2014-11-13T21:16:11-06:00 2013-12-31 PricewaterhouseCoopers LLP 300 Madison Avenue New York NY 10017 990 2013-01-01 113403968 CATHOLIC HEALTH SYSTEM OF LONG ISLAND % CATHOLIC HEALTH SERVICES OF CATH 5167053700 992 NORTH VILLAGE AVENUE Suite ROCKVILLE CENTRE NY 11570 ALAN D GUERCI PRESIDENT & CEO 5167053700 2014-11-10 2013 2015-11-30 17:44:51Z CATHOLIC HEALTH SERVICES OF LI ALAN D GUERCI MD 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 35168066 false 0928 X HTTP://WWW.CHSLI.ORG X 1997 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 16 0 0 1740000 12814178 19563012 21387807 1135268 966081 0 0 22438280 35168066 1850000 9359454 0 0 9059360 10056037 0 0 0 10822360 12010201 21731720 31425692 706560 3742374 147160189 151297149 146749168 147143754 411021 4153395 X CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHSLI), 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 20540588 0 21387807 CATHOLIC HEALTH SERVICES OF LONG ISLAND PROMOTES THE EFFICIENT GOVERNANCE AND MANAGEMENT OF THE SUPPORTED ORGANIZATIONS. IN ADDITION, CHSLI'S COOPERATIVE PLANNING AND EFFICIENT USE OF RESOURCES ASSISTS THE SUPPORTED ORGANIZATIONS TO ACHIEVE THEIR RESPECTIVE AND COLLABORATIVE GOALS. 1630000 1630000 0 SUPPORTING AND STRENGTHENING THE MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE. 7704967 7704967 0 SUPPORTING AND STRENGTHENING THE MINISTRIES OF THE CHSLI HEALTH SYSTEM AND RELATED ORGANIZATIONS. 24487 24487 0 29900042 true true false false false false false false false false true false true true true true false true false false true true false false false false false true false true true false false false false false false false false false false false false false false true true true true false false true 36 0 true 16 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 CATHOLIC HEALTH SERVICES OF 5167051938 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 X RICHARD JJ SULLIVAN JR CHAIR 2.0 X X Sister Elaine Callahan OP VICE CHAIR 2.0 X X Thomas E Christman TREASURER 2.0 X X Eugene Murphy SECRETARY 2.0 X X VIRGINIA EWEN TRUSTEE SINCE JAN 2013 2.0 X Barbara Ellen Black TRUSTEE 2.0 X Thomas Dowling Jr MD TRUSTEE 2.0 X Sister Audrey Harsen TRUSTEE 2.0 X Sister Margaret John Kelly DC TRUSTEE 2.0 X Rev Msgr Robert Morrissey TRUSTEE 2.0 X Patricia Nazemetz TRUSTEE 2.0 X Joseph Tantillo TRUSTEE 2.0 X Brian McGuire TRUSTEE 2.0 X FRANK L KURRE TRUSTEE SINCE JAN 2013 2.0 X CHRIS PASCUCCI TRUSTEE SINCE APRIL 2013 2.0 X DANIEL T ROWE TRUSTEE SINCE JAN 2013 2.0 X REV MSGR JAMES VLAUN TRUSTEE 1.0 X 0 0 0 JOHN J WAGNER TRUSTEE 1.0 X 0 0 0 ALAN D GUERCI MD PRESIDENT&CEO SINCE JULY 2013 50.0 X X 1320796 0 53241 COLLEEN BLYE EXEVUTIVE VP & CFO 50.0 X 1054087 0 418912 DENNIS VERZI CHIEF OPERATING OFFICER 50.0 X 739433 529708 132701 David Decerbo EVP & GENERAL COUNSEL 50.0 X 794112 0 213415 Joel Yohai MD EXEC VP MED AFFRS & CMO 50.0 X 705350 0 38996 Anthony Pellicano SVP CHIEF HR OFFICER 50.0 X 626682 0 124514 JAMES CALDAS EVP STRATEGIC PLANNING 50.0 X 905395 0 1824265 JOSEPH TOMAINO EVP CONTINUING CARE 50.0 X 698389 0 414909 Lawrence McManus FORMER PRESIDENT & CEO 0.0 X 1525911 0 26128 8370155 529708 3247081 11 true true false ISEMAN CUNNINGHAM RIESTER HYDE 9 THURLOW TERRACE ALBANY NY 12203 LEGAL SERVICES 1200884 DELOITTE TOUCHE LLP 4152 COLLECTIONS CENTER DR CHICAGO IL 60693 CONSULTING SERVICES 592418 PROSKAUER ROSE LLP 1585 BROADWAY NEW YORK NY 10036 LEGAL SERVICES 294909 PARK STRATEGIES LLC 101 PARK AVENUE SUITE 2506 NEW YORK NY 10178 CONSULTING SERVICES 220000 KPMG LLP 345 PARK AVENUE NEW YORK NY 10154 AUDITING SERVICES 197500 12 12630000 184178 12814178 MANAGEMENT SERVICES REVENUE 900099 21387807 21387807 21387807 966081 966081 0 0 0 0 0 0 0 0 0 0 35168066 21387807 966081 9344454 9344454 0 15000 15000 0 3719170 3719170 0 5003791 5003791 732193 732193 330597 330597 270286 270286 0 1183748 1183748 200333 200333 0 0 0 2286370 2286370 1150 1150 29920 29920 0 0 0 128427 128427 62969 62969 0 0 3770079 3770079 0 55031 55031 9168 9168 MEMBERSHIP DUES 2711155 2711155 CONTRIBUTIONS 251488 251488 ALL OTHER EXPENSES 1320363 1316389 3974 31425692 29900042 1525650 0 16199956 55073123 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1624605 1914980 2546623 2419595 140847 127028 0 0 0 0 64500274 20526936 0 0 64694507 73655082 147160189 151297149 13628873 12877426 0 0 0 0 80876197 80310992 0 0 0 0 36651192 35793627 0 0 15592906 18161709 146749168 147143754 X 238108 3801758 172913 351637 0 0 411021 4153395 147160189 151297149 3742374 X false true X true false X X X false false false GOOD SAMARITAN HOSPITAL MEDICAL CENTER 111888924 03 true true true 0 MERCY MEDICAL CENTER 111635088 03 true true true 0 ST CHARLES HOSPITAL 111871039 03 true true true 0 ST FRANCIS HOSPITAL 112050523 03 true true true 0 ST CATHERINE OF SIENA MEDICAL CENTER 061562701 03 true true true 0 WSNCHS NORTH LLC 113438973 03 true true true 0 SIENA VILLAGE INC 061569129 09 true true true 0 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 113284066 09 true true true 0 CATHOLIC HOME CARE 112126736 09 true true true 0 GOOD SHEPHERD HOSPICE 112958438 09 true true true 0 CHS HOME SUPPORT SERVICES INC 113594561 09 true true true 0 MARYHAVEN CENTER OF HOPE 112861698 09 true true true 0 MARYHAVEN SCHOOL CORPORATION 112861690 02 true true true 0 13 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 106444 100302 6142 146704 143274 3430 2289502 2174948 114554 3973 1071 2902 127028 TRUSTEE HELD ASSETS 20526936 F 20526936 DUE FROM RELATED ORGANIZATIONS 49069576 INVESTMENT IN SUBSIDIARIES 3292460 EXECUTIVE RETIREMENT ASSETS 16235610 AWUL FREECARE 3741503 DONOR RESTRICTED FUNDS 517146 457B FUNDS 798787 73655082 0 DUE TO RELATED ORGS & AFFILIATES 850000 EXECUTIVE RETIREMENT LIABILITY 17311709 18161709 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 Central America and the Caribbean Grantmaking 15000 15000 15000 Central America and the Caribbean MEDICAL CARE HAITI 10000 CHECK NONE NONE 1 0 false false false false false false PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE 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. THE CAREGIVERS COMMITTEE, COMPRISED OF STAFF WHO ARE DONATING THEIR SERVICES, MANAGE THE CAREGIVERS FUND. THROUGHOUT THE YEAR, ORGANIZATIONS SUBMIT GRANT APPLICATIONS TO REQUEST FUNDS THAT ARE USED TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. THE CAREGIVERS COMMITTEE REVIEWS THESE APPLICATIONS, AND CHOOSES RECIPIENTS BASED ON THE FOLLOWING CRITERIA: I) CLEAR AND IDENTIFIED NEED, II) ABILITY TO USE THE FUNDS RESPONSIBLY, III) CARE FOR THE CAREGIVERS ON THE FRONT LINE, IV) ABILITY OF THE RECIPIENTS TO USE THE FUNDS FOR THE RECOMMENDED PURPOSES, AND V) CONFIRMATION OF THE LEGAL STATUS OF THE RECIPIENT. FOLLOWING SELECTION, THE COMMITTEE DIRECTS THE GIFTS TO BE MADE TO RECIPIENTS WITH COVER LETTERS INDICATING THE INTENDED PURPOSES. RECIPIENTS ARE ASKED TO PROVIDE FOLLOW-UPS ON THE USE OF THE FUNDS TO THE COMMITTEE WITHIN SIX MONTHS OF THE USE OF FUNDS. true DIOCESE OF ROCKVILLE CENTRE - CATHOLIC MINISTRIES 50 N PARK AVE ROCKVILLE CTR NY 11570 111837437 501(c)(3) 1630000 NONE NONE GENERAL SUPPORT WSNCHS INC (ST JOSEPH) 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 113438973 501(C)(3) 7704967 NONE NONE GENERAL SUPPORT DOMINICAN SISTERS OF AMITYVILLE 555 ALBANY AVE AMITYVILLE NY 11701 141831211 501(C)(3) 9487 NONE NONE ELDERLY SISTERS CARE 3 PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE THE DIOCESE OF ROCKVILLE CENTRE PROVIDES ANNUAL UPDATES TO ALL CONTRIBUTORS TO THE CATHOLIC MINISTRIES APPEAL; WHETHER PARISHIONERS OR CORPORATE CONTRIBUTORS LIKE CHSLI. CHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR CATHOLIC HEALTH SYSTEM OF LONG ISLAND AND WSNCHS, INC. (ST JOSEPH) AND IS THEREFORE ABLE TO MONITOR THAT WSNCHS, INC. (ST JOSEPH) USES THE GRANT FUNDS AS GENERAL SUPPORT. 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. THE CAREGIVERS COMMITTEE, COMPRISED OF STAFF WHO ARE DONATING THEIR SERVICES, MANAGE THE CAREGIVERS FUND. THROUGHOUT THE YEAR, ORGANIZATIONS SUBMIT GRANT APPLICATIONS TO REQUEST FUNDS THAT ARE USED TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. THE CAREGIVERS COMMITTEE REVIEWS THESE APPLICATIONS, AND CHOOSES RECIPIENTS BASED ON THE FOLLOWING CRITERIA: I) CLEAR AND IDENTIFIED NEED, II) ABILITY TO USE THE FUNDS RESPONSIBLY, III) CARE FOR THE CAREGIVERS ON THE FRONT LINE, IV) ABILITY OF THE RECIPIENTS TO USE THE FUNDS FOR THE RECOMMENDED PURPOSES, AND V) CONFIRMATION OF THE LEGAL STATUS OF THE RECIPIENT. FOLLOWING SELECTION, THE COMMITTEE DIRECTS THE GIFTS TO BE MADE TO RECIPIENTS WITH COVER LETTERS INDICATING THE INTENDED PURPOSES. RECIPIENTS ARE ASKED TO PROVIDE FOLLOW-UPS ON THE USE OF THE FUNDS TO THE COMMITTEE WITHIN SIX MONTHS OF THE USE OF FUNDS. PART II, LINE 1 COLUMN (H) NAME OF ORGANIZATION OR GOVERNMENT: DIOCESE OF ROCKVILLE CENTRE - CATHOLIC MINISTRIES APPEAL (H) PURPOSE OF GRANT OR ASSISTANCE: TO PROVIDE GENERAL SUPPORT OF 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. X X X X X X true true false false false false false false false Lawrence McManus FORMER PRESIDENT & CEO 0 0 0 0 1525911 0 0 0 26128 0 1552039 0 1525911 0 David Decerbo EVP & GENERAL COUNSEL 599701 0 175000 0 19411 0 184027 0 29388 0 1007527 0 0 0 Joel Yohai MD EXEC VP MED AFFRS & CMO 309662 0 203000 0 192688 0 28432 0 10564 0 744346 0 0 0 Anthony Pellicano SVP CHIEF HR OFFICER 507962 0 100000 0 18720 0 123027 0 1487 0 751196 0 0 0 JAMES CALDAS EVP STRATEGIC PLANNING 724676 0 159000 0 21719 0 1803934 0 20331 0 2729660 0 0 0 JOSEPH TOMAINO EVP CONTINUING CARE 581586 0 100000 0 16803 0 393027 0 21882 0 1113298 0 0 0 ALAN D GUERCI MD PRESIDENT&CEO SINCE JULY 2013 1002487 0 170000 0 148309 0 23027 0 30214 0 1374037 0 0 0 COLLEEN BLYE EXEVUTIVE VP & CFO 766598 0 250000 0 37489 0 391027 0 27885 0 1472999 0 0 0 DENNIS VERZI CHIEF OPERATING OFFICER 419676 231688 0 150000 319757 148020 11513 109386 5942 5860 756888 644954 0 0 PART I, LINE 4A - SEVERANCE PAYMENT JAMES CALDAS, EVP STRATEGIC PLANNING IS ENTITLED TO SEVERANCE OF $1,531,826. LAWRENCE MCMANUS, FORMER PRESIDENT & CEO RECEIVED PAYMENT OF SEVERANCE OF $1,164,618. PART I, LINE 4B - SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN COLLEEN BLYE $368,000 PARTICIPATION IN PLAN LAWRENCE MCMANUS $321,015 VESTED IN PLAN DAVID DECERBO $161,000 PARTICIPATION IN PLAN JOEL YOHAI, MD $15,000 PARTICIPATION IN PLAN ANTHONY PELLICANO $100,000 PARTICIPATION IN PLAN JOSEPH TOMAINO $370,000 PARTICIPATION IN PLAN JAMES CALDAS $251,000 PARTICIPATION IN PLAN DENNIS VERZI $98,000 PARTICIPATION IN PLAN. $303,670 VESTED IN PLAN ALAN D. GUERCI, MD $105,347 VESTED IN PLAN PART II - COMPENSATION 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 (F) - COMPENSATION REPORTED AS DEFERRED ON PRIOR FORM 990 DENNIS VERZI BECAME A KEY EMPLOYEE OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND AS OF JULY 2013. HIS SERP PAYMENT OF $199,289 WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION ON THE PRIOR 990 OF ST. CATHERINE OF SIENA MEDICAL CENTER, A RELATED ORGANIZATION. ALAD D. GUERCI, MD BECAME AN OFFICER OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND AS OF JULY 2013. HIS SERP PAYMENT OF $105,347 WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION ON THE PRIOR 990 OF ST. FRANCIS HOSPITAL, A RELATED ORGANIZATION. A SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORP 273722095 86476RAU8 2011-12-14 192616434 CAPITAL EXPEN, REFUNDING 1999,2000 false false false B NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE CORP 274291221 63165BAKO 2011-12-14 65530479 CAPITAL EXPEN, REFUNDING 1999,2000 false false false A 0 0 192616434 0 0 0 3077681 0 0 7969428 178409835 3159490 false false false true B 0 0 65530479 0 0 0 1093112 0 0 15524031 37671277 11242059 false false false true A false true true true false 0 false false false true B false true true true false 0 false false false true A false true false false false false 0 false 0 false true B false true false false false false 0 false 0 false true A true B true FORM 990, SCHEDULE K THE TAX-EXEMPT BOND ISSUANCES REFLECTED IN SCHEDULE K, PART I ARE ISSUED ON BEHALF OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND'S RELATED OPERATING ENTITIES. PLEASE NOTE THAT SCHEDULE K, PARTS II, III AND IV HAVE BEEN COMPLETED BASED ON THE TOTAL AMOUNT OF THE TAX-EXEMPT BOND ISSUANCES FOR THE GROUP, NOT BY EACH INDIVIDUAL ENTITY, AS THE OFFERING WAS ON BEHALF OF THE GROUP AS A WHOLE. SCHEDULE K, PART III BOTH THE SUFFOLK COUNTY AND NASSAU COUNTY BONDS REPORT PRIVATE BUSINESS USE OF 0% FOR TAX YEAR ENDED 12/31/2013. CATHOLIC HEALTH SYSTEM OF LONG ISLAND'S BOND COUNSEL HAS A PROCESS IN PLACE TO MONITOR PRIVATE BUSINESS USE. FORM 990, PART III, LINE 4D - OTHER PROGRAM SERVICES 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. THE CAREGIVERS COMMITTEE, COMPRISED OF STAFF WHO ARE DONATING THEIR SERVICES, MANAGE THE CAREGIVERS FUND. THROUGHOUT THE YEAR, ORGANIZATIONS SUBMIT GRANT APPLICATIONS TO REQUEST FUNDS THAT ARE USED TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. THE CAREGIVERS COMMITTEE REVIEWS THESE APPLICATIONS, AND CHOOSES RECIPIENTS BASED ON THE FOLLOWING CRITERIA: I) CLEAR AND IDENTIFIED NEED, II) ABILITY TO USE THE FUNDS RESPONSIBLY, III) CARE FOR THE CAREGIVERS ON THE FRONT LINE, IV) ABILITY OF THE RECIPIENTS TO USE THE FUNDS FOR THE RECOMMENDED PURPOSES, AND V) CONFIRMATION OF THE LEGAL STATUS OF THE RECIPIENT. FOLLOWING SELECTION, THE COMMITTEE DIRECTS THE GIFTS TO BE MADE TO RECIPIENTS WITH COVER LETTERS INDICATING THE INTENDED PURPOSES. RECIPIENTS ARE ASKED TO PROVIDE FOLLOW-UPS ON THE USE OF THE FUNDS TO THE COMMITTEE WITHIN SIX MONTHS OF THE USE OF FUNDS. FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHSLI) IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS. CHSLI IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE. FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE,AS THE SPONSOR OF CATHOLIC HEALTH SERVICES OF LONG ISLAND HAS THE ABILITY TO NOMINATE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY AS OUTLINED IN THE BY-LAWS OF CATHOLIC HEALTH SERVICES OF LONG ISLAND, CERTAIN BOARD DECISIONS ALSO REQUIRE THE APPROVAL OF THE ORGANIZATION'S MEMBERS. FORM 990, PART VI, LINE 11B - REVIEW PROCESS OF FORM 990 THE FORM 990 AND APPROPRIATE SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS (THE BOARD), WHICH HAS BEEN DELEGATED THE REVIEW FUNCTION BY THE BOARD. UPON APPROVAL OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO ALL VOTING MEMBERS OF THE BOARD 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 DISCLOSURES SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFERRED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. IF A CONFLICT OF INTEREST IS IDENTIFIED AND IF A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANZIATION WITHOUT A CONFLICT,AND WISHES TO GO FORWARD WITH IT. PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIMSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, LINE 15 - COMPENSATION POLICY THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE SYSTEM CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE POLICY. THE POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER, AND CHIEF OPERATING OFFICERS OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS; D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AN OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE DONE BY AN INDEPENDENT CONSULTANT ANNUALLY. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE BOARD OF TRUSTEES. FORM 990, PART VI, LINE 19 - DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION 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. COLLEEN BLYE, EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER - 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) AND CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968). 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 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); ST. CHARLES HOSPITAL (11-1871039). CHS ACCOUNTABLE CARE ORGANIZATION LLC 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 ACCNTBLE CARE NY 0 0 CHSLI CHS PHYSICIAN HOSPITAL ORGANIZATION LLC 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 PHYSICIAN ORG NY 0 523000 CHSLI CHS SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113555766 SUPPORT ORG NY 501(C)(3) 11A- II CHSLI true CHS AMBULANCE SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 141801961 DORMANT NY 501(C)(3) 3 CHSLI true GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 111888924 HOSPITAL NY 501(C)(3) 3 CHSLI true GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112537396 SELF INSURANC NY 501(C)(3) 11A- I GOOD SAMARTN true MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113434776 TRANSPORTATIO NY 501(C)(3) 11A- I MARYHAVENCTR true MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861698 Prgm-disabled NY 501(C)(3) 9 CHSLI true MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861690 Schl-disabled NY 501(C)(3) 2 MARYHAVENCTR true THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113638367 SUPPORT ORG NY 501(C)(3) 11A- I MARYHAVENCTR true 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 true OUR LADY OF CONSOLATION GERIATRIC CARE 111 BEACH DRIVE WEST ISLIP NY 11795 113284066 LT NURSE CARE NY 501(C)(3) 9 CHSLI true RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112499790 RENTING NY 501(C)(2) MARYHAVENCTR true SIENA VILLAGE INC 2000 BISHOPS ROAD SMITHTOWN NY 11787 061569129 SR HOUSING NY 501(C)(3) 9 STCATHERINE true ST CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN NY 11787 061562701 HOSPITAL NY 501(C)(3) 3 CHSLI true ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 111871039 HOSPITAL NY 501(C)(3) 3 CHSLI true CHS HOME SUPPORT SERVICES INC 15 POWER DRIVE HAUPPAUGE NY 11788 113594561 RESP THERAPY NY 501(C)(3) 9 CATHHOMECARE true ST FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112050523 HOSPITAL NY 501(C)(3) 3 CHSLI true 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 true THE ST CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 112983148 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI true THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112716640 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI true WISDOM GARDENS HOUSING DEVELOPMENT FUND 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113559713 SR HOUSING NY 501(C)(3) 9 MARYHAVENCTR true GOOD SHEPHERD HOSPICE 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 112958438 HOSPICE SVC NY 501(C)(3) 9 CHSLI true ST CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 412076312 SUPPORT ORG NY 501(C)(3) 11A- I ST CHARLES true GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 770611240 SUPPORT ORG NY 501(C)(3) 11A- I GOOD SAMARTN true MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 550813603 SUPPORT ORG NY 501(C)(3) 11A- I MERCY MEDCTR true ST CATHERINE OF SIENA MEDICAL CTR FDN 50 ROUTE 25A SMITHTOWN NY 11787 271459941 SUPPORT ORG NY 501(C)(3) 11A- I STCATHERINE true CATHOLIC HOME CARE FOUNDATION 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 452907761 SUPPORT ORG NY 501(C)(3) 11A- I CATHHOMECARE true GOOD SHEPHERD HOSPICE FOUNDATION 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 263169427 SUPPORT ORG NY 501(C)(3) 11A- I GOODSHEPHERD true OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP NY 11795 450517566 SUPPORT ORG NY 501(C)(3) 11A- I OURLADYOFC true RVC SUPPORT 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 271531084 REAL ESTATE NY 501(C)(3) 11A- I CHSLI true ST FRANCIS CARDIOVASCULAR PHYSICIANS P 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113613997 HEALTHCARESVC NY 501(C)(3) 11A- I ST FRANCIS true RVC INSURANCE COMPANYINC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 208067039 CAPTIVE INS NY 501(C)(3) 11A- II CHSLI true SAMARITAN EMERGENCY MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208243412 HEALTHCARESVC NY 501(C)(4) GOOD SAMARTN true 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 CENTRE NY 115719024 113633515 PHYSICIAN SVC NY MERCY MED CTR S-CORP false true true true true true false false false true true true true true false true true true true true ST CHARLES HOSPITAL C,S 208139 COST ST CATHERINE OF SIENA MEDICAL CENTER S 196580 COST ST CATHERINE OF SIENA MEDICAL CENTER B,C,J 4533952 COST WSNCHS NORTH INC (ST JOSEPH HOSPITAL) C,S 205227 COST CHS SERVICES INC C,Q 10382783 COST GOOD SAMARITAN HOSPITAL MEDICAL CENTER S 502356 COST MERCY MEDICAL CENTER S 174840 COST MERCY MEDICAL CENTER BC,JK 753073 COST ST FRANCIS HOSPITAL S 438127 COST WSNCHS NORTH INC (ST JOSEPH HOSPITAL) BJ,L, 8117854 COST OUR LADY OF CONSOLATION GERIATRIC CARE CENTER C,L,Q 416626 COST CATHOLIC HOME CARE C,L,Q 116297 COST ST FRANCIS HOSPITAL BC,J, 1677733 COST GOOD SAMARITAN HOSPITAL MEDICAL CENTER C,J,L 2273886 COST