BROOKHAVEN HEALTH CARE SERVICES CORPORATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BROOKHAVEN HEALTH CARE SERVICES CORPORATION (EIN 11-2950196)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201313199349301186
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)
EIN112950196EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BROOKHAVEN HEALTH CARE SERVICES CORPORATIONBusinessNameLine1
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 TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1BMH FOUNDATIONBusinessNameLine1
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 Receipts9405465GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.BROOKHAVENHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1984YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTO SEEK PHILANTHROPIC SUPPORT AND GRANT FUNDS TO BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER AND OTHER NOT-FOR-PROFIT ORGANIZATIONS UNDER THE DIRECTION OF THE ORGANIZATION'S BOARD OF DIRECTORS.ActivityOrMissionDescription
Nbr Voting Members Governing Body25NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers21TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year2336674ContributionsGrantsPriorYear
Contributions Grants Current Year1857073ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY0ProgramServiceRevenueCY
Investment Income Prior Year871290InvestmentIncomePriorYear
Investment Income Current Year1120231InvestmentIncomeCurrentYear
Other Revenue Prior Year251417OtherRevenuePriorYear
Other Revenue Current Year204229OtherRevenueCurrentYear
Total Revenue Prior Year3459381TotalRevenuePriorYear
Total Revenue Current Year3181533TotalRevenueCurrentYear
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 Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year508106TotalFundrsngExpCurrentYear
Other Expense Prior Year706176OtherExpensePriorYear
Other Expenses Current Year803008OtherExpensesCurrentYear
Total Expenses Prior Year706176TotalExpensesPriorYear
Total Expenses Current Year803008TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2753205RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2378525RevenuesLessExpensesCY
Total Assets BOY31857459TotalAssetsBOY
Total Assets EOY35238514TotalAssetsEOY
Total Liabilities BOY2097TotalLiabilitiesBOY
Total Liabilities EOY4965TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY31855362NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY35233549NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO SEEK PHILANTHROPIC SUPPORT ON THE BEHALF OF BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER AND OTHER NOT-FOR-PROFIT ORGANIZATIONS AND TO GRANT FUNDS TO BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CENTER AND OTHER NOT-FOR-PROFIT ORGANIZATIONS UNDER THE DIRECTION OF THE ORGANIZATION'S BOARD OF DIRECTORS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense11675Expense
DescriptionFAMILY FUN DAY - TO EDUCATE THE COMMUNITY ABOUT HEALTH AWARENESS.Description
Total Program Service Expense11675TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
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 ActivitiestrueFundraisingActivities
GamingtrueGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
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 EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10965NumberFormsTransmittedWith1096
Number W2 G Included1NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OftrueForm8282PropertyDisposedOf
Number Of8282 Filed1NumberOf8282Filed
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 CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
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 Line1FINANCE DEPT 101 HOSPITAL ROADAddressLine1
CityPATCHOGUECity
StateNYState
ZIP Code11772ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
T OCKERS CEO
PRESIDENT & CEO/DIRECTOR0.537.5XX060048581600
R W SCHWARZ
CHAIRMAN0.50.5XX000
L ROSE
VICE CHAIRMAN0.50.5XX000
J MAYER
TREASURER0.50.5XX046410
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
DIRECTOR0.50.5X0198000
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. STAFF0.50.5X0907300
S NORTON REMMER
DIRECTOR0.50.5X000
R ROCHE FROM 42012
DIRECTOR/PRES. OF MED. BOARD0.50.5X0850000
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
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs800656TotalReportableCompFrmRltdOrgs
Total Other Compensation81600TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Info In Schedule O Part VIIIXInfoInScheduleOPartVIII
Fundraising Events666075FundraisingEvents
All Other Contributions1190998AllOtherContributions
Total Contributions1857073TotalContributions
Total Program Service Revenue0TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column975372TotalRevenueColumn
Exclusion$975,372ExclusionAmount

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)
Securities6093456Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities5948597Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities144859Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column144859TotalRevenueColumn
Exclusion$144,859ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events451909GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events666075CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses260335FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column191574TotalRevenueColumn
Exclusion$191,574ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Gaming27655GrossIncomeGaming
Gaming Direct Expenses15000GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column12655TotalRevenueColumn
Exclusion$12,655ExclusionAmount

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3181533TotalRevenueColumn
Exclusion$1,324,460ExclusionAmount

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)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total0Total

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total58500Total
Management And General58500ManagementAndGeneral

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)
Total201197Total
Management And General201197ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total34351Total
Fundraising34351Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4914Total
Fundraising4914Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total6878Total
Fundraising6878Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total19561Total
Fundraising19561Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalFundraisingFundraisingManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
LEASED EMPLOYEES307425307425
RESERVE FOR UNCOLLECTIBLE121600121600
SPONSORSHIPS2353023530
HEALTH AWARE./FAM FUN DAY1167511675

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total13377Total
Fundraising13377Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total803008Total
Program Services11675ProgramServices
Management And General283227ManagementAndGeneral
Fundraising508106Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY192138BOY
EOY185513EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5024313BOY
EOY6096615EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1373612BOY
EOY1101941EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY14000BOY
EOY14000EOY

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)
BOY683884BOY
EOY341148EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1560BOY
EOY1688EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY24124908BOY
EOY27113145EOY

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)
BOY443044BOY
EOY384464EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY31857459BOY
EOY35238514EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2097BOY
EOY0EOY

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)
BOY0BOY
EOY4965EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2097BOY
EOY4965EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY10474761BOY
EOY12292711EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY21380601BOY
EOY22940838EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY31855362BOY
EOY35233549EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY31857459BOY
EOY35238514EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses2378525ReconcilationRevenueExpenses
Reconciliation Unrealized Invest999662ReconciliationUnrealizedInvest
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 Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years900455CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years786498CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years941626CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2336674CurrentTaxYearMinus1Year
Current Tax Year1857073CurrentTaxYear
Total6822326Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years900455CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years786498CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years941626CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2336674CurrentTaxYearMinus1Year
Current Tax Year1857073CurrentTaxYear
Total6822326Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total0AmountsSubstContributorsTotal
Public Support Total1706822326PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1034440CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years825632CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years981266CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year922614CurrentTaxYearMinus1Year
Current Tax Year975372CurrentTaxYear
Total4739324Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years130368CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years232658CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years224649CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year251417CurrentTaxYearMinus1Year
Current Tax Year204229CurrentTaxYear
Total1043321Total
FieldValueIRS element (for citing)
Total Support12604971TotalSupport
Public Support Pertcentage1700.54124PublicSupportPertcentage170
Public Support Pertcent Prior Year0.58456PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
Public Support Percentage5090.00000PublicSupportPercentage509

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 D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years
LandLand
BuildingsBuildings
Leasehold ImprovementsLeaseholdImprovements
EquipmentEquipment
Other Land BuildingsOtherLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionHOSPITAL, A RELATED ORG.Description
Amount$4,965Amount
FieldValueIRS element (for citing)
Total Of Amounts4965TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt4456530TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments999662NetUnrealizedGainsInvestments
Other Revenues275335OtherRevenues
Revenue Not Rptd F9901274997RevenueNotRptdF990
Revenue Subtotal3181533RevenueSubtotal
Total Revenue Per Form9903181533TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1078343TotExpensesEtcAuditedFinclStmt
Other Expenses Included275335OtherExpensesIncluded
Expenses Not Rptd F990275335ExpensesNotRptdF990
Expenses Subtotal803008ExpensesSubtotal
Total Expenses Per Form990803008TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierExplanationExplanation
PART X, LINE 2:Brookhaven Health Care Services Corporation 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 filed 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 consolidated financial statements.
PART XI, LINE 2D AND PART XII, LINE 2D:SPECIAL EVENTS DIRECT EXPENSES..........$260,335. GAMING ACTIVITIES DIRECT EXPENSES.......$ 15,000. TOTAL...................................$275,335.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1ANNUAL BALLNameOfEvent1
Gross Receipts Event1605456GrossReceiptsEvent1
Charitable Contributions Event1390816CharitableContributionsEvent1
Gross Revenue Event1214640GrossRevenueEvent1
Other Direct Expenses Event1120603OtherDirectExpensesEvent1
Name Of Event2TOURNAMENTSNameOfEvent2
Gross Receipts Event2247610GrossReceiptsEvent2
Charitable Contributions Event2147911CharitableContributionsEvent2
Gross Revenue Event299699GrossRevenueEvent2
Other Direct Expenses Event250329OtherDirectExpensesEvent2
Total Number Of Other Events4TotalNumberOfOtherEvents
Gross Receipts Other Events264918GrossReceiptsOtherEvents
Charitable Contrib Other Events127348CharitableContribOtherEvents
Gross Revenue Other Events137570GrossRevenueOtherEvents
Other Direct Expenses Other Events89403OtherDirectExpensesOtherEvents
Gross Receipts Total1117984GrossReceiptsTotal
Charitable Contributions Total666075CharitableContributionsTotal
Gross Revenue Total Events451909GrossRevenueTotalEvents
Other Direct Expenses Total Events260335OtherDirectExpensesTotalEvents
Direct Expense Summary Events260335DirectExpenseSummaryEvents
Net Income Summary191574NetIncomeSummary

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming27655GrossRevenueOtherGaming
Cash Prizes Other Gaming15000CashPrizesOtherGaming
Gross Revenue Total Gaming27655GrossRevenueTotalGaming
Cash Prizes Total Gaming15000CashPrizesTotalGaming
Direct Expense Summary Gaming15000DirectExpenseSummaryGaming
Net Gaming Income Summary12655NetGamingIncomeSummary
FieldValueIRS element (for citing)
States Where Gaming ConductedNYStatesWhereGamingConducted
LicensedtrueLicensed
License Suspended EtcfalseLicenseSuspendedEtc
Gaming With NonmemberstrueGamingWithNonmembers
Member Of Other EntityfalseMemberOfOtherEntity
Percentage Of Gaming Own Facility0.50000PercentageOfGamingOwnFacility
Percentage Of Gaming Othr Facility0.50000PercentageOfGamingOthrFacility
Name Of Gaming Rec Keeper PersonC BANKSNameOfGamingRecKeeperPerson

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL ROADAddressLine1
CityPATCHOGUECity
StateNYState
ZIP Code11772ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam RevfalseContractWith3rdPartyForGamRev
Gaming Manager Name PersonC BANKSGamingManagerNamePerson
Gaming Manager Is EmployeeXGamingManagerIsEmployee
Charitable Distrib RequiredfalseCharitableDistribRequired

Form990 Schedule G Part IV Form990ScheduleGPartIV

FieldValueIRS element (for citing)
IdentifierPART III, LINE 16:Identifier
ExplanationMR. BANKS IS A LEASED EMPLOYEE OF THE ORGANIZATION. HE IS PAID BY BROOKHAVEN MEMORIAL HOSPITAL, AN AFFILIATE OF THE ORGANIZATION, AND THE COST OF HIS COMPENSATION AS VICE PRESIDENT OF DEVELOPMENT AND EXTERNAL AFFAIRS IS INCLUDED IN THE EXPENSES OF THE ORGANIZATION. MR. BANKS DOES NOT RECEIVE ANY ADDITIONAL COMPENSATION FOR GAMING ACTIVITIES AS PART OF HIS POSITION.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
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

FieldValueIRS element (for citing)
Name PersonT OCKERS CEONamePerson
TitlePRESIDENT & CEO/DIRECTORTitle
Base Compensation Filing Org0BaseCompensationFilingOrg
Comp Based On Related Orgs594000CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs6485OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs65444DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org0NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs16156NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org0TotalCompensationFilingOrg
Total Compensation Related Orgs682085TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierPART I, LINE 3:Identifier
ExplanationBrookhaven Memorial Hospital Medical Center, an affiliate of the reporting organization paid compensation to the reporting organization's top management official. Brookhaven Memorial Hospital Medical Center has established the compensation of the top management official using compensation committee, independent compensation consultant, compensation survey and study, and approval by the board or compensation committee.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierExplanationExplanation
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 USA, LLP. 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, LINES 12-14:All of the Directors, Officers and Employees of the Organization are also Directors, Officers and Employees of Brookhaven Memorial Hospital Medical Center ("Hospital"), a related organization. All of these individuals are governed by and subject to the policies of the Hospital including its Conflict of Interest and Whistle Blower polices. These and other Hospital policies are recognized by the Organization as applicable to it.
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 and its related parties, including but not limited to Brookhaven Health Care Services Corporation, dba BMH Foundation, are required to complete and sign the conflict of interest disclosure statement annually and whenever new information of 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 office 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:THERE ARE NO EMPLOYEES ON THE ORGANIZATION'S PAYROLL.
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.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1BROOKHAVEN MEMORIAL HOSPITAL MEDICAL CTRBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1101 HOSPITAL ROADAddressLine1
CityPATCHOGUECity
StateNYState
ZIP Code11772ZIPCode
FieldValueIRS element (for citing)
EIN111704595EIN
Primary ActivitiesHOSPITALPrimaryActivities
Legal Domicile StateNYLegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status3PublicCharityStatus
Controlled OrgfalseControlledOrg

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateType Of EntityTypeOfEntity
Brookhaven Physician Services
100 HOSPITAL ROADPATCHOGUENY11772260628913HOSPITALNYCORPORATION
Brookhaven Surgical Services PC
100 Hospital ROADPatchogueNY11772260885844HOSPITALNYCORPORATION
LI Orthopedic & Spine Specialist PC
100 Hospital ROADpatchogueNY11772274670754hospitalNYcorporation
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 OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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