THE NASSAU-SUFFOLK HOSPITAL COUNCIL'S PUBLIC HEALTH WORKGROUP, WHICH INCLUDED REPRESENTATIVES OF LONG ISLAND'S HOSPITALS, HEALTH SYSTEMS, COUNTY HEALTH DEPARTMENTS, AND ACADEMIC INSTITUTIONS, WITH REPRESENTATIVES OF LOCAL CHAPTERS OF THE AMERICAN HEART ASSOCIATION, THE AMERICAN DIABETES ASSOCIATION, AND UNITED WAY. TRANSCRIPTS OF THESE CONVERSATIONS, DURING WHICH THE INTERVIEWER WAS ABLE TO PROBE FOR INFORMATION AND DISCUSS RESPONSES AT LENGTH, PROVIDED A MORE QUALITATIVE AND CONTEXTUAL FRAMEWORK FOR THE SURVEY FINDINGS.
PART V, SECTION B, LINE 6A	BROOKHAVEN MEMORIAL HOSPITAL HUNTINGTON HOSPITAL JOHN T. MATHER MEMORIAL HOSPITAL PECONIC BAY MEDICAL CENTER ST. CATHERINE OF SIENA MEDICAL CENTER ST. CHARLES HOSPITAL SOUTHAMPTON HOSPITAL SOUTHSIDE HOSPITAL STONY BROOK UNIVERSITY HOSPITAL VETERANS AFFAIRS MEDICAL CENTER
PART V, SECTION B, LINE 6B	NASSAU AND SUFFOLK HEALTH DEPARTMENTS, STONY BROOK UNIVERSITY AND VARIOUS COMMUNITY-BASED ORGANIZATIONS, NOW COLLECTIVELY KNOWN AS THE LONG ISLAND HEALTH COLLABORATIVE (LIHC).
PART V, SECTION B, LINE 11	PRIORITY 1: NUTRITION AND WEIGHT MANAGEMENT THE HOSPITAL IS IMPROVING COMMUNITY HEALTH BY WORKING TO REDUCE THE INCIDENCE OF OBESITY AND RELATED CO-MORBIDITIES SUCH AS HEART DISEASE AND DIABETES BY PROVIDING INDIVIDUALS WITH THE TOOLS AND KNOWLEDGE TO POSITIVELY IMPACT FOOD CHOICES AND ACTIVITY LEVELS. IN 2015, THE HOSPITAL OFFERED THE HEALTHIER FAMILIES PROGRAM WHICH IS A FREE, 10 WEEK EDUCATIONAL SERIES THAT PROMOTES A HEALTHY LIFESTYLE OFFERED IN COLLABORATION WITH THE BAY SHORE WELLNESS ALLIANCE ASSISTING CHILDREN IN GRADES 3-5 WHO HAVE BEEN IDENTIFIED AS BEING AT RISK FOR FUTURE OBESITY-RELATED HEALTH ISSUES IN THE IDENTIFIED, UNDERSERVED AREA IN THE BAY SHORE SCHOOL DISTRICT. ALSO, GOOD SAMARITAN CONTINUED TO OFFER THE NEW YORK STATE DIABETES PREVENTION PROGRAM. PRIORITY 2: CANCER THE HOSPITAL IS WORKING TO REDUCE CANCER MORTALITY AND MORBIDITY WITH EDUCATION, SCREENINGS AND SUPPORT AND IS PROVIDING THE LATEST TREATMENT OPTIONS FOR THOSE WITH MALIGNANT DISEASE, WITH SPECIAL ATTENTION TO HEALTH DISPARITIES SUCH AS A HIGHER INCIDENCE OF CANCER IN SPECIFIC POPULATIONS. IN 2015, GOOD SAMARITAN HOSPITAL HOSTED ITS SECOND FREE "POSITIVELY PINK!" EVENT AT THE WESTFIELD SOUTH SHORE MALL IN BAY SHORE WHICH IS CLOSE TO MEDICALLY UNDERSERVED COMMUNITIES. MORE THAN 300 COMMUNITY MEMBERS HAD THE OPPORTUNITY TO TALK TO BREAST HEALTH EXPERTS, REGISTERED DIETITIANS AND NURSES OFFERING INFORMATION ON BREAST HEALTH AND PREVENTION. BLOOD PRESSURE SCREENINGS AND ON-SITE MAMMOGRAPHY APPOINTMENT SCHEDULING WERE ALSO PROVIDED. FREE "GOOD SAM UNIVERSITY" COMMUNITY LECTURES HIGHLIGHTING CANCER WERE OFFERED: "TAKE THE BREAST CARE OF YOURSELF"WHAT'S IN YOUR GENES?" GOOD SAMARITAN OFFERS A FREE NAVIGATION PROGRAM AS PART OF A SERVICE FOR BREAST CANCER PATIENTS. THE NAVIGATION PROGRAM PROVIDES PERSONALIZED SUPPORT AND EDUCATES AND GUIDES PATIENTS AND THEIR FAMILIES THROUGH DIAGNOSIS, TREATMENT AND RECOVERY. PRIORITY 3: MENTAL HEALTH THE HOSPITAL IS PROVIDING TARGETED POPULATIONS WITH INFORMATION ABOUT THE SIGNS AND SYMPTOMS OF MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES (OFTEN OCCURRING CONCOMITANTLY WITH A CHRONIC DISEASE) AND OFFERING LINKS TO COMMUNITY-BASED CLINICAL PROGRAMS AND SERVICES. THROUGH THIS EFFORT, WE HOPE TO ACHIEVE EARLIER IDENTIFICATION OF MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES AMONG PATIENTS OF ALL AGES. IN ADDITION, THE HOSPITAL WILL USE LIHCS DATABASE TO IDENTIFY OR RECOMMEND ADDITIONAL RESOURCES. THROUGH A COMPREHENSIVE AND AGGRESSIVE COMMUNITY OUTREACH PROGRAM, GOOD SAMARITAN HOSPITAL WILL CONTINUE TO ADDRESS THE PRIORITY AREAS OF CHRONIC DISEASE IDENTIFIED IN THE MOST RECENT CHNA REPORT, WHICH ARE NUTRITION AND WEIGHT MANAGEMENT AND CANCER. GOOD SAMARITAN WILL CONTINUE TO STRIVE TO IMPROVE THE OVERALL HEALTH AND WELL-BEING OF THE INDIVIDUALS IN THE COMMUNITY THROUGH EDUCATION, SCREENINGS AND SUPPORT. SUCH INITIATIVES' PRIMARY FOCUS IS MANAGING PATIENTS' CHRONIC CONDITIONS, INCLUDING DIABETES, HYPERTENSION AND HIGH CHOLESTEROL, WHICH ARE CO-MORBIDITIES OF POOR NUTRITION AND OBESITY. IN GOOD SAMARITAN'S CHNA SURVEY, BACK AND JOINT PAIN WERE AMONG THE FREQUENTLY CITED HEALTH CARE NEEDS. HOWEVER, DUE TO THE HOSPITAL'S SOMEWHAT LIMITED FINANCIAL AND HUMAN RESOURCES THIS WAS NOT AMONG THE AREAS SELECTED FOR THE HOSPITAL'S COMMUNITY HEALTH IMPROVEMENT PROJECTS. INSTEAD IT WAS BELIEVED THAT BY FOCUSING RESOURCES ON THE THREE SELECTED AREAS, A MORE ROBUST AND MEASURABLE IMPLEMENTATION PLAN COULD BE LAUNCHED.
PART V, SECTION B, LINE 20E	GOOD SAMARITAN HOSPITAL MEDICAL CENTER HAS POSTED MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN GOOD SAMARITAN HOSPITAL MEDICAL CENTER, INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREA. SAID NOTICES ARE PUBLISHED IN ENGLISH AND SPANISH, AND ARE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. GOOD SAMARITAN HOSPITAL MEDICAL CENTER HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE.

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

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Field	Value	IRS element (for citing)
Business Name Line1	GOOD SAMARITAN NURSING HOME	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	101 ELM STREET	AddressLine1Txt
City	SAYVILLE	CityNm
State Abbreviation	NY	StateAbbreviationCd
ZIP	11782	ZIPCd

Field	Value	IRS element (for citing)
Facility	SKILLED NURSING FACILITY	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART I, LINE 7 - RATIO OF PATIENT CARE COST TO CHARGES WORKSHEET	RATIO OF PATIENT CARE COST TO CHARGES WORKSHEET (WORKSHEET 2 ) AS PRESCRIBED BY THE IRS INSTRUCTIONS TO SCHEDULE H FORM 990 WAS THE METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN PART I, LINE 7 CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST LINES 7A, 7B AND 7C AND 7D. ALL OTHER LINES INCLUDE COSTS THAT WERE DERIVED BASED ON THE RCC METHODOLOGY OR ACTUAL COSTS FOR THE SERVICES AS TRACKED BY HOSPITAL PERSONNEL UTILIZING DIRECT HOURLY LABOR COSTS, FRINGES AND SUPPLY COSTS.
PART I, LINE 7A, COLUMN (D)	DIRECT OFFSETTING REVENUES REPRESENT DISTRIBUTIONS FROM THE NEW YORK STATE (NYS) INDIGENT CARE POOL (ICP) WHICH IS SHOWN NET OF HOSPITAL CONTRIBUTIONS TO THE STATEWIDE POOL. THE FORMULA EMPLOYED BY NYS TO DETERMINE DISTRIBUTIONS TO HOSPITALS FROM THE ICP IS COMPLEX AND IS DERIVED FROM A HOSPITAL'S "NEED" CALCULATION. THIS CALCULATION CONSIDERS 100% OF A HOSPITAL'S "NEED" BASED ON A "UNITS OF SERVICE" METHODOLOGY FOR UNINSURED PATIENTS. THE CALCULATION ALSO MAKES ADJUSTMENTS BASED ON THE PROPORTION OF MEDICAID ELIGIBLE PATIENTS TREATED AT THE FACILITY. THE HOSPITAL HAS APPORTIONED THE ICP REVENUE BETWEEN BAD DEBT AND CHARITY CARE FOR REPORTING ON LINE 7A BASED ON THE PROPORTION OF EACH TO THE TOTAL OF ACTUAL BAD DEBT AND CHARITY CARE FOR 2015.
PART III, LINE 2,3 - BAD DEBT AS COMMUNITY BENEFIT	AS PART OF ITS TAX EXEMPT PURPOSE, GOOD SAMARITAN HOSPITAL MEDICAL CENTER PROVIDES ACCESS TO MEDICALLY NECESSARY CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS, REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, OR CULTURAL BACKGROUND. GOOD SAMARITAN HOSPITAL MEDICAL CENTER TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF WHETHER THEY HAVE THIRD-PARTY COVERAGE OR THE ABILITY TO PAY. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON-ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, GOOD SAMARITAN HOSPITAL MEDICAL CENTER IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE FROM GOOD SAMARITAN HOSPITAL MEDICAL CENTER SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT SINCE CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR TAX EXEMPT PURPOSE, WHICH IS MEETING THE NEED FOR EMERGENCY AND NON-ELECTIVE MEDICAL CARE SERVICES IN THE COMMUNITY.
PART III, LINES 2 AND 4 - TEXT OF FOOTNOTE DISCUSSING BAD DEBT	THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING HISTORICAL BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THIS ALLOWANCE BASED UPON HISTORICAL WRITE OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE MEDICAL CENTER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY CHS POLICY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE. THE HOSPITAL DOES NOT HAVE ANY OFF-BALANCE-SHEET CREDIT EXPOSURE RELATED TO ITS PATIENT ACCOUNTS RECEIVABLE.
PART III, LINE 8 - COSTING METHODOLOGY	THE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 2015 CMS-2552 (MEDICARE COST REPORT). MEDICARE REVENUE IS BASED ON THE MEDICARE PROVIDER STATISTICAL AND REIMBURSEMENT REPORT AND MEDICARE COSTS ARE DEVELOPED UTILIZING A RATIO OF MEDICARE ALLOWABLE COSTS TO CHARGES METHODOLOGY. AMOUNTS SHOWN FOR TOTAL REVENUE RECEIVED AND MEDICARE ALLOWABLE COSTS ARE NET OF ANY AMOUNTS ALREADY INCLUDED WITHIN PART I, LINE 7, PRIMARILY IN SUBSIDIZED HEALTH SERVICES.
PART III, LINE 8 - MEDICARE SHORTFALL AS COMMUNITY BENEFIT	LOSSES ON TREATING MEDICARE BENEFICIARIES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT IN THEIR ENTIRETY. THIS REPRESENTS THE AMOUNT BY WHICH COSTS TO DELIVER CARE TO MEDICARE RECIPIENTS EXCEEDS THE LEVEL OF PAYMENT. GOOD SAMARITAN BEARS THE BURDEN OF NOT ONLY PROVIDING THE BEST AND MOST ADVANCED MEDICAL CARE POSSIBLE TO THE COMMUNITY BUT ALSO DOING SO WITH NO RECOURSE IN OBTAINING PAYMENT FOR THE COST OF PROVIDING CARE IN EXCESS OF THE MEDICARE PAYMENT. AS MEDICARE REVENUE DECLINES AND THE COST TO PROVIDE CUTTING-EDGE CARE TO THE COMMUNITY INCREASES, THE HOSPITAL WILL CARRY THE BURDEN. AS A PARTICIPATING PROVIDER AND A CHARITABLE ORGANIZATION, MEDICARE PATIENTS, THE MAJORITY OF WHOM ARE ELDERLY AND DISABLED ARE NOT TURNED AWAY, SO GOOD SAMARITAN WILL CONTINUE TO BEAR THE LOSS IN PROVIDING THE BEST CARE POSSIBLE TO THE LOCAL COMMUNITY.
PART III, LINE 9B	THE HOSPITAL'S CHARITY CARE POLICY DESCRIBES THE POLICIES AND PROCEDURES RELATING TO THE PROVISION OF CHARITY CARE TO PERSONS WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THEIR BILL. NO INDIVIDUAL WILL BE DENIED MEDICALLY NECESSARY HOSPITAL SERVICES BASED ON A DEMONSTRATED INABILITY TO PAY FOR THOSE SERVICES. IN ADDITION, UPON APPLYING FOR CHARITY CARE, EACH PATIENT AND PATIENT GUARANTOR'S ABILITY TO PAY WILL BE ASSESSED. ELIGIBILITY FOR ASSISTANCE: A REASONABLE REVIEW SHALL BE PERFORMED PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (I.E. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE CHS CHARITY CARE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY ACCOUNT THAT SUBSEQUENTLY IS DETERMINED TO MEET THE CHARITY CARE CRITERIA SHALL BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT FOR APPROPRIATE FOLLOW-UP. THE THIRD-PARTY COLLECTION AGENT SHALL ADVISE THE PATIENT/GUARANTOR OF THE HOSPITAL'S CHARITY CARE POLICY AND RETURN THE ACCOUNT IMMEDIATELY IF IT IS DETERMINED THAT THE QUALIFICATIONS ARE MET.
PART VI, LINE 2 - ASSESSMENT OF COMMUNITY NEEDS AND GOALS	COMMUNITY HEALTH NEEDS ARE ASSESSED ON A CONTINUAL BASIS, DURING MEETINGS OF THE HOSPITAL'S BOARD OF TRUSTEES AND EXECUTIVE LEADERSHIP COUNCIL, COMMUNITY HEALTH AND EDUCATION DEPARTMENT MEETINGS, AT COLLABORATIVE SESSIONS WITH MEMBER HOSPITALS OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), WITH PARTNERS AT COMMUNITY AGENCIES AND ORGANIZATIONS SUCH AS SCHOOLS, NURSING HOMES AND REHABILITATION CENTERS, AND THROUGH PARTICIPANT SURVEYS CONDUCTED AT MULTIPLE OUTREACH SITES IN THE COMMUNITY. THE HEALTHY SUNDAYS PROGRAM, WHICH PROVIDES FREE HEALTH SCREENINGS AND EDUCATION TO THE UNDERSERVED FOLLOWING WORSHIP SERVICES, WAS THE RESULT OF A JOINT COMMUNITY NEEDS ASSESSMENT BY CHS HOSPITALS. IT HAS ALSO BECOME A PRIMARY SOURCE OF PUBLIC PARTICIPATION. BY DISTRIBUTING COMMUNITY NEEDS SURVEYS (AVAILABLE IN ENGLISH AND SPANISH) TO PARTICIPANTS AT SCREENING SITES. EVERY POINT OF CONTACT DOUBLES AS AN OPPORTUNITY TO REQUEST FEEDBACK ON HOW THE HOSPITAL CAN BETTER MEET THE NEEDS OF THE COMMUNITY. THESE EVENTS ARE PROMOTED VIA CALENDAR LISTINGS IN PARISH BULLETINS AND FLYERS POSTED IN PLACES OF BUSINESS AND WORSHIP IN THE COMMUNITY SURROUNDING THE OUTREACH SITE AND ON CHS'S WEBSITE. ADDITIONALLY, COMMUNITY NEEDS SURVEYS ARE COMPLETED BY PARTICIPANTS ATTENDING THE HOSPITAL'S HEALTH SCREENINGS AT LIBRARIES AND SENIOR CENTERS THROUGHOUT THE COUNTY. IN 2013, GOOD SAMARITAN CONDUCTED A RIGOROUS COMMUNITY HEALTH NEEDS ASSESSMENT. AS AN OUTCOME OF THIS ASSESSMENT, IN CONJUNCTION WITH THE INFORMATION GATHERED AND OUTLINED IN THE AFOREMENTIONED DATA COLLECTION METHODOLOGY OF COMMUNITY NEEDS, CHRONIC DISEASE PREVENTION THROUGH NUTRITION AND WEIGHT MANAGEMENT AND THE IMPROVEMENT OF OUTCOMES FOR CANCER PATIENTS WERE IDENTIFIED AS PRIORITIES. RISK FACTORS ASSOCIATED WITH BEING OVERWEIGHT AND OBESE, INCLUDING CARDIOVASCULAR DISEASE, DIABETES AND HYPERTENSION, ARE MORE PREVALENT AMONG THE MEDICALLY UNDERSERVED, SUCH AS THE UNINSURED AND UNDERINSURED, LOW-INCOME FAMILIES, AND RACIAL AND ETHNIC MINORITIES. BREAST AND PROSTATE CANCER WERE ALSO IDENTIFIED AS HEALTH ISSUES DISPROPORTIONATELY IMPACTING UNDERSERVED RESIDENTS WITHIN THE HOSPITAL'S CATCHMENT AREA. CONSEQUENTLY, THESE AREAS WERE SELECTED AS THE FOCUS OF COMMUNITY EDUCATION AND OUTREACH INITIATIVES. IN 2015, TO BETTER IDENTIFY AND ADDRESS THE REGION'S PREVALENT HEALTH NEEDS, GOOD SAMARITAN CONTINUED TO COLLABORATE WITH OTHER HOSPITALS, LOCAL HEALTH DEPARTMENTS, HEALTH CARE PROVIDERS, PUBLIC HEALTH SPECIALISTS FROM ACADEMIC INSTITUTIONS AND COMMUNITY-BASED ORGANIZATIONS IN THE LONG ISLAND HEALTH COLLABORATIVE (LIHC), ONE OF THE FIRST BI-COUNTY INITIATIVES OF ITS KIND IN NEW YORK. LIHC'S WEBSITE OFFERS COMPREHENSIVE INFORMATION TO PROMOTE GOOD HEALTH AND PREVENT CHRONIC DISEASE. IN ADDITION TO PROVIDING NUMEROUS RESOURCES SUCH AS HEALTH PROGRAM INVENTORIES, HEALTH INSURANCE INFORMATION AND EDUCATIONAL VIDEOS, LIHC AND ITS MEMBERS HAVE ORGANIZED WALKING PROGRAMS AND DEVELOPED A UNIVERSAL SCREENING TOOL TO HELP MEASURE THE EFFECTIVENESS OF COMMUNITY HEALTH EFFORTS. MORE INFORMATION CAN BE FOUND AT WWW.LIHEALTHCOLLAB.ORG.
PART VI, LINE 3 - COMMUNICATION OF FINANCIAL ASSISTANCE POLICY	1. SINCE IT IS THE DUTY OF THE MEDICAL CENTER TO ENSURE THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF THE MEDICAL CENTER'S CHARITY CARE POLICY, ALL EMPLOYEES IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS HAVE BEEN FULLY VERSED IN THE MEDICAL CENTER'S CHARITY CARE POLICY, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ARE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE HOSPITAL REPRESENTATIVES. 2. THE MEDICAL CENTER HAS POSTED MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN THE MEDICAL CENTER INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREA. SAID NOTICES ARE PUBLISHED IN ENGLISH AND SPANISH, AND ARE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. 3. THE MEDICAL CENTER PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM, PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS OF APPLYING FOR ASSISTANCE. THIS SUMMARY IS WRITTEN AT OR BELOW A SIXTH GRADE READING LEVEL. 4. THE MEDICAL CENTER HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE. 5. THE MEDICAL CENTER PROVIDES ALL PATIENTS ACCESS TO INTERPRETERS TO ASSIST THEM IN UNDERSTANDING THE MEDICAL CENTER'S CHARITY CARE PROGRAM IN THE LANGUAGE SPOKEN BY THE PATIENT DURING ANY PRE-ADMISSION, ADMISSION, AND DISCHARGE PROCESS. 6. ON ALL BILLS AND STATEMENTS SENT TO PATIENTS, INFORMATION IS INCLUDED REGARDING THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING CHARITY CARE, AND A CONTACT NUMBER TO CALL TO OBTAIN FURTHER DETAILS. THIS INFORMATION IS AVAILABLE AT OR BELOW A SIXTH GRADE READING LEVEL.
PART VI, LINE 4 - COMMUNITY INFORMATION	GOOD SAMARITAN'S PRIMARY CATCHMENT AREA HAS A POPULATION OF APPROXIMATELY 491,000 AND INCLUDES: AMITYVILLE, BABYLON, NORTH BABYLON, WEST BABYLON, BAY SHORE, BRENTWOOD, COPIAGUE, DEER PARK, LINDENHURST, WEST ISLIP, CENTRAL ISLIP, EAST ISLIP, ISLIP, SAYVILLE, OAKDALE AND WYANDANCH. THESE COMMUNITIES REPRESENT APPROXIMATELY 75% OF TOTAL ADMISSIONS. OUR SECONDARY SERVICE AREA HAS A POPULATION OF MORE THAN 475,000 AND ACCOUNTS FOR ANOTHER 15% OF THE HOSPITAL'S ADMISSIONS. THE SECONDARY SERVICE AREA INCLUDES: BOHEMIA, BRIGHTWATERS, DIX HILLS, ISLIP TERRACE, MASSAPEQUA, PATCHOGUE AND RONKONKOMA.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH	GOOD SAMARITAN HOSPITAL MEDICAL CENTER (GOOD SAMARITAN) IS A NOT-FOR-PROFIT COMPREHENSIVE HEALTH CARE FACILITY RENDERING INPATIENT, AMBULATORY, EMERGENCY, HOME HEALTH, AND CHRONIC DIALYSIS MEDICAL CARE TO THE COMMUNITY. IN ADDITION, GOOD SAMARITAN OPERATES A NURSING HOME AND THE BISHOP MCHUGH HEALTH CENTER IN BABYLON, WHICH CARES FOR MEDICALLY UNDESERVED RESIDENTS. IN 2015, THE HEALTH CENTER HAD 262 PATIENT VISITS AND 120 REFERRALS FOR SPECIALTY CARE. PARTNERSHIPS GOOD SAMARITAN HAS LONGSTANDING, ACTIVE PARTNERSHIPS WITH MANY ORGANIZATIONS AND GROUPS THROUGHOUT THE COMMUNITY SUCH AS THE WITNESS PROJECT, AMERICAN CANCER SOCIETY, BAY SHORE WELLNESS ALLIANCE, LOCAL BREAST CANCER COALITIONS, LOCAL LIBRARIES, THE LOCAL RETAIL MALL, WEST ISLIP FIRE DEPARTMENT, WEST ISLIP SCHOOL DISTRICT, WILD BY NATURE, AND WEST ISLIP YOUTH ENRICHMENT SERVICES. CANCER SURVIVORS' DAY GOOD SAMARITAN HOLDS AN ANNUAL CANCER SURVIVORS' DAY IN NOVEMBER WITH HUNDREDS OF PARTICIPANTS ATTENDING. THE EVENT HONORS CANCER SURVIVORS AND THEIR FAMILIES FOR THEIR STRENGTH AND COURAGE AND THE CONTRIBUTIONS OF THEIR FAMILIES AND FRIENDS. GOOD SAMARITAN'S CANCER SURVIVORS' DAY IS DESIGNED TO BRING TOGETHER PEOPLE WHOSE LIVES HAVE BEEN TOUCHED BY CANCER, AND TO PROVIDE INSPIRATION AND HOPE FOR LIFE AFTER A DIAGNOSIS OF CANCER. CAR SEAT SAFETY GOOD SAMARITAN CONTINUES TO OFFER A CHILD PASSENGER SAFETY PROGRAM TO PROMOTE THE PROPER INSTALLATION OF CHILD SAFETY SEATS AND BOOSTER SEATS. GOOD SAMARITAN SERVES AS A COMMUNITY RESOURCE FOR CHILD PASSENGER SAFETY AND PROVIDES EDUCATION TO PARENTS BY APPOINTMENT ON PROPER TECHNIQUES FOR TRANSPORTING CHILDREN, ALONG WITH FREE CHILD SAFETY SEAT CHECKS. BLOOD DRIVES GOOD SAMARITAN HOSTS BLOOD DRIVES THROUGHOUT THE YEAR IN WHICH DONORS ARE PRIMARILY GOOD SAMARITAN STAFF, AS WELL AS COMMUNITY MEMBERS. ALSO, GOOD SAMARITAN CONDUCTS HEALTH FAIRS AT LOCAL SCHOOLS, SENIOR CENTERS AND OTHER VENUES, PROVIDING FREE CHOLESTEROL, BLOOD PRESSURE AND OTHER SCREENINGS AS WELL AS EDUCATIONAL INFORMATION TO THE COMMUNITY. "LEARN TO BE TOBACCO FREE", BREATHE FREELY INFORMATION REGARDING OUR SMOKING CESSATION PROGRAMS, WHICH ARE OFFERED SEVERAL TIMES A YEAR, APPEARS IN OUR COMMUNITY NEWSLETTER AND ON THE HOSPITAL WEBSITE. EDUCATIONAL MATERIAL ON THIS TOPIC IS MADE AVAILABLE TO THE PUBLIC AT COMMUNITY LECTURES AND OTHER OUTREACH EVENTS. INPATIENTS IDENTIFIED AS SMOKERS DURING ASSESSMENT RECEIVE EDUCATION ON SMOKING CESSATION, BROCHURES, COUNSELLING RESOURCES, AND REFERRALS TO SUPPORT GROUPS. MEDICATION PATCHES FOR SYMPTOM RELIEF ARE ALSO OFFERED. PREVENTING UNINTENTIONAL FALLS WORKING WITH COMMUNITY ORGANIZATIONS SUCH AS THE SUFFOLK COUNTY DOH, AARP AND OTHER HOSPITALS IN THE REGION, GOOD SAMARITAN HAS UNDERTAKEN AN INITIATIVE TO PREVENT FALLS. IN 2015, ELECTIVE JOINT REPLACEMENT SURGERY PATIENTS WERE INSTRUCTED ON PREVENTING FALLS, WITH PATIENTS RECEIVING PREADMISSION EDUCATION. ALSO, STAFF FROM THE REHABILITATION DEPARTMENT OFFER SENIOR CITIZENS FREE LECTURES AND BALANCE ASSESSMENTS IN THE COMMUNITY. HEALTHIER FAMILIES PROGRAM IN 2015, IN COLLABORATION WITH THE BAY SHORE SCHOOL DISTRICT AND THE BAY SHORE WELLNESS ALLIANCE, GOOD SAMARITAN HOSPITAL OFFERED A FREE, 10-WEEK WEIGHT MANAGEMENT PROGRAM FOR CHILDREN IN GRADES 3 - 5 WHO WERE IDENTIFIED AS BEING AT RISK FOR OBESITY-RELATED HEALTH ISSUES. THE PROGRAM MET AT THE BAY SHORE MIDDLE SCHOOL TWICE EACH WEEK FOR A 45-MINUTE EXERCISE SESSION, WHICH TOOK PLACE IN THE SCHOOL'S WELLNESS CENTER UNDER THE SUPERVISION OF LICENSED PHYSICAL EDUCATION INSTRUCTORS. ONE DAY EACH WEEK, PARENTS OR GUARDIANS WERE ASKED TO ATTEND FOR AN ADDITIONAL 45-MINUTE EDUCATIONAL SESSION TAUGHT BY A GOOD SAMARITAN HOSPITAL REGISTERED DIETITIAN. STUDENTS AND PARENTS LEARNED TO MAKE APPROPRIATE FOOD CHOICES, HOW TO READ A FOOD LABEL, AND THE IMPORTANCE OF CALORIE COUNTING, FAT CONTENT, AND PORTION CONTROL. SAFE PROGRAM VICTIMS OF SEXUAL ASSAULT HAVE SPECIAL AND SERIOUS MEDICAL NEEDS THAT MUST BE ADDRESSED PROMPTLY, WITH EXPERTISE AND SENSITIVITY, WHILE SIMULTANEOUSLY ENSURING THE ACCURATE AND APPROPRIATE COLLECTION OF FORENSIC EVIDENCE. TO THAT END, GOOD SAMARITAN DEVELOPED THE SEXUAL ASSAULT FORENSIC EXAMINER PROGRAM (SAFE). THE SAFE CENTER IS AN EXTENSION OF THE EMERGENCY DEPARTMENT. IT PROVIDES A PRIVATE AND SUPPORTIVE SETTING TO ALL VICTIMS TO ENSURE THE PROPER EVALUATION, TREATMENT AND REFERRAL FOLLOW UP. IN ADDITION, APPROPRIATE EVIDENCE COLLECTION AND DOCUMENTATION IS ALSO COMPLETED IN THIS SETTING. HEALTH REFERRAL LINE IN 2015, THERE WERE A TOTAL OF 44,315 RECORDED REQUESTS BY THE COMMUNITY REGARDING PHYSICIAN REFERRALS, SPECIALTY DEPARTMENT AND SERVICES INFORMATION, COMMUNITY LECTURES, HEALTH AND WELLNESS FAIRS, HEALTH SCREENINGS AND SPECIAL EVENTS.
PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEM	GOOD SAMARITAN HOSPITAL MEDICAL CENTER (GOOD SAMARITAN) IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH IS LOCATED ON A SINGLE CAMPUS IN WEST ISLIP NY, AND A SKILLED NURSING FACILITY ON A SEPARATE CAMPUS IN SAYVILLE NY. ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS, GOOD SAMARITAN THROUGH ITS DAILY OPERATIONS, PROVIDES TO THE AREA ACUTE, EMERGENT AND OUTPATIENT CARE. GOOD SAMARITAN IS A MEMBER OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH SERVICES OF LONG ISLAND)(CHS), WHICH IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE. AS OF DECEMBER 31, 2015, CHS COMPRISED SIX HOSPITALS (MERCY MEDICAL CENTER, ST. FRANCIS HOSPITAL AND ST. JOSEPH HOSPITAL IN NASSAU COUNTY, AND GOOD SAMARITAN HOSPITAL MEDICAL CENTER, ST. CHARLES HOSPITAL AND ST. CATHERINE OF SIENA MEDICAL CENTER IN SUFFOLK COUNTY), AS WELL AS THREE NURSING HOMES (ST. CATHERINE OF SIENA NURSING AND REHABILITATION CARE CENTER, GOOD SAMARITAN NURSING HOME AND OUR LADY OF CONSOLATION NURSING AND REHABILITATIVE CARE CENTER, ALL IN SUFFOLK COUNTY), A REGIONAL HOME CARE AND HOSPICE NETWORK, AND A COMMUNITY-BASED AGENCY FOR PERSONS WITH SPECIAL NEEDS. WITH APPROXIMATELY 17,000 STAFF AND 4,600 MEDICAL STAFF WORKING THROUGHOUT THE SYSTEM, CHS PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES. OUR MISSION STATES: CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), 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, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTH CARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. MEMBER ORGANIZATIONS OF CHS OFFER VIRTUALLY EVERY MEDICAL SPECIALTY AND CLINICAL SERVICE, AND SHARE A DEDICATION TO CONTINUOUSLY UPGRADE THE SCOPE, QUALITY AND ACCESSIBILITY OF CARE. ALL OF CHS'S MEMBER ORGANIZATIONS HAVE RETAINED THEIR INDIVIDUAL LINKS TO THEIR HISTORY AND THEIR DISTINCTIVE PERSONALITIES, AS WELL AS THE SERVICE SPECIALTIES WHICH THEY ARE KNOWN FOR, THUS EMBEDDING THE ORGANIZATION IN THE COMMUNITY AND SERVING IT EFFECTIVELY. CHS PROVIDES AN ABUNDANCE OF EDUCATION AND SUPPORT GROUPS, PROVIDES FREE HEALTH SCREENINGS THROUGH ITS HEALTHY SUNDAYS PROGRAMS, HEALTH FAIRS AND OTHER PROGRAMS, WHICH HELP THE COMMUNITIES SERVED BY CHS ACCESS CARE. SINCE 1907, CATHOLIC HEALTH CARE ON LONG ISLAND HAS BUILT A DISTINGUISHED TRADITION OF OPERATING COMMUNITY-BASED HOSPITALS AND HUMAN SERVICE ORGANIZATIONS WITH THE PRIMARY OBJECTIVE OF SERVING THE COMMUNITY. TO FURTHER THE MISSION OF BRINGING CARE TO THE COMMUNITY, CHS AND ITS MEMBER HOSPITALS, TOGETHER WITH A NUMBER OF OTHER HEALTH CARE PROVIDERS ON LONG ISLAND, ENTERED INTO A PARTNERSHIP AGREEMENT, WHICH OPERATES AS THE LONG ISLAND HEALTH NETWORK (LIHN). LIHN WAS CREATED TO ESTABLISH A COMPREHENSIVE AND EFFICIENT HOSPITAL NETWORK IN NASSAU AND SUFFOLK COUNTIES WORKING TO, AMONG OTHER THINGS, IMPROVE QUALITY OF CARE, FACILITATE CLINICAL INTEGRATION, BENCHMARK BEST PRACTICES AND REDUCE LENGTH OF STAY AND COSTS.

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 ROCKVILLE CNTR	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	$304,839	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 SAMARITAN HOSPITAL MEDICAL CENTER 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)

NAMES 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)
Idemnification Gross Up Pmts	Yes (X)	IdemnificationGrossUpPmtsInd
Written Policy Ref T And E Expnss	Yes (true)	WrittenPolicyRefTAndEExpnssInd
Substantiation Required	Yes (true)	SubstantiationRequiredInd
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Form990 Of Other Organizations	Yes (X)	Form990OfOtherOrganizationsInd
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
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 (11 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
ALAN D GUERCI MD
PRESIDENT & CEO	$0	$1,341,026	$0	$350,000	$0	$685,326	$0	$334,696	$0	$32,933	$0	$2,743,981	$0	$649,093
NANCY SIMMONS
CAO	$412,357	$0	$125,000	$0	$73,995	$0	$102,294	$0	$20,146	$0	$733,792	$0	$53,441	$0
JEROME WEINER
CMO THRU DECEMBER 2015	$524,964	$0	$40,000	$0	$109,232	$0	$564,735	$0	$19,521	$0	$1,258,452	$0	$0	$0
DONALD TEPLITZ
CHIEF MEDICAL OFFICER	$482,751	$0	$60,000	$0	$2,243	$0	$21,294	$0	$27,367	$0	$593,655	$0	$0	$0
WILLIAM C ARMSTRONG
SVP FINANCE	$0	$634,545	$0	$130,000	$0	$105,542	$0	$162,696	$0	$30,370	$0	$1,063,153	$0	$85,342
NEIL LOBO
PHYSICIAN	$745,383	$0	$351,084	$0	$1,242	$0	$21,294	$0	$29,517	$0	$1,148,520	$0	$0	$0
KOUROSH ADHAMI
PHYSICIAN	$745,580	$0	$351,084	$0	$1,242	$0	$21,294	$0	$29,320	$0	$1,148,520	$0	$0	$0
JAMES KOHLROSER
PHYSICIAN	$742,833	$0	$321,084	$0	$810	$0	$21,294	$0	$32,067	$0	$1,118,088	$0	$0	$0
BABAK DANESH
PHYSICIAN	$749,529	$0	$311,084	$0	$777	$0	$21,294	$0	$1,881	$0	$1,084,565	$0	$0	$0
KENNETH GOLD
PHYSICIAN	$526,928	$0	$253,255	$0	$6,566	$0	$21,294	$0	$29,543	$0	$837,586	$0	$0	$0
JAMES CALDAS
FORMER PRESIDENT & CEO	$0	$0	$0	$0	$0	$346,651	$0	$0	$0	$0	$0	$346,651	$0	$346,651

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART I, LINE 4A - SEVERANCE PAYMENT

JAMES CALDAS, FORMER PRESIDENT & CEO RECEIVED PAYMENT OF SEVERANCE OF $346,651. MEDICAL BENEFITS WERE ALSO PROVIDED DURING 2015. JEROME WEINER, CMO THROUGH DECEMBER 2015, RECEIVED PAYMENT OF SEVERANCE OF $25,559 AND PAYMENT OF ACCRUED VACATION OF $78,328 DURING 2015. HE IS ENTITLED TO AN ADDITIONAL $543,441 OF SEVERANCE.

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. ALAN GUERCI $314,000 PARTICIPATION IN THE PLAN WILLIAM ARMSTRONG $142,000 PARTICIPATION IN THE PLAN NANCY SIMMONS $81,000 PARTICIPATION IN THE PLAN THE DEFERRED COMPENSATION IN COLUMN C FOR THESE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NON-QUALIFIED RETIREMENT PLANS. THE FOLLOWING INDIVIDUALS VESTED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III). THESE AMOUNTS INCLUDE A TAX GROSS UP. ALAN GUERCI $649,093, VESTED IN PLAN WILLIAM ARMSTRONG $85,342, VESTED IN PLAN NANCY SIMMONS, $53,441, VESTED IN PLAN THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2015 FORM W-2, BOX 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT.

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc
SAMARITAN MEDICAL SERVICES PC
SEE PART V	$337,620	SEE PART V
SOUTHWEST SUFFOLK MEDICAL PC
SEE PART V	$1,214,940	SEE PART V

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE L, PART IV LINE (1) COLUMN (B) RELATIONSHIP	ENTITY MORE THAN 35% OWNED BY DONALD TEPLITZ, KEY EMPLOYEE SCHEDULE L, PART IV, LINE (1) COLUMN (D) DESCRIPTION OF TRANSACTION MANAGEMENT FEE PAID TO THE HOSPITAL FOR SALARIES, INSURANCE AND SUPPLIES.
SCHEDULE L, PART IV, LINE (2) COLUMN (B) RELATIONSHIP	ENTITY MORE THAN 35% OWNED BY DONALD TEPLITZ, KEY EMPLOYEE SCHEDULE L, PART IV, LINE (2) COLUMN (D) DESCRIPTION OF TRANSACTION MANAGEMENT FEE PAID TO THE HOSPITAL FOR SALARIES, INSURANCE AND SUPPLIES.

Schedule M IRS990ScheduleM

Field	Value	IRS element (for citing)
Works Of Art		WorksOfArtGrp
Art Historical Treasures		ArtHistoricalTreasuresGrp
Art Fractional Interest		ArtFractionalInterestGrp
Books And Publications		BooksAndPublicationsGrp
Clothing And Household Goods		ClothingAndHouseholdGoodsGrp
Cars And Other Vehicles		CarsAndOtherVehiclesGrp
Boats And Planes		BoatsAndPlanesGrp
Intellectual Property		IntellectualPropertyGrp
Securities Publicly Traded		SecuritiesPubliclyTradedGrp
Securities Closely Held Stock		SecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust Intrsts		SecurPrtnrshpTrustIntrstsGrp
Securities Miscellaneous		SecuritiesMiscellaneousGrp
Qualified Contrib Hist Struct		QualifiedContribHistStructGrp
Qualified Contrib Other		QualifiedContribOtherGrp
Real Estate Residential		RealEstateResidentialGrp
Real Estate Commercial		RealEstateCommercialGrp
Real Estate Other		RealEstateOtherGrp
Collectibles		CollectiblesGrp
Food Inventory		FoodInventoryGrp
Drugs And Medical Supplies		DrugsAndMedicalSuppliesGrp
Taxidermy		TaxidermyGrp
Historical Artifacts		HistoricalArtifactsGrp
Scientific Specimens		ScientificSpecimensGrp
Archaeological Artifacts		ArchaeologicalArtifactsGrp

Other Non Cash Contri Table OtherNonCashContriTableGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Desc	ENERGY EFFICIENT LIGHTING EQUIPMENT	Desc
Contribution	1	ContributionCnt
Noncash Contributions Rpt F990	$552,709	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FMV	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Any Property That Must Be Held	false	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (true)	ReviewProcessUnusualNCGiftsInd
Third Parties Used	false	ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE M, PART I, COLUMN (B)	FormAndLineReferenceDesc
Explanation	THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS IN COLUMN B.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION	THE SOLE MEMBER OF GOOD SAMARITAN HOSPITAL 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 SAMARITAN HOSPITAL MEDICAL CENTER, AND AS SUCH HAS THE RIGHT TO APPOINT THE GOVERNING BODY.
FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY	AS THE SOLE MEMBER OF GOOD SAMARITAN HOSPITAL MEDICAL CENTER, CHS IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERING BODY OF GOOD SAMARITAN HOSPITAL. THE GOVERNING BODY OF GOOD SAMARITAN HOSPITAL IS THE SAME AS THAT OF CHS.
FORM 990, PART VI, LINE 11B - REVIEW PROCESS FOR FORM 990	THE FORM 990 AND RELATED SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD, AND PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS OF CHS, WHICH HAS BEEN DELEGATED THE FORM 990 REVIEW FUNCTION BY THE BOARD. UPON REVIEW AND RECOMMENDATION OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO THE BOARD FOR APPROVAL. UPON BOARD APPROVAL, THE FORM 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST	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 CHS COMPLIANCE AND AUDIT COMMITTEE BY CHS' COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE IS GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE CHS BOARD OF DIRECTORS. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. 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 BOARD OF DIRECTORS SHALL PROVIDE A 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 SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. THE PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIM/HERSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT.
FORM 990, PART VI, LINE 15 - COMPENSATION POLICY	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 CHS EXECUTIVE COMPENSATION POLICY (COMPENSATION POLICY). THE COMPENSATION 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 (CEO), AND CHIEF OPERATING OFFICERS (COO) OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS (CFO); 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 CHS CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE OF THE CHS BOARD OF DIRECTORS 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 PERFORMED ANNUALLY BY AN INDEPENDENT CONSULTANT. 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 PROVIDED, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE CHS BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 19 - DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION	GOVERNING DOCUMENTS-CERTIFICATE OF INCORPORATION FILED WITH NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT MADE 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. ALAN D. GUERCI, PRESIDENT & CEO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY, INC. (20-8067039); CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); SIENA VILLAGE (06-1569129); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL (11-1871039). NANCY SIMMONS, CAO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396). WILLIAM ARMSTRONG, SR VP FINANCE - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER OR HIGHEST PAID EMPLOYEE FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); SIENA VILLAGE, INC. (06-1569129); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396) AND GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240).
FORM 990, PART X, LINE 20 - TAX EXEMPT BOND LIABILITIES	THE TAX-EXEMPT BOND ISSUANCES REFLECTED ON PART X, LINE 20 ARE ISSUED ON BEHALF OF THE CATHOLIC HEALTH SERVICES OF LONG ISLAND OBLIGATED GROUP PROJECT WHICH INCLUDES THE FILING ENTITY AND RELATED ENTITIES. THREE BONDS WERE ISSUED TO THE OBLIGATED GROUP, SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION (SERIES 2011 SUFFOLK BONDS), SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION (SERIES 2014C SUFFOLK BONDS) AND NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE AND FINANCING CORPORATION (SERIES 2011 NASSAU BONDS). THE BONDS ARE REPORTED ON SCHEDULE K OF THE PARENT ORGANIZATION, CATHOLIC HEALTH SERVICES OF LONG ISLAND.
FORM 990, PART XI, LINE 9 - CHANGES IN NET ASSETS	POST RETIREMENT BENEFIT PLAN CHANGE: $287,000

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	Yes (true)
CHS AMBULANCE SERVICES INC
992 NORTH VILLAGE AVENUE	ROCKVILLE CENTRE	NY	11570	141801961	DORMANT	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	Yes (true)
MARYHAVEN TRANSPORTATION SERVICES
51 TERRYVILLE ROAD	PORT JEFFERSN ST	NY	11776	113434776	TRANSPORTATIO	NY	501(C)(3)	11A- I	MARYHAVENCTR	false
MARYHAVEN CENTER OF HOPE
51 TERRYVILLE ROAD	PORT JEFFERSN ST	NY	11776	112861698	Prgm-disabled	NY	501(C)(3)	9	CHSLI	false
MARYHAVEN SCHOOL CORPORATION
51 TERRYVILLE ROAD	PORT JEFFERSN ST	NY	11776	112861690	Schl-disabled	NY	501(C)(3)	2	MARYHAVENCTR	false
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	Yes (true)
CATHOLIC HOME CARE
110 BI-COUNTY BLVD SUITE 114	FARMINGDALE	NY	11735	112126736	HOME CARE	NY	501(C)(3)	9	CHSLI	false
OUR LADY OF CONSOLATION GERIATRIC CARE
111 BEACH DRIVE	WEST ISLIP	NY	11795	113284066	LT NURSE CARE	NY	501(C)(3)	9	CHSLI	false
RIVERHEAD HOSTEL HOLDING CORPORATION
51 TERRYVILLE ROAD	PORT JEFFERSN ST	NY	11776	112499790	RENTING	NY	501(C)(2)		MARYHAVENCTR	false
SIENA VILLAGE INC
2000 BISHOPS ROAD	SMITHTOWN	NY	11787	061569129	SR HOUSING	NY	501(C)(3)	9	STCATHERINE	Yes (true)
ST CATHERINE OF SIENA MEDICAL CENTER
50 ROUTE 25A	SMITHTOWN	NY	11787	061562701	HOSPITAL	NY	501(C)(3)	3	CHSLI	Yes (true)
ST CHARLES HOSPITAL
200 BELLE TERRE ROAD	PORT JEFFERSN ST	NY	11777	111871039	HOSPITAL	NY	501(C)(3)	3	CHSLI	Yes (true)
CHS HOME SUPPORT SERVICES INC
15 POWER DRIVE	HAUPPAUGE	NY	11788	113594561	RESP THERAPY	NY	501(C)(3)	9	CATHHOMECARE	false
ST FRANCIS HOSPITAL
100 PORT WASHINGTON BLVD	ROSLYN	NY	11576	112050523	HOSPITAL	NY	501(C)(3)	3	CHSLI	Yes (true)
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	Yes (true)
WSNCHS NORTH INC
4295 HEMPSTEAD TURNPIKE	BETHPAGE	NY	11714	113438973	HOSPITAL	NY	501(C)(3)	3	CHSLI	Yes (true)
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	false
GOOD SHEPHERD HOSPICE
110 BI-COUNTY BLVD SUITE 114	FARMINGDALE	NY	11735	112958438	HOSPICE SVC	NY	501(C)(3)	9	CHSLI	false
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	Yes (true)
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	Yes (true)
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	false
GOOD SHEPHERD HOSPICE FOUNDATION
110 BI-COUNTY BLVD SUITE 114	FARMINGDALE	NY	11735	263169427	SUPPORT ORG	NY	501(C)(3)	11A- I	GOODSHEPHERD	false
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	Yes (true)
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	Share Of Total IncomeShareOfTotalIncomeAmt	Share Of EOY AssetsShareOfEOYAssetsAmt	Disproportionate AllocationsDisproportionateAllocationsInd	UBI Code VUBICodeVAmt	General Or Managing PartnerGeneralOrManagingPartnerInd	OwnershipOwnershipPct
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	GSH	RELATED	$672,969	$2,086,947	false	$0	false	0.51000
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	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	Yes (true)	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	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	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (9 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
CHS SERVICES
LMPS	$1,083,200	COST
MERCY MEDICAL CENTER
LMS	$127,544	COST
ST FRANCIS HOSPITAL
LMS	$95,705	COST
ST CHARLES HOSPITAL
LMS	$401,621	COST
ST CATHERINE OF SIENA MEDICAL CENTER
LMS	$552,301	COST
WSNCHS NORTH
LMS	$154,213	COST
GOOD SAMARITAN HOSPITAL FOUNDATION
C	$1,218,146	COST
SAMARITAN EMERGENCY MEDICAL SERVICES
LNOQ	$121,959	COST
IDHC LLC
S	$204,001	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