2013-11-13T10:33:19-06:00 2012-12-31 990 2012-01-01 112837244 THE LONG ISLAND HOME % MS PATRICIA PORTER CFO LONG 6316085107 400 SUNRISE HIGHWAY Suite AMITYVILLE NY 11701 PATRICIA A PORTER 2013-11-08 2012 2016-03-07 17:11:31Z ROBERT E DETOR CEO 400 SUNRISE HIGHWAY AMITYVILLE NY 11701 89353705 false X WWW.LONGISLANDHOME.ORG X 1999 NY THE LONG ISLAND HOME STRIVES TO PROVIDE INNOVATIVE, EFFECTIVE AND COST EFFICIENT SERVICES WITHIN AN INTEGRATED COMMUNITY HEALTH DELIVERY SYSTEM. 21 16 1275 0 1078338 522512 86449678 88370935 59467 17058 358833 427956 87946316 89338461 0 0 0 0 64989063 72771888 0 0 0 25345072 27615614 90334135 100387502 -2387819 -11049041 56592748 86194772 66052324 73088201 -9459576 13106571 THE LONG ISLAND HOME PROVIDES INNOVATIVE, EFFECTIVE AND COST-EFFICIENT SERVICES WITHIN AN INTEGRATED COMMUNITY HEALTH DELIVERY SYSTEM, AND PROMOTES THE HIGHEST PRACTICAL LEVELS OF WELLNESS AND INDEPENDENCE FOR PATIENTS AND FAMILIES. false false 48775135 0 47410981 SOUTH OAKS HOSPITAL (SOH) IS A FREESTANDING PYSCHIATRIC HOSPITAL LICENSED BY THE NEW YORK STATE OFFICE OF MENTAL HEALTH (OMH) AND OFFICE OF ALCOHOLISM AND SUBSTANCE ABUSE SERVICES (OASAS). MENTAL HEALTH SERVICES ARE PROVIDED TO CHILDREN, ADOLESCENTS, ADULTS, AND GERIATRICS. SOH ALSO PROVIDES PARTIAL HOSPITALIZATION TREATMENT FOR ADULTS AND ADOLESCENTS. THIS SETTING PROVIDES INTENSIVE PSYCHIATRIC TREATMENT IN A STRUCTURED ENVIRONMENT. COMPREHENSIVE OUTPATIENT BEHAVIORAL SERVICES (COBS) PROGRAM SERVICES YOUTHS AND FAMILIES WITHIN THE COMMUNITY. 39115102 0 38806495 BROADLAWN MANOR NURSING AND REHABILITATION CENTER IS A COMPREHENSIVE RESIDENTIAL HEALTH CARE FACILITY, LICENSED IN NEW YORK STATE, OFFERING PROGRESSIVE AND INNOVATIVE CARE. INCLUDED IN THEIR FACILITY BEDS ARE A 40 BED SUBACUTE UNIT AND TWO 40 BED UNITS DEDICATED TO ALZHEIMER'S DISEASE AND RELATED DEMENTIAS. THE NURSING CENTER ALSO PROVIDES A NUMBER OF SPECIALTY SERVICES. ADULT DAY HEALTH SERVICES PROVIDES THERAPEAUTIC, REHABILITATIVE AND RECREATIONAL SERVICES TO THE MEDICALLY IMPAIRED OLDER ADULT AND THE DISABLED. 87890237 true true false false false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 55 0 true 1275 true false false false false false false false false false false false false false X 21 16 true false true false false false false true true false false true true true true true true true true false NY X MS PATRICIA PORTER CFO 6316085107 400 SUNRISE HIGHWAY AMITYVILLE NY 11701 ROBERT E DETOR 35.0 X X 2910022 0 326266 ROGER A BLUMENCRANZ 2.0 X 0 0 0 ROBERT W CHASANOFF 2.0 X 0 0 0 ELLEN RICCIUTI 1.0 X X 0 0 0 STEPHEN SIPOLA 1.0 X 0 0 0 MICHAEL STOLTZ 1.0 X 0 0 0 MICHAEL E FELDMAN 2.0 X 0 0 0 ROBERT F ROSE 1.0 X X 0 0 0 JOHN T O CONNELL 1.0 X 0 0 0 RICHARD DUNNE 1.0 X 0 0 0 RAYMOND J FUREY 1.0 X 0 0 0 JACQUELINE S HARRIS 1.0 X 0 0 0 MARK CLASTER 2.0 X 0 0 0 LLOYD M GOLDMAN 2.0 X 0 0 0 RICHARD D GOLDSTEIN 2.0 X 0 0 0 MARK SHAW 1.0 X 0 0 0 DONALD ZUCKER 2.0 X 0 0 0 ROBERT S SHAPIRO 50.0 X 0 1139452 231819 KEITH THOMPSON 50.0 X 0 2868822 533031 HOWARD GOLD 50.0 X 0 1299856 298209 LAURENCE A KRAEMER 50.0 X 0 466657 42600 HARRY GINDI 50.0 X 0 284559 42600 JEFFREY A KRAUT 50.0 X 0 826861 201661 WINIFRED MACK 50.0 X 0 748551 361382 MARK SOLAZZO 50.0 X 0 1698389 216113 DEBORAH TASCONE 50.0 X 0 2976117 251538 PATRICIA PORTER 35.0 X 819764 0 96101 YOGENDRA UPADHYAY MD 35.0 X 479644 0 38043 KIRAN KAMDAR MD 35.0 X 342218 0 16090 RICHARD KRUGLEY MD 35.0 X 317483 0 33271 KARAN KUMAR MD 35.0 X 375688 0 23077 WILLIAM NEWTON 35.0 X 254312 0 28745 5499131 12309264 2740546 47 false true false AFFINITY REHABILITATION 10600 YORK ROAD SUITE 105 COCKEYSVILLE MD 21030 PT/OT/ST THERAPY 1755091 TRANSCARE CORP ONE METROTECH CENTER 20TH FL BROOKLYN NY 11201 TRANSPORTATION SVCS 883315 NORTH SHORE-LIJ CORE LABORATORY 10 NEVADA DRIVE LAKE SUCCESS NY 11042 LABORATORY SERVICES 586992 ISEMAN CUNNINGHAM RIESTER HYDE NINE THURLOW TERRACE ALBANY NY 12203 LEGAL 194805 PHOENIX MEDICAL BILLING CONSULTAN PO BOX 1203 BELLMORE NY 11710 PHYSICIAN BILLING 148752 6 429502 93010 522512 BEHAVIORAL HEALTH PSYCHIATRIC 900099 49057889 49057889 SENIOR HEALTH SERVICES 623000 39313046 39313046 88370935 32302 32302 0 0 39468 39468 0 39468 15244 -15244 -15244 0 0 0 EXCESS UTILITIES 221000 27758 27758 CAFETERIA 722210 96839 96839 CHALLENGE ACCTIVITIES ROPES 900099 51931 51931 211960 83645 128315 388488 89338461 88506511 285214 0 0 0 0 3729786 3729786 0 46043041 44685216 1357825 0 7755060 6920616 834444 11308481 10091437 1217044 3935520 3511970 423550 0 321928 321928 241533 241533 0 0 0 0 114001 1864 112137 293467 234137 59330 778926 778926 0 1687204 1385393 301811 45264 38633 6631 0 25277 17635 7642 1604067 1604067 0 2519731 2281410 238321 3371055 3000894 370161 BAD DEBT 2153458 2153458 PURCHASED SERVICES 5773807 5060194 713613 COST OF DRUGS 2014866 2012888 1978 STATE CASH ASSESSMENT 1780102 1780102 4890928 4714390 176538 100387502 87890237 12497265 0 584083 1620546 3567374 2580510 0 0 12006405 11806244 0 0 0 0 0 0 475604 481362 796030 604145 56145809 1136495 27194964 55009314 39574 74146 0 0 0 0 0 0 11928714 14018505 56592748 86194772 7335946 7990661 0 0 0 0 0 0 0 0 0 0 33524878 31824920 0 0 25191500 33272620 66052324 73088201 X -9459576 13106571 0 0 0 0 -9459576 13106571 56592748 86194772 X -11049041 49816 33565372 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20669023 20669023 29002613 385827 28616786 4999173 750668 4248505 1475000 0 1475000 55009314 INSURANCE CLAIMS RECIEVABLE 4595868 457B PLAN ASSETS 364378 INTANGIBLE ASSETS 8700000 OTHER ASSETS 358259 14018505 0 PENSION & POST-RET. BENEFITS 2474522 RESERVE FOR PROFESSIONAL LIAB. 2605037 ACCRUED PENSION LIAB 18639269 DUE TO THIRD PARTY PAYORS 681907 INTEREST RATE SWAP LIABILITY 2686911 INSURANCE CLAIMS LIABILITY 4595868 NOTE PAYABLE TO AFFILIATE 1589106 33272620 X 87571210 49816 -1817067 -1767251 89338461 89338461 94123500 94123500 6264002 6264002 100387502 FIN 48 PART X, LINE 2 Certain entities included in the System's consolidated financial statements are taxable entities under Federal or state laws. U.S. generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in income in the period of enactment. At December 31, 2012 and 2011, the System has a deferred income tax asset which has been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion, or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to the allowance for doubtful accounts receivable and net operating loss carry forwards. Certain entities have net operating loss carry forwards aggregating approximately $149,000,000, which expire in varying amounts through 2032, and are available to offset future taxable income. RECONCILIATION OF REVENUE PART XI, LINE 2D PROVISION FOR BAD DEBT (2,153,458) CHANGE IN EQUITY UNDER FAS 136 336,391 TOTAL (1,817,067) RECONCILIATION OF EXPENSE PART XII, LINE 4B ADDITIONAL MINIMUM PENSION LIABILITY 4,110,544 PROVISION FOR BAD DEBTS 2,153,458 TOTAL 6,264,002 true true X true X true X 500. true true true false true true 1 587000 587000 0.00620 1 49167068 36842945 12324123 0.13090 2 49754068 36842945 12911123 0.13710 56585 56585 0.00060 645637 645637 0.00690 702222 702222 0.00750 2 50456290 36842945 13613345 0.14460 false 2334820 147175 20136618 18014752 2121866 X true true 1 1 SOUTH OAKS HOSPITAL

400 SURNISE HIGHWAY AMITYVILLE NY 11701

X SOUTH OAKS HOSPITAL 1 true true 100 true 500. true X X X X X X true true X X X X X X X true false X X X X X true X false true 1 BROADLAWN MANOR NURSING & REHABILITATION

399 COUNTY LINE ROAD AMITYVILLE NY 11701

SKILLED NURSING FACILITY PART VI - SUPPLEMENTAL INFORMATION Question 1. Part I, Line 3c: This hospital is an affiliated entity of the North Shore-LIJ Health System ("North Shore-LIJ" or "the System"). North Shore-LIJ uses FPG to determine eligibility and utilizes the New York State Department of Health (NYSDOH) guidelines regarding the consideration of assets. Asset tests cannot be used to deny financial assistance, but only to "upgrade" a patient's level of obligation, up to the legal maximum permitted under the financial assistance law. Part I, Line 6a: The Community Benefit report is prepared by the hospital, in conjunction with an affiliated entity (North Shore-Long Island Jewish Health System) of the hospital. The Community Benefit Report is accessible to the public and can be accessed on the North Shore-LIJ website: http://www.northshorelij.com. Part I, 7: Row (a) The cost of charity care was determined by utilizing the ratio of cost to charges (RCC) calculated on Worksheet 2 applied to gross charges written off for patients qualifying for charity under the hospital's financial assistance policy. Bad Debt was not reported in any row of Part I, Line 7. Row (b) The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. A RCC is developed from these costs, and that RCC is applied to total Medicaid gross ancillary services charges to determine the cost of services provided to Medicaid patients. Row (e) Costs associated with Community Health Improvement Services were determined by adding indirect or overhead costs to the direct costs of the activity. Indirect costs were calculated as a percentage of direct costs. Direct costs for staff expenses were calculated using average hospital facility hourly rates, and were adjusted to account for fringe benefits, using a blended rate based on the ratio of total employee benefit expenses to total salary and wages. Row (f) The Bad Debt Expense that appears on Form 990, Part IX, Line 25 column (A), but not included for purposes of calculating the percentage in this column is equal to the amount reported on Form 990, Part X. The costs related to health professions education were determined by utilizing the step down method of cost finding. Row (h) Costs associated with research activities were determined by adding indirect, or overhead, costs to the direct costs of the activity. Indirect costs were calculated as a percentage of costs. Row (i) The cost of in-kind contributions to community groups is comprised of the direct costs of personnel whose compensated time was donated to various charities and community groups. The salaries and wages were adjusted to include benefits using a rate based on the ratio of total employee benefit expenses to total salary and wages. Indirect costs were calculated as a percentage of direct costs. Column (a) The number of activities or programs was determined by counting unique community benefit activities or programs conducted throughout the year. Each activity or program may include multiple occurrences. In Part I line 7a-k, column (a) represents the total number of unique community benefit activities and programs; not the number of occurrences for each activity and program. Column (b) Persons served were determined by the unique number of community members that encountered a specific community benefit activity or program. Persons were reported multiple times when engaged in services in different categories of activity or program. Column (f) for Rows (a)-(k) The percentage of Net Community Benefit Expense divided by Total Expense for the hospital (to calculate the percent of total expense). Note: For the entire North Shore-LIJ Health System, Part I, Line 7 (Row K, Column F) is approximately 10.9% as a percentage of expenses. Part II: All community building activities improve access to health services and address federal, state, or local public health priorities, as well as leverage public health department activities, and in doing so, they provide relief of government burden. These activities broadly serve low-income, underserved patients, and include: collaboration with various community coalitions, system-wide recycling initiative, organizational response to worldly disasters, and bioterrorism efforts. The System's bioterrorism & disaster preparedness includes Center for Emergency Medical Services, which is a state and federal planning resource on weapons of mass destruction, and a designated a Bioterrorism Resource Center. The System has conducted staff training for more than 100 hospitals and area first responders and invested heavily in the infrastructure needed for large-scale emergencies. During catastrophes, (i.e. Super storm Sandy), North Shore-LIJ provides a safe haven for thousands of patients, outside nursing home residents, and community members seeking shelter. North Shore-LIJ ambulances assists with the transport of patients throughout the metropolitan area and stand ready to contribute food, medicine and blankets to numerous individuals who may lose power in their homes, and assist both affiliated and non-affiliated hospital patients. Investment in a field hospital has furthered the public health infrastructure needed for mass casualties that could result from a terrorist attack, natural attack, or large-scale emergency. Part III, Line 4: For patients who were determined by the System to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. Bad debt expenses are determined by applying the ratio of cost to charges from Worksheet 2 to gross patient charges written off to bad debt. Part III, Line 8: Medicare costs are determined utilizing a combination of the step down method of cost findings and a cost per unit of service. Cost per unit of service is used to calculate the routine cost of services provided to Medicare patients. The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. An RCC is developed from these costs, and that RCC is applied to total Medicare gross ancillary services charges to determine the cost of services provided to Medicare patients. Part III, Line 9b: The organization's collection policy is standard to all accounts regardless of insurance status (e.g. insured, underinsured, and uninsured). The hospital's collection policy states that they will not send patient accounts to collection if a decision on a financial assistance application is pending, or if a patient is determined to be eligible for Medicaid at the time services were rendered and for which services Medicaid payment is available. Part V, Section B, line 8: N/A Part V, Section B, line 9b: The organization's financial assistance policy will review a patient's assets if they fall within the family size and income levels approved by the New York State to provide free or discounted care. Asset test cannot be used to deny financial assistance, but only to "upgrade" a patient's level of obligation, up to the legal maximum permitted under the financial assistance law. Part V, Section B, line 10: N/A Part V, Section B, line 11: N/A Part V, Section B, line 12h: The hospital also uses household size. Part V, Section B, line 14g: The policy is included in the hospital's Community Service Plan and provided at health fairs and presentations open to the community at no cost, in addition to mailing financial policy summary brochures. Part V, Section B, line 16e: N/A Part V, Section B, line 17e: N/A Part V, Section B, line 18e: Before initiating any of the actions, the hospital facility sends letters, makes telephone calls and utilizes presumptive eligibility. Part V, Section B, line 19d: N/A Part V, Section B, line 20d: The hospital used a blended Medicaid rate as a criterion during the tax year to determine the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care. Under NYS Health Law Section 2807-k (9a) indigent care pool requires a sliding fee scale from qualifying patients. A reduction from gross charges must result in an expected payment that does not exceed the amount paid for the same services by the hospital's highest volume payer (i.e. Medicare or Medicaid) Part V, Section B, line 21: N/A Part V, Section B, line 22: In general, the hospital facility does not charge its FAP-eligible patients an amount equal to the gross charge for any service provided. The hospital may charge an amount equal to the gross charge when it is less than the Medicaid rate. Question 2. NEEDS ASSESSMENT: The Community Health Needs Assessment (CHNA) is performed on an ongoing basis. North Shore-LIJ conducts and participates in population, demographic, and health status evaluations of our respective hospitals' service areas based on county regions and the communities we serve. There is a special effort to include individuals with health disparities and organizations who serve these communities in the CHNA process. The CHNA includes the analysis of primary and secondary data. M X X X X X true true false false false false false true false ROBERT E DETOR 424675 0 126072 0 2359275 0 303302 0 22964 0 3236288 0 1354781 0 PATRICIA PORTER 232319 0 46226 0 541219 0 88218 0 7883 0 915865 0 333478 0 YOGENDRA UPADHYAY MD 479644 0 0 0 0 0 23448 0 14595 0 517687 0 0 0 KIRAN KAMDAR MD 342218 0 0 0 0 0 8207 0 7883 0 358308 0 0 0 RICHARD KRUGLEY MD 317483 0 0 0 0 0 18676 0 14595 0 350754 0 0 0 KARAN KUMAR MD 375688 0 0 0 0 0 8482 0 14595 0 398765 0 0 0 WILLIAM NEWTON 254312 0 0 0 0 0 5242 0 23503 0 283057 0 0 0 ROBERT S SHAPIRO 0 921946 0 190000 0 27506 0 209519 0 22300 0 1371271 0 0 KEITH THOMPSON 0 724853 0 113000 0 2030969 0 511950 0 21081 0 3401853 0 313468 HOWARD GOLD 0 928383 0 340000 0 31473 0 283109 0 15100 0 1598065 0 0 LAURENCE A KRAEMER 0 413711 0 32634 0 20312 0 27500 0 15100 0 509257 0 0 HARRY GINDI 0 280028 0 0 0 4531 0 27500 0 15100 0 327159 0 0 JEFFREY A KRAUT 0 695349 0 101010 0 30502 0 186561 0 15100 0 1028522 0 0 WINIFRED MACK 0 628818 0 88000 0 31733 0 346282 0 15100 0 1109933 0 0 MARK SOLAZZO 0 974451 0 700000 0 23938 0 198500 0 17613 0 1914502 0 0 DEBORAH TASCONE 0 832625 0 113000 0 2030492 0 236438 0 15100 0 3227655 0 237891 CHANGE OF CONTROL PAYMENT PART I, LINE 4A Payments made to officers as part of their employment contract due to the acquisition of The Longs Island Home by North Shore-LIJ Health System on 7/1/2012: ROBERT E. DETOR ($816,212) AND PATRICIA A. PORTER ($172,254) SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PART I, LINE 4B Certain individuals participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. Accordingly, the individual may never actually receive the unvested benefit amount and the amounts outlined herein were properly not reported in each individual's Form W-2, Box 5. These amounts are included in Schedule J, Column C for Mark Solazzo ($171,000), Robert Shapiro ($182,019), Howard Gold ($255,609), Keith Thompson ($484,450), Jeffery Kraut ($159,061), Deborah Tascone ($208,938), Winifred Mack ($318,782), Robert Detor ($270,634) and Patricia Porter ($67,451). BONUS AND INCENTIVE COMPENSATION PART I, LINE 7 On Form 990, Part VII, Section A, line 1A, the organization may provide non-fixed payments, not described on lines 5 and 6, to certain listed persons. The organization bases such payments on many performance based factors. Payments of this type appear on Schedule J, Part II, B (ii). BOARD MEMBER RELATIONS PART VI, SECTION A, LINE 2 All transactions with North Shore-LIJ Health System entities are as follows: (1) negotiated at arm's length; (2) all purchases are at fair market value; and (3) all products or services are rendered on an "as needed" basis. Roger Blumencranz has a business relationship with Richard Goldstein. Mark Claster has a business relationship with Richard Goldstein and Lloyd Goldman. Richard Goldstein has a business relationship with Roger Blumencranz, Mark Claster and Lloyd Goldman Lloyd Goldman has a business relationship with Mark Claster and Richard Goldstein. ACQUISITION PART VI, SECTION A, LINE 4 On July 1, 2012 (The "Acquisition Date"), The Long Island Home was acquired by LHH Corporation ("LHH"), a not-for-profit corporation organized under the laws of the State of New York. LHH is the sole member of The Long Island Home. LHH is a subsidiary of North Shore-Long Island Jewish Health System, Inc. (The "System"). The System is an integrated health care delivery system operating in the New York Metropolitan area. EXECUTIVE COMMITTEE PART VI, SECTION B, LINE 11 All North Shore-LIJ Health System Inc. and affiliated entities prepare the annual Return of Organization Exempt Form Income Tax (Form 990) with input from various departments including Corporate Compliance, Finance, Human Resources, and Legal. Before filing the returns, the documents are electronically made available for review to members of the Executive Committee. The Executive Committee, which is a committee made up of members from the Board of Trustees, may exercise all of the authority of the Board of Trustees except as such authority is limited by applicable law and except to the extent, if any, that such authority would be inconsistent with any provision of these By-laws or is limited by any resolution to such effect adopted by the Board of Trustees. CONFLICTS OF INTEREST PART VI, SECTION B, LINE 12 The North Shore-Long Island Jewish Health System ("Health System") has several control mechanisms to mitigate conflicts of interest. The Health System's Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, our Code of Ethical Conduct requires individuals to conduct Health System business in a manner that places the interests of the Health System ahead of their personal interests. In addition, the Health System has a Conflicts of Interest Policy Statement further elaborating upon individuals' disclosure and recusal obligations. Individuals that are in a position to influence the business or other decisions of the Health System are required to fill out a conflicts of interest disclosure form on a regular basis. The Corporate Compliance Office reviews all disclosures of possible conflicts, including matters disclosed in any conflicts of interest disclosure report and takes any actions deemed required or appropriate to manage or resolve any actual or potential conflicts of interest. In appropriate cases these disclosures and responsive actions will be reported to the Health System's Audit and Corporate Compliance Committee and other applicable committees. In addition, the Health System provides training to individuals on an annual basis regarding conflicts of interest and other compliance related topics. If an individual violates the Code of Ethical Conduct or any related policy such as the Conflicts of Interest Policy Statement, appropriate disciplinary action is taken based upon the facts and circumstances of the situation. OFFICERS COMPENSATION PART VI, SECTION B, LINE 15b The by-laws of the Health System create a committee of the Board with full powers of the Board to review and approve the compensation of officers and other key employees. The committee consists of approximately 6 trustees who have no connection to the System except as trustees and they have no conflicts as to matters they consider. The committee meets several times a year as needed but always meets in November/December to review and determine officer and key employee compensation for the following year. For purposes of their review the committee considers the recommendations of the CEO for all persons other than the CEO. For purposes of the review each year the committee receives information from an outside independent compensation consultant as to compensation for comparable positions in comparable organizations and makes its decisions on this basis, with the overall objective of paying base salary at the 50th percentile. Any contracts or other compensation for officers or key employees are separately considered and normally only approved after receipt of a "fairness opinion" from the independent consultant. .All the work and process of the committee is structured to fall within the applicable safe harbor regulations. DISCLOSURE PART VI, SECTION C, LINE 19 CURRENTLY THE ORGANIZATION PROVIDES GOVERNANCE DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. RECONCILIATION OF NET ASSETS PART XI, LINE 9 CHANGE IN EQUITY UNDER FAS 136 (11,456,700) CHANGE IN INTEREST RATE SWAP ( 331,769) TRANSFER FROM AFFILIATE 11,793,091 FMV OF ACQUISITION OF ASSETS & LIAB BY NSLIJ 33,560,750 TOTAL OTHER CHANGES IN NET ASSETS OR FUND BALANCES 33,565,372 THE LONG ISLAND HOME FOUNDATION 400 SUNRISE HIGHWAY AMITYVILLE NY 11701 112049038 SUPPORT NY 501(C)(3) 11, TYPE 1 LHH CORP true NORTH SHORE-LIJ HEALTH SYSTEM 972 BRUSH HOLLOW RD WESTBURY NY 11590 113418133 SUPPORT NY 501(C)(3) 11, TYPE 1 NA false NORTH SHORE-LIJ HEALTH CARE INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 112965586 SUPPORT NY 501(C)(3) 11, TYPE 1 NSLIJ HS false NORTH SHORE UNIVERSITY HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 111562701 HEALTH CARE NY 501(C)(3) 3 NSLIJ HCI false LONG ISLAND JEWISH MEDICAL CENTER 972 BRUSH HOLLOW RD WESTBURY NY 11590 112241326 HEALTH CARE NY 501(C)(3) 3 NSLIJ HCI false GLEN COVE HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 111633487 HEALTH CARE NY 501(C)(3) 3 NSLIJ HCI false FOREST HILLS HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 112163522 HEALTH CARE NY 501(C)(3) 3 NSLIJ HCI false PLAINVIEW HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 113241243 HEALTH CARE NY 501(C)(3) 3 NSLIJ HCI false FRANKLIN HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 112296824 HEALTH CARE NY 501(C)(3) 3 NSLIJ HCI false SOUTHSIDE HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 111667761 HEALTH CARE NY 501(C)(3) 3 NSLIJ HCI false NORTH SHORE-LIJ HEALTH SYSTEM LABS 972 BRUSH HOLLOW RD WESTBURY NY 11590 113412370 SUPPORT NY 501(C)(3) 11, TYPE 1 NSLIJ HS false FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH 972 BRUSH HOLLOW RD WESTBURY NY 11590 112673595 RESEARCH NY 501(C)(3) 4 NSLIJ HS false NORTH SHORE-LIJ HEALTH SYSTEM FOUNDATION 972 BRUSH HOLLOW RD WESTBURY NY 11590 112965586 FUNDRAISING NY 501(C)(3) 7 NSLIJ HS false NS-LIJ STERN FAMILY CENTER FOR REHAB 972 BRUSH HOLLOW RD WESTBURY NY 11590 237007485 NURSING HOME NY 501(C)(3) 9 NSLIJ HCI false LIJ AT HOME PHARMACY 972 BRUSH HOLLOW RD WESTBURY NY 11590 113251128 SUPPORT NY 501(C)(3) 11, TYPE 1 NSLIJ HS false LIJ FOUNDATION 972 BRUSH HOLLOW RD WESTBURY NY 11590 112661239 SUPPORT NY 501(C)(3) 11, TYPE 1 NSLIJ HS false NORTH SHORE-LIJ MEDICAL CARE CENTERS INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 113473923 SUPPORT NY 501(C)(3) 11, TYPE 1 NSLIJ HS false SSH INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 112774102 SUPPORT NY 501(C)(3) 11, TYPE 1 SOUTHSIDE false NORTH SHORE COMMUNITY SERVICES INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 237273200 HOUSING NY 501(C)(2) N/A NSLIJ HS false NORTH SHORE UNIVERSITY HOSPITAL HOUSING 972 BRUSH HOLLOW RD WESTBURY NY 11590 112171903 HOUSING NY 501(C)(2) N/A NSLIJ HS false NSUH AT GLEN COVE HOUSING 972 BRUSH HOLLOW RD WESTBURY NY 11590 237010468 HOUSING NY 501(C)(2) N/A NSLIJ HS false HILLSIDE HOUSING HOUSES INC 972 BRUSH HOLLOW RD WESTBURY NY 11590 112113949 HOUSING NY 501(C)(2) N/A NSLIJ HS false SIUH SYSTEMS INC 475 SEAVIEW AVE STATEN ISLAND NY 10305 061074604 FUNDRAISING NY 501(C)(3) 7 NSLIJ HCI false STATEN ISLAND UNIVERSITY HOSPITAL 475 SEAVIEW AVE STATEN ISLAND NY 10305 112868878 HEALTH CARE NY 501(C)(3) 3 NSLIJ HCI false STATEN ISLAND UNIVERSITY HOSPITAL FDN 360 SEAVIEW AVE STATEN ISLAND NY 10305 870765787 FUNDRAISING NY 501(C)(3) 7 SIUH false THE HEART INSTITUTE 475 SEAVIEW AVE STATEN ISLAND NY 10305 311757254 INACTIVE NY 501(C)(3) 11, TYPE 1 NA false CHAPS COMMUNITY HEALTH CENTER INC 1 EDGEWATER PLAZA 6TH FL STATEN ISLAND NY 10305 113345477 INACTIVE NY 501(C)(3) 9 SIUH false PHYSICIANS OF UNIVERSITY HOSPITAL PC 1 EDGEWATER PLAZA 6TH FL STATEN ISLAND NY 10305 200096809 HEALTH CARE NY 501(C)(3) 11, TYPE 1 SIUH false HOSPICE CARE NETWORK 99 SUNNYSIDE BVLD WOODBURY NY 11797 112925757 HOSPICE NY 501(C)(3) 9 NSLIJ HS false HUNTINGTON HOSPITAL 270 PARK AVENUE HUNTINGTON NY 11743 111630914 HEALTH CARE NY 501(C)(3) 3 NSLIJ HCI false HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH 284 PULASKI RD GREENLAWN NY 11740 113368503 HEALTH CARE NY 501(C)(3) 3 HUNTINGTON 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false false false false false THE LONG ISLAND HOME FOUNDATION b 49274 AT COST THE LONG ISLAND HOME FOUNDATION c 11842365 AT COST THE LONG ISLAND HOME FOUNDATION e 27966670 AT COST THE LONG ISLAND HOME FOUNDATION e 1825394 AT COST