2013-11-13T15:10:54-06:00 2012-12-31 PricewaterhouseCoopers LLP 300 Madison Avenue New York NY 10017 990 2012-01-01 112126736 NURSING SISTERS HOME CARE INC % CATHOLIC HOME CARE NURS 6314656457 110 Bi-County Blvd Suite 114 Suite FARMINGDALE NY 11735 MARY ELLIN POLIT 6464656457 2013-11-05 true 6464713000 2012 2016-02-24 21:20:13Z CATHOLIC HOME CARE JOSEPH TOMAINO 1150 PORTION RD HOLTSVILLE NY 11742 36595939 false 0928 X HTTP://CATHOLICHOMECARE.CHSLI.ORG X 1968 NY CATHOLIC 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. 19 18 712 0 0 23593 5776 31171916 36510013 3878 28707 30378 51443 31229765 36595939 12308 13798 0 0 29432744 30909192 0 0 0 5039648 5877272 34484700 36800262 -3254935 -204323 6009628 8814378 24556517 27564342 -18546889 -18749964 X NURSING 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. false false 31235649 13798 36526456 NURSING 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. 31235649 true false false false false false false false false true true false false false true true false true false false false false false false false false false true false true false false false false false false false false false false false false false true true true false false true 22 0 true 712 true false false false false false false false false false false X 19 18 false false false false true true true true true false false true true true true true true true true false X CATHOLIC HOME CARE 6318287411 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 X Hon Angie Carpenter 2.0 X X 0 0 0 Bernadette Curry PHD RN 2.0 X X 0 0 0 Charles Falkner 2.0 X X 0 0 0 Sister Dolores Castellano CIJ 2.0 X X 0 0 0 Donato Balsamo DO 2.0 X 0 6118 0 Robert Doyle 2.0 X 0 0 0 Philip Fava 2.0 X 0 0 0 Sr Margaret Kelliher DW 2.0 X 0 0 0 Walter Lace 2.0 X 0 0 0 Brother Campion Lally OSF 2.0 X 0 0 0 Timothy J Mattimore Esq 2.0 X 0 0 0 Rev Msgr Thomas Mulvanerty 2.0 X 0 0 0 Diane Sweeney 2.0 X 0 0 0 Richard Romer 2.0 X 0 0 0 Daniel Rowe 2.0 X 0 0 0 Charles SpenCer 2.0 X 0 0 0 Debbie Van Bourgondien 2.0 X 0 0 0 Sister Dolores Wisniewski 2.0 X 0 0 0 Joseph Tomaino 50.0 X X 0 785524 189739 Karen Estrada 50.0 X 0 251671 47294 Mary Ellen Polit 50.0 X 0 371432 165533 Janice Remmers 37.5 X 155277 0 42035 Denise Fasano 37.5 X 135896 0 22646 Catherine Ciresi 37.5 X 125856 0 36170 Danielle Stein 37.5 X 128822 0 37841 Nancy Pol Stith 37.5 X 126261 0 36341 WILLIAM MEAD 50.0 X 0 367525 121538 672112 1782270 699137 15 true true false ALLSCRIPTS LLC 24630 NETWORK PL CHICAGO IL 60673 CLINICAL LICENSES 259434 1150 CORP 1150 PORTION RD SUITE 16 HOLTSVILLE NY 11742 RENT/CLEANING SVCS 245970 ABLE HEALTHCARE SERVICES 1240 BROADCAST PLAZA MERRICK NY 11566 HOME HEALTH AIDS SVS 223209 PERSONAL TOUCH 640 MONTAUK HWY SHIRLEY NY 11967 HOME HEALTH AIDS SVS 182092 HONEYWELL HOMMED LLC 23262 NETWORK PL CHICAGO IL 60673 MEDICAL SUPPLY SVCS 175388 5 5776 5776 PATIENT SERVICE REVENUE 621610 36510013 36510013 36510013 28707 28707 0 0 0 0 0 0 0 0 0 CONSULTING FEES 900099 35000 35000 MED TRANSCRIPT FEES 900099 16443 16443 51443 36595939 36526456 63707 13798 13798 0 0 0 0 0 23891470 21766632 2124838 1720004 1566924 153080 3461503 3153429 308074 1836215 1672792 163423 0 5048 5048 72702 72702 0 0 0 1417855 1314019 103836 70504 70504 301659 168757 132902 0 0 0 370330 264877 105453 816871 769694 47177 0 18757 5400 13357 3059 3059 79691 79691 559689 559689 70729 70729 CHS SERVICES 754214 754214 MEDICAL SUPPLIES 472899 472899 RESERVE ON LOAN RECEIVABLE 400000 400000 NY HOMECARE MEDICAID ASSESSMEN 124166 124166 339099 66428 272671 36800262 31235649 5564613 0 0 1400 685812 1928078 0 0 4096009 5065951 0 0 0 0 0 0 11865 11865 53915 35169 4196546 2695661 910371 1500885 16953 26712 0 0 0 0 0 0 234703 244318 6009628 8814378 3525884 3947546 0 0 0 0 0 0 0 0 0 0 0 0 0 0 21030633 23616796 24556517 27564342 X -18766454 -18964270 70699 65440 148866 148866 -18546889 -18749964 6009628 8814378 -204323 1248 X false true X true false X 308608 15979 24220 23593 5776 378176 24552860 28214971 31260116 31171916 36510013 151709876 0 0 0 24861468 28230950 31284336 31195509 36515789 152088052 0 0 0 152088052 2901 2918 5200 3878 28707 43604 0 2901 2918 5200 3878 28707 43604 0 85189 74964 54489 30378 51443 296463 24949558 28308832 31344025 31229765 36595939 152428119 0.99777 0.99740 0.00029 0.00030 X 148866 1248 1248 148866 148866 2907 2907 148866 148866 16739 16739 148866 148866 5008 5008 148866 148866 6 6 148866 1.00000 false false 281570 170564 111006 3506547 2213103 1293444 408429 311994 96435 1500885 0 DUE TO RELATED PARTIES 23406946 PENSION LIABILITY 176082 DUE TO THIRD PARTY 33768 23616796 X SCHEDULE D, PART X, LINE 2 MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE COMBINED FINANCIAL STATEMENTS. true DIOCESE OF ROCKVILLE CENTRE - CATHOLIC MINISTRIES 50 NORTH PARK AVEROCKVILLE CENTRE ROCKVILLE CENTRE NY 11570 111837437 501(c)(3) 13798 0 N/A N/A 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 THE DIOCESE OF ROCKVILLE CENTRE PROVIDES ANNUAL UPDATES TO ALL CONTRIBUTORS TO THE CATHOLIC MINISTRIES APPEAL, WHETHER PARISHIONERS OR CORPORATE CONTRIBUTORS LIKE CHSLI. 1 SCHEDULE I, PART I, LINE 2 PROCEDURE FOR MONITORING GRANT FUND USE THE 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 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. X X X X X false true false false false false false false false Joseph Tomaino 0 619528 0 149200 0 16796 0 160810 0 28929 0 975263 0 0 Karen Estrada 0 241134 0 0 0 10537 0 21332 0 25962 0 298965 0 0 Mary Ellen Polit 0 287081 0 82700 0 1651 0 136646 0 28887 0 536965 0 0 Janice Remmers 154973 0 0 0 304 0 16141 0 25894 0 197312 0 0 0 Denise Fasano 135441 0 0 0 455 0 13866 0 8780 0 158542 0 0 0 Catherine Ciresi 124882 0 0 0 974 0 13432 0 22738 0 162026 0 0 0 Danielle Stein 128529 0 0 0 293 0 13343 0 24498 0 166663 0 0 0 Nancy Pol Stith 125883 0 0 0 378 0 12401 0 23940 0 162602 0 0 0 WILLIAM MEAD 0 310892 0 45000 0 11633 0 96766 0 24772 0 489063 0 0 SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN JOSEPH TOMAINO $138,735 PARTICIPATION IN PLAN MARY ELLEN POLIT $116,046 PARTICIPATION IN PLAN WILLIAM MEAD $76,741 PARTICIPATION IN PLAN SCHEDULE J, PART II COMPENSATION THE 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 II FORMER OFFICER DURING 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. FORM 990, PART VI, LINE 6 MEMBERS OF THE ORGANIZATION THE 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 7A ELECTION OF THE GOVERNING BODY CHS 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 7B DECISIONS OF THE GOVERNING BODY CHS 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 11A REVIEW PROCESS OF FORM 990 THE 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 12C CONFLICT OF INTEREST POLICY 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.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 15 COMPENSATION POLICY 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. 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 19 DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION GOVERNING 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 VII SECTION A, LINE 1A - COMPENSATION OF OFFICERS HOURS 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) CATHOLIC HEALTH SYSTEM OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113403968 SUPPORT ORG NY 501(C)(3) 11A- I NA false CHS SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113555766 SUPPORT ORG NY 501(C)(3) 11A- II CHSLI false CHS AMBULANCE SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 141801961 DORMANT NY 501(C)(3) 3 CHSLI false GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 111888924 HOSPITAL NY 501(C)(3) 3 CHSLI false GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112537396 SELF INSURANC NY 501(C)(3) 11A- I GOOD SAMARTN false MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113434776 TRANSPORTATIO NY 501(C)(3) 9 MARYHAVENCTR true MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861698 Prgm-disabled NY 501(C)(3) 9 CHSLI true MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861690 Schl-disabled NY 501(C)(3) 2 MARYHAVENCTR true THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113638367 SUPPORT ORG NY 501(C)(3) 9 MARYHAVENCTR true MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CTR NY 11570 111635088 HOSPITAL NY 501(C)(3) 3 CHSLI false OUR LADY OF CONSOLATION GERIATRIC CARE 111 BEACH DRIVE WEST ISLIP NY 11795 113284066 LT NURSE CARE NY 501(C)(3) 9 CHSLI true RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112499790 RENTING NY 501(C)(2) MARYHAVENCTR true SIENA VILLAGE INC 2000 BISHOPS ROAD SMITHTOWN NY 11787 061569129 SR HOUSING NY 501(C)(3) 9 STCATHERINE false ST CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN NY 11787 061562701 HOSPITAL NY 501(C)(3) 3 CHSLI false ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 111871039 HOSPITAL NY 501(C)(3) 3 CHSLI false CHS HOME SUPPORT SERVICES INC 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 113594561 RESP THERAPY NY 501(C)(3) 9 CATHHOMECARE true ST FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112050523 HOSPITAL NY 501(C)(3) 3 CHSLI false ST FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112916033 SUPPORT ORG NY 501(C)(3) 11A- I ST FRANCIS false ST FRANCIS HOSPITAL RESEARCH & EDUCATIO 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113090867 RESEARCH ORG NY 501(C)(3) 11A- I ST FRANCIS false WSNCHS NORTH INC 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 113438973 HOSPITAL NY 501(C)(3) 3 CHSLI false SUFFOLK HEARING & SPEECH CENTER INC 369 EAST MAIN STREET EAST ISLIP NY 11730 112110488 DIAGN TESTING NY 501(C)(3) 9 GOOD SAMARTN false THE ST CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 112983148 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI false THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112716640 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI false WISDOM GARDENS HOUSING DEVELOPMENT FUND 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113559713 SR HOUSING NY 501(C)(3) 9 MARYHAVENCTR true GOOD SHEPHERD HOSPICE 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 112958438 HOSPICE SVC NY 501(C)(3) 9 CHSLI true ST CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 412076312 SUPPORT ORG NY 501(C)(3) 11A- II ST CHARLES false GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 770611240 SUPPORT ORG NY 501(C)(3) 11A- I GOOD SAMARTN false ST FRANCIS-MERCY CORPORATION 100 PORT WASHINGTON BLVD ROSLYN NY 11576 111635088 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI false MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 550813603 SUPPORT ORG NY 501(C)(3) 11A- I MERCY MEDCTR false ST CATHERINE OF SIENA MEDICAL CTR FDN 50 ROUTE 25A SMITHTOWN NY 11787 271459941 SUPPORT ORG NY 501(C)(3) 11A- I STCATHERINE false CATHOLIC HOME CARE FOUNDATION 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 452907761 SUPPORT ORG NY 501(C)(3) 11A- I CATHHOMECARE true GOOD SHEPHERD HOSPICE FOUNDATION 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 263169427 SUPPORT ORG NY 501(C)(3) 11A- I GOODSHEPHERD true OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP NY 11795 450517566 SUPPORT ORG NY 501(C)(3) 11A- II OURLADYOFC true RVC SUPPORT 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 271531084 REAL ESTATE NY 501(C)(3) 11A- I CHSLI false ST FRANCIS CARDIOVASCULAR PHYSICIANS P 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113613997 HEALTHCARESVC NY 501(C)(3) 11A- I ST FRANCIS false RVC INSURANCE COMPANYINC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 208067039 CAPTIVE INS NY 501(C)(3) 11A- II CHSLI false RADIOLOGY CONSULTING OF LONG ISLANDPLLC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 421646134 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN EMERGENCY MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208243412 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN PEDIATRIC SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208180263 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208088453 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SOUTHWEST SUFFOLK MEDICAL PC 580 UNION BOULEVARD WEST ISLIP NY 11795 061603195 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false CARDIAC EKG INTERPRETATION PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112924518 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208964140 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112838185 HEALTHCARE SVC NY CHSLI C-CORP false FAIRVIEW HILL MANAGEMENT CO INC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 112798383 HOLDING CO NY CHSLI C-CORP false ADVANCED REHABILIATION MEDICINE PLLC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 113640709 HEALTHCARE SVC NY STCHARLES HOSP C-CORP false ST FRANCIS CARDIAC PREVENTION SERVICES 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113224885 HEALTHCARE SVC NY STFRANCIS HOSP C-CORP false SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113307977 HEALTHCARE SVC NY SAMARITAN MGMT C-CORP false SAMARITAN HOME CARE AMERICA 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113319259 HEALTHCARE SVC NY SAMARITAN MGMT C-CORP false HEALTH CARE TEMP SERVICES INC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 112801136 EMPLOYMENT AGENCY NY FAIRVIEW HILL C-CORP false MERCY INTERNAL MEDICINE PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 510639649 HEALTHCARE SVC NY MERCY MED CTR C-CORP false LONG ISLAND EMERGENCY CARE PC 1000 N VILLAGE AVE ROCKVILLE CENTRE NY 115719024 113633515 PHYSICIAN SVC NY MERCY MED CTR S-CORP false false false false false true false false false false false true false false true true true true true false OUR LADY OF CONSOLATION GERIATRIC CARE E,O,P 652525 CHS HOME SUPPORT SERVICES O 225681 GOOD SHEPHERD HOSPICE O 73788