2013-11-13T15:10:54-06:00 2012-12-31 PricewaterhouseCoopers LLP 300 Madison Avenue New York NY 10017 990 2012-01-01 061562701 ST CATHERINE OF SIENA MEDICAL CENTER % CHS SERVICES INC STCA 6318623000 50 ROUTE 25A Suite SMITHTOWN NY 11787 DENNIS VERZI 6318623000 2013-11-05 true 6464713000 2012 2016-02-24 21:20:13Z JAMES CALDAS 50 ROUTE 25A SMITHTOWN NY 11787 251477548 false 0928 X HTTP://STCATHERINES.CHSLI.ORG X 2000 NY CATHOLIC HEALTH SERVICES OF LONG ISLAND AND ITS MEMBERS, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUE CHRIST'S HEALING MISSION, BY PROMOTING EXCELLENCE IN CARE AND COMMITTING ITSELF TO THOSE IN NEED. 18 17 2376 215 0 414936 3708616 254756670 242914264 589064 282437 2475183 3068524 258235853 249973841 264159 212578 0 0 150268177 156238660 0 0 0 98921743 96843703 249454079 253294941 8781774 -3321100 170806861 168818914 220941600 222480293 -50134739 -53661379 X ST. CATHERINE OF SIENA MEDICAL CENTER, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED. CHS AFFIRMS THE SANCTITY OF LIFE, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. false false 203918695 195402 215309252 ST. CATHERINE OF SIENA MEDICAL CENTER IS A 318 BED ACUTE CARE HOSPITAL DEVOTED TO PROVIDING ADVANCED HEALTHCARE IN AN ENVIRONMENT OF COMPASSION. IN 2012, THE MEDICAL CENTER HAD 14,604 DISCHARGES AND PROVIDED CARE FOR 32,309 EMERGENCY ROOM VISITS. IN ACCORDANCE WITH ITS MISSION AND PHILOSOPHY, THE MEDICAL CENTER PROVIDES CARE REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY AND ALONG WITH OTHER UNCOMPENSATED CARE REPORTED, AT COST, $2,245,923 IN CHARITY CARE. COMMUNITY SERVICE AND OTHER CHARITABLE ACTIVITIES PROVIDED FOR THE COMMUNITY TOTALED, AT COST, $7,929,242 AND REPORTED, AT COST, $1,356,468 IN UNCOMPENSATED CARE AS BAD DEBTS IN 2012. 28060634 17176 30413951 ST. CATHERINE OF SIENA NURSING HOME IS LOCATED ON THE CAMPUS OF ST.CATHERINE OF SIENA MEDICAL CENTER. CONSISTING OF 240 BEDS, THE NURSING HOME PROVIDED 84,065 DAYS OF CARE IN 2012. THE NURSING HOME PROVIDED $657,000 IN UNCOMPENSATED CARE AS BAD DEBT IN 2012. 231979329 true true false true false false false false false false true false false true true true false true false false false false false false true false true true true false true false false false false false false false false false false false false true true true true false false true 157 0 true 2376 true false false false false false true true false false false false X 18 17 false false false false true true true true true false false true true true true true true true true false X CHS SERVICES INC 5167051937 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 X JEROME POLLER 2.0 X X 0 0 0 RAYMOND BORSELLA 2.0 X X 0 0 0 MICHAEL LAMBERT ESQ 2.0 X X 0 0 0 ROBERT CARLIN MD 2.0 X 0 0 0 SYLVIA DIAZ 2.0 X 0 0 0 JAMES DILTS 2.0 X 0 0 0 HON JEANNE GARANT 2.0 X 0 0 0 J ROBERT GROSS DC 2.0 X 0 0 0 JOHN HALLERON III ESQ 2.0 X 0 0 0 WILLIAM MULLANEY 2.0 X 0 0 0 REV MSGR JAMES MCNAMARA 2.0 X 0 0 0 JERRY NINIA MD 2.0 X 0 0 0 GEORGE RICE ESQ 2.0 X 0 0 0 RICHARD SCHMIDT 2.0 X 0 0 0 HENRY SCHREIBER JR 2.0 X 0 0 0 SISTER ANN GRAY DW 2.0 X 0 0 0 JOHN VAN BOURGONDIEN 2.0 X 0 0 0 JAMES CALDAS 50.0 X X 0 1161743 195991 DAN MACKSOOD 50.0 X 0 484510 38441 DENNIS VERZI 50.0 X 631144 0 208624 PATRICK O'SHAUGHNESSY 50.0 X 471651 0 48311 DAVID RIVADENEIRA 40.0 X 906188 0 52616 GARA EDELSTEIN 50.0 X 480187 0 154929 MICHAEL WEBER 40.0 X 429182 0 38987 JOHN POHLMAN 50.0 X 362889 0 50211 JUNE LEE 40.0 X 336374 0 33306 3617615 1646253 821416 212 false true false TGC LLC PO BOX 130 HIGHLAND MD 20777 MEDICARE SETTLEMENT 683523 PIONEER GROUP HARDSCAPE DESIGN 168 TOWNLINE ROAD KINGS PARK NY 11754 ENGINEERING SERVICES 523215 ISLAND NEONATOLOGY PLLC PO BOX 272 EAST ISLIP NY 11730 PHYSICIAN SERVICES 450000 HORIZON HEALTHCARE STAFFING 20 JERUSALEM AVE 3RD FL HICKSVILLE NY 11801 NURSING AGENCY FEES 443707 CHEM RX 750 PARK PLACE LONG BEACH NY 11561 PHARMACY 424645 15 1551 262490 3000000 332795 111780 3708616 NET PATIENT REV-HOSP 621990 212500313 212500313 NET PATIENT REV-NH 623000 30413951 30413951 242914264 282437 282437 0 0 1584042 1410465 173577 0 173577 173577 0 118512 262490 93242 25270 25270 0 0 CONTRACTED SVCS-SWSM 900099 2635362 2635362 TELEPHONE 900099 105704 105704 CAFETERIA 722514 33118 33118 95493 95493 2869677 249973841 245723203 542022 212578 212578 0 0 0 1102795 1102795 0 115256617 109362311 5894306 8153500 7766207 387293 22925500 21815212 1110288 8800248 8379362 420886 2891741 453804 2437937 372729 372729 129827 129827 41719 41719 0 0 10422216 8789388 1632828 691029 14568 676461 4972627 3850359 1122268 0 0 0 3918667 3773962 144705 44444 31266 13178 0 66715 45160 21555 4399895 4399895 1428379 118008 1310371 9085775 9085775 4179457 3703660 475797 MEDICAL SUPPLIES 36638250 36638111 139 SERVICE/MAINTENANCE CONTRACTS 2824109 2760150 63959 HOME OFFICE ALLOCATION 2111988 0 2111988 CHS SERVICES 12579500 10763301 1816199 44636 16252 28384 253294941 231979329 21315612 0 13440337 5047230 5984874 1126739 59918 86961 29443219 30630587 0 0 0 0 0 0 3082660 3264914 969631 2171243 158499145 67654661 88559675 90844484 6843900 7122775 0 0 0 0 0 0 22422647 28523981 170806861 168818914 25030361 26906800 0 0 0 0 68875949 68801692 0 0 0 0 1250000 0 0 0 125785290 126771801 220941600 222480293 X -50555216 -54412391 420477 751012 0 0 -50134739 -53661379 170806861 168818914 X -3321100 43541 -249081 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 41719 41719 false PART II-B LINE 1 - LOBBYING ACTIVITIES AMOUNT REFLECTS PORTION OF TRADE ASSOCIATION DUES WHICH WERE USED FOR LEGISLATIVE LOBBYING ON THE BEHALF OF THE HEALTHCARE INDUSTRY THOSE TRADE ORGANIZATIONS REPRESENT. 10126496 10126496 84187479 33809360 50378119 55620925 33299934 22320991 8564245 545367 8018878 90844484 INSURANCE CLAIMS RECEIVABLE 23000765 OTHER ASSETS 5468806 DUE FROM RELATED PARTIES, NET 54410 28523981 0 RESIDENT FUNDS AND SECURITY DEPOSITS 375869 THIRD PARTY PAYOR LIABILITY 26420107 RETIREMENT LIABILITY - PENSION 579138 RETIREMENT LIABILITY - 457B FUNDS 122184 RETIREMENT LIABILITY - POST RETIREMENT 1919000 ESTIMATED MALPRACTICE LIABILITY 24455594 SELF INSURED LIABILITY 25455630 DUE TO RELATED PARTIES 47444279 126771801 X PART X, OTHER LIABILITIES LINE 2, FIN 48 FOOTNOTE THE MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES PURSUANT TO SECTION 501(A) OF THE CODE. THERE ARE CERTAIN TRANSACTIONS THAT COULD BE DEEMED "UNRELATED BUSINESS INCOME" AND WOULD RESULT IN A TAX LIABILITY. MANAGEMENT REVIEWS TRANSACTIONS TO ESTIMATE POTENTIAL TAX LIABILITIES USING A THRESHOLD OF MORE LIKELY THAN NOT OF BEING SUSTAINED. NY GALA 246827 169085 77742 44618 4750 12990 GOLF OUTING 134175 93405 40770 2148 15580 8932 4224 0 381002 262490 118512 2148 15580 53550 4750 17214 93242 25270 true true true X 300. true X true true true false true true 3010200 764277 2245923 0.00890 27869745 25140503 2729243 0.01080 540257 442352 97905 0.00040 31420202 26347132 5073071 0.02010 742835 742835 0.00290 24477 24477 0.00010 24952542 20617760 4334782 0.01710 25719854 20617760 5102094 0.02010 57140056 46964892 10175165 0.04020 1676 1676 40691 40691 0.00020 636 636 43003 43003 0.00020 true 1356468 81314603 101997132 -20682529 X true true 1 1 ST CATHERINE OF SIENA HOSPITAL

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SKILLED NURSING FACILITY PART I, LINE 4 THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY DOES NOT SPECIFICALLY ADDRESS FREE OR DISCOUNTED CARE FOR THE MEDICALLY INDIGENT. WHEN ESTABLISHED, THE POLICY'S FACTOR IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE WAS SPECIFICALLY SET HIGHER THAN FEDERALLY REQUIRED GUIDELINES IN ORDER TO CAPTURE POTENTIALLY MEDICALLY INDIGENT PATIENTS WHO MAY PRESENT THEMSELVES AT THE HOSPITAL FOR CARE. THE POLICY OF THE HOSPITAL IS CURRENTLY BEING REVISED TO SPECIFICALLY DISCUSS CARE TO THE MEDICALLY INDIGENT. PART I, LINE 7 RATIO OF PATIENT CARE COST TO CHARGES WORKSHEET (WORKSHEET 2) AS PRESCRIBED BY THE IRS INSTRUCTIONS TO SCHEDULE H FORM 990 WAS THE METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN PART 1, LINE 7 CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST LINES 7A,7B AND 7C AND 7D. ALL OTHER LINES INCLUDE COSTS THAT WERE DERIVED ON THE RCC METHODOLOGY OR ACTUAL COSTS FOR THE SERVICES AS TRACKED BY HOSPITAL PERSONNEL UTILIZING DIRECT HOURLY LABOR COSTS, FRINGES AND SUPPLY COSTS. PART I, LINE 7A COLUMN D DIRECT OFFSETTING REVENUES REPRESENT DISTRIBUTIONS FROM THE NEW YORK STATE (NYS) INDIGENT CARE POOL (ICP) WHICH IS SHOWN NET OF HOSPITAL CONTRIBUTIONS TO THE STATEWIDE POOL. THE FORMULA EMPLOYED BY NYS TO DETERMINE DISTRIBUTIONS TO HOSPITALS FROM THE ICP IS COMPLEX AND IS DERIVED FROM A HOSPITAL'S "NEED" CALCULATION. THIS CALCULATION CONSIDERS 90% OF A HOSPITAL'S "NEED" IS BASED ON BAD DEBTS AND CHARITY CARE WRITE OFFS AND 10% IS BASED ON A "UNITS OF SERVICE" METHODOLOGY FOR UNINSURED PATIENTS. THE HOSPITAL APPORTIONED THE ICP REVENUE BETWEEN BAD DEBT AND CHARITY CARE FOR REPORTING ON LINE 7A BASED ON THE PROPORTION OF EACH TO THE TOTAL OF ACTUAL BAD DEBTS AND CHARITY CARE FOR 2012. IT IS IMPORTANT HOWEVER TO BE AWARE THAT THE COSTS OF BAD DEBTS ARE NOT INCLUDED IN LINE 7A, COLUMN C WHILE THE OFFSETTING REVENUE IS INCLUDED IN LINE 7A, COLUMN D. BAD DEBTS AT COST ARE EXCLUDED FROM LINE 7 AND REPORTED IN PART III, LINE 2 IN ACCORDANCE WITH THE INSTRUCTIONS. AS A RESULT, THE NET COST OF "FINANCIAL ASSISTANCE AT COST" ON LINE 7A, COLUMN F IS UNDERSTATED FOR NYS HOSPITALS WHO REPORT IN ACCORDANCE WITH THE INSTRUCTIONS AND IN SOME INSTANCES MAY SHOW A GAIN DUE TO THE MISMATCHING OF REVENUE AND EXPENSE. IT IS IMPORTANT TO CONSIDER THE BAD DEBTS AT COST AMOUNT IN PART III, LINE 2 WHEN EVALUATING THE NET COSTS OF UNCOMPENSATED CARE FOR HOSPITALS IN NYS. PART I, LINE 7 REFLECTS HOSPITAL INFORMATION ONLY. PART II - FOOD DRIVES ST. CATHERINE CONDUCTS SEVERAL FOOD DRIVES THROUGHOUT THE YEAR TO ASSIST LOCAL FOOD PANTRIES. ALL NON-PERISHABLE ITEMS AND PERSONAL CARE ITEMS ARE DONATED TO THE LOCAL CONSORTIUM OF FOOD PANTRIES CONSISTING OF LOCAL PARISHES. IN ADDITION TO THANKSGIVING AND CHRISTMAS, FOOD DRIVES ARE HELD BEFORE EACH OF THE FIVE HEALTHY SUNDAYS (OUTREACH TO PROVIDE SERVICES TO UNDERSERVED COMMUNITIES ORGANIZED THROUGH PARISHES) AND THE ITEMS COLLECTED ARE DONATED TO THE PARISH'S FOOD PANTRY WHERE HEALTHY SUNDAYS ARE HELD. WHEN REQUESTED, DRIVES FOR MOTHERS IN NEED OF BABY ITEMS ARE COODINATED FOR THE PARISH WHERE THE HEALTHY SUNDAY IS HELD. IN 2012, 83 OF ST. CATHERINE'S STAFF MEMBERS VOLUNTEERED TO COVER HEALTHY SUNDAYS REACHING FOUR HUNDRED AND TWENTY EIGHT PARISHIONERS. APPROXIMATELY 600 POUNDS OF FOOD AND CLOTHES WERE DONATED BY STAFF. IN OCTOBER 2012, A SPECIAL DRIVE FOR HURRICANE SANDY VICTIMS WAS HELD. OVER TWENTY BOXES OF FOOD, CLEANING SUPPLIES AND PERSONAL HYGIENE ITEMS WERE BROUGHT TO ST. PATRICK'S PARISH IN SMITHTOWN. ST. CATHERINE OF SIENA ATTENDS MANY COMMUNITY EVENTS THROUGH THE YEAR, INCLUDING: THE HAUPPAUGE INDUSTRIAL ASSOCIATION TRADESHOW, KINGS PARK DAY, ST. JAMES DAY, SMITHTOWN DAY, SUFFOLK SENIOR EVENT, UNITED CEREBAL PALSY HEALTH FAIR, HBO HEALTH FAIR, AND PROVIDES REPRESENTATIVES FROM SEVERAL DEPARTMENTS WHO EDUCATE ATTENDEES AND DISTRIBUTE INFORMATIONAL MATERIAL. IN ADDITION TO THE INFORMATION ON HEALTH RELATED TOPICS SUCH AS BREAST HEALTH, DIGESTIVE TRACT HEALTH AND HEALTHY LIFE STYLE/NUTRITION, SCREENINGS FOR BLOOD PRESSURE, GLUCOSE, BODY MASS INDEX, BONE DENSITY AND SKIN CANCER ARE AVAILABLE AT MANY OF THESE EVENTS. IN 2012, ST. CATHERINE HELD A HEALTH FAIR THAT WAS ATTENDED BY OVER 900 COMMUNITY MEMBERS, TWO COLON CANCER AWARENESS LECTURES, AND A HEART HEALTH DAY. FOUR TOTAL CONTINUING MEDICAL EDUCATION DINNER LECTURES WERE HELD FOR FIRST RESPONDERS IN THE AREA AT NO CHARGE. ST. CATHERINE HELD ITS FIRST CANCER SURVIVOR DINNER, TO OFFER AN UPLIFTING EVENING OF HEALTH AND WELLNESS. BREAST HEALTH EDUCATION WAS PROVIDED BY ST. CATHERINE PROFESSIONALS AS PART OF THE WALT WHITMAN MALL "PAINT THE MALL PINK' BREAST CANCER EVENT. FOUR BLOOD DRIVES WERE HELD THROUGOUT THE YEAR AND ST. CATHERINE IS A PARTNER IN LOCAL 5K RUNS INCLUDING THE COMMACK AMBULANCE CORPS, SMITHTOWN ROTARY AND JUDY'S RUN FOR STROKE AWARENESS. ST. CATHERINE DONATES A TRADITIONAL THANKSGIVING MEAL TO ALL HOMEBOUND RESIDENTS OF SIENA VILLAGE. THE MEALS ARE PREPARED BY THE HOSPITAL STAFF AND DELIVERED TO SIENA VILLAGE WHERE THEY ARE DISTRIBUTED TO INDIVIDUAL RESIDENT APARTMENTS BY A LOCAL YOUTH GROUP. PART III, LINE 2 - COSTING METHODOLOGY BAD DEBT AT COST WAS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO FROM WORKSHEET 2 TO BAD DEBT EXPENSE, WHICH IS REPORTED AT CHARGES. PART III, LINE 4 - TEXT OF FOOTNOTE DISCUSSING BAD DEBT THE ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THIS ALLOWANCE BASED UPON HISTORICAL COLLECTION AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTABLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE MEDICAL CENTER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE. PART III, LINE 4 - BAD DEBT AS COMMUNITY BENEFIT AS PART OF ITS TAX EXEMPT PURPOSE THE HOSPITAL PROVIDES ACCESS TO MEDICALLY NECESSARY CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, OR CULTURAL BACKGROUND. THE HOSPITAL TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF WHETHER THEY HAVE THIRD-PARTY COVERAGE OR THE ABILITY TO PAY. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE HOSPITAL IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. A PATIENTS PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE FROM THE HOSPITAL SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT SINCE CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR TAX EXEMPT PURPOSE, WHICH IS MEETING THE NEED FOR EMERGENCY AND NON-ELECTIVE MEDICAL CARE SERVICES IN THE COMMUNITY. PART III, LINE 8 THE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 2012 CMS-2552 (MEDICARE COST REPORT). MEDICARE REVENUE IS BASED ON THE MEDICARE PROVIDER STATISTICAL AND REIMBURSEMENT REPORT AND MEDICARE COSTS ARE DEVELOPED UTILIZING A RATIO OF MEDICARE ALLOWABLE COSTS TO CHARGES METHODOLOGY. ST. CATHERINE INCURRED A LOSS OF APPROXIMATELY $20.7 MILLION TO DELIVER CARE TO MEDICARE PATIENTS. THIS REPRESENTS THE AMOUNT BY WHICH COSTS TO DELIVER CARE TO MEDICARE RECIPIENTS EXCEEDS THE LEVEL OF PAYMENT. ST. CATHERINE BEARS THE BURDEN OF NOT ONLY PROVIDING THE BEST AND MOST ADVANCED MEDICAL CARE POSSIBLE TO THE COMMUNITY, BUT ALSO DOING SO WITH NO RECOURSE TO OBTAIN PAYMENT FOR THE COST OF PROVIDING CARE IN EXCESS OF THE MEDICARE PAYMENT. AS MEDICARE REVENUE DECLINES AND THE COST TO PROVIDE CUTTING EDGE CARE TO THE COMMUNITY INCREASES, THE HOSPITAL WILL CARRY THE BURDEN. AS A PARTICIPATING PROVIDER AND A CHARITABLE ORGANIZATION, MEDICARE PATIENTS, THE MAJORITY OF WHOM ARE ELDERLY AND DISABLED ARE NOT TURNED AWAY, SO ST. CATHERINE WILL CONTINUE TO BEAR THE LOSS IN PROVIDING THE BEST CARE POSSIBLE TO THE LOCAL COMMUNITY. LOSSES ON TREATING MEDICARE BENEFICIARIES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT IN THEIR ENTIRETY. PART III, LINE 9B THE HOSPITAL'S CHARITY CARE POLICY DESCRIBES THE POLICIES AND PROCEDURES RELATING TO THE PROVISION OF CHARITY CARE TO PERSONS WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THEIR BILL. NO INDIVIDUAL WILL BE DENIED MEDICALLY NECESSARY HOSPITAL SERVICES BASED ON A DEMONSTRATED INANBILITY TO PAY FOR THOSE SERVICES. IN ADDITION, UPON APPLYING FOR CHARITY CARE, EACH PATIENT AND PATIENT GUARANTOR'S ABILITY TO PAY WILL BE ASSESSED. ELIGIBILITY FOR ASSISTANCE: A REASONABLE REVIEW SHALL BE PERFORMED PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (I.E. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE MEDICAL CENTERS CHARITY CARE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY ACCOUNT THAT SUBSEQUENTLY IS DETERMINED TO MEET THE CHARITY CARE CRITERIA SHALL BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT FOR APPROPRIATE FOLLOW-UP. THE THIRD-PARTY COLLECTION AGENT SHALL ADVISE THE PATIENT/GUARANTOR OF THE HOSPITAL'S CHARITY CARE POLICY AND RETURN THE ACCOUNT IMMEDIATELY IF IT IS DETERMINED THAT THE QUALIFICATIONS ARE MET. PART VI, LINE 2 - ASSESSMENT OF COMMUNITY NEEDS AND GOALS ST. CATHERINE'S PROVIDES HIGH QUALITY CARE WITH COMPASSION AND RESPECT FOR EACH PATIENT REGARDLESS OF AGE, RELIGION, RACE, GENDER OR ABILITY TO PAY. THE STANDARD OF CARE IS EQUAL FOR ALL PATIENTS. ST. CATHERINE'S IS CONTINUOUSLY EVALUATING THE SERVICE AREA NEEDS BY REVIEWING PATIENT SURVEYS, COMMUNITY FEEDBACK, DEMOGRAPHIC DATA, COMMUNITY HEALTH INDICATORS AND PATIENT CARE TRENDS TO DEVELOP AND REFINE ITS SCOPE OF SERVICES AND DELIVERY OF CARE. THE HEALTHY SUNDAY's PROGRAM, WHICH PROVIDES FREE MEDICAL SCREENINGS AND EDUCATION TO THE UNDERSERVED FOLLOWING WORSHIP SERVICES ON A BIMONTHLY BASIS, WAS THE RESULT OF A JOINT COMMUNITY NEEDS ASSESSMENT BY CHS HOSPITALS. THESE EVENTS ARE PROMOTED VIA CALENDAR LISTINGS IN PARISH BULLETINS AND FLYERS POSTED IN PLACES OF BUSINESS AND WORSHIP IN THE COMMUNITY SURROUNDING THE OUTREACH SITE. THE NUTRITIONAL OPTIMAL WEIGHT WELLNESS PROGRAM (N.O.W.) WAS DEVELOPED IN COLLABORATION WITH THE YMCA AND WEIGHT WATCHERS FOR PATIENTS AT RISK FOR OBESITY AND CHRONIC DISEASES ASSOCIATED WITH BEING OVERWEIGHT. PART VI, LINE 3 - COMMUNICATION OF FINANCIAL ASSISTANCE POLICY 1. SINCE IT IS THE DUTY OF THE MEDICAL CENTER TO ENSURE THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF ITS CHARITY CARE POLICY, ALL EMPLOYEES IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS ARE FULLY VERSED IN THE CHARITY CARE POLICY, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE MEDICAL CENTER REPRESENTATIVES. 2. THE MEDICAL CENTER HAS POSTED MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN THE MEDICAL CENTER INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREAS. SAID NOTICES ARE PUBLISHED IN AT LEAST ENGLISH AND SPANISH, AND ARE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. 3. THE MEDICAL CENTER PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS OF APPLYING FOR ASSISTANCE. THIS SUMMARY IS WRITTEN AT OR BELOW A SIXTH GRADE READING LEVEL. 4. THE MEDICAL CENTER POSTS ITS CHARITY CARE POLICY SUMMARY ON THEIR INTERNET WEBSITE. 5. THE MEDICAL CENTER PROVIDES ALL PATIENTS ACCESS TO INTERPRETERS TO ASSIST THEM IN UNDERSTANDING ITS CHARITY CARE PROGRAM IN THE PRIMARY LANGUAGE SPOKEN BY THE PATIENT DURING ANY PRE-ADMISSION, ADMISSION, AND DISCHARGE PROCESS. 6. ON ALL BILLS AND STATEMENTS SENT TO PATIENTS, A STATEMENT IS INCLUDED REGARDING THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING CHARITY CARE, AND A CONTACT NUMBER TO CALL TO OBTAIN FURTHER INFORMATION. THIS INFORMATION IS PROVIDED AT OR BELOW A SIXTH GRADE READING LEVEL. PART VI, LINE 4 - COMMUNITY INFORMATION ST. CATHERINE'S SERVICE AREA CONSISTS OF 21 COMMUNITIES LOCATED IN WESTERN SUFFOLK COUNTY. ST. CATHERINE'S PRIMARY CATCHMENT AREA HAS A POPULATION OF APPROXIMATELY 648,000 PER 2010 CSP AND INCLUDES: SMITHTOWN, ST. JAMES, HAUPPAUGE, KINGS PARK, COMMACK, NESCONSET, NORTHPORT AND EAST NORTHPORT. THESE COMMUNITIES REPRESENT APPROXIMATELY 53% OF TOTAL ADMISSIONS. ST CATHERINE'S PRIMARY SERVICE AREA, DEFINED AS 75% TOTAL DISCHARGES, CONSISTS OF 13 COMMUNITIES LOCATED IN SUFFOLK COUNTY AND IN 2010 HAD A POPULATION OF APPROXIMATELY 414,000 RESIDENTS ACCORDING THE EHANYS: MARKET EXPERT. THE TOWNS INCLUDE SMITHTOWN, RONKONKOMA, KINGS PARK, COMMACK, ST. JAMES, HAUPPAUGE, NESCONSET, BRENTWOOD, CENTRAL ISLIP, EAST NORTHPORT, HOLBROOK, CENTEREACH AND BAYSHORE. FROM 2010-2015, THERE IS A PROJECTED INCREASE OF APPROXIMATELY 2% (OR 8,700) OF THOSE RESIDENTS WITHIN ST. CATHERINE OF SIENA MEDICAL CENTER'S PRIMARY SERVICE AREA THAT ARE 65 YEARS OF AGE OR OLDER. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH ST. CATHERINE OF SIENA MEDICAL CENTER OFFERS A WIDE AND COMPREHENSIVE ARRAY OF COMMUNITY SERVICE PROGRAMS THAT ADDRESS CRITICAL HEALTH ISSUES TO A DIVERSITY OF PATIENTS, INCLUDING: ANNUAL COMMUNITY HEALTH FAIR: ST. CATHERINE'S ANNUAL COMMUNITY HEALTH FAIR IS A PIVOTAL EDUCATION PORTAL AND WAS ATTENDED BY APPROXIMATELY 900 COMMUNITY MEMBERS IN 2012. THE HEALTH FAIR OFFERS FREE HEALTH CARE EDUCATION AND SCREENINGS, WHICH INCLUDED SKIN CANCER AND PROSTATE SCREENINGS, FREE FLU SHOTS WERE ADMINISTERED AND SERVICES ON CAMPUS WERE HIGHLIGHTED. AUXILIARY VOLUNTEER DEPARTMENT: THE AUXILIARY AND VOLUNTEERS OF ST. CATHERINE OF SIENA MEDICAL CENTER ARE A GROUP OF DEDICATED AND GENEROUS INDIVIDUALS, WHO OFFER THEIR TIME, TALENT AND SERVICES TO PATIENTS AND STAFF ON A DAILY BASIS. THE AUXILIARY ALSO DONATES FUNDS TO SUPPORT THE MISSION OF THE MEDICAL CENTER, RAISED THROUGH FUNDRAISING ACTIVITIES THAT INCLUDE: MANAGING THE HOSPITAL GIFT SHOP, PLANTS SALES AND SPECIAL EVENTS. COMMUNITY BLOOD DRIVES: ST. CATHERINE HOSTS FOUR BLOOD DRIVES ANNUALLY IN COLLABORATION WITH LONG ISLAND BLOOD SERVICES, A DIVISION OF NEW YORK BLOOD CENTER. COMMUNITY NEWSLETTER: ST. CATHERINE'S PUBLISHES A QUARTERLY NEWSLETTER, THE VOICE. MAILED THROUGHOUT THE PRIMARY CATCHMENT AREA, WHICH COVERS OVER 100,000 HOUSEHOLDS, THE VOICE HAS BEEN INCREASED TO A 12-PAGE DOCUMENT AND THE VOICE IS A PRIMARY COMPONENT OF EDUCATING THE COMMUNITY ABOUT HEALTH-RELATED ISSUES AND KEEPING THEM INFORMED OF UPCOMING EVENTS AND HOSPITAL SERVICES. EMERGENCY RESPONSE APPRECIATION DINNERS: EMERGENCY RESPONSE PERSONNEL ARE AT THE FOREFRONT OF THE MEDICAL PROCESS. THEY PROVIDE IMMEDIATE MEDICAL SERVICE AND WORK COLLABORATIVELY TO OFFER TIMELY CARE. ST. CATHERINE'S OFFERS A QUARTERLY EMERGENCY RESPONSE APPRECIATION AND CONTINUING MEDICAL EDUCATION (CME) DINNER FOR LOCAL EMERGENCY RESPONSE PERSONNEL. THE APPRECIATION DINNERS WERE IMPLEMENTED IN 2008, AND HAVE BECOME A HIGHLIGHT FOR ST. CATHERINE'S AND LOCAL EMERGENCY RESPONSE TEAMS. EACH DINNER ACTS AS A REMINDER OF HOW GRATEFUL THE HOSPITAL IS FOR PROMPTNESS AND EFFICIENCY IN THE FIELD. THE DINNERS OFFER A FORUM FOR SPECIAL EDUCATIONAL PROGRAMS AND AN OPPORTUNITY FOR EMERGENCY RESPONSE PERSONNEL TO GAIN EDUCATION CREDITS. HEALTHY SUNDAY SERIES: THE HEALTHY SUNDAY PROGRAM MANIFESTS THE COMMITMENT OF CATHOLIC HEALTH SERVICES OF LONG ISLAND BY PROACTIVELY HELPING UNDERSERVED COMMUNITIES BY PROVIDING EDUCATIONAL SEMINARS AND PREVENTIVE SCREENINGS THAT MAY BE OTHERWISE UNAVAILABLE. THE PROGRAM REACHES OUT INTO COMMUNITIES OF NEED THROUGH LOCAL PARISHES TO HELP BRIDGE THE GAP BETWEEN THE INDIVIDUAL AND THE HEALTH PROVIDER TO PROVIDE QUALITY, ACCESSIBLE SERVICES ULTIMATELY BUILDING A LINK FOR THE COORDINATION OF CARE. HEALTHY SUNDAYS PROVIDES A SAFE AVENUE TO IMPROVE ACCESS TO VITAL PRIMARY CARE SERVICES. MATERNITY EDUCATION: YOU AND YOUR BABY EDUCATION SERIES -THE MATERNITY DEPARTMENT OFFERS A VARIETY OF FEE AND NON-FEE SUPPORT GROUPS AND WORKSHOPS FOR NEW MOTHERS AND FAMILY MEMBERS AS FOLLOWS: BREAST-FEEDING SUPPORT GROUPS, CHILDBIRTH EDUCATION, EARLY PREGNANCY CLASSES, FAMILY AND FRIENDS CPR: INFANT ONLY, GRANDPARENTS CLASSES, INFANT CARE CLASSES, PRENATAL BREAST-FEEDING CLASSES, SIBLING CLASSES AND MOTHER'S CIRCLE OF HOPE, A POST PARTUM SUPPORT GROUP. MEDICAL COMMUNITY EDUCATION: ST. CATHERINE'S IS DEDICATED TO EDUCATING THE COMMUNITY AND PROUDLY OFFERS FREE LECTURES AND PRESENTATIONS ON A VARIETY OF HEALTH AND WELLNESS TOPICS TO HELP EDUCATE AND RAISE AWARENESS. WITH THE COMBINATION OF LECTURES AND PRESENTATIONS OFFERED, ST. CATHERINE'S HOPES TO IMPROVE THE QUALITY OF LIFE, PROMOTE WELLNESS AND HEALTHY LIVING FOR ALL THOSE WHO LIVE AND WORK IN THE COMMUNITY. HEALTHCARE CAREER EXPLORATION AND INTERNSHIP PROGRAM (HCEIP): ST. CATHERINE IN COLLABORATION WITH SMITHTOWN AND COMMACK HIGH SCHOOLS CONDUCTS A 16 WEEK SEMINAR AND HANDS ON WORKSHOP FOR STUDENTS INTERESTED IN CAREERS IN HEALTH CARE. PROFESSIONALS FROM VARIOUS CLINICAL DEPARTMENTS LECTURE/TEACH AND PROVIDE SKILL BASED TRAINING, ALONG WITH INFORMATION REGARDING COLLEGE CHOICES AND DEGREE REQUIREMENTS, SO THAT STUDENTS CAN MAKE INFORMED CHOICES ABOUT A CAREER CHOICE. UPON COMPLETION OF THE PROGRAM AND 30 HOURS OF VOLUNTEER SERVICE IN EITHER THE HOSPITAL OR NURSING AND REHABILITATION CARE CENTER, STUDENTS ARE ELIGIBLE TO RECEIVE HALF A HEALTH CREDIT. PASTORAL CARE: PASTORAL CARE SERVICE IS AVAILABLE FOR PATIENTS FOR ALL DENOMINATIONS DURING THEIR HOSPITAL STAY. THE DEPARTMENT PROVIDES SPIRITUAL RESOURCES, COUNSEL AND PRAYER, AND ASSISTS PATIENTS WITH INTEGRATING THEIR SPIRITUAL BELIEFS INTO THEIR HEALING PROCESS. PASTORAL CARE IS OFTEN CALLED UPON FOR ETHICAL ADVICE WITH ADVANCE DIRECTIVES IN COLLABORATION WITH THE PATIENT ADVOCATE. OTHER SUPPORT GROUPS OFFERED TO THE COMMUNITY: BARIATRIC SUPPORT GROUPS CARDIAC DEVICE SUPPORT GROUPS DIABETES CLUB (GLAD) STROKE SUPPORT GROUPS PARKINSON'S DISEASE SUPPORT GROUPS BEREAVEMENT SUPPORT GROUPS JOINT REPLACEMENT CLASS PART IV, LINE 6 ST. CATHERINE OF SIENA MEDICAL CENTER (ST. CATHERINE OR THE HOSPITAL OR THE MEDICAL CENTER) AND ST. CATHERINE OF SIENA NURSING AND REHABILITATION CARE CENTER ARE LOCATED ON A SINGLE CAMPUS IN SMITHTOWN, NEW YORK. ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS ST. CATHERINE, THROUGH ITS DAILY OPERATION, PROVIDES TO THE AREA ACUTE, EMERGENT AND OUTPATIENT CARE AS WELL AS LONG TERM CARE AND HOUSING. ST. CATHERINE IS A MEMBER OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS) WHICH IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE. AS OF DECEMBER 31, 2012, CHS COMPRISED SIX HOSPITALS (MERCY MEDICAL CENTER, ST. FRANCIS HOSPITAL AND ST. JOSEPH HOSPITAL IN NASSAU COUNTY, AND GOOD SAMARITAN HOSPITAL MEDICAL CENTER, ST. CHARLES HOSPITAL AND REHABILITATION CENTER AND ST. CATHERINE OF SIENA MEDICAL CENTER IN SUFFOLK COUNTY), AS WELL AS THREE NURSING HOMES (ST. CATHERINE OF SIENA NURSING AND REHABILITATION CARE CENTER, GOOD SAMARITAN NURSING HOME AND OUR LADY OF CONSOLATION NURSING AND REHABILITATIVE CARE CENTER, ALL IN SUFFOLK COUNTY), A REGIONAL HOME CARE AND HOSPICE NETWORK, AND A COMMUNITY-BASED AGENCY FOR PERSONS WITH SPECIAL NEEDS. WITH MORE THAN 17,000 STAFF AND 4,600 MEDICAL STAFF WORKING THROUGHOUT THE SYSTEM, CHS PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES. MEMBER ORGANIZATIONS OF CHS OFFER VIRTUALLY EVERY MEDICAL SPECIALTY AND CLINICAL SERVICES, AND SHARE A DEDICATION TO CONTINUOUSLY UPGRADE THE SCOPE, QUALITY AND ACCESSIBILITY OF CARE. EACH OF CHS' MEMBER ORGANIZATIONS HAVE RETAINED THEIR INDIVIDUAL LINKS TO THEIR HISTORY, THEIR DISTINCTIVE PERSONALITIES, AS WELL AS THE SERVICE SPECIALTIES WHICH THEY ARE KNOWN FOR, THUS EMBEDDING THE ORGANIZATION IN THE COMMUNITY AND SERVING IT EFFECTIVELY. THE CHS SYSTEM PROVIDES AN ABUNDANCE OF EDUCATION AND SUPPORT GROUPS, FREE HEALTH SCREENINGS THROUGH THE HEALTHY SUNDAYS PROGRAM, HEALTH FAIRS AND OTHER PROGRAMS WHICH HELP THE COMMUNITIES SERVED BY CHS ACCESS CARE. SINCE 1907 CATHOLIC HEALTH CARE ON LONG ISLAND HAS BUILT A DISTINGUISHED TRADITION OF OPERATING COMMUNITY-BASED HOSPITALS AND HUMAN SERVICE ORGANIZATIONS WITH THE PRIMARY OBJECTIVE OF SERVING THE COMMUNITY. TO FURTHER THE MISSION OF BRINGING CARE TO THE COMMUNITY, CHS AND ITS MEMBER HOSPITALS, TOGETHER WITH A NUMBER OF OTHER HEALTHCARE PROVIDERS ON LONG ISLAND ENTERED INTO A PARTNERSHIP AGREEMENT WHICH OPERATES AS THE LONG ISLAND HEALTH NETWORK (LIHN). LIHN WAS CREATED TO ESTABLISH A COMPREHENSIVE AND EFFICIENT HOSPITAL NETWORK IN NASSAU AND SUFFOLK COUNTIES BY WORKING TO, AMONG OTHER THINGS, IMPROVE QUALITY OF CARE, FACILITATE CLINICAL INTEGRATION, BENCHMARK BEST PRACTICES, AND REDUCE LENGTH OF STAY AND COSTS. PART VI, LINE 7 - LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT NY true DIOCESE OF ROCKVILLE CENTRE- CATHOLIC MINIS 111837437 501(C)(3) 212578 GENERAL SUPPORT 1 PART I, LINE 2 PROCEDURE FOR MONITORING GRANT FUND USE THE DIOCESE OF ROCKVILLE CENTER PROVIDES ANNUAL UPDATES TO ALL CONTRIBUTORS TO THE CATHOLIC MINISTRIES APPEAL, WHETHER PARISHIONERS OR CORPORATE CONTRIBUTORS LIKE CHSLI. PART II, LINE 1, COLUMN (H) NAME OF ORGANIZATION OR GOVERNMENT: DIOCESE OF ROCKVILLE CENTRE-CATHOLIC MINISTRIES APPEAL (H) PURPOSE OF GRANT OR ASSISTANCE: TO PROVIDE GENERAL SUPPORT OF THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD. X X X X X false true false false false false false false false JAMES CALDAS 0 840675 0 300000 0 21068 0 168700 0 27291 0 1357734 0 0 DAN MACKSOOD 0 396660 0 46900 0 40950 0 20600 0 17841 0 522951 0 0 DENNIS VERZI 447903 0 127800 0 55441 0 199289 0 9335 0 839768 0 34773 0 PATRICK O'SHAUGHNESSY 405222 0 66000 0 429 0 22325 0 25986 0 519962 0 0 0 DAVID RIVADENEIRA 693268 0 211878 0 1042 0 22325 0 30291 0 958804 0 0 0 GARA EDELSTEIN 307568 0 67000 0 105619 0 130808 0 24121 0 635116 0 83103 0 MICHAEL WEBER 398126 0 30000 0 1056 0 22325 0 16662 0 468169 0 0 0 JOHN POHLMAN 268844 0 93400 0 645 0 22325 0 27886 0 413100 0 0 0 JUNE LEE 331752 0 0 4622 0 22325 0 10981 0 369680 0 0 0 PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN JAMES CALDAS $148,100 PARTICIPATION IN PLAN DENNIS VERZI $176,964 PARTICIPATION IN PLAN; $34,773 PAYMENT FROM PLAN GARA EDELSTEIN $108,483 PARTICIPATION IN PLAN; $93,475 PAYMENT FROM PLAN THE AMOUNTS REFLECTED IN COLUMN B(III) AND COLUMN C FOR THE INDIVIDUALS INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP"). THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2012 FORM W-2 BOX, 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NONQUALIFIED RETIREMENT PLANS. FORM 990, PART VI LINE 6 - MEMBERS OF THE ORGANIZATION THE SOLE MEMBER OF ST. CATHERINE OF SIENA MEDICAL CENTER IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS). CHS IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER. FORM 990, PART VI LINE 7A - ELECTION OF THE GOVERNING BODY CHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF ST CATHERINE OF SIENA MEDICAL CENTER, AND HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF ST. CATHERINE. FORM 990, PART VI LINE 7B - DECISIONS OF THE GOVERNING BODY CHS AS THE SOLE MEMBER AND CO-OPERATOR OF ST. CATHERINE IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY ST. CATHERINE'S GOVERNING BODY. FORM 990, PART VI LINE 11A - REVIEW PROCESS FOR FORM 990 THE FORM 990 AND APPROPRIATE SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF TRUSTEES (THE BOARD), WHICH HAS BEEN DELEGATED THE DETAILED REVIEW FUNCTION BY THE BOARD. UPON APPROVAL OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO ALL VOTING MEMBERS OF THE BOARD. ONCE APPROVED BY THE BOARD (OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE), THE ORGANIZATION'S BOARD CHAIR AND CHIEF EXECUTIVE OFFICER COMMUNICATES, IN WRITING TO THE CHS COMPLIANCE AND AUDIT COMMITTEE AND CHS BOARD CHAIR. AFTER REVIEW OF ANY APPLICABLE COMMENTS FROM THE BOARD, THE COMPLIANCE AND AUDIT COMMITTEE WILL THEN RECOMMEND THE APPROVAL OF THE FORM 990 TO THE CHS BOARD OF DIRECTORS WHO WILL THEN REVIEW THE RECOMMENDATIONS AND PROVIDE THE FINAL APPROVAL OF THE FORM 990. THE FORM 990 IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI LINE 12C - CONFLICT OF INTEREST POLICY DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE BY THE ORGANIZATION'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFFERED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORTH WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIMSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI LINE 15 - COMPENSATION POLICY THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE CORPORATE CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE POLICY. THE POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER, AND CHIEF OPERATING OFFICERS OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS; D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AN OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE DONE BY AN INDEPENDANT CONSULTANT ANNUALLY. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASURABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE BOARD OF TRUSTEES. FORM 990, PART VI LINE 19 - DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND. FORM 990, PART VII SECTION A, LINE 1A - COMPENSATION OF OFFICERS HOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. JAMES CALDAS, PRESIDENT AND CEO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); ST CHARLES CORPORATION (11-2983148); SIENA VILLAGE (06-1569129); THE SAMARITAN CORPORATION (11-2716640); SUFFOLK HEARING AND SPEECH CENTER INC (11-2110488). DAN MACKSOOD, SVP FINANCE AND CFO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); ST CHARLES CORPORATION (11-2983148); SIENA VILLAGE (06-1569129); THE SAMARITAN CORPORATION (11-2716640); SUFFOLK HEARING AND SPEECH CENTER INC (11-2110488). DENNIS VERZI, EXECUTIVE VP AND CAO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); SIENA VILLAGE (06-1569129). FORM 990, PART X LINE 20 - TAX-EXEMPT BOND LIABILITIES THE TAX-EXEMPT BOND ISSUANCES REFLECTED ON PART X, LINE 20 ARE ISSUED ON BEHALF OF THE CATHOLIC HEALTH SERVICES OF LONG ISLAND OBLIGATED GROUP PROJECT WHICH INCLUDES THE FILING ENTITY AND RELATED ENTITIES. TWO BONDS WERE ISSUED TO THE OBLIGATED GROUP, SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION (SERIES 2011 SUFFOLK BONDS) AND NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE AND FINANCING CORPORATION (SERIES 2011 NASSAU BONDS). THE BONDS ARE REPORTED ON SCHEDULE K OF THE PARENT ORGANIZATION, CATHOLIC HEALTH SERVICES OF LONG ISLAND. FORM 990, PART XI LINE 9 - CHANGES IN NET ASSETS POSTRETIREMENT BENEFIT PLAN CHANGES OTHER THAN PERIODIC BENEFIT COST: -252,000 MISCELLANEOUS: 2,919 TOTAL TO FORM 990, PART XI, LINE 9: -249,081 SIENA RETIREMENT REALTY CCRC 50 ROUTE 25A SMITHTOWN NY 11787 061569102 RETIRE COMMUN NY 0 3507208 STCATHERINE SIENA MEDICAL REALTY 50 ROUTE 25A SMITHTOWN NY 11787 061568934 MED BUILDING NY 1527881 7953189 STCATHERINE CATHOLIC HEALTH SYSTEM OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113403968 SUPPORT ORG NY 501(C)(3) 11A- I NA false CHS SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113555766 SUPPORT ORG NY 501(C)(3) 11A- II CHSLI false CHS AMBULANCE SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 141801961 DORMANT NY 501(C)(3) 3 CHSLI false GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 111888924 HOSPITAL NY 501(C)(3) 3 CHSLI true GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112537396 SELF INSURANC NY 501(C)(3) 11A- I GOOD SAMARTN true MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113434776 TRANSPORTATIO NY 501(C)(3) 9 MARYHAVENCTR false MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861698 Prgm-disabled NY 501(C)(3) 9 CHSLI false MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861690 Schl-disabled NY 501(C)(3) 2 MARYHAVENCTR false THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113638367 SUPPORT ORG NY 501(C)(3) 9 MARYHAVENCTR false MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CTR NY 11570 111635088 HOSPITAL NY 501(C)(3) 3 CHSLI false CATHOLIC HOME CARE 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 112126736 HOME CARE NY 501(C)(3) 9 CHSLI false OUR LADY OF CONSOLATION GERIATRIC CARE 111 BEACH DRIVE WEST ISLIP NY 11795 113284066 LT NURSE CARE NY 501(C)(3) 9 CHSLI false RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112499790 RENTING NY 501(C)(2) MARYHAVENCTR false SIENA VILLAGE INC 2000 BISHOPS ROAD SMITHTOWN NY 11787 061569129 SR HOUSING NY 501(C)(3) 9 STCATHERINE true ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 111871039 HOSPITAL NY 501(C)(3) 3 CHSLI true CHS HOME SUPPORT SERVICES INC 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 113594561 RESP THERAPY NY 501(C)(3) 9 CATHHOMECARE false ST FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112050523 HOSPITAL NY 501(C)(3) 3 CHSLI false ST FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112916033 SUPPORT ORG NY 501(C)(3) 11A- I ST FRANCIS false ST FRANCIS HOSPITAL RESEARCH & EDUCATIO 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113090867 RESEARCH ORG NY 501(C)(3) 11A- I ST FRANCIS false WSNCHS NORTH INC 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 113438973 HOSPITAL NY 501(C)(3) 3 CHSLI false SUFFOLK HEARING & SPEECH CENTER INC 369 EAST MAIN STREET EAST ISLIP NY 11730 112110488 DIAGN TESTING NY 501(C)(3) 9 GOOD SAMARTN true THE ST CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 112983148 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI false THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112716640 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI false WISDOM GARDENS HOUSING DEVELOPMENT FUND 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113559713 SR HOUSING NY 501(C)(3) 9 MARYHAVENCTR false GOOD SHEPHERD HOSPICE 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 112958438 HOSPICE SVC NY 501(C)(3) 9 CHSLI false ST CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 412076312 SUPPORT ORG NY 501(C)(3) 11A- II ST CHARLES false GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 770611240 SUPPORT ORG NY 501(C)(3) 11A- I GOOD SAMARTN false ST FRANCIS-MERCY CORPORATION 100 PORT WASHINGTON BLVD ROSLYN NY 11576 111635088 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI false MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 550813603 SUPPORT ORG NY 501(C)(3) 11A- I MERCY MEDCTR false ST CATHERINE OF SIENA MEDICAL CTR FDN 50 ROUTE 25A SMITHTOWN NY 11787 271459941 SUPPORT ORG NY 501(C)(3) 11A- I STCATHERINE true CATHOLIC HOME CARE FOUNDATION 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 452907761 SUPPORT ORG NY 501(C)(3) 11A- I CATHHOMECARE false GOOD SHEPHERD HOSPICE FOUNDATION 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 263169427 SUPPORT ORG NY 501(C)(3) 11A- I GOODSHEPHERD false OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP NY 11795 450517566 SUPPORT ORG NY 501(C)(3) 11A- II OURLADYOFC false RVC SUPPORT 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 271531084 REAL ESTATE NY 501(C)(3) 11A- I CHSLI false ST FRANCIS CARDIOVASCULAR PHYSICIANS P 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113613997 HEALTHCARESVC NY 501(C)(3) 11A- I ST FRANCIS false RVC INSURANCE COMPANYINC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 208067039 CAPTIVE INS NY 501(C)(3) 11A- II CHSLI false RADIOLOGY CONSULTING OF LONG ISLANDPLLC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 421646134 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN EMERGENCY MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208243412 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN PEDIATRIC SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208180263 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208088453 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SOUTHWEST SUFFOLK MEDICAL PC 580 UNION BOULEVARD WEST ISLIP NY 11795 061603195 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false CARDIAC EKG INTERPRETATION PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112924518 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208964140 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112838185 HEALTHCARE SVC NY CHSLI C-CORP false FAIRVIEW HILL MANAGEMENT CO INC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 112798383 HOLDING CO NY CHSLI C-CORP false ADVANCED REHABILIATION MEDICINE PLLC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 113640709 HEALTHCARE SVC NY STCHARLES HOSP C-CORP false ST FRANCIS CARDIAC PREVENTION SERVICES 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113224885 HEALTHCARE SVC NY STFRANCIS HOSP C-CORP false SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113307977 HEALTHCARE SVC NY SAMARITAN MGMT C-CORP false SAMARITAN HOME CARE AMERICA 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113319259 HEALTHCARE SVC NY SAMARITAN MGMT C-CORP false HEALTH CARE TEMP SERVICES INC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 112801136 EMPLOYMENT AGENCY NY FAIRVIEW HILL C-CORP false MERCY INTERNAL MEDICINE PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 510639649 HEALTHCARE SVC NY MERCY MED CTR C-CORP false LONG ISLAND EMERGENCY CARE PC 1000 N VILLAGE AVE ROCKVILLE NY 11571 113633515 PHYSICIAN SVC NY MERCY MED CTR S-CORP false false false true true true false false false false false false true true false true true true true false GOOD SAMARITAN HOSPITAL R 1954000 COST GOOD SAMARITAN HOSPITAL C 3000000 COST ST CHARLES HOSPITAL M 14000 COST GOOD SAMARITAN HOSPITAL M, P 1961000 COST SIENA VILLAGE L, Q 52995 COST