MERCY MEDICAL CENTER: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MERCY MEDICAL CENTER (EIN 11-1635088)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2013-01-07
- IRS object ID
- 201300079349301615
- 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 | 2013-01-07T14:01:44-06:00 | 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 | COHNREZNICK 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 | 070681739 | 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 | 111635088 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MERC | NameControl |
| Phone | 5167052525 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 NORTH VILLAGE AVENUE | AddressLine1 |
| City | ROCKVILLE CENTRE | City |
| State | NY | State |
| ZIP Code | 11570 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ALAN D GUERCI MD | Name |
| Title | PRES & CEO | Title |
| Phone | 5167052525 | 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 | ALAN D GUERCI MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 NORTH VILLAGE AVENUE | AddressLine1 |
| City | ROCKVILLE CENTRE | City |
| State | NY | State |
| ZIP Code | 11570 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 207141173 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | HTTP://MERCYMEDICALCENTER.CHSLI.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1913 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | MERCY 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. CHS AFFIRMS THE SANCTITY OF LIFE, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. CHS 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 | 22 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 21 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1698 | TotalNbrEmployees |
| Total Nbr Volunteers | 1025 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 6783886 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 7474013 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 185289934 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 195083274 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 255531 | InvestmentIncomePriorYear |
| Investment Income Current Year | 222396 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 3102624 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3832880 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 195431975 | TotalRevenuePriorYear |
| Total Revenue Current Year | 206612563 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 150520 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 233812 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 109640109 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 108767971 | 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 | 77386938 | OtherExpensePriorYear |
| Other Expenses Current Year | 84999514 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 187177567 | TotalExpensesPriorYear |
| Total Expenses Current Year | 194001297 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 8254408 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 12611266 | RevenuesLessExpensesCY |
| Total Assets BOY | 160796058 | TotalAssetsBOY |
| Total Assets EOY | 191170091 | TotalAssetsEOY |
| Total Liabilities BOY | 135381314 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 153892344 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 25414744 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 37277747 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | MERCY 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, AFFIRMS THE SANCTITY OF LIFE, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. CHS 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 | 175730355 | Expense |
| Revenue | 196256163 | Revenue |
| Description | MERCY MEDICAL CENTER IS A 375 BED, NOT-FOR-PROFIT ACUTE CARE HOSPITAL SERVING THE HEALTHCARE NEEDS OF NASSAU COUNTY AND ITS SURROUNDING AREA. FOUNDED IN 1913 BY THE NURSING SISTERS OF THE CONGREGATION OF THE INFANT JESUS, MERCY MEDICAL CENTER HAS GROWN FROM A THREE FLOOR WOODEN STRUCTURE TO AN EXTENSIVE INSTITUTION OCCUPYING A 42-ACRE CAMPUS THAT HOUSES SOME OF THE MOST ADVANCED MEDICAL TECHNOLOGIES. ACCORDING TO INTERNAL DATA, OVER 32% OF MMC'S TOTAL INPATIENT DISCHARGES IN 2011 CAME FROM HEMPSTEAD, UNIONDALE, FREEPORT, AND ROOSEVELT. THESE FOUR COMMUNITIES HAVE BEEN REFERRED TO AS "COMMUNITIES AT RISK", MANY OF THE RESIDENTS LIVING IN POVERTY AND HAVING POOR HEALTH OUTCOMES. OF THE 30,989 ED TREATED & RELEASED VISITS MMC HAD IN 2011, 15,304 OR NEARLY 49% CAME FROM THESE SAME FOUR ZIP CODES. | Description |
| Total Program Service Expense | 175730355 | 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 | 1 | 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 | 0 | 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 | 130 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1698 | 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 | 0 | QuidProQuoContributions |
| 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 | 22 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 21 | 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 | 5167051926 | 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 (31 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| PETER QUICK | ||||||||
| CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | ||
| DANIEL J DENIHAN | ||||||||
| VICE CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | ||
| C JUSTIN MCCARTHY | ||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | ||
| REV MSGR FRANCIS J CALDWELL | ||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | ||
| JAMES DADDARIO | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| SR DOLORES WISNIEWSKI CIJ | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| SR BETTY KEEGAN | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| DELORES C KERSHAW | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| DAVID J MILLER DDS | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| RABBI BARRY DOV SCHWARTZ PHD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| SUSAN POWERS SCHOTT | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| THOMAS E CHRISTMAN | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| KEVIN J CONWAY | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| EDWARD J COOK PHD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| THOMAS J FANNING | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| JOSEPH A GRIMALDI | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| EUGENE F MURPHY | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| CHRISTOPHER S PASCUCCI | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| ROBERT P QUINN | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| MATTHEW D SERRA | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| EUGENE P SOUTHER ESQ | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| ALAN D GUERCI MD | ||||||||
| PRESIDENT & CEO | 50.00 | X | X | 0 | 2258256 | 596927 | ||
| WILLIAM C ARMSTRONG | ||||||||
| VP & CHIEF FINANCIAL OFFICER | 50.00 | X | 0 | 1600307 | 462970 | |||
| NANCY SIMMONS | ||||||||
| EVP & CAO | 50.00 | X | 836322 | 75222 | 91132 | |||
| AARON GLATT | ||||||||
| EVP & CAO | 50.00 | X | 31205 | 498192 | 48911 | |||
| JOHN REILLY | ||||||||
| CMO | 50.00 | 371583 | 0 | 41830 | X | |||
| RONALD STEIMEL | ||||||||
| CHIEF OPERATING OFFICER | 50.00 | 332628 | 0 | 41685 | X | |||
| STEPHEN TRAPANI | ||||||||
| VICE PRESIDENT OF FINANCE | 50.00 | 348859 | 11923 | 65395 | X | |||
| SWARNA DEVARAJAN MD | ||||||||
| DIRECTOR OF PEDIATRICS | 38.00 | 325782 | 0 | 44488 | X | |||
| ALAN WONG MD | ||||||||
| SECTION CHIEF, ICU | 38.00 | 394290 | 0 | 42624 | X | |||
| RENEE MAURIELLO | ||||||||
| CHIEF NURSING OFFICER | 38.00 | 281692 | 0 | 41752 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2922361 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4443900 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1477714 | TotalOtherCompensation |
| Number Individuals GT100 K | 144 | NumberIndividualsGT100K |
| Formers Listed | 0 | 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 |
|---|---|---|---|---|---|
| LI EMERGENCY CARE PC | |||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | EMERGENCY MEDICINE SERVICES | 1650000 |
| VIRTUAL RADIOLOGIC PROF OF NY | |||||
| 11995 SINGLETREE LANE SUITE 500 | MINNEAPOLIS | MN | 55344 | RADIOLOGY SERVICES | 621030 |
| MADONNA PHYSICIANS SERVICES PC | |||||
| 200 OLD COUNTRY ROAD | MINEOLA | NY | 11501 | NEONATOLOGY SERVICES | 386427 |
| ALLIED UROLOGICAL SVCS LLC | |||||
| 205 LEXINGTON AVE | NEW YORK | NY | 10687 | SURGICAL SERVICES | 193300 |
| PATRICK E MCMANUS MD PC | |||||
| 303 E PARK AVE | LONG BEACH | NY | 11561 | OBSTETRICS SERVICES | 180980 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 17 | NumberOfContractorsGT100K |
| Fundraising Events | 81278 | FundraisingEvents |
| Related Organizations | 6423000 | RelatedOrganizations |
| Government Grants | 568130 | GovernmentGrants |
| All Other Contributions | 401605 | AllOtherContributions |
| Total Contributions | 7474013 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICES | Description |
| Business Code | 621300 | BusinessCode |
| Total Revenue Column | 195083274 | TotalRevenueColumn |
| Related Or Exempt Function Income | 195083274 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 195083274 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 222396 | TotalRevenueColumn |
| Exclusion | $222,396 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2709121 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 183192 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 2525929 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2525929 | TotalRevenueColumn |
| Exclusion | $2,525,929 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 479480 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 81278 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 345418 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 134062 | TotalRevenueColumn |
| Exclusion | $134,062 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| CAFETERIA/COFFEE SHOP | 561000 | 600753 | 600753 |
| RADIOLOGY SCHOOL TUITI | 561499 | 214100 | 214100 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 358036 | TotalRevenueColumn |
| Related Or Exempt Function Income | 358036 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1172889 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 206612563 | TotalRevenueColumn |
| Related Or Exempt Function Income | 196256163 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,882,387 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 233812 | Total |
| Program Services | 233812 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1239110 | Total |
| Program Services | 371583 | ProgramServices |
| Management And General | 867527 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 83676794 | Total |
| Program Services | 77903510 | ProgramServices |
| Management And General | 5773284 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5168859 | Total |
| Program Services | 4764631 | ProgramServices |
| Management And General | 404228 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12445014 | Total |
| Program Services | 11471757 | ProgramServices |
| Management And General | 973257 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6238194 | Total |
| Program Services | 5750339 | ProgramServices |
| Management And General | 487855 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 347715 | Total |
| Management And General | 347715 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 338334 | Total |
| Management And General | 338334 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 181004 | Total |
| Management And General | 181004 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3363066 | Total |
| Program Services | 3363066 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 996357 | Total |
| Program Services | 15095 | ProgramServices |
| Management And General | 981262 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6661914 | Total |
| Program Services | 5721260 | ProgramServices |
| Management And General | 940654 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3761383 | Total |
| Program Services | 3761383 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114088 | Total |
| Program Services | 105114 | ProgramServices |
| Management And General | 8974 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1126808 | Total |
| Program Services | 1126808 | ProgramServices |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3051610 | Total |
| Program Services | 1344843 | ProgramServices |
| Management And General | 1706767 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8784910 | Total |
| Program Services | 8784910 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4984781 | Total |
| Program Services | 4984781 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 22566265 | 22566265 | |
| FINANCE AND TECHNOLOGY | 13515038 | 11487782 | 2027256 |
| PROVISION FOR BAD DEBT | 4518009 | 4518009 | |
| EQUIPMENT SERVICE CONTR | 2868051 | 2863818 | 4233 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7820181 | Total |
| Program Services | 4591589 | ProgramServices |
| Management And General | 3228592 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 194001297 | Total |
| Program Services | 175730355 | ProgramServices |
| Management And General | 18270942 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4887614 | BOY |
| EOY | 9080955 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 218299 | BOY |
| EOY | 248723 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 784765 | BOY |
| EOY | 208359 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18948749 | BOY |
| EOY | 21631565 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2818601 | BOY |
| EOY | 2345469 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2606067 | BOY |
| EOY | 1930067 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 268887796 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 163708703 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108593548 | BOY |
| EOY | 105179093 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12206479 | BOY |
| EOY | 13628313 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9731936 | BOY |
| EOY | 36917547 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160796058 | BOY |
| EOY | 191170091 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19092917 | BOY |
| EOY | 19389394 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43423732 | BOY |
| EOY | 37958030 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12759116 | BOY |
| EOY | 9122541 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60105549 | BOY |
| EOY | 87422379 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135381314 | BOY |
| EOY | 153892344 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23259876 | BOY |
| EOY | 35029684 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2154868 | BOY |
| EOY | 2248063 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25414744 | BOY |
| EOY | 37277747 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160796058 | BOY |
| EOY | 191170091 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 12611266 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -748263 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| 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 | $58,461 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 58461 | 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 BEHALF OF THE HEALTHCARE INDUSTRY THOSE TRADE ORGANIZATIONS REPRESENT. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 329471 | BeginningOfYearBalance |
| Contributions | 18230 | Contributions |
| Grants Or Scholarships | 2750 | GrantsOrScholarships |
| Other Expenditures | 23079 | OtherExpenditures |
| End Of Year Balance | 321872 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 341486 | BeginningOfYearBalance |
| Contributions | 2030 | Contributions |
| Grants Or Scholarships | 2000 | GrantsOrScholarships |
| Other Expenditures | 12045 | OtherExpenditures |
| End Of Year Balance | 329471 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 350792 | BeginningOfYearBalance |
| Contributions | 1860 | Contributions |
| Grants Or Scholarships | 2000 | GrantsOrScholarships |
| Other Expenditures | 9166 | OtherExpenditures |
| End Of Year Balance | 341486 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 360363 | BeginningOfYearBalance |
| Contributions | 7910 | Contributions |
| Grants Or Scholarships | 2000 | GrantsOrScholarships |
| Other Expenditures | 15481 | OtherExpenditures |
| End Of Year Balance | 350792 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Endowment EOY Balance | 1.00000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 8529460 | OtherCostOrOtherBasis |
| Book Value | 8529460 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 161043733 | OtherCostOrOtherBasis |
| Depreciation | 80387808 | Depreciation |
| Book Value | 80655925 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 397287 | OtherCostOrOtherBasis |
| Depreciation | 305206 | Depreciation |
| Book Value | 92081 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 92215597 | OtherCostOrOtherBasis |
| Depreciation | 78738729 | Depreciation |
| Book Value | 13476868 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6701719 | OtherCostOrOtherBasis |
| Depreciation | 4276960 | Depreciation |
| Book Value | 2424759 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 105179093 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (5 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| ASSETS LIMITED AS TO USE | 4461357 |
| OTHER INVESTMENTS AT COST | 408392 |
| OTHER RECEIVALBES-CURRENT | 1414214 |
| 457B FUNDS | 251573 |
| INSURANCE CLAIMS RECEIVABLE | 30382011 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 36917547 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED THIRD PARTY PAYOR LIABILITIES | $13,918,471 |
| AMOUNTS DUE TO RELATED PARTIES | $22,166,606 |
| ESTIMATED MALPRACTICE LIABILITY | $32,919,696 |
| OTHER SELF INSURANCE LIABILITY | $18,417,606 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 87422379 | TotalOfAmounts |
| Total Revenue | 206612563 | TotalRevenue |
| Total Expenses | 194001297 | TotalExpenses |
| Excess Or Deficit For Year | 12611266 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 4962 | NetUnrealizedGLOnInvestments |
| Other | -$753,225 | OtherAmount |
| Total Adjustments | -748263 | TotalAdjustments |
| Excess Or Deficit Per FS | 11863003 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 200029538 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 200029538 | RevenueSubtotal |
| Other Revenues Not Included | 6583025 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 6583025 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 206612563 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 191224352 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 191224352 | ExpensesSubtotal |
| Other Expenses Not Included | 2776945 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 2776945 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 194001297 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | PART V, LINE 4: MERCY MEDCIAL CENTER'S MAGOVERN FUND IS RESTRICTED FOR THE PURPOSE OF FUNDING EXPENDITURES RELATING TO THE HOSPITAL'S RADIOLOGY TRAINING PROGRAM. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | MERCY 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 WHICH 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: | MIMS PC CHANGE IN UNRESTRICTED NET ASSETS -40,264. POSTRETIREMENT BENEFIT PLAN CHANGES OTHER THAN NET PERIODIC BENEFIT COST -121,000. LOSS ON EXTINGUISHMENT OF DEBT -591,961. TOTAL TO SCHEDULE D, PART XI, LINE 8: -753,225. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | GRANT FROM ST FRANCIS HOSPITAL 6,423,000. GRANT FROM DASNY FOR PURCHASES OF EQUIPMENT 209,674. RESTRICTED CONTRIBUTIONS 556,334. NET ASSETS RELEASED FROM RESTRICITION FOR OPERATIONS -97,506. MIMS PC REVENUE -508,477. | |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | ASSESSMENTS FROM RELATED PARTIES 3,285,422. MIMS PC EXPENSES -508,477. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Special Fundraising Events | X | SpecialFundraisingEvents |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | BALL | NameOfEvent1 |
| Gross Receipts Event1 | 324261 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 46999 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 277262 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 21271 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 157911 | RentFacilityCostsEvent1 |
| Other Direct Expenses Event1 | 74102 | OtherDirectExpensesEvent1 |
| Name Of Event2 | GOLF | NameOfEvent2 |
| Gross Receipts Event2 | 167381 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 24261 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 143120 | GrossRevenueEvent2 |
| Non Cash Prizes Event2 | 7822 | NonCashPrizesEvent2 |
| Rent Facility Costs Event2 | 42426 | RentFacilityCostsEvent2 |
| Other Direct Expenses Event2 | 9775 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 1 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 69116 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 10018 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 59098 | GrossRevenueOtherEvents |
| Cash Prizes Other Events | 3250 | CashPrizesOtherEvents |
| Rent Facility Costs Other Events | 17687 | RentFacilityCostsOtherEvents |
| Other Direct Expenses Other Events | 11174 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 560758 | GrossReceiptsTotal |
| Charitable Contributions Total | 81278 | CharitableContributionsTotal |
| Gross Revenue Total Events | 479480 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 3250 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 29093 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 218024 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 95051 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 345418 | DirectExpenseSummaryEvents |
| Net Income Summary | 134062 | 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 | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4899038 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3839587 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1059451 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00550 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 29607746 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 26051417 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3556329 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01830 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 34506784 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 29891004 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4615780 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02380 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 643867 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9800 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 634067 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00330 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 722797 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 210757 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 512040 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00260 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15661937 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13716702 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1945235 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01000 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 68326 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 68326 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00040 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17036 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 17036 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17113963 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 13937259 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3176704 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01640 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 51620747 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 43828263 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7792484 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04020 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 150220 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 726 | DirectOffsettingRevenue |
| Net Community Building Expense | 149494 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 7012 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 7012 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 109 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 109 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 11386 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 11386 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 5095 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 5095 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 9956 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 9956 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 183778 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 726 | DirectOffsettingRevenue |
| Net Community Building Expense | 183052 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $1,152,092 | BadDebtExpenseAmount |
| Amount Attributable To | 0 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 62621730 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 63065717 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -443987 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| 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 | MERCY MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 NORTH VILLAGE AVENUE | AddressLine1 |
| City | ROCKVILLE CENTRE | City |
| State | NY | State |
| ZIP Code | 11570 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
| Other | PSYCHIATRIC UNIT / REHABILITATIVE SERVICES | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| 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 VI Form990ScheduleHPartVI (11 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| 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 THE METHODOLOGY WAS 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 OTHER LINES INCLUDE COSTS THAT WERE DERIVED BASED ON THE RCC METHODOLOGY OR ACTUAL COSTS FOR THE SERVICES AS TRACKED BY HOSPITAL PERSONNEL UTILIZING DIRECT HOURLY LABOR COSTS, FRINGES AND SUPPLY COSTS.PART I, LINE 7A, COLUMN D DIRECT OFFSETTING REVENUES REPRESENT DISTRIBUTIONS FROM THE NEW YORK STATE (NYS) INDIGENT CARE POOL (ICP) WHICH IS SHOWN NET OF HOSPITAL CONTRIBUTIONS TO THE STATEWIDE POOL. THE FORMULA EMPLOYED BY NYS TO DETERMINE DISTRIBUTIONS TO HOSPITALS FROM THE ICP IS COMPLEX AND IS DERIVED FROM A HOSPITAL'S "NEED" CALCULATION. THIS CALCULATION CONSIDERS 90% OF A HOSPITAL'S "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 HAS APPOINTED THE ICP REVENUE BETWEEN BAD DEBT AND CHARITY CARE FOR REPORTING ON LINE 7A BASED ON THE PROPORTION OF EACH TO THE TOTAL OF ACTUAL BAD DEBT AND CHARITY CARE FOR 2011. | ||
| PART I, L7 COL(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 $ 4,518,008. | ||
| PART II: MMC'S COMMUNITY BUILDING ACTIVITIES PROMOTE THE COMMUNITY'S HEALTH IN MANY WAYS. FOR EXAMPLE, ASSISTING PATIENTS TO ENROLL IN PUBLIC PROGRAMS EXPANDS THEIR ACCESS TO CARE. DISASTER READINESS DRILLS BEYOND MINIMUM MANDATES ENSURES AVAILABILITY OF HOSPITAL SERVICES DURING TIMES OF HIGHEST NEED. COLLECTION AND DISPOSAL OF SYRINGES FOR THE COMMUNITY ELIMINATES A HEALTH HAZARD. ADVOCACY FOR BEHAVIORAL HEALTH CLIENTS PROMOTES THE INTERESTS OF A VULNERABLE POPULATION. DEFENSIVE DRIVING CLASSES PREVENT INJURY FROM CAR ACCIDENTS. | ||
| PART III, LINE 4: PART III, LINE 4 - COSTING METHODOLOGY:BAD 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 UNCOLLECTIBLE 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 WRITE OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE MEDICAL CENTER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE.PART III, LINE 4 - BAD DEBT AS COMMUNITY BENEFIT:AS PART OF ITS TAX EXEMPT PURPOSE MERCY MEDICAL CENTER PROVIDES ACCESS TO MEDICALLY NECESSARY CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, OR CULTURAL BACKGROUND. MERCY 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, MERCY IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE FROM THE HOSPITAL SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT SINCE CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR TAX EXEMPT PURPOSE, WHICH IS MEETING THE NEED FOR EMERGENCY AND NON-ELECTIVE MEDICAL CARE SERVICES IN THE COMMUNITY.PART III, LINE 9BTHE HOSPITAL'S CHARITY CARE POLICY DESCRIBES THE POLICIES AND PROCEDURES RELATING TO THE PROVISION OF CHARITY CARE TO PERSONS WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THEIR BILL. NO INDIVIDUAL WILL BE DENIED MEDICALLY NECESSARY HOSPITAL SERVICES BASED ON A DEMONSTRATED INABILITY TO PAY FOR THOSE SERVICES. IN ADDITION, UPON APPLYING FOR CHARITY CARE, EACH PATIENT AND PATIENT GUARANTOR'S ABILITY TO PAY WILL BE ASSESSED.ELIGIBILITY FOR ASSISTANCE: A REASONABLE REVIEW SHALL BE PERFORMED PRIORTO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TOINSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENTAND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (I.E.MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE CHS CHARITY CAREPOLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT,ANY ACCOUNT THAT SUBSEQUENTLY IS DETERMINED TO MEET THE CHARITY CARECRITERIA SHALL BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENTFOR APPROPRIATE FOLLOW-UP.THE THIRD-PARTY COLLECTION AGENT SHALL ADVISE THE PATIENT/GUARANTOR OF THEHOSPITAL'S CHARITY CARE POLICY AND RETURN THE ACCOUNT IMMEDIATELY IF IT IS DETERMINED THAT THE QUALIFICATIONS ARE MET. | ||
| PART III, LINE 8: - COSTING METHODOLOGY:THE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III, SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 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.PART III, LINE 8 -MEDICARE SHORTFALL AS COMMUNITY BENEFIT:LOSSES ON TREATING MEDICARE BENEFICIARIES SHOULD BE INCLUDED AS A COMMUNITYBENEFIT IN THEIR ENTIRETY. MERCY INCURRED A LOSS OF APPROXIMATELY $444 THOUSAND TO DELIVER CARE TO MEDICARE PATIENTS. THIS REPRESENTS THE AMOUNT BY WHICH COSTS TO DELIVER CARE TO MEDICARE RECIPIENTS EXCEEDS THE LEVEL OF PAYMENT. MERCY BEARS THE BURDEN OF NOT ONLY PROVIDING THE BEST AND MOST ADVANCED MEDICAL CAREPOSSIBLE TO THE COMMUNITY, BUT ALSO DOING SO WITH NO RECOURSE TO OBTAINPAYMENT FOR THE COST OF PROVIDING CARE IN EXCESS OF THE MEDICARE PAYMENT.AS MEDICARE REVENUE DECLINES AND THE COST TO PROVIDE CUTTING EDGE CARE TOTHE 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 MERCY WILL CONTINUE TO BEAR THE LOSS IN PROVIDING THE BEST CARE POSSIBLE TO THE LOCAL COMMUNITY. | ||
| PART VI, LINE 2: NEEDS ASSESSMENT:MERCY MEDICAL CENTER WORKS WITH MANY OUTSIDE PARTICIPANTS IN THE COMMUNITY IN ONGOING IDENTIFICATION OF COMMUNITY HEALTH NEEDS, INCLUDING NEIGHBORING SCHOOLS, PARISHES, BUSINESSES, COMMUNITY CENTERS, AND LOCAL CHAPTERS OF ORGANIZATIONS. MERCY STRIVES TO REACH INDIVIDUALS OF ALL AGES AND BACKGROUNDS TO PROVIDE QUALITY CARE AND HEALTH EDUCATION. THE HEALTHY SUNDAYS PROGRAM, WHICH PROVIDES FREE MEDICAL SCREENINGS ANDEDUCATION TO THE UNDERSERVED FOLLOWING WORSHIP SERVICES ON A BIMONTHLYBASIS SERVES AS A PRIMARY SOURCE OF PUBLIC PARTICIPATION AS COMMUNITY NEEDS SURVEYS (AVAILABLE IN ENGLISH AND SPANISH) ARE OFTEN DISTRIBUTED AT THESE SCREENING SITES. THUS EVERY POINT OF CONTACT DOUBLES AS AN OPPORTUNITY TO REQUEST FEEDBACK ON HOW THE HOSPITAL CAN BETTER MEET THE NEEDS OF THE COMMUNITY. THESE EVENTS ARE PROMOTED VIA CALENDAR LISTINGS IN PARISH BULLETINS AND FLYERS POSTED IN PLACES OF BUSINESS AND WORSHIP IN THE COMMUNITY SURROUNDING THE OUTREACH SITE.OVER THE YEAR, MERCY HAS WORKED WITH MANY ORGANIZATIONS TO DEVELOP HEALTH CARE PROGRAMS FOR RESIDENTS IN THE AREA: AMERICAN CANCER ASSOCIATION, AMERICAN HEART ASSOCIATION, CATHOLIC CHARITIES; DOWNSTATE NEW YORK HEALTHY START PROGRAM; ECONOMIC OPPORTUNITY CENTER; NASSAU COUNTY DEPARTMENT OF DRUG & ALCOHOL; NASSAU COUNTY DEPARTMENT OF MENTAL HEALTH; ROCKVILLE CENTRE CHAMBER OF COMMERCE, ROCKVILLE CENTRE LIONS CLUB AND DIOCESE OF ROCKVILLE CENTRE.IN SELECTING THE PREVENTION AGENDA PRIORITIES, MERCY MET IN THE PAST WITH OTHER HEALTHCARE PROVIDERS TO SELECT 2 PRIORITIES TO WORK ON TOGETHER FOR A JOINT COUNTY WIDE EFFORT. THESE OTHER PROVIDERS INCLUDED THE NASSAU COUNTY DEPARTMENT OF HEALTH, AND MANY NASSAU COUNTY HOSPITALS (LONG BEACH MEDICAL CENTER, NORTH SHORE LONG ISLAND JEWISH HEALTH CENTER, SOUTH NASSAU COMMUNITIES HOSPITAL, ST. FRANCIS HOSPITAL AND WINTHROP UNIVERSITY HOSPITAL). THE PRIORITIES SELECTED WERE PREVENTION OF INTENTIONAL INJURY FROM FALL RELATED HOSPITALIZATIONS AGE 65+ (FALLS PREVENTION) AND TOBACCO USE IN ADOLESCENT AND ADULTS (SMOKING CESSATION). MERCY CONTINUED TO WORK WITH SOME OF THE ORIGINAL HOSPITAL PARTNERS AND THE CENTER FOR TOBACCO CONTROL AND THE TOBACCO ACTION COALITION OF LONG ISLAND ON THE SMOKING CESSATION INITIATIVE, AND THE TOWN OF HEMPSTEAD DEPARTMENT OF SENIOR ENRICHMENT AND THE NASSAU COUNTY DEPARTMENT OF SENIOR AFFAIRS ON THE FALLS INITIATIVE. IN 2011 MERCY ADDED ANOTHER PREVENTION AGENDA PRIORITY , CHRONIC DISEASES SUCH AS DIABETES. IN WORKING WITH THE AMERICAN DIABETES ASSOCIATION, AMERICAN ASSOCIATION OF DIABETES EDUCATORS, HOSPITAL MEDICAL STAFF, AND CHS HOSPITALS, MERCY HOPES TO REDUCE INPATIENT HOSPITALIZATIONS BY PROMOTING DIABETES AWARENESS AND EDUCATION THROUGH COMMUNITY LECTURES, SUPPORT GROUPS AND SELF MANAGEMENT CLASSES.COMMUNITY HEALTH NEEDS ARE DISCUSSED AND ASSESSED ON A CONTINUAL BASIS AMONG THE HOSPITAL BOARD OF TRUSTEES, THE MISSION AND MINISTRY COMMITTEE AND THE PLANNING COMMITTEE OF THE BOARD, MERCY SENIOR LEADERSHIP, AND VARIOUS COMMITTEES WITHIN THE HOSPITAL SUCH AS THE COMMUNITY OUTREACH COMMITTEE AND THE CANCER COMMITTEE WHICH HAVE MULTI DISCIPLINARY REPRESENTATION OF HOSPITAL STAFF. OVER THE YEAR, MERCY CONTINUALLY SOLICITED INPUT FROM OUR AUXILIARY ORGANIZATIONS AT THE HOSPITAL - THE FRIENDS OF MERCY MEDICAL CENTER AND THE COUNCIL OF LEAGUES, REPRESENTING OVER 2000 VOICES. COMMUNITY HEALTH NEEDS ARE ALSO ASSESSED BY THE ADMINISTRATIVE STAFF AND BOARD OF TRUSTEES OF OUR PARENT CORPORATION, CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS). MERCY DISTRIBUTES A COMMUNITY NEEDS SURVEY AT ITS OUTREACH PROGRAMS. THROUGH PATIENT SATISFACTION SURVEYS, INPATIENTS AND EMERGENCY DEPARTMENT PATIENTS HAVE THE OPPORTUNITY TO MAKE COMMENTS ABOUT THEIR ONGOING AND FUTURE HEALTH CARE NEEDS. THROUGH A JOINT COMMUNITY NEEDS ASSESSMENT BY MERCY ADMINISTRATION, THE PASTORAL CARE DEPARTMENT, CHS OUTREACH COORDINATOR AND THE PARISH COMMUNITY, MERCY IS ABLE TO IDENTIFY THOSE POPULATIONS AT GREATEST RISK AND PROVIDE APPROPRIATE SERVICES (HEALTHY SUNDAYS WAS A RESULT OF THIS ASSESSMENT). | ||
| PART VI, LINE 3: COMMUNICATION OF FINANCIAL ASSISTANCE POLICY:ALL EMPLOYEES IN THE SCHEDULING, PATIENT ACCESS,PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS ARE FULLY VERSED IN THE CHARITY CARE POLICY, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ARE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE HOSPITAL REPRESENTATIVES. THE HOSPITAL POSTS MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CAREIN SEVERAL PROMINENT LOCATIONS WITHIN THE HOSPITAL INCLUDING, BUT NOTLIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FORPURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATIONAREA. SAID NOTICES ARE PUBLISHED IN AT LEAST ENGLISH AND SPANISH, AND ARECLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED.THE HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITSCHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM PROVIDESSPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY ANDTHE MEANS OF APPLYING FOR ASSISTANCE. THIS SUMMARY IS WRITTEN AT OR BELOWA SIXTH GRADE READING LEVEL.THE HOSPITAL POSTS ITS CHARITY CARE POLICY SUMMARY ON ITS INTERNETWEBSITE.THE HOSPITAL PROVIDES ALL PATIENTS INTERPRETERS TO ASSIST THEM INUNDERSTANDING ITS CHARITY CARE PROGRAM IN THE LANGUAGE SPOKEN BY THEPATIENT DURING ANY PRE-ADMISSION, ADMISSION, AND DISCHARGE PROCESS.ON ALL BILLS AND STATEMENTS SENT TO PATIENTS, A STATEMENT IS INCLUDEDREGARDING THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS,INCLUDING CHARITY CARE, AND A CONTACT NUMBER TO CALL TO OBTAIN FURTHERINFORMATION. THIS INFORMATION IS AVAILABLE AT OR BELOW A SIXTH GRADEREADING LEVEL. | ||
| PART VI, LINE 4: COMMUNITY INFORMATION:MMC'S PRIMARY SERVICE AREA CONTINUES TO INCLUDE HEMPSTEAD, ROCKVILLE CENTRE, WEST HEMPSTEAD, LYNBROOK, FREEPORT, BELLMORE/NORTH BELLMORE, MERRICK/NORTH MERRICK, VALLEY STREAM, ELMONT, UNIONDALE, ROOSEVELT, BALDWIN AND EAST MEADOW, A TOTAL POPULATION OF APPROXIMATELY 450,000. ACCORDING TO INTERNAL DATA, OVER 30% OF MMC'S TOTAL INPATIENT DISCHARGES IN 2011 CAME FROM HEMPSTEAD, UNIONDALE, FREEPORT, AND ROOSEVELT. THE NASSAU COUNTY DEPARTMENT OF HEALTH HAS REFERRED TO THESE TOWNS AS "COMMUNITIES AT RISK", WITH MANY RESIDENTS LIVING IN POVERTY AND HAVING POOR HEALTH OUTCOMES. ALMOST HALF (49%) OF MERCY'S EMERGENCY ROOM VISITS IN 2011 CAME FROM THESE 4 ZIP CODES. | ||
| PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:MERCY, IN CONJUNCTION WITH OTHER CATHOLIC HEALTH SERVICES OF LONG ISLAND HOSPITALS, PARTICIPATES IN THE HEALTHY SUNDAYS PROGRAM, A COMMUNITY OUTREACH PROGRAM HELD IN PARISHES DESIGNED TO PROMOTE EDUCATION ON MANY IMPORTANT HEALTH SUBJECTS SUCH AS CANCER AWARENESS, DIABETES, BLOOD PRESSURE, HEALTHY EATING, SMOKING CESSATION AND CHOLESTEROL.MANAGING WEIGHT AND ASSOCIATED HEALTH ISSUES HAS BECOME A FACT OF LIFE AND CHALLENGE FOR MANY AMERICANS. AS A BARIATRIC CENTER OF EXCELLENCE, MERCY MEDICAL CENTER DEVELOPED THREE WEIGHT MANAGEMENT PROGRAMS THAT BEGAN IN 2009. MERCY PROVIDES A FACILITATED SUPPORT GROUP FOR POST BARIATRIC SURGERY PATIENTS, AS WELL AS CONDUCTING TWO FACILITATED WEIGHT MANAGEMENT GROUPS, ONE FOR ADULTS AND THE OTHER FOR ADOLESCENTS.IN 2011 MERCY INCREASED ITS COMMUNITY OUTREACH PROGRAMS FOR FALL PREVENTION AND SMOKING CESSATION. MERCY CONDUCTED PROGRAMS AT SENIOR CENTERS, COMMUNITY HEALTH FAIRS AND LIBRARIES, AS WELL AS WITHIN THE HOSPITAL FOR MANY OF ITS INPATIENTS AND OUTPATIENTS WITH FALL HISTORY OR WHO SMOKE. THROUGH MERCY'S NEW RISK ASSESSMENT FORM, HOSPITAL EMPLOYEES EDUCATED INPATIENTS ON RISK FACTORS AND WAYS TO AVOID FUTURE FALLS. NURSING CONTINUES TO REVIEW POTENTIAL CHANGES IN INPATIENT PROCEDURES TO REDUCE INPATIENT FALLS, SUCH AS RISK ADMISSION ASSESSMENTS, DEVELOPING A FALL PLAN OF CARE, PATIENT AND FAMILY EDUCATION, USING SPECIALTY BEDS WITH EXIT ALARMS, INITIATING SAFETY WATCHES AND OFFERING FREQUENT TOILETING IN ORDER TO AVOID A POTENTIAL FALL, WITH THE GOAL OF ENCOURAGING PATIENTS TO FOLLOW THESE PROCEDURES AT HOME. MERCY BECAME A SMOKE FREE CAMPUS ON MAY 1, 2011 (EXCEPT FOR THE PSYCHIATRIC INPATIENT UNIT WHICH HAS A CLEARLY DEFINED POLICY WHEN ITS PATIENTS MAY TO SMOKE). ALL PATIENTS ARE SCREENED UPON ADMISSION AND THOSE IDENTIFIED AS SMOKERS ARE ENTERED INTO A DATA BASE, SO NURSING STAFF CAN EDUCATE PATIENTS MOST IN NEED. IN 2011 MERCY ADDED SMOKING CESSATION DRUGS TO ITS FORMULARY. MERCY USES PHARMACY MEDICATION RECORDS TO TRACK THE NUMBER OF PATIENTS WITH PRESCRIPTIONS WRITTEN FOR A SMOKING CESSATION MEDICATION. MERCY EMPLOYEES OFFER SMOKING CESSATION INFORMATION, REFERRALS TO SMOKING CESSATION PROGRAMS AND NY-QUIT LINE CARDS AT ALL COMMUNITY OUTREACH EVENTS. MERCY ITSELF OFFERS THE GREEN SEMINAR, A MONTHLY SMOKING CESSATION PROGRAM TO PATIENTS AND OTHER COMMUNITY MEMBERS. MERCY OFFERS SMOKING CESSATION PROGRAMS TO EMPLOYEES THROUGH ITS EMPLOYEE ASSISTANCE PROGRAM AND TO PHYSICIANS THROUGH THE CENTER FOR TOBACCO CONTROL. | ||
| PART VI, LINE 6: AFFILIATED HEALTHCARE SYSTEM:MERCY MEDICAL CENTER IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH IS LOCATED ON A SINGLE CAMPUS IN ROCKVILLE CENTRE, NEW YORK. ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS MERCY, THROUGH ITS DAILY OPERATION, PROVIDES TO THE AREA ACUTE, PSYCHIATRIC, REHABILITATIVE, EMERGENT AND OUTPATIENT CARE. MERCY 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 OF SIENA MEDICAL CENTER IN SUFFOLK COUNTY; AND AS PASSIVE PARENT TO ST. JOSEPH HOSPITAL IN NASSAU COUNTY); THREE NURSING HOMES (ST. CATHERINE OF SIENA 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 17,000 STAFF AND 3,800 MEDICAL STAFF WORKING THROUGHOUT THE SYSTEM, CHS PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES.MEMBER ORGANIZATIONS OF CHS OFFER VIRTUALLY EVERY MEDICAL SPECIALTY AND CLINICAL SERVICE, AND SHARE A DEDICATION TO CONTINUOUSLY UPGRADE THE SCOPE, QUALITY AND ACCESSIBILITY OF CARE. EACH OF CHS' MEMBER ORGANIZATIONS HAVE RETAINED THEIR INDIVIDUAL LINKS TO HISTORY, A DISTINCTIVE PERSONALITY, 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 WORKING TO, AMONG OTHER THINGS, IMPROVE QUALITY OF CARE, FACILITATE CLINICAL INTEGRATION, BENCHMARK BEST PRACTICES, AND REDUCE LENGTH OF STAY AND COSTS. | ||
| NY | REPORTS FILED WITH STATES | PART VI, LINE 7 |
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 AVE | AddressLine1 |
| City | ROCKVILLE CENTRE | City |
| State | NY | State |
| ZIP Code | 11571 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 111837437 | EINOfRecipient |
| Amount Of Cash Grant | 233812 | AmountOfCashGrant |
| Purpose Of Grant | TO FURTHER THE MISSION OF THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE. | PurposeOfGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | PART II, LINE 1, COLUMN (H): NAME OF ORGANIZATION OR GOVERNMENT: DIOCESE OF ROCKVILLE CENTRE - CATHOLIC MINISTRIES APPEAL (H) PURPOSE OF GRANT OR ASSISTANCE: TO PROVIDE GENERAL SUPPORT OF THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD. | 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 | 0 | 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALAN D GUERCI MD | |||||||||||||
| 0 | 760965 | 0 | 345300 | 0 | 1151991 | 0 | 567098 | 0 | 29829 | 0 | 2855183 | 0 | 0 |
| WILLIAM C ARMSTRONG | |||||||||||||
| 0 | 487907 | 0 | 160000 | 0 | 952400 | 0 | 436336 | 0 | 26634 | 0 | 2063277 | 0 | 776631 |
| NANCY SIMMONS | |||||||||||||
| 312446 | 73203 | 80000 | 0 | 443876 | 2019 | 68476 | 3365 | 16263 | 3028 | 921061 | 81615 | 427346 | 0 |
| AARON GLATT | |||||||||||||
| 31129 | 377980 | 0 | 105000 | 76 | 15212 | 0 | 23201 | 1994 | 23716 | 33199 | 545109 | 0 | 0 |
| JOHN REILLY | |||||||||||||
| 347177 | 0 | 20000 | 0 | 4406 | 0 | 16895 | 0 | 24935 | 0 | 413413 | 0 | 0 | 0 |
| RONALD STEIMEL | |||||||||||||
| 300687 | 0 | 20000 | 0 | 11941 | 0 | 16895 | 0 | 24790 | 0 | 374313 | 0 | 0 | 0 |
| STEPHEN TRAPANI | |||||||||||||
| 295932 | 11923 | 40000 | 0 | 12927 | 0 | 38771 | 0 | 26617 | 7 | 414247 | 11930 | 0 | 0 |
| SWARNA DEVARAJAN MD | |||||||||||||
| 324848 | 0 | 0 | 0 | 934 | 0 | 16895 | 0 | 27593 | 0 | 370270 | 0 | 0 | 0 |
| ALAN WONG MD | |||||||||||||
| 394066 | 0 | 0 | 0 | 224 | 0 | 16895 | 0 | 25729 | 0 | 436914 | 0 | 0 | 0 |
| RENEE MAURIELLO | |||||||||||||
| 250629 | 0 | 20000 | 0 | 11063 | 0 | 16895 | 0 | 24857 | 0 | 323444 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUPPLEMENTAL INFORMATION | PART III | SCHEDULE J PART II B(III), OTHER REPORTABLE COMPENSATION INCLUDES A SERP DISTRIBUTION OF $427,346 FOR NANCY SIMMONS AND $776,631 FOR BILL ARMSTRONG, WHICH RELATES TO PRIOR YEAR CONTRIBUTIONS. SCHEDULE J PART II C, RETIREMENT AND DEFERRED COMPENSATION INCLUDES THE 2012 CONTRIBUTIONS TOWARD A SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN. THE CONTRIBUTIONS TO THE PLAN ARE AS FOLLOWS: NANCY SIMMONS = $54,427 STEPHEN TRAPANI = $21,876 |
| SUPPLEMENTAL INFORMATION | 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. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (14 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF MERCY 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 (DIOCESE). | |
| FORM 990, PART VI, SECTION A, LINE 7A | CHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF MERCY MEDICAL CENTER AND AS SUCH, HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF MERCY MEDICAL CENTER. | |
| FORM 990, PART VI, SECTION A, LINE 7B | CHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF MERCY MEDICAL CENTER IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY MERCY'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 IF A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO 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 | 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. | |
| 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. | |
| PART VII, SECTION A, LINE 1A: | ALAN GUERCI, M.D. PRESIDENT AND CEO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. FRANCIS HOSPITAL (11-2050523); ST. FRANCIS HOSPITAL FOUNDATION (11-2916033); ST. FRANCIS RESEARCH AND EDUCATIONAL CORPORATION INC. (11-3090867); MERCY MEDICAL CENTER (11-1635088). WILLIAM ARMSTRONG, SENIOR VICE PRESIDENT AND CFO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. FRANCIS HOSPITAL (11-2050523); ST. FRANCIS HOSPITAL FOUNDATION (11-2916033); ST. FRANCIS RESEARCH AND EDUCATIONAL CORPORATION INC. (11-3090867); MERCY MEDICAL CENTER (11-1635088) | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 4,962. MIMS PC CHANGE IN UNRESTRICTED NET ASSETS -40,264. POSTRETIREMENT BENEFIT PLAN CHANGES OTHER THAN NET PERIODIC BENEFIT COST -121,000. LOSS ON EXTINGUISHMENT OF DEBT -591,961. TOTAL TO FORM 990, PART XI, LINE 5: -748,263. | 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 |
| 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 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 | |
| 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 CATHERINE OF SIENA MEDICAL CENTER | |||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 061562701 | HOSPITAL | NY | 501(C)(3) | LINE 3 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| 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 11A, I | 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 |
|---|---|---|---|---|---|---|---|---|
| ADVANCED REHABILIATION MEDICINE PLLC | ||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 113640709 | HEALTHCARE SERVICES | NY | ST CHARLES HOSPITAL | C |
| CARDIAC EKG INTERPRETATION PC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 112924518 | HEALTHCARE SERVICES | NY | GOOD SAMARITAN HOSPITAL | C |
| FAIRVIEW HILL MANAGEMENT CO INC | ||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 112798383 | SERVICES | NY | ST CHARLES CORPORATION | C |
| LI REGIONAL ARTHRITIS & OSTEOPOROSIS CARE PC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208964140 | 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 |
| 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 MANAGEMENT SERVICES INC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 112838185 | HEALTHCARE SERVICES | NY | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | C |
| SAMARITAN MEDICAL SERVICES PC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208088453 | 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 |
| SOUTH SHORE PRACTICE MANAGEMENT | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 113307977 | HEALTHCARE SERVICES | NY | GOOD SAMARITAN HOSPITAL | C |
| SOUTHWEST SUFFOLK MEDICAL PC | ||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 061603195 | HEALTHCARE SERVICES | NY | GOOD SAMARITAN HOSPITAL | C |
| ST FRANCIS CARDIAC PREVENTION SERVICES PC | ||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113224885 | HEALTHCARE SERVICES | NY | ST FRANCIS HOSPITAL | 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 | 0 | 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 | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | 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 | ||
| P | -581022 | COST |
| CHS SERVICES INC | ||
| P | 1263958 | COST |
| MARYHAVEN CENTER OF HOPE | ||
| P | 474654 | COST |
| GOOD SAMARITAN HOSPITAL MEDICAL CENTER | ||
| P | 81947 | COST |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | PART V, TRANSACTIONS WITH RELATED PARTIES MERCY MEDICAL CENTER HAS DISCLOSED IN SCHEDULE R THE PREDOMINANT TRANSACTION TYPE WITH EACH FACILITY WITH WHICH IT HAS CONDUCTED TRANSACTIONS. HOWEVER, THERE ARE ADDITIONAL TRANSACTION TYPES TO DESCRIBE THE ACTIVITIES CHS HAS ENGAGED IN WITH ITS RELATED PARTY ORGANIZATIONS. THE FOLLOWING IS A LIST OF ADDITIONAL TRANSACTION TYPES BY FACILITY. NAME OF ADDITIONAL ORGANIZATION EIN TRANSACTION TYPES CATHOLOIC HEALTH SYSTEM OF LI 11-3403968 P CHS SERVICES, INC. 11-3555766 L,J,N,O MARYHAVEN CENTER OF HOPE 11-2861698 N,O GOOD SAMARITAN HOSPITAL MEDICAL CENTER 11-1888924 N,O | Explanation |
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