HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH CENTER INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH CENTER INC (EIN 11-3368503)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-13
- IRS object ID
- 201433179349302153
- Schema version
- 2013v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-13T09:51:21-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 113368503 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH CEN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MICHAEL FAGAN | InCareOfNm |
| Business Name Control | HUNT | BusinessNameControlTxt |
| Phone | 6314254262 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 284 PULASKI ROAD | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | GREENLAWN | City |
| State | NY | State |
| ZIP Code | 11740 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN LAWLOR | PersonNm |
| Person Title | PRES & CEO | PersonTitleTxt |
| Signature | 2014-10-28 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEVIN LAWLOR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 284 PULASKI ROAD | AddressLine1 |
| City | GREENLAWN | City |
| State | NY | State |
| ZIP Code | 11740 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,388,346 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE HUNTINGTON HOSPITAL DOLAN FAMILY Health CENTER IS A FREE-STANDING HOSPITAL-OWNED FACILITY DEDICATED TO PROVIDING MEDICAL CARE TO THE UNINSURED AND UNDER INSURED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 18 | VotingMembersIndependentCnt |
| Total Employee | 57 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $40,850 | PYContributionsGrantsAmt |
| CY Contributions Grants | $44,674 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,816,598 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,006,208 | CYProgramServiceRevenueAmt |
| PY Investment Income | $94,968 | PYInvestmentIncomeAmt |
| CY Investment Income | $194,155 | CYInvestmentIncomeAmt |
| PY Other Revenue | $113,582 | PYOtherRevenueAmt |
| CY Other Revenue | $143,309 | CYOtherRevenueAmt |
| PY Total Revenue | $7,065,998 | PYTotalRevenueAmt |
| CY Total Revenue | $7,388,346 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,293,418 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,600,631 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $6,272 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,298,503 | PYOtherExpensesAmt |
| CY Other Expenses | $2,252,112 | CYOtherExpensesAmt |
| PY Total Expenses | $7,591,921 | PYTotalExpensesAmt |
| CY Total Expenses | $7,852,743 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$525,923 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$464,397 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,080,870 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,562,196 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,019,071 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,071,100 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$938,201 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$508,904 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF THE HEALTH CENTER IS TO PROVIDE COMPREHENSIVE CARE & OB SERVICES TO THE MEDICALLY INDIGENT AND UNDERSERVED RESIDENTS FROM NORTHWESTERN SUFFOLK COUNTRY. THE CENTER SERVES AS THE ENTRY POINT INTO THE HEALTH SYSTEM FOR INDIVIDUALS AND FAMILIES SEEKING SUCH CARE. EVERY PATIENT WILL BE PROVIDED COMPREHENSIVE AND CONTINUOUS PREVENTIVE CARE, PRIMARY DIAGNOSTIC AND TREATMENT SERVICES AND EFFECTIVE COORDINATION OF CARE WITH SPECIALISTS AND SERVICES IN THE LARGER HEALTHCARE SYSTEM. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $7,426,709 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $7,006,208 | RevenueAmt |
| Desc | THE HEALTH CENTER IS A COMPREHENSIVE COMMUNITY HEALTH CENTER WHICH PROVIDES PRIMARY, PEDIATRIC, PRENATAL, AND OBSTETRICAL CARE SERVICES TO THE POOR AND UNDERSERVED RESIDENTS IN THE COMMUNITY. IT IS THE ONLY SUCH CENTER BOTH OWNED AND OPERATED BY A HOSPITAL ON LONG ISLAND. ALL PATIENTS HAVE ACCESS TO A SUFFOLK COUNTY FACILITATED ENROLLER FOR MEDICAID MANAGED CARE, CHILD HEALTH PLUS, AND FAMILY HEALTH PLUS THROUGH A PARTNERSHIP WITH THE NASSAU SUFFOLK HOPSITAL COUNCIL. IN ADDITION, THE DOLAN CENTER'S SOCIAL WORK DEPARTMENT ASSISTS PATIENTS WITH ACCESS TO INSURANCE FOR PREGNANT WOMEN THROUGH NEW YORK STATE'S PRENATAL CARE ASSISTANCE PROGRAM. THE DOLAN FAMILY HEALTH CENTER PROVIDED 31,700 PATIENT VISITS IN 2013. | Desc |
| Total Program Service Expenses | $7,426,709 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 57 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 18 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL FAGAN | PersonNm |
| Phone | 6314254262 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 270 PARK AVENUE | AddressLine1 |
| City | HUNTINGTON | City |
| State | NY | State |
| ZIP Code | 11743 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DANIELLE ASHER | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| MARGARET BOYD | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| VIVIAN CAHN | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| MARTHA CARLSTROM | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| RONALD J GAUDREAULT | ||||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | 2.0 | |||
| RALPH FENDERSON MD | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| VICTORIA GREEN | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| REV LARRY JENNINGS SR | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| JANET KUSHNICK | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| KEVIN LAWLOR | ||||||||
| PRES & CEO HUNTINGOTN | Yes (X) | $0 | $713,588 | $286,966 | 50.0 | Yes (X) | ||
| SHIRLEY LEVITT | ||||||||
| VICE CHAIRWOMAN | 2.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| THOMAS G LEDERER | ||||||||
| BOARD MEMBER | Yes (X) | $0 | $0 | $0 | 2.0 | Yes (X) | ||
| MARIA O'MALLEY | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM GEHRHARDT MD | ||||||||
| MEDICAL DIRECTOR | 50.0 | Yes (X) | $233,308 | $0 | $43,150 | |||
| SEAN O'MALLEY | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| ROXANNE SANDS-RAPELYEA | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| MIKE SLIPPEN MD | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| TERENCE SMITH | ||||||||
| BOARD MEMBER/ADMINISTRATOR | Yes (X) | $0 | $181,981 | $43,150 | 50.0 | |||
| LINDA TAYLOR | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| DOLORES THOMPSON | ||||||||
| CHAIRPERSON | 2.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JOSEPH VOLAVKA | ||||||||
| BOARD MEMBER | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| ROGELIO CO MD | ||||||||
| PHYSICIAN | 50.0 | $215,003 | $0 | $43,150 | Yes (X) | |||
| ROBERTO BLANDO MD | ||||||||
| PHYSICIAN | 50.0 | $195,685 | $0 | $43,150 | Yes (X) | |||
| SAILI DESAI MD | ||||||||
| PHYSICIAN | 50.0 | $149,952 | $0 | $43,150 | Yes (X) | |||
| LISA ROLON | ||||||||
| PHYSICIAN | 50.0 | $204,529 | $0 | $43,150 | Yes (X) | |||
| BRENDA GEORGE | ||||||||
| PHYSICIAN | 50.0 | $144,413 | $0 | $43,150 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,142,890 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $895,569 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $589,016 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NONE | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Address | ContractorAddress |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $44,674 | AllOtherContributionsAmt |
| Total Contributions | $44,674 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621300 | $4,524,272 | $4,524,272 |
| SUFFOLK COUNTY CONTRACT | 621300 | $2,481,936 | $2,481,936 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,006,208 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $144,292 | TotalRevenueColumnAmt |
| Exclusion | $144,292 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $49,863 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $49,863 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,863 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ELECTRONIC HEALTH RECORD INCOME | 900099 | $84,280 | $84,280 |
| RESIDENCY ROTATION | 900099 | $50,000 | $50,000 |
| MISCELLANEOUS OTHER | 900099 | $9,029 | $9,029 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $143,309 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,388,346 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,149,517 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $144,292 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $233,308 | TotalAmt |
| Program Services | $233,308 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,779,359 | TotalAmt |
| Program Services | $3,561,668 | ProgramServicesAmt |
| Management And General | $214,186 | ManagementAndGeneralAmt |
| Fundraising | $3,505 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,125 | TotalAmt |
| Program Services | $38,756 | ProgramServicesAmt |
| Management And General | $2,331 | ManagementAndGeneralAmt |
| Fundraising | $38 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,279,573 | TotalAmt |
| Program Services | $1,205,869 | ProgramServicesAmt |
| Management And General | $72,517 | ManagementAndGeneralAmt |
| Fundraising | $1,187 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $267,266 | TotalAmt |
| Program Services | $251,871 | ProgramServicesAmt |
| Management And General | $15,147 | ManagementAndGeneralAmt |
| Fundraising | $248 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $681,179 | TotalAmt |
| Program Services | $641,943 | ProgramServicesAmt |
| Management And General | $38,604 | ManagementAndGeneralAmt |
| Fundraising | $632 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,213 | TotalAmt |
| Program Services | $242,397 | ProgramServicesAmt |
| Management And General | $14,577 | ManagementAndGeneralAmt |
| Fundraising | $239 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $425,065 | TotalAmt |
| Program Services | $400,581 | ProgramServicesAmt |
| Management And General | $24,090 | ManagementAndGeneralAmt |
| Fundraising | $394 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,754 | TotalAmt |
| Program Services | $7,754 | ProgramServicesAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,445 | TotalAmt |
| Program Services | $8,445 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,904 | TotalAmt |
| Program Services | $69,647 | ProgramServicesAmt |
| Management And General | $4,257 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,573 | TotalAmt |
| Program Services | $287,573 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $6,217 | $6,217 | |
| PURCHASED SERVICES | $439,480 | $439,480 | |
| CENTRALIZED ADMIN EXP | $32,177 | $32,177 | |
| DUES & SUBSCRIPTIONS | $1,992 | $1,879 | $113 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,113 | TotalAmt |
| Program Services | $29,321 | ProgramServicesAmt |
| Management And General | $1,763 | ManagementAndGeneralAmt |
| Fundraising | $29 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,852,743 | TotalAmt |
| Program Services | $7,426,709 | ProgramServicesAmt |
| Management And General | $419,762 | ManagementAndGeneralAmt |
| Fundraising | $6,272 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $450 | BOYAmt |
| EOY | $226,746 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,310,340 | BOYAmt |
| EOY | $2,174,842 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $238,336 | BOYAmt |
| EOY | $385,086 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,379,887 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $148,286 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $746,245 | BOYAmt |
| EOY | $1,231,601 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,089,505 | BOYAmt |
| EOY | $5,102,168 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $695,994 | BOYAmt |
| EOY | $441,753 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,080,870 | BOYAmt |
| EOY | $9,562,196 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $607,229 | BOYAmt |
| EOY | $806,972 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,411,842 | BOYAmt |
| EOY | $9,264,128 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,019,071 | BOYAmt |
| EOY | $10,071,100 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$6,027,706 | BOYAmt |
| EOY | -$6,429,621 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $686,582 | BOYAmt |
| EOY | $1,517,544 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,402,923 | BOYAmt |
| EOY | $4,403,173 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$938,201 | BOYAmt |
| EOY | -$508,904 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,080,870 | BOYAmt |
| EOY | $9,562,196 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$464,397 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $893,694 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,402,923 | BeginningYearBalanceAmt |
| Contributions | $250 | ContributionsAmt |
| End Year Balance | $4,403,173 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,401,523 | BeginningYearBalanceAmt |
| Contributions | $1,400 | ContributionsAmt |
| End Year Balance | $4,402,923 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,399,993 | BeginningYearBalanceAmt |
| Contributions | $1,530 | ContributionsAmt |
| End Year Balance | $4,401,523 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,398,363 | BeginningYearBalanceAmt |
| Contributions | $1,630 | ContributionsAmt |
| End Year Balance | $4,399,993 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,388,426 | BeginningYearBalanceAmt |
| Contributions | $9,937 | ContributionsAmt |
| End Year Balance | $4,398,363 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $430,009 | OtherCostOrOtherBasisAmt |
| Depreciation | $36 | DepreciationAmt |
| Book Value | $429,973 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $760,921 | OtherCostOrOtherBasisAmt |
| Depreciation | $122,812 | DepreciationAmt |
| Book Value | $638,109 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $66,397 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,640 | DepreciationAmt |
| Book Value | $60,757 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $122,560 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,798 | DepreciationAmt |
| Book Value | $102,762 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,231,601 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| EST. NET PAYABLE DUE THIRD PAR | $356,136 |
| DUE TO AFFILIATES | $8,907,992 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,264,128 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,444,611 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $223,879 | OtherRevenueAmt |
| Revenue Not Reported | $223,879 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,220,732 | RevenueSubtotalAmt |
| Other Revenues Not Included | $167,614 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $167,614 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,388,346 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,846,526 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $7,846,526 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $6,217 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $6,217 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $7,852,743 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4 | THE INVESTMENT INCOME OF THE ENDOWMENT FUNDS IS UNRESTRIECTED AND IS THEREFORE USED TO HELP SUPPORT THE OPERATION OF THE HUNTINGTON HOSPITAL DOLAN FMAILY HEALTH CENTER. |
| PART X, LINE 2 | Certain entities included in the System's consolidated financial statements are taxable entities under Federal or state laws. U.S. generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in income in the period of enactment. At December 31, 2013 and 2012, the System has a deferred income tax asset which has been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion, or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to the allowance for doubtful accounts receivable and net operating loss carry forwards. Certain entities have net operating loss carry forwards aggregating approximately $167,000,000, which expire in varying amounts through 2033, and are available to offset future taxable income. |
| PART XI - LINE 2D AND LINE 4B | REVENUE ON BOOKS NOT ON RETURN NET ASSETS RELEASED FROM RESTRICTIONS 230,096 PROVISION FOR BAD DEBT (6,217) TOTAL 223,879 REVENUE ON RETURN NOT ON BOOKS TEMPORARILY/PERMANENTLY RESTRICTED CONTRIBUTIONS 12,664 TEMPORARILY RESTRICTED INVESTMENTS 154,950 TOTAL 167,614 |
| PART XII - LINE 4B | PROVISION FOR BAD DEBT 6,217 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN LAWLOR | ||||||||||||||
| PRES & CEO HUNTINGOTN | $0 | $593,009 | $0 | $71,000 | $0 | $49,579 | $0 | $271,866 | $0 | $15,100 | $0 | $1,000,554 | $0 | $0 |
| WILLIAM GEHRHARDT MD | ||||||||||||||
| MEDICAL DIRECTOR | $194,009 | $0 | $0 | $0 | $39,299 | $0 | $28,050 | $0 | $15,100 | $0 | $276,458 | $0 | $0 | $0 |
| ROGELIO CO MD | ||||||||||||||
| PHYSICIAN | $187,624 | $0 | $0 | $0 | $27,379 | $0 | $28,050 | $0 | $15,100 | $0 | $258,153 | $0 | $0 | $0 |
| ROBERTO BLANDO MD | ||||||||||||||
| PHYSICIAN | $187,999 | $0 | $0 | $0 | $7,686 | $0 | $28,050 | $0 | $15,100 | $0 | $238,835 | $0 | $0 | $0 |
| SAILI DESAI MD | ||||||||||||||
| PHYSICIAN | $145,338 | $0 | $0 | $0 | $4,614 | $0 | $28,050 | $0 | $15,100 | $0 | $193,102 | $0 | $0 | $0 |
| LISA ROLON | ||||||||||||||
| PHYSICIAN | $194,279 | $0 | $10,000 | $0 | $250 | $0 | $28,050 | $0 | $15,100 | $0 | $247,679 | $0 | $0 | $0 |
| TERENCE SMITH | ||||||||||||||
| BOARD MEMBER/ADMINISTRATOR | $0 | $126,254 | $0 | $9,867 | $0 | $45,860 | $0 | $28,050 | $0 | $15,100 | $0 | $225,131 | $0 | $0 |
| BRENDA GEORGE | ||||||||||||||
| PHYSICIAN | $143,235 | $0 | $0 | $0 | $1,178 | $0 | $28,050 | $0 | $15,100 | $0 | $187,563 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B | Certain individuals participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. Accordingly, the individual may never actually receive the unvested benefit amount and the amounts outlined herein were properly not reported in each individual's Form W-2, Box 5. These amounts are included in Schedule J, Column C for Kevin Lawlor ($243,816). |
| PART I, LINE 7 | On Form 990, Part VII, Section A, line 1A, the organization may provide non-fixed payments, not described on lines 5 and 6, to certain listed persons. The organization bases such payments on many performance based factors. Payments of this type appear on Schedule J, Part II, B (ii). |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - PART I - LINE 5 PART V - LINE 2A/2B | THE STAFF OF THE HEALTH CENTER IS EMPLOYED BY HUNTINGTON HOSPITAL ASSOCIATION (THE "HOSPTIAL") AND THEIR SALARY AND RELATED COSTS ARE ALLOCATED TO THE HEALTH CENTER. NO SALARY COSTS ARE PAID DIRECTLY BY THE HEALTH CENTER. THE W-2S FOR THE NUMBER OF EMPLOYEES LISTED ON THESE LINES ARE ISSUED BY THE HOSPITAL ON BEHALF OF THE HEALTH CENTER. AS SUCH, THE HEALTH CENTER IS NOT REQUIRED TO FILE ANY FEDERAL EMPLOYMENT TAX RETURNS. |
| FORM 990 - PART IV - LINE 12 AND PART XII - LINES 2 B/C | THE FINANCIAL STATEMENTS FOR THE HOSPITAL AND THE HEALTH CENTER ARE AUDITED ON A CONSOLIDATED BASIS WITH INDIVIDUAL CONSOLIDATING STATEMENTS FOR EACH ENTITY INCLUDED AS SUPPLEMENTAL SCHEDULES. A RECONCILIATION OF AMOUNTS PER THE CONSOLIDATING STATEMENTS FOR THE HEALTH CENTER INCLUDED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS, TO THE AMOUNTS REPORTED IN THE FORM 990 IS INCLUDED IN THE SUPPLEMENTAL SECTION OF SCHEDULE D. THE HOSPTIAL HAS AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. |
| FORM 990 - PART VI - LINES 6, 7 A/B | THE SOLE MEMBER OF THE HEALTH CENTER IS THE HOSPITAL. BOTH THE HEALTH CENTER AND THE HOSPITAL ARE MEMBERS OF THE NORTH SHORE LONG ISLAND JEWISH HEALTH SYSTEM, INC. (THE "SYSTEM"). THE SYSTEM AND ITS MEMBER ORGANIZATIONS AND OTHER AFFILIATED ENTITIES ARE AN INTEGRATED HEALTH DELIVERY SYSTEM IN THE NY METRO AREA. THE SYSTEM IS THE SOLE MEMBER OF THE NORTH SHORE LONG ISLAND JEWISH HEALTH CARE, INC. ("HEALTH CARE, INC."). HEALTH CARE, INC. IS THE SOLE MEMBER OF THE HOSPITAL AND THE SOLE MEMBER OF OTHER HEALTH CARE ORGANIZATIONS THAT ARE NOT PART OF THE HOSPTIAL. THE BOARD OF DIRECTORS FOR THE HEALTH CENTER IS COMPRISED OF THE EXECUTIVE COMMITTEE OF THE BOARD OF THE HOSPTIAL. THE SYSTEM HAS THE RIGHT TO ELECT THE MEMEBERS OF THE HOSPITAL'S BOARD OF DIRECTORS, INCLUDING THE RIGHT TO APPOINT 3 PERSONS TO THE BOARD WHO ARE TRUSTEES OR EMPLOYED CORPORATE OFFICERS OF THE SYSTEM. THE MAJORITY OF THE HOSPITAL'S BOARD OF DIRECTORS MUST BE RESIDENTS OF THE PRIMARY SERVICE AREA SERVED BY THE HOSPITAL. CERTAIN DECISIONS OF THE BOARD REQUIRE THE APPROVAL OF THE SYSTEM AS OUTLINED IN THE CORPORATED BY-LAWS. |
| FORM 990 PART VI - LINE 11A | The annual Return of Organization Exempt From Income Tax (Form 990) for North Shore-LIJ Health System Inc. and Affiliated entities are prepared with input from various departments including Corporate Compliance, Finance, Human Resources, and Legal. Before filing the returns, the documents are electronically made available to all trustees through a secure online portal. Members of the Executive Committee are then informed the returns are ready for review. The Executive Committee, which is a committee made up of members from the Board of Trustees, may exercise all of the authority of the Board of Trustees except as such authority is limited by applicable law and except to the extent, if any, that such authority would be inconsistent with any provision of these By-laws or is limited by any resolution to such effect adopted by the Board of Trustees. |
| FORM 990 PART VI - LINE 12 C | AS MEMBERS OF THE NORTH SHORE LoNG ISLAND JEWISH HEALTH SYSTEM, THE HEALTH CENTER AND AFFILIATED ENTITIES HAVE SEVERAL CONTROL MECHANISMS TO MITIGATE CONFLICTS OF INTEREST. THE CODE OF ETHICAL CONDUCT POLICY CONTAINS A DETAILED SECTION EDUCATING INDIVIDUALS ABOUT HOW TO AVOID POTENTIAL CONFLICTS OF INTEREST. SPECIFICALLY, THE CODE OF ETHICAL CONDUCT REQUIRES INDIVIDUALS TO CONDUCT BUSINESS IN A MANNER THAT PLACES THE INTEREST OF THE ORGANIZATION AHEAD OF PERSONAL INTERSTS. IN ADDITION, THE ORGANIZATION HAS A CONFLICTS OF INTEREST POLICY STATEMENT FURTHER ELABORATING UPON INDIVIDUAL'S DISCLOSURE AND RECUSAL OBLIGATIONS. INDIVIDUALS THAT ARE IN A POSITION TO INFLUENCE THE BUSINESS OR OTHER DECISIONS ARE REQUIRED TO FILL OUT A CONFLICTS OF INTEREST DISCLOSURE FORM ON A REGULAR BASIS. THE CORPORATE COMPLIANCE OFFICER REVIEWS ALL DISCLOSURES OF POSSIBLE CONFLICTS, INCLUDING MATTERS DISCLOSED IN ANY CONFLICTS OF INTEREST DISCLOSURE REPORT AND TAKES ANY ACTIONS DEEMED REQUIRED OR APPROPRIATE TO MANAGE OR RESOLVE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. IN APPROPRIATE CASES, THESE DISCLOSURES AND RESPONSIVE ACTIONS WILL BE REPORTED TO THE AUDIT AND CORPORATE COMPLIANCE COMMITTEE AND OTHER APPLICABLE COMMITTEES. IN ADDITION, THE ORGANIZATION PROVIDES TRAINING TO INDIVIDUALS ON AN ANNUAL BASIS REGARDING CONFLICTS OF INTEREST AND OTHER COMPLIANCE RELATED TOPICS. IF AN INDIVIDUAL VIOLATES THE CODE OF ETHICAL CONDUCT OR ANY RELATED POLICY SUCH AS THE CONFLICTS OF INTEREST POLICY STATEMENT, APPROPRIATE DISCIPLINARY ACTIONS IS TAKEN BASED UPON THE FACTS AND CIRCUMSTANCES OF THE SITUATION. |
| FORM 990 - PART VI - LINE 15 | THE BOARD OF DIRECTORS OF THE HOSPTIAL APPOINTED A COMPENSATION COMMITTEE WITH THE RESPONSIBILTY FOR REVIEWING AND APPROVING THE WAGES AND BENEFITS OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES. THE COMMITTEE CONSITS OF AT LEAST THREE INDIVIDUALS, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPED AN EXECUTIVE COMPENSATION POLICY THAT INCLUDES THE USE OF INDEPENDENT COMPENSATION SURVEYS COMPLIED BY INDEPENDENT FIRMS. THE COMMITTEE MEETS AT LEAST ANNUALLY. MINUTES OF THOSE MEETINGS ARE MAINTAINED BY HUMAN RESOURCES. COMPENSATION IS NOT PAID DIRECTLY BY THE HEALTH CENTER. |
| FORM 990 - PART VI - LINE 19 | THE HOSPITAL AND THE HEALTH CENTER MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ALSO AVAILABLE ONLINE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| HUNTINGTON HOSPITAL ASSOCIATION | ||||||||||
| 270 PARK AVENUE | HUNTINGTON | NY | 11743 | 111630914 | HOSPTIAL | NY | 501(c)(3) | 3 | HUNTINGTON | false |
| NORTH SHORE LIJ HEALTH SYSTEM | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 113418133 | SUPPORTING OR | NY | 501(c)(3) | 11, TYPE 1 | NA | false |
| NORTH SHORE LIJ HEALTH SYSTEM LABORATORI | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 113412370 | SUPPORTING OR | NY | 501(c)(3) | 11, TYPE 1 | NSLIJ HS | false |
| NORTH SHORE LIJ HEALTH CARE INC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 112965586 | SUPPORTING OR | NY | 501(c)(3) | 11, TYPE 1 | NSLIJ HS | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
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