FURP.ORG / PUBLIC DATA EXPLORER

CENTRAL SUFFOLK HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
CENTRAL SUFFOLK HOSPITAL (EIN 11-1661359)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-14
IRS object ID
201413189349307056
Schema version
2013v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2014-11-14T15:01:18-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN131517563PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LOEB & TROPER LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1655 THIRD AVENUE 12TH FLOORAddressLine1
CityNEW YORKCity
StateNYState
ZIP Code10017ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN111661359EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CENTRAL SUFFOLK HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlCENTBusinessNameControlTxt
Phone6315486064PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1
CityRIVERHEADCity
StateNYState
ZIP Code11901ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANDREW MITCHELLPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone6315486064PhoneNum
Signature2014-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonISRAEL TANNENBAUMPreparerPersonNm
PTINP01589203PTIN
Phone2128674000PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1PECONIC BAY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Principal OfficerANDREW MITCHELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1
CityRIVERHEADCity
StateNYState
ZIP Code11901ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$155,416,992GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PBMEDICALCENTER.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1951FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionSEE SCHEDULE OCENTRAL SUFFOLK HOSPITAL (CSH) IS A NOT-FOR-PROFIT HOSPITAL CONSISTING OF 122 ACUTE CARE BEDS, A 60-BED SKILLED NURSING FACILITY AND A CERTIFIED HOME CARE AGENCY. CSH PROVIDES A FULL RANGE OF HEALTH CARE SERVICES TO THE LOCAL COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body28VotingMembersGoverningBodyCnt
Voting Members Independent24VotingMembersIndependentCnt
Total Employee1314TotalEmployeeCnt
Total Volunteers162TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$8,915,623PYContributionsGrantsAmt
CY Contributions Grants$4,026,717CYContributionsGrantsAmt
PY Program Service Revenue$133,860,699PYProgramServiceRevenueAmt
CY Program Service Revenue$142,848,353CYProgramServiceRevenueAmt
PY Investment Income$47,893PYInvestmentIncomeAmt
CY Investment Income$1,158,719CYInvestmentIncomeAmt
PY Other Revenue$798,951PYOtherRevenueAmt
CY Other Revenue$3,058,511CYOtherRevenueAmt
PY Total Revenue$143,623,166PYTotalRevenueAmt
CY Total Revenue$151,092,300CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$77,138,387PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$80,736,732CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$146,701CYTotalFundraisingExpenseAmt
PY Other Expenses$61,178,596PYOtherExpensesAmt
CY Other Expenses$66,474,188CYOtherExpensesAmt
PY Total Expenses$138,316,983PYTotalExpensesAmt
CY Total Expenses$147,210,920CYTotalExpensesAmt
PY Revenues Less Expenses$5,306,183PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,881,380CYRevenuesLessExpensesAmt
Total Assets BOY$119,049,801TotalAssetsBOYAmt
Total Assets EOY$124,631,163TotalAssetsEOYAmt
Total Liabilities BOY$104,485,885TotalLiabilitiesBOYAmt
Total Liabilities EOY$100,700,781TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$14,563,916NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$23,930,382NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCENTRAL SUFFOLK HOSPITAL (CSH) IS A NOT-FOR-PROFIT HOSPITAL CONSISTING OF 122 ACUTE CARE BEDS, A 60-BED SKILLED NURSING FACILITY AND A CERTIFIED HOME CARE AGENCY. CSH PROVIDES A FULL RANGE OF HEALTH CARE SERVICES TO THE LOCAL COMMUNITY.MissionDesc
Significant New Program SrvcYes (1)SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$113,289,786ExpenseAmt
Revenue$142,848,353RevenueAmt
DescCOMPREHENSIVE HEALTHCARE SERVICES INCLUDING EMERGENCY, SURGICAL, MEDICAL, ICU AND OBSTETRICS/GYNECOLOGICAL. TOTAL PATIENT DAYS FOR ALL INPATIENT SERVICES WERE 49,408. TOTAL OUTPATIENT VISITS WERE 98,209.Desc
Total Program Service Expenses$113,289,786TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of ArtYes (1)CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer EntYes (1)BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (1)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document88IRPDocumentCnt
IRP Document W2 G1IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee1314EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members28GoverningBodyVotingMembersCnt
Independent Voting Member24IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHAEL F O'DONNELLBusinessNameLine1
FieldValueIRS element (for citing)
Phone6315486074PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1
CityRIVERHEADCity
StateNYState
ZIP Code11901ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (40 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
ANDREW MITCHELL
CHIEF EXECUTIVE OFFICER/PRESIDENT22.5015.00Yes (X)Yes (X)$574,386$0$54,252
GERARD ZUNNO
COO / BOARD MEMBER37.50Yes (X)Yes (X)$246,406$0$34,055
JESSE R GOODALE
PAST CHAIR1.00Yes (X)Yes (X)$0$0$0
SHERRY PATTERSON
CHAIR15.00Yes (X)Yes (X)$0$0$0
J GORDON HUSZAGH
VICE CHAIR15.0010.00Yes (X)Yes (X)$0$0$0
CHARLES MASSOUD
TREASURER15.00Yes (X)Yes (X)$0$0$0
ANDREW MENDELSON
SECRETARY15.00Yes (X)Yes (X)$0$0$0
MARC ALESSI
BOARD MEMBER1.00Yes (X)$0$0$0
KENN BARRA
BOARD MEMBER1.001.00Yes (X)$0$0$0
MICHAEL DEMPSEY MD
BOARD MEMBER1.00Yes (X)$0$0$0
JAMES R FARRELL
BOARD MEMBER1.00Yes (X)$0$0$0
ROBERT GAFFNEY
BOARD MEMBER1.00Yes (X)$0$0$0
JOSEPH GERGELA
BOARD MEMBER10.00Yes (X)$0$0$0
RICHARD ISRAEL
BOARD MEMBER1.001.00Yes (X)$0$0$0
JOAN LEVAN
BOARD MEMBER1.001.00Yes (X)$0$0$0
MARILYN A MCLAUGHLIN MD
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD V MUSTO MD
BOARD MEMBER1.00Yes (X)$0$0$0
STEVEN OUZOUNIAN MD
BOARD MEMBER1.00Yes (X)$0$0$0
REUVEN PASTERNAK MD
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD RUBENSTIEN MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
GEORGE RUGGIERO DO
BOARD MEMBER1.00Yes (X)$0$0$0
SCOTT B SHEREN MD
BOARD MEMBER10.00Yes (X)$0$0$0
WILLIAM SIEMERS
BOARD MEMBER1.00Yes (X)$0$0$0
GEORGE SUMMERS
BOARD MEMBER1.00Yes (X)$0$0$0
MARY YARUSSO
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD L WINSLOW
BOARD MEMBER1.001.00Yes (X)$0$0$0
JOSEPH VAN DE WETERING
BOARD MEMBER1.001.00Yes (X)$0$0$0
STANLEY ZINBERG MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
ALAN SCHECHTER
EXECUTIVE VICE PRESIDENT37.50Yes (X)$445,259$0$21,525
MICHAEL O'DONNELL
CHIEF FINANCIAL OFFICER37.50Yes (X)$268,602$0$51,583
DEMETRIOS KADENAS
CHIEF DEVELOPMENT OFFICER37.50Yes (X)$186,065$0$9,528
JAY ZUCKERMAN
CORPORATE COMPLIANCE OFFIC37.50Yes (X)$210,749$0$2,775
RONALD MCMANUS
COO OF PBHS37.50$212,438$0$51,583Yes (X)
RICHARD KUBIAK
CHIEF MEDICAL OFFICER37.50$328,332$0$51,583Yes (X)
CHERYL MAKOSKE
VP FINANCE37.50$179,509$0$22,454Yes (X)
PETER SULTAN MD
PHYSICIAN37.50$1,028,568$0$44,083Yes (X)
DAVID PRENTISS MD
PHYSICIAN37.50$257,126$0$13,000Yes (X)
MAHMOOD AFGHANI MD
PHYSICIAN37.50$232,402$0$33,789Yes (X)
JANE FRANZ
SENIOR VP CHIEF PLANNING OFFICER37.50$236,496$0$0Yes (X)
STEPHEN JOHN MD
PHYSICIAN37.50$231,647$0$20,199Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$4,637,985TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$410,409TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K107IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
SIEMENS
PO BOX 7777W3580PHILADELPHIAPA19175INFORMATION TECHNOLOGY$3,366,324
SODEXO
PO BOX 81049WOBURNMA01813CAFETERIA SERVICES$1,506,900
CROTHALL FACILITIES
955 CHESTERBROOK BLVDWAYNEPA19087HOUSEKEEPING SERVICES$587,117
UNITEX TEXTILE
401 SO MACQUESTEN PKWYMT VERNONNY10550LAUNDRY & LINEN$493,172
MATTOO & BHAT
23-14 COLLEGE POINT BLVDCOLLEGE POINTNY11356DIALYSIS SERVICES$485,491
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K13CntrctRcvdGreaterThan100KCnt
Fundraising$334,891FundraisingAmt
Government Grants$2,469,386GovernmentGrantsAmt
All Other Contributions$1,222,440AllOtherContributionsAmt
Total Contributions$4,026,717TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT CARE621400$142,691,073$142,691,073
PROVISION OF MEDICAL SERVICES BY621110$157,280$157,280
FieldValueIRS element (for citing)
Total Program Service Revenue$142,848,353TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$110,054TotalRevenueColumnAmt
Exclusion$110,054ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$5,243,220SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$4,194,555SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$1,048,665SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,048,665TotalRevenueColumnAmt
Exclusion$1,048,665ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$27,405FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$334,891ContriRptFundraisingEventAmt
Fundraising Direct Expenses$130,137FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$102,732TotalRevenueColumnAmt
Exclusion-$102,732ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MEANINGFUL USE900099$1,989,246$1,989,246
SELF INSURANCE TRUST900099$416,082$416,082
CAFETERIA624210$337,020$337,020

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$418,895TotalRevenueColumnAmt
Exclusion$418,895ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$3,161,243OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$151,092,300TotalRevenueColumnAmt
Related Or Exempt Func Income$142,848,353RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$4,272,077ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,951,084TotalAmt
Management And General$2,951,084ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$57,576,405TotalAmt
Program Services$44,416,188ProgramServicesAmt
Management And General$13,160,217ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$4,380,650TotalAmt
Program Services$2,749,971ProgramServicesAmt
Management And General$1,630,679ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$11,591,148TotalAmt
Program Services$9,857,359ProgramServicesAmt
Management And General$1,733,789ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,237,445TotalAmt
Program Services$3,261,031ProgramServicesAmt
Management And General$976,414ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$739,033TotalAmt
Management And General$739,033ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$177,000TotalAmt
Management And General$177,000ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$10,785TotalAmt
Management And General$10,785ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$65,196TotalAmt
Management And General$65,196ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$11,577,944TotalAmt
Program Services$11,185,252ProgramServicesAmt
Management And General$392,692ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$683,062TotalAmt
Program Services$536,361ProgramServicesAmt
Fundraising$146,701FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$27,888,581TotalAmt
Program Services$20,730,344ProgramServicesAmt
Management And General$7,158,237ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,336,324TotalAmt
Management And General$3,336,324ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,551,426TotalAmt
Program Services$5,551,426ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$123,241TotalAmt
Program Services$94,843ProgramServicesAmt
Management And General$28,398ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$208,055TotalAmt
Program Services$208,055ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$5,906,796TotalAmt
Program Services$5,906,796ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,317,500TotalAmt
Program Services$3,317,500ProgramServicesAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescNEW YORK STATE ASSESSMEDesc
Total$750,229TotalAmt
Program Services$750,229ProgramServicesAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,139,016TotalAmt
Program Services$4,724,431ProgramServicesAmt
Management And General$1,414,585ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$147,210,920TotalAmt
Program Services$113,289,786ProgramServicesAmt
Management And General$33,774,433ManagementAndGeneralAmt
Fundraising$146,701FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$13,350,611BOYAmt
EOY$15,193,448EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$6,102,830BOYAmt
EOY$6,148,837EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,815,070BOYAmt
EOY$2,906,560EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$14,969,476BOYAmt
EOY$14,595,591EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$4,201,170BOYAmt
EOY$5,651,299EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,277,580BOYAmt
EOY$3,164,225EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$653,411BOYAmt
EOY$879,896EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$141,581,503LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$78,045,012LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$59,782,553BOYAmt
EOY$63,536,491EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,845,519BOYAmt
EOY$4,246,607EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$1,270,284EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$8,051,581BOYAmt
EOY$7,037,925EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$119,049,801BOYAmt
EOY$124,631,163EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$19,892,668BOYAmt
EOY$21,678,518EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$38,260,000BOYAmt
EOY$36,210,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$7,550,803BOYAmt
EOY$8,209,226EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$38,782,414BOYAmt
EOY$34,603,037EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$104,485,885BOYAmt
EOY$100,700,781EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,057,925BOYAmt
EOY$18,915,554EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,719,083BOYAmt
EOY$4,227,920EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$786,908BOYAmt
EOY$786,908EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,563,916BOYAmt
EOY$23,930,382EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$119,049,801BOYAmt
EOY$124,631,163EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$3,881,380ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$75,400NetUnrlzdGainsLossesInvstAmt
Investment Expense$65,196InvestmentExpenseAmt
Other Changes In Net Assets$5,344,490OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$10,785OtherActivitiesAmt
Total Lobbying Expenditures$10,785TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationPORTION OF MEMBERSHIP DUES ASSOCIATED WITH LOBBYING ACTIVITIESExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Collection Used Pub ExhibitionYes (X)CollectionUsedPubExhibitionInd
Solicited Assets Sale0SolicitedAssetsSaleInd

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$786,908BeginningYearBalanceAmt
Investment Earnings Or Losses$100,483InvestmentEarningsOrLossesAmt
Other Expenditures$100,483OtherExpendituresAmt
End Year Balance$786,908EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$786,908BeginningYearBalanceAmt
Investment Earnings Or Losses$36,084InvestmentEarningsOrLossesAmt
Other Expenditures$36,084OtherExpendituresAmt
End Year Balance$786,908EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$786,908BeginningYearBalanceAmt
Investment Earnings Or Losses$1,368InvestmentEarningsOrLossesAmt
Other Expenditures$1,368OtherExpendituresAmt
End Year Balance$786,908EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$786,908BeginningYearBalanceAmt
Investment Earnings Or Losses$61,625InvestmentEarningsOrLossesAmt
Other Expenditures$61,625OtherExpendituresAmt
End Year Balance$786,908EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$786,908BeginningYearBalanceAmt
Investment Earnings Or Losses$90,497InvestmentEarningsOrLossesAmt
Other Expenditures$90,497OtherExpendituresAmt
End Year Balance$786,908EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$380,654OtherCostOrOtherBasisAmt
Book Value$380,654BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$47,407,313OtherCostOrOtherBasisAmt
Depreciation$40,570,359DepreciationAmt
Book Value$6,836,954BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$93,056,889OtherCostOrOtherBasisAmt
Depreciation$37,402,625DepreciationAmt
Book Value$55,654,264BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$736,647OtherCostOrOtherBasisAmt
Depreciation$72,028DepreciationAmt
Book Value$664,619BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$63,536,491TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
EQUITY INTEREST IN THE CENTRAL SUFFOLK HOSPITAL FOUNDATION/ DBA PECONIC BAY$2,748,862
DEFERRED EXPENSES$2,329,160
ESTIMATED DUE FROM THIRD PARTY PAYORS$1,959,903
FieldValueIRS element (for citing)
Total Book Value Other Assets$7,037,925TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
ESTIMATED MALPRACTICE COSTS$11,658,989
ESTIMATED DUE TO THIRD-PARTY PAYORS$6,481,763
DUE TO AFFILIATE$9,000,000
SWAP LIABILTY$5,531,826
ACCRUED PENSION COSTS$1,930,459
FieldValueIRS element (for citing)
Total Liability$34,603,037TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$156,512,190TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$75,400NetUnrealizedGainsInvstAmt
Other Revenue$5,344,490OtherRevenueAmt
Revenue Not Reported$5,419,890RevenueNotReportedAmt
Revenue Subtotal$151,092,300RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$151,092,300TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$147,210,920TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$147,210,920ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$147,210,920TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 4:THE DONATED ARTWORK PROVIDES A SOOTHING AND CALMING ENVIRONMENT TO THE PATIENTS AND THEIR FAMILIES WHEN THEY ATTEND THE HOSPITAL FOR MEDICAL SERVICES. THE HOSPITAL HOPES THAT WITH A GOOD EXPERIENCE, THEIR PATIENTS CONTINUE TO UTILIZE THE HOSPITAL TO PROVIDE MEDICAL SERVICES.
PART V, LINE 4:ENDOWMENT FUNDS HAVE BEEN RESTRICED BY DONORS TO BE MAINTAINED BY CSH IN PERPETUITY, THE INCOME FROM WHICH IS AVAILABLE FOR GENERAL PURPOSES.
PART X, LINE 2:CSH HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2010 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES.
PART XI, LINE 2D - OTHER ADJUSTMENTS:GAIN ON SWAP AGREEMENT 3,968,892. PENSION ADJUSTMENTS 3,015,080. CHANGE IN EQUITY INTEREST IN CENTRAL SUFFOLK HOSPITAL FOUNDATION -639,482. NET ASSETS RELEASED FROM RESTRICTIONS -1,000,000.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1ANNUAL BALLNameOfEvent1Amt
Gross Receipts Event1$362,296GrossReceiptsEvent1Amt
Charitable Contri Event1$334,891CharitableContriEvent1Amt
Gross Revenue Event1$27,405GrossRevenueEvent1Amt
Cash Prizes Event1$20,000CashPrizesEvent1Amt
Rent Facility Costs Event1$2,289RentFacilityCostsEvent1Amt
Food And Beverage Event1$48,326FoodAndBeverageEvent1Amt
Entertainment Event1$9,000EntertainmentEvent1Amt
Other Direct Expenses Event1$50,522OtherDirectExpensesEvent1Amt
Gross Receipts Total$362,296GrossReceiptsTotalAmt
Charitable Contributions Tot$334,891CharitableContributionsTotAmt
Gross Revenue Total Events$27,405GrossRevenueTotalEventsAmt
Cash Prizes Total Events$20,000CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$2,289RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$48,326FoodAndBeverageTotalEventsAmt
Entertainment Total Events$9,000EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$50,522OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$130,137DirectExpenseSummaryEventsAmt
Net Income Summary-$102,732NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.000000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,236,285TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$307,524DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,928,761NetCommunityBenefitExpnsAmt
Total Expense0.01310TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$21,785,805TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,140,267DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,645,538NetCommunityBenefitExpnsAmt
Total Expense0.07910TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,022,090TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$10,447,791DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,574,299NetCommunityBenefitExpnsAmt
Total Expense0.09220TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,994,805TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,087,143DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,907,662NetCommunityBenefitExpnsAmt
Total Expense0.01980TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,868,016TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,509,674DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,358,342NetCommunityBenefitExpnsAmt
Total Expense0.07040TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,862,821TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,596,817DirectOffsettingRevenueAmt
Net Community Benefit Expns$13,266,004NetCommunityBenefitExpnsAmt
Total Expense0.09020TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$42,884,911TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,044,608DirectOffsettingRevenueAmt
Net Community Benefit Expns$26,840,303NetCommunityBenefitExpnsAmt
Total Expense0.18240TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$5,576,001BadDebtExpenseAmt
Bad Debt Expense Attributable$16,400,002BadDebtExpenseAttributableAmt
Reimbursed By Medicare$42,917,327ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$52,787,862CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$9,870,535MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PECONIC BAY MEDICAL CENTERBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1
CityRIVERHEADCity
StateNYState
ZIP Code11901ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PECONIC BAY MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.PBMCHEALTH.ORGOwnWebsiteURLTxt
Adopt Implementation StrategyYes (X)AdoptImplementationStrategyInd
Exec Implementation StrategyYes (X)ExecImplementationStrategyInd
Develop Community Wide PlanYes (X)DevelopCommunityWidePlanInd
Exec Community Wide PlanYes (X)ExecCommunityWidePlanInd
Include Operational PlanYes (X)IncludeOperationalPlanInd
Adopt BudgetYes (X)AdoptBudgetInd
Prioritize Health NeedsYes (X)PrioritizeHealthNeedsInd
Prioritize ServicesYes (X)PrioritizeServicesInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free Care0FPGUsedDeterEligFreeCareInd
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Explained Basis0ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Attached To InvoiceYes (X)AttachedToInvoiceInd
Posted In Emergency RoomYes (X)PostedInEmergencyRoomInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Provided On AdmissionYes (X)ProvidedOnAdmissionInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Permit LawsuitYes (X)PermitLawsuitInd
Permit Lien On ResidenceYes (X)PermitLienOnResidenceInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
LawsuitYes (X)LawsuitInd
Liens On ResidencesYes (X)LiensOnResidencesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PECONIC BAY MEDICAL CENTERPART V, SECTION B, LINE 3: THE PRIMARY ORGANIZATIONAL APPROACH THAT CENTRAL SUFFOLK HOSPITAL USES FOR COMMUNITY INVOLVEMENT AND PERSPECTIVE IS THROUGH VARIOUS COMMITTEES AND PARTNERSHIPS. THE NEEDS OF THE COMMUNITY ARE CONTINUALLY ASSESSED BY THE CSH HEALTH BOARD OF DIRECTORS, EAST END HEALTH ALLIANCE BOARDOF TRUSTEES, CSH HEALTH AND THE MEDICAL CENTER MANAGEMENT AND STAFF, VOLUNTEERS, AND LOCAL LEADERS OF LOCAL NOT-FOR-PROFIT ORGANIZATIONS AND GOVERNMENTAL AGENCIES. CSH INFORMS THE PUBLIC ABOUT COMMUNITY PROGRAMS IN A NUMBER OF WAYS: DIRECT MAIL, FLYERS, NEWSLETTERS, SEMINARS, CALENDAR LISTINGS, E-MAIL COMMUNICATIONS, TELEPHONE INFORMATION LINES,NEWSPRINT ADVERTISING, AND LOCAL CABLE TELEVISION. COMMUNITY MEMBERS ARE ENCOURAGED TO GIVE THEIR PERSPECTIVE ON CSH'S COMMUNITY PROGRAMS VIA E-MAIL AND SURVEYS THAT ARE COLLECTED AT MANY OF ITS PUBLIC EVENTS.
PECONIC BAY MEDICAL CENTERPART V, SECTION B, LINE 20D: RATES OF THE HIGHEST VOLUME PAYOR.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1RIVERHEAD MANAGEMENT CORPORATIONBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1
CityREVERHEADCity
StateNYState
ZIP Code11901ZIPCode
FieldValueIRS element (for citing)
FacilityMANAGEMENT SERVICE ORGANIZATIONFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 4:BAD DEBT EXPENSES ON ACCOUNTS RECEIVABLE AND CONTRIBUTIONS RECEIVABLE ARE CHARGED IF THE RECEIVABLE IS DETERMINED TO BE UNCOLLECTIBLE BASED ON PERIODIC REVIEW BY MANAGEMENT. FACTORS USED TO DETERMINE WHETHER AN ALLOWANCE SHOULD BE RECORDED INCLUDE THE AGE OF THE RECEIVABLE AND A REVIEW OF PAYMENTS SUBSEQUENT TO YEAR END.
PART III, LINE 9B:PECONIC BAY MEDICAL CENTER TAKES THE DISCOUNTED AMOUNT AFTER CHARITY (SELF PAY BALANCE) AND FOLLOWS THE SAME GUIDELINES AS SELF PAY.
PART VI, LINE 2:PECONIC BAY MEDICAL CENTER WAS AN ACTIVE PARTICIPANT IN THE COLLABORATIVE PLANNING PROCESS WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH AND COMMUNITY PARTNERS TO ASSESS COMMUNITY HEALTH NEEDS IDENTIFY HEALTH PRIORITIES AND DEVELOP PUBLIC HEALTH PROGRAMS TO MEET THE IDENTIFIED NEEDS. THIS COLLABORATIVE GROUP MET FROM THE FALL OF 2008 THROUGH AUGUST OF 2009, AND SELECTED TOBACCO USE AND UNINTENTIONAL INJURY AS THE TWO HEALTH PRIORITIES IDENTIFIED IN THE NEW YORK STATE PREVENTION AGENDA TOWARD THE HEALTHIEST STATE.SMOKING CESSATION WAS SELECTED BECAUSE THE USE OF TOBACCO IS THE NUMBER ONE UNDERLYING RISK FACTOR FOR MULTIPLE DISEASES. MOREOVER, NASSAU AND SUFFOLK COUNTIES SUFFER FROM SOME OF THE HIGHEST MORTALITY RATES FROM HEART DISEASE IN NEW YORK STATE. UNINTENTIONAL INJURIES WAS SELECTED AS A PRIORITY GIVEN THE FACT THAT SUFFOLK COUNTY HAS A RELATIVELY HIGH MORTALITY RATE FOR UNINTENTIONAL INJURIES WHEN COMPARED TO NEW YORK STATE AND NATIONALLY. THE GROUP ALSO AGREED THAT GIVEN THE SHORTAGE OF RESOURCES AVAILABLE TO ADVANCE PUBLIC HEALTH AGENDAS, IT WAS IMPORTANT TO SELECT PRIORITIES THAT COULD BUILD ON PROGRAMS THAT ARE ALREADY IN PLACE.BOTH SMOKING CESSATION AND PROGRAMS TO REDUCE UNINTENTIONAL INJURIES ACCOMPLISH THIS GOAL. ONE OF THE PRIORITY INITIATIVES FOR THE SUFFOLK COUNTY OFFICE OF HEALTH EDUCATION IS TO DEVELOP AND IMPLEMENT EFFECTIVE ANTI-SMOKING PROGRAMS THAT WILL REDUCE THE RATE OF TOBACCO USE IN SCHOOL-AGED CHILDREN. IN ADDITION, MANY OF THE HOSPITALS IN SUFFOLK COUNTY, INCLUDING PECONIC BAY MEDICAL CENTER HAVE PROGRAMS AND SUPPORT GROUPS IN PLACE TO WORK WITH THEIR EMPLOYEES AND COMMUNITY BASED ORGANIZATIONS TO REDUCE SMOKING. COMMUNITY BASED PROGRAMS AUGMENT COUNTY AND HOSPITAL EFFORTS IN REDUCING TOBACCO USE. THE TOBACCO ACTION COALITION AND HEALTHY MOTHERS/HEALTHY BABY COALITION WILL BE SOUGHT OUT TO ENGAGE IN COLLABORATIVE EFFORTS AS WELL.THERE ARE ALSO A NUMBER OF EXISTING PROGRAMS IN SUFFOLK COUNTY THAT HAVE DEVELOPED STRATEGIES FOR REDUCING THE INCIDENCE OF UNINTENTIONAL INJURIES. THE COUNTY'S BUREAU OF PUBLIC HEALTH NURSING PROVIDES HOME HEALTH CARE SERVICES FOR PATIENTS SUFFERING THE SEQUELAE OF UNINTENTIONAL INJURIES. THE COUNTY ALSO PROVIDES EDUCATION AND SUPPORT TO MOTHERS AND CHILDREN AIMED AT PREVENTING INJURIES FROM BURNS. A PARTNERSHIP BETWEEN ST. JOSEPHS COLLEGE AND THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES HAS HELP IDENTIFY THE APPROPRIATE TARGET POPULATION FOR EDUCATION AND INTERVENTIONS TO REDUCE THESE INJURIES. FINALLY, ARTICLE 6 FUNDS CAN BE USED BY THE SUFFOLK COUNTY HEALTH DEPARTMENT CONSISTENT WITH NEW YORK STATE'S HEALTH AGENDA TO REDUCE THESE INJURIES.THESE TWO PRIORITIES WILL BE A MAJOR OPERATIONAL COMMITMENT OF PECONIC BAY MEDICAL CENTER OVER THE NEXT THREE YEARS. THE MEDICAL CENTER WILL CONTINUE TO COLLABORATE WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH AND COMMUNITY PARTNERS IN ENSURING THAT WE REACH THE GOALS SET FOR THESE TWO PRIORITY AREAS, MEASURE PROGRESS IN ACHIEVING THESE GOALS AND ELIMINATING RACIAL, ETHNIC AND SOCIOECONOMIC HEALTH DISPARITIES WHERE THEY EXIST.ONCE THE PLANNING GROUP ADOPTED THESE PRIORITIES, REPRESENTATIVES FROM THE SUFFOLK COUNTY DEPARTMENT OF HEALTH, SUFFOLK COUNTY HOSPITALS, INCLUDING PECONIC BAY MEDICAL CENTER AND COMMUNITY REPRESENTATIVES DIVIDED INTO TWO WORK GROUPS. EACH WORK GROUP WAS CHARGED WITH DEVELOPING A SET OF RECOMMENDATIONS TO IMPLEMENT EFFECTIVE STRATEGIES TO ADDRESS BOTH HEALTH CARE PRIORITIES.
PART VI, LINE 4:THE MEDICAL CENTER'S PRIMARY SERVICE AREA INCLUDES THE FOLLOWING ZIP CODES: RIVERHEAD (11901); CALVERTON (11933): MANORVILLE (11949). THESE ZIP CODES ACCOUNT FOR FIFTY PERCENT OF THE MEDICAL CENTER'S TOTAL DISCHARGES.THE MEDICAL CENTER'S SECONDARY SERVICE AREA INCLUDES THE FOLLOWING ZIP CODES: HAMPTON BAYS (1946); EAST QUOGUE (11942); MATTITUCK (11952); WESTHAMPTON BEACH (11978); EASTPORT (11941); CENTER MORICHES (11934); EAST MORICHES (11940); WESTHAMPTON (11977); CUTCHOGUE (11935); SHIRLEY (11967); WADING RIVER (11792): SOUTHOLD (11971); RIDGE (11961); MASTIC (11950); GREENPORT (11944); AND LAUREL (11948). THESE ZIP CODES ACCOUNT FOR THIRTY-FIVE PERCENT OF THE MEDICAL CENTER'S TOTAL DISCHARGES.THE SERVICE HAS MORE THAN 191,000 RESIDENTS AND THE POPULATION IS EXPECTED TO GROW BY FIVE PERCENT FROM 2008 TO 2013. AS THE POPULATION OF THIS REGION CONTINUES TO GROW AND IS DRIVING INCREASED DEMAND FOR HEALTH CARE SERVICES, THE MEDICAL CENTER HAS RESPONDED BY MAKING CAPITAL INVESTMENTS IN EMERGENCY ROOM AND SURGICAL SERVICES, AND THE RECRUITMENT OF PHYSICIANS TO BE ABLE TO MEET THESE NEEDS.THE SERVICE AREA HAS A SIGNIFICANTLY HIGHER PERCENTAGE OF ELDERLY THAN SUFFOLK COUNTY, NASSAU COUNTY AND NEW YORK STATE. APPROXIMATELY ONE IN FIVE RESIDENTS OF THE MEDICAL CENTER'S SERVICE AREA ARE OVER THE AGE OF FIFTY-FIVE,THE POPULATION THAT DRIVES HIGHER DEMAND FOR HEALTH CARE SERVICES. MOREOVER, THIS AGE COHORT IS EXPECTED TO INCREASE AS A PERCENTAGE OF THE TOTAL POPULATION OVER THE NEXT FIVE YEARS.THE HOSPITAL HAS DEVELOPED PROGRAMS, ENHANCED ORTHOPEDICS AND NEUROSURGICAL SERVICES, ENHANCED HOME HEALTH CARE AND SKILLED NURSING SERVICES THAT ARE SPECIFICALLY GEARED TOWARDS MEETING THE UNIQUE HEALTH CARE NEEDS OF THIS POPULATION.TO THE EXTENT THAT THERE ARE HEALTH CARE DISPARITIES BASED ON RACE AND ETHNICITY, THE EAST END OF SUFFOLK COUNTY FACES A CHALLENGE WITH A HIGH PROPORTION OF MINORITY RESIDENTS -- AN AVERAGE OF TWENTY PERCENT -- BUT AS HIGH AS THIRTY-THREE PERCENT IN SOME OF THE PRIMARY AND SECONDARY SERVICE AREAS.THERE ARE NO FIRM ESTIMATES OF THE NUMBER OF MIGRANT AGRICULTURAL WORKERS THAT COME INTO THIS AREA. AGRICULTURE IS ONE OF SUFFOLK COUNTY'S LEADING INDUSTRIES. ITS SUCCESS RELIES ON WORKERS WHO MOVE THROUGH THE EASTERN UNITED STATES IN RESPONSE TO THE AVAILABILITY OF SEASONAL WORK. PECONIC BAY MEDICAL CENTER RECOGNIZES THAT THIS POPULATION PRESENTS SERIOUS HEALTH PROBLEMS AND IS COMMITTED TO PROVIDING CARE FOR ITS CULTURALLY DIVERSE PATIENT POPULATION. MANY OF THESE INDIVIDUALS ARE UNINSURED AND UNABLE TO SPEAK ENGLISH. THEY RELY ON THE MEDICAL CENTER'S EMERGENCY DEPARTMENT, AS WELL AS THE SUFFOLK COUNTY HEALTH CLINIC, LOCATED IN RIVERHEAD, FOR HEALTH CARE. THE HOSPITAL PROVIDES BI-LINGUAL PUBLICATIONS AND SIGNAGE AND ACTIVELY ASSISTS THE CULTURALLY DIVERSE COMMUNITIES THAT ARE CARED FOR AT THE MEDICAL CENTER.PUBLIC PARTICIPATION:PECONIC BAY MEDICAL CENTER HAS AN EXTENSIVE PROGRAM OF COMMUNITY OUTREACH THAT IS COMPLEMENTED BY THE EFFORTS OF THE EAST END HEALTH ALLIANCE, THE MEDICAL CENTER'S ACTIVE PARENT. INPUT ON THE COMMUNITY SERVICE PLAN IS RECEIVED FROM BOTH INTERNAL AND EXTERNAL SOURCES. NEEDS ARE ASSESSED ON AN ANNUAL BASIS BY THE BOARD OF TRUSTEES, MEDICAL CENTER MANAGEMENT AND STAFF, VOLUNTEERS, AND LEADERS OF LOCAL NOT-FOR-PROFIT ORGANIZATIONS AND GOVERNMENTAL AGENCIES.COMMUNITY PROGRAMS ARE PUBLICIZED IN A VARIETY OF WAYS: DIRECT MAIL, FLYERS, CALENDAR LISTINGS, E-MAIL COMMUNICATIONS, TELEPHONE INFORMATION LINES, NEWSPRINT ADVERTISING, AND LOCAL CABLE TELEVISION. COMMUNITY MEMBERS ARE ENCOURAGED TO OFFER INPUT ON PECONIC BAY MEDICAL CENTER'S COMMUNITY PROGRAMS BY E-MAIL AND VIA SURVEYS COLLECTED AT PUBLIC EVENTS. THE MEDICAL CENTER'S PRESIDENT AND CHIEF EXECUTIVE OFFICER AND OTHER SENIOR STAFF REGULARLY MEET WITH COMMUNITY GROUPS FROM THE EAST END REGION OF LONG ISLAND TO KEEP AREA RESIDENTS INFORMED ABOUT MEDICAL CENTER PROGRAMS AND TO RECEIVE FEEDBACK AND FIELD QUESTIONS FROM THE COMMUNITY.THE MEDICAL CENTER'S WEB SITE WWW.PBMEDICALCENTER.ORG OFFERS A USER-FRIENDLY FORMAT AND EASY ACCESS TO INFORMATION ON MEDICAL CENTER SERVICES AND PROGRAMS. IN ADDITION, THE SITE ALLOWS FOR PHYSICIAN SEARCHES, ON-LINE INQUIRIES AND ON-LINE JOB APPLICATIONS.SERVICES FOR SHORT-TERM AND LONG-TERM CARE FOR CHRONIC AND ACUTE ILLNESS ARE CONTINUALLY EVALUATED THROUGH STATISTICAL DATA THAT INCLUDE QUALITY INDICATORS AND PATIENT OUTCOMES. THIS DATA IS COMPARED NATIONALLY WITH OTHER HEALTH FACILITIES AND INFORMS THE HOSPITAL'S STRATEGIC PLAN AND COMMUNITY SERVICE PLAN. THE MEDICAL CENTER'S STRATEGIC PLANNING COMMITTEE INCLUDES COMMUNITY MEMBERS, MEDICAL CENTER STAFF AND MEDICAL CENTER AND FOUNDATION BOARD MEMBERS WHO WORK COLLABORATIVELY TO ASSESS COMMUNITY NEEDS AND DEVELOP STRATEGIES TO MEET THESE NEEDS. THE EXTERNAL AFFAIRS COMMITTEE WAS ESTABLISHED TO ENHANCE COMMUNICATION BETWEEN THE MEDICAL CENTER AND THE COMMUNITIES IT SERVES. MEMBERS OF THE COMMITTEE INCLUDE A CROSS-SECTION OF PHYSICIANS, NURSES, MEDICAL CENTER MANAGEMENT, MEDICAL CENTER EMPLOYEES AND COMMUNITY VOLUNTEERS.THE MEDICAL CENTER HAS A LONGSTANDING COMMITMENT AND EXPERIENCE IN OUTREACH HAVING ADMINISTERED THE SUFFOLK COUNTY DEPARTMENT OF HEALTH'S WOMEN'S HEALTH PARTNERSHIP FOR THE PAST FIVE YEARS. THIS PROGRAM PROVIDES NO-COST BREAST CANCER SCREENING AND DIAGNOSTIC SERVICES TO WOMEN WHO ARE UNINSURED, AS WELL AS SCREENING FOR PROSTATE, COLORECTAL AND GYNECOLOGIC ONCOLOGY FOR BOTH MEN AND WOMEN. IT ALSO PROVIDES PATIENT NAVIGATION AND COORDINATION OF SERVICES FOR WOMEN DIAGNOSED WITH BREAST AND CERVICAL CANCER THROUGH THE SCREENING PROGRAM. THE MEDICAL CENTER PROVIDES INFORMATION AND SUPPORT SERVICES IN SPANISH TO ACCOMMODATE THOSE WOMEN WHO ARE NOT PROFICIENT IN ENGLISH. THE PARTNERSHIP MODEL WAS CONCEIVED AND IMPLEMENTED BASED ON THE PRINCIPLE THAT COMMUNITY MEMBERS ARE THE BEST PEOPLE TO IDENTIFY THE NEEDS OF THEIR COMMUNITY AND TO CARRY OUT A PLAY OF ACTION THAT ADDRESSES THOSE NEEDS.RESPONDING TO THE NEEDS OF THE COMMUNITY FOR OBSTETRICAL CARE, INCLUDING THOSE WHO ARE UNDER OR UNINSURED, PECONIC BAY MEDICAL CENTER PROVIDES OBSTETRICAL AND GYNECOLOGICAL SERVICES TO THE SUFFOLK COUNTY HEALTH CENTER. IN ADDITION, A SEPARATE GROUP OF PRIMARY CARE PHYSICIANS PROVIDE CARE TO ANY RIVERHEAD HEALTH CENTER PATIENT WHO NEEDS TO BE ADMITTED TO THE MEDICAL CENTER. IN CONJUNCTION WITH SUFFOLK COUNTY, THE MEDICAL CENTER OPERATES A SECURED FORENSIC UNIT FOR INMATES OF THE SUFFOLK COUNTY JAIL WHO REQUIRE HOSPITALIZATION. THE MEDICAL CENTER PROVIDES FREE FLU SHOTS TO RESIDENTS OF THE COMMUNITY WHO ARE AT HIGH RISK FOR INFLUENZA. THE MEDICAL CENTER ALSO HAS RESPONDED TO COMMUNITY NEEDS BY SPONSORING A NUMBER OF COMMUNITY HEALTH FAIRS OFFERING FREE BLOOD PRESSURE, CHOLESTEROL AND GLUCOSE SCREENINGS AS WELL AS PROVIDING IMPORTANT HEALTH AND WELLNESS INFORMATION. THESE HEALTH FAIRS ALSO CREATE THE OPPORTUNITY FOR MEDICAL CENTER STAFF TO OBTAIN IMPORTANT COMMUNITY FEEDBACK, INFORMATION THAT IS SHARED WITH MEDICAL CENTER LEADERSHIP AND CONSIDERED IN FUTURE COMMUNITY OUTREACH.SUPPORTING THIS EDUCATIONAL OUTREACH AND OPPORTUNITY FOR COMMUNITY INPUT, THE MEDICAL CENTER HAS A SPEAKERS BUREAU THAT PROVIDES PROFESSIONAL INPUT RELATED TO HEALTH AND WELLNESS TOPICS, HEALTH HEART DIET, TREATING OVARIAN CANCER, ETC.BASED ON COMMUNITY INPUT, THE MEDICAL CENTER HAS ALSO LAUNCHED PROJECT CARE IN CONJUNCTION WITH STONY BROOK UNIVERSITY'S SCHOOL OF HEALTH MANAGEMENT AND TECHNOLOGY. THIS PROGRAM PROVIDES IN-HOME MONITORING FOR HIGH-RISK PATIENTS THAT WOULD OTHERWISE HAVE DIFFICULTY ACCESSING CARE. THE MEDICAL CENTER HAS ALSO RESPONDED TO COMMUNITY INPUT FROM THE REGIONS AMBULANCE CORPS AND WITH THE SUPPORT OF STONY BROOK PROVIDES THREE FIRST RESPONDER VEHICLES THAT AUGMENT THE LOCAL EMS DURING PEAK HOURS.PBMC WAS SUCCESSFUL IN OBTAINING FUNDING FOR A PATIENT TRANSPORTATION VAN THAT PROVIDES TRANSPORT ROOM OUR SKILLED NURSING FACILITY FOR MEDICAL SERVICES, AS WELL AS PATIENTS FROM OTHER COMMUNITY NURSING HOMES THAT MAY NEED RADIOLOGY OR LABORATORY TESTING.COMMUNITY ORGANIZATION PARTICIPATION: THE HOSPITAL ALSO ROUTINELY SEEKS FEEDBACK FROM COMMUNITY MEMBERS WHO PARTICIPATE IN OUR COMMUNITY OUTREACH PROGRAMS. PECONIC BAY MEDICAL CENTER HAS SIGNIFICANT REPRESENTATION ON A WIDE-RANGE OF COMMUNITY ORGANIZATIONS THAT FACILITATE INPUT FROM RESIDENTS, CORPORATE AND COMMUNITY LEADERS, PATIENTS AND ALLIED HEALTH PROFESSIONS. THIS PARTICIPATION SUPPORTS EFFECTIVE INPUT FROM THE COMMUNITY THROUGH MEDICAL CENTER STAFF AND MEDICAL CENTER TRUSTEE PARTICIPATION COMPLEMENTED BY A CONTINUAL AND OPEN DIALOGUE WITH RESPECTED COMMUNITY LEADERS.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (1)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANDREW MITCHELL
CHIEF EXECUTIVE OFFICER/PRESIDENT$567,112$0$6,500$0$774$0$23,000$0$31,252$0$628,638$0$0$0
GERARD ZUNNO
COO / BOARD MEMBER$245,632$0$0$0$774$0$15,000$0$19,055$0$280,461$0$0$0
ALAN SCHECHTER
EXECUTIVE VICE PRESIDENT$85,496$0$0$0$359,763$0$5,899$0$15,626$0$466,784$0$0$0
MICHAEL O'DONNELL
CHIEF FINANCIAL OFFICER$268,188$0$0$0$414$0$23,000$0$28,583$0$320,185$0$0$0
DEMETRIOS KADENAS
CHIEF DEVELOPMENT OFFICER$185,927$0$0$0$138$0$0$0$9,528$0$195,593$0$0$0
JAY ZUCKERMAN
CORPORATE COMPLIANCE OFFIC$48,870$0$0$0$161,879$0$1,525$0$1,250$0$213,524$0$0$0
RONALD MCMANUS
COO OF PBHS$211,664$0$0$0$774$0$23,000$0$28,583$0$264,021$0$0$0
RICHARD KUBIAK
CHIEF MEDICAL OFFICER$327,144$0$0$0$1,188$0$23,000$0$28,583$0$379,915$0$0$0
CHERYL MAKOSKE
VP FINANCE$179,239$0$0$0$270$0$5,304$0$17,150$0$201,963$0$0$0
PETER SULTAN MD
PHYSICIAN$417,382$0$611,006$0$180$0$15,500$0$28,583$0$1,072,651$0$0$0
DAVID PRENTISS MD
PHYSICIAN$256,712$0$0$0$414$0$13,000$0$0$0$270,126$0$0$0
MAHMOOD AFGHANI MD
PHYSICIAN$232,258$0$0$0$144$0$5,206$0$28,583$0$266,191$0$0$0
JANE FRANZ
SENIOR VP CHIEF PLANNING OFFICER$235,308$0$0$0$1,188$0$0$0$0$0$236,496$0$0$0
STEPHEN JOHN MD
PHYSICIAN$206,500$0$24,900$0$247$0$4,301$0$15,898$0$251,846$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3THE HOSPITAL UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS PERFORMED IN 2012
PART I, LINES 4A-BALAN SCHECHTER (SEVERANCE) - $359,763 JAY ZUCKERMAN (SEVERANCE) - $161,879 ANDREW MITCHELL (NON-QUALIFIED RETIREMENT PLAN) - $17,000
PART I, LINE 5THE MEDICAL CENTER HAS A CONTRACTUAL ARRANGEMENT FOR A PHYSICIAN ENTITLING THE PHYSICIAN TO ADDITIONAL COMPENSATION BASED UPON CASH COLLECTIONS.
PART I, LINE 7PERFORMANCE BASED ON BOARD DISCRETION. AN EMPLOYMENT AGREEMENT IS IN PLACE WITH THE HOSPITAL WITH THE CEO

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
TOWN OF RIVERHEAD INDUSTRIAL DEVELOPMENT AGENCY
A112560077768765AB52006-06-23$35,000,000CONSTRUCTION OF FACILITY AND REFUNDING OF PRIOR ISSUE (8/12/1993)000
TOWN OF RIVERHEAD INDUSTRIAL DEVELOPMENT AGENCY
B112560077768765AE92007-06-27$12,000,000CONSTRUCTION OF FACILITY000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmt
A$9,695,000$36,622,284$700,000$359,652$24,392,812$11,169,8202008Yes (1)0Yes (1)Yes (1)
B$1,095,000$12,350,712$240,000$307,959$11,752,481200900Yes (1)Yes (1)$5,009,217$50,272

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0000000
B0000000

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndTerm Of HedgeTermOfHedgePctSuperintegrated HedgeSuperintegratedHedgeIndHedge TerminatedHedgeTerminatedIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line1GICProviderName/BusinessNameLine1Term Of GICTermOfGICPctRegulatory Safe Harbor StsfdRegulatorySafeHarborStsfdIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
HSBC BANK
A00Yes (1)Yes (1)Yes (1)Yes (1)25.00000000000000Yes (1)MBIA INC2.200000000000Yes (1)00
HSBC BANK
B000Yes (1)Yes (1)Yes (1)25.00000000000000000

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
A0
B0

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
RICHARD ISRAEL
BOARD MEMBER$392,567RENTAL OF PROPERTY0
STEVEN OUZOUNIAN MD
BOARD MEMBER$75,000AGREEMENT FOR DIRECTORSHIP0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 2IN SEPTEMBER 2013, CSH OPENED THE CAMPUS FOR ADVANCED AMBULATORY AND PREVENTIVE CARE IN MANORVILLE, NEW YORK. THE CAMPUS HAS A WALK-IN URGENT CARE CENTER AS WELL AS PRACTICES SPECIALIZING IN FAMILY CARE, PEDIATRICS AND OB/GYN. ANOTHER BUILDING CURRENTLY IN CONSTRUCTION WILL INCLUDE ADVANCED-TECHNOLOGY OFFICE SPACE FOR UROLOGY SERVICES, A DIGESTIVE DISEASE CENTER, AND GENERAL SURGERY.
FORM 990, PART VI, SECTION B, LINE 11THE CHIEF EXECUTIVE OFFICER / PRESIDENT, CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER REVIEW THE 990. A COPY OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. IN THE EVENT OF ANY ISSUES WITH THE 990, THE MATTERS ARE BROUGHT TO THE ATTENTION OF THE CHIEF FINANCIAL OFFICER.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICTS OF INTEREST POLICY APPLIES TO MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, VICE PRESIDENTS, ASSISTANT VICE PRESIDENTS, DEPARTMENT HEADS, CLINICAL DIRECTORS OF DEPARTMENTS, AND OTHER EMPLOYEES (INCLUDING PHYSICIANS) WHO ARE IN A POSITION TO INFLUENCE ANY SUBSTANTIVE BUSINESS DECISION BETWEEN THE MEDICAL CENTER AND A VENDOR. THE DIRECTOR OF CORPORATE COMPLIANCE CONTINUOUSLY MONITORS ALL TRANSACTIONS TO DETERMINE IF ANY POTENTIAL CONFLICT EXISTS. IF IT IS DETERMINED THAT A POTENTIAL CONFLICT EXISTS, THE INDIVIDUAL IS PROHIBITED FROM PARTICIPATING IN THE DECISIONS OF THE TRANSACTION.
FORM 990, PART VI, SECTION B, LINE 15CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER, A RELATED ORGANIZATION, UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2013.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:PENSION ADJUSTMENT TO REFLECT FUNDED STATUS 3,015,080. GAIN ON SWAP AGREEMENT 3,968,892. CHANGE IN EQUITY INTEREST IN CENTRAL SUFFOLK HOSPITAL FOUNDATION -639,482. NET ASSETS RELEASED FROM RESTRICTIONS -1,000,000.
FORM 990, PART XI, LINE 2C:THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1CityUSAddress/CityStateUSAddress/StateZIP CodeUSAddress/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
PECONIC BAY MEDICAL CENTER FOUNDATION
1300 ROANOKE AVENUERIVERHEADNY11901200714587FUNDRAISING/PHILANTHROPICNY501(C)(3)7PECONIC BAY HEALTH SYSTEM0
EAST END HEALTH ALLIANCE
201 MANOR PLACEGREENPORTNY11944113407476PARENT COMPANY OF PBMC, SOUTHAMPTON HOSPITAL, EASTERN LONG ISLAND HOSPITALNY501(C)(3)11, TYPE I0N/A
PECONIC BAY HEALTH SYSTEMS
1300 ROANOKE AVENUERIVERHEADNY11901112761795PARENT COMPANY OF PBMCNY501(C)(3)11, TYPE I0N/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1RIVERHEAD MANAGEMENT CORPORATIONBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1
CityRIVERHEADCity
StateNYState
ZIP Code11901ZIPCode
FieldValueIRS element (for citing)
EIN112800287EIN
Primary ActivitiesMANAGEMENT SERVICE ORGANIZATIONPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1RIVERHEAD MANAGEMENT CORPORATIONBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeDTransactionTypeTxt
Involved$677,747InvolvedAmt
Method Of Amount DeterminationCOSTMethodOfAmountDeterminationTxt