CALVARY HOSPITAL INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CALVARY HOSPITAL INC (EIN 13-1740274)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-13
- IRS object ID
- 201323179349302992
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-13T14:56:11-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | TWO JERICHO PLAZA | AddressLine1 |
| City | JERICHO | City |
| State | NY | State |
| ZIP Code | 11753 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 131740274 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALVARY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CALV | NameControl |
| Phone | 7185182069 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1740 EASTCHESTER ROAD | AddressLine1 |
| City | BRONX | City |
| State | NY | State |
| ZIP Code | 104612392 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANDREW V GRECO | Name |
| Title | CFO | Title |
| Phone | 7185182069 | Phone |
| Date Signed | 2013-11-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CHRISTINE KAWECKI | Name |
| PTIN | P00743140 | PTIN |
| Phone | 5169187000 | Phone |
| Date Prepared | 2013-11-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ANDREW V GRECO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1740 EASTCHESTER ROAD | AddressLine1 |
| City | BRONX | City |
| State | NY | State |
| ZIP Code | 104612392 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 113865814 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CALVARYHOSPITAL.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1899 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | SEE SCHEDULE O. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1039 | TotalNbrEmployees |
| Total Nbr Volunteers | 150 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 8967700 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 6767700 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 100576500 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 101211500 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2386500 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2207100 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 858132 | OtherRevenuePriorYear |
| Other Revenue Current Year | 813100 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 112788832 | TotalRevenuePriorYear |
| Total Revenue Current Year | 110999400 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 78363000 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 82709900 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 32817400 | OtherExpensePriorYear |
| Other Expenses Current Year | 51833000 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 111180400 | TotalExpensesPriorYear |
| Total Expenses Current Year | 134542900 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 1608432 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -23543500 | RevenuesLessExpensesCY |
| Total Assets BOY | 104925700 | TotalAssetsBOY |
| Total Assets EOY | 105173900 | TotalAssetsEOY |
| Total Liabilities BOY | 45965300 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 68240400 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 58960400 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 36933500 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | CALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALITY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 101885862 | Expense |
| Revenue | 80262500 | Revenue |
| Description | SEE SCHEDULE O. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 16289601 | Expense |
| Revenue | 18817600 | Revenue |
| Description | SEE SCHEDULE O. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 2460737 | Expense |
| Revenue | 1341300 | Revenue |
| Description | SEE SCHEDULE O. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3291600 | Expense |
| Revenue | 1120636 | Revenue |
| Description | ADVANCED CANCER CARE OUTPATIENT/OTHER PROGRAMS THE OUTPATIENT CLINIC PROVIDES CARE THROUGH A MULTIDISCIPLINARY APPROACH, WHICH ENCOMPASSES THE PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS OF THE PATIENT AND THEIR FAMILY. THE AIM OF THE CLINIC IS TO PROVIDE COMPREHENSIVE HEALTH CARE FOR THE ADVANCED CANCER PATIENT. OUTPATIENT SERVICES 1. THE OUTPATIENT CLINIC SPECIALIZES IN PAIN CONTROL, WOUND CARE AND OTHER SERVICES SPECIFIC TO THE ADVANCED CANCER PATIENT.2. EACH' PATIENT IS ASSIGNED A PRIMARY PHYSICIAN, REGISTERED NURSE, SOCIAL WORKER AND DIETITIAN.3. THE SERVICES OF PASTORAL CARE, THERAPEUTIC RECREATION, RADIOLOGY, LABORATORY, ENTEROSTOMAL THERAPY AND OTHER SERVICES ARE AVAILABLE IF NEEDED.4. THE OUTPATIENT NURSES PROVIDE ADDITIONAL SUPPORT TO PATIENTS AND FAMILIES THROUGH FREQUENT TELEPHONE CALLS.5. ASSISTANCE WITH TRANSPORTATION ARRANGEMENTS WILL BE PROVIDED IF NEEDED.6. TWENTY-FOUR HOUR TELEPHONE COVERAGE WITH A NURSE AND PHYSICIAN FOR ADVICE OR REASSURANCE IS AVAILABLE.7. CONSULTATION WITH MEDICAL SPECIALISTS CAN BE ARRANGED AND COORDINATED.8. COORDINATION OF SERVICES IS PROVIDED AMONG THE PATIENT'S PHYSICIAN, HOME CARE AGENCY AND OTHER PROVIDERS TO ASSURE APPROPRIATE AND CONTINUAL CARE. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 3291600 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 1120636 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 123927800 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 1 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 1 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 62 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1039 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDREW GRECO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7185182069 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1740 EASTCHESTER ROAD | AddressLine1 |
| City | BRONX | City |
| State | NY | State |
| ZIP Code | 104612069 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (28 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| MANFRED ALTSTADT | ||||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | |||
| JOHN P BERTSCH | ||||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | |||
| JOHN A DECINA | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| THOMAS J FAHEY JR MD | ||||||||
| CHAIRMAN OF BOARD | 2.00 | X | 0 | 0 | 0 | |||
| THOMAS G FERRARA | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| TERENCE GALLAGHER | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| STEVEN J GOLUB | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| EDWARD D HEBEN | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| MSGR EDWARD H BARRY | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| SCOTT LARUE | ||||||||
| DIRECTOR | 2.00 | X | 0 | 650469 | 202022 | |||
| RENA M MURTHA RN | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| AMIT SIKDAR | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| MINTO L SOARES | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| JOSEPH A TARANTINO | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| ANNE COTE TAYLOR | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| MICHAEL J BRESCIA MD | ||||||||
| EXECUTIVE MEDICAL DIRECTOR | 36.00 | 448526 | 0 | 24405 | X | |||
| FRANK A CALAMARI | ||||||||
| PRESIDENT/ EXECUTIVE DIREC | 36.00 | 932645 | 0 | 38418 | X | |||
| CHRISTOPHER COMFORT MD | ||||||||
| MED DIRECTOR | 36.00 | 401371 | 0 | 52297 | X | |||
| RICHARD KUTILEK | ||||||||
| CHIEF OPERATIONS OFFICER | 36.00 | 517955 | 0 | 46649 | X | |||
| ANDREW V GRECO | ||||||||
| CHIEF FINANCIAL OFFICER | 36.00 | 262361 | 0 | 53081 | X | |||
| SALLY UMBRO RN | ||||||||
| VP FOR PATIENT CARE SERVIC | 36.00 | 224891 | 0 | 41618 | X | |||
| ANTHONY TARANTO | ||||||||
| ASST. ADMIN. ENVIRONMENT C | 36.00 | 177159 | 0 | 46334 | X | |||
| NANCY D'AGOSTINO RN | ||||||||
| DIRECTOR HOME CARE/HOSPICE | 36.00 | 225548 | 0 | 49983 | X | |||
| SREENIVASA PATIBANDLA MD | ||||||||
| STAFF PHYSICIAN | 36.00 | 372715 | 0 | 27570 | X | |||
| ALMA CARRINGTON MD | ||||||||
| ATTENDING PHYSICIAN | 36.00 | 268805 | 0 | 35918 | X | |||
| ROBERT BRESCIA MD | ||||||||
| DIRECTOR PAL CR | 36.00 | 324954 | 0 | 39818 | X | |||
| DEVMANI JAITLY MD | ||||||||
| ATTENDING PHYSICIAN | 36.00 | 494642 | 0 | 52297 | X | |||
| GAIL CHRZANOWSKI MD | ||||||||
| ATTENDING PHYSICIAN | 36.00 | 295888 | 0 | 44149 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 4947460 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 650469 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 754559 | TotalOtherCompensation |
| Number Individuals GT100 K | 124 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| NICHOLSON & GALLOWAY INC | |||||
| 261 GLEN HEAD RD | GLEN HEAD | NY | 11545 | MASONRY RESTORATION ROOFING & WATERPROOF | 926450 |
| MBL CONSTRUCTION CORP | |||||
| 2620 ST RAYMOND AVENUE | BRONX | NY | 10461 | CONSTRUCTIONS | 894781 |
| FARRELL MEDIA GROUP | |||||
| 887 KINDERKAMACK ROAD 1ST FI | RIVEREDGE | NJ | 07661 | ADVERTISING/MEDIA PLANNING | 791130 |
| AMERICAN TRAVELER | |||||
| PO BOX 93201 | ATLANTA | GA | 31193 | STAFF TRAVEL NURSE | 672935 |
| C&C HOMECARE | |||||
| 125 NEWTON ROAD SUITE 300 | PLAINVIEW | NY | 11803 | HOME HEALTH CARE PROVIDER, HOME MEDICAL | 670945 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 51 | NumberOfContractorsGT100K |
| Related Organizations | 3255000 | RelatedOrganizations |
| All Other Contributions | 3512700 | AllOtherContributions |
| Total Contributions | 6767700 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICARE REVENUE | 900099 | 79255995 | 79255995 |
| MEDICAID REVENUE | 900099 | 15297346 | 15297346 |
| PATIENT SERVICE REVENU | 900099 | 6658159 | 6658159 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 101211500 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 833700 | TotalRevenueColumn |
| Exclusion | $833,700 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 42000 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 42000 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 42000 | TotalRevenueColumn |
| Exclusion | $42,000 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4239814 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 2866414 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1373400 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1373400 | TotalRevenueColumn |
| Exclusion | $1,373,400 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| PARKING LOT REVENUE | 900099 | 246375 | $246,375 | |
| CAFETERIA | 900099 | 187699 | $187,699 | |
| EMERGENCY PREPAREDNESS | 900099 | 61736 | 61736 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 275290 | TotalRevenueColumn |
| Related Or Exempt Function Income | 268800 | RelatedOrExemptFunctionIncome |
| Exclusion | $6,490 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 771100 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 110999400 | TotalRevenueColumn |
| Related Or Exempt Function Income | 101542036 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $2,689,664 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5499997 | Total |
| Program Services | 3648888 | ProgramServices |
| Management And General | 1851109 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53069303 | Total |
| Program Services | 49354330 | ProgramServices |
| Management And General | 3714973 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7334000 | Total |
| Program Services | 6755366 | ProgramServices |
| Management And General | 578634 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12720200 | Total |
| Program Services | 11716608 | ProgramServices |
| Management And General | 1003592 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4086400 | Total |
| Program Services | 3763993 | ProgramServices |
| Management And General | 322407 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 918500 | Total |
| Management And General | 918500 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 351300 | Total |
| Management And General | 351300 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 497900 | Total |
| Management And General | 497900 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7867600 | Total |
| Program Services | 7779500 | ProgramServices |
| Management And General | 88100 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1143300 | Total |
| Program Services | 1053096 | ProgramServices |
| Management And General | 90204 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2520500 | Total |
| Program Services | 2321639 | ProgramServices |
| Management And General | 198861 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2179300 | Total |
| Program Services | 2007359 | ProgramServices |
| Management And General | 171941 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 207500 | Total |
| Program Services | 191129 | ProgramServices |
| Management And General | 16371 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4213900 | Total |
| Program Services | 3881434 | ProgramServices |
| Management And General | 332466 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 174000 | Total |
| Management And General | 174000 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | FundraisingFundraising | Management And GeneralManagementAndGeneral |
|---|---|---|---|---|
| ARCHDIOCESAN PENSION WI | 20965600 | 20965600 | 0 | |
| OTHER ANCILLARY MEDICAL | 5935000 | 5935000 | 0 | 0 |
| MAINTENANCE AND REPAIRS | 1530400 | 1409655 | 0 | 120745 |
| FOOD EXPENSE | 996100 | 996100 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2332100 | Total |
| Program Services | 2148103 | ProgramServices |
| Management And General | 183997 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 134542900 | Total |
| Program Services | 123927800 | ProgramServices |
| Management And General | 10615100 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -1953400 | BOY |
| EOY | -1599700 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6253600 | BOY |
| EOY | 6394800 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 23083500 | BOY |
| EOY | 22415300 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 193699 | BOY |
| EOY | 186943 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 585301 | BOY |
| EOY | 342577 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 82826500 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 65871100 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16202600 | BOY |
| EOY | 16955400 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16776100 | BOY |
| EOY | 17304800 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21964000 | BOY |
| EOY | 22100000 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21820300 | BOY |
| EOY | 21073780 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104925700 | BOY |
| EOY | 105173900 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15005800 | BOY |
| EOY | 16186100 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30959500 | BOY |
| EOY | 52054300 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 45965300 | BOY |
| EOY | 68240400 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30427200 | BOY |
| EOY | 11133300 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26698100 | BOY |
| EOY | 23964000 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1835100 | BOY |
| EOY | 1836200 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58960400 | BOY |
| EOY | 36933500 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104925700 | BOY |
| EOY | 105173900 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -23543500 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 2239900 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -723300 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Both | X | FinancialStatementBoth |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $18,209 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 18209 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | CALVARY HOSPITAL, INC. DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES; HOWEVER, IT DOES BEAR INDIRECT COSTS THAT HAVE LOBBYING IMPLICATIONS. THE $18,209 REPORTED ON PART II-B, LINE 1(I) REPRESENTS THAT PORTION OF ITS MEMBERSHIP DUES THE HOSPITAL PAYS TO THE HOSPITAL ASSOCIATION OF NEW YORK STATE (HANYS) AND THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA) THAT RELATES TO LOBBYING EXPENSES. THIS AMOUNT HAS BEEN DETERMINED IN ACCORDANCE WITH MEDICARE PROVIDER REIMBURSEMENT MANUAL, PART I, SECTION 2139. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 28533200 | BeginningOfYearBalance |
| Contributions | 1612400 | Contributions |
| Investment Earnings Or Losses | 821000 | InvestmentEarningsOrLosses |
| Other Expenditures | 5166400 | OtherExpenditures |
| End Of Year Balance | 25800200 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 25734400 | BeginningOfYearBalance |
| Contributions | 2031600 | Contributions |
| Investment Earnings Or Losses | 2502900 | InvestmentEarningsOrLosses |
| Other Expenditures | 1735700 | OtherExpenditures |
| End Of Year Balance | 28533200 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 22916700 | BeginningOfYearBalance |
| Contributions | 1901600 | Contributions |
| Investment Earnings Or Losses | 2815700 | InvestmentEarningsOrLosses |
| Other Expenditures | 1899600 | OtherExpenditures |
| End Of Year Balance | 25734400 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 20492500 | BeginningOfYearBalance |
| Contributions | 1747600 | Contributions |
| Investment Earnings Or Losses | 2610800 | InvestmentEarningsOrLosses |
| Other Expenditures | 1934200 | OtherExpenditures |
| End Of Year Balance | 22916700 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 20492500 | BeginningOfYearBalance |
| End Of Year Balance | 20492500 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.07100 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.92900 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 538000 | OtherCostOrOtherBasis |
| Book Value | 538000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 30551300 | OtherCostOrOtherBasis |
| Depreciation | 22358700 | Depreciation |
| Book Value | 8192600 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3690300 | OtherCostOrOtherBasis |
| Depreciation | 2797200 | Depreciation |
| Book Value | 893100 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 48046900 | OtherCostOrOtherBasis |
| Depreciation | 40715200 | Depreciation |
| Book Value | 7331700 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 16955400 | TotalOfBookValueLandBuildings |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND | Description |
| Book Value | 22100000 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Program Related | 22100000 | TotalOfBookValueProgramRelated |
Other Assets OtherAssets (8 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM THIRD PARTIES | 878600 |
| HELD IN ESCROW UNDER PLEDGE SECURITY AGREEMENT | 6004335 |
| SELF INSURANCE FUND ASSETS | 2223000 |
| EQUIPMENT ESCROW FUND | 8744100 |
| DONOR RESTRICTED ASSETS | 1592700 |
| DEFERRED COMPENSATION ASSET | 1334500 |
| OTHER ASSETS | 251800 |
| DUE FROM AFFILIATES | 44745 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 21073780 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED PENSION LIABILITY | $28,462,800 |
| DUE TO THIRD PARTIES | $1,914,700 |
| MALPRACTICE LIABILITY | $711,200 |
| ARCHDIOCESAN WITHRAWAL FEE PAYABLE | $20,965,600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 52054300 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 118405700 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 2239900 | NetUnrealizedGainsInvestments |
| Other Revenues | 5166400 | OtherRevenues |
| Revenue Not Rptd F990 | 7406300 | RevenueNotRptdF990 |
| Revenue Subtotal | 110999400 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 110999400 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 140432600 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 5889700 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 5889700 | ExpensesNotRptdF990 |
| Expenses Subtotal | 134542900 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 134542900 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | NET ASSETS RELEASED FROM RESTRICTIONS 1,842,000. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | NET ASSETS RELEASED FROM RESTRICTION 5,166,400. PENSION RELATED ADJUSTMENTS 859,300. BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND, INC. -136,000. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 0 | ExpensesExceededBudget |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 38773 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 38773 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00030 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3785430 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3785430 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02810 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3824203 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3824203 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02840 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3824203 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 3824203 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02840 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 19 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 358478 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 358478 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00270 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 2000 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 2000 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 2 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 11800 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 11800 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 1 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 12854 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 12854 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 385132 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 385132 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00290 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 23 | NumberOfActivitiesOrPrograms |
| Total Community Building Expense | 770264 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 770264 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00580 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $754,500 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 41166689 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 55831208 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -14664519 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Critical Access HospitalCriticalAccessHospital | OtherOther |
|---|---|---|---|---|---|---|---|---|
| CALVARY HOSPITAL INC | ||||||||
| 1 | 1740 EASTCHESTER ROAD | BRONX | NY | 10461 | X | X | X | LONG-TERM CARE HOSPITAL |
| CALVARY HOSPITAL INC (BROOKLYN CAMPUS) | ||||||||
| 2 | 150 55TH STREET | BROOKLYN | NY | 11220 | X | X | X | |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALVARY HOSPITAL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 300.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Provided On Admission | X | ProvidedOnAdmission |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 0 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Nondiscrim Emergency Care Policy | 0 | NondiscrimEmergencyCarePolicy |
| No Emergency Care | X | NoEmergencyCare |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: CALVARY HOSPITAL INC. USES THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE TO LOW-INCOME PATIENTS. | ||
| PART I, LINE 6A: CALVARY HOSPITAL, INC. IS REQUIRED TO PREPARE AN ANNUAL COMMUNITY SERVICE PLAN (CSP) A.K.A., THE COMPREHENSIVE COMMUNITY SERVICE PLAN FOR THE NYS DEPARTMENT OF HEALTH. THIS REPORT IS FILED WITH THE NYS DOH. THE COMMUNITY SERVICE PLAN IS AVAILABLE ON THE ORGANIZATION'S WEB SITE (WWW.CALVARYHOSPITAL.ORG). ADDITIONALLY, CALVARY POSTS INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS AND HAS A CALENDAR ON PROGRAMMATIC INFORMATION AS IT BECOMES AVAILABLE REGARDING BEREAVEMENT GROUPS AND SUPPORT NETWORKS ON THE ORGANIZATION'S WEB SITE. | ||
| PART I, LINE 7: CALVARY HOSPITAL, INC. HAS UTILIZED NET REALIZABLE VALUE OF THE SERVICES RENDERED FOR THE CHARITY CARE AMOUNT LISTED ON PART I LINE 7. CALVARY UTILIZED THE AMOUNT REPORTED IN ITS COST REPORT PREPARED FOR THE NYS DOH. | ||
| PART I, LINE 7G: CALVARY HOSPITAL, INC. HAS INCLUDED CHARITY CARE SERVICES IN THE AMOUNT OF $38,772 ON THE FORM 990, PART VIII LINE 2G. THIS AMOUNT IS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7(F) AS PER THE INSTRUCTIONS.CALVARY HOSPITAL, INC. IS A NOT-FOR PROFIT SPECIALTY HOSPITAL THAT PROVIDES SERVICES FOR THE CARE OF TERMINALLY ILL CANCER PATIENTS. CALVARY HOSPITAL, INC. IS OPERATED IN CONNECTION WITH THE ROMAN CATHOLIC ARCHDIOCESE OF NEW YORK.THE MISSION OF CALVARY HOSPITAL, INC. IS AS FOLLOWS, FROM ITS INCEPTION IN 1899, CALVARY HOSPITAL HAS BEEN FAITHFULLY DEVOTED TO PROVIDING PALLIATIVE CARE TO ADULT PATIENTS IN THE ADVANCED STAGES OF CANCER, ADDRESSING THE SYMPTOMS OF THE DISEASE, NOT ITS CURE. A VOLUNTARY, NOT-FOR-PROFIT HOSPITAL, OPERATED IN CONNECTION WITH THE ARCHDIOCESE OF NEW YORK, CALVARY CONTINUES TO EMBODY THIS TRADITION OF CARING THROUGH THE SERVICES AND PROGRAMS OFFERED BY AND THROUGH THE DEDICATION AND CONCERN SHOWN BY ITS STAFF MEMBERS.THE HOSPITAL WILL CONTINUE TO BE FAITHFUL TO THIS TRADITION THROUGH A TWOFOLD COMMITMENT. CALVARY WILL STRIVE PRIMARILY TO EXPAND ITS PROGRAMS AND SERVICES TO MEET THE EMERGING PHYSICAL, PSYCHOSOCIAL, AND SPIRITUAL NEEDS OF BOTH PATIENTS AND FAMILIES THROUGH THE PROVISION OF ACUTE INPATIENT, OUTPATIENT, HOME CARE, HOSPICE, AND SATELLITE SERVICES. IN ADDITION, THROUGH THE PALLIATIVE CARE INSTITUTE THE HOSPITAL ENDEAVORS TO TRANSMIT TO OTHER HEALTH CARE PROFESSIONALS, THROUGH RESEARCH AND EDUCATION, THE KNOWLEDGE AND COMPETENCE WHICH IT HAS DEVELOPED IN THE CARE OF THE ADVANCED CANCER PATIENT. THROUGH THIS TWOFOLD COMMITMENT, CALVARY HOSPITAL WILL DEEPEN AND STRENGTHEN THE PHILOSOPHY OF COMPASSIONATE CARE WHICH HAS BEEN THE CORNERSTONE OF ITS PROGRAM OF SERVICE, AND WILL OFFER TO THOSE IN OUR EXPANDED COMMUNITY AND OTHERS, A TRADITION OF SUCCESSFUL EXPERIENCE IN THE CARE OF THE ADVANCED CANCER PATIENT.CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. WITH 225 BEDS IN THE BRONX AND BROOKLYN AND MORE THAN 1029 EMPLOYEES, CALVARY SERVES MORE THAN 5,500 PATIENTS ANNUALLY. CALVARY PROVIDES PALLIATIVE CARE, WHICH IS THE ACTIVE TREATMENT OF THE SYMPTOMS, NOT THE CURE OF THE DISEASE, IN ORDER TO MAKE OUR PATIENTS AS COMFORTABLE AS POSSIBLE. CALVARY'S PROGRAMS INCLUDE INPATIENT CARE CASE MANAGEMENT OUTPATIENT CARE, HOSPICE, HOME CARE AND SUPPORT PROGRAMS FOR FAMILIES AND FRIENDS.AS CALVARY APPROACHES THE FUTURE WITH A SENSE OF HOPE AND PROMISE, CALVARY IS EVER MINDFUL OF THE LEGACY OF OUR FOUNDERS, THE WOMEN OF CALVARY, TO PROVIDE COMPREHENSIVE CARE WHILE RECOGNIZING THE INDIVIDUALITY AND DIGNITY OF EVERY PATIENT. AT THE SAME TIME, CALVARY WILL CONTINUE TO DEVELOP NEW PROGRAMS AND SERVICES TO MEET THE NEEDS OF TODAY'S WORLD. PART I LINE 7 COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990.PART IX LINE 25 COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING. THE PERCENTAGE IN THIS COLUMN IS $XX,XXX. | ||
| PART II: CALVARY HOSPITAL MAKES A NUMBER OF DIFFERENT SUPPORT GROUPS AVAILABLE TO THE COMMUNITY. THESE SUPPORT GROUPS ARE ADVERTISED ON CALVARY HOSPITAL'S WEBSITE, WWW.CALVARYHOSPITAL.ORG, ON ITS CALENDAR OF EVENTS. ALL GROUPS ARE FREE AND ARE OPEN TO THE COMMUNITY.CALVARY HOSPITAL PROVIDES BEREAVEMENT SUPPORT FOR ADULTS WHO HAVE LOST LOVED ONES AT CALVARY HOSPITAL OR CALVARY@HOME, AND THOSE FROM THE COMMUNITY AT LARGE WHO HAVE LOST SOMEONE BECAUSE OF ILLNESS ACCIDENTS VIOLENCE, OR ANY OTHER CAUSE. GROUPS ARE OFFERED IN THE BRONX AND BROOKLYN.THE HOSPITAL OFFERS AGE-APPROPRIATE SUPPORT GROUPS FOR CHILDREN, AGES 6 THROUGH 11, AND FOR ADOLESCENTS, AGES 12 TO 18.CALVARY IN TOUCH, A BI-MONTHLY NEWSLETTER ABOUT BEREAVEMENT ISSUES IS AVAILABLE THROUGH THE HOSPITAL'S WEBSITE. THESE COMMUNITY SUPPORT GROUPS INCLUDE BUT ARE NOT LIMITED TO:- SUPPORT GROUPS FOR BEREAVED PARENTS- PRECIOUS MOMENTS SUPPORT GROUP FOR CHILDREN AGES 6 TO 11- TEEN BEREAVEMENT GROUP- DEATH OF A SPOUSE BEREAVEMENT GROUP- DEATH OF A PARENT BEREAVEMENT GROUP- CAMP COURAGEOUS DAY CAMP FOR BEREAVED CHILDREN GROUPS ARE OPEN TO ALL, ARE FREE OF CHARGE, AND ARE LED BY CALVARY HOSPITAL STAFF. REGISTRATION IN ADVANCE OF PARTICIPATION IS REQUIRED.CALVARY HOSPITAL ALSO MAKES AVAILABLE A NUMBER OF DIFFERENT WELLNESS ACTIVITIES TO THE COMMUNITY. THESE WELLNESS ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO YOGA CLASSES AND RECREATIONAL THERAPY. CALVARY HOSPITAL'S THERAPEUTIC RECREATION AND "MUSIC THERAPY PROGRAMS WERECREATED TO GIVE PATIENTS A SENSE OF ACCOMPLISHMENT AND TO RELIEVE THE SUFFERING OF OUR PATIENTS AND THEIR FAMILIES. THERAPEUTIC RECREATION ACTIVITIES INCLUDES DRAWING, SCULPTURE, AND CERAMICS PROJECTS; HORTICULTURE; A GAMES AND DISCUSSION HOUR; AND HOLIDAY PARTIES. MUSIC THERAPY OFTEN HELPS SOOTHE PATIENTS AND HELPS THEM FOCUS ON LIFE. OUR BOARD CERTIFIED MUSIC THERAPISTS USE MUSIC THERAPY INTERVENTIONS TO SOOTHE PATIENTS, RELIEVE ANXIETY, REMINISCE, AND EASE PAIN AND SUFFERING. MUSIC THERAPY INTERVENTIONS MAY ALSO PROVIDE RELEASE IN THE LAST HOURS OR MOMENTS OF LIFE. PATIENTS RECEIVING MUSIC THERAPY SOMETIMES WRITE SONGS ASSISTED BY THE MUSIC THERAPISTS TO LEAVE FOR LOVED ONES, OR FIND OTHER WAYS TO OPEN THEIR HEARTS THROUGH MUSIC. OUR CLINICIANS REPORT THAT IN SOME CASES, THE ONLY TIME A PATIENT LAUGHS OR SMILES IS DURING A MUSIC THERAPY SESSION. WE ALSO FIND THAT MUSIC THERAPY IS AVAILABLE AT BOTH INPATIENT LOCATIONS AND IS ALSO ONE OF THE SERVICES WE OFFER THROUGH CALVARY@HOME.IN KEEPING WITH OUR MISSION TO SHARE OUR KNOWLEDGE AND EXPERIENCE WITH OTHERS, CALVARY OFFERS INTERNSHIP PROGRAMS IN THE FOLLOWING AREAS:PALLIATIVE CARE AND MUSIC THERAPY, WHICH IS RECOGNIZED AS A NATIONAL CLINICAL TRAINING SITE BY THE AMERICAN MUSIC THERAPY ASSOCIATION. THROUGH ITS EDDIE HIGGINS SCHOLARSHIP PROGRAM, CALVARY HOSPITAL PROVIDES LEADERSHIP DEVELOPMENT AND TRAINING. THE EDDIE HIGGINS SCHOLARSHIP IS NAMED AFTER A CHERISHED MEMBER OF THE CALVARY FAMILY WHO CAME TO THE HOSPITAL AS A YOUNG BOY. EDDIE WAS HOSPITALIZED INTERMITTENTLY FOR 15 YEARS AT CALVARY UNTIL HIS DEATH IN 1982 AT THE AGE OF 29. EDDIE IS REMEMBERED FOR HIS LOVE OF GOD AND HIS REMARKABLE COURAGE DESPITE HIS ILLNESS. CALVARY HAS GIVEN THE ANNUAL SCHOLARSHIP SINCE 1985. CALVARY HOSPITAL IS VERY ACTIVE IN THE COMMUNITY AND PARTICIPATES IN ANNUAL EVENTS SUCH AS THE COMMUNITY COLUMBUS DAY PARADE AND THE ANNUAL ORCHARD BEACH BREAST CANCER WALK. | ||
| PART III, LINE 4: THE CALVARY HOSPITAL, INC. AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE REGARDING BAD DEBT.COSTING METHODOLOGY USED FOR BAD DEBT:THE METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED IN LINE 2 IS BASED ON THE HOSPITAL'S COLLECTION/BAD DEBT WRITE-OFF POLICY WHICH STATESTHAT ALL REASONABLE EFFORTS WILL BE MADE TO OBTAIN PAYMENTS AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. COLLECTION EFFORTS AREMADE ON THE NET REALIZABLE AMOUNT. | ||
| PART III, LINE 8: CALVARY HOSPITAL INC. HAS REPORTED A SHORTFALL IN PART III SECTION B LINE 7. THE EXPENSES, REVENUES AND SHORTFALL REPORTED IN PART III LINES 5-7 WERE DEVELOPED FROM THE 2010 CALVARY HOSPITAL, INC. COST REPORTS FILED WITH THE NYS DOH AND NATIONAL GOVERNMENT SERVICES (MEDICARE INTERMEDIARY). | ||
| PART III, LINE 9B: CALVARY HOSPITAL, INC. 'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE.CALVARY HOSPITAL'S COLLECTION: BAD DEBT WRITE-OFFS POLICY INDICATES THAT ALL REASONABLE EFFORTS WILL BE MADE BY PATIENT ACCOUNTS REPRESENTATIVES TOOBTAIN PAYMENT AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. THE PATIENT ACCOUNTING SYSTEM WILL BEAR ENTRIES OF SUCH ATTEMPTS,INCLUDING THE DATE AND THE REPRESENTATIVE'S INITIALS. ACCOUNTS RESISTING SETTLEMENT MAY BE REFERRED TO A COLLECTION AGENCY. | ||
| PART V, SECTION B, LINE 14G: THE HOSPITAL PUBLISHES AVAILABILITY OF CHARITY CARE IN THE NEW YORK TIMES. | CALVARY HOSPITAL INC. | |
| PART V, SECTION B, LINE 19C: THE HOSPITAL DOES NOT HAVE EMERGENCY ROOM. | CALVARY HOSPITAL INC. | |
| PART V, SECTION B, LINE 20D: 15% OF GROSS CHARGES WHICH IS BELOW OUR LOWEST PAYER. | CALVARY HOSPITAL INC. | |
| PART VI, LINE 2: CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADULT ADVANCED CANCER PATIENTS IN THE UNITED STATES LOCATED IN THE BRONX AND BROOKLYN.CALVARY HOSPITAL USES A VARIETY OF METHODS AND SERVICES TO GATHER COMMUNITY INPUT ASSESS THE NEEDS OF THE COMMUNITY, AND TO ASSURE INPUT IN THE COMMUNITY SERVICE PLAN. SOME OF THESE METHODS ARE:A. COMMUNITY OUTREACH SERVICES -COMMUNITY OUTREACH SERVICES FUNCTIONS AS A LIAISON WITH THE COMMUNITY, REFERRERS, PHYSICIANS, PATIENTS, AND FAMILIES AND FACILITATES ADMISSION TO CALVARY HOSPITAL. THE DEPARTMENT OUTREACHES THROUGH THE TRI-STATE REGION AND EDUCATES THE HEALTH CARE AND PATIENT COMMUNITIES AS TO THE CONTINUUM OF SERVICES CALVARY PROVIDES (INPATIENT, OUTPATIENT, HOME CARE, HOSPICE NURSING HOME HOSPICE, AND WOUND CARE). THROUGH ON-SITE VISITS, PUBLIC PRESENTATIONS AND PARTICIPATION IN COMMUNITY AND PROVIDER ACTIVITIES, THEOUTREACH STAFF CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY. B. PROFESSIONAL ADVISORY BOARD -THE PROFESSIONAL ADVISORY BOARD WAS ESTABLISHED IN 1992 TO OBTAIN INPUT FROM THE COMMUNITY. THE ADVISORY BOARD MEETS AT LEAST ANNUALLY AND IS COMPRISED OF PHYSICIANS NURSES, AND SOCIAL WORKERS, REPRESENTING HOSPITALS, AND HOME CARE AGENCIES, AS WELL AS THE COMMUNITY. THIS GROUP HAS CONTRIBUTED A VARIETY OF IDEAS FOR ENHANCING SERVICES TO THE COMMUNITY.C. COMMUNITY PLANNING BOARDEACH YEAR THE HOSPITAL INVITES THE HEALTH COMMITTEE OF COMMUNITY PLANNING BOARD *11 AND *10 TO VISIT THE HOSPITAL AND MEET WITH SENIOR STAFF.D. OUTREACH REPRESENTATION (OPEN HOUSE) FOR HEALTH CARE PROFESSIONALS -COMMUNITY OUTREACH HOSTS OPEN HOUSES AT BOTH THE BRONX AND BROOKLYN LOCATIONS TO PROVIDE INFORMATION TO AND RECEIVE INFORMATION FROM ITS REFERRERS. CALVARY HOSPITAL, INC. ALSO HAS PUBLIC PARTICIPATION IN THE EXTENDED. COMMUNITY THROUGH PARTICIPATION IN:- GREATER NEW YORK HOSPITAL ASSOCIATION- HOSPITAL ASSOCIATION OF NEW YORK STATE- AMERICAN HOSPITAL ASSOCIATION- NEW YORK CITY DEPARTMENT OF HEALTH- NEW YORK STATE DEPARTMENT OF HEALTH- CATHOLIC HEALTHCARE ASSOCIATION- CMS THROUGH ONGOING PARTICIPATION IN THE GROUPS ABOVE, CALVARY HOSPITAL CONTINUALLY MONITORS THE TRENDS IN THE HEALTHCARE NEEDS OF THE LARGER COMMUNITY. ALTHOUGH THE NATURE OF ITS SERVICES IS LIMITED BY ITS SPECIALIZED MISSION, CALVARY HAS IDENTIFIED A VARIETY OF ACTIVITIES TO PARTICIPATE IN IMPROVING THE HEALTH OF ITS EXTENDED COMMUNITY. | ||
| PART VI, LINE 3: EACH PERSON REQUESTING CALVARY'S SERVICES MUST BE MADE AWARE OF CALVARY'S UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES PROGRAM AS FOLLOWS:1. DISTRIBUTE AN INDIVIDUAL NOTICE TO EACH PERSON WHO IS SEEKING SERVICES ON BEHALF OF HIMSELF OR ANOTHER. THIS NOTICE IS PASSED TO THE INDIVIDUALUSUALLY AT THE POINT OF ADMISSION OR REGISTRATION WHEN FINANCIAL ARRANGEMENTS ARE BEING DISCUSSED. THE "NOTICE OF AVAILABILITY OF UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES" IS UPDATED ANNUALLY.2. POST SIGNS PROVIDED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES CONSPICUOUSLY IN THE ADMITTING OFFICE, BUSINESS OFFICE, CLINICS, HOME HEALTH AGENCY, AND HOSPICE AREAS. THE SIGNS ARE TO BE IN ENGLISH AND SPANISH. ADDITIONALLY, CALVARY HAS ACCESS TO A LANGUAGE TELEPHONE SERVICE THAT ADDS 58 ADDITIONAL LANGUAGES TO ENGLISH AND SPANISH. 3. PUBLISH NOTICE OF HILL-BURTON UNCOMPENSATED SERVICES OBLIGATION ANNUALLY IN LOCAL NEWSPAPER IN SERVICE AREA (NEW YORK TIMES LEGAL). | ||
| PART VI, LINE 4: CALVARY HOSPITAL'S MAIN CAMPUS IS LOCATED IN THE BRONX, NY. THE BRONX IS CONSIDERED THE PRIMARY COMMUNITY FOR THE PURPOSES OF PUBLIC HEALTH PLANNING, AND 48% OF ITS EMPLOYEES RESIDE IN THE PRIMARY SERVICE AREA. IN ADDITION, AS A TERTIARY REFERRAL CENTER FOR ADVANCED DISEASE, CALVARY HOSPITAL SERVES THE ENTIRE TRI-STATE REGION. THE SECONDARY SERVICE IS DETERMINED BASED ON CURRENT REFERRAL PATTERNS.THE PRIMARY REFERRAL SOURCES FOR ADMISSIONS CONTINUE TO BE THE ACUTE CARE HOSPITALS. CURRENTLY 85% OF ADMISSIONS ARE REFERRED BY HOSPITALS LOCATEDWITHIN THE BOROUGHS OF NEW YORK CITY, ROCKLAND, AND WESTCHESTER COUNTIES, LONG ISLAND, AND THE STATES OF NEW JERSEY AND CONNECTICUT. OTHER REFERRALSOURCES ARE CALVARY HOSPITAL HOME CARE, HOSPICE, AND OTHER HOME CARE AND HOSPICE AGENCIES. CALVARY OUTPATIENT SERVICES, FAMILIES, PHYSICIANS,NURSING HOMES, AND COMMUNITY AGENCIES.IN 2001, CALVARY EXPANDED ITS SERVICES WITH THE OPENING OF CALVARY HOSPITAL - THE BROOKLYN CAMPUS, AT LUTHERAN MEDICAL CENTER. | ||
| NY | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 0 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SCOTT LARUE | ||||||||||||||
| DIRECTOR | 0 | 561169 | 0 | 89300 | 0 | 0 | 0 | 177900 | 0 | 24122 | 0 | 852491 | 0 | 89300 |
| MICHAEL J BRESCIA MD | ||||||||||||||
| EXECUTIVE MEDICAL DIRECTOR | 373746 | 0 | 9425 | 0 | 65355 | 0 | 16170 | 0 | 8235 | 0 | 472931 | 0 | 0 | 0 |
| FRANK A CALAMARI | ||||||||||||||
| PRESIDENT/ EXECUTIVE DIREC | 433358 | 0 | 11000 | 0 | 488287 | 0 | 27570 | 0 | 10848 | 0 | 971063 | 0 | 0 | 0 |
| CHRISTOPHER COMFORT MD | ||||||||||||||
| MED DIRECTOR | 331393 | 0 | 8450 | 0 | 61528 | 0 | 27570 | 0 | 24727 | 0 | 453668 | 0 | 0 | 0 |
| RICHARD KUTILEK | ||||||||||||||
| CHIEF OPERATIONS OFFICER | 256105 | 0 | 6600 | 0 | 255250 | 0 | 27570 | 0 | 19079 | 0 | 564604 | 0 | 0 | 0 |
| ANDREW V GRECO | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 242366 | 0 | 6250 | 0 | 13745 | 0 | 27570 | 0 | 25511 | 0 | 315442 | 0 | 0 | 0 |
| SALLY UMBRO RN | ||||||||||||||
| VP FOR PATIENT CARE SERVIC | 215331 | 0 | 5469 | 0 | 4091 | 0 | 24758 | 0 | 16860 | 0 | 266509 | 0 | 0 | 0 |
| ANTHONY TARANTO | ||||||||||||||
| ASST. ADMIN. ENVIRONMENT C | 163735 | 0 | 4159 | 0 | 9265 | 0 | 21607 | 0 | 24727 | 0 | 223493 | 0 | 0 | 0 |
| NANCY D'AGOSTINO RN | ||||||||||||||
| DIRECTOR HOME CARE/HOSPICE | 216073 | 0 | 5458 | 0 | 4017 | 0 | 25257 | 0 | 24726 | 0 | 275531 | 0 | 0 | 0 |
| SREENIVASA PATIBANDLA MD | ||||||||||||||
| STAFF PHYSICIAN | 164908 | 0 | 4123 | 0 | 203684 | 0 | 27570 | 0 | 0 | 0 | 400285 | 0 | 0 | 0 |
| ALMA CARRINGTON MD | ||||||||||||||
| ATTENDING PHYSICIAN | 211132 | 0 | 5359 | 0 | 52314 | 0 | 27570 | 0 | 8348 | 0 | 304723 | 0 | 0 | 0 |
| ROBERT BRESCIA MD | ||||||||||||||
| DIRECTOR PAL CR | 298206 | 0 | 7650 | 0 | 19098 | 0 | 27570 | 0 | 12248 | 0 | 364772 | 0 | 0 | 0 |
| DEVMANI JAITLY MD | ||||||||||||||
| ATTENDING PHYSICIAN | 244414 | 0 | 5573 | 0 | 244655 | 0 | 27570 | 0 | 24727 | 0 | 546939 | 0 | 0 | 0 |
| GAIL CHRZANOWSKI MD | ||||||||||||||
| ATTENDING PHYSICIAN | 219706 | 0 | 5573 | 0 | 70609 | 0 | 27570 | 0 | 16579 | 0 | 340037 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | EFFECTIVE JUNE 1, 1998, THE HOSPITAL ESTABLISHED THE CALVARY HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO PROVIDE PENSION BENEFITS FOR WAGES EARNED BY CERTAIN PHYSICIANS AND SENIOR EXECUTIVE STAFF WITH COMPENSATION IN EXCESS OF THE IRS LIMITS AND ALSO ESTABLISHED THE CALVARY HOSPITAL KEY EMPLOYEE SHARE OPTION PLAN (KEYSOP) TO PROVIDE ADDITIONAL AND ALTERNATIVE FORMS OF COMPENSATION TO KEY EMPLOYEES. PRIOR TO 2002, THE HOSPITAL UTILIZED THE KEYSOP TO FUND THE SERP. AS A RESULT OF THE IRS 457 REGULATIONS WHICH WERE ISSUED DURING 2002, THE UTILIZATION OF THE KEYSOP TO FUND THE SERP BECAME UNFEASIBLE. AFTER CONSIDERATION OF VARIOUS REPLACEMENT OPTIONS, IN 2003, CALVARY HOSPITAL CHOSE THE TAX GROSS-UP OPTION, WHEREBY, INDIVIDUAL PARTICIPANTS' DEFERRALS WOULD BE GROSSED-UP TO DUPLICATE THE BENEFITS HE WOULD RECEIVE IN A TAX-DEFERRED ARRANGEMENT AND PAID THEM OUT DIRECTLY TO THE PARTICIPANTS. THE FOLLOWING EXECUTIVES RECEIVED TAX GROSS-UP PAYMENTS IN 2010 IN ORDER TO DUPLICATE A TAX DEFERRED VEHICLE: (THE AMOUNTS WERE CALCULATED BY DELOITTE CONSULTING LLP UTILIZING EXPECTED TAX RATES TO CALCULATE THE NET AMOUNTS.) THE FOLLOWING TAX EXECUTIVES ALSO RECEIVED KEYSOP DIVIDENDS AS TAX GROSS-UP PAYMENTS IN 2012: - FRANK A. CALAMARI - RICHARD KUTILEK THE ORGANIZATION PROVIDED SOCIAL CLUB DUES IN 2012 FOR FRANK CALAMARI AND THE DUES WERE INCLUDED AS TAXABLE COMPENSATION. |
| PART I, LINE 4B | THE FOLLOWING CALVARY HOSPITAL OFFICERS PARTICPATE IN A NOW-DEFUNCT SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: FRANK CALAMARI, MICHAEL BRESCIA, AND RICHARD KUTILEK. SCHEDULE J, PART I, LINE 4B: SCOTT LARUE PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE CONTRIBUTED $16,500 TO THE PLAN IN 2012. |
| PART I, LINE 7 | THE FOLLOWING CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE EMPLOYEE RECEIVED A BOARD DISCRETIONARY BONUS IN THEIR 2012 W-2: - SCOTT LARUE, $89,300 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (12 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART I, LINE 1 | CALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALITY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCES CANCER PATIENTS IN THE UNITED STATES. |
| ADVANCED CANCER CARE INPATIENT | FORM 990, PART III, LINE 4A | CALVARY SERVES ABOUT 30% OF ALL INDIVIDUALS WHO DIE OF CANCER IN THE NEW YORK METROPOLITAN AREA EACH YEAR. PATIENTS ARE REFERRED TO CALVARY FROM EVERY MAJOR HOSPITAL AND MEDICAL CENTER IN NEW YORK CITY. IN 2012, CALVARY CARED FOR MORE THAN 5,300 PATIENTS AND FAMILIES AS INPATIENTS IN OUR 200-BED BRONX CAMPUS AND OUR 25-BED SATELLITE AT LUTHERAN MEDICAL CENTER IN BROOKLYN, AS OUTPATIENTS, THROUGH OUR CENTER FOR CURATIVE AND PALLIATIVE WOUND CARE; AND THROUGH HOSPICE AND HOME CARE. THE AVERAGE LENGTH OF INPATIENT STAY IS 25.4 DAYS. |
| HOSPICE PROGRAM | FORM 990, PART III, LINE 4B | CALVARY HOSPITAL HOSPICE IS A MEDICARE-CERTIFIED HOSPICE PROGRAM, WHICH PROVIDES AN INTERDISCIPLINARY CARE TEAM FOR PATIENTS WITH A TERMINAL PROGNOSIS FOR ALL END-STAGE DISEASES. CALVARY HOSPITAL HOSPICE EMBRACES AND IMPLEMENTS THE BASIC ASSUMPTIONS OF THE HOSPICE CONCEPT, INCLUDING THE FOLLOWING: - HOSPICE PROVIDES PALLIATIVE MEDICAL CARE, TREATING THE PHYSICAL, EMOTIONAL AND SPIRITUAL PAIN OF THE PATIENT AND FAMILY. - HOSPICE TREATS THE PATIENT AND LOVED ONES TOGETHER AS A WHOLE UNIT OF CARE AND OFFERS BEREAVEMENT COUNSELING FOR SURVIVING CAREGIVERS AFTER THE PATIENT'S DEATH. - HOSPICE PATIENTS REMAIN IN THE FAMILIAR, COMFORTING SURROUNDINGS OF HOME, WHETHER IT'S A PRIVATE RESIDENCE, NURSING HOME, HOSPITAL OR AN ASSISTED LIVING FACILITY. - HOSPICE CARE PROVIDES THE FOLLOWING FOUR LEVELS OF CARE: ROUTINE CARE, GENERAL INPATIENT CARE (IF NEEDED), CONTINUOUS CARE (DURING A CRISIS), AND RESPITE CARE. HOSPICE SERVICES - NURSING CARE, AS NECESSARY TO MAINTAIN THE PATIENT AT HOME - 24 HOURS A DAY, 7 DAYS A WEEK ON-CALL NURSE PHYSICIAN SERVICES - MEDICAL SOCIAL SERVICES - PASTORAL CARE - COUNSELING SERVICES - NUTRITIONAL COUNSELING - SHORT-TERM INPATIENT AND RESPITE CARE - MEDICAL SUPPLIES RELATED TO TERMINALLY ILL - PERSONAL CARE PROVIDED BY CERTIFIED HOME HEALTH AIDES - THERAPIES (E.G., PHYSICAL, OCCUPATIONAL AND SPEECH) - MEDICATIONS FOR SYMPTOM MANAGEMENT AND PAIN CONTROL RELATED TO THE TERMINALLY ILL - BEREAVEMENT COUNSELING FOR FAMILY MEMBERS - VOLUNTEER SERVICES |
| HOMECARE PROGRAM | FORM 990, PART III, LINE 4C | CALVARY'S HOME HEALTH AGENCY SERVES PATIENTS IN THE BRONX, QUEENS, NORTHERN MANHATTAN, AND SOUTHERN WESTCHESTER COUNTY. CALVARY OFFERS HOME CARE TO PATIENTS WITH ALL DIAGNOSES. MOST PATIENTS RETURN TO PRE-ILLNESS FUNCTION AND ARE DISCHARGED TO SELF-CARE WITHIN SIX TO EIGHT WEEKS. ALL OF OUR PATIENTS WHO WE CARE FOR AT HOME GET THE SAME LEVEL OF HIGH-QUALITY AND UNIQUE "CALVARY CARE" AS ALL OF OUR INPATIENTS. THE FOLLOWING SERVICES ARE AVAILABLE TO PATIENTS AND THEIR FAMILIES THROUGH CALVARY'S CERTIFIED HOME HEALTH AGENCY: NURSING SERVICES - OUR COMMUNITY HEALTH NURSES PROVIDE NURSING VISITS TO PATIENTS IN THEIR HOMES. - SPECIALIZED NURSING IS AVAILABLE SUCH AS ENTEROSTOMAL THERAPY. - 24-HOUR TELEPHONE ACCESS TO RN (REGISTERED NURSE) ON-CALL. HOME HEALTH AIDE - PROVIDES ASSISTANCE WITH PERSONAL CARE AND OTHER ACTIVITIES RELATED TO HEALTH CARE. NUTRITIONAL SERVICES - CALVARY'S DIETITIANS ARE AVAILABLE BY PHONE TO HELP IN PLANNING THERAPEUTIC NUTRITIONAL MANAGEMENT. THERAPY SERVICES - PHYSICAL THERAPY - OCCUPATIONAL THERAPY - SPEECH THERAPY MEDICAL CARE - CALVARY HOME CARE STAFF WILL WORK CLOSELY WITH THE PATIENT'S OWN PHYSICIAN TO MEET HOME HEALTH NEEDS. - OUR STAFF HAS EXTENSIVE KNOWLEDGE OF PAIN MANAGEMENT. MEDICAL SOCIAL WORK A FULL RANGE OF SOCIAL WORK SERVICES ARE AVAILABLE TO HELP PATIENTS AND FAMILIES COPE WITH THE PROBLEMS OF ILLNESS. - ASSISTANCE IN MEDICAID APPLICATION - ASSISTANCE IN LONG-TERM PLANNING REFERRING PATIENTS - REFERRALS MAY BE MADE BY PATIENTS FAMILY MEMBERS, FRIENDS, HOSPITALS, CLINICS, PHYSICIANS, OTHER HEALTH CARE PROFESSIONALS AND COMMUNITY AGENCIES. - TO MAKE A REFERRAL OR TO LEARN MORE ABOUT OUR SERVICES, PLEASE CALL (718) 430-9540. PART OF THE CALVARY CONTINUUM FACILITATE ADMISSION TO INPATIENT CARE FOR SYMPTOM MANAGEMENT - REFERRAL TO OUTPATIENT AND WOUND CARE CLINICS - PROVIDE INFORMATION ON CALVARY PROGRAMS INCLUDING BEREAVEMENT SUPPORT |
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF CALVARY HOSPITAL IS ARCHCARE. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CALVARY HOSPITAL BYLAWS RESERVE CERTAIN RIGHTS TO ARCHCARE AS THE SOLE MEMBER OF THE HOSPITAL. THESE RIGHTS ARE ENUMERATED IN ARTICLE IV AND INCLUDE THE RIGHT TO AMEND THE HOSPITAL'S BYLAWS AND ORGANIZING DOCUMENTS, APPOINT AND REMOVE BOARD MEMBERS AND APPROVE CERTAIN DECISIONS OF THE HOSPITAL'S BOARD OF DIRECTORS, INCLUDING BUT NOT LIMITED TO, THE ADOPTION OF A STRATEGIC PLAN, ACQUISITION OF ANOTHER ORGANIZATION, REAL ESTATE TRANSACTIONS EXCEEDING A CERTAIN DOLLAR THRESHOLD, ADOPTION OF CRITERIA FOR MANAGED CARE CONTRACTING, AND ADOPTION OF SYSTEM-WIDE MEASURES. | |
| FORM 990, PART VI, SECTION A, LINE 7B | ARCHCARE HAS THE FOLLOWING POWERS AND RIGHTS WHICH ARE VESTED IN ARCHCARE BY LAW, THE CERTIFICATE OF INCORPORATION AND THE HOSPITAL BYLAWS. SUCH POWERS AND RIGHTS INCLUDE AMENDMENT TO THE BYLAWS AND CERTIFICATE OF INCORPORATION OF THE HOSPITAL, APPOINTMENT AND REMOVAL OF THE MEMBERS OF THE BOARD OF DIRECTORS AND THE CHAIRMAN OF THE BOARD OF DIRECTORS OF THE HOSPITAL, ADOPTION OF THE HOSPITAL BUDGETS, ADOPTION OR AMENDMENT OF THE BUSINESS AND STRATEGIC PLAN EN TITY, CERTAIN REAL ESTATE AND CAPITAL TRANSACTIONS AND APPROVAL OF MANAGEMENT CONTRACTS SUBJECT TO AGREED-UPON THRESHOLDS, PROGRAM OR SERVICE CHANGES BY THE HOSPITAL, APPROVAL OF ANY MERGER, PURCHASE, JOINT OPERATING AGREEMENT OR OTHER AFFILIATION OR WITHDRAWAL FROM, DISPOSITION OF AN INTEREST IN OR DISSOLUTION OF ANY SUCH AFFILIATION. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 2012 FORM 990 OF CALVARY HOSPITAL WAS PREPARED BY DELOITTE TAX WITH THE ASSISTANCE OF CALVARY ACCOUNTING PERSONNEL. THE DRAFT OF FORM 990 WAS REVIEWED BY DELOITTE TAX, THE CONTROLLER AND CFO OF CALVARY HOSPITAL BEFORE DISTRIBUTION OF THE FULL VERSION OF THE FINAL DRAFT TO THE BOARD. A COPY OF THE FORM 990 DRAFT WAS PROVIDED TO EACH MEMBER OF THE CALVARY HOSPITAL BOARD OF DIRECTORS ON 11/5/13 PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE IN ELECTRONIC FORMAT | |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH OFFICER, DIRECTOR, TRUSTEE AND KEY EMPLOYEE IS REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THAT ARISE BY VIRTUE OF THEIR EMPLOYMENT AND POSITION WITH CALVARY HOSPITAL OR CALVARY FUND. CALVARY MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL QUESTIONNAIRE SUBMITTED TO THESE INDIVIDUALS. POTENTIAL CONFLICTS ARE INVESTIGATED IMMEDIATELY AND, IF ANY ARE UNCOVERED, THERE ARE POLICIES IN PLACE TO ENSURE THAT THOSE INDIVIDUALS RECUSE THEMSELVES FROM PARTICIPATING IN ANY DECISIONMAKING RELATED TO SUCH CONFLICT. | |
| FORM 990, PART VI, SECTION B, LINE 15 | CALVARY HOSPITAL, INC UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS TO ITS TOP MANAGEMENT OFFICIALS AND ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS REASONABLE. IN RELEVANT PART, THE BOARD OF DIRECTORS HAS ESTABLISHED A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN THE PROPOSED COMPENSATION ARRANGEMENT. THE BOARD OF DIRECTORS USES AN INDEPENDENT COMPENSATION CONSULTANT TO HELP ADVISE ON THE APPROPRIATE COMPENSATION LEVELS FOR THE AFOREMENTIONED INDIVIDUALS. THAT COMPENSATION CONSULTANT WILL USE COMPARABILITY OR BENCHMARKLNG DATA (BASED ON INDUSTRY SURVEYS) THAT DOCUMENTS THE COMPENSATION OF PERSONS HOLDING SIMILAR PERSONS IN SIMILAR ORGANIZATIONS. ONCE THE COMPENSATION CONSULTANT HAS MADE ITS RECOMMENDATIONS, THE CALVARY COMPENSATION COMMITTEE MUST APPROVE THE COMPENSATION, WITHOUT INPUT OR VOTING PARTICIPATION BY THE PERSON WHOSE COMPENSATION IS BEING APPROVED OR BY ANY OTHER INDIVIDUAL WITH A CONFLICT OF INTEREST THE FINAL DETERMINATION IS THEN DOCUMENTED IN COMMITTEE MINUTES THOSE MINUTES WILL CONTAIN THE TERMS OF THE PROPOSED COMPENSATION, THE DECISIONS OF THOSE INDIVIDUALS WHO VOTED ON THE COMPENSATION, AND THE COMPARABILITY DATA THAT WAS RELIED UPON. | |
| FORM 990, PART VI, SECTION C, LINE 19 | CALVARY HOSPITAL MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC BY RETAINING A COPY AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION. | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL TRUST 136,000. PENSION-RELATED ADJUSTMENTS -859,300. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|
| CALVARY PALLIATIVE CARE NETWORK LLC | ||||
| 1740 EASTCHESTER ROAD | BRONX | NY | 10461 | NY |
| NETWORK INDEPENDENT PRACTICE ASSOCIATION | ||||
| 1740 EATCHESTER ROAD | BRONX | NY | 10461 | NY |
| CALVARY NETWORK MANAGEMENT SERVICES LLC | ||||
| 1740 EASTCHESTER ROAD | BRONX | NY | 10461 | NY |
Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|
| CALVARY FUND INC | |||||||
| 1740 EASTCHESTER ROAD | BRONX | NY | 10461 | NY | 501(C)(3) | LINE 11, TYPE I: 509 | 0 |
| CALVARY HOLDING COMPANY | |||||||
| 1740 EASTCHESTER ROAD | BRONX | NY | 10461 | NY | 501(C)(3) | LINE 9: 509(A)(2) | 0 |
| ARCHCARE | |||||||
| 155 EAST 56TH STREET FLOOR 2 | NEW YORK | NY | 10022 | NY | 501(C)(3) | LINE 9: 509(A)(2) | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Comments