NURSING SISTERS HOME CARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NURSING SISTERS HOME CARE INC (EIN 11-2126736)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-13
IRS object ID
201303179349305170
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-13T15:10:54-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1300 Madison AvenueAddressLine1
CityNew YorkCity
StateNYState
ZIP Code10017ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN112126736EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1NURSING SISTERS HOME CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% CATHOLIC HOME CAREInCareOfName
Name ControlNURSNameControl
Phone6314656457Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1110 Bi-County Blvd Suite 114AddressLine1
Address Line2SuiteAddressLine2
CityFARMINGDALECity
StateNYState
ZIP Code11735ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARY ELLIN POLITName
TitleEXECUTIVE VP, CAOTitle
Phone6464656457Phone
Date Signed2013-11-05DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone6464713000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HOME CAREBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOSEPH TOMAINONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11150 PORTION RDAddressLine1
CityHOLTSVILLECity
StateNYState
ZIP Code11742ZIPCode
FieldValueIRS element (for citing)
Gross Receipts36595939GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteHTTP://CATHOLICHOMECARE.CHSLI.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1968YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionCATHOLIC HEALTH SERVICES OF LONG ISLAND AND ITS MEMBERS, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUE CHRIST'S HEALING MISSION BY PROMOTING EXCELLENCE IN CARE AND COMMITING ITSELF TO THOSE IN NEED.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members18NbrIndependentVotingMembers
Total Nbr Employees712TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year23593ContributionsGrantsPriorYear
Contributions Grants Current Year5776ContributionsGrantsCurrentYear
Program Service Revenue Prior Year31171916ProgramServiceRevenuePriorYear
Program Service Revenue CY36510013ProgramServiceRevenueCY
Investment Income Prior Year3878InvestmentIncomePriorYear
Investment Income Current Year28707InvestmentIncomeCurrentYear
Other Revenue Prior Year30378OtherRevenuePriorYear
Other Revenue Current Year51443OtherRevenueCurrentYear
Total Revenue Prior Year31229765TotalRevenuePriorYear
Total Revenue Current Year36595939TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year12308GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY13798GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year29432744SalariesEtcPriorYear
Salaries Etc Current Year30909192SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5039648OtherExpensePriorYear
Other Expenses Current Year5877272OtherExpensesCurrentYear
Total Expenses Prior Year34484700TotalExpensesPriorYear
Total Expenses Current Year36800262TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-3254935RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-204323RevenuesLessExpensesCY
Total Assets BOY6009628TotalAssetsBOY
Total Assets EOY8814378TotalAssetsEOY
Total Liabilities BOY24556517TotalLiabilitiesBOY
Total Liabilities EOY27564342TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-18546889NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-18749964NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionNURSING SISTERS HOME CARE D/B/A CATHOLIC HOME CARE, 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, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense31235649Expense
Grants13798Grants
Revenue36526456Revenue
DescriptionNURSING SISTERS HOME CARE (DBA CATHOLIC HOME CARE) PROVIDES APPROXIMATELY 211,930 VISITS TO 12,601 HOME CARE RECIPIENTS IN 2012. SERVICES INCLUDE SKILLED NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH LANGUAGE PATHOLOGY, NUTRITIONAL COUNSELING, MEDICAL SOCIAL WORKERS, WOUND CARE NURSES AND CLOSELY SUPERVISED HOME HEALTH AIDES.Description
Total Program Service Expense31235649TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109622NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees712NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members18NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCATHOLIC HOME CARENamePerson
Telephone Number6318287411TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1110 BI-COUNTY BLVD SUITE 114AddressLine1
CityFARMINGDALECity
StateNYState
ZIP Code11735ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeAverage Hours Per Week RelatedAverageHoursPerWeekRelatedFormerFormer
Hon Angie Carpenter
Chairperson2.0XX000
Bernadette Curry PHD RN
Vice Chairperson2.0XX000
Charles Falkner
Treasurer2.0XX000
Sister Dolores Castellano CIJ
Secretary2.0XX000
Donato Balsamo DO
Board Member2.0X061180
Robert Doyle
Board Member2.0X000
Philip Fava
Board Member2.0X000
Sr Margaret Kelliher DW
Board Member2.0X000
Walter Lace
Board Member2.0X000
Brother Campion Lally OSF
Board Member2.0X000
Timothy J Mattimore Esq
Board Member2.0X000
Rev Msgr Thomas Mulvanerty
Board Member2.0X000
Diane Sweeney
Board Member2.0X000
Richard Romer
Board Member2.0X000
Daniel Rowe
Board Member2.0X000
Charles SpenCer
Board Member2.0X000
Debbie Van Bourgondien
Board Member2.0X000
Sister Dolores Wisniewski
Board Member2.0X000
Joseph Tomaino
EVP Continuing Care50.0XX0785524189739
Karen Estrada
SVP/CFO50.0X025167147294
Mary Ellen Polit
EVP & CAO50.0X0371432165533
Janice Remmers
Director of Patient Accts37.5155277042035X
Denise Fasano
CARE MANAGER37.5135896022646X
Catherine Ciresi
Director of Business Operation37.5125856036170X
Danielle Stein
Dir Finance Home Care & Hosp37.5128822037841X
Nancy Pol Stith
CARE MANAGER37.5126261036341X
WILLIAM MEAD
FORMER CFO/SVP CONTINUING CARE036752512153850.0X
FieldValueIRS element (for citing)
Total Reportable Comp From Org672112TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1782270TotalReportableCompFrmRltdOrgs
Total Other Compensation699137TotalOtherCompensation
Number Individuals GT100 K15NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ALLSCRIPTS LLC
24630 NETWORK PLCHICAGOIL60673CLINICAL LICENSES259434
1150 CORP
1150 PORTION RD SUITE 16HOLTSVILLENY11742RENT/CLEANING SVCS245970
ABLE HEALTHCARE SERVICES
1240 BROADCAST PLAZAMERRICKNY11566HOME HEALTH AIDS SVS223209
PERSONAL TOUCH
640 MONTAUK HWYSHIRLEYNY11967HOME HEALTH AIDS SVS182092
HONEYWELL HOMMED LLC
23262 NETWORK PLCHICAGOIL60673MEDICAL SUPPLY SVCS175388
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
All Other Contributions5776AllOtherContributions
Total Contributions5776TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUEDescription
Business Code621610BusinessCode
Total Revenue Column36510013TotalRevenueColumn
Related Or Exempt Function Income36510013RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue36510013TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column28707TotalRevenueColumn
Exclusion$28,707ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
CONSULTING FEES90009935000$35,000
MED TRANSCRIPT FEES9000991644316443
FieldValueIRS element (for citing)
Total Other Revenue51443TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column36595939TotalRevenueColumn
Related Or Exempt Function Income36526456RelatedOrExemptFunctionIncome
Exclusion$63,707ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total13798Total
Program Services13798ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total23891470Total
Program Services21766632ProgramServices
Management And General2124838ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1720004Total
Program Services1566924ProgramServices
Management And General153080ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3461503Total
Program Services3153429ProgramServices
Management And General308074ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1836215Total
Program Services1672792ProgramServices
Management And General163423ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total5048Total
Management And General5048ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total72702Total
Management And General72702ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1417855Total
Program Services1314019ProgramServices
Management And General103836ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total70504Total
Management And General70504ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total301659Total
Program Services168757ProgramServices
Management And General132902ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total370330Total
Program Services264877ProgramServices
Management And General105453ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total816871Total
Program Services769694ProgramServices
Management And General47177ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total18757Total
Program Services5400ProgramServices
Management And General13357ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3059Total
Management And General3059ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total79691Total
Management And General79691ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total559689Total
Management And General559689ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total70729Total
Management And General70729ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
CHS SERVICES754214754214
MEDICAL SUPPLIES472899472899
RESERVE ON LOAN RECEIVABLE400000400000
NY HOMECARE MEDICAID ASSESSMEN124166124166

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total339099Total
Program Services66428ProgramServices
Management And General272671ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total36800262Total
Program Services31235649ProgramServices
Management And General5564613ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY1400EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY685812BOY
EOY1928078EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY4096009BOY
EOY5065951EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY11865BOY
EOY11865EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY53915BOY
EOY35169EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4196546LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2695661LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY910371BOY
EOY1500885EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY16953BOY
EOY26712EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY234703BOY
EOY244318EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6009628BOY
EOY8814378EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY3525884BOY
EOY3947546EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY21030633BOY
EOY23616796EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY24556517BOY
EOY27564342EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-18766454BOY
EOY-18964270EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY70699BOY
EOY65440EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY148866BOY
EOY148866EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-18546889BOY
EOY-18749964EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6009628BOY
EOY8814378EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-204323ReconcilationRevenueExpenses
Reconciliation Unrealized Invest1248ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years308608CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years15979CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years24220CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23593CurrentTaxYearMinus1Year
Current Tax Year5776CurrentTaxYear
Total378176Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years24552860CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years28214971CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years31260116CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year31171916CurrentTaxYearMinus1Year
Current Tax Year36510013CurrentTaxYear
Total151709876Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years24861468CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years28230950CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years31284336CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year31195509CurrentTaxYearMinus1Year
Current Tax Year36515789CurrentTaxYear
Total152088052Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509152088052PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2901CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2918CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5200CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3878CurrentTaxYearMinus1Year
Current Tax Year28707CurrentTaxYear
Total43604Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years2901CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2918CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5200CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3878CurrentTaxYearMinus1Year
Current Tax Year28707CurrentTaxYear
Total43604Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years85189CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years74964CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years54489CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year30378CurrentTaxYearMinus1Year
Current Tax Year51443CurrentTaxYear
Total296463Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years24949558CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years28308832CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years31344025CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year31229765CurrentTaxYearMinus1Year
Current Tax Year36595939CurrentTaxYear
Total152428119Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99777PublicSupportPercentage509
Prior Year Support Percentage0.99740PriorYearSupportPercentage
Investment Income Percentage0.00029InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00030PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance148866BeginningOfYearBalance
Investment Earnings Or Losses1248InvestmentEarningsOrLosses
Other Expenditures1248OtherExpenditures
End Of Year Balance148866EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance148866BeginningOfYearBalance
Investment Earnings Or Losses2907InvestmentEarningsOrLosses
Other Expenditures2907OtherExpenditures
End Of Year Balance148866EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance148866BeginningOfYearBalance
Investment Earnings Or Losses16739InvestmentEarningsOrLosses
Other Expenditures16739OtherExpenditures
End Of Year Balance148866EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance148866BeginningOfYearBalance
Investment Earnings Or Losses5008InvestmentEarningsOrLosses
Other Expenditures5008OtherExpenditures
End Of Year Balance148866EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance148866BeginningOfYearBalance
Investment Earnings Or Losses6InvestmentEarningsOrLosses
Other Expenditures6OtherExpenditures
End Of Year Balance148866EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
LandLand
BuildingsBuildings

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis281570OtherCostOrOtherBasis
Depreciation170564Depreciation
Book Value111006BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3506547OtherCostOrOtherBasis
Depreciation2213103Depreciation
Book Value1293444BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis408429OtherCostOrOtherBasis
Depreciation311994Depreciation
Book Value96435BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1500885TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO RELATED PARTIES$23,406,946
PENSION LIABILITY$176,082
DUE TO THIRD PARTY$33,768
FieldValueIRS element (for citing)
Total Of Amounts23616796TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierSCHEDULE D, PART X, LINE 2Identifier
ExplanationMANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE COMBINED FINANCIAL STATEMENTS.Explanation

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1DIOCESE OF ROCKVILLE CENTRE - CATHOLIC MINISTRIESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line150 NORTH PARK AVEROCKVILLE CENTREAddressLine1
CityROCKVILLE CENTRECity
StateNYState
ZIP Code11570ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient111837437EINOfRecipient
IRC Section501(c)(3)IRCSection
Amount Of Cash Grant13798AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Method Of ValuationN/AMethodOfValuation
Description Of Non Cash AssistanceN/ADescriptionOfNonCashAssistance
Purpose Of GrantTO 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 THE DIOCESE OF ROCKVILLE CENTRE PROVIDES ANNUAL UPDATES TO ALL CONTRIBUTORS TO THE CATHOLIC MINISTRIES APPEAL, WHETHER PARISHIONERS OR CORPORATE CONTRIBUTORS LIKE CHSLI.PurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE I, PART I, LINE 2PROCEDURE FOR MONITORING GRANT FUND USETHE DIOCESE OF ROCKVILLE CENTRE PROVIDES ANNUAL UPDATES TO ALL CONTRIBUTORS TO THE CATHOLIC MINISTRIES APPEAL, WHETHER PARISHIONERS OR CORPORATE CONTRIBUTORS LIKE CHSLI.
SCHEDULE I, PART II, LINE 1, COLUMN (H)PURPOSE OF GRANT OR ASSISTANCETO 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.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Joseph Tomaino
EVP Continuing Care061952801492000167960160810028929097526300
Karen Estrada
SVP/CFO024113400010537021332025962029896500
Mary Ellen Polit
EVP & CAO0287081082700016510136646028887053696500
Janice Remmers
Director of Patient Accts1549730003040161410258940197312000
Denise Fasano
CARE MANAGER135441000455013866087800158542000
Catherine Ciresi
Director of Business Operation1248820009740134320227380162026000
Danielle Stein
Dir Finance Home Care & Hosp1285290002930133430244980166663000
Nancy Pol Stith
CARE MANAGER1258830003780124010239400162602000
WILLIAM MEAD
FORMER CFO/SVP CONTINUING CARE0310892045000011633096766024772048906300

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE J, PART I, LINE 4BSUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANJOSEPH TOMAINO $138,735 PARTICIPATION IN PLAN MARY ELLEN POLIT $116,046 PARTICIPATION IN PLAN WILLIAM MEAD $76,741 PARTICIPATION IN PLAN
SCHEDULE J, PART IICOMPENSATIONTHE AMOUNTS REFLECTED IN COLUMN B(III) AND COLUMN C FOR THE INDIVIDUALS INCLUDE PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP"). THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2012 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 J, PART IIFORMER OFFICERDURING 2012, WILLIAM MEAD TRANSFERRED FROM HIS ROLE IN THE CONTINUING CARE DIVISION TO ANOTHER ROLE WITHIN THE CHS SYSTEM AND THEREFORE HAS BEEN LISTED AS A FORMER EMPLOYEE IN PART VII.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, LINE 6MEMBERS OF THE ORGANIZATIONTHE SOLE MEMBER OF NURSING SISTERS HOME CARE D/B/A CATHOLIC HOME CARE 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, LINE 7AELECTION OF THE GOVERNING BODYCHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATER OF CATHOLIC HOME CARE, AND AS SUCH HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF CATHOLIC HOME CARE.
FORM 990, PART VI, LINE 7BDECISIONS OF THE GOVERNING BODYCHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATER OF CATHOLIC HOME CARE IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERNING BODY OF CATHOLIC HOME CARE.
FORM 990, PART VI, LINE 11AREVIEW PROCESS OF FORM 990THE FORM 990 AND APPROPRIATE SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE 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, LINE 12CCONFLICT OF INTEREST POLICYDISCLOSURE 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.PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIMSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL INTO THE TRANSACTION OR ARRANGEMENT.
FORM 990, PART VI, LINE 15COMPENSATION POLICYTHE 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. THE POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER, AND CHIEF OPERATING OFFICERS OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS; D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AN OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE DONE BY AN INDEPENDENT CONSULTANT ANNUALLY. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE BOARD OF TRUSTEES.
FORM 990, PART VI, LINE 19DOCUMENTS AVAILABLE FOR PUBLIC INSPECTIONGOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND.
FORM 990, PART VIISECTION A, LINE 1A - COMPENSATION OF OFFICERSHOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. JOSEPH TOMAINO, EVP CONTINUING CARE - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CENTER OF HOPE FOUNDATION (11-3638367), RIVERHEAD HOSTEL HOLDING CORP (11-2499790), OLGCC (11-3284066), MARYHAVEN TRANSPORTATION SERVICES (11-3434776), MARYHAVEN SCHOOL (11-2861690), MARYHAVEN CENTER OF HOPE (11-2861698), GOOD SHEPHERD HOSPICE (11-2958438), CHS HOME SUPPORT SERVICES (11-3594561), CATHOLIC HOME CARE (11-2126736) KAREN ESTRADA, SVP/CFO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CENTER OF HOPE FOUNDATION (11-3638367), RIVERHEAD HOSTEL HOLDING CORP (11-2499790), OLGCC (11-3284066), MARYHAVEN TRANSPORTATION SERVICES (11-3434776), MARYHAVEN SCHOOL (11-2861690), GOOD SHEPHERD HOSPICE (11-2958438), CHS HOME SUPPORT SERVICES (11-3594561), CATHOLIC HOME CARE (11-2126736) MARY ELLEN POLIT, EVP & CAO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SHEPHERD HOSPICE (11-2958438), CHS HOME SUPPORT SERVICES (11-3594561), CATHOLIC HOME CARE (11-2126736)

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (36 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CATHOLIC HEALTH SYSTEM OF LONG ISLAND
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113403968SUPPORT ORGNY501(C)(3)11A- INAfalse
CHS SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113555766SUPPORT ORGNY501(C)(3)11A- IICHSLIfalse
CHS AMBULANCE SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570141801961DORMANTNY501(C)(3)3CHSLIfalse
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
1000 MONTAUK HIGHWAYWEST ISLIPNY11795111888924HOSPITALNY501(C)(3)3CHSLIfalse
GOOD SAMARITAN SELF INSURANCE AGAINST
MALPRACTICE 1000 MONTAUK HIGHWAYWEST ISLIPNY11795112537396SELF INSURANCNY501(C)(3)11A- IGOOD SAMARTNfalse
MARYHAVEN TRANSPORTATION SERVICES
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113434776TRANSPORTATIONY501(C)(3)9MARYHAVENCTRtrue
MARYHAVEN CENTER OF HOPE
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112861698Prgm-disabledNY501(C)(3)9CHSLItrue
MARYHAVEN SCHOOL CORPORATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112861690Schl-disabledNY501(C)(3)2MARYHAVENCTRtrue
THE CENTER OF HOPE FOUNDATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113638367SUPPORT ORGNY501(C)(3)9MARYHAVENCTRtrue
MERCY MEDICAL CENTER
1000 NORTH VILLAGE AVENUEROCKVILLE CTRNY11570111635088HOSPITALNY501(C)(3)3CHSLIfalse
OUR LADY OF CONSOLATION GERIATRIC CARE
111 BEACH DRIVEWEST ISLIPNY11795113284066LT NURSE CARENY501(C)(3)9CHSLItrue
RIVERHEAD HOSTEL HOLDING CORPORATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112499790RENTINGNY501(C)(2)MARYHAVENCTRtrue
SIENA VILLAGE INC
2000 BISHOPS ROADSMITHTOWNNY11787061569129SR HOUSINGNY501(C)(3)9STCATHERINEfalse
ST CATHERINE OF SIENA MEDICAL CENTER
50 ROUTE 25ASMITHTOWNNY11787061562701HOSPITALNY501(C)(3)3CHSLIfalse
ST CHARLES HOSPITAL
200 BELLE TERRE ROADPORT JEFFERSN STNY11777111871039HOSPITALNY501(C)(3)3CHSLIfalse
CHS HOME SUPPORT SERVICES INC
110 Bi-County Blvd Suite 114FARMINGDALENY11735113594561RESP THERAPYNY501(C)(3)9CATHHOMECAREtrue
ST FRANCIS HOSPITAL
100 PORT WASHINGTON BLVDROSLYNNY11576112050523HOSPITALNY501(C)(3)3CHSLIfalse
ST FRANCIS HOSPITAL FOUNDATION
100 PORT WASHINGTON BLVDROSLYNNY11576112916033SUPPORT ORGNY501(C)(3)11A- IST FRANCISfalse
ST FRANCIS HOSPITAL RESEARCH & EDUCATIO
100 PORT WASHINGTON BLVDROSLYNNY11576113090867RESEARCH ORGNY501(C)(3)11A- IST FRANCISfalse
WSNCHS NORTH INC
4295 HEMPSTEAD TURNPIKEBETHPAGENY11714113438973HOSPITALNY501(C)(3)3CHSLIfalse
SUFFOLK HEARING & SPEECH CENTER INC
369 EAST MAIN STREETEAST ISLIPNY11730112110488DIAGN TESTINGNY501(C)(3)9GOOD SAMARTNfalse
THE ST CHARLES CORPORATION
200 BELLE TERRE ROADPORT JEFFERSN STNY11777112983148SUPPORT ORGNY501(C)(3)11A- ICHSLIfalse
THE SAMARITAN CORPORATION
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570112716640SUPPORT ORGNY501(C)(3)11A- ICHSLIfalse
WISDOM GARDENS HOUSING DEVELOPMENT FUND
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113559713SR HOUSINGNY501(C)(3)9MARYHAVENCTRtrue
GOOD SHEPHERD HOSPICE
110 Bi-County Blvd Suite 114FARMINGDALENY11735112958438HOSPICE SVCNY501(C)(3)9CHSLItrue
ST CHARLES HOSPITAL FOUNDATION
200 BELLE TERRE ROADPORT JEFFERSONNY11777412076312SUPPORT ORGNY501(C)(3)11A- IIST CHARLESfalse
GOOD SAMARITAN HOSPITAL FOUNDATION
1000 MONTAUK HIGHWAYWEST ISLIPNY11795770611240SUPPORT ORGNY501(C)(3)11A- IGOOD SAMARTNfalse
ST FRANCIS-MERCY CORPORATION
100 PORT WASHINGTON BLVDROSLYNNY11576111635088SUPPORT ORGNY501(C)(3)11A- ICHSLIfalse
MERCY MEDICAL CENTER FOUNDATION
1000 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570550813603SUPPORT ORGNY501(C)(3)11A- IMERCY MEDCTRfalse
ST CATHERINE OF SIENA MEDICAL CTR FDN
50 ROUTE 25ASMITHTOWNNY11787271459941SUPPORT ORGNY501(C)(3)11A- ISTCATHERINEfalse
CATHOLIC HOME CARE FOUNDATION
110 Bi-County Blvd Suite 114FARMINGDALENY11735452907761SUPPORT ORGNY501(C)(3)11A- ICATHHOMECAREtrue
GOOD SHEPHERD HOSPICE FOUNDATION
110 Bi-County Blvd Suite 114FARMINGDALENY11735263169427SUPPORT ORGNY501(C)(3)11A- IGOODSHEPHERDtrue
OUR LADY OF CONSOLATION FOUNDATION
111 BEACH DRIVEWEST ISLIPNY11795450517566SUPPORT ORGNY501(C)(3)11A- IIOURLADYOFCtrue
RVC SUPPORT
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570271531084REAL ESTATENY501(C)(3)11A- ICHSLIfalse
ST FRANCIS CARDIOVASCULAR PHYSICIANS P
100 PORT WASHINGTON BLVDROSLYNNY11576113613997HEALTHCARESVCNY501(C)(3)11A- IST FRANCISfalse
RVC INSURANCE COMPANYINC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570208067039CAPTIVE INSNY501(C)(3)11A- IICHSLIfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrg
RADIOLOGY CONSULTING OF LONG ISLANDPLLC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795421646134HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN EMERGENCY MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208243412HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN PEDIATRIC SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208180263HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208088453HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SOUTHWEST SUFFOLK MEDICAL PC
580 UNION BOULEVARDWEST ISLIPNY11795061603195HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
CARDIAC EKG INTERPRETATION PC
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570112924518HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208964140HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN MANAGEMENT SERVICES
1000 MONTAUK HIGHWAYWEST ISLIPNY11795112838185HEALTHCARE SVCNYCHSLIC-CORPfalse
FAIRVIEW HILL MANAGEMENT CO INC
200 BELLE TERRE ROADPORT JEFFERSONNY11777112798383HOLDING CONYCHSLIC-CORPfalse
ADVANCED REHABILIATION MEDICINE PLLC
200 BELLE TERRE ROADPORT JEFFERSONNY11777113640709HEALTHCARE SVCNYSTCHARLES HOSPC-CORPfalse
ST FRANCIS CARDIAC PREVENTION SERVICES
100 PORT WASHINGTON BLVDROSLYNNY11576113224885HEALTHCARE SVCNYSTFRANCIS HOSPC-CORPfalse
SOUTH SHORE PRACTICE MANAGEMENT
1000 MONTAUK HIGHWAYWEST ISLIPNY11795113307977HEALTHCARE SVCNYSAMARITAN MGMTC-CORPfalse
SAMARITAN HOME CARE AMERICA
1000 MONTAUK HIGHWAYWEST ISLIPNY11795113319259HEALTHCARE SVCNYSAMARITAN MGMTC-CORPfalse
HEALTH CARE TEMP SERVICES INC
200 BELLE TERRE ROADPORT JEFFERSONNY11777112801136EMPLOYMENT AGENCYNYFAIRVIEW HILLC-CORPfalse
MERCY INTERNAL MEDICINE PC
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570510639649HEALTHCARE SVCNYMERCY MED CTRC-CORPfalse
LONG ISLAND EMERGENCY CARE PC
1000 N VILLAGE AVEROCKVILLE CENTRENY115719024113633515PHYSICIAN SVCNYMERCY MED CTRS-CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgtrueLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
OUR LADY OF CONSOLATION GERIATRIC CARE
E,O,P652525
CHS HOME SUPPORT SERVICES
O225681
GOOD SHEPHERD HOSPICE
O73788

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