2013-01-15T13:42:08-06:00 2011-12-31 221478099 COHNREZNICK LLP 4 BECKER FARM ROAD ROSELAND NJ 070681739 990 2011-01-01 112126736 NURSING SISTERS HOME CARE INC NURS 6314656457 1150 PORTION RD NO STE 1 HOLTSVILLE NY 11742 JOSEPH TOMAINO 6314656457 2013-01-15 1 THOMAS LANNING P00851654 9732283500 2011 2016-02-25 16:41:14Z CATHOLIC HOME CARE JOSEPH TOMAINO 1150 PORTION RD NO STE 1 HOLTSVILLE NY 11742 31229765 0 0928 X HTTP://CATHOLICHOMECARE.CHSLI.ORG X 1968 NY NURSING SISTER HOME CARE, INC., A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND, (CHS),AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, COMMITTED TO THOSE IN NEED, AFFIRMS THE SANCTITY OF LIFE, AND ADVOCATES FOR THE POOR. 22 20 590 3 0 0 24220 23593 31260116 31171916 5200 3878 54489 30378 31344025 31229765 0 12308 0 0 27630853 29432744 0 0 0 3641788 5039648 31272641 34484700 71384 -3254935 4508383 6009628 19803244 24556517 -15294861 -18546889 X NURSING SISTERS HOME CARE DBA CATHOLIC HOME CARE, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND,AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED. CHSLI AFFIRMS THE SANCTITY OF LIFE, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. 0 0 29634549 12308 31171916 NURSING SISTERS HOME CARE (DBA CATHOLIC HOME CARE)PROVIDES APPROXIMATELY 189,200 VISITS TO 9,989 HOME CARE RECIPIENTS IN 2011. SERVICES INCLUDE SKILLED NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH LANGUAGE PATHOLOGY, NUTRITIONAL COUNSELING, MEDICAL SOCIAL WORKERS, WOUND CARE NURSES AND CLOSELY SUPERVISED HOME HEALTH AIDES. 29634549 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 21 0 1 590 1 0 0 0 0 0 0 0 0 0 0 X 22 20 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X CATHOLIC HOME CARE 6314656258 245 OLD COUNTRY RD MELVILLE NY 11747 X BERNADETTE CURRY PHD RN 2.00 X X 0 0 0 BROTHER CAMPION LALLY OSF 2.00 X 0 0 0 CHARLES FALKNER 2.00 X X 0 0 0 CHARLES SPENCER 2.00 X X 0 0 0 DANIEL ROWE 2.00 X X 0 0 0 DEBBIE VAN BOURGONDIEN 2.00 X 0 0 0 DIANE SWEENEY 2.00 X 0 0 0 DONATO BALSAMO DO 2.00 X 0 12959 71 HON ANGIE CARPENTER 2.00 X X 0 0 0 JTIMOTHY SHEAESQ 2.00 X 0 0 0 JEFFREY VOLLMUTH 2.00 X 0 0 0 JOSEPH TOMAINO 50.00 X X 0 418470 176579 PHILIP FAVA 2.00 X X 0 0 0 REVMSGRTHOMAS MULVANERTY 2.00 X 0 0 0 RICHARD ROMER 2.00 X 0 0 0 ROBERT DOYLE 2.00 X 0 0 0 SR KATHLEEN MCCARTHY OP 2.00 X 0 0 0 SR MARGARET KELLIHER DW 2.00 X 0 0 0 SR DOLORES CASTELLANO CIJ 2.00 X X 0 0 0 SR DOLORES WISNIEWSKI 2.00 X 0 0 0 TIMOTHY J MATTIMORE ESQ 2.00 X 0 0 0 WALTER LACE 2.00 X 0 0 0 MARY ELLEN POLIT 50.00 X 0 1012337 101104 WILLIAM MEAD 50.00 X 0 371519 100035 KAREN ESTRADA 50.00 X 0 186922 40053 CATHERINE CIRESI 37.50 X 126303 0 31665 DENISE FASANO 37.50 X 133835 0 21639 ELLEN LASORSA 37.50 X 123780 0 18128 JANICE REMMERS 37.50 X 149885 0 39877 NANCY POL STITH 37.50 X 126236 0 36381 660039 2002207 565532 5 0 1 0 UNLIMITED CARE 333 WESTCHESTER AVE WEST BUILDING WHITE PLAINS NY 11742 HOME HEALTH AIDE 293542 PERSONAL TOUCH 640 MONTAUK HWY SHIRLEY NY 11767 HOME HEALTH AIDE 222726 BEST CARE PO BOX 9010 LEVITTOWN NY 11756 HOME HEALTH AIDE 215484 ABLE HEALTHCARE SERVICES 1240 BROADCAST PLAZA MERRICK NY 11566 HOME HEALTH AIDE 119699 KPMG LLP DEPT 0511 PO BOX 120511 DALLAS TX 753120511 AUDITING SERVICES 117600 5 23593 23593 PATIENT SERVICE REVENU 621610 31171916 31171916 31171916 3878 3878 MEDICAL EQUIPMENT TO A 532000 21718 21718 MED TRANSCRIPT FEES 900099 8660 8660 30378 31229765 31180576 0 25596 12308 12308 21681270 19821558 1859712 1597138 1460143 136995 4500830 4114772 386058 1653506 1511676 141830 59838 59838 1195739 1077861 117878 59512 59512 309277 203194 106083 373405 275005 98400 700731 672692 28039 18850 2975 15875 14496 14496 57443 57443 331575 331575 11418 11418 FINANCE AND TECHNOLOGY 670190 670190 BAD DEBT EXPENSE 469286 469286 MED/SURGICAL SUPPLIES 440643 440643 TELEPHONE 91562 19957 71605 235683 21765 213918 34484700 29634549 4850151 0 442094 685812 3036006 4096009 11518 11865 14330 53915 3046341 2135970 756039 910371 15709 16953 232687 234703 4508383 6009628 3226902 3525884 16576342 21030633 19803244 24556517 X -15502387 -18766454 58660 70699 148866 148866 -15294861 -18546889 4508383 6009628 X -3254935 2908 X 0 1 1 X 0 X 26210 308608 15979 24220 23593 398610 22729221 24552860 28214971 31260116 31171916 137929084 22755431 24861468 28230950 31284336 31195509 138327694 0 0 0 138327694 22440 2901 2918 5200 3878 37337 22440 2901 2918 5200 3878 37337 72819 85189 74964 54489 30378 317839 22850690 24949558 28308832 31344025 31229765 138682870 0.99740 0.99640 0.00030 0.00030 X 148866 2907 2907 148866 148866 16739 16739 148866 148866 5008 5008 148866 148866 6 6 148866 1.00000 0 0 279538 140504 139034 2380100 1748540 631560 386703 246926 139777 910371 DUE TO RELATED PARTIES 20720133 PENSION LIABILITY 176082 DUE TO THRID PARTY 134418 21030633 31229765 34484700 -3254935 2908 2908 -3252027 31223375 2907 2741 5648 31217727 12039 12039 31229766 34414949 0 34414949 69751 69751 34484700 PART XII, LINE 2D - OTHER ADJUSTMENTS: CHS HOME CARE FOUNDATION ADJUSTMENT $2,741 PART XII, LINE 4B - OTHER ADJUSTMENTS: TEMP. RESTRICTED CONTRIB. RECEIVED AND REPORTED AS A CHANGE IN NET ASSETS $12,039 PAYMENT TO AFFILIATES REPORTED AS AN ADJUSTMENT TO EQUITY ON THE AUDITED FINANCIAL STATEMENTS. SCHEDULE D PART XIV MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIIONS THAT REQUIRE RECOGNITION IN THE COMBINED FINANCIAL STATEMENTS. 0 DIOCESE OF ROCKVILLE CENTRE-CATHOLIC MINISTRIES 50 NORTH PARK AVE ROCKVILLE CENTRE NY 11570 111837437 12308 TO PROVIDE GENERAL SUPPORT OF THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD. PART II, LINE 1 COLUMN H THE DIOCESE OF ROCKVILLE CENTRE PROVIDES ANNUAL UPDATES TO ALL CONTRIBUTORS TO THE CATHOLIC MINISTRIES APPEAL, WHETHER PARISHIONERS OR CORPORATE CONTRIBUTORS LIKE CHSLI. X X X X 0 1 0 0 0 0 0 0 0 JOSEPH TOMAINO 0 352299 0 0 0 66171 0 151509 0 25070 0 595049 0 0 MARY ELLEN POLIT 0 250213 0 113800 0 648324 0 73452 0 27652 0 1113441 0 430359 WILLIAM MEAD 0 270778 0 90000 0 10741 0 76902 0 23133 0 471554 0 0 KAREN ESTRADA 0 186516 0 0 0 406 0 16085 0 23968 0 226975 0 0 CATHERINE CIRESI 125370 0 0 0 933 0 12733 0 18932 0 157968 0 0 0 DENISE FASANO 133405 0 0 0 430 0 13201 0 8438 0 155474 0 0 0 JANICE REMMERS 149605 0 0 0 280 0 14983 0 24894 0 189762 0 0 0 NANCY POL STITH 125881 0 0 0 355 0 11734 0 24647 0 162617 0 0 0 PART I, LINE 4B SERP CONTRIBUTION EXPENSE WAS AS FOLLOWS: MARY ELLEN POLIT: $53,898 WILLIAM MEAD: $55,509 JOSEPH TOMAINO: $131,127 SUPPLEMENTAL INFORMATION PART III PART VII, SECTION A, LINE 1A TRUSTEE DONATO BALSAMO, D.O. RECEIVED COMPENSATION FOR THE PERFORMANCE OF SERVICES AS A PHYSICIAN FOR GOOD SAMARITAN HOSPITAL (RELATED ORGANIZATION). MR.BALSAMO RECEIVED NO COMPENSATION AS A TRUSTEE FOR NURSING SISTERS HOME CARE, D/B/A CATHOLIC HOME CARE. SUPPLEMENTAL INFORMATION PART III JOSEPH TOMAINO, EVP CONTINUING CARE - THE TOTAL HOURS WORK REPORTED REFLECTS TIME WORKED AS OFFICERS FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SHEPHERD HOSPICE (11-2958438); NURSING SISTERS HOME CARE, INC D/B/A CATHOLIC HOME CARE (11-2126736); CHS HOME SUPPORT SERVICES, INC. (11-3594561); OUR LADY OF CONSOLATION GERIATRIC CARE CENTER (11-3284066); MARYHAVEN CENTER OF HOPE (11-2861698). SUPPLEMENTAL INFORMATION PART III WILLIAM MEAD, CFO/SVP CONTINUING CARE - THE TOTAL HOURS WORK REPORTED REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SHEPHERD HOSPICE (11-2958438); NURSING SISTERS HOME CARE, INC. D/B/A CATHOLIC HOME CARE (11-2126736); CHS HOME SUPPORT SERVICES, INC. (11-3594561); OUR LADY OF CONSOLATION GERIATRIC CARE CENTER (11-3284066); MARYHAVEN CENTER OF HOPE (11-2861698). SUPPLEMENTAL INFORMATION PART III MARY ELLEN POLIT, EVP, CAO CATHOLIC HOME CARE - THE TOTAL HOURS WORK REPORTED REFLECTS TIME WORKED AS OFFICERS FOR THE FOLLOWING RELATED ENTITIES: NURSING SISTERS HOME CARE, INC D/B/A CATHOLIC HOME CARE (11-2126736); CHS HOME SUPPORT SERVICES, INC. (11-3594561); GOOD SHEPERD HOSPICE (11-2958438); AND AS AN ADMINISTRATOR FOR THE FOLLOWING RELATED ENTITIES: GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924)AND OUR LADY OF CONSULATION GERIATIRC CARE CENTER (11-3284066). SUPPLEMENTAL INFORMATION PART III KAREN ESTRADA, SVP CONTINUING CARE - THE TOTAL HOURS WORK REPORTED REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SHEPHERD HOSPICE (11-2958438); NURSING SISTERS HOME CARE, INC. D/B/A CATHOLIC HOME CARE (11-2126736); CHS HOME SUPPORT SERVICES, INC. (11-3594561); OUR LADY OF CONSOLATION GERIATRIC CARE CENTER (11-3284066); MARYHAVEN CENTER OF HOPE (11-2861698). SUPPLEMENTAL INFORMATION PART III THE AMOUNTS REFLECTED IN COLUMN B(III) AND COLUMN C FOR THE INDIVIDUALS INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP"). THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2011 FORM W-2 BOX, 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NONQUALIFIED RETIREMENT PLANS. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF NURSING SISTERS HOME CARE D/B/A CATHOLIC HOME CARE IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS). CHS IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER (DIOCESE). FORM 990, PART VI, SECTION A, LINE 7A CHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATER OF CATHOLIC HOME CARE AND AS SUCH HAS THE RIGHT TO APPOINT THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B CHS, AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATER OF CATHOLIC HOME CARE, IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY CATHOLIC HOME CARE'S GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990, AND APPROPRIATE SCHEDULES, IS COMPLETED BY THE ACCOUNTING AND FINANCE STAFF OF THE ORGANIZATION AND REVIEWED INTERNALLY BY MANAGEMENT. IT IS THEN REVIEWED BY OUTSIDE TAX ADVISORS. THE FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF TRUSTEES (THE BOARD), WHICH HAS BEEN DELEGATED THE DETAILED REVIEW FUNCTION BY THE BOARD. UPON APPROVAL OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO ALL VOTING MEMBERS OF THE BOARD. ONCE APPROVED BY THE BOARD (OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE), THE ORGANIZATION'S BOARD CHAIR AND CHIEF EXECUTIVE OFFICER COMMUNICATES, IN WRITING TO THE CHS COMPLIANCE AND AUDIT COMMITTEE AND CHS BOARD CHAIR. AFTER REVIEW OF ANY APPLICABLE COMMENTS FROM THE BOARD, THE COMPLIANCE AND AUDIT COMMITTEE WILL THEN RECOMMEND THE APPROVAL OF THE FORM 990 TO THE CHS BOARD OF DIRECTORS WHO WILL THEN REVIEW THE RECOMMENDATIONS AND PROVIDE THE FINAL APPROVAL OF THE FORM 990. THE FORM 990 IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE BY THE ORGANIZATION'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFFERED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. IF A CONFLICT OF INTEREST IS IDENTIFIED AND IF A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORTH WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15 THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE CORPORATE CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE POLICY. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND. HOURS FOR TRUSTEES REFLECTED IN PART VII SECTION A LINE 1A ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 2,908. ELECTION TO ALLOCATE BUSINESS ASSET EXPENSE CONTROLLED GROUP ELECTION STATEMENT THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS, AS DEFINED IN SECTION 179(D)(7), HEREBY CONSENT TO THE APPORTIONMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2010 ELECTION TO ALLOCATE $40,000 ALTERNATIVE MINIMUM TAX EXEMPTION THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS(WITHIN THE MEANING OF SECTION 1563(A)), HEREBY CONSENT UNDER REGULATION 1.58-1(C)(3) TO THE APPORTIONMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2010. ELECTION TO ALLOCATE $150,000 ALTERNATIVE MINIMUM TAX PHASE-OUT THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS (WITHIN THE MEANING OF SECTION 1563(A)), HEREBY CONSENT UNDER REGULATION 1.58-1(C(3) TO THE APPOINTMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2010. EMPLOYER ID NO. $128,00 $40,000 $150,000 11-3403968 NONE NONE NONE 14-1801961 NONE NONE NONE 11-3594561 NONE NONE NONE 11-3555766 NONE NONE NONE 11-1888924 NONE NONE NONE 77-0611240 NONE NONE NONE 11-2537396 NONE NONE NONE 11-2958438 NONE NONE NONE 11-3434776 NONE NONE NONE 11-2861698 NONE NONE NONE 11-2861690 NONE NONE NONE 11-3638367 NONE NONE NONE 11-1635088 NONE NONE NONE 11-2126736 NONE NONE NONE 11-3284066 NONE NONE NONE 20-8067039 NONE NONE NONE 11-2499790 NONE NONE NONE 06-1569129 NONE NONE NONE 06-1562701 NONE NONE NONE 11-1871039 NONE NONE NONE 41-2076312 NONE NONE NONE 11-3613997 NONE NONE NONE 11-2050523 NONE NONE NONE 11-2916033 NONE NONE NONE 11-3090867 NONE NONE NONE 11-2110488 NONE NONE NONE 11-2983148 NONE NONE NONE 11-2716640 NONE NONE NONE 11-3559713 NONE NONE NONE 11-1635088 NONE NONE NONE 55-0813603 NONE NONE NONE 27-1459941 NONE NONE NONE IN PROCESS NONE NONE NONE 26-3169427 NONE NONE NONE 45-0517566 NONE NONE NONE 27-1531084 NONE NONE NONE 11-2798383 NONE NONE NONE 11-2801136 NONE NONE NONE 11-2838185 $128,000 $40,000 $150,000 11-3319259 NONE NONE NONE 06-1568934 NONE NONE NONE 11-3307977 NONE NONE NONE 11-2126736 NONE NONE NONE CONTROLLED GROUP ELECTION - CONTINUED EMPLOYER NAME, ADDRESS & TAX YEAR-END ID NO. 11-3403968 CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 14-1801961 CHS AMBULANCE SERVICES 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-3594561 CHS HOME SUPPORT SERVICES, INC. 15 POWER DRIVE HAUPPAUGUE, NY 11788 TAX YEAR END: 12/31/10 11-3555761 CHS SERVICES, INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-1888924 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 77-0611240 GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2537396 GOOD SAMARITAN HOSPITAL SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2958438 GOOD SHEPHERD HOSPICE 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 11-3434776 MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAX YEAR END: 12/31/10 11-2861698 MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-2861690 MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-3638367 THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAXABLE YEAR: 12/31/10 11-1635088 MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2126736 CATHOLIC HOME CARE 1150 PORTION BLVD. SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 11-3284066 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 20-8067039 RVC INSURANCE COMPANY, INC. 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2499790 RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 06-1569129 SIENA VILLAGE 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 06-1562701 ST. CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 11-1871039 ST. CHARLES HOSPITAL AND REHABILITATION CENTER 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 41-2076312 ST. CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-3613997 ST. FRANCIS CARDIOVASCULAR PHYSICIANS PC 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2050523 ST. FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2916033 ST. FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-3090867 ST. FRANCIS RESEARCH & EDUCATIONAL CORPORATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2110488 SUFFOLK HEARING & SPEECH 369 EAST MAIN STREET EAST ISLIP, NY 11730 TAX YEAR END: 12/31/10 11-2983148 THE ST. CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-2716640 THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 11-3559713 WISDOM GARDENS HOUSING DEVELOPMENT CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-1635088 ST. FRANCIS-MERCY CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 55-0813603 MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 27-1459941 ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 45-2907761 CHS HOME CARE FOUNDATION 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 26-3169427 GOOD SHEPHERD HOSPICE FOUNDATION 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 45-0517566 OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 27-1531084 OUR LADY OF CONSOLATION FOUNDATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2798383 FAIRVIEW HILL MANAGEMENT CORP 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2801136 HEALTHCARE TEMP SERVICES 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2838185 SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-3319259 SAMARITAN HOME CARE AMERICA, INC. 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 06-1568934 SIENA MEDICAL REALTY 50 ROUTE 25A SMITHTOWN, NY 11787 TAXABLE YEAR: 12/31/10 11-3307977 SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-2126736 NURSING SISTERS HOME CARE, INC 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAXABLE YEAR: 12/31/10 TAX BRACKET ALLOCATION THE AMOUNTS IN EACH TAXABLE INCOME BRACKET IN THE TAX TABLE IN SECTION 11(B) HAVE BEEN ALLOCATED TO THE CORPORATIONS LISTED BELOW PURSUANT TO REGULATION 1.1561-3(A). THE ORIGINAL COPY OF THIS STATEMENT IS FILED WITH THE INTERNAL REVENUE SERVICE CENTER IN OGDEN, UTAH. AUTHORIZATION CONSENT FOR ALLOCATION ON BEHALF OF MEMBER COMPANIES ____________________________________________ EMPLOYER ID NO. $50,000 $25,000 $9,925,000 BRACKET BRACKET BRACKET 11-3403968 NONE NONE NONE 14-1801961 NONE NONE NONE 11-3594561 NONE NONE NONE 11-3555766 NONE NONE NONE 11-1888924 NONE NONE NONE 77-0611240 NONE NONE NONE 11-2537396 NONE NONE NONE 11-2958438 NONE NONE NONE 11-3434776 NONE NONE NONE 11-2861698 NONE NONE NONE 11-2861690 NONE NONE NONE 11-3638367 NONE NONE NONE 11-1635088 NONE NONE NONE 11-2126736 NONE NONE NONE 11-3284066 NONE NONE NONE 20-8067039 NONE NONE NONE 11-2499790 NONE NONE NONE 06-1569129 NONE NONE NONE 06-1562701 NONE NONE NONE 11-1871039 NONE NONE NONE 41-2076312 NONE NONE NONE 11-3613997 NONE NONE NONE 11-2050523 NONE NONE NONE 11-2916033 NONE NONE NONE 11-3090867 NONE NONE NONE 11-2110488 NONE NONE NONE 11-2983148 NONE NONE NONE 11-2716640 NONE NONE NONE 11-3559713 NONE NONE NONE 11-1635088 NONE NONE NONE 55-0813603 NONE NONE NONE 27-1459941 NONE NONE NONE IN PROCESS NONE NONE NONE 26-3169427 NONE NONE NONE 45-0517566 NONE NONE NONE 27-1531084 NONE NONE NONE 11-2798383 NONE NONE NONE 11-2801136 NONE NONE NONE 11-2838185 $50,000 $25,000 $9,925,000 11-3319259 NONE NONE NONE 06-1568934 NONE NONE NONE 11-3307977 NONE NONE NONE 11-2126736 NONE NONE NONE TAX BRACKET ALLOCATION - CONTINUED EMPLOYER NAME, ADDRESS & TAX YEAR-END ID NO. 11-3403968 CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 14-1801961 CHS AMBULANCE SERVICES 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-3594561 CHS HOME SUPPORT SERVICES, INC. 15 POWER DRIVE HAUPPAUGUE, NY 11788 TAX YEAR END: 12/31/10 11-3555761 CHS SERVICES, INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-1888924 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 77-0611240 GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2537396 GOOD SAMARITAN HOSPITAL SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2958438 GOOD SHEPHERD HOSPICE 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 11-3434776 MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAX YEAR END: 12/31/10 11-2861698 MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-2861690 MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-3638367 THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAXABLE YEAR: 12/31/10 11-1635088 MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2126736 CATHOLIC HOME CARE 1150 PORTION BLVD. SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 11-3284066 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 20-8067039 RVC INSURANCE COMPANY, INC. 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2499790 RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 06-1569129 SIENA VILLAGE 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 06-1562701 ST. CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 11-1871039 ST. CHARLES HOSPITAL AND REHABILITATION CENTER 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 41-2076312 ST. CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-3613997 ST. FRANCIS CARDIOVASCULAR PHYSICIANS PC 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2050523 ST. FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2916033 ST. FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-3090867 ST. FRANCIS RESEARCH & EDUCATIONAL CORPORATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2110488 SUFFOLK HEARING & SPEECH 369 EAST MAIN STREET EAST ISLIP, NY 11730 TAX YEAR END: 12/31/10 11-2983148 THE ST. CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-2716640 THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 11-3559713 WISDOM GARDENS HOUSING DEVELOPMENT CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-1635088 ST. FRANCIS-MERCY CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 55-0813603 MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 27-1459941 ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 45-2907761 CHS HOME CARE FOUNDATION 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 26-3169427 GOOD SHEPARD HOSPICE FOUNDATION 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 45-0517566 OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 27-1531084 OUR LADY OF CONSOLATION FOUNDATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2798383 FAIRVIEW HILL MANAGEMENT CORP 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2801136 HEALTHCARE TEMP SERVICES 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2838185 SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-3319259 SAMARITAN HOME CARE AMERICA, INC. 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 06-1568934 SIENA MEDICAL REALTY 50 ROUTE 25A SMITHTOWN, NY 11787 TAXABLE YEAR: 12/31/10 11-3307977 SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-2126736 NURSING SISTERS HOME CARE, INC 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAXABLE YEAR: 12/31/10 CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 113403968 SUPPORT ORG NY 501(C)(3) LINE 11A, I N/A 0 CATHOLIC HOME CARE FOUNDATION 1150 PORTION RD SUITE 1 HOLTSVILLE NY 11742 SUPPORT ORG NY 501(C)(3) LINE 9 CATHOLIC HOME CARE 0 CHS AMBULANCE SERVICES 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 141801961 DORMANT NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 CHS HOME SUPPORT SERVICES INC 15 POWER DR HAUPPAUGE NY 11788 113594561 RESPITROY THERAPY SVC/MED. EQUIPMENT NY 501(C)(3) LINE 9 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 CHS SERVICES INC 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 113555766 SUPPORT ORG NY 501(C)(3) LINE 11A, I CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 770611240 SUPPORT ORG NY 501(C)(3) LINE 11A, I GOOD SAMARITAN HOSPITAL 0 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 111888924 HOSPITAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 GOOD SAMARITAN HOSPITAL SELF INSURANCE 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112537396 SELF INSURANCE NY 501(C)(3) LINE 11A, I GOOD SAMARITAN HOSPITAL 0 GOOD SHEPHERD HOSPICE 245 OLD COUNTRY ROAD MELVILLE NY 11747 112958438 HOSPICE SERVICE NY 501(C)(3) LINE 9 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 GOOD SHEPHERD HOSPICE FOUNDATION 245 OLD COUNTRY ROAD MELVILLE NY 11747 263169427 SUPPORT ORG NY 501(C)(3) LINE 11A, I GOOD SHEPARD HOSPICE 0 MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSON STATION NY 11776 112861698 PROGRAM/HOUSING FOR THE DEVELOPMENTALLY DISABLED NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION NY 11776 112861690 SCHOOL FOR DEVELOPMENTALLY DISABLED NY 501(C)(3) LINE 9 MARYHAVEN CENTER OF HOPE 0 MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSON STATION NY 11776 113434776 TRANSPORTATION SERVICES NY 501(C)(3) LINE 9 MARYHAVEN CENTER OF HOPE 0 MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 111635088 HOSPITAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 550813603 SUPPORT ORG NY 501(C)(3) LINE 11A, I MERCY MEDICAL CENTER 0 OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP NY 11795 450517566 SUPPORT ORG NY 501(C)(3) LINE 11A, I OUR LADY OF CONSOLATION 0 OUR LADY OF CONSOLATION GERIATRIC CARE 111 BEACH DRIVE WEST ISLIP NY 11795 113284066 LT NURSING CARE NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 RIVERHEAD HOSTEL HOLDINGS CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION NY 11776 112499790 RENTING NY 501(C)(2) LINE 9 MARYHAVEN CENTER OF HOPE 0 RVC INSURANCE COMPANY 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 208067039 CAPTIVE INSURANCE COMPANY NY 501(C)(3) LINE 11A, I CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 RVC SUPPORT 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 271531084 REAL ESTATE NY 501(C)(3) LINE 11A, I CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 SIENA VILLAGE INC 50 ROUTE 25A SMITHTOWN NY 11787 061569129 SENIOR HOUSING NY 501(C)(3) LINE 9 STCATHERINE OF SIENA MEDICAL CENTER 0 ST CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN NY 11787 061562701 HOSPITAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 ST CATHERINE OF SIENA MEDICAL CENTER FOUNDATION 50 ROUTE 25A SMITHTOWN NY 11787 271459941 SUPPORT ORG NY 501(C)(3) LINE 11A, I STCATHERINE OF SIENA MEDICAL CENTER 0 ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 111871039 HOSPITAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 ST CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 412076312 SUPPORT ORG NY 501(C)(3) LINE 11A, I STCHARLES HOSPITAL 0 ST FRANCIS CARDIOVASCULAR PHYSICIANS PC 61-34 188TH ST SUITE 214 FRESH MEADOWS NY 11365 113613997 HEALTH CARE SERVICES NY 501(C)(3) LINE 3 STFRANCIS HOSPITAL 0 ST FRANCIS HOSPITAL 100 PORT WASHINGTON BOULEVARD ROSLYN NY 11576 112050523 HOSPITAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 ST FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BOULEVARD ROSLYN NY 11576 112916033 SUPPORT ORG NY 501(C)(3) LINE 11A, I STFRANCIS HOSPITAL 0 ST FRANCIS HOSPITAL RESEARCH & EDUCATIONAL CORP 100 PORT WASHINGTON BOULEVARD ROSLYN NY 11576 113090867 RESEARCH ORGANIZATION NY 501(C)(3) LINE 9 STFRANCIS HOSPITAL 0 ST FRANCIS-MERCY CORPORATION 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 111635088 SUPPORT ORG NY 501(C)(3) LINE 11A, I CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 SUFFOLK HEARING & SPEECH CENTER INC 369 E MAIN ST EAST ISLIP NY 11730 112110488 DIAGNOSTIC TESTING NY 501(C)(3) LINE 3 GOOD SAMARITAN HOSPITAL 0 THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION NY 11776 113638367 SUPPORT ORG NY 501(C)(3) LINE 11A, I MARYHAVEN CENTER OF HOPE 0 THE SAMARITAN CORPORATION 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 112716640 SUPPORT ORG NY 501(C)(3) LINE 11A, I CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 THE ST CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 112983148 SUPPORT ORG NY 501(C)(3) LINE 11A, I CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 WISDOM GARDENS HOUSING DEVELOPMENT 51 TERRYVILLE ROAD PORT JEFFERSON STATION NY 11776 113559713 SENIOR HOUSING NY 501(C)(3) LINE 9 MARYHAVEN CENTER OF HOPE 0 WSNCHS NORTH INC 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 113438973 HOSPTIAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH SYSTEM OF LONG ISLAND 0 ADVANCE REHABILITATION MEDICINE PLLC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 113640709 HEALTHCARE SERVICES NY ST CHARLES HOSPITAL C CARDIAC EKG INTERPRETATION PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112924518 HEALTHCARE SERVICES NY GOOD SAMARITAN HOSPITAL C FAIRVIEW HILL MANAGEMENT CO INC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 112798383 SERVICES NY ST CHARLES CORPORATION C LI REGIONAL ARTHRITIS & OSTEOPOROSIS CARE PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208964140 HEALTHCARE SERVICES NY GOOD SAMARITAN HOSPITAL C RADIOLOGY CONSULTING OF LONG ISLAND PLLC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 421646134 HEALTHCARE SERVICES NY GOOD SAMARITAN HOSPITAL C SAMARITAN EMERGENCY MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208243412 DIAGNOSTIC TESTING NY GOOD SAMARITAN HOSPITAL C SAMARITAN MANAGEMENT SERVICES INC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112838185 HEALTHCARE SERVICES NY CATHOLIC HEALTH SYSTEM OF LONG ISLAND C SAMARITAN MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208088453 DIAGNOSTIC TESTING NY GOOD SAMARITAN HOSPITAL C SAMARITAN PEDIATRIC SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208180263 HEALTHCARE SERVICES NY GOOD SAMARITAN HOSPITAL C SOUTHWEST SUFFOLK MEDICAL PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 061603195 HEALTHCARE SERVICES NY GOOD SAMARITAN HOSPITAL C ST FRANCIS CARDIAC PREVENTION SERVICES PC 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113224885 HEALTHCARE SERVICES NY ST FRANCIS HOSPITAL C SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113307977 HEALTHCARE SERVICES NY GOOD SAMARITAN HOSPITAL C MERCY INTERNAL MEDICINE PC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11710 510639649 HEALTHCARE SERVICES NY MERCY MEDICAL CENTER C 0 0 0 0 1 0 0 0 0 1 0 0 1 1 1 1 1 0 CATHOLIC HEALTH SERVICES OF LONG ISLAND N -63728 COST CHS SERVICES INC N -3857020 COST OUR LADY OF CONSOLATION N -83083 COST CHS HOME SUPPORT SERVICES N -332801 COST GOOD SHEPHERD HOSPICE N 78670 COST ST FRANCIS HOSPITAL P 57421 COST TRANSACTIONS WITH RELATED PARTIES SCHEDULE R PART V NURSING SISTERS HOME CARE HAS DISCLOSED IN SCHEDULE R THE PREDOMINANT TRANSACTION TYPE WITH EACH FACILITY WITH WHICH IT HAS CONDUCTED TRANSACTIONS. HOWEVER, THERE ARE ADDITIONAL TRANSACTION TYPES TO DESCRIBE THE ACTIVITIES NURSING SISTERS HOME CARE HAS ENGAGED IN WITH ITS RELATED PARTY ORGANIZATIONS. THE FOLLOWING IS A LIST OF ADDITIONAL TRANSACTION TYPES BY FACILITY. NAME OF ORGANIZATION EIN ADDITIONAL TRANS. CATHOLIC HEALTH SERVICES OF LONG ISLAND 11-3405968 O CHS SERVICES INC. 11-3555766 O OUR LADY OF CONSOLATION 11-3284066 O,P CHS HOME SUPPORT SERVICES, INC. 11-3594561 O,M,P GOOD SHEPHERD HOSPICE 11-2958438 O,P