FURP.ORG / PUBLIC DATA EXPLORER

SAMARITAN HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
SAMARITAN HOSPITAL (EIN 14-1338544)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201323199349307822
Schema version
2012v2.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T14:35:08-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN861065772EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11700 MARKET STREET 25TH FLOORAddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code191033984ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN141338544EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Samaritan HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSAMANameControl
Phone5182715073Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12215 Burdett AvenueAddressLine1
CityTroyCity
StateNYState
ZIP Code12180ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDaniel KochieName
TitleCFO Acute Care TroyTitle
Phone5182715073Phone
Date Signed2013-11-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWilliam J HomerName
PTINP00994519PTIN
Phone2152462300Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonNorman DascherNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12215 Burdett AvenueAddressLine1
CityTroyCity
StateNYState
ZIP Code12180ZIPCode
FieldValueIRS element (for citing)
Gross Receipts139575978GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.nehealth.comWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1898YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionSamaritan Hospital's mission is to improve the health of the community by providing high quality, cost effective inpatient, outpatient, primary care and community outreach services with an emphasis on patient safety and satisfaction.ActivityOrMissionDescription
Nbr Voting Members Governing Body40NbrVotingMembersGoverningBody
Nbr Independent Voting Members32NbrIndependentVotingMembers
Total Nbr Employees1839TotalNbrEmployees
Total Nbr Volunteers256TotalNbrVolunteers
Total Gross UBI1610663TotalGrossUBI
Net Unrelated Business Txbl Income396062NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year1747709ContributionsGrantsPriorYear
Contributions Grants Current Year1589288ContributionsGrantsCurrentYear
Program Service Revenue Prior Year124301754ProgramServiceRevenuePriorYear
Program Service Revenue CY125084680ProgramServiceRevenueCY
Investment Income Prior Year198786InvestmentIncomePriorYear
Investment Income Current Year4122421InvestmentIncomeCurrentYear
Other Revenue Prior Year2429712OtherRevenuePriorYear
Other Revenue Current Year6311801OtherRevenueCurrentYear
Total Revenue Prior Year128677961TotalRevenuePriorYear
Total Revenue Current Year137108190TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year66836811SalariesEtcPriorYear
Salaries Etc Current Year70603724SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year56602508OtherExpensePriorYear
Other Expenses Current Year54176337OtherExpensesCurrentYear
Total Expenses Prior Year123439319TotalExpensesPriorYear
Total Expenses Current Year124780061TotalExpensesCurrentYear
Revenues Less Expenses Prior Year5238642RevenuesLessExpensesPriorYear
Revenues Less Expenses CY12328129RevenuesLessExpensesCY
Total Assets BOY128016469TotalAssetsBOY
Total Assets EOY139898444TotalAssetsEOY
Total Liabilities BOY39597072TotalLiabilitiesBOY
Total Liabilities EOY40790759TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY88419397NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY99107685NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTo provide a high-quality, accessible continuum of healthcare, supportive housing and community services.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense29343136Expense
Revenue48377096Revenue
Description238 (certified) bed acute facility providing inpatient services including medical, surgical, progressive care, intensive care and coronary care.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense26917332Expense
Revenue22929809Revenue
DescriptionDiagnostic treatment and ancillary services including laboratory, blood bank,diagnostic imaging, nuclear medicine, pharmacy, respiratory, physical medicine, audiology and speech.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense24083613Expense
Revenue17845208Revenue
DescriptionOutpatient and community outreach services including emergency room, cancer treatment, primary care preventive health care and injury management services.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense14496793Expense
Revenue39788348Revenue
DescriptionSurgical servcies including operating room, anesthesiology and post anesthesia care provided to patients on both an inpatient and outpatient basis.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp14496793TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev39788348TotalOfOtherProgramServiceRev
Total Program Service Expense94840874TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person1GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109697NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1839NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members40NbrVotingGoverningBodyMembers
Number Independent Voting Members32NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Daniel KochieBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5182685757TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12215 Burdett AveAddressLine1
CityTroyCity
StateNYState
ZIP Code12180ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (52 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
Altes Jane PHD
Trustee0.5014.50X000
Boyle Steven
Trustee, CEO1.0036.50X096035314641X
Bylancik Robert J
Trustee0.5014.50X0500000
Cartwright Mark
Trustee0.5014.50X000
Cortell Barbara
Trustee0.5014.50X000
Dake Susan
Trustee0.5014.50X000
DiSarro Ann
Trustee0.5014.50X000
Doyle Rev Kenneth
Trustee0.5014.50X000
Filippone John MD
Trustee0.5014.50X000
Foley William J PHD
Trustee0.5014.50X000
Fortune Robert
Trustee0.5014.50X000
Goldberg Alan
Trustee0.5014.50X000
Gordon Harold Esq
2nd Vice0.5014.50X000
Guzior Ronald L
Trustee0.5014.50X000
Hearst George
Trustee0.5014.50X000
Herbert Sr Phyllis
Trustee0.5014.50X000
Johnson Robert W III Esq
Co-Chair0.5014.50X000
Jones Sydney Tucker III
Co-Chair0.5014.50X000
Karpiak Beverly
Trustee0.5014.50X000
Keegan Michael
Treasurer0.5014.50X000
Lang John M
Trustee0.5014.50X000
Massry Norman
Trustee0.5014.50X000
Natwin Sr Kathleen
Trustee0.5014.50X000
Nowak Thomas
Trustee0.5014.50X000
Opalka Chester
Trustee0.5014.50X000
Oster Russell
Trustee0.5014.50X000
Philip George
1st Vice Chair0.5014.50X000
Powell Curtis
Trustee0.5014.50X000
Puleo James H MD
Trustee0.5014.50X000
Puleo James V MD
Trustee0.5014.50X000
Reed James K MD
Trustee, President1.5036.00X081028737905X
Robinson Harry Esq
Trustee0.5014.50X000
Rosenberg Stuart MD
Trustee0.5014.50X000
Sanders Alan MD
Trustee0.5014.50X000
Slavin James MD
Trustee0.5014.50X000
Somerville Sr Jane
Trustee0.5014.50X000
Tartaglia Anthony P MD
Secretary0.5014.50X000
Thorn Lisa MD
Trustee0.5014.50X000
Turley Sr Kathleen
Trustee0.5014.50X000
Tyrrell Thomas
Trustee0.5014.50X000
Gavin James
CFO1.0036.500387863159110X
Schuhle Thomas
CFO1.0036.50041345927530X
Dascher Norman
Exec. VP Acute Care Troy19.3018.30449031019321X
Silverman Daniel
CMO-Acute Care Troy19.3018.30289640023738X
Kochie Daniel
CFO-Acute Care Troy18.8018.80029612347367X
Brodbeck Kathy
Exec. VP, CNO1.0036.500332151116131X
Priore Jacquiline
CNO37.5015476506375X
Biguzzi Sergio
Physician40.0035768509959X
Singh Vinita
Physician40.00320401023041X
Field Gregory
Physician40.00338001024706X
Silk Yusuf
Physician40.00427824017650X
Gist Christorpher
Physician40.00502954018633X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2840301TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3250236TotalReportableCompFrmRltdOrgs
Total Other Compensation546107TotalOtherCompensation
Number Individuals GT100 K67NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
HMP of Samaritan PLLC
4535 Dressler Road NWCantonOH44718Medical Services1615082
Labcorp of America Holdings
PO Box 1214BurlingtonNC27216Laboratory Services1463730
Morrison Management Services
PO Box 102289AtlantaGA30368Food Management Services1225990
All About Staffing Inc
1000 Sawgrass Corporate Parkway 6tSunriseFL33323Patient Services1047992
Favorite Healthcare Staffing Inc
PO Box 803356Kansas CityMO64180Patient Services873454
FieldValueIRS element (for citing)
Number Of Contractors GT100 K22NumberOfContractorsGT100K
Related Organizations278479RelatedOrganizations
Government Grants1310809GovernmentGrants
Total Contributions1589288TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNet Patient RevenueDescription
Business Code621110BusinessCode
Total Revenue Column125084680TotalRevenueColumn
Related Or Exempt Function Income123474017RelatedOrExemptFunctionIncome
Unrelated Business Revenue1610663UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Total Program Service Revenue125084680TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4669459TotalRevenueColumn
Exclusion$4,669,459ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other1920750Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other2467788Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-547038Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-547038TotalRevenueColumn
Exclusion-$547,038ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
EMR Conversion90009926216072621607
All Other Revenue90009912341011051006$183,095
School of Nursing623000956014956014

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1500079TotalRevenueColumn
Related Or Exempt Function Income837817RelatedOrExemptFunctionIncome
Exclusion$662,262ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue6311801TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column137108190TotalRevenueColumn
Related Or Exempt Function Income128940461RelatedOrExemptFunctionIncome
Unrelated Business Revenue1610663UnrelatedBusinessRevenue
Exclusion$4,967,778ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2840301Total
Management And General2840301ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total57355365Total
Program Services48976866ProgramServices
Management And General8378499ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1611204Total
Program Services1311821ProgramServices
Management And General299383ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4530139Total
Program Services3688380ProgramServices
Management And General841759ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4266715Total
Program Services3473903ProgramServices
Management And General792812ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total6090212Total
Program Services809344ProgramServices
Management And General5280868ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total115271Total
Program Services54049ProgramServices
Management And General61222ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total8244Total
Program Services744ProgramServices
Management And General7500ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total9435581Total
Program Services8226685ProgramServices
Management And General1208896ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total269548Total
Program Services185395ProgramServices
Management And General84153ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total25158949Total
Program Services21272845ProgramServices
Management And General3886104ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3812548Total
Program Services1035623ProgramServices
Management And General2776925ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total187306Total
Program Services138171ProgramServices
Management And General49135ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total28400Total
Program Services21300ProgramServices
Management And General7100ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total6561808Total
Program Services4921356ProgramServices
Management And General1640452ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total743234Total
Management And General743234ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Other fees-for-service*602778164925862860
NYS Assessment42312842312800
Licenses/Permits3218031118852099180
Med School Contracts-SO11974411974400

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total297783Total
Program Services53143ProgramServices
Management And General244640ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total124780061Total
Program Services94840874ProgramServices
Management And General29939187ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY14396988BOY
EOY21257076EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY11580993BOY
EOY12222310EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1880633BOY
EOY1940981EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1174431BOY
EOY797857EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis148306024LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec110363656LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY39235210BOY
EOY37942368EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY35190677BOY
EOY36737329EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY9898976BOY
EOY16229634EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY14658561BOY
EOY12770889EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY128016469BOY
EOY139898444EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY14211764BOY
EOY13487636EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY437041BOY
EOY250181EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY24948267BOY
EOY27052942EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY39597072BOY
EOY40790759EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY84123342BOY
EOY94303357EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2302474BOY
EOY2819861EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1993581BOY
EOY1984467EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY88419397BOY
EOY99107685EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY128016469BOY
EOY139898444EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses12328129ReconcilationRevenueExpenses
Reconciliation Unrealized Invest49294ReconciliationUnrealizedInvest
Reconcilation Other Changes-1689135ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1993581BeginningOfYearBalance
Investment Earnings Or Losses-9114InvestmentEarningsOrLosses
End Of Year Balance1984467EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1968447BeginningOfYearBalance
Contributions25134Contributions
End Of Year Balance1993581EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1715442BeginningOfYearBalance
Contributions450849Contributions
Investment Earnings Or Losses-197844InvestmentEarningsOrLosses
End Of Year Balance1968447EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1522807BeginningOfYearBalance
Contributions-12300Contributions
Investment Earnings Or Losses204935InvestmentEarningsOrLosses
End Of Year Balance1715442EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1787938BeginningOfYearBalance
Contributions58330Contributions
Investment Earnings Or Losses-323461InvestmentEarningsOrLosses
End Of Year Balance1522807EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis281869OtherCostOrOtherBasis
Book Value281869BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis61861223OtherCostOrOtherBasis
Depreciation39474283Depreciation
Book Value22386940BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1896381OtherCostOrOtherBasis
Depreciation1326996Depreciation
Book Value569385BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis72480136OtherCostOrOtherBasis
Depreciation59590284Depreciation
Book Value12889852BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis11786415OtherCostOrOtherBasis
Depreciation9972093Depreciation
Book Value1814322BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings37942368TotalOfBookValueLandBuildings

Financial Derivatives FinancialDerivatives

FieldValueIRS element (for citing)
Book Value16229634BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Securities16229634TotalOfBookValueSecurities

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
Assets whose Use is Limited405285
Deferred Compensation Agreements224196
Due to/from Affiliates1047160
Goodwill200000
Interest in Northeast Health Foundation1234318
Other Current Assets7363065
Rubin Dialysis Receivable1801489
Tuition Receivable495376
FieldValueIRS element (for citing)
Total Book Value Other Assets12770889TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (8 entries)

DescriptionDescriptionAmountAmount
Accrued Pension Liability$14,312,817
Asset Retirement Obligation$1,582,010
Deferred Compensation Payable$224,197
Due to Affiliates$419,601
Estimated Third-Party Settlements$7,799,321
A/R Credit$643,875
Malpractice/Worker's comp insurance$1,068,846
Other$1,002,275
FieldValueIRS element (for citing)
Total Of Amounts27052942TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDescription of Intended Use of Endowment Funds:Identifier
Return ReferencePart V, Line 4:ReturnReference
ExplanationThe endowment funds are invested and the investment realized gains are used for the ongoing operations of the hospital or the specific purpose identified by the donor.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense1800766TotalCommunityBenefitExpense
Net Community Benefit Expense1800766NetCommunityBenefitExpense
Percent Of Total Expense0.01440PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense8070773TotalCommunityBenefitExpense
Direct Offsetting Revenue7896775DirectOffsettingRevenue
Net Community Benefit Expense173998NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense17093746TotalCommunityBenefitExpense
Direct Offsetting Revenue14144194DirectOffsettingRevenue
Net Community Benefit Expense2949552NetCommunityBenefitExpense
Percent Of Total Expense0.02360PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense26965285TotalCommunityBenefitExpense
Direct Offsetting Revenue22040969DirectOffsettingRevenue
Net Community Benefit Expense4924316NetCommunityBenefitExpense
Percent Of Total Expense0.03940PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense136TotalCommunityBenefitExpense
Net Community Benefit Expense136NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1513677TotalCommunityBenefitExpense
Direct Offsetting Revenue1456798DirectOffsettingRevenue
Net Community Benefit Expense56879NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2193371TotalCommunityBenefitExpense
Direct Offsetting Revenue2055720DirectOffsettingRevenue
Net Community Benefit Expense137651NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense221880TotalCommunityBenefitExpense
Net Community Benefit Expense221880NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3929064TotalCommunityBenefitExpense
Direct Offsetting Revenue3512518DirectOffsettingRevenue
Net Community Benefit Expense416546NetCommunityBenefitExpense
Percent Of Total Expense0.00340PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense30894349TotalCommunityBenefitExpense
Direct Offsetting Revenue25553487DirectOffsettingRevenue
Net Community Benefit Expense5340862NetCommunityBenefitExpense
Percent Of Total Expense0.04280PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,576,366BadDebtExpenseAmount
Amount Attributable To81016AmountAttributableTo
Amount Reimbursed By Medicare21988528AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare27908800CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5920272MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost Accounting SystemXCostAccountingSystem
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Samaritan HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12215 Burdett AveAddressLine1
CityTroyCity
StateNYState
ZIP Code12180ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Samaritan HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent100.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities6NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
1 Cohoes Family Care
95 Remsen StreetCohoesNY12047Primary Care Center
Family Medical Group
279 Troy Road Route 4RensselaerNY12144Primary Care Center
Riverside Family Medical Group
35 Lower Hudson AveGreen IslandNY12183Primary Care Center
South Troy Health Center
300 Fourth StreetTroyNY12180Primary Care Center
Waterford Health Center
158 Saratoga AvenueWaterfordNY12188Primary Care Center
Continuing Treatment Services
1801 Sixth AvenueTroyNY12180Outpatient Continuing Treatment Svc/MICA

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 3c: Samaritan Hospital's financial assistance policy uses the Federal Poverty Guidelines to determine eligibility, and does not use an asset test.
Part I, Line 6a: The community benefit report, in the form of a document entitled "Community Service Plan - Comprehensive Three-Year Plan," was prepared by Northeast Health, Inc., a related organization that controls Samaritan Hospital.
Part I, Line 7: Samaritan Hospital utilized the same methodology required by the NYS Institutional Cost Report. This methodology requires the Hospital to use a cost-to-charge ratio (from the annual Medicare Cost Report) to calculate (at cost) uncollected amounts attributable to services provided to unisured patients found to be eligible for financial aid as well as uncollected co-insuarnace and deductibles for insured patients found to be eligible for financial aid. Samaritan Hospital used its internal cost accounting system to calculate the amounts used in the table. The Hospital's cost accounting system includes all operations and service lines the hospital offers and includes all payor groups with detail for Medicare, Medicaid, Commercial Insurers, HMO's, Managed Care Plans, Private Insurance, Self Pay, etc.
Part I, Line 7g: Samaritan Hospital reported costs of $2,193,371 for the operation of primary care clinics. These costs are net of Medicaid and other means-tested government programs, charity care and bad debt.
Part I, L7 Col(f): Samaritan Hospital used the step-down costs as reported in our 2012 Medicare Cost Report to calculate the costs for the School of Nursing program costs reported on line 7f.
Part III, Line 2:In order to determine the Hospital's bad debt expense at cost for Part III, line 2, we first identified what portion of the bad debt was inpatient and what portion was outpatient. We then applied the appropriate cost-to-charge ratio (I/P or O/P) as reported in our 2012 Medicare Cost Report to the bad debt expense amounts (I/P and O/P) to determine bad debt expense at cost.Account balances on patient accounts are transferred to bad debt accounts receivable once they are determined to be uncollectible. The balances are net of discounts, adjustments and payments that have been applied to these accounts.Part III, Line 3:The Hospital's estimate of bad debt expense at cost attributable to patients that may have been eligible under organization's charity care policy, but for whom sufficient information was unable to be obtained in order to make a determination, is based on the following: - We took the accounts with incomplete applications for charity care and researched each account to see what amount, if any, was transferred to bad debt and multiplied that amount by the appropriate ratio of cost to charges (RCC) to calculate the bad debt at cost. - Accounts with incomplete applications that actually had balances transferred to bad debt were considered to have qualified for charity care because, had these patients completed the process, they would have qualified as, in all likelihood, they did not have the means to pay what was owed.Part III, Line 4:The combined financial statements for Northeast Health, Inc. and Affiliates (which includes Samaritan Hospital), contain the following note regarding bad debt expense:The Affiliates grant credit without collateral to patients, most of whom are local residents and are insured under third-party agreements. Additions to the allowance for estimated uncollectible accounts are made by means of the provision for bad debts. Accounts written off as uncollectible are deducted from the allowance and subsequent recoveries are added. The amount of the provision for bad debts is based upon management's assessment of historical and expected net collections, business and economic conditions, trends in Federal and state governmental health care coverage and other collection indicators. Services rendered to individuals when payment is expected and ultimately not received are written off to the allowance for estimated uncollectible accounts.
Part III, Line 8: Samaritan Hospital used its internal cost accounting system to calculate the amounts used in the table. The Hospital's cost accounting system includes all operations and service lines the hospital offers and includes all payor groups with detail for Medicare, Medicaid, Commercial Inurers, HMO's, Managed Care Plans, Private Insurance, Self Pay, etc.The Shortfall on Part III, Line 7 represents the difference between the revenue related to Medicare patients (including revenue received for DSH and other pass-through reimbursements) and the costs associated with providing these services.
Part III, Line 9b: If a patient qualifies for financial assistance, their account will not be subject to the usual collection practices during this process. If the patient does not submit the necessary documentation within 90 days, then their account could be forwarded to collections.
Part V, Section B, Line 20d: The hospital used its negotiated commercial insurance rate negotiated with its highest volume commercial payer as allowed by NYS PBH Law section 2807-k(9).Samaritan Hospital
Part VI, Line 2: The organization, as a component of the Northeast Health system, has been a participant in the Healthy Capital District Initiative ("HCDI") since 1999. Other participants include all hospitals, county health departments and payers in the Albany, Rensselaer and Schenectady counties. Recently, HCDI undertook a three-pronged initiative to engage the public and assess community need. The three efforts consisted of:1. The collection and analysis of data in the Community Health Profile;2. The production of a Community Health Forum broadcast by the local PBS affiliate; and3. The collection of data using an online Community Health Survey to assess respondents' opinions on the health of the Capital District.Through the HCDI process, consideration of the New York State Commissioner of Health's ten public health priorities, and through other local efforts to obtain additional community input, Northeast Health developed health services priorities contained in its Community Service Plan.
Part VI, Line 3: In addition to posting Samaritan Hospital's financial assistance policy on the hospital's website, Samaritan Hospital physically posts the policy at almost all inpatient and outpatient intake desks. All registration personnel are trained to know the procedures for assisting patients who have no insurance. Samaritan Hospital has also contracted with a firm that supplies the services of a Medicaid enroller "on-site".
Part VI, Line 4: General DescriptionSamaritan Hospital is part of the Northeast Health network, a regional, comprehensive, not-for-profit provider of health care and community services. Northeast Health was formed in 1995 by the merger of Samaritan Hospital and The Eddy, joined by Albany Memorial Hospital in 1997 and Sunnyview Rehabilitation Hospital in 2007. The components of Northeast Health are deeply rooted in their communities, each with a long tradition of providing high quality care and services.Serving 22 counties in the greater Capital Region of Upstate New York, Northeast Health cares for approximately 175,000 people each year and provides a vast array of senior care, hospital services, rehabilitation, specialty services and retirement living options. Our Primary Care Network offers a full range of medical, preventive and diagnostic services for people of all ages at nine locations throughout the region.Communities ServedSamaritan Hospital (238 beds) serves primarily the population of Albany and Rensselaer counties, New York. These contiguous counties (separated north to south by the Hudson River) contain 458,764 persons. Their populations are concentrated along the Hudson River in the cities of Albany, Cohoes, Rensselaer and Troy, which accounts for about 40% of the population. The balance of the population is dispersed among smaller cities, villages, suburbs and rural areas.Albany and Rensselaer counties have a fairly consistent demographic profile based on income, poverty and health insurance measures as illustrated below.Demographic Albany Rensselaer2010 Population 302,162 156,6022020 Population 307,201 158,579% Change 1.7% 1.3%2010 Households 125,729 62,3852020 Households 129,568 64,442% Change 3.1% 3.3% 2009 Median Household Income $53,317 $52,232Persons Below Poverty Level (2007 Estimate) 33,254 (11.7%) 15,898 (10.6%)Number of Medicaid Enrollees 2008 37,659 (12.5%) 21,767 (13.9%)Number of Uninsured (2007 Estimate) 33,550 (11.1%) 17,098 (10.9%)On a percentage basis, the communities are very similar for median income, poverty, Medicaid enrollees and the uninsured.Other HospitalsThere are four other hospitals in the two county area. Albany Medical Center Hospital (Albany) is a 600-bed tertiary care facility. St. Peter's Hospital (Albany) is a 450-bed tertiary care facility. Albany Memorial Hospital (Albany) is a 160-bed acute care general hospital, also part of the Northeast Health network. Seton Health System/St. Mary's Hospital (Troy), is a 190-bed acute care facility.Medically Underserved Areas / PopulationsEach of these counties has areas that are designated as medically underserved. In Rensselaer County, those parts of the City of Troy which border the Hudson River are designated as medically underserved populations (MUP). The City of Albany areas adjacent to the river are designated as a medically underserved area (MUA) Samaritan Hospital is located adjacent to the MUP and delivers services to that population through the Emergency Room and a Primary Care practice located within the MUP designated area.
Part VI, Line 5: In addition to its activities in delivering health care services to the community as described elsewhere in this filing, Samaritan Hospital furthers its exempt purposes through the following means:1. Samaritan Hospital is managed by a community board of directors, on which the substantial majority of directors are residents of the hospital's primary or secondary service area and who are neither employees nor contractors of the hospital;2. With certain departments which, in the interests of efficiency, quality and proper administration, are traditionally reserved to a single physician group having an exclusive arrangement with respect to the department (e.g., radiology, anesthesia, pathology, etc.), Samaritan Hospital maintains an open medical staff that extends privileges to all qualified physician applicants; and3. The organization generally applies all surplus funds to ensuring financially prudent availability of funds, capital maintenance and improvements, and the addition of services that benefit the community.In 2010 Northeast Health, the health system to which Samaritan Hospital belongs, entered into an affiliation agreement with St. Peter's Health Care Services, principally located in Albany, and Seton Health System, principally located in Troy, under which the parties formed a new not-for-profit entity that will become the parent of the constituent systems. The parties consummated the affiliation transaction in the fall of 2011. The affiliation parties believe that by combining their complementary strengths, they can significantly improve their ability to meet the healthcare needs of the region through more coordination, improved efficiency, reduced fragmentation of care, and improved access for the poor and underserved people in the Capital Region and beyond. The affiliation will better position the parties to address such challenges and to meet the needs of the community.
Part VI, Line 6: Samaritan Hospital is affiliated with Northeast Health, a network of healthcare, supportive housing and community services. The affiliation furthers Samaritan Hospital's ability to promote health care in many ways. Northeast Health affiliation helps ensure Samaritan Hospital's financial stability through reduced administrative overhead costs, access to capital and supply chain management, among other things. Samaritan Hospital's affiliation with Northeast Health also enables greater collaboration with affiliated hospitals and other providers of services. In addition to sharing policies and procedures and ideas for best operational and management practices, system affiliates participate jointly in quality improvement activities. The Northeast Health Board Quality Committee oversees quality improvement activities in the system's acute care hospitals, rehabilitation hospital, skilled nursing facilities, primary care network, visiting nurse and community service programs, adult housing and program for all-inclusive care for the elderly ("PACE" program). Through this committee and other joint activities, the system seeks to ensure collaboration on quality initiatives among varied provider types. For example, several quality initiatives commenced in 2009 are intended to lead to measurable improvements in patient care transitions between hospitals, nursing homes, home health and supportive housing. Northeast Health has also successfully deployed the Lean Thinking and Tools developed by the Toyota Production System, in its integrated health care delivery system. This sophisticated system of process improvement is used by Northeast Health affiliates to improve and optimize managerial, operational and clinical processes. Samaritan Hospital's affiliation with Northeast Health has enabled it to adopt Lean Thinking and Tools with a degree of success unlikely to have been attained but for the affiliation. Lean Thinking and Tools have enabled Samaritan Hospital to provide better care and services to the community.
NYReports Filed With StatesPart VI, Line 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Boyle Steven
Trustee, CEO0528964034209408929501125003391097499400
Reed James K MD
Trustee, President056650801003940143385011250026655084819200
Gavin James
CFO017838207379901356820144226014884054697300
Schuhle Thomas
CFO0329632062253021574010369017161044098900
Dascher Norman
Exec. VP Acute Care Troy353068065247030716010956083650468352000
Silverman Daniel
CMO-Acute Care Troy25827003008001290084640152740313378000
Kochie Daniel
CFO-Acute Care Troy02764080720001251504033907028034349000
Brodbeck Kathy
Exec. VP, CNO0267964062848013390100797015334044828200
Priore Jacquiline
CNO15399100077404543018320161140000
Biguzzi Sergio
Physician356466000121908295016640367644000
Singh Vinita
Physician319987000414080350150060343442000
Field Gregory
Physician2942310435000270082180164880362707000
Silk Yusuf
Physician351343058707017774050000126500445474000
Gist Christorpher
Physician48577400017180050000136330521587000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part I, Line 1aSamaritan Hospital pays for the dues associated with CEO Norman Dascher's membership to a country club. All invoices are received by Samaritan Hospital. Mr. Dascher reimburses the organization for the personal use charges that are unrelated to dues, so that only the dues payments represent additional compensation to Mr. Dascher. The organization pays for business-related charges. Reimbursement for this benefit is covered by Samaritan Hospital's general expense reimbursement policy.
Part I, Line 3Compensation of the organization's top management officials: Steven Boyle and James Reed were compensated by CHE which used one or more of the following methods to establish compensation for these officials: - Compensation committee - Independent compensation consultant - Written employment contract - Compensation survey - Approval by the board or compensation committee On an annual basis, the organization uses an independent compensation consultant to review the salaries for other executives and ensure such salaries are consistent with market salaries paid to similarly situated executives. In addition, a compensation committee reviews this information annually and it is then approved by the board or compensation committee. Finally, executives receive a written letter outlining the specifics of their compensation.
Part I, Lines 4a-bPart I, Lines 4a-b: Line 4a: James Gavin received a severance payment in the amount of $118,268. Line 4b: Supplemental Executive Retirement Plan is provided to certain key executive employees. Contributions made to the plan on their behalf are vested and reflected in their compensation at the time of the contribution.

Schedule L IRS990ScheduleL

Form990 Schedule L Part III Form990ScheduleLPartIII

FieldValueIRS element (for citing)
Name Of Interested Person10 unnamed individualsNameOfInterestedPerson
Relationship With OrganizationCurrent or Former Director, Officer,or Key EmployeeRelationshipWithOrganization
Type Of Assistancecourtesy discountsTypeOfAssistance
Purpose Of AssistanceSee Part VPurposeOfAssistance

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Medical Liability Mutual Insurance Co
Director James K Reed, M.D. is a board member45083Aggregate premiums for general/professional liability insurance0
Times Union
George Hearst is a board member18000Advertising Employment0

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierSch L, Part III, Grants or Assistance Benefitting Interested Persons:Identifier
ExplanationItems described in this part of Schedule L are courtesy discounts for hospital services provided by the organization to interested persons. The names of such persons are not provided in order to protect their health information privacy, consistent with the privacy provisions of the federal Health Insurance Portability and Accountability Act of 1996, and implementing regulations, popularly known as HIPAA. The courtesy discounts are provided under two established hospital policies, one that provides a hospital services discount benefit to all employees of the organization and their dependents, and one that provides the same discount benefit to all current and former board members of the organization, and their dependents. In 2012, 10 interested persons listed on Form 990, Part VII received such benefits, none of whom received more than $600 in aggregate discounts.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VI, Section A, line 2Directors James H. Puleo, M.D. and James V. Puleo, M.D. have a family relationship.
Form 990, Part VI, Section A, line 6Northeast Health, Inc. is the sole member.
Form 990, Part VI, Section A, line 7aYes, Northeast Health, Inc. approves the appointment of the members of the governing body.
Form 990, Part VI, Section A, line 7bSt. Peter's Health Partners, Northeast Health, Inc, and/or Catholic Health East, may have limited reserve powers to approve decisions of the governing body.
Form 990, Part VI, Section B, line 11The organization took steps to educate management, members of the board and members of appropriate subcommittees of the board on the compliance requirements mandated by the Form 990. The Form 990 is reviewed by the Governance Committee of the Board of Trustees of St. Peter's Health Partners. The Board of Trustees is updated on all major areas included in the filing. In addition, the annual filing of Form 990 is provided to the entire Board of Trustees prior to filing.
Form 990, Part VI, Section B, line 12cThe organization had adopted CHE's Policy 103 prior to 11/27/12 and followed its own policy (SPHP Conflict of Interest) at yearend which sets forth the organization's conflict-of-interest policy and processes. Annually, all those serving the organization in a fiduciary capacity, including directors, officers and key employees receive a copy of the policy and annual disclosure statement to be completed. Disclosures of financial interest or other reportable circumstances as defined in the policy are submitted and reviewed by the organization's CEO and members of the board. Summary information is reported to the entire board and available to the board throughout the year as business comes before the board or management for action. The policy contains a continuing affirmative obligation on all affected individuals to disclose compensation or other circumstances throughout the year which may rise to the level of an actual or apparent conflict. The determination of whether a disclosed financial or other interest constitutes a conflict of interest is made by the board or an appropriate committee thereof comprised of dis- interested persons and without the participation of the affected individual except to respond to questions about the disclosure. The policy further addresses the procedure for the board's further consideration of the proposed transaction/matter without the participation of the affected person and the documentation of the proceedings. Lastly, the policy addresses potential disciplinary action for violations of the policy. The policy is available to the public upon request.
Form 990, Part VI, Section B, line 15The organization relies on CHE to determine compensation for the CEO and President of the organization. The CHE board has an independent committee review and approve all elements of remuneration for all disqualified parties, as well as other key management. The board/committee has an established compensation philosophy which details the objectives of market positioning and pay elements. The committee engages with external consultants to provide market data comparing the organization's roles to similarly sized health systems utilizing both title and job content comparisons. The committee reviews the market analysis, approves any salary adjustments for the executive population, considers both reasonableness and effectiveness of all remunerative programs and establishes the detailed performance expectations which are incorporated into the incentive plan. All of these discussions and decisions are documented through the provision of meeting minutes. The compensation of other officers and key employees of the organization are reviewed by an independent compensation consultant who reviews the salaries to ensure they are within market and market competitive. This is done on an annual basis, reviewed by either the organization's or a related organization's compensation committee and communicated to the other officers and key employees.
Form 990, Part VI, Section C, line 19Organizational Articles of Incorporation, Corporate Bylaws, governance policies believed to be of interest to the public, conflict-of-interest policy and IRS Form 990 are available upon request.
Form 990, Part XI, line 9:Capital Transfer -68,290. Contributions 780,357. Net Assets Released -257,488. Prepaid Pension Writedown -1,864,552. Other changes in net assets -279,162.Changes in Net Assets or Fund Balances:
Disclosure Statement Related to Form 5471 Filed by Catholic Health East and Saint Michael's Medical Center Under the constructive ownership rule of Internal Revenue Code Sections 318(a) and 958(b), the organization is required to file Form 5471, Information Return of U.S. Persons With Respect to Certain Foreign Corporations, as a Category 4 and/or Category 5 filer with respect to Stella Maris Insurance Company Limited and Chestnut Risk Services, LTD (collectively, the "foreign corporations"). This filing requirement is, or will be, satisfied through the filing of Forms 5471 with respect to the foreign corporations on the organization's behalf by the U.S. organizations identified below. Foreign Corporation: Stella Maris Insurance Company U.S. Organization: Catholic Health East Address: 3805 West Chester Pike, Suite 100, Newtown Square, Pennsylvania 19073 Identifying Number of U.S. Tax Return with Which Form 5471 was filed: 23-2929748 IRS Service Center Where U.S. Return Was Filed: Ogden, UT Foreign Corporation: Chestnut Risk Services, LTD U.S. Organization: Saint Michael's Medical Center Address: 111 Central Avenue, Newark, New Jersey 07102 Identifying Number of U.S. Tax Return with Which Form 5471 was filed: 26-2616046 IRS Service Center Where U.S. Return Was Filed: Ogden, UT

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Seton Real Estate HoldingsBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11300 Massachusetts AvenueAddressLine1
CityTroyCity
StateNYState
ZIP Code12180ZIPCode
FieldValueIRS element (for citing)
EIN320393870EIN
Primary ActivitiesManagement Real EstatePrimaryActivities
Legal Domicile StateNYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Seton Health System IncBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (143 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Catholic Health East
3805 West Chester Pike Suite 100Newtown SquarePA19073232929748Management ServicesPA501(c)(3)Line 11c, III-FIN/A1
Continuing Care Management Services Network
3805 West Chester Pike Suite 100Newtown SquarePA19073352336834Management & Support ServicesPA501(c)(3)Line 11b, II1Catholic Health East
VNA Home Health & Hospice
50 Foden RoadSouth PortlandME04106010246804Home Health & HospiceME501(c)(3)Line 11a, I1Mercy Health System of Maine
Mercy Hospital
144 State StreetPortlandMA04101010211534HospitalME501(c)(3)Line 31Mercy Health System of Maine
Mercy Health System of Maine
144 State StreetPortlandMA04101010484074Management & Support ServicesME501(c)(3)Line 11c, III-FI1Catholic Health East
Sunnyview Hospital & Rehabilitation Center Foundation
1270 Belmont AveSchenectadyNY12308222505127Supporting foundationNY501(c)(3)Line 11a, I1Sunnyview Hospital & Rehabilitation Ctr
St Mary's Woodland Village Inc
1300 Massachusetts AvenueTroyNY12180141675183Discontinued OperationsNY501(c)(3)Line 91Seton Health System Inc
Mercy Care for Kids Inc
310 South Manning BlvdAlbanyNY12208141717564Day care centerNY501(c)(3)Line 91St Peter's Health Care Services
Our Lady of Mercy Life Center
2 Mercycare LaneGuilderlandNY12084141743506Nursing Home FacilityNY501(c)(3)Line 31St Peter's Health Care Services
St Peter's Auxiliary
315 South Manning BlvdAlbanyNY01228222843206AuxiliaryNY501(c)(3)Line 11a, I1St Peter's Health Care Services
St Peter's Health Care Services
315 South Manning BlvdAlbanyNY12208222702507Management & Support ServicesNY501(c)(3)Line 91St Peter's Health Partners
St Peter's Hospital
315 South Manning BlvdAlbanyNY12208141348692HospitalNY501(c)(3)Line 31St Peter's Health Care Services
St Peter's Hospital Foundation Inc
319 South Manning Blvd Suite 309AlbanyNY12208222262982Fundraising & Public RelationsNY501(c)(3)Line 71St Peter's Health Care Services
Eddy Licensed Home Care Agency
433 River St Suite 3000TroyNY12180141818568Home HealthNY501(c)(3)Line 31LTC(Eddy) Inc
The Community Hospice Foundation Inc
295 Valley View BlvdRensselaerNY12144222692940Fundraising & Public RelationsNY501(c)(3)Line 71The Community Hospice Inc
The Community Hospice Inc
295 Valley View BlvdRensselaerNY12144141608921Serving seriously ill people & their familiesNY501(c)(3)Line 31St Peter's Health Care Services
Villa Mary Immaculate
301 Hackett BlvdAlbanyNY12208141438749Nursing Home & Physical RehabNY501(c)(3)Line 31St Peter's Hospital
Warde Service Corporation Inc
159 Wolf Road 3rd FloorAlbanyNY12205141732097Supporting & strengthing the ministries of rel. sr. mercyNY501(c)(3)Line 91St Peter's Health Care Services
Northeast Health Inc
2212 Burdett AveTroyNY12180042450756Supporting OrganizationNY501(c)(3)Line 11b, II1St Peter's Health Partners
Memorial Hospital Albany NY
600 Northern BlvdAlbanyNY12204141338457General HospitalNY501(c)(3)Line 31Northeast Health Inc
The Northeast Health Foundation Inc
2224 Burdett AveTroyNY12180222743478Supporting foundationNY501(c)(3)Line 71Northeast Health Inc
Samaritan Child Care Center Inc
2213 Burdett AveTroyNY12180141710225Child day careNY501(c)(3)Line 91Northeast Health Inc
Shaker Properties Inc
2212 Burdett AveTroyNY12180223119822Real Estate holdingNY501(c)(2)N/A1Northeast Health Inc
Sunnyview Hospital & Rehabilitation Ctr
1270 Belmont AveSchenectadyNY12308141338386Rehabilitation hospitalNY501(c)(3)Line 31LTC (Eddy) Inc
James A Eddy Memorial Geriatric Center Inc
2256 Burdett AveTroyNY12180222570478Nursing homeNY501(c)(3)Line 91LTC (Eddy) Inc
Capital Region Geriatric Center Inc
421 West Columbia StCohoesNY12047141701597Nursing HomeNY501(c)(3)Line 91LTC (Eddy) Inc
Heritage House Nursing Center Inc
2920 Tibbits AveTroyNY12180141725101Nursing homeNY501(c)(3)Line 91LTC (Eddy) Inc
The Marjorie Doyle Rockwell Center Inc
421 West Columbia StCohoesNY12047141793885Adult Home/AlzheimersNY501(c)(3)Line 91LTC (Eddy) Inc
Beverwyck Inc
40 Autumn DriveSlingerlandsNY12159141717028Independent/Assisted Living Retirement CommunityNY501(c)(3)Line 91LTC (Eddy) Inc
Hawthorne Ridge Inc
30 Community WayEast GreenbushNY12061800102840Independent/Assisted Living Retirement CommunityNY501(c)(3)Line 91LTC (Eddy) Inc
Glen Eddy Inc
One Glen Eddy DriveNiskayunaNY12309141794150Independent/Assisted Living CommunityNY501(c)(3)Line 91LTC (Eddy) Inc
Beechwood Inc
2212 Burdett AveTroyNY12180141651563Real estate holdingNY501(c)(2)N/A1LTC (Eddy) Inc
Senior Care Connection Inc
504 State StSchenectadyNY12305141708754PACE ProgramNY501(c)(3)Line 91LTC (Eddy) Inc
Home Aid Service of Eastern New York Inc
433 River St Suite 3000TroyNY12180141514867Home careNY501(c)(3)Line 91LTC (Eddy) Inc
Seton Health System Inc
1300 Massachusetts AvenueTroyNY12180141776186HospitalNY501(c)(3)Line 31St Peter's Health Partners
Seton Health at Schuyler Ridge Residential Healthcare
1 Abele BlvdClifton ParkNY12065141756230Skilled NursingNY501(c)(3)Line 91Seton Health System Inc
Seton Health Foundation
1300 Massachusetts AvenueTroyNY12180222345416Supporting OrganizationNY501(c)(3)Line 11a, I1Seton Health System Inc
Seton Auxiliary Inc
1300 Massachusetts AvenueTroyNY12180141505031Supporting OrganizationNY501(c)(3)Line 91Seton Health System Inc
Seton Licensed Home Care Inc
1300 Massachusetts AvenueTroyNY12180141809134Licensed Home Health AgencyNY501(c)(3)Line 31Seton Health System Inc
Empire Home Infusion Service Inc
10 Blacksmith DriveMaltaNY12020141795732Home careNY501(c)(3)Line 91Home Aid Service of Eastern New York Inc
LTC (Eddy) Inc
2212 Burdett AveTroyNY12180222564710Elderly health/housing supporting orgNY501(c)(3)Line 11a, I1Northeast Health Inc
St Peter's Health Partners
315 South Manning BlvdAlbanyNY12208453570715Management & Support ServicesNY501(c)(3)Line 11b, II1Catholic Health East
St Peter's Health Partners Medical Associates PC
315 South Manning BlvdAlbanyNY12208461177336Physicians PracticeNY501(c)(3)Line 91St Peter's Health Partners
Providence Place Inc
5 Gamelin StreetHolyokeMA01040043404084Retirement CommunityMA501(c)(3)Line 91Sisters of Providence Health System Inc
Brightside Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040042182395Behavioral CareMA501(c)(3)Line 91Sisters of Providence Health System Inc
Farren Care Center Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040042501711Long Term CareMA501(c)(3)Line 31Sisters of Providence Health System Inc
Mercy Hospital Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040043398280Acute CareMA501(c)(3)Line 31Sisters of Providence Health System Inc
Mercy Specialist Physicians Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040264033168Neurosurgery Medical ServicesMA501(c)(3)Line 31Sisters of Providence Health System Inc
Sisters of Providence Care Centers Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040222541103Long Term CareMA501(c)(3)Line 31Sisters of Providence Health System Inc
Sisters of Providence Health System Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040043398374Management & Support ServicesMA501(c)(3)Line 11a, I1Catholic Health East
Mercy LIFE Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA01040453086711Acute CareMA501(c)(3)Line 31Sisters of Providence Health System Inc
Pioneer Valley Cardiology Associates Inc
c/o SPHS 1221 Main Street Suite 213HolyokeMA01040454208896Cardiology ServicesMA501(c)(3)Line 41Sisters of Providence Health System Inc
Mercy Oncology Services Inc
c/o SPHS 1221 Main Street Suite 213HolyokeMA01040454884805Oncology Medical ServicesMA501(c)(3)N/A1Sisters of Providence Health System Inc
McAuley Center Inc
275 Steele RoadWest HartfordCT06117061058086Independent LivingCT501(c)(3)Line 91Mercy Community Health Inc
Mercy Community Health Inc
2021 Albany AvenueWest HartfordCT06117061492707Management & Support ServicesCT501(c)(3)Line 11a, I1Catholic Health East
Mercy Community HomeCare Services
2021 Albany AvenueWest HartfordCT06117061488137In Home Health CareCT501(c)(3)Line 91Mercy Community Health Inc
Mercy Services
2021 Albany AvenueWest HartfordCT06117061453323Support ServicesCT501(c)(3)Line 11Mercy Community Health Inc
Mercyknoll Inc
2021 Albany AvenueWest HartfordCT06117060757380Skilled NursingCT501(c)(3)Line 31Mercy Community Health Inc
Saint Mary Home II Inc
2021 Albany AvenueWest HartfordCT06117061164104Elderly CareCT501(c)(3)Line 31Mercy Community Health Inc
St Mary Home Incorporated
2021 Albany AvenueWest HartfordCT06117060646843Skilled NursingCT501(c)(3)Line 31Mercy Community Health Inc
Mercy Healthcare Center
114 Wawbeek AvenueTupper LakeNY12986150532211In DissolutionNY501(c)(3)Line 31Catholic Health East
Mercy Uihlein Health Corporation
185 Old Military RoadLake PlacidNY12946161535133Mgt. & Support ServicesNY501(c)(3)Line 11b, II1Mercy Healthcare Center
Uihlein Mercy Center
185 Old Military RoadTupper LakeNY12986150532190In DissolutionNY501(c)(3)Line 31Mercy Healthcare Center
St James Mercy Foundation Inc
411 Canisteo StreetHornellNY14843161486437FoundationNY501(c)(3)Line 71St James Mercy Health System Inc
St James Mercy Health System Inc
411 Canisteo StreetHornellNY14843223127184Management & Support ServicesNY501(c)(3)Line 11b, II1Catholic Health East
St James Mercy Hospital
411 Canisteo StreetHornellNY14843160743310HospitalNY501(c)(3)Line 31St James Mercy Health System Inc
Maxis Medical Services
100 Lincoln AveCarbondalePA18407232577185Physician PracticesPA501(c)(3)Line 31Maxis Health System
Marian Community Hospital
100 Lincoln AveCarbondalePA18407240711230HospitalPA501(c)(3)Line 31Maxis Health System
Marian Community Hospital Auxiliary
100 Lincoln AveCarbondalePA18407251874733FundraisingPA501(c)(3)Line 11b, II1Maxis Health System
Maxis Foundation
100 Lincoln AveCarbondalePA18407232330090FundraisingPA501(c)(3)Line 11b, II1Maxis Health System
Maxis Health System
100 Lincoln AveCarbondalePA18407911940902Health Care SystemPA501(c)(3)Line 11b, II1Maxis Health System
Tri-County Human Services Center Inc
PO BOX 517CarbondalePA18407231938528Behavioral Health OrganizationPA501(c)(3)Line 71Maxis Health System
Columbus Acquisition Corp
1160 Raymond BoulevardNewarkNJ07102262616342Inactive EntityNJ501(c)(3)Line 91Saint Michaels Medical Center
Saint Michaels Medical Center
111 Central AvenueNewarkNJ07102262616046HospitalNJ501(c)(3)Line 31Catholic Health East
St James Care Inc
1160 Raymond BoulevardNewarkNJ07102262616230Inactive EntityNJ501(c)(3)Line 91Saint Michaels Medical Center
St Michael's Foundation Inc
1160 Raymond BoulevardNewarkNJ07102223311976FoundationNJ501(c)(3)Line 11a, I1Saint Michaels Medical Center
University Heights Property Company Inc
1160 Raymond BoulevardNewarkNJ07102223100162Medical Property Holding CompanyNJ501(c)(2)N/A1Saint Michaels Medical Center
Life St Francis Corporation
601 Hamilton AvenueTrentonNJ08629222797282Health ServicesNJ501(c)(3)Line 11a, I1St Francis Medical Center Trenton NJ
St Francis Medical Center Foundation NJ
601 Hamilton AvenueTrentonNJ08629521025476FoundationNJ501(c)(3)Line 11a, I1St Francis Medical Center Trenton NJ
St Francis Medical Center Trenton NJ
601 Hamilton AvenueTrentonNJ08629223431049HospitalNJ501(c)(3)Line 31Catholic Health East
Langhorne MRI Inc
1201 Langhorne-Newtown RoadLanghornePA19047232519529Inactive EntityPA501(c)(3)Line 91St Mary Medical Center
Langhorne Physician Services Inc
1201 Langhorne-Newtown RoadLanghornePA19047232571699Physician ServicesPA501(c)(3)Line 9: 509(a)(2)1St Mary Medical Center
LIFE St Mary
1201 Langhorne-Newtown RoadLanghornePA19047262976184Elderly CarePA501(c)(3)Line 91St Mary Medical Center
St Mary Medical Center
1201 Langhorne-Newtown RoadLanghornePA19047231913910HospitalPA501(c)(3)Line 31Catholic Health East
St Mary Medical Center Foundation Inc
1201 Langhorne-Newtown RoadLanghornePA19047232567468FoundationPA501(c)(3)Line 71St Mary Medical Center
East Norriton Physician Services
c/o One West Elm StreetConshohockenPA19428232515999Physician ServicesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Mercy Catholic Medical Center of Southeastern Pennsylvania
One West Elm StreetConshohockenPA19428231352191Acute Care HospitalPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Mercy Family Support
1001 Baltimore Pike Suite 301SpringfieldPA19064232325059Home HealthPA501(c)(3)Line 91Mercy Health System of Southeastern Pennsylvania
Mercy Health Foundation of Southeastern Pennsylvania
c/o One West Elm StreetConshohockenPA19428232829864FundraisingPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Health Plan
c/o One West Elm StreetConshohockenPA19428222483605Health PlansPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Health System of Southeastern Pennsylvania
One West Elm StreetConshohockenPA19428232212638Management & Support ServicesPA501(c)(3)Line 11b, II1Catholic Health East
Mercy Home Health
1001 Baltimore Pike Suite 310SpringfieldPA19064231352099Home HealthPA501(c)(3)Line 91Mercy Health System of Southeastern Pennsylvania
Mercy Home Health Services
1001 Baltimore Pike Suite 301SpringfieldPA19064232325058Home HealthPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Management of Southeastern Pennsylvania
One West Elm StreetConshohockenPA19428232627944Physician PracticesPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Mercy Suburban Hospital
One West Elm StreetConshohockenPA19428231396763Acute Care HospitalPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Nazareth Health Care Foundation
2701 Holme AvenuePhiladelphiaPA19152232300951FundraisingPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Nazareth Hospital
2601 Holme AvenuePhiladelphiaPA19152232794121Acute Care HospitalPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
Nazareth Physician Services Inc
2601 Holme AvenuePhiladelphiaPA19152203261266Physician PracticesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
NE Physician Services
2601 Holme AvenuePhiladelphiaPA19152232497355Physician PracticesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
St Agnes Continuing Care Center
1900 S Broad StreetPhiladelphiaPA19145232840137Continuing Care ServicesPA501(c)(3)Line 31Mercy Health System of Southeastern Pennsylvania
St Agnes Continuing Care Center Foundation
1900 S Broad StreetPhiladelphiaPA19145232415137FundraisingPA501(c)(3)Line 11b, II1Mercy Health System of Southeastern Pennsylvania
Life at Lourdes Inc
1600 Haddon AvenueCamdenNJ08108261854750Elderly CareNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Lourdes Ancillary Services
1600 Haddon AvenueCamdenNJ08103222568525Supporting OrganizationNJ501(c)(3)Line 11b, II1Our Lady of Lourdes Health Care Services
Lourdes Dialysis at Innova Inc
1600 Haddon AvenueCamdenNJ08108263237625HospitalNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Lourdes Medical Center Burlington County
218 Sunset RoadWillingboroNJ08046223612265HospitalNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Our Lady of Lourdes Health Care Services
1600 Haddon AvenueCamdenNJ08103222568528Management & Support ServicesNJ501(c)(3)Line 11b, II1Catholic Health East
Our Lady of Lourdes Health Foundation Inc
1600 Haddon AvenueCamdenNJ08103222351960FoundationNJ501(c)(3)Line 71Our Lady of Lourdes Health Care Services
Our Lady of Lourdes Medical Center
1600 Haddon AvenueCamdenNJ08103210635001HospitalNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Lourdes Cardiology Services PC
1600 Haddon AvenueCamdenNJ08108274357794Cardiology ServicesNJ501(c)(3)Line 31Our Lady of Lourdes Health Care Services
Franciscan Eldercare Corporation
PO Box 2500WilmingtonDE19805223008680EldercareDE501(c)(3)Line 91St Francis Hospital
St Francis Foundation
PO Box 2500WilmingtonDE19805510374158FoundationDE501(c)(3)Line 11b, II1St Francis Hospital
St Francis Hospital
PO Box 2500WilmingtonDE19805510064326HospitalDE501(c)(3)Line 31Catholic Health East
LIFE at St Francis Healthcare Inc
7th Clayton StreetsWilmingtonDE19805452569214Elderly CareDE501(c)(3)Line 31St Francis Hospital
McAuley Ministries
McAuley Hall 3333 Fifth AvenuePittsburghPA15213943436142Management & Support ServicesPA501(c)(3)Line 91Pittsburgh Mercy Health System
Mercy Jeannette Hospital
3805 West Chester PikeNewtown SquarePA19073251310602Inactive EntityPA501(c)(3)Line 91Pittsburgh Mercy Health System
Mercy Life Center Corporation
1200 Reedsdale StreetPittsburghPA15233251604115Community TreatmentPA501(c)(3)Line 91Pittsburgh Mercy Health System
Pittsburgh Mercy Health System
3333 5th AvenuePittsburghPA15213251464211Management & Support ServicesPA501(c)(3)Line 11b, II1Catholic Health East
St Joseph's of the Pines Inc
100 Gossman Drive Suite BSouthern PinesNC28387560694200HospitalNC501(c)(3)Line 31Catholic Health East
Life St Joseph of the Pines Inc
100 Gossman Drive Suite BSouthern PinesNC28387272159847Healthcare ServicesNC501(c)(3)Line 31St Joseph's of the Pines Inc
Mercy Senior Care Inc
300 Chatillon Road PO Box 866RomeGA30162581366508Community OutreachGA501(c)(3)Line 71Saint Joseph's Health System Inc
Saint Joseph's Health System Inc
424 Decatur StreetAtlantaGA30312581744848Management & Support ServicesGA501(c)(3)Line 11b, II1Catholic Health East
Saint Joseph's Mercy Care Services Inc
424 Decatur StreetAtlantaGA30312581752700Community OutreachGA501(c)(3)Line 71Saint Joseph's Health System Inc
Saint Joseph's Mercy Foundation Inc
424 Decatur StreetAtlantaGA30312581448522FundraisingGA501(c)(3)Line 11b, II1Saint Joseph's Health System Inc
Mercy Services Downtown Inc
424 Decatur StreetAtlantaGA30312272046353Real Estate Holding CompanyGA501(c)(3)Line 11b, II1Saint Joseph's Health System Inc
St Mary's Health Care System Inc
1230 Baxter StreetAthensGA30606580566223HospitalGA501(c)(3)Line 31Catholic Health East
St Mary's Foundation Inc
1230 Baxter StreetAthensGA30606582544232FundraisingGA501(c)(3)Line 11b, II1St Mary's Health Care System Inc
St Mary's Highland Hills Inc
1230 Baxter StreetAthensGA30606020576648Assisted Living & Retirement CommunityGA501(c)(3)Line 31St Mary's Health Care System Inc
St Mary's Medical Group Inc
1230 Baxter StreetAthensGA30606261858563Hospital / Physician ServicesGA501(c)(3)Line 31St Mary's Health Care System Inc
Good Samaritan Hospital Inc
1201 Siloam RoadGreensboroGA30462261720984HospitalGA501(c)(3)Line 31Saint Joseph's Health System Inc
Mercy Medical Corporation
PO Box 1090 101 Villa DriveDaphneAL36526636002215HospitalAL501(c)(3)Line 31Catholic Health East
Mercy LIFE of Alabama
PO Box 1090 101 Villa DriveDaphneAL36526273163002HospitalAL501(c)(3)Line 31Mercy Medical Corporation
Allegany Franciscan Ministries Inc
33920 US Highway 19 North Suite 269Palm HarborFL34684581492325Management & Support ServicesFL501(c)(3)Line 11b, II1Catholic Health East
St Francis Hospital Inc
33920 US Highway 19 North Suite 269Palm HarborFL34684590624442Grant-making OrganizationFL501(c)(3)Line 11a, I1Allegany Franciscan Ministries Inc
Holy Cross Hospital Inc
4725 North Federal HighwayFt LauderdaleFL33308590791028Hospital-Healthcare ProviderFL501(c)(3)Line 31Catholic Health East
Holy Cross Long-Term Inc
4725 North Federal HighwayFt LauderdaleFL33308650787320Medical ServicesFL501(c)(3)Line 31Holy Cross Hospital Inc
Holy Cross Medical Properties Inc
4725 North Federal HighwayFt LauderdaleFL33308650666283Medical Building Real Estate ManagementFL501(c)(2)N/A1Holy Cross Hospital Inc
SSJ Health Foundation Inc
3663 South Miami AvenueMiamiFL33133591709438FundraisingFL501(c)(3)Line 71Mercy Hospital Inc
Mercy Hospital Inc
3663 South Miami AvenueMiamiFL33133590791034HospitalFL501(c)(3)Line 31Catholic Health East
Mercy Medical Development Inc
3663 South Miami AvenueMiamiFL33133592789194Outpatient ServicesFL501(c)(3)Line 91Mercy Hospital Inc
Mercy Mission Services Inc
3663 South Miami AvenueMiamiFL33133650435764Health CareFL501(c)(3)Line 11a, I1Mercy Hospital Inc
Mercy Outpatient Services Inc DBA Sister Emmanuel Hospital
3663 South Miami AvenueMiamiFL33133510461511HospitalFL501(c)(3)Line 31Mercy Hospital Inc
Global Health Ministry
3805 West Chester Pike Suite 100Newtown SquarePA19073233068656Health CarePA501(c)(3)Line 71Catholic Health East
Intracoastal Health Systems
3805 West Chester Pike Suite 100Newtown SquarePA19073650556413Management & Support ServicesPA501(c)(3)Line 11a, I1Catholic Health East

Form990 Schedule R Part III Form990ScheduleRPartIII (17 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
St Peter's Ambulatory Surgery Center LLC
1375 Washington Avenue Ste 201AlbanyNY12206460463892Outpatient SurgeryNYN/A
Catherine Horan Building Limited Partnership
1221 Main Street Room 108HolyokeMA010400000042723429Property ManagementMAN/A
Western Massachusetts PETCT Imaging Center LLC
100 Bayview Circle Ste 400Newport BeachCA92660204744663Outpatient Medical ServicesDEN/A
Central New Jersey Heart Services LLC
29 E 29th Street 2nd FloorBayonneNJ07002208525458Cardiac ProgramNJN/A
SMMC MOB II LP
1201 Langhorne-Newtown RoadLanghornePA19047364559869Investment and operation of a medical buildingPAN/A
The Ambulatory Surgery Center at St Mary LLC
1203 Langhorne-Newtown RoadLanghornePA19047232871206Outpatient SurgeryPAN/A
East Norriton Medical Associates
One West Elm StreetConshohockenPA19428232319531Medical Office BuildingPAN/A
East Norriton Medical Associates
One West Elm StreetConshohockenPA19428232319531Medical Office BuildingPAN/A
Gateway Health Plan
300 Grant StreetPittsburghPA15219251691945Medicaid & Medicare/Special Needs Managed Care OrganizationPAN/A
MercyManor Partnership
PO Box 10086ToledoOH436990086521931012Nursing HomePAN/A
St Agnes Long Term Intensive Care LLP
c/o Mercy Health System One West ElConshohockenPA19428200984882Long Term Intensive CarePAN/A
St Agnes Long Term Intensive Care LLP
c/o Mercy Health System One West ElConshohockenPA19428200984882Long Term Intensive CarePAN/A
Nazareth Medical Office Building Associates LP
c/o Nazareth Hospital 2601 Holme AvPhiladelphiaPA19152232388040Medical Office BuildingPAN/A
Nazareth Medical Office Building Associates LP
c/o Nazareth Hospital 2601 Holme AvPhiladelphiaPA19152232388040Medical Office BuildingPAN/A
SJV Management LLC
200 Century Pkwy Ste 200EMount LaurelNJ08054202273476RadiologyNJN/A
Physicians Outpatient Surgery Center LLC
1000 NE 56th StreetOakland ParkFL33334352325646Ambulatory Surgery CenterFLN/A
Center for Surgery & Digestive Orders
3641 South Miami AvenueMiamiFL33133510438152Outpatient Medical ServicesFLN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (32 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityControlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountryProvince Or StateAddressForeign/ProvinceOrStatePostal CodeAddressForeign/PostalCode
Samaritan Medical Office Building Inc
2212 Burdett AvenueTroyNY12180141607244Real EstateNYN/AC1
Affiliated Management Services Corporation Inc
1300 Massachusetts AvenueTroyNY12180141668024Real EstateNYN/AC1
Catherine Horan Building Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000042938160Building ManagementMAN/AC1
Diversified Community Services Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000043128890Medical ServicesMAN/AC1
Mercy Inpatient Medical Associates Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000043029929Medical ServicesMAN/AC1
Providence Home Care Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000043317426Health Care ServicesMAN/AC1
System Coordinated Services Inc
c/o SPHS 1221 Main Street Suite 108HolyokeMA010400000042938181Lab ServicesMAN/AC1
Physicians Medical Office Building Condominium Trust
1221 Main Street Room 108HolyokeMA010400000046608649Property ManagementMAN/AC1
SJM Properties Inc
411 Canisteo StreetHornellNY148482101161294991Property HoldingsNYN/AC1
Carbondale Area Physicians' Association PC
100 Lincoln AveCarbondalePA18407232801677Medical Insurance ContractingPAN/AC1
Carbondale Area Physicians' PHO Inc
100 Lincoln AveCarbondalePA18407232801676InactivePAN/AC1
Carbondale Physicians' Services Inc
100 Lincoln AveCarbondalePA18407232365077PharmacyPAN/AC1
Chestnut Risk Services Ltd
InsuranceN/AC111 Victoria StreetHamiltonBDBD
LifeCare Physicians PC
601 Hamilton AvenueTrentonNJ086291986261649038Health Care ServicesNJN/AC1
Multicare Plus Inc
601 Hamilton AvenueTrentonNJ086291986223435844InactiveNJN/AC1
Langhorne Services II Inc
1201 Langhorne-Newtown RoadLanghornePA19047253795549General Partner of LMOB Partners, IIPAN/AC1
Langhorne Services Inc
1201 Langhorne-Newtown RoadLanghornePA19047232625981General Partner of LMOB Partners,PAN/AC1
Gateway Health Plan Inc
600 Grant StreetPittsburghPA15219251505506Health CarePAN/AC1
Gateway Health Plan Inc of Ohio
600 Grant StreetPittsburghPA15219300282076Health CarePAN/AC1
MCMC Eastwick Inc
c/o MHS One West Elm StreetConshohockenPA19428232184261Medical Office BuildingsPAN/AC1
Health Management Services Org Inc
500 Grove Street Suite 100Haddon HeightsNJ08035223366580Health Care BillingNJN/AC1
Lourdes Medeical Associates PA
500 Grove Street Suite 100Haddon HeightsNJ08035223361862Medical ServicesNJN/AC1
Jeannette Medical Providers
3805 West Chester PikeNewtown SquarePA19073251787334Holding CompanyPAN/AC1
Jeannette OBGYN Group 1 Inc
3805 West Chester PikeNewtown SquarePA19073232890748Holding CompanyPAN/AC1
Jeannette Primary Care Group 1 Inc
3805 West Chester PikeNewtown SquarePA19073232890743Holding CompanyPAN/AC1
Georgia Health Enterprises LLC
1230 Baxter StreetAthensGA30606541806329HealthcareGAN/AC1
St Mary's Highland Hills Village Inc
1660 Jennings Mill PklyBogartGA30622582276801Assisted LivingGAN/AC1
GHE Physicians PC
3500 Piedmont RoadAtlantaGA30305582277939Practice ManagementGAN/AC1
Nursing Network Inc
4725 North Federal HighwayFort Lauderdale HighwaFL333080000591145192Medical ServicesFLN/AC1
Mercy Physician Group Inc
3663 South Miami AvenueMiamiFL33133202970015Health CareFLN/AC1
Stella Maris Insurance Company Limited
980078266InsuranceN/AC1PO Box 69Grand CaymanCJCJCayman IslandsKY1-1102
Catholic Health East Senior Services
3805 West Chester Pike Suite 100Newtown SquarePA19073371572595Senior ServicesPAN/AC1
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org1LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Northeast Health Inc
M6086838FMV
Albany Memorial Hospital
O4500217FMV
Northeast Health Foundation
C2132331FMV
The Community Hospice
L368401FMV
Samaritan Medical Office Building
D688781FMV
Samaritan Medical Office Building
K128261FMV
Sunnyview Hospital & Rehabilitation
O332511FMV
Sunnyview Hospital & Rehabilitation
P298562FMV
Capital Region Geriatric Center
K185565FMV
Heritage House Nursing Center
K134081FMV
James A Eddy Memorial Geriatric Center
K102639FMV
Hawthorne Ridge Inc
K109414FMV