2014-11-13T18:58:47-06:00 2013-12-31 PricewaterhouseCoopers LLP 300 Madison Avenue New York NY 10017 990 2013-01-01 112050523 ST FRANCIS HOSPITAL % CHS SERVICES STFR 5165626000 100 PORT WASHINGTON BLVD Suite ROSLYN NY 11576 RUTH HENNESSEY EVP/CAO 5165626000 2014-11-09 2013 2015-11-30 17:44:51Z ALAN D GUERCI MD 100 PORT WASHINGTON BLVD ROSLYN NY 11576 949972252 false 0928 X HTTP://STFRANCISHEARTCENTER.CHSLI.ORG X 1964 NY CHSLI AND ITS MEMBERS, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUE CHRIST'S HEALING MISSION, BY PROMOTING EXCELLENCE IN CARE AND COMMITTING ITSELF TO THOSE IN NEED. 19 18 3615 604 0 12438012 4830681 473484461 505599925 31393681 31822723 5406807 13289572 522722961 555542901 8403807 15545886 0 0 266123955 268952411 0 0 0 207797314 231235591 482325076 515733888 40397885 39809013 834508131 887855235 271866850 265193398 562641281 622661837 X ST. FRANCIS HOSPITAL, A MEMBER OF 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, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. false false 465581935 15545886 514336667 THE 364 CERTIFIED BED HOSPITAL PROVIDES CARDIOVASCULAR TESTING AND OTHER GENERAL MEDICAL SERVICES NECESSARY TO SUPPORT CARDIOVASCULAR PATIENTS AND ALSO PROVIDES NON-CARDIOVASCULAR SERVICES IN RESPONSE TO THE GENERAL NEEDS OF THE COMMUNITY. DURING 2013, THE HOSPITAL ADMITTED 16,410 PATIENTS, PERFORMED 1,398 OPEN HEART OPERATIONS AND 7,397 CATHETERIZATIONS. FURTHER, THE HOSPITAL PERFORMED 2,879 PTCA'S AND 3,646 CARDIAC ARRYTHMIA PROCEDURES. IN ADDITION, THERE WERE 23,167 EMERGENCY ROOM VISITS AND DURING THE YEAR THE HOSPITAL SERVICED 192,755 OUTPATIENTS. 465581935 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true true false false false false false true false false false false false false false false false true true true false false true 163 0 true 3615 true false false false false false false false false false false X 19 18 false false false false true true true true true false false true true true true true true true true false X CHS SERVICES 5167051933 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 X PETER QUICK CHAIRMAN 2.0 X X 0 0 0 REV MSGR FRANCIS J CALDWELL SECRETARY 2.0 X X 0 0 0 PETER P D'ANGELO TREASURER 2.0 X X 0 0 0 RABBI BARRY DOV SCHWARTZ PHD TRUSTEE 2.0 X 0 0 0 EUGENE F MURPHY TRUSTEE 2.0 X 0 0 0 JOSEPH GRIMALDI TRUSTEE 2.0 X 0 0 0 SUSAN POWERS SCHOTT TRUSTEE 2.0 X 0 0 0 THOMAS J FANNING TRUSTEE 2.0 X 0 0 0 SR BETTY KEEGAN TRUSTEE 2.0 X 0 0 0 KEVIN J CONWAY TRUSTEE 2.0 X 0 0 0 SR DOLORES WISNIEWSKI CIJ TRUSTEE 2.0 X 0 0 0 BRIAN P HEHIR TRUSTEE 2.0 X 0 0 0 STEPHEN F MCLOUGHLIN TRUSTEE 2.0 X 0 0 0 HERBERT J MCCOOEY JR TRUSTEE 2.0 X 0 0 0 REV PETER DUGANDZIC TRUSTEE 2.0 X 0 0 0 BRIAN POISSANT ESQ TRUSTEE 2.0 X 0 0 0 THOMAS CHRISTMAN TRUSTEE 2.0 X 0 0 0 MICHAEL VITTORIO TRUSTEE 2.0 X 0 0 0 ALAN D GUERCI MD PRESIDENT & CEO 50.0 X X 0 1320796 53241 WILLIAM C ARMSTRONG SVP & CHIEF FINACIAL OFFICER 50.0 X 821991 0 125611 RUTH HENNESSEY EXEC VP & CAO 50.0 X 692429 0 143984 JACK SOTERAKIS MD VP MEDICAL AFFAIRS 50.0 X 488701 0 38459 RICHARD SHLOFMITZ MD CHAIRMAN CARDIOLOGY 50.0 X 3609620 0 40362 GEORGE PETROSSIAN MD PHYSICIAN 50.0 X 1496499 0 47079 THOMAS PAPPAS MD PHYSICIAN 50.0 X 1046321 0 48730 THEOFANI TSIAMTSIOURIS MD PHYSICIAN 50.0 X 994046 0 48067 HOWARD SACHER MD PHYSICIAN PRACTICE LEADER 50.0 X 982641 0 18388 GARY GECELTER MD DIR/PHYS SURGERY 50.0 X 896162 0 51215 11028410 1320796 615136 639 false true false PHYSICIANS DIAGNOSTIC IMAGING 100 PORT WASHINGTON BLVD ROSLYN NY 11576 PHYSICIAN SERVICES 1615997 NASSAU CHEST PHYSICIANS PC 233 EAST SHORE ROAD GREAT NECK NY 11023 PHYSICIAN SERVICES 1590139 WINTHROP UNIVERSITY HOSPITAL 200 OLD COUNTRY ROAD DIALYSIS CTR MINEOLA NY 11501 HEMODIALYSIS SVCS 1395986 DELLA FEMINA ROTHSCHILD JEARY PO BOX 641052 PITTSBURGH PA 15264 ADVERTISING SERVICES 1214401 PROSKAUER ROSE LLP 1585 BROADWAY NEW YORK NY 10036 LEGAL SERVICES 722554 16 4774691 55990 4830681 PATIENT REVENUE 621400 505599925 505599925 505599925 7532902 7532902 0 0 1515970 1515970 0 1515970 1515970 418719172 394429351 24289821 24289821 24289821 0 0 0 MANAGEMENT FEES - 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LOBBYING ACTIVITIES AMOUNT REFLECTS PORTION OF TRADE ASSOCIATION DUES WHICH WERE USED FOR LEGISLATIVE LOBBYING ON THE BEHALF OF THE HEALTHCARE INDUSTRY THOSE TRADE ORGANIZATIONS REPRESENT. 105130 105130 348341873 148718669 199623204 11885473 6397807 5487666 209337513 168576514 40760999 910382 910382 246887381 DUE FROM RELATED PARTIES 31534667 INSURANCE CLAIMS RECEIVABLE 19585757 51120424 0 POST RETIREMENT LIABILITIES 13980846 ESTIMATED MALPRACTICE LIABILITIES 18088416 OTHER SELF INSURED LIABILITIES 23723226 THIRD PARTY PAYOR LIABILITIES 26788394 82580882 X PART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTE CHS AND MOST OF ITS SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CHS ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE 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. true true X true X 300. true X true true true false true true 6039398 1539900 4499498 0.00870 13220895 7788150 5432744 0.01050 301584 252435 49149 0.00010 19561877 9580485 9981391 0.01930 1690430 1690430 0.00330 1460496 616679 843817 0.00160 5963910 5963910 0.01160 294245 294245 0.00060 9409081 616679 8792402 0.01710 28970958 10197164 18773793 0.03640 true 2985609 190228765 208040456 -17811691 X true true 1 1 ST FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD ROSLYN NY 11576 HTTP://STFRANCISHEARTCENTER.CHSLI.ORG 2953000H X X X X CARDIOVASCULAR SVCS ST FRANCIS HOSPITAL 1 true X X X X X X X X 13 true true true X WWW.STFRANCISHEARTCENTER.COM X WWW.CHSLI.ORG X X X X X X X X X false false true true 300. true 400. true X X true true X X X X true false true X false false PART V, SECTION B, LINE 3 ST. FRANCIS HOSPITAL CONDUCTED A CHNA THAT INCLUDED INPUT FROM THE DEMATTEIS CENTER FOR CARDIAC RESEARCH AND EDUCATION'S OUTPATIENTS, INPATIENTS, EMPLOYEES, PATIENTS SCREENED AT COMMUNITY OUTREACH EVENTS, FAMILY MEMBERS AND GENERAL COMMUNITY MEMBERS WHO ATTENDED THE HOSPITAL'S ANNUAL HEALTH FAIR. INPUT WAS SOUGHT FROM PEOPLE IN THE MEDICALLY UNDERSERVED "SELECT COMMUNITIES" BY ST. FRANCIS'S OUTREACH STAFF WHEN CONDUCTING HEALTH SCREENINGS AT VARIOUS COMMUNITY AND PARISH SITE LOCATIONS. IN ADDITION, ST. FRANCIS COLLABORATED WITH THE NASSAU COUNTY DEPARTMENT OF HEALTH. IN-PERSON INTERVIEWS WERE CONDUCTED WITH KEY LONG ISLAND LEADERS FROM COMMUNITY-BASED ORGANIZATIONS, WHICH INCLUDED THE AMERICAN HEART ASSOCIATION, THE AMERICAN DIABETES ASSOCIATION, THE AMERICAN CANCER SOCIETY, ISLAND HARVEST FOOD PANTRY AND THE UNITED WAY OF LONG ISLAND. CRITICAL INFORMATION WAS THEN FILTERED BACK. NEEDS WERE IDENTIFIED THROUGH THIS COUNTY-WIDE EFFORT. ALL OF THESE COMMUNITY-BASED ORGANIZATIONS REACH OUT TO MEDICALLY UNDERSERVED AND MINORITY POPULATIONS, ESPECIALLY ISLAND HARVEST AND THE UNITED WAY OF LONG ISLAND. A STANDARD SURVEY TOOL WAS DEVELOPED AND GIVEN TO LEADERS OF ALL OF THE ABOVE ORGANIZATIONS. PART V, SECTION B, LINE 4 ST. JOSEPH HOSPITAL, MERCY MEDICAL CENTER, LONG BEACH MEMORIAL HOSPITAL, THE NORTH SHORE-LIJ SYSTEM, SOUTH NASSAU COMMUNITIES HOSPITAL AND WINTHROP-UNIVERSITY HOSPITAL. PART V, SECTION B, LINE 5B - OTHER WEBSITE NSHC.ORG/LONG-ISLAND-HEALTH-COLLABORATIVE/ PART V, SECTION B, LINE 7 THE AREAS OF MENTAL HEALTH, SUBSTANCE ABUSE, AND PRENATAL CARE WERE NOT SELECTED, AS ST. FRANCIS DOES NOT HAVE A BEHAVIORAL HEALTH DEPARTMENT OR OB/GYN SERVICES TO SUPPORT INITIATIVES IN THESE AREAS. 3 ST FRANCIS RESEARCH & EDUCATIONAL 101 NORTHERN BLD OLD BROOKVILLE NY 11545 RESEARCH, COMMUNITY ED, CARDIAC REHAB, WOMEN'S HEALTH CENTER ST FRANCIS SOUTHBAY CARDIOVASCULAR CL 540 UNION BLVD WEST ISLIP NY 11795 OUTPATIENT CARDIOVASCULAR SERVICES MCHUGH HEALTH CENTER 750 SOUTH BROADWAY HICKSVILLE NY 11801 PRIMARY CARE FOR UNINSURED AND UNDERINSURED PART I, LINE 4 WHEN ESTABLISHED, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY'S FACTOR IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE WAS SPECIFICALLY SET HIGHER THAN FEDERALLY REQUIRED GUIDELINES IN ORDER TO CAPTURE POTENTIALLY MEDICALLY INDIGENT PATIENTS WHO MAY PRESENT THEMSELVES AT THE HOSPITAL FOR CARE. THE POLICY OF THE HOSPITAL WAS REVISED IN 2014 TO SPECIFICALLY DISCUSS CARE TO THE MEDICALLY INDIGENT. PART I, LINE 7 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 2013. PART III, LINE 2,3 - BAD DEBT AS COMMUNITY BENEFIT AS PART OF ITS TAX EXEMPT PURPOSE THE HOSPITAL PROVIDES ACCESS TO MEDICALLY NECESSARY CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, OR CULTURAL BACKGROUND. THE HOSPITAL 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, THE HOSPITAL 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 THE HOSPITAL 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 BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THIS ALLOWANCE BASED UPON HISTORICAL COLLECTION AND 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 HOSPITAL FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. 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 2013 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. PART III LINE 8- MEDICARE SHORTFALL AS COMMUNITY BENEFIT LOSSES ON TREATING MEDICARE BENEFICIARIES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT IN THEIR ENTIRETY. ST. FRANCIS INCURRED A LOSS OF APPROXIMATELY $17.7 MILLION TO DELIVER CARE TO MEDICARE PATIENTS. THIS REPRESENTS THE AMOUNT BY WHICH COSTS TO DELIVER CARE TO MEDICARE RECIPIENTS EXCEEDS THE LEVEL OF PAYMENT. ST. FRANCIS BEARS THE BURDEN OF NOT ONLY PROVIDING THE BEST AND MOST ADVANCED MEDICAL CARE POSSIBLE TO THE COMMUNITY, BUT DOING SO WITH NO RECOURSE TO OBTAIN 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 ST. FRANCIS 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 - NEEDS ASSESSMENT 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 PERIODICALLY THROUGHOUT THE YEAR, 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. PART VI, LINE 3 - COMMUNICATION OF FINANCIAL ASSISTANCE POLICY ALL EMPLOYEES IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS ARE FULLY VERSED IN THE CHARITY CARE POLICY, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ARE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE HOSPITAL REPRESENTATIVES. THE HOSPITAL POSTS MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN THE HOSPITAL 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 AT LEAST ENGLISH AND SPANISH, AND ARE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. THE HOSPITAL 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. THE HOSPITAL POSTS ITS CHARITY CARE POLICY SUMMARY ON ITS INTERNET WEBSITE. THE HOSPITAL PROVIDES ALL PATIENTS INTERPRETERS TO ASSIST THEM IN UNDERSTANDING ITS CHARITY CARE PROGRAM IN THE LANGUAGE SPOKEN BY THE PATIENT DURING ANY PRE-ADMISSION, ADMISSION, AND DISCHARGE PROCESS. ON ALL BILLS AND STATEMENTS SENT TO PATIENTS, A STATEMENT IS INCLUDED REGARDING THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING CHARITY CARE, AND A CONTACT NUMBER TO CALL TO OBTAIN FURTHER INFORMATION. THIS INFORMATION IS AVAILABLE AT OR BELOW A SIXTH GRADE READING LEVEL. PART VI, LINE 4 - COMMUNITY INFORMATION A NOT-FOR-PROFIT HOSPITAL, ST. FRANCIS HOSPITAL IS A MEMBER OF CHS. ST. FRANCIS HOSPITAL IS LOCATED ON THE NORTH SHORE OF NASSAU COUNTY IN THE TOWN OF NORTH HEMPSTEAD. ST. FRANCIS HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREAS INCLUDE 85% OF HOSPITAL DISCHARGES. THE PRIMARY SERVICE AREA IS NASSAU COUNTY, FROM WHICH THE HOSPITAL OBTAINED 56.3% OF ITS DISCHARGES IN 2012 (UP FROM 55.3% IN 2011). THE SECONDARY SERVICE AREA PROVIDES ANOTHER 29.2% OF DISCHARGES (DOWN FROM 29.8%) AND COMPRISES TWO AREAS, WEST AND EAST. THE WEST AREA CONSISTS OF 30 ZIP CODES IN QUEENS, AND ONE IN BROOKLYN, AND PROVIDED 15.6% OF ST. FRANCIS DISCHARGES (SAME AS 2011). THE EAST AREA CONSISTS OF 26 ZIP CODES IN SUFFOLK COUNTY AND PROVIDED 13.6% OF ST. FRANCIS DISCHARGES (DOWN FROM 14.2%). PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH ST. FRANCIS HOSPITAL CONTINUES TO PARTNER WITH OTHER COMMUNITY ORGANIZATIONS TO ADDRESS THE DIVERSE NEEDS OF UNDERINSURED AND UNINSURED INDIVIDUALS ACROSS LONG ISLAND. FOLLOWING ARE SEVERAL PROGRAMS WHICH WERE REPRESENTATIVE OF THESE EFFORTS IN 2013: - ST. FRANCIS HOSPITAL OPERATES THE BISHOP MCHUGH HEALTH CENTER IN HICKSVILLE WITH A FOCUS ON PROVIDING PRIMARY CARE TO THE UNINSURED AND UNDERINSURED. THE CENTER'S MEDICAL STAFF PROVIDES PHYSICAL EXAMINATIONS, LAB WORK, X-RAYS, FLU SHOTS, IMMUNIZATIONS AND SPECIALTY REFERRALS AS NEEDED. IN 2013, THERE WERE MORE THAN 1,500 PATIENT VISITS AT THE CENTER, WITH MORE THAN 1,200 REFERRALS FOR SPECIALTY CARE. - THE CHS HEALTHY SUNDAYS PROGRAM OFFERED FREE HEALTH SCREENINGS, FOLLOWING WEEKEND SERVICES AT LOCAL HOUSES OF WORSHIP, TO INDIVIDUALS WHO WOULD OTHERWISE HAVE DIFFICULTY ACCESSING HEALTH CARE. AS PART OF THE COLLABORATION BETWEEN MEMBER HOSPITALS OF CHS, ST. FRANCIS HOSPITAL CONDUCTED 1,052 HEALTH SCREENINGS AND/OR FLU SHOTS AT HEALTHY SUNDAYS EVENTS IN 2013. HEALTHY SUNDAYS CONTINUES TO PROVIDE A VITAL LINK TO PRIMARY CARE REFERRALS FOR THE MEDICALLY UNDERSERVED. - ST. FRANCIS HOSPITAL'S MOBILE HEALTH SCREENING UNIT PROVIDED CARE TO THOUSANDS OF INDIVIDUALS WHO DID NOT HAVE ACCESS TO A TRADITIONAL HEALTH CARE FACILITY. THE SELF-CONTAINED MOBILE UNIT WAS ONSITE AT 196 LOCATIONS IN QUEENS, NASSAU AND SUFFOLK COUNTIES IN 2013. DURING THESE OUTREACH VISITS, ST. FRANCIS HOSPITAL PHYSICIANS AND NURSES PROVIDED 4,470 HEALTH SCREENINGS AND/OR FLU SHOTS TO PATIENTS WITHOUT ADEQUATE HEALTH COVERAGE. - CONCERN ABOUT THE SUDDEN DEATH OF SEVERAL STUDENT-ATHLETES IN RECENT YEARS HAS LED TO HIGH DEMAND FOR FREE CARDIAC SCREENINGS AT ST. FRANCIS HOSPITAL THROUGH ITS STUDENT ATHLETE CARDIAC SCREENING PROGRAM. THE HOSPITAL PROVIDED 219 CARDIAC SCREENINGS AT NO COST TO LOCAL HIGH SCHOOL ATHLETES IN 2013. THESE SCREENINGS INCLUDE EKG AS WELL AS ECHOCARDIOGRAM. THE GOAL IS TO DETECT AND ASSESS ANY UNDERLYING CARDIAC ABNORMALITIES WHICH MAY PUT A STRAIN ON AN ATHLETE'S HEART, ESPECIALLY DURING STRENUOUS PHYSICAL ACTIVITY. IN AN EFFORT TO REDUCE OBESITY, ST. FRANCIS HOSPITAL OFFERED FREE BODY MASS INDEX (BMI) SCREENINGS AT TWO HEALTHY SUNDAYS EVENTS (FEBRUARY 23 AND JUNE 23, 2013), WITH INDIVIDUALS FROM MEDICALLY UNDERSERVED POPULATIONS RECEIVING BMI SCREENINGS. IN 2013, TO BETTER IDENTIFY AND ADDRESS THE REGION'S PREVALENT HEALTH NEEDS, ST. FRANCIS JOINED FORCES WITH OTHER HOSPITALS, LOCAL HEALTH DEPARTMENTS, HEALTH CARE PROVIDERS, PUBLIC HEALTH SPECIALISTS FROM ACADEMIC INSTITUTIONS AND COMMUNITY-BASED ORGANIZATIONS TO FORM 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 NSHC.ORG/LONG-ISLAND-HEALTH-COLLABORATIVE. PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEM ST. FRANCIS HOSPITAL (ST. FRANCIS) IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH IS LOCATED ON A SINGLE CAMPUS IN ROSLYN, NEW YORK. ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS, ST. FRANCIS THROUGH ITS DAILY OPERATIONS, PROVIDES TO THE AREA ACUTE, EMERGENT AND OUTPATIENT CARE. ST. FRANCIS 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, 2013, 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 REHABILITATION CENTER 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 EMPLOYEES AND 4,600 MEDICAL STAFF WORKING THROUGHOUT THE SYSTEM, CHS PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES. 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. THE CHS SYSTEM PROVIDES AN ABUNDANCE OF EDUCATION AND SUPPORT GROUPS, AND PROVIDES FREE HEALTH SCREENINGS THROUGH THE HEALTHY SUNDAYS PROGRAMS, HEALTH FAIRS AND OTHER PROGRAMS THAT 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. MERCY MEDICAL CENTER, A RELATED ORGANIZATION, PROVIDES UNCOMPENSATED CARE THROUGH A BROAD RANGE OF COMMUNITY SERVICE PROGRAMS AND CHARITABLE ACTIVITIES. true ST FRANCIS CARDIOVASCULAR PHYSICIANS PC 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113613997 501(C)(3) 14605759 NONE NONE WORKING CAP. SUBSIDY CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 113403968 501(C)(3) 690127 NONE NONE OUTPATIENT CENTERS FRANCISCAN MISSIONARIES OF MARY 3305 WALLACE AVE BRONX NY 10467 132988747 501(C)(3) 250000 NONE NONE GENERAL SUPPORT 3 PART I LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE CHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR ST. FRANCIS HOSPITAL (SFH), ST. FRANCIS CARDIOVASCULAR PHYSICIANS PC (SFPC), AND CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS) AND IS THEREFORE ABLE TO MONITOR THAT SFPC USES THE GRANT AS A WORKING CAPITAL SUBSIDY AND CHS USES THE GRANT FUNDS FOR OUTPATIENT CENTERS. THE FRANCISCAN MISSIONARIES OF MARY PROVIDES UPDATES TO CONTRIBUTORS LIKE ST. FRANCIS HOSPITAL. PART II, LINE 1, COLUMN (H) NAME OF ORGANIZATION OR GOVERNMENT: CATHOLIC HEALTH SYSTEM OF LONG ISLAND (H) PURPOSE OF GRANT: 1) SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND AS A PASS THROUGH TO PROVIDE GENERAL SUPPORT TO THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD; AND 2) PROVIDE SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND TO FUND OUTPATIENT CENTERS THAT PROVIDE CHARITY CARE TO THOSE CENTERS COMMUNITIES. X X X X X X false true false false false false false false false ALAN D GUERCI MD PRESIDENT & CEO 0 1002487 0 170000 0 148309 0 23027 0 30214 0 1374037 0 105347 WILLIAM C ARMSTRONG SVP & CHIEF FINACIAL OFFICER 589925 0 75000 0 157066 0 97349 0 28262 0 947602 0 0 0 RUTH HENNESSEY EXEC VP & CAO 528536 0 86000 0 77893 0 117349 0 26635 0 836413 0 73523 0 JACK SOTERAKIS MD VP MEDICAL AFFAIRS 405788 0 20000 0 62913 0 20349 0 18110 0 527160 0 49886 0 RICHARD SHLOFMITZ MD CHAIRMAN CARDIOLOGY 3386320 0 219045 0 4255 0 20349 0 20013 0 3649982 0 0 0 GEORGE PETROSSIAN MD PHYSICIAN 986049 0 507354 0 3096 0 20349 0 26730 0 1543578 0 0 0 THOMAS PAPPAS MD PHYSICIAN 795725 0 247500 0 3096 0 20349 0 28381 0 1095051 0 0 0 THEOFANI TSIAMTSIOURIS MD PHYSICIAN 795766 0 197200 0 1080 0 20349 0 27718 0 1042113 0 0 0 HOWARD SACHER MD PHYSICIAN PRACTICE LEADER 974376 0 0 0 8265 0 0 0 18388 0 1001029 0 0 0 GARY GECELTER MD DIR/PHYS SURGERY 893066 0 0 0 3096 0 20349 0 30866 0 947377 0 0 0 PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN ALAN D. GUERCI, MD $105,347 VESTED IN PLAN WILLIAM ARMSTRONG $77,000 PARTICIPATION IN PLAN RUTH HENNESSEY $97,000 PARTICIPATION IN PLAN, $73,523 VESTED IN PLAN JACK SOTERAKIS $49,886 VESTED IN PLAN THE AMOUNTS REFLECTED IN COLUMN B(III) AND COLUMN C FOR THE INDIVIDUALS INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP"). THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2013 FORM W-2 BOX, 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NONQUALIFIED RETIREMENT PLANS. PART II, COLUMN B(III) - WILLIAM C ARMSTRONG WILLIAM C ARMSTRONG RECEIVED APPROXIMATELY $141,591 OF VACATION PAYOUT, WHICH IS REPORTED IN COLUMN B(III) AS OTHER REPORTABLE COMPENSATION. A DORMITORY AUTHORITY OF THE STATE OF NY 146000293 64983TH30 2004-11-09 100447098 HOSPITAL CONSTRUCTION false false false A 0 0 99387011 6745930 0 0 1882067 0 0 90129454 629384 0 2008 false false true true A false false false true false 0 false false false true A false false false true false false 0 false 0 false true A true SCHEDULE K, PART I AND PART II - BOND ISSUE PRICE DIFFERENCE THE TOTAL PROCEEDS OF THE BOND ISSUE REPORTED ON PART II, LINE 3 ARE NOT IDENTICAL TO THE ISSUE PRICE LISTED IN PART I, COLUMN (E) DUE TO A PREMIUM ON THE BOND. SCHEDULE K, PART IV, LINE 2C THE REBATE COMPUTATION WAS PERFORMED ON OCTOBER 31, 2013. RICHARD SHLOFMITZ KEY EMPLOYEE PERSONAL/FAMILY X 1000000 934045 false true true 934045 PART II - LOANS TO AND FROM INTERESTED PERSONS (A) NAME OF PERSON: RICHARD SHLOFMITZ, MD FORM 990, PART VI - LINE 6 - MEMBERS OF THE ORGANIZATION THE SOLE MEMBER OF ST. FRANCIS 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 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 ST. FRANCIS HOSPITAL AND AS SUCH HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF ST. FRANCIS HOSPITAL. FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY CHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF ST. FRANCIS HOSPITAL IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERING BODY OF ST. FRANCIS. FORM 990, PART VI, LINE 11B - REVIEW PROCESS FOR FORM 990 THE FORM 990 AND APPROPRIATE SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS (THE BOARD)OF CHS, WHICH HAS BEEN DELEGATED THE REVIEW FUNCTION BY THE BOARD. UPON APPROVAL OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO ALL VOTING MEMBERS OF THE BOARD OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE. THE FORM 990 IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST POLICY DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE BY THE ORGANIZATION'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFERRED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE 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. PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIMSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, LINE 15 - COMPENSATION POLICY THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE SYSTEM CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE POLICY. THE POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER, AND CHIEF OPERATING OFFICERS OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS; D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AN OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE DONE BY AN INDEPENDENT CONSULTANT ANNUALLY. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASURABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE BOARD OF TRUSTEES. FORM 990, PART VI, LINE 19 - DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND. FORM 990, PART VII, SECTION A - LINE 1A HOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. ALAN GUERCI, M.D. PRESIDENT AND 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 CARDIOVASCULAR PHYSICIANS PC (11-3613997); 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)AND ST. CHARLES HOSPITAL (11-1871039). WILLIAM ARMSTRONG, SENIOR VICE PRESIDENT AND CFO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. FRANCIS HOSPITAL (11-2050523); ST. FRANCIS HOSPITAL FOUNDATION (11-2916033); ST. FRANCIS RESEARCH AND EDUCATIONAL CORPORATION INC. (11-3090867); MERCY MEDICAL CENTER (11-1635088); ST. JOSEPH HOSPITAL (11-3438973). RUTH HENNESSEY, EXECUTIVE VP AND CAO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. FRANCIS HOSPITAL (11-2050523); ST. FRANCIS HOSPITAL FOUNDATION (11-2916033); ST. FRANCIS RESEARCH AND EDUCATIONAL CORPORATION INC. (11-3090867). JACK SOTERAKIS, MD, VP MEDICAL AFFAIRS - THE TOTAL HOURS WORKED REPORTED (50.0) RELFECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. FRANCIS HOSPITAL (11-2050523); ST. FRANCIS CARDIOVASCULAR PHYSICIANS P.C. (11-3613997). THOMAS PAPPAS, MD, PHYSICIAN - THE TOTAL HOURS WORKED REPORTED (50.0) RELFECTS TIME WORKED AS A BOARD MEMBER OR HIGHLY COMPENSATED EMPLOYEE FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. FRANCIS HOSPITAL (11-2050523); ST. FRANCIS CARDIOVASCULAR PHYSICIANS P.C. (11-3613997). FORM 990, PART X, LINE 20 - TAX EXEMPT BOND LIABILITIES THE TAX-EXEMPT BOND ISSUANCES REFLECTED ON PART X, LINE 20 CONSIST MAINLY OF TAX-EXEMPT BOND LIABILITIES REPORTED ON SCHEDULE K. A PORTION OF THE 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. TWO BONDS WERE ISSUED TO THE OBLIGATED GROUP, SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION (SERIES 2011 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 CHANGE IN NET ASSETS DEFINED BENEFIT PLAN: 5,267,000 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113403968 SUPPORT ORG NY 501(C)(3) 11A- I NA false CHS SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113555766 SUPPORT ORG NY 501(C)(3) 11A- II CHSLI false CHS AMBULANCE SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 141801961 DORMANT NY 501(C)(3) 3 CHSLI false GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 111888924 HOSPITAL NY 501(C)(3) 3 CHSLI false GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112537396 SELF INSURANC NY 501(C)(3) 11A- I GOOD SAMARTN false MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113434776 TRANSPORTATIO NY 501(C)(3) 11A- I MARYHAVENCTR 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 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 false ST CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN NY 11787 061562701 HOSPITAL NY 501(C)(3) 3 CHSLI false ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 111871039 HOSPITAL NY 501(C)(3) 3 CHSLI false CHS HOME SUPPORT SERVICES INC 15 POWER DRIVE HAUPPAUGE NY 11788 113594561 RESP THERAPY NY 501(C)(3) 9 CATHHOMECARE false ST FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112916033 SUPPORT ORG NY 501(C)(3) 11A- I ST FRANCIS true ST FRANCIS HOSPITAL RESEARCH & EDUCATIO 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113090867 RESEARCH ORG NY 501(C)(3) 11A- I ST FRANCIS true WSNCHS NORTH INC 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 113438973 HOSPITAL NY 501(C)(3) 3 CHSLI false THE ST CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 112983148 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI false THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112716640 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI false WISDOM GARDENS HOUSING DEVELOPMENT FUND 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113559713 SR HOUSING NY 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