FURP.ORG / PUBLIC DATA EXPLORER

LONG ISLAND COMMUNITY HOSPITAL AT: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
LONG ISLAND COMMUNITY HOSPITAL AT (EIN 11-1704595)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201303199349301245
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)
Timestamp2013-11-15T08:58:23-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BDO USA LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1100 PARK AVENUEAddressLine1
CityNEW YORKCity
StateNYState
ZIP Code10017ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN111704595EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTERBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% B FARRELL VP/CFOInCareOfName
Name ControlBROONameControl
Phone6316547100Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL ROADAddressLine1
Address Line2SuiteAddressLine2
CityPATCHOGUECity
StateNYState
ZIP Code11772ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRENDA FARRELLName
TitleCFOTitle
Phone6316547100Phone
Date Signed2013-11-05DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NamePaul HammerschmidtName
Phone2128858000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonT OCKERS CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL ROADAddressLine1
CityPATCHOGUECity
StateNYState
ZIP Code11772ZIPCode
FieldValueIRS element (for citing)
Gross Receipts282858991GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BROOKHAVENHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1947YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionDELIVER ACCESSIBLE HIGH-QUALITY HEALTH SERVICES IN A FOCUSED CARING AND TEACHING ENVIRONMENT WHILE PROVIDING HEALTH ADVOCACY FOR THE COMMUNITY AND PEOPLE WE SERVE.ActivityOrMissionDescription
Nbr Voting Members Governing Body25NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees2610TotalNbrEmployees
Total Nbr Volunteers307TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year6006740ContributionsGrantsPriorYear
Contributions Grants Current Year1971737ContributionsGrantsCurrentYear
Program Service Revenue Prior Year265205680ProgramServiceRevenuePriorYear
Program Service Revenue CY277370686ProgramServiceRevenueCY
Investment Income Prior Year211016InvestmentIncomePriorYear
Investment Income Current Year203783InvestmentIncomeCurrentYear
Other Revenue Prior Year4904477OtherRevenuePriorYear
Other Revenue Current Year3312785OtherRevenueCurrentYear
Total Revenue Prior Year276327913TotalRevenuePriorYear
Total Revenue Current Year282858991TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year172319941SalariesEtcPriorYear
Salaries Etc Current Year173375609SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year23700TotalFundrsngExpCurrentYear
Other Expense Prior Year103271384OtherExpensePriorYear
Other Expenses Current Year108562790OtherExpensesCurrentYear
Total Expenses Prior Year275591325TotalExpensesPriorYear
Total Expenses Current Year281938399TotalExpensesCurrentYear
Revenues Less Expenses Prior Year736588RevenuesLessExpensesPriorYear
Revenues Less Expenses CY920592RevenuesLessExpensesCY
Total Assets BOY151432198TotalAssetsBOY
Total Assets EOY161906400TotalAssetsEOY
Total Liabilities BOY141580125TotalLiabilitiesBOY
Total Liabilities EOY145964392TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY9852073NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY15942008NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionDELIVER ACCESSIBLE HIGH-QUALITY HEALTH SERVICES IN A FOCUSED CARING AND TEACHING ENVIRONMENT WHILE PROVIDING HEALTH ADVOCACY FOR THE COMMUNITY AND PEOPLE WE SERVE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense155731355Expense
Revenue173437378Revenue
DescriptionINPATIENT CARE SERVICES - INCLUDES MEDICAL/SURGICAL PROCEDURES, PEDIATRICS, ICU, CCU, NURSERY, ROUTINE AND PSYCHIATRIC CARE. TOTAL 2012 INPATIENT DAYS: 94,503Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense38388733Expense
Revenue31007488Revenue
DescriptionEMERGENCY ROOM SERVICES - AVAILABLE TO THE COMMUNITY 24 HOURS, 7 DAYS A WEEK. TOTAL 2012 TREAT AND RELEASE VISITS: 56,903.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense19275180Expense
Revenue19115362Revenue
DescriptionAMBULATORY SURGERY SERVICES - AVAILABLE TO THE COMMUNITY. TOTAL 2012 CASES: 7,662.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp38167009TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev55868229TotalOfOtherProgramServiceRev
Total Program Service Expense251562277TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
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 AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096226NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2610NumberOfEmployees
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 Members25NbrVotingGoverningBodyMembers
Number Independent Voting Members19NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
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 VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonB FARRELL VPCFONamePerson
Telephone Number6316547100TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL ROADAddressLine1
CityPATCHOGUECity
StateNYState
ZIP Code11772ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (41 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
T OCKERS CEO
PRESIDENT & CEO/DIRECTOR37.50.5XX600485081600
R W SCHWARZ
CHAIRMAN0.50.5XX000
L ROSE
VICE CHAIRMAN0.50.5XX000
J MAYER
TREASURER0.50.5XX464100
M MULHOLLAND
SECRETARY0.50.5XX000
R BERMAN MD
DIRECTOR0.50.5X000
F C BRAUN III
DIRECTOR0.50.5X000
G BROWN
DIRECTOR0.50.5X000
T CULLEN
DIRECTOR0.50.5X000
F GRUCCI JR
DIRECTOR0.50.5X000
E KORMYLO DPM
DIRECTOR0.50.5X1980000
W LADICK
DIRECTOR0.50.5X000
W LEHMANN
DIRECTOR0.50.5X000
L LOURIE
DIRECTOR0.50.5X000
J MAIORINO
DIRECTOR0.50.5X000
Y MICHEL FROM 42012
DIRECTOR0.50.5X000
P MOLONEY FROM 72012
DIRECTOR0.50.5X000
J MONTEITH
DIRECTOR0.50.5X000
B NATH
DIRECTOR/DIR. OF MED. STAFF0.50.5X9073000
S NORTON REMMER
DIRECTOR0.50.5X000
R ROCHE FROM 42012
DIRECTOR/PRES. OF MED. BOARD0.50.5X8500000
F ROSE
DIRECTOR0.50.5X000
E RUSSO
DIRECTOR0.50.5X000
E PATRICK SMITH
DIRECTOR0.50.5X000
J SULLIVAN
DIRECTOR0.50.5X000
S TAITZ
DIRECTOR0.50.5X000
R A GIRAULO CFO THRU 712
SR. VICE PRESIDENT/CFO37.5X389279077598
R T MARGULIS
EXECUTIVE VP AND COO37.5X354461077860
B FARRELL FROM 712
VP FINANCE, CFO37.5X273194035794
J TSIALAS
MED EDU DIR & MED INFORMATICS37.5256068035772X
A ALCASABAS
PHYSICIAN ADVISOR MEDICAL AFF.37.5249068012724X
M THOMAS
CHAIRPERSON PSYCHIATRY37.5242736027939X
R KLEIN MD CMO THRU 812
VP MEDICAL AFFAIRS37.5241799016176X
C BANKS
VP DEVELOPMENT37.5225589035364X
K MENDEZ
VP CHIEF NURSING EXECUTIVE37.5222950066506X
S WALKER MD
PHYSICIAN37.5299744074862X
L MINEI MD
PHYSICIAN, MEDICAL DIR HC WEST37.5228187081993X
H PREVAL MD
PHYSICIAN37.5227377012854X
V IZGUR MD
PHYSICIAN37.5216507026921X
S POWERS MD
PSYCHIATRIST37.5216187019737X
V RAFFALE THRU 911
VP HUMAN RESOURCES (KEY EMP.)249635069652X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4693437TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation753352TotalOtherCompensation
Number Individuals GT100 K209NumberIndividualsGT100K
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
HURON CONSULTING SERVICES LLC
3005 MOMENTUM PLACECHICAGOIL60689CONSULTING7426204
VRP OF NY PA
25983 NETWORK PLACECHICAGOIL60673RADIOLOGY5563378
ALLIANCE HEALTHCARE
PO BOX 96485CHICAGOIL60673HOME HEALTH SERVICES3020961
WIEDERSUM ASSOCIATES
140 ADAMS AVENUE SUITE B-14HAUPPAUGENY11788ARCHITECT SERVICES1380806
TGC LLC
PO BOX 130HIGHLANDMD20777HOME HEALTH SERVICES822102
FieldValueIRS element (for citing)
Number Of Contractors GT100 K42NumberOfContractorsGT100K
Info In Schedule O Part VIIIXInfoInScheduleOPartVIII
Federated Campaigns2368FederatedCampaigns
Government Grants849744GovernmentGrants
All Other Contributions1119625AllOtherContributions
Total Contributions1971737TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE624200264445272264445272
FEES AND CONTRACTS FROM GOV'T AGENCIES6242001292541412925414
FieldValueIRS element (for citing)
Total Program Service Revenue277370686TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column200333TotalRevenueColumn
Exclusion$200,333ExclusionAmount

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

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other3450Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other3450Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3450TotalRevenueColumn
Exclusion$3,450ExclusionAmount

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 (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
COFFEE SHOP REVENUE900099698753$698,753
PURCHASE DISCOUNTS AND VENDORS REBATES900099629853629853
CAFETERIA INCOME722514190527$190,527

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1793652TotalRevenueColumn
Related Or Exempt Function Income1427918RelatedOrExemptFunctionIncome
Exclusion$365,734ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue3312785TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column282858991TotalRevenueColumn
Related Or Exempt Function Income279428457RelatedOrExemptFunctionIncome
Exclusion$1,458,797ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

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)
Total3723131Total
Management And General3723131ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total559480Total
Management And General559480ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total121170294Total
Program Services112647393ProgramServices
Management And General8510792ManagementAndGeneral
Fundraising12109Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total10209740Total
Program Services9570668ProgramServices
Management And General637514ManagementAndGeneral
Fundraising1558Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total28659800Total
Program Services26041394ProgramServices
Management And General2616184ManagementAndGeneral
Fundraising2222Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total9053164Total
Program Services8168192ProgramServices
Management And General884046ManagementAndGeneral
Fundraising926Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4491011Total
Program Services4052002ProgramServices
Management And General439009ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total742450Total
Management And General742450ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total156576Total
Management And General156576ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total128600Total
Program Services128600ProgramServices

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)
Total24390833Total
Program Services23407727ProgramServices
Management And General976221ManagementAndGeneral
Fundraising6885Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total768476Total
Program Services693355ProgramServices
Management And General75121ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1309957Total
Program Services1181905ProgramServices
Management And General128052ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2801530Total
Program Services2527672ProgramServices
Management And General273858ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4474574Total
Program Services4037172ProgramServices
Management And General437402ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total132667Total
Program Services119698ProgramServices
Management And General12969ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total103757Total
Program Services93614ProgramServices
Management And General10143ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total1917838Total
Program Services1730364ProgramServices
Management And General187474ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total10130751Total
Program Services9217677ProgramServices
Management And General913074ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total4115126Total
Program Services3712861ProgramServices
Management And General402265ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES3100935931009359
PROVISION FOR UNCOLLECTIBLE59920405992040
OTHER SERVICES51682804663066505214
REPAIRS AND MAINTENANCE46991484239793459355

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total6029817Total
Program Services4319765ProgramServices
Management And General1710052ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total281938399Total
Program Services251562277ProgramServices
Management And General30352422ManagementAndGeneral
Fundraising23700Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1538586BOY
EOY1080118EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY19982659BOY
EOY19199888EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY38772252BOY
EOY47133148EOY

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)
BOY3914134BOY
EOY4126110EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2107614BOY
EOY1054120EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis194064479LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec114634158LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY74136661BOY
EOY79430321EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY166663BOY
EOY149995EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY10813629BOY
EOY9732700EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY151432198BOY
EOY161906400EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY47179494BOY
EOY50426701EOY

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)
BOY17945000BOY
EOY17365000EOY

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)
BOY15369961BOY
EOY14673820EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY61085670BOY
EOY63498871EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY141580125BOY
EOY145964392EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5808772BOY
EOY12067991EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY948234BOY
EOY2974017EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3095067BOY
EOY900000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9852073BOY
EOY15942008EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY151432198BOY
EOY161906400EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses920592ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-169284ReconciliationUnrealizedInvest
Reconcilation Other Changes5338627ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$32,600DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$96,000OtherActivitiesAmount
Total Lobbying Expenditures IIB128600TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV (2 entries)

IdentifierIdentifierExplanationExplanation
PART II-B, LINE 1G:INCLUDES ALLOCABLE MEMBERSHIP FEES OF 5 ORGANIZATIONS THAT ADVOCATE THE INTERESTS OF ITS MEMBER HOSPITALS BEFORE THE STATE AND FEDERAL LEGISLATURES AND EXECUTIVE BRANCHES.
PART II-B, LINE 1I:OTHER (NOT RELATED TO POLITICAL CONSULTING)

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 Balance3319139BeginningOfYearBalance
Other Expenditures2419139OtherExpenditures
End Of Year Balance900000EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance3648621BeginningOfYearBalance
Investment Earnings Or Losses-171300InvestmentEarningsOrLosses
Other Expenditures158182OtherExpenditures
End Of Year Balance3319139EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3404768BeginningOfYearBalance
Investment Earnings Or Losses414991InvestmentEarningsOrLosses
Other Expenditures171138OtherExpenditures
End Of Year Balance3648621EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance3066722BeginningOfYearBalance
Investment Earnings Or Losses512384InvestmentEarningsOrLosses
Other Expenditures174338OtherExpenditures
End Of Year Balance3404768EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4463791BeginningOfYearBalance
Investment Earnings Or Losses-1197034InvestmentEarningsOrLosses
Other Expenditures200035OtherExpenditures
End Of Year Balance3066722EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1531487OtherCostOrOtherBasis
Book Value1531487BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis43813355OtherCostOrOtherBasis
Depreciation29467969Depreciation
Book Value14345386BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1182837OtherCostOrOtherBasis
Depreciation463396Depreciation
Book Value719441BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis118704345OtherCostOrOtherBasis
Depreciation80694551Depreciation
Book Value38009794BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis28832455OtherCostOrOtherBasis
Depreciation4008242Depreciation
Book Value24824213BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings79430321TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
SECURITY DEPOSITS262158
ASSETS LIMITED TO USE3637389
ESTIMATED MALPRACTICE REC.5115000
DEFERRED FINANCING FEES558673
ABATEMENT159480
FieldValueIRS element (for citing)
Total Book Value Other Assets9732700TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
CAPITAL LEASE OBLIGATIONS$5,912,371
ACCRUED PENSION COSTS$11,661,606
ESTIMATED MALPRACTICE LIABILITY$30,523,898
CHANGE IN VALUATION OF SWAP$4,102,450
ASBESTOS ABATEMENT$1,563,273
DUE TO MEDICARE$2,491,676
SETTLEMENT WITH US DEPT. OF JUSTICE$1,993,578
NET$5,250,019
FieldValueIRS element (for citing)
Total Of Amounts63498871TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt288028334TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-169284NetUnrealizedGainsInvestments
Other Revenues5338627OtherRevenues
Revenue Not Rptd F9905169343RevenueNotRptdF990
Revenue Subtotal282858991RevenueSubtotal
Total Revenue Per Form990282858991TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt281938399TotExpensesEtcAuditedFinclStmt
Expenses Subtotal281938399ExpensesSubtotal
Total Expenses Per Form990281938399TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierExplanationExplanation
PART V, LINES 1 AND 4:A $1,000,000 trust was initially established by a donor in 1969. The Hospital had classified the original value of the gift along with the allocable compounded earnings as permanently restricted net assets to be held in perpetuity. In order to comply with the donor agreement and to fairly represent the classification of restricted net assets, the Hospital reclassified $2,195,067 from permanently restricted net assets to temporarily restricted net assets during the current year, as this amount represents the 10% interest in the principal amount of the trust the Hospital will become entitled to in 2019 ($100,000) and the income earned on the fund since inception less amounts appropriated for general purposes. The Hospital is entitled to the income earned on the trust, as per the donor agreement, and is allowed to spend 5% of the prior three years total value as mandated by a past court decision. The amount that is reported in permanently restricted net assets of $900,000 represents the portion of the trust to be held in perpetuity.
PART X, LINE 2:Brookhaven Memorial Hospital Medical Center has not taken an uncertain tax position that would require provision of a liability under ASC 740, "Income Taxes". Under ASC 740, an organization must recognize the tax benefit associated with tax positions taken for tax return purposes when it is more likely than not that the position will be sustained. The organization does not believe there are any material uncertain tax positions and, accordingly, has not recognized any liability for unrecognized tax benefits. The organization has filed Internal Revenue Service ("IRS") Form 990, as required, and all other applicable returns in jurisdictions where it is required. For the years ended December 31, 2012 and 2011, there were no interest or penalties recorded or included in the financial statements.
PART XI, LINE 2D:change in minimum pension liability.......................$5,267,700 change in valuation of interest rate swap agreement.......$ 70,927 Total.....................................................$5,338,627

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage425.DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served2711PersonsServed
Total Community Benefit Expense11583024TotalCommunityBenefitExpense
Net Community Benefit Expense11583024NetCommunityBenefitExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served33205PersonsServed
Total Community Benefit Expense26832964TotalCommunityBenefitExpense
Net Community Benefit Expense26832964NetCommunityBenefitExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served35916PersonsServed
Total Community Benefit Expense38415988TotalCommunityBenefitExpense
Net Community Benefit Expense38415988NetCommunityBenefitExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Persons Served100000PersonsServed
Total Community Benefit Expense131381TotalCommunityBenefitExpense
Net Community Benefit Expense131381NetCommunityBenefitExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Persons Served1750PersonsServed
Total Community Benefit Expense49040TotalCommunityBenefitExpense
Net Community Benefit Expense49040NetCommunityBenefitExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Persons Served2393PersonsServed
Total Community Benefit Expense3868982TotalCommunityBenefitExpense
Net Community Benefit Expense3868982NetCommunityBenefitExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Persons Served104143PersonsServed
Total Community Benefit Expense4049403TotalCommunityBenefitExpense
Net Community Benefit Expense4049403NetCommunityBenefitExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Persons Served140059PersonsServed
Total Community Benefit Expense42465391TotalCommunityBenefitExpense
Net Community Benefit Expense42465391NetCommunityBenefitExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense42750TotalCommunityBuildingExpense
Net Community Building Expense42750NetCommunityBuildingExpense
Percent Of Total Expense1.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense42750TotalCommunityBuildingExpense
Net Community Building Expense42750NetCommunityBuildingExpense
Percent Of Total Expense1.00000PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$11,960,476BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare67164373AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare72936866CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5772493MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Number Of Hospital Facilities8NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (8 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalFacility Reporting GroupFacilityReportingGroupGeneral Medical And SurgicalGeneralMedicalAndSurgical
BROOKHAVEN MEMORIAL HOSPITAL MED CTR
1101 HOSPITAL ROADEAST PATCHOGUENY11772XA
HOME HEALTH CARE
2103 WEST MAIN STREETPATCHOGUENY11772BX
BROOKHAVEN MEMORIAL HOSP DIALYSIS CTR
3109 WEST MAIN STREETPATCHOGUENY11772BX
CTR FOR WOUND CARE & HYPERBARIC MEDIC
433 MEDFORD AVENUEPATCHOGUENY11772BX
HOSPICE
5105 WEST MAIN STREETPATCHOGUENY11772BX
OUT PATIENT IMAGING
6100 HOSPITAL ROADPATCHOGUENY11772BX
WOMEN'S IMAGING SERVICES CENTER
7285 SILLS ROAD BUILDING 5-6PATCHOGUENY11772BX
CARDIO REHABILITATION CENTER
8100 HOSPITAL ROADPATCHOGUENY11772BX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB (2 entries)

Hospital Facility NumberHospitalFacilityNumberCHNA ConductedCHNAConductedCommunity DefinitionCommunityDefinitionCommunity DemographicsCommunityDemographicsExisting ResourcesExistingResourcesNeeds Assessment ConductedNeedsAssessmentConductedTake Into AccountTakeIntoAccountOther FacilitiesOtherFacilitiesCHNA Widely AvailableCHNAWidelyAvailableOwn WebsiteOwnWebsiteAdopt Implement StrategyAdoptImplementStrategyExecute Implement StrategyExecuteImplementStrategyDevelop Community PlanDevelopCommunityPlanPrioritize Health NeedsPrioritizeHealthNeedsAll Needs AddressedAllNeedsAddressedOrganization Incur Excise TaxOrganizationIncurExciseTaxEligibility Criteria ExplainedEligibilityCriteriaExplainedUses FPG FreeUsesFPGFreeFPG Free PercentFPGFreePercentUses FPG DiscountedUsesFPGDiscountedFPG Discount PercentFPGDiscountPercentExplains BasisExplainsBasisIncome LevelIncomeLevelInsurance StatusInsuranceStatusUninsured DiscountUninsuredDiscountExplains Application MethodExplainsApplicationMethodIncludes Publicity MeasuresIncludesPublicityMeasuresPosted On WebsitePostedOnWebsiteAttached To InvoicesAttachedToInvoicesPosted In Emergency RoomPostedInEmergencyRoomPosted In Admission OfficePostedInAdmissionOfficeProvided On AdmissionProvidedOnAdmissionAvailable On RequestAvailableOnRequestActions On NonpaymentActionsOnNonpaymentCollection ActivitiesCollectionActivitiesReport To Credit AgencyReportToCreditAgencyLawsuitLawsuitLien On ResidenceLienOnResidenceNotify Upon AdmissionNotifyUponAdmissionNotify Before DischargeNotifyBeforeDischargeNotified All PatientsNotifiedAllPatientsDocumented DeterminationDocumentedDeterminationNondiscrim Emergency Care PolicyNondiscrimEmergencyCarePolicyUsed Other MethodUsedOtherMethodAmounts Generally BilledAmountsGenerallyBilledGross ChargesGrossCharges
A
1trueXXX10truetruetrueXXXXXfalsefalsetruetrue200.true425.trueXXXtruetrueXXXXXXfalsetrueXXXXXXXtrueXfalsetrue
B
falsetruetrue200.true425.trueXXXtruetrueXXXXXXfalsetrueXXXXXXXtrueXfalsetrue

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

IdentifierIdentifierExplanationExplanation
PART I, LINE 3B:The percent of FPG used by BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER to calculate discounted care starts at 201% (90% discount) and goes to 425% (10% discount).
PART I, LINE 6A:BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER PREPARES A COMMUNITY BENEFIT REPORT, IT IS AVAILABLE ON THE HOSPITALS WEBSITE.
PART II, LINE 7:Brookhaven Memorial Hospital Medical Center is proud to be a member of Spirit of Women, a network of more than 75+ premier hospitals and health systems nationwide dedicated to educating women about their health and the health of their loved ones. Brookhaven offers a wide variety of Spirit of Women programs including educational programs, community wellness events, membership programs, health fairs, and other creative outreach events to the women of our community.
PART III, LINE 4:1) Patient accounts receivable are recorded at the reimbursable or contracted amount and do not bear interest. The allowance for doubtful accounts is the Hospital's best estimate of the amount of probable credit losses in the Hospital's existing accounts receivable. The Hospital determines the allowance based on historical write-off experience. The Hospital reviews its allowance for doubtful accounts monthly. Past due balances are reviewed individually for collectibility. Account balances are charged off against the allowance after all means of collection have been exhausted and the potential for recovery is considered remote. 2) The costing methodology used in determining bad debt at cost is a ratio of patient care costs to charges per IRS schedule H instructions, worksheet 2.
PART III, LINE 8:1) All of the shortfall on Part III, Line 7 Section B, Line 8 should be considered a community benefit. 2) Medicare allowable costs are calculated on the HCFA 2552 Medicare cost report worksheet E, Part A.
PART V, SECTION B, LINE 3:The Medical Center has established a leadership position in health promotion, prevention and education throughout the community. Regional health planning is accomplished through a number of Agency contacts including the Suffolk County Department of Health, Mental Health Agencies and the New York State Department of Health. In addition, the Hospital works closely with the Suffolk County Police Department and Southside Hospital in regard to mental health issues. Brookhaven Memorial Hospital Medical Center is dedicated to communicating with key staff and community members, as the Hospital prepares to plan for the future health care needs of the people we serve. Focus groups are held periodically, which include meeting with the medical staff, members of the Board of Directors, employees and the Employee Council, community members, the LI2Day Organization, the West Islip Breast Cancer Coalition, the Southampton Breast Cancer Coalition, Hospital Advisory Council, who are the voice of the community and hold positions on various community based service groups, as well as the Health Center Advisory Council members. These constituents have the ability to collect information from varied perspectives. The Hospital's ability to collect information from these groups and translate the dialog into a needs assessment is a valuable resource to the Hospital as well as the community.
PART V, SECTION B, LINE 4:HOME HEALTH CARE; BROOKHAVEN MEMORIAL HOSPITAL DIALYSIS CENTER; CENTER FOR WOUND CARE AND HYPERBARIC MEDIC; HOSPICE; OUT PATIENT IMAGING; WOMEN'S IMAGING SERVICES CENTER; AND CARDIO REHABILITATION CENTER.
PART V, SECTION B, LINE 7:At this time Brookhaven Memorial Hospital Medical Center has not been able to meet all the behavioral health needs because construction of the access center and the Family Medicine practice has not been completed.
PART V, SECTION B, LINE 20:All accounts are billed at gross charges. Gross charges are adjusted , if applicable, for any negotiated rates with insurance providers or agencies. If it is determined that a patient is eligible for free or discounted care under the Hospital's financial assistance policy , adjustments will be made to their account.
PART V, SECTION B, LINE 21:THE HOSPITAL DID NOT CHARGE PATIENTS IF THEY WERE ELIGIBLE FOR CARE.
PART V, SECTION B, LINE 22:THROUGH ALL FISCAL YEARS THERE WILL BE PATIENTS WHO WERE CHARGED AND WHO PAID FACILITY CHARGES FOR THE MEDICALLY NECESSARY CARE PROVIDED TO THE PATIENT.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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 (16 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
T OCKERS CEO
PRESIDENT & CEO/DIRECTOR59400000064850654440161560682085000
R A GIRAULO CFO THRU 712
SR. VICE PRESIDENT/CFO38590200033770620030155950466877000
R T MARGULIS
EXECUTIVE VP AND COO35000000044610551340227260432321000
B FARRELL FROM 712
VP FINANCE, CFO2723850008090142000215940308988000
J TSIALAS
MED EDU DIR & MED INFORMATICS25606800000142000215720291840000
V RAFFALE THRU 911
VP HUMAN RESOURCES (KEY EMP.)0000249635060684089680319287000
A ALCASABAS
PHYSICIAN ADVISOR MEDICAL AFF.2490680000011557011670261792000
M THOMAS
CHAIRPERSON PSYCHIATRY24273600000134580144810270675000
R KLEIN MD CMO THRU 812
VP MEDICAL AFFAIRS2417990000017000144760257975000
C BANKS
VP DEVELOPMENT22558900000129790223850260953000
K MENDEZ
VP CHIEF NURSING EXECUTIVE22295000000442310222750289456000
S WALKER MD
PHYSICIAN29974400000537840210780374606000
L MINEI MD
PHYSICIAN, MEDICAL DIR HC WEST22818700000599910220020310180000
H PREVAL MD
PHYSICIAN227377000000000227377000
V IZGUR MD
PHYSICIAN2165070000055370213840243428000
S POWERS MD
PSYCHIATRIST2161870000011285084520235924000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierPART I, LINE 4A:Identifier
ExplanationV. Raffale, VP Human Resources, received severance payments totaling $319,287. This amount is reported on Schedule J, Part II, Columns (B), (C), and (D).Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1TOWN OF BROOKHAVEN INDUSTRIAL DEVELOPMENT AGENCYBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN521299559IssuerEIN
Date Issued2006-12-21DateIssued
Issue Price20000000IssuePrice
Description Of PurposeREFINANCE SERIES 2000 BONDSDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired17945000AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds0TotalProceeds
Amount In Reserve Fund0AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow0RefundingEscrow
Issuance Costs From Proceeds117836IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures0CapitalExpenditures
Other Spent Proceeds0OtherSpentProceeds
Amount Unspent0AmountUnspent
Year Of Subst Completion2003YearOfSubstCompletion
Current RefundingfalseCurrentRefunding
Advance RefundingtrueAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers
Bond Iss Meet Prvt Security Pay TestfalseBondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed PropfalseChangeInUseBondFinancedProp
Remedial Action TakenfalseRemedialActionTaken
Non Qualified Bond Remed ProcdrstrueNonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiled
Rebate Not Due YettrueRebateNotDueYet
No Rebate DuetrueNoRebateDue
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Superintegrated HedgefalseSuperintegratedHedge
Hedge TerminatedfalseHedgeTerminated
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Written Proc To Monitor ReqstrueWrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective ActiontrueProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierPART IV, LINE 2C:Identifier
Return Reference0ReturnReference
Explanation12/21/2011Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
J DUDEK
SEE PART V125210EMPLOYMENTfalse
E GIRAULO
SEE PART V81343EMPLOYMENTfalse
L B SCHWARZ
SEE PART V18117EMPLOYMENTfalse
A SINKOFF
SEE PART V15523EMPLOYMENTfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierPART IV:Identifier
ExplanationJ. DUDECK IS THE SISTER OF J. MAYER, TREASURER. E. GIRAULO IS THE SISTER-IN-LAW OF R. A. GIRAULO, SR. VICE PRESIDENT/CFO. L. B. SCHWARZ IS THE DAUGHTER OF R. W. SCHWARZ, CHAIRMAN. A. SINKOFF IS THE SISTER OF S. NORTON REMMER, DIRECTOR.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanation
FORM 990, PART III, LINE 4D:1) HOME HEALTH AGENCY - PROVIDES CERTIFIED HOME HEALTH AND LONG TERM CARE TO THE COMMUNITY. TOTAL VISITS: 69,695 EXPENSES: $9,588,488. REVENUE: $8,694,319. 2) RENAL DIALYSIS - TOTAL VISITS: 24,479. EXPENSES: $9,381,430. REVENUE: $8,656,356. 3) REFERRED AMBULATORY - SERVICES AVAILABLE TO THE COMMUNITY. TOTAL VISITS: 29,867. EXPENSES: $3,900,777. REVENUE: $11,489,148. 4) HOSPICE - TOTAL DAYS: 13,715. EXPENSES: $2,892,585. REVENUE: $2,772,076. 5) MENTAL HEALTH AND CHEMICAL DEPENDENCY OUTPATIENT CLINICS - TOTAL VISITS: 19,340. EXPENSES: $2,890,772. REVENUE: $1,727,194. 6) WOUND CARE - TOTAL VISITS: 7,309. EXPENSES: $2,444,029. REVENUE: $3,452,236. 7) SLEEP PROGRAM - TOTAL VISITS: 329. EXPENSES: $330,410. REVENUE: $1,025,982. 8) SUFFOLK COUNTY HEALTH CENTERS - EXPENSES: NONE. REVENUE: $12,925,414. (INCURRED $12,671,001 OF OPERATING EXPENSES) 9) PROFESSIONAL COMPONENT - EXPENSES NONE. REVENUE: $1,791,516. (INCURRED $258,831 OF OPERATING EXPENSES EXCLUSIVE OF SALARIES AND BENEFITS) 10) OTHER PROGRAM SERVICES - EXPENSES: $6,738,518. REVENUE: $3,333,988.
FORM 990, PART VI, SECTION A, LINE 2:L. ROSE AND F. ROSE ARE BOARD MEMBERS AND HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI, SECTION B, LINE 11B:A) FIRST DRAFT PROVIDED TO MANAGEMENT FROM BDO. B) FINAL DRAFT PRESENTED TO JOINT MEETING OF FINANCE AND AUDIT COMMITTEES FOR REVIEW. C) FINAL DRAFT POSTED ON BOARD PORTAL. D) FORM 990 REVIEWED AT BOARD MEETING. E) FORM 990 FILED TIMELY.
FORM 990, PART VI, SECTION B, LINE 12C:Members of the Board of Directors, Administrators, Department Heads and medical staff working for or on behalf of Brookhaven MEMORIAL HOSPITAL MEDICAL CENTER are required to complete and sign the Conflict of Interest Disclosure Statement annually and whenever new information or changes arise that may require different responses from those included in the previous Conflict of Interest Disclosure Statement. Individuals are required to notify the Compliance Officer when they believe changes in the responses may be necessary or when they believe a transaction may involve an actual or potential conflict of interest. The Hospital By-Laws require that anyone with an actual or potential conflict of interest immediately disclose this fact to the Board of Directors or to a designated board committee for their review and evaluation. Further, the by-laws prohibit any individual or entity deemed to have an actual or potential conflict of interest from participating in any evaluation or decision making process regarding products or services provided by or through that individual or entity or from using this relationship to obtain goods or services on terms that are not available to individuals who are not affiliated with the hospital. The Board of Directors is responsible for enforcement of the aforementioned policy and report any conduct that it believes in good faith to be a violation of the Conflict of Interest Policy.
FORM 990, PART VI, SECTION B, LINES 15A AND 15B:The Executive Compensation Committee is comprised of the Chief Executive Officer, the Chairperson of the Board of Directors and selected Members of the Board of Directors. An Executive Compensation Consultant is invited to present data and trends to this Committee for their review and evaluation of the current salaries and fringe benefits of the Executive Team of BMHMC as compared to other "like" organizations. In setting compensation levels for each executive, the Committee compares each base salary and total cash compensation level to market comparison data (based on healthcare systems with comparably sized operational budgets), organizational success against predetermined objectives, and individual performance against predetermined operational goals, as well as the data provided by the Consultant. The CEO, will be excused from the meeting of the Executive Compensation Committee, for a review of the CEO's compensation. Again, the Committee will use Industry Standards from comparably sized operational budgets, organizational success against predetermined objectives, and individual performance against predetermined operational goals, to establish the CEO's compensation. The Executive Compensation Committee will make the final approval of all compensation. The information is presented to the Overall brookhaven memorial hospital medical center Board, subject to ratification of the Board of Directors.
FORM 990, PART VI, SECTION C, LINE 19:GOVERNING DOCUMENTS - NOT AVAILABLE TO THE PUBLIC. CONFLICT OF INTEREST POLICY - NOT AVAILABLE TO THE PUBLIC. FINANCIAL STATEMENTS - NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9:change in minimum pension liability.......................$5,267,700 change in valuation of interest rate swap agreement.......$ 70,927 Total....................................................$5,338,627

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1BROOKHAVEN HEALTH CARE SERVICES CORPBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL ROADAddressLine1
CityPATCHOGUECity
StateNYState
ZIP Code11772ZIPCode
FieldValueIRS element (for citing)
EIN112950196EIN
Primary ActivitiesSUPPORTPrimaryActivities
Legal Domicile StateNYLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status9PublicCharityStatus
Controlled OrgfalseControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipControlled OrgControlledOrg
Brookhaven Physician Services
100 HOSPITAL ROADPATCHOGUENY11772260628913HOSPITALNYC000.00000false
Brookhaven Surgical Services PC
100 Hospital ROADPatchogueNY11772260885844HOSPITALNYC000.00000false
LI Orthopedic & Spine Specialist PC
100 Hospital ROADpatchogueNY11772274670754hospitalNYc000.00000false
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgtrueLoansOrGuaranteesToOtherOrg
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 OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg