ST CATHERINE OF SIENA MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ST CATHERINE OF SIENA MEDICAL CENTER (EIN 06-1562701)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2013-01-07
- IRS object ID
- 201300079349301570
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-01-07T13:58:21-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 221478099 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JH COHN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4 BECKER FARM ROAD | AddressLine1 |
| City | ROSELAND | City |
| State | NJ | State |
| ZIP Code | 07068 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061562701 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CATHERINE OF SIENA MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STCA | NameControl |
| Phone | 6318623000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 ROUTE 25A | AddressLine1 |
| City | SMITHTOWN | City |
| State | NY | State |
| ZIP Code | 11787 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JAMES CALDAS | Name |
| Title | PRESIDENT & CEO | Title |
| Phone | 6318623000 | Phone |
| Date Signed | 2013-01-07 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THOMAS LANNING | Name |
| PTIN | P00851654 | PTIN |
| Phone | 9732283500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JAMES CALDAS | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 ROUTE 25A | AddressLine1 |
| City | SMITHTOWN | City |
| State | NY | State |
| ZIP Code | 11787 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 259626178 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | HTTP://STCATHERINES.CHSLI.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | ST CATHERINE OF SIENA MEDICAL CENTER, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED, CHSLI AFFIRMS THE SANCTITY OF LIFE, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 23 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 22 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2426 | TotalNbrEmployees |
| Total Nbr Volunteers | 206 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 453782 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 414936 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 242916127 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 254756670 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 453872 | InvestmentIncomePriorYear |
| Investment Income Current Year | 589064 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2824435 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2475183 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 246648216 | TotalRevenuePriorYear |
| Total Revenue Current Year | 258235853 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 155389 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 264159 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 142552535 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 150268177 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 96782194 | OtherExpensePriorYear |
| Other Expenses Current Year | 98921743 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 239490118 | TotalExpensesPriorYear |
| Total Expenses Current Year | 249454079 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 7158098 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 8781774 | RevenuesLessExpensesCY |
| Total Assets BOY | 169490228 | TotalAssetsBOY |
| Total Assets EOY | 170806861 | TotalAssetsEOY |
| Total Liabilities BOY | 226721170 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 220941600 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -57230942 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -50134739 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | ST CATHERINE OF SIENA MEDICAL CENTER, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, COMMITTED TO THOSE IN NEED, CHSLI AFFIRMS THE SANCTITY OF LIFE, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 199539704 | Expense |
| Revenue | 221376709 | Revenue |
| Description | ST. CATHERINE OF SIENA MEDICAL CENTER IS A 318 BED ACUTE CARE HOSPITAL DEVOTED TO PROVIDING ADVANCED HEALTHCARE IN AN ENVIRONMENT OF COMPASSION. IN 2011, THE MEDICAL CENTER HAD 15,488 DISCHARGES AND PROVIDED CARE FOR 33,249 EMERGENCY ROOM VISITS. IN ACCORDANCE WITH ITS MISSION AND PHILOSOPHY, THE MEDICAL CENTER PROVIDES CARE REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY AND ALONG WITH OTHER UNCOMPENSATED CARE REPORTED, AT COST, $3,014,000 IN CHARITY CARE. COMMUNITY SERVICE AND OTHER CHARITABLE ACTIVITIES PROVIDED FOR THE COMMUNITY TOTALED, AT COST, $2,690,000 AND REPORTED, AT COST, $1,314,000 IN UNCOMPENSATED CARE AS BAD DEBTS IN 2011. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 29790608 | Expense |
| Revenue | 35564492 | Revenue |
| Description | ST. CATHERINE OF SIENA NURSING HOME IS LOCATED ON THE CAMPUS OF ST. CATHERINE OF SIENA MEDICAL CENTER. CONSISTING OF 240 BEDS, THE NURSING HOME PROVIDED 84,167 DAYS OF CARE IN 2011. THE NURSING HOME PROVIDED $686,500 IN UNCOMPENSATED CARE AS BAD DEBT IN 2011. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 229330312 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 156 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 2426 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 23 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 22 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHS SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 5167051937 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 992 NORTH VILLAGE AVENUE | AddressLine1 |
| City | ROCKVILLE CENTRE | City |
| State | NY | State |
| ZIP Code | 11570 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (34 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| GARY VEITH MD | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| GEORGE RICE | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| HENRY C SCHREIBER | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| HON JEANNE GARANT | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| J ROBERT GROSS DC | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| JAMES CALDAS | |||||||||
| PRESIDENT & CEO | 50.00 | X | 0 | 1119792 | 195571 | X | |||
| JAMES DILTS | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| JAMES UMBDENSTOCK | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| JEROME POLLER | |||||||||
| VICE CHAIR | 2.00 | X | 0 | 0 | 0 | X | |||
| JERRY NINIA MD | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| JOHN F VAN BOURGONDIEN | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| JOHN HALLERON III ESQ | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| MICHAEL LAMBERT | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| RAYMOND BORSELLA | |||||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | X | |||
| REV MSGR JOHN ROWAN | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| REV MSGR JAMES MCNAMARA | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| RICHARD SCHMIDT | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| ROBERT CARLIN MD | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| SALVATORE SODANO | |||||||||
| CHAIRPERSON | 2.00 | X | 0 | 0 | 0 | X | |||
| SISTER ANN GRAY DW | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| SYLVIA DIAZ | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| THOMAS REILLY | |||||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | X | |||
| WILLIAM A MULLANEY | |||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | ||||
| DAN MACKSOOD | |||||||||
| SVP FINANCE/CFO EASTERN DIV | 50.00 | 0 | 189743 | 12563 | X | ||||
| DENNIS VERZI | |||||||||
| EXEC V/P & CAO | 50.00 | 1375744 | 0 | 153668 | X | ||||
| PATRICK O'SHAUGHNESSY | |||||||||
| CHIEF MEDICAL OFFICER | 50.00 | 340796 | 0 | 19216 | X | ||||
| DAVID RIVADENEIRA | |||||||||
| PHYSICIAN | 40.00 | 871568 | 0 | 50930 | X | ||||
| GARA EDELSTEIN | |||||||||
| SENIOR V/P ADMIN & CNO | 50.00 | 869923 | 0 | 106262 | X | ||||
| JILL GENUA | |||||||||
| PHYSICIAN | 40.00 | 239020 | 0 | 44017 | X | ||||
| JUNE J LEE | |||||||||
| PHYSICIAN | 40.00 | 376412 | 0 | 32309 | X | ||||
| MICHAEL QUARTARARO | |||||||||
| VP OF LONG TERM HEALTH | 50.00 | 236177 | 0 | 41472 | X | ||||
| FRANK J FOX | |||||||||
| FORMER SENIOR V/P & CEO | 0.00 | 0 | 1756606 | 16424 | X | ||||
| WILLIAM ALLISON | |||||||||
| FORMER PRESIDENT & CEO | 0.00 | 0 | 577460 | 0 | X | ||||
| SHARON KENNISH | |||||||||
| FORMER EXECUTIVE DIRECTOR | 0.00 | 615485 | 0 | 1354 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4925125 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3643601 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 673786 | TotalOtherCompensation |
| Number Individuals GT100 K | 195 | NumberIndividualsGT100K |
| Formers Listed | 1 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| HUNTER ROBERTS INC | |||||
| 2 WORLD FINANCIAL CENTER | NEW YORK | NY | 10281 | CONTRACTOR-RENOVATIONS | 2042620 |
| JVK OPERATIONS LIMITED | |||||
| 130 NEW HIGHWAY | NORTH AMITYVILLE | NY | 11701 | LAUNDRY SERVICES | 692578 |
| ISLAND NEONATOLOGY LLC | |||||
| PO BOX 272 | EAST ISLIP | NY | 11730 | MEDICAL SERVICES | 450000 |
| LAB CORP OF AMERICA HOLDGIN | |||||
| PO BOX 12140 | BURLINGTON | NY | 27216 | MEDICAL SERVICES | 381200 |
| HORIZON HEALTHCARE STAFFING | |||||
| 20 JERUSALEM AVE | HICKSVILLE | NY | 11801 | STAFFING SERVICES | 284704 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 22 | NumberOfContractorsGT100K |
| Federated Campaigns | 1411 | FederatedCampaigns |
| Fundraising Events | 272235 | FundraisingEvents |
| Government Grants | 11589 | GovernmentGrants |
| All Other Contributions | 129701 | AllOtherContributions |
| Total Contributions | 414936 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REV-HOSP | 621990 | 219192178 | 219192178 |
| NET PATIENT REV-NH | 623000 | 35564492 | 35564492 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 254756670 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 589064 | TotalRevenueColumn |
| Exclusion | $589,064 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1593738 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1290169 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 303569 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 303569 | TotalRevenueColumn |
| Related Or Exempt Function Income | 303569 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 145164 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 272235 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 100156 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 45008 | TotalRevenueColumn |
| Exclusion | $45,008 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Business CodeBusinessCode | ExclusionExclusionAmount |
|---|---|---|---|---|
| CONTRACTED SVCS-SWSM | 1880962 | 1880962 | ||
| TELEPHONE | 96892 | 900099 | $96,892 | |
| CAFETERIA | 72425 | 722210 | $72,425 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 76327 | TotalRevenueColumn |
| Exclusion | $76,327 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2126606 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 258235853 | TotalRevenueColumn |
| Related Or Exempt Function Income | 256941201 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $879,716 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 264159 | Total |
| Program Services | 264159 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5152556 | Total |
| Program Services | 2925150 | ProgramServices |
| Management And General | 2227406 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 106608291 | Total |
| Program Services | 103240097 | ProgramServices |
| Management And General | 3368194 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7559046 | Total |
| Program Services | 7162291 | ProgramServices |
| Management And General | 396755 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22240060 | Total |
| Program Services | 21072735 | ProgramServices |
| Management And General | 1167325 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8708224 | Total |
| Program Services | 8251151 | ProgramServices |
| Management And General | 457073 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1937662 | Total |
| Program Services | 446066 | ProgramServices |
| Management And General | 1491596 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 765342 | Total |
| Management And General | 765342 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 137296 | Total |
| Management And General | 137296 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 48365 | Total |
| Management And General | 48365 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10319077 | Total |
| Program Services | 9898867 | ProgramServices |
| Management And General | 420210 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 790252 | Total |
| Program Services | 701735 | ProgramServices |
| Management And General | 88517 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4218682 | Total |
| Program Services | 3778413 | ProgramServices |
| Management And General | 440269 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2868667 | Total |
| Program Services | 2450040 | ProgramServices |
| Management And General | 418627 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35275 | Total |
| Program Services | 31324 | ProgramServices |
| Management And General | 3951 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65512 | Total |
| Program Services | 58174 | ProgramServices |
| Management And General | 7338 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5256464 | Total |
| Program Services | 4667678 | ProgramServices |
| Management And General | 588786 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3400900 | Total |
| Program Services | 1397633 | ProgramServices |
| Management And General | 2003267 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7049495 | Total |
| Program Services | 6259869 | ProgramServices |
| Management And General | 789626 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1547071 | Total |
| Program Services | 1156609 | ProgramServices |
| Management And General | 390462 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 37948816 | 37948816 | |
| FINANCE AND TECHNOLOGY | 10280386 | 9075525 | 1204861 |
| PROVISION FOR BAD DEBTS | 4457880 | 4457880 | |
| MISCELLANEOUS | 3366479 | 153980 | 3212499 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4428122 | Total |
| Program Services | 3932120 | ProgramServices |
| Management And General | 496002 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 249454079 | Total |
| Program Services | 229330312 | ProgramServices |
| Management And General | 20123767 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25188382 | BOY |
| EOY | 13440337 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2960175 | BOY |
| EOY | 5984874 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 59918 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28048406 | BOY |
| EOY | 29443219 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2841429 | BOY |
| EOY | 3082660 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 788787 | BOY |
| EOY | 969631 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 146805497 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 58245822 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 84960779 | BOY |
| EOY | 88559675 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22710216 | BOY |
| EOY | 6843900 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1992054 | BOY |
| EOY | 22422647 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 169490228 | BOY |
| EOY | 170806861 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25711959 | BOY |
| EOY | 25030361 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 76890260 | BOY |
| EOY | 68875949 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28766667 | BOY |
| EOY | 1250000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 95352284 | BOY |
| EOY | 125785290 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 226721170 | BOY |
| EOY | 220941600 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -57609932 | BOY |
| EOY | -50555216 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 378990 | BOY |
| EOY | 420477 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -57230942 | BOY |
| EOY | -50134739 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 169490228 | BOY |
| EOY | 170806861 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 8781774 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -1685571 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $48,365 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 48365 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | AMOUNT REFLECTS PORTION OF TRADE ASSOCIATION DUES WHICH WERE USED FOR LEGISLATIVE LOBBYING ON THE BEHALF OF THE HEALTHCARE INDUSTRY THOSE TRADE ORGANIZATIONS REPRESENT. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10126496 | OtherCostOrOtherBasis |
| Book Value | 10126496 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 87873496 | OtherCostOrOtherBasis |
| Depreciation | 30523373 | Depreciation |
| Book Value | 57350123 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 47896670 | OtherCostOrOtherBasis |
| Depreciation | 27234663 | Depreciation |
| Book Value | 20662007 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 908835 | OtherCostOrOtherBasis |
| Depreciation | 487786 | Depreciation |
| Book Value | 421049 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 88559675 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| INSURANCE CLAIMS RECEIVABLE | 20679157 |
| OTHER ASSETS | 288915 |
| DEFERRED FINANCING COSTS, NET | 1418395 |
| DUE FROM RELATED PARTIES, NET | 36180 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 22422647 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (8 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| RESIDENT FUNDS AND SECURITY DEPOSITS | $384,439 |
| THIRD PARTY PAYOR LIABILITY | $30,511,854 |
| RETIREMENT LIABILITY-PENSION | $579,138 |
| RETIREMENT LIABILITY-457B FUNDS | $122,184 |
| RETIREMENT LIABILITY-POST RETIREMENT | $1,551,000 |
| ESTIMATED MALPRACTICE LIABILITY | $22,343,650 |
| SELF INSURED LIABILITY | $26,804,885 |
| DUE TO RELATED PARTIES | $43,488,140 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 125785290 | TotalOfAmounts |
| Total Revenue | 258235853 | TotalRevenue |
| Total Expenses | 249454079 | TotalExpenses |
| Excess Or Deficit For Year | 8781774 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -111042 | NetUnrealizedGLOnInvestments |
| Donated Services And Facilities | 27483 | DonatedServicesAndFacilities |
| Other | -$1,602,012 | OtherAmount |
| Total Adjustments | -1685571 | TotalAdjustments |
| Excess Or Deficit Per FS | 7096203 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 262908279 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 27483 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | 3789254 | OtherRevenues |
| Revenue Not Rptd F990 | 3816737 | RevenueNotRptdF990 |
| Revenue Subtotal | 259091542 | RevenueSubtotal |
| Other Revenues Not Included | -855689 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -855689 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 258235853 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 250414439 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 4625419 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 4625419 | ExpensesNotRptdF990 |
| Expenses Subtotal | 245789020 | ExpensesSubtotal |
| Other Expenses Not Included | 3665059 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 3665059 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 249454079 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THERE ARE NO TRANSACTIONS THAT MANAGEMENT HAS DEEMED TO BE "UNRELATED BUSINESS INCOME" AND THEREFORE NO TAX LIABILITY HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. MANAGEMENT REVIEWS TRANSACTIONS TO ESTIMATE POTENTIAL TAX LIABILITIES USING A THRESHOLD OF MORE LIKELY THAN NOT OF BEING SUSTAINED. |
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | POSTRETIREMENT BENEFIT PLAN CHANGES OTHER THAN PERIODIC BENEFIT COST -139,000. LOSS ON DEBT EXTINGUISHMENT -1,463,012. TOTAL TO SCHEDULE D, PART XI, LINE 8: -1,602,012. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | SIENA VILLAGE REVENUE-SEPARATE ENTITY 3,726,889. NARR-OPERATIONS 62,365. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | MEDICAL OFFICE BUILDING RENTAL EXPENSES -1,290,169. RESTRICTED CONTRIBUTIONS 427,813. GRANT INCOME FOR PURCHASE OF PPE 6,667. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | MEDICAL OFFICE BUILDING EXPENSES 1,290,169. SIENA VILLAGE EXPENSES-SEPARATE ENTITY 3,335,250. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | CHS TRANSFER 2,788,328. CHSLI TRANSFER 876,731. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | DINNER DANCE | NameOfEvent1 |
| Gross Receipts Event1 | 282719 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 185950 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 96769 | GrossRevenueEvent1 |
| Food And Beverage Event1 | 48007 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 4750 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 14688 | OtherDirectExpensesEvent1 |
| Name Of Event2 | GOLF OUTING | NameOfEvent2 |
| Gross Receipts Event2 | 134680 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 86285 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 48395 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 2524 | NonCashPrizesEvent2 |
| Rent Facility Costs Event2 | 15602 | RentFacilityCostsEvent2 |
| Food And Beverage Event2 | 8928 | FoodAndBeverageEvent2 |
| Other Direct Expenses Event2 | 5657 | OtherDirectExpensesEvent2 |
| Gross Receipts Total | 417399 | GrossReceiptsTotal |
| Charitable Contributions Total | 272235 | CharitableContributionsTotal |
| Gross Revenue Total Events | 145164 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 2524 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 15602 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 56935 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 4750 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 20345 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 100156 | DirectExpenseSummaryEvents |
| Net Income Summary | 45008 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent400 | X | Pcent400 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3795536 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 428928 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3366608 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01370 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17199327 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15770163 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1429164 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00580 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 69242 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 104674 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -35432 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 21064105 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 16303765 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4760340 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01950 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 630463 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 630463 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00260 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 11117 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 11117 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 923909 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 888691 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 35218 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1565489 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 888691 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 676798 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 22629594 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17192456 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5437138 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02220 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,150,133 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 78280751 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 90459876 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -12179125 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CATHERINE OF SIENA HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 ROUTE 25A | AddressLine1 |
| City | SMITHTOWN | City |
| State | NY | State |
| ZIP Code | 11787 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
| Other | PSYCHIATRIC UNIT | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STCATHERINE OF SIENA MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | 0 | CHNAConducted |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 300.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 400.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Lowest Negotiated Rates | X | LowestNegotiatedRates |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CATHERINE OF SIENA NURSING HOME | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 52 ROUTE 25A | AddressLine1 |
| City | SMITHTOWN | City |
| State | NY | State |
| ZIP Code | 11787 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | SKILLED NURSING FACILITY | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| ExplanationExplanation | Return ReferenceReturnReference | IdentifierIdentifier |
|---|---|---|
| PART I, LINE 7: RATIO OF PATIENT CARE COST TO CHARGES WORKSHEET (WORKSHEET 2) AS PRESCRIBED BY THE IRS INSTRUCTIONS TO SCHEDULE H FORM 990 WAS THE METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN PART 1, LINE 7 CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST LINES 7A,7B AND 7C AND 7D. ALL OTEHR LINES INCLUDE COSTS THAT WERE DERIVED ON THE RCC METHODOLOGY OR ACTUAL COSTS FOR THE SERVICES AS TRACKED BY HOSPITAL PERSONNEL UTILIZING DIRECT HOURLY LABOR COSTS, FRINGES AND SUPPLY COSTS.PART 1, LINE 7A COLUMN DDIRECT OFFSETTING REVENUES REPRESENT DISTRIBUTIONS FROM THE NEW YORK STATE (NYS) INDIGENT CARE POOL (ICP) WHICH IS SHOWN NET OF HOSPITAL CONTRIBUTIONS TO THE STATEWIDE POOL. THE FORMULA EMPLOYED BY NYS TO DETERMINE DISTRIBUTIONS TO HOSPITALS FROM THE ICP IS COMPLEX AND IS DERIVED FROM A HOSPITAL'S "NEED" CALCULATION. THIS CALCULATION CONSIDERS 90% OF A HOSPITALS "NEED" IS BASED ON BAD DEBTS AND CHARITY CARE WRITE OFFS AND 10% IS BASED ON A "UNITS OF SERVICE" METHODOLOGY FOR UNINSURED PATIENTS. THE HOSPITAL APPORTIONED THE ICP REVENUE BETWEEN BAD DEBT AND CHARITY CARE FOR REPORTING ON LINE 7A BASED ON THE PROPORTION OF EACH TO THE TOTAL OF ACTUAL BAD DEBTS AND CHARITY CARE FOR 2011. IT IS IMPORTANT HOWEVER TO BE AWARE THAT THE COSTS OF BAD DEBTS ARE NOT INCLUDED IN LINE 7A, COLUMN C WHILE THE OFFSETTING REVENUE IS INCLUDED IN LINE 7A, COLUMN D. BAD DEBTS AT COST ARE EXCLUDED FROM LINE 7 AND REPORTED IN PART III, LINE 2 IN ACCORDANCE WITH THE INSTRUCTIONS. AS A RESULT, THE NET COST OF FINANCIAL ASSISTANCE AT COST ON LINE 7A, COLUMN F IS UNDERSTATED FOR NYS HOSPITALS WHO REPORT IN ACCORDANCE WITH THE INSTRUCTIONS AND IN SOME INSTANCES MAY SHOW A GAIN DUE TO THE MISMATCHING OF REVENUE AND EXPENSE. IT IS IMPORTANT TO CONSIDER THE BAD DEBTS AT COST AMOUNT IN PART III, LINE 2 WHEN EVALUATING THE NET COSTS OF UNCOMPENSATED CARE FOR HOSPITALS IN NYS. | ||
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4457880. | ||
| REFLECTS HOSPITAL INFORMATION ONLY. | PART I, LINE 7 | |
| PART II: FOOD DRIVES ST. CATHERINE CONDUCTS SEVERAL FOOD DRIVES THROUGHOUT THE YEAR INCLUDING THANKSGIVING AND CHRISTMAS TO ASSIST LOCAL FOOD PANTRIES. ALL NON-PERISHABLE ITEMS AND PERSONAL CARE ITEMS ARE DONATED TO THE LOCAL CONSORTIUM OF FOOD PANTRIES CONSISTING OF LOCAL PARISHES. IN ADDITION, FOOD DRIVES ARE HELD BEFORE EACH OF THE FIVE HEALTHY SUNDAYS (OUTREACH TO PROVIDE SERVICES TO UNDERSERVED COMMUNITIES ORGANIZED THROUGH PARISHES) AND THE ITEMS COLLECTED ARE DONATED TO THE PARISHS FOOD PANTRY WHERE HEALTHY SUNDAYS ARE HELD. IN 2011, 83 OF ST. CATHERINES STAFF MEMBERS VOLUNTEERED TO COVER FOUR HEALTHY SUNDAYS REACHING FOUR HUNDRED AND TWENTY EIGHT PARISHIONERS.APPROXIMATELY 600 POUNDS OF FOOD AND CLOTHES WERE DONATED BY STAFF.ST. CATHERINE OF SIENA ATTENDS MANY COMMUNITY EVENTS THROUGH THE YEAR, INCLUDING: HAUPPAUGE INDUSTRIAL ASSOCIATION TRADESHOW, KINGS PARK DAY, ST. JAMES DAY, SMITHTOWN DAY, SUFFOLK SENIOR EVENT, UNITED CEREBAL PALSY HEALTH FAIR, HBO HEALTH FAIR, AND PROVIDES REPRESENTATIVES FROM SEVERAL DEPARTMENTS TO ATTEND AND ANSWER HEALTH RELATED QUESTIONS AND DISTRIBUTE INFORMATIONAL MATERIALS. IN ADDITION, IN 2011, ST. CATHERINE HELD A HEALTH FAIR THAT WAS ATTENDED BY OVER 700 COMMUNITY MEMBERS, TWO COLON CANCER AWARENESS LECTURES, AND A HEART HEALTH DAY. FOUR TOTAL CONTINUING MEDICAL EDUCATION DINNER LECTURES WERE HELD FOR FIRST RESPONDERS IN THE AREA AT NO CHARGE. AND, ST. CATHERINE HELD ITS FIRST CANCER SURVIVOR DINNER, TO OFFER AN UPLIFTING EVENING OF HEALTH AND WELLNESS. THANKSGIVING MEALS FOR HOMEBOUND RESIDENTS OF SIENA VILLAGE - ST.CATHERINE DONATES A TRADITIONAL THANKSGIVING MEAL TO ALL HOMEBOUND RESIDENTS OF SIENA VILLAGE. THE MEALS ARE PREPARED BY THE HOSPITAL STAFF AND DELIVERED TO SIENA VILLAGE WHERE THEY ARE DISTRIBUTED TO INDIVIDUAL RESIDENT APARTMENTS BY A LOCAL YOUTH GROUPKINGS PARK DAY REPRESENTATIVES FROM SEVERAL DEPARTMENTS ATTEND THIS EVENT TO ANSWER HEALTH RELATED QUESTIONS AND EDUCATE ATTENDEES ON HEALTH RELATED TOPICS SUCH AS BREAST HEALTH, DIGESTIVE TRACT HEALTH AND HEALTHY LIFE STYLE/NUTRITION. EDUCATIONAL MATERIAL IS ALSO PROVIDED.THANKSGIVING MEALS FOR HOMEBOUND RESIDENTS OF SIENA VILLAGE - ST. CATHERINE DONATES A TRADITIONAL THANKSGIVING MEAL TO ALL HOMEBOUND RESIDENTS OF SIENA VILLAGE. THE MEALS ARE PREPARED BY THE HOSPITAL STAFF AND DELIVERED TO SIENA VILLAGE WHERE THEY ARE DISTRIBUTED TO INDIVIDUAL RESIDENT APARTMENTS BY A LOCAL YOUTH GROUP | ||
| PART III, LINE 4: COSTING METHODOLOGYBAD DEBT AT COST WAS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 TO BAD DEBT EXPENSE, WHICH IS REPORTED AT CHARGES.PART III LINE 4-TEXT OF FOOTNOTE DISCUSSING BAD DEBT:THE ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THIS ALLOWANCE BASED UPON HISTORICAL COLLECTION AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTABLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE MEDICAL CENTER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE.PART III LINE 4-BAD DEBT AS COMMUNITY BENEFIT:AS PART OF ITS TAX EXEMPT PURPOSE THE HOSPITAL PROVIDES ACCESS TO MEDICALLY NECESSARY CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, OR CULTURAL BACKGROUND. THE HOSPITAL TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF WHETHER THEY HAVE THIRD-PARTY COVERAGE OR THE ABILITY TO PAY. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE HOSPITAL IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. A PATIENTS PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE FROM THE HOSPITAL SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT SINCE CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR TAX EXEMPT PURPOSE, WHICH IS MEETING THE NEED FOR EMERGENCY AND NON-ELECTIVE MEDICAL CARE SERVICES IN THE COMMUNITY. | ||
| PART III, LINE 8: THE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 2011 CMS-2552 (MEDICARE COST REPORT). MEDICARE REVENUE IS BASED ON THE MEDICARE PROVIDER STATISTICAL AND REIMBURSEMENT REPORT AND MEDICARE COSTS ARE DEVELOPED UTILIZING A RATIO OF MEDICARE ALLOWABLE COSTS TO CHARGES METHODOLOGY.ST. CATHERINE INCURRED A LOSS OF APPROXIMATELY $12.0 MILLION TO DELIVER CARE TO MEDICARE PATIENTS. THIS REPRESENTS THE AMOUNT BY WHICH COSTS TO DELIVER CARE TO MEDICARE RECIPIENTS EXCEEDS THE LEVEL OF PAYMENT. ST. CATHERINE BEARS THE BURDEN OF NOT ONLY PROVIDING THE BEST AND MOST ADVANCED MEDICAL CARE POSSIBLE TO THE COMMUNITY, BUT ALSO DOING SO WITH NO RECOURSE TO OBTAIN PAYMENT FOR THE COST OF PROVIDING CARE IN EXCESS OF THE MEDICARE PAYMENT. AS MEDICARE REVENUE DECLINES AND THE COST TO PROVIDE CUTTING EDGE CARE TO THE COMMUNITY INCREASES, THE HOSPITAL WILL CARRY THE BURDEN. AS A PARTICIPATING PROVIDER AND A CHARITABLE ORGANIZATION, MEDICARE PATIENTS, THE MAJORITY OF WHOM ARE ELDERLY AND DISABLED ARE NOT TURNED AWAY, SO ST. CATHERINE WILL CONTINUE TO BEAR THE LOSS IN PROVIDING THE BEST CARE POSSIBLE TO THE LOCAL COMMUNITY.LOSSES ON TREATING MEDICARE BENEFICIARIES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT IN THEIR ENTIRETY. | ||
| PART III, LINE 9B: THE HOSPITAL'S CHARITY CARE POLICY DESCRIBES THE POLICIES AND PROCEDURES RELATING TO THE PROVISION OF CHARITY CARE TO PERSONS WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THEIR BILL. NO INDIVIDUAL WILL BE DENIED MEDICALLY NECESSARY HOSPITAL SERVICES BASED ON A DEMONSTRATED INANBILITY TO PAY FOR THOSE SERVICES. IN ADDITION, UPON APPLYING FOR CHARITY CARE, EACH PATIENT AND PATIENT GUARANTOR'S ABILITY TO PAY WILL BE ASSESSED.ELIGIBILITY FOR ASSISTANCE: A REASONABLE REVIEW SHALL BE PERFORMED PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (I.E. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE MEDICAL CENTERS CHARITY CARE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY ACCOUNT THAT SUBSEQUENTLY IS DETERMINED TO MEET THE CHARITY CARE CRITERIA SHALL BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT FOR APPROPRIATE FOLLOW-UP.THE THIRD-PARTY COLLECTION AGENT SHALL ADVISE THE PATIENT/GUARANTOR OF THE HOSPITAL'S CHARITY CARE POLICY AND RETURN THE ACCOUNT IMMEDIATELY IF IT IS DETERMINED THAT THE QUALIFICATIONS ARE MET. | ||
| PART VI, LINE 2: ASSESSMENT OF COMMUNITY NEEDS AND GOALSST. CATHERINES PROVIDES HIGH QUALITY CARE WITH COMPASSION AND RESPECT FOR EACH PATIENT REGARDLESS OF AGE, RELIGION, RACE, GENDER OR ABILITY TO PAY. THE STANDARD OF CARE IS EQUAL FOR ALL PATIENTS. ST. CATHERINES IS CONTINUOUSLY EVALUATING THE SERVICE AREA NEEDS BY REVIEWING PATIENT SURVEYS, COMMUNITY FEEDBACK, DEMOGRAPHIC DATA, COMMUNITY HEALTH INDICATORS AND PATIENT CARE TRENDS TO DEVELOP AND REFINE ITS SCOPE OF SERVICES AND DELIVERY OF CARE.THE HEALTHY SUNDAYS PROGRAM, WHICH PROVIDES FREE MEDICAL SCREENINGS AND EDUCATION TO THE UNDERSERVED FOLLOWING WORSHIP SERVICES ON A BIMONTHLY BASIS, WAS THE RESULT OF A JOINT COMMUNITY NEEDS ASSESSMENT BY CHS HOSPITALS. THESE EVENTS ARE PROMOTED VIA CALENDAR LISTINGS IN PARISH BULLETINS AND FLYERS POSTED IN PLACES OF BUSINESS AND WORSHIP IN THE COMMUNITY SURROUNDING THE OUTREACH SITE. | ||
| PART VI, LINE 3: COMMUNICATION OF FINANCIAL ASSISTANCE POLICY:1. SINCE IT IS THE DUTY OF THE MEDICAL CENTER TO ENSURE THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF ITS CHARITY CARE POLICY, ALL EMPLOYEES IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS ARE FULLY VERSED IN THE CHARITY CARE POLICY, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE MEDICAL CENTER REPRESENTATIVES.2. THE MEDICAL CENTER HAS POSTED MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN THE MEDICAL CENTER INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREAS. SAID NOTICES ARE PUBLISHED IN AT LEAST ENGLISH AND SPANISH, AND ARE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED.3. THE MEDICAL CENTER PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS OF APPLYING FOR ASSISTANCE. THIS SUMMARY IS WRITTEN AT OR BELOW A SIXTH GRADE READING LEVEL.4. THE MEDICAL CENTER POSTS ITS CHARITY CARE POLICY SUMMARY ON THEIR INTERNET WEBSITE.5. THE MEDICAL CENTER PROVIDES ALL PATIENTS ACCESS TO INTERPRETERS TO ASSIST THEM IN UNDERSTANDING ITS CHARITY CARE PROGRAM IN THE PRIMARY LANGUAGE SPOKEN BY THE PATIENT DURING ANY PRE-ADMISSION, ADMISSION, AND DISCHARGE PROCESS. 6. ON ALL BILLS AND STATEMENTS SENT TO PATIENTS, A STATEMENT IS INCLUDED REGARDING THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING CHARITY CARE, AND A CONTACT NUMBER TO CALL TO OBTAIN FURTHER INFORMATION. THIS INFORMATION IS PROVIDED AT OR BELOW A SIXTH GRADE READING LEVEL. | ||
| PART VI, LINE 4: COMMUNITY INFORMATIONST. CATHERINES SERVICE AREA CONSISTS OF 21 COMMUNITIES LOCATED IN WESTERN SUFFOLK COUNTY. ST. CATHERINES PRIMARY CATCHMENT AREA HAS A POPULATION OF APPROXIMATELY 648,000 PER 2010 CSP AND INCLUDES: SMITHTOWN, ST. JAMES, HAUPPAUGE, KINGS PARK, COMMACK, NESCONSET, NORTHPORT AND EAST NORTHPORT. THESE COMMUNITIES REPRESENT APPROXIMATELY 53% OF TOTAL ADMISSIONS.ST CATHERINES PRIMARY SERVICE AREA, DEFINED AS 75% TOTAL DISCHARGES, CONSISTS OF 13 COMMUNITIES LOCATED IN SUFFOLK COUNTY AND IN 2010 HAD A POPULATION OF APPROXIMATELY 414,000 RESIDENTS ACCORDING THE EHANYS: MARKET EXPERT. THE TOWNS INCLUDE SMITHTOWN, RONKONKOMA, KINGS PARK, COMMACK, ST. JAMES, HAUPPAUGE, NESCONSET, BRENTWOOD, CENTRAL ISLIP, EAST NORTHPORT, HOLBROOK, CENTEREACH AND BAYSHORE.FROM 2010-2015, THERE IS A PROJECTED INCREASE OF APPROXIMATELY 2% (OR 8,700) OF THOSE RESIDENTS WITHIN ST. CATHERINE OF SIENA MEDICAL CENTERS PRIMARY SERVICE AREA THAT ARE 65 YEARS OF AGE OR OLDER. | ||
| PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTHST. CATHERINE OF SIENA MEDICAL CENTER OFFERS A WIDE AND COMPREHENSIVE ARRAY OF COMMUNITY SERVICE PROGRAMS THAT ADDRESS CRITICAL HEALTH ISSUES TO A DIVERSITY OF PATIENTS, INCLUDING:ANNUAL COMMUNITY HEALTH FAIR: ST. CATHERINES ANNUAL COMMUNITY HEALTH FAIRIS A PIVOTAL EDUCATION PORTAL AND WAS ATTENDED BY APPROXIMATELY 700 COMMUNITY MEMBERS IN 2011. THE HEALTH FAIR OFFERS FREE HEALTH CAREEDUCATION AND SCREENINGS, WHICH INCLUDED SKIN CANCER AND PROSTATE SCREENINGS, FREE FLU SHOTS WERE ADMINISTERED AND SERVICES ON CAMPUS WERE HIGHLIGHTED.AUXILIARY VOLUNTEER DEPARTMENT: THE AUXILIARY AND VOLUNTEERS OF ST. CATHERINE OF SIENA MEDICAL CENTER ARE A GROUP OF DEDICATED AND GENEROUS INDIVIDUALS, WHO OFFER THEIR TIME, TALENT AND SERVICES TO PATIENTS AND STAFF ON A DAILY BASIS. THE AUXILIARY ALSO DONATES FUNDS TO SUPPORT THE MISSION OF THE MEDICAL CENTER, RAISED THROUGH FUNDRAISING ACTIVITIES THAT INCLUDE: MANAGING THE HOSPITAL GIFT SHOP, PLANTS SALES AND SPECIAL EVENTS.COMMUNITY BLOOD DRIVES: ST. CATHERINE HOSTS FOUR BLOOD DRIVES ANNUALLY IN COLLABORATION WITH LONG ISLAND BLOOD SERVICES, A DIVISION OF NEW YORK BLOOD CENTER.COMMUNITY NEWSLETTER: ST. CATHERINES PUBLISHES A QUARTERLY NEWSLETTER, THE VOICE. WHICH IS MAILED THROUGHOUT THE PRIMARY CATCHMENT AREA, WHICH COVERS OVER 100,000 HOUSEHOLDS. THE VOICE HAS BEEN INCREASED TO A 12-PAGE DOCUMENT AND THE VOICE IS A PRIMARY COMPONENT OF EDUCATING THE COMMUNITY ABOUT HEALTH-RELATED ISSUES AND KEEPING THEM INFORMED OF UPCOMING EVENTS AND HOSPITAL SERVICES.EMERGENCY RESPONSE APPRECIATION DINNERS: EMERGENCY RESPONSE PERSONNEL ARE AT THE FOREFRONT OF THE MEDICAL PROCESS. THEY PROVIDE IMMEDIATE MEDICAL SERVICE AND WORK COLLABORATIVELY TO OFFER TIMELY CARE. ST. CATHERINES OFFERS A QUARTERLY EMERGENCY RESPONSE APPRECIATION AND CONTINUING MEDICAL EDUCATION (CME) DINNER FOR LOCAL EMERGENCY RESPONSE PERSONNEL. THE APPRECIATION DINNERS WERE IMPLEMENTED IN 2008, AND HAVE BECOME A HIGHLIGHT FOR ST. CATHERINES AND LOCAL EMERGENCY RESPONSE TEAMS. EACH DINNER ACTS AS A REMINDER OF HOW GRATEFUL THE HOSPITAL IS FOR PROMPTNESS AND EFFICIENCY IN THE FIELD. THE DINNERS OFFER A FORUM FOR SPECIAL EDUCATIONAL PROGRAMS AND AN OPPORTUNITY FOR EMERGENCY RESPONSE PERSONNEL TO GAIN EDUCATION CREDITS.HEALTHY SUNDAY SERIES: THE HEALTHY SUNDAY PROGRAM MANIFESTS THE COMMITMENT OF CATHOLIC HEALTH SERVICES OF LONG ISLAND BY PROACTIVELY HELPING UNDERSERVED COMMUNITIES BY PROVIDING EDUCATIONAL SEMINARS AND PREVENTIVE SCREENINGS THAT MAY BE OTHERWISE UNAVAILABLE. THE PROGRAM REACHES OUT INTO COMMUNITIES OF NEED THROUGH LOCAL PARISHES TO HELP BRIDGE THE GAP BETWEEN THE INDIVIDUAL AND THE HEALTH PROVIDER TO PROVIDE QUALITY, ACCESSIBLE SERVICES ULTIMATELY BUILDING A LINK FOR THE COORDINATION OF CARE. HEALTHY SUNDAYS PROVIDES A SAFE AVENUE TO IMPROVE ACCESS TO VITAL PRIMARY CARE SERVICES.MATERNITY EDUCATION: YOU AND YOUR BABY EDUCATION SERIESTHE MATERNITY DEPARTMENT OFFERS A VARIETY OF FEE AND NON-FEE SUPPORT GROUPS AND WORKSHOPS FOR NEW MOTHERS AND FAMILY MEMBERS AS FOLLOWS: BREAST-FEEDING SUPPORT GROUPS, CHILDBIRTH EDUCATION, EARLY PREGNANCY CLASSES, FAMILY AND FRIENDS CPR: INFANT ONLY, GRANDPARENTS CLASSES, INFANT CARE CLASSES, PRENATAL BREAST-FEEDING CLASSES, SIBLING CLASSES AND MOTHERS CIRCLE OF HOPE, A POST PARTUM SUPPORT GROUP.MEDICAL COMMUNITY EDUCATION: ST. CATHERINES IS DEDICATED TO EDUCATING THE COMMUNITY AND PROUDLY OFFERS FREE LECTURES AND PRESENTATIONS ON A VARIETY OF HEALTH AND WELLNESS TOPICS TO HELP EDUCATE AND RAISE AWARENESS. WITH THE COMBINATION OF LECTURES AND PRESENTATIONS OFFERED, ST. CATHERINES HOPES TO IMPROVE THE QUALITY OF LIFE, PROMOTE WELLNESS AND HEALTHY LIVING FOR ALL THOSE WHO LIVE AND WORK IN THE COMMUNITY.PASTORAL CARE: PASTORAL CARE SERVICE IS AVAILABLE FOR PATIENTS FOR ALL DENOMINATIONS DURING THEIR HOSPITAL STAY. WE PROVIDE SPIRITUAL RESOURCES, COUNSEL AND PRAYER, AND ASSIST PATIENTS WITH INTEGRATING THEIR SPIRITUAL BELIEFS INTO THEIR HEALING PROCESS. PASTORAL CARE IS OFTEN CALLED UPON FOR ETHICAL ADVICE WITH ADVANCE DIRECTIVES IN COLLABORATION WITH THE PATIENT ADVOCATE.OTHER SUPPORT GROUPS OFFERED TO THE COMMUNITY:BARIATRIC SUPPORT GROUPSCARDIAC DEVICE SUPPORT GROUPSDIABETES CLUB (GLAD)GREEN SEMINARPARKINSONS DISEASE SUPPORT GROUPSBEREAVEMENT SUPPORT GROUPSJOINT REPLACEMENT CLASS | ||
| PART VI, LINE 6: ST. CATHERINE OF SIENA MEDICAL CENTER (ST. CATHERINE OR THE HOSPITAL OR THE MEDICAL CENTER) AND ST. CATHERINE OF SIENA NURSING HOME, ARE LOCATED ON A SINGLE CAMPUS IN SMITHTOWN, NEW YORK.ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS ST. CATHERINE, THROUGH ITS DAILY OPERATION, PROVIDES TO THE AREA ACUTE, EMERGENT AND OUTPATIENT CARE AS WELL AS LONG TERM CARE AND HOUSING. ST. CATHERINE IS A MEMBER OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS) WHICH IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE.AS OF DECEMBER 31, 2011 CHS WAS COMPRISED OF SIX HOSPITALS (MERCY MEDICAL CENTER AND ST. FRANCIS HOSPITAL IN NASSAU COUNTY; GOOD SAMARITAN HOSPITAL MEDICAL CENTER, ST. CHARLES HOSPITAL AND ST. CATHERINE IN SUFFOLK COUNTY; AND AS PASSIVE PARENT TO ST.JOSEPH HOSPITAL IN NASSAU COUNTY) THREE NURSING HOMES (ST. CATHERINE NURSING HOME; GOOD SAMARITAN NURSING HOME AND OUR LADY OF CONSOLATION RESIDENCE, ALL IN SUFFOLK COUNTY), A REGIONAL HOME CARE AND HOSPICE NETWORK AND A COMMUNITY BASED AGENCY FOR PERSONS WITH SPECIAL NEEDS. WITH MORE THAN 17,500 STAFF AND 4,600 CREDENTIALED PHYSICIANS WORKING THROUGHOUT THE SYSTEM, CHS PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES.MEMBER ORGANIZATIONS OF CHS OFFER VIRTUALLY EVERY MEDICAL SPECIALTY AND CLINICAL SERVICES, AND SHARE A DEDICATION TO CONTINUOUSLY UPGRADE THE SCOPE, QUALITY AND ACCESSIBILITY OF CARE. EACH OF CHS' MEMBER ORGANIZATIONS HAVE RETAINED THEIR INDIVIDUAL LINKS TO THEIR HISTORY, THEIR DISTINCTIVE PERSONALITIES, AS WELL AS THE SERVICE SPECIALTIES WHICH THEY ARE KNOWN FOR, THUS EMBEDDING THE ORGANIZATION IN THE COMMUNITY AND SERVING IT EFFECTIVELY.THE CHS SYSTEM PROVIDES AN ABUNDANCE OF EDUCATION AND SUPPORT GROUPS, FREE HEALTH SCREENINGS THROUGH THE HEALTHY SUNDAYS PROGRAM, HEALTH FAIRS AND OTHER PROGRAMS WHICH HELP THE COMMUNITIES SERVED BY CHS ACCESS CARE. SINCE 1907 CATHOLIC HEALTH CARE ON LONG ISLAND HAS BUILT A DISTINGUISHED TRADITION OF OPERATING COMMUNITY-BASED HOSPITALS AND HUMAN SERVICE ORGANIZATIONS WITH THE PRIMARY OBJECTIVE OF SERVING THE COMMUNITY.TO FURTHER THE MISSION OF BRINGING CARE TO THE COMMUNITY, CHS AND ITS MEMBER HOSPITALS, TOGETHER WITH A NUMBER OF OTHER HEALTHCARE PROVIDERS ON LONG ISLAND ENTERED INTO A PARTNERSHIP AGREEMENT WHICH OPERATES AS THE LONG ISLAND HEALTH NETWORK (LIHN). LIHN WAS CREATED TO ESTABLISH A COMPREHENSIVE AND EFFICIENT HOSPITAL NETWORK IN NASSAU AND SUFFOLK COUNTIES BY WORKING TO, AMONG OTHER THINGS, IMPROVE QUALITY OF CARE, FACILITATE CLINICAL INTEGRATION, BENCHMARK BEST PRACTICES, AND REDUCE LENGTH OF STAY AND COSTS. | ||
| NY | PART VI, LINE 7 | REPORTS FILED WITH STATES |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIOCESE OF ROCKVILLE CENTRE-CATHOLIC MINISTRIES APPEAL | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 NORTH PARK AVENUE | AddressLine1 |
| City | ROCKVILLE CENTRE | City |
| State | NY | State |
| ZIP Code | 11570 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 111837437 | EINOfRecipient |
| Amount Of Cash Grant | 264159 | AmountOfCashGrant |
| Purpose Of Grant | TO PROVIDE GENERAL SUPPORT OF THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD | PurposeOfGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | PART 1 LINE 2:-THE DIOCESE OF ROCKVILLE CENTER PROVIDES ANNUAL UPDATES TO ALL CONTRIBUTORS TO THE CATHOLIC MINISTRIES APPEAL, WHETHER PARISHIONERS OR CORPORATE CONTRIBUTORS LIKE CHSLI. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 1 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES CALDAS | |||||||||||||
| 0 | 761619 | 0 | 337500 | 0 | 20673 | 0 | 169859 | 0 | 25712 | 0 | 1315363 | 0 | 0 |
| DAN MACKSOOD | |||||||||||||
| 0 | 158205 | 0 | 0 | 0 | 31538 | 0 | 9253 | 0 | 3310 | 0 | 202306 | 0 | 0 |
| DENNIS VERZI | |||||||||||||
| 423021 | 0 | 161400 | 0 | 791323 | 0 | 144997 | 0 | 8671 | 0 | 1529412 | 0 | 0 | 773018 |
| PATRICK O'SHAUGHNESSY | |||||||||||||
| 290488 | 0 | 50000 | 0 | 308 | 0 | 0 | 0 | 19216 | 0 | 360012 | 0 | 0 | 0 |
| DAVID RIVADENEIRA | |||||||||||||
| 693527 | 0 | 176878 | 0 | 1163 | 0 | 21644 | 0 | 29286 | 0 | 922498 | 0 | 0 | 0 |
| GARA EDELSTEIN | |||||||||||||
| 278991 | 0 | 75000 | 0 | 515932 | 0 | 83103 | 0 | 23159 | 0 | 976185 | 0 | 503985 | 0 |
| JILL GENUA | |||||||||||||
| 219842 | 0 | 19000 | 0 | 178 | 0 | 19242 | 0 | 24775 | 0 | 283037 | 0 | 0 | 0 |
| JUNE J LEE | |||||||||||||
| 296821 | 0 | 75000 | 0 | 4591 | 0 | 21644 | 0 | 10665 | 0 | 408721 | 0 | 0 | 0 |
| MICHAEL QUARTARARO | |||||||||||||
| 189665 | 0 | 45000 | 0 | 1512 | 0 | 16560 | 0 | 24912 | 0 | 277649 | 0 | 0 | 0 |
| FRANK J FOX | |||||||||||||
| 0 | 170671 | 0 | 64000 | 0 | 1521935 | 0 | 0 | 0 | 16424 | 0 | 1773030 | 0 | 1756606 |
| WILLIAM ALLISON | |||||||||||||
| 0 | 0 | 0 | 0 | 0 | 577460 | 0 | 0 | 0 | 0 | 0 | 577460 | 0 | 577460 |
| SHARON KENNISH | |||||||||||||
| -175 | 0 | 0 | 0 | 615660 | 0 | 0 | 0 | 1354 | 0 | 616839 | 0 | 562223 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART I, LINES 4A-B | PART I, LINES 4A-B: SEVERENCE PAYMENT WILLIAM ALLISON, FORMER PRESIDENT & CEO RECEIVED PAYMENT OF SEVERENCE. FRANK J FOX, FORMER SENIOR V/P & CFO RECEIVED PAYMENT OF SEVERENCE. SHARON KENNISH, FORMER EXECUTIVE DIRECTOR RECEIVED PAYMENT OF SEVERENCE. PART I, LINE 4B SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN FRANK J FOX $949,416 PAYMENT FROM PLAN JAMES CALDAS $132,354 PARTICIPATION IN PLAN DENNIS VERZI $175,554 PARTICIPATION IN PLAN; $773,018 PAYMENT FROM PLAN GARA EDELSTEIN $108,269 PARTICIPATION IN PLAN; $503,985 PAYMENT FROM PLAN | |
| PART III | THE AMOUNTS REFLECTED IN COLUMN B(III) AND COLUMN C FOR THE INDIVIDUALS INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP"). THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2 BOX, 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NONQUALIFIED RETIREMENT PLANS. | SUPPLEMENTAL INFORMATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF ST. CATHERINE OF SIENA MEDICAL CENTER IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS). CHS IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER. | |
| FORM 990, PART VI, SECTION A, LINE 7A | CHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF ST CATHERINE OF SIENA MEDICAL CENTER, AND HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF ST. CATHERINE. | |
| FORM 990, PART VI, SECTION A, LINE 7B | CHS AS THE SOLE MEMBER AND CO-OPERATOR OF ST. CATHERINE IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY ST. CATHERINE'S GOVERNING BODY | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990, AND APPROPRIATE SCHEDULES, IS COMPLETED BY THE ACCOUNTING AND FINANCE STAFF OF THE ORGANIZATION AND REVIEWED INTERNALLY BY MANAGEMENT. IT IS THEN REVIEWED BY OUTSIDE TAX ADVISORS. THE FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF TRUSTEES (THE BOARD), WHICH HAS BEEN DELEGATED THE DETAILED REVIEW FUNCTION BY THE BOARD. UPON APPROVAL OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO ALL VOTING MEMBERS OF THE BOARD. ONCE APPROVED BY THE BOARD (OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE), THE ORGANIZATION'S BOARD CHAIR AND CHIEF EXECUTIVE OFFICER COMMUNICATES, IN WRITING TO THE CHS COMPLIANCE AND AUDIT COMMITTEE AND CHS BOARD CHAIR. AFTER REVIEW OF ANY APPLICABLE COMMENTS FROM THE BOARD, THE COMPLIANCE AND AUDIT COMMITTEE WILL THEN RECOMMEND THE APPROVAL OF THE FORM 990 TO THE CHS BOARD OF DIRECTORS WHO WILL THEN REVIEW THE RECOMMENDATIONS AND PROVIDE THE FINAL APPROVAL OF THE FORM 990. THE FORM 990 IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE. | |
| FORM 990, PART VI, SECTION B, LINE 12C | DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE BY THE ORGANIZATION'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFFERED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORTH WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE CORPORATE CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE POLICY. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE BOARD OF TRUSTEES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILIED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND. | |
| FORM 990, PART VII, SECTION A, LINE 1A | REFLECTED IN PART VII, SECTION A, LINE 1A ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. JAMES CALDAS, PRESIDENT AND CEO-THE TOTAL HOURS REPORTED REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SAMARITAN HOSPITAL (11-1888924); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240); ST CATHERINE OF SIENA MED CENTER (06-1562701); ST CHARLES HOSPITAL & REHAB (11-1871039); ST CHARLES FOUNDATION (41-2076312); ST CHARLES CORPORATION (11-2983148); SIENA VILLAGE (06-1569129); THE SAMARITAN CORPORATION (11-2716640); SUFFOLK HEARING AND SPEECH INC (11-2110488). DAN MACKSOOD, SVP FINANCE/CFO EASTERN DIVISION-THE TOTAL HOURS REPORTED REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SAMARITAN HOSPITAL (11-1888924); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240); ST CATHERINE OF SIENA MED CENTER (06-1562701); ST CHARLES HOSPITAL & REHAB (11-1871039); ST CHARLES FOUNDATION (41-2076312); ST CHARLES CORPORATION (11-2983148); SIENA VILLAGE (06-1569129); THE SAMARITAN CORPORATION (11-2716640); SUFFOLK HEARING AND SPEECH INC (11-2110488). | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -111,042. DONATED SERVICES AND USE OF FACILITIES: 27,483. POSTRETIREMENT BENEFIT PLAN CHANGES OTHER THAN PERIODIC BENEFIT COST -139,000. LOSS ON DEBT EXTINGUISHMENT -1,463,012. TOTAL TO FORM 990, PART XI, LINE 5: -1,685,571. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| CONTROLLED GROUP ELECTION STATEMENT | THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS, AS DEFINED IN SECTION 179(D)(7), HEREBY CONSENT TO THE APPORTIONMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2011 ELECTION TO ALLOCATE $40,000 ALTERNATIVE MINIMUM TAX EXEMPTION THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS(WITHIN THE MEANING OF SECTION 1563(A)), HEREBY CONSENT UNDER REGULATION 1.58-1(C)(3) TO THE APPORTIONMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2011. ELECTION TO ALLOCATE $150,000 ALTERNATIVE MINIMUM TAX PHASE-OUT THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS (WITHIN THE MEANING OF SECTION 1563(A)), HEREBY CONSENT UNDER REGULATION 1.58-1(C(3) TO THE APPOINTMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2011. EMPLOYER ID NO. $128,00 $40,000 $150,000 11-3403968 NONE NONE NONE 14-1801961 NONE NONE NONE 11-3594561 NONE NONE NONE 11-3555766 NONE NONE NONE 11-1888924 NONE NONE NONE 77-0611240 NONE NONE NONE 11-2537396 NONE NONE NONE 11-2958438 NONE NONE NONE 11-3434776 NONE NONE NONE 11-2861698 NONE NONE NONE 11-2861690 NONE NONE NONE 11-3638367 NONE NONE NONE 11-1635088 NONE NONE NONE 11-2126736 NONE NONE NONE 11-3284066 NONE NONE NONE 20-8067039 NONE NONE NONE 11-2499790 NONE NONE NONE 06-1569129 NONE NONE NONE 06-1562701 NONE NONE NONE 11-1871039 NONE NONE NONE 41-2076312 NONE NONE NONE 11-3613997 NONE NONE NONE 11-2050523 NONE NONE NONE 11-2916033 NONE NONE NONE 11-3090867 NONE NONE NONE 11-2110488 NONE NONE NONE 11-2983148 NONE NONE NONE 11-2716640 NONE NONE NONE 11-3559713 NONE NONE NONE 11-1635088 NONE NONE NONE 55-0813603 NONE NONE NONE 27-1459941 NONE NONE NONE IN PROCESS NONE NONE NONE 26-3169427 NONE NONE NONE 45-0517566 NONE NONE NONE 27-1531084 NONE NONE NONE 11-2798383 NONE NONE NONE 11-2801136 NONE NONE NONE 11-2838185 $128,000 $40,000 $150,000 11-3319259 NONE NONE NONE 06-1568934 NONE NONE NONE 11-3307977 NONE NONE NONE 11-2126736 NONE NONE NONE | ELECTION TO ALLOCATE BUSINESS ASSET EXPENSE |
| FORM 990, PART IV, LINE 12 A AND B | THE HOSPITALS (GOOD SAMARITAN HOSPITAL MEDICAL CENTER, ST. CATHERINE OF SIENA MEDICAL CENTER AND ST. CHARLES HOSPITAL) HAVE BOTH SEPARATE AND CONSOLIDATED AUDITIED FINANCIAL STATEMENTS. HOWEVER, THE HOSPITALS RESPECTIVE 990'S ARE PREPARED ON THE CONSOLIDATED BASIS AND AS SUCH PART IV, LINE 12 A HAS BEEN ANSWERED "NO" AND LINE 12 B HAS BEEN ANSWERED "YES". | |
| EMPLOYER NAME, ADDRESS & TAX YEAR-END ID NO. 11-3403968 CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 14-1801961 CHS AMBULANCE SERVICES 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 11-3594561 CHS HOME SUPPORT SERVICES, INC. 15 POWER DRIVE HAUPPAUGUE, NY 11788 TAX YEAR END: 12/31/11 11-3555761 CHS SERVICES, INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 11-1888924 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/11 77-0611240 GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/11 11-2537396 GOOD SAMARITAN HOSPITAL SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/11 11-2958438 GOOD SHEPHERD HOSPICE 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/11 11-3434776 MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAX YEAR END: 12/31/11 11-2861698 MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/11 11-2861690 MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/11 11-3638367 THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAXABLE YEAR: 12/31/11 11-1635088 MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 11-2126736 CATHOLIC HOME CARE 1150 PORTION BLVD. SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/11 11-3284066 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/11 20-8067039 RVC INSURANCE COMPANY, INC. 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 11-2499790 RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/11 06-1569129 SIENA VILLAGE 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/11 06-1562701 ST. CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/11 11-1871039 ST. CHARLES HOSPITAL AND REHABILITATION CENTER 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/11 41-2076312 ST. CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/11 11-3613997 ST. FRANCIS CARDIOVASCULAR PHYSICIANS PC 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/11 11-2050523 ST. FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/11 11-2916033 ST. FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/11 11-3090867 ST. FRANCIS RESEARCH & EDUCATIONAL CORPORATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/11 11-2110488 SUFFOLK HEARING & SPEECH 369 EAST MAIN STREET EAST ISLIP, NY 11730 TAX YEAR END: 12/31/11 11-2983148 THE ST. CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/11 11-2716640 THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/11 11-3559713 WISDOM GARDENS HOUSING DEVELOPMENT CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/11 11-1635088 ST. FRANCIS-MERCY CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/11 55-0813603 MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/11 27-1459941 ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/11 IN PROCESS CATHOLIC HOME CARE FOUNDATION 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/11 26-3169427 CATHOLIC HOME CARE FOUNDATION 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/11 45-0517566 OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/11 27-1531084 OUR LADY OF CONSOLATION FOUNDATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 11-2798383 FAIRVIEW HILL MANAGEMENT CORP 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/11 11-2801136 HEALTHCARE TEMP SERVICES 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/11 11-2838185 SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/11 11-3319259 SAMARITAN HOME CARE AMERICA, INC. 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/11 06-1568934 SIENA MEDICAL REALTY 50 ROUTE 25A SMITHTOWN, NY 11787 TAXABLE YEAR: 12/31/11 11-3307977 SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/11 11-2126736 NURSING SISTERS HOME CARE, INC 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAXABLE YEAR: 12/31/11 | CONTROLLED GROUP ELECTION - CONTINUED | |
| THE AMOUNTS IN EACH TAXABLE INCOME BRACKET IN THE TAX TABLE IN SECTION 11(B) HAVE BEEN ALLOCATED TO THE CORPORATIONS LISTED BELOW PURSUANT TO REGULATION 1.1561-3(A). THE ORIGINAL COPY OF THIS STATEMENT IS FILED WITH THE INTERNAL REVENUE SERVICE CENTER IN OGDEN, UTAH. AUTHORIZATION CONSENT FOR ALLOCATION ON BEHALF OF MEMBER COMPANIES ____________________________________________ EMPLOYER ID NO. $50,000 $25,000 $9,925,000 BRACKET BRACKET BRACKET 11-3403968 NONE NONE NONE 14-1801961 NONE NONE NONE 11-3594561 NONE NONE NONE 11-3555766 NONE NONE NONE 11-1888924 NONE NONE NONE 77-0611240 NONE NONE NONE 11-2537396 NONE NONE NONE 11-2958438 NONE NONE NONE 11-3434776 NONE NONE NONE 11-2861698 NONE NONE NONE 11-2861690 NONE NONE NONE 11-3638367 NONE NONE NONE 11-1635088 NONE NONE NONE 11-2126736 NONE NONE NONE 11-3284066 NONE NONE NONE 20-8067039 NONE NONE NONE 11-2499790 NONE NONE NONE 06-1569129 NONE NONE NONE 06-1562701 NONE NONE NONE 11-1871039 NONE NONE NONE 41-2076312 NONE NONE NONE 11-3613997 NONE NONE NONE 11-2050523 NONE NONE NONE 11-2916033 NONE NONE NONE 11-3090867 NONE NONE NONE 11-2110488 NONE NONE NONE 11-2983148 NONE NONE NONE 11-2716640 NONE NONE NONE 11-3559713 NONE NONE NONE 11-1635088 NONE NONE NONE 55-0813603 NONE NONE NONE 27-1459941 NONE NONE NONE IN PROCESS NONE NONE NONE 26-3169427 NONE NONE NONE 45-0517566 NONE NONE NONE 27-1531084 NONE NONE NONE 11-2798383 NONE NONE NONE 11-2801136 NONE NONE NONE 11-2838185 $50,000 $25,000 $9,925,000 11-3319259 NONE NONE NONE 06-1568934 NONE NONE NONE 11-3307977 NONE NONE NONE 11-2126736 NONE NONE NONE | STATEMENT OF TAX BRACKET ALLOCATION | |
| EMPLOYER NAME, ADDRESS & TAX YEAR-END ID NO. 11-3403968 CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 14-1801961 CHS AMBULANCE SERVICES 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 11-3594561 CHS HOME SUPPORT SERVICES, INC. 15 POWER DRIVE HAUPPAUGUE, NY 11788 TAX YEAR END: 12/31/11 11-3555761 CHS SERVICES, INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 11-1888924 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/11 77-0611240 GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/11 11-2537396 GOOD SAMARITAN HOSPITAL SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/11 11-2958438 GOOD SHEPHERD HOSPICE 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/11 11-3434776 MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAX YEAR END: 12/31/11 11-2861698 MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/11 11-2861690 MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/11 11-3638367 THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAXABLE YEAR: 12/31/11 11-1635088 MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 11-2126736 CATHOLIC HOME CARE 1150 PORTION BLVD. SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/11 11-3284066 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/11 20-8067039 RVC INSURANCE COMPANY, INC. 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 11-2499790 RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/11 06-1569129 SIENA VILLAGE 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/11 06-1562701 ST. CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/11 11-1871039 ST. CHARLES HOSPITAL AND REHABILITATION CENTER 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/11 41-2076312 ST. CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/11 11-3613997 ST. FRANCIS CARDIOVASCULAR PHYSICIANS PC 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/11 11-2050523 ST. FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/11 11-2916033 ST. FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/11 11-3090867 ST. FRANCIS RESEARCH & EDUCATIONAL CORPORATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/11 11-2110488 SUFFOLK HEARING & SPEECH 369 EAST MAIN STREET EAST ISLIP, NY 11730 TAX YEAR END: 12/31/11 11-2983148 THE ST. CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/11 11-2716640 THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/11 11-3559713 WISDOM GARDENS HOUSING DEVELOPMENT CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/11 11-1635088 ST. FRANCIS-MERCY CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/11 55-0813603 MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/11 27-1459941 ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/11 IN PROCESS CATHOLIC HOME CARE FOUNDATION 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/11 26-3169427 CATHOLIC HOME CARE FOUNDATION 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/11 45-0517566 OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/11 27-1531084 OUR LADY OF CONSOLATION FOUNDATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/11 11-2798383 FAIRVIEW HILL MANAGEMENT CORP 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/11 11-2801136 HEALTHCARE TEMP SERVICES 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/11 11-2838185 SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/11 11-3319259 SAMARITAN HOME CARE AMERICA, INC. 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/11 06-1568934 SIENA MEDICAL REALTY 50 ROUTE 25A SMITHTOWN, NY 11787 TAXABLE YEAR: 12/31/11 11-3307977 SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/11 11-2126736 NURSING SISTERS HOME CARE, INC 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAXABLE YEAR: 12/31/11 | STATEMENT OF TAX BRACKET ALLOCATION - CONTINUED |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | EOY AssetsEOYAssets | Direct Controlling Entity NADirectControllingEntityNA | Total IncomeTotalIncome |
|---|---|---|---|---|---|---|---|---|
| SIENA RETIREMENT REALTY CCRC | ||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | RETIREMENT COMMUNITY | NY | 3507990 | N/A | |
| SIENA MEDICAL REALTY | ||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | MEDICAL OFFICE BUILDING | NY | 7961939 | N/A | 1554331 |
Form990 Schedule R Part II Form990ScheduleRPartII (36 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 113403968 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | N/A | 0 | |
| CHS SERVICES INC | |||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 113555766 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| CHS AMBULANCE SERVICES INC | |||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 141801961 | DORMANT | NY | 501(C)(3) | LINE 3 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| GOOD SAMARITAN HOSPITAL MEDICAL CENTER | |||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 111888924 | HOSPITAL | NY | 501(C)(3) | LINE 3 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE | |||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 112537396 | SELF INSURANCE | NY | 501(C)(3) | LINE 11A, I | 0 | GOOD SAMARITAN HOSPITAL | |
| MARYHAVEN TRANSPORTATION SERVICES | |||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 113434776 | TRANSPORTATION SERVICES | NY | 501(C)(3) | LINE 9 | 0 | MARYHAVEN CENTER OF HOPE | |
| MARYHAVEN CENTER OF HOPE | |||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 112861698 | PROGRAMS/HOUSING FOR THE DEVELOPMENTALLY DISABLED | NY | 501(C)(3) | LINE 3 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| MARYHAVEN SCHOOL CORPORATION | |||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 112861690 | SCHOOL FOR DEVELOPMENTALLY DISABLED | NY | 501(C)(3) | LINE 9 | 0 | MARYHAVEN CENTER OF HOPE | |
| THE CENTER OF HOPE FOUNDATION | |||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 113638367 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | MARYHAVEN CENTER OF HOPE | |
| MERCY MEDICAL CENTER | |||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 111635088 | HOSPITAL | NY | 501(C)(3) | LINE 3 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| CATHOLIC HOME CARE | |||||||||||
| 1150 PORTION ROAD SUITE 1 | HOLTSVILLE | NY | 11742 | 112126736 | HOME CARE | NY | 501(C)(3) | LINE 9 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| OUR LADY OF CONSOLATION GERIATRIC CARE CENTER | |||||||||||
| 111 BEACH DRIVE | WEST ISLIP | NY | 11795 | 113284066 | LT NURSING CARE | NY | 501(C)(3) | LINE 3 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| RIVERHEAD HOSTEL HOLDING CORPORATION | |||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 112499790 | RENTING | NY | 501(C)(3) | LINE 9 | 0 | MARYHAVEN CENTER OF HOPE | |
| SIENA VILLAGE INC | |||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 061569129 | SENIOR HOUSING | NY | 501(C)(3) | LINE 9 | 0 | ST CATHERINE OF SIENA MEDICAL CENTER | |
| ST CHARLES HOSPITAL | |||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON STATION | NY | 11777 | 111871039 | HOSPITAL | NY | 501(C)(3) | LINE 3 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| CHS HOME SUPPORT SERVICES INC | |||||||||||
| 15 POWER DRIVE | HAUPPAUGE | NY | 11788 | 113594561 | RESPIRATORY THERAPY SVC/MED. EQUIP. | NY | 501(C)(3) | LINE 9 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| ST FRANCIS HOSPITAL | |||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 112050523 | HOSPITAL | NY | 501(C)(3) | LINE 3 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| ST FRANCIS HOSPITAL FOUNDATION | |||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 112916033 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | ST FRANCIS HOSPITAL | |
| ST FRANCIS HOSPITAL RESEARCH & EDUCATIONAL CORP | |||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113090867 | RESEARCH ORGANIZATION | NY | 501(C)(3) | LINE 9 | 0 | ST FRANCIS HOSPITAL | |
| WSNCHS NORTH INC | |||||||||||
| 4295 HEMPSTEAD TURNPIKE | BETHPAGE | NY | 11714 | 113438973 | HOSPITAL | NY | 501(C)(3) | LINE 3 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| SUFFOLK HEARING & SPEECH CENTER INC | |||||||||||
| 369 EAST MAIN STREET | EAST ISLIP | NY | 11730 | 112110488 | DIAGNOSTIC TESTING | NY | 501(C)(3) | LINE 3 | 0 | GOOD SAMARITAN HOSPITAL | |
| THE ST CHARLES CORPORATION | |||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 112983148 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| THE SAMARITAN CORPORATION | |||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 112716640 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| WISDOM GARDENS HOUSING DEVELOPMENT FUND INC | |||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 113559713 | SENIOR HOUSING | NY | 501(C)(3) | LINE 9 | 0 | MARYHAVEN CENTER OF HOPE | |
| GOOD SHEPHERD HOSPICE | |||||||||||
| 245 OLD COUNTRY ROAD | MELVILLE | NY | 11747 | 112958438 | HOSPICE SERVICES | NY | 501(C)(3) | LINE 9 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| ST CHARLES HOSPITAL FOUNDATION | |||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 412076312 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | ST CHARLES HOSPITAL | |
| GOOD SAMARITAN HOSPITAL FOUNDATION | |||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 770611240 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | GOOD SAMARITAN HOSPITAL | |
| ST FRANCIS-MERCY CORPORATION | |||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 111635088 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| MERCY MEDICAL CENTER FOUNDATION | |||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 550813603 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | MERCY MEDICAL CENTER | |
| ST CATHERINE OF SIENA MEDICAL CENTER FOUNDATION | |||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 271459941 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | ST CATHERINE OF SIENA MEDICAL CENTER | |
| CATHOLIC HOME CARE FOUNDATION | |||||||||||
| 1150 PORTION ROAD SUITE 1 | HOLTSVILLE | NY | 11742 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | CATHOLIC HOME CARE | ||
| GOOD SHEPHERD HOSPICE FOUNDATION | |||||||||||
| 245 OLD COUNTRY ROAD | MELVILLE | NY | 11747 | 263169427 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | GOOD SHEPHERD HOSPICE | |
| OUR LADY OF CONSOLATION FOUNDATION | |||||||||||
| 111 BEACH DRIVE | WEST ISLIP | NY | 11795 | 450517566 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | 0 | OUR LADY OF CONSOLATION | |
| RVC SUPPORT | |||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 271531084 | REAL ESTATE | NY | 501(C)(3) | LINE 11A, I | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| ST FRANCIS CARDIOVASCULAR PHYSICIANS PC | |||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113613997 | HEALTHCARE SERVICES | NY | 501(C)(3) | LINE 3 | 0 | ST FRANCIS HOSPITAL | |
| RVC INSURANCE COMPANYINC | |||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 208067039 | CAPTIVE INSURANCE COMPANY | NY | 501(C)(3) | LINE 11A, I | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
Form990 Schedule R Part IV Form990ScheduleRPartIV (13 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity |
|---|---|---|---|---|---|---|---|---|
| RADIOLOGY CONSULTING OF LONG ISLAND PLLC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 421646134 | HEALTHCARE SERVICES | NY | GOOD SAMARITAN HOSPITAL | C |
| SAMARITAN EMERGENCY MEDICAL SERVICES PC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208243412 | DIAGNOSTIC TESTING | NY | GOOD SAMARITAN HOSPITAL | C |
| SAMARITAN PEDIATRIC SERVICES PC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208180263 | HEALTHCARE SERVICES | NY | GOOD SAMARITAN HOSPITAL | C |
| SAMARITAN MEDICAL SERVICES PC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208088453 | DIAGNOSTIC TESTING | NY | GOOD SAMARITAN HOSPITAL | C |
| SOUTHWEST SUFFOLK MEDICAL PC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 061603195 | HEALTHCARE SERVICES | NY | GOOD SAMARITAN HOSPITAL | C |
| CARDIAC EKG INTERPRETATION PC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 112924518 | HEALTHCARE SERVICES | NY | GOOD SAMARITAN HOSPITAL | C |
| LI REGIONAL ARTHRITIS & OSTEOPOROSIS CARE PC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208964140 | HEALTHCARE SERVICES | NY | GOOD SAMARITAN HOSPITAL | C |
| SAMARITAN MANAGEMENT SERVICES INC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 112838185 | HEALTHCARE SERVICES | NY | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | C |
| FAIRVIEW HILL MANAGEMENT CO INC | ||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 112798383 | SERVICES | NY | ST CHARLES CORPORATION | C |
| ADVANCED REHABILIATION MEDICINE PLLC | ||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 113640709 | HEALTHCARE SERVICES | NY | ST CHARLES HOSPITAL | C |
| ST FRANCIS CARDIAC PREVENTION SERVICES PC | ||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113224885 | HEALTHCARE SERVICES | NY | ST FRANCIS HOSPITAL | C |
| SOUTH SHORE PRACTICE MANAGEMENT | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 113307977 | HEALTHCARE SERVICES | NY | GOOD SAMARITAN HOSPITAL | C |
| MERCY INTERNAL MEDICINE PC | ||||||||
| 992 N VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11710 | 510639649 | HEALTHCARE SERVICES | NY | MERCY MEDICAL CENTER | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (4 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| CATHOLIC HEALTH SERVICES OF LONG ISLAND | ||
| E | -18686372 | COST |
| ST FRANCIS HOSPITAL | ||
| O | 88664 | COST |
| OUR LADY OF CONSOLATION GERIATRIC CARE | ||
| N | 65262 | COST |
| CHS SERVICES INC 11-3555766 | ||
| O | 542061 | COST |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | TRANSACTIONS WITH RELATED ORGANIZATIONS | Identifier |
| Return Reference | SCHEDULE R PART V LINE 2 | ReturnReference |
| Explanation | ST. CATHERINE HAS DISCLOSED IN SCHEDULE R THE PREDOMINANT TRANSACTION TYPE WITH EACH FACILITY WITH WHICH IT HAS CONDUCTED TRANSATIONS. HOWEVER, THERE ARE ADDITIONAL TRANSACTION TYPES TO DESCRIBE THE ACTIVITIES ST. CATHERINE HAS ENGAGED IN WITH ITS RELATED PARTY ORGANIZATIONS. THE FOLLOWING IS A LIST OF ADDITIONAL TRANSACTION TYPES BY FACILITY NAME OF ORGANIZATION EIN ADD'NL TRANS TYPES CATHOLIC HEALTH SERVICES OF LONG ISLAND 11-3405968 N,O,P ST.FRANCIS HOSPITAL 11-2050523 P OUR LADY OF CONSOLATION GERIATRIC CARE 11-3284066 O,P CATHOLIC HEALTH SERVICES 11-3555766 P | Explanation |
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