2013-11-15T09:22:04-06:00 2012-12-31 WithumSmithBrown PC 465 South St Ste 200 Morristown NJ 079606497 990 2012-01-01 112868878 STATEN ISLAND UNIVERSITY HOSPITAL % THOMAS RECA STAT 7182261148 475 SEAVIEW AVENUE Suite STATEN ISLAND NY 10305 THOMAS RECA 9738989494 2013-11-15 true Anthony J Panico 9738989494 2012 2016-02-25 16:41:14Z ANTHONY C FERRERI 475 SEAVIEW AVENUE STATEN ISLAND NY 10305 838881263 false X www.siuh.edu X 1869 NY Staten Island University Hospital is part of the North Shore-LIJ Health System, WHICH STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITies IT SERVES. SEE PART III. 136 128 6679 918 8987748 -105387 3676168 3971783 783155014 825262856 1987289 4083113 5267929 5563511 794086400 838881263 0 0 0 0 502034828 525486600 0 0 0 265494006 270285594 767528834 795772194 26557566 43109069 676230590 744558374 487447058 498952883 188783532 245605491 X STATEN ISLAND UNIVERSITY HOSPITAL IS PART OF THE NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM ("THE SYSTEM"), WHICH STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES AND IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CLINICAL CARE; EDUCATING THE CURRENT AND FUTURE GENERATIONS OF HEALTHCARE PROFESSIONALS; SEARCHING FOR NEW ADVANCES IN MEDICINE THROUGH THE CONDUCT OF BIOMEDICAL RESEARCH; PROMOTING HEALTH EDUCATION; AND CARING FOR THE ENTIRE COMMUNITY REGARDLESS OF THE ABILITY TO PAY. false false 537900232 0 669319043 STATEN ISLAND UNIVERSITY HOSPITAL PROVIDES ACUTE CARE HOSPITAL SERVICES AT TWO FACILITIES IN RICHMOND COUNTY. NORTH AND SOUTH SITE CAMPUSES PROVIDE SERVICES IN CARDIOLOGY, BURN CARE, TRAUMA, ORTHOPEDICS, ONCOLOGY, GERIATRICS, OBSTETRICS, PEDIATRICS, REHABILITATION, PRIMARY CARE, COMMUNITY OUTREACH, HOSPICE, AND HOME CARE REGARDLESS OF ABILITY TO PAY. IN 2012 THE COMBINED CAMPUSES OF THE HOSPITAL HAD 42,172 DISCHARGES, (EXCLUDING NORMAL NEWBORN DISCHARGES); 2,904 DELIVERIES; 124,552 EMERGENCY DEPARTMENT VISITS (includes 31,632 admits); AND 15,392 AMBULATORY SURGERY CASES. 65715923 0 58227826 EXPENSES INCURRED IN PROVIDING EMERGENCY DEPARTMENT SERVICES TO ALL INDIVIDUALS, 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR, IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. 45591133 0 42262541 EXPENSES INCURRED IN PROVIDING AMBULATORY SURGERY SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. 33928086 0 55453446 683135374 true true false true false false false false false true true false true true true true false true false false true false false false false false true true false false true true false false false false false false false false true true false false false false true true true true false false true 402 0 true 6679 true true true false false false false false false false false false X 136 128 true false false false false true true true true false false true true true true true true true true false NY X X THOMAS RECA 7182261148 ONE EDGEWATER PLAZA STATEN ISLAND NY 10305 X RICHARD D GOLDSTEIN 3.0 X X 0 0 0 JOHN W ALEXANDER 2.0 X X 0 0 0 RICHARD S ABRAMSON 2.0 X 0 0 0 WILLIAM ACHENBAUM 2.0 X 0 0 0 PHILIP S ALTHEIM 2.0 X 0 0 0 STANLEY A APPLEBAUM 2.0 X 0 0 0 MICHAEL L ASHNER 2.0 X 0 0 0 BEVERLY BANKER 2.0 X 0 0 0 RALPH M BARUCH 2.0 X 0 0 0 FRANK J BESIGNANO 2.0 X 0 0 0 ELISE M BLOOM 2.0 X 0 0 0 ERIC S BLUMENCRANZ 2.0 X 0 0 0 ROGER A BLUMENCRANZ 2.0 X 0 0 0 DAVID BLUMENFELD 2.0 X 0 0 0 EDWARD BLUMENFELD 2.0 X 0 0 0 E STEVE BRAUN 2.0 X 0 0 0 DAYTON T BROWN JR 2.0 X 0 0 0 ALLEN E BUSCHING 2.0 X 0 0 0 JONATHAN S CANNO 2.0 X 0 0 0 MICHAEL CARIDI 2.0 X 0 0 0 REV DEMETRIUS CAROLINA SR EDD 2.0 X 0 0 0 RUDOLPH C CARRYL 2.0 X 0 0 0 ROBERT W CHASANOFF 2.0 X 0 0 0 ALAN CHOPP 2.0 X 0 0 0 MARK CLASTER 2.0 X 0 0 0 DIANA F COLGATE 2.0 X 0 0 0 DANIEL M CROWN 2.0 X 0 0 0 PHILIPPE P DAUMAN 2.0 X 0 0 0 DANIEL C DE ROULET 2.0 X 0 0 0 LORINDA DE ROULET 2.0 X 0 0 0 THOMAS E DEWEY JR 2.0 X 0 0 0 THOMAS E DOOLEY 2.0 X 0 0 0 MICHAEL J DOWLING 50.0 X 0 2823350 1128235 ROBERT N DOWNEY 2.0 X 0 0 0 MELVIN DUBIN 2.0 X 0 0 0 PATRICK R EDWARDS 2.0 X 0 0 0 MICHAEL A EPSTEIN 2.0 X 0 0 0 LEONARD FEINSTEIN 2.0 X 0 0 0 MICHAEL E FELDMAN 2.0 X 0 0 0 ANTHONY C FERRERI 50.0 X X 0 1049046 387210 ARLENE LANE FISHER 2.0 X 0 0 0 CATHERINE C FOSTER 2.0 X 0 0 0 WILLIAM H FRAZIER 2.0 X 0 0 0 EUGENE B FRIEDMAN MD 2.0 X 0 0 0 WILLIAM J FRITZ PHD 2.0 X 0 0 0 SY GARFINKEL 2.0 X 0 0 0 LLOYD MICHAEL GOLDMAN 2.0 X 0 0 0 J JOAQUIN GONZALEZ 2.0 X 0 0 0 MICHAEL GOULD 2.0 X 0 0 0 ALBERT L GRANGER DDS 2.0 X 0 0 0 ALAN I GREENE 2.0 X 0 0 0 JAMES R GREENE 2.0 X 0 0 0 STANLEY GREY 2.0 X 0 0 0 RICHARD GUARASCI PHD 2.0 X 0 0 0 PAUL B GUENTHER 2.0 X 0 0 0 AMY M HAGEDORN 2.0 X 0 0 0 IRA HAZAN 2.0 X 0 0 0 LINDA W HEANEY 2.0 X 0 0 0 MARLENE HESS 2.0 X 0 0 0 WILLIAM O HILTZ 2.0 X 0 0 0 GEDALE B HOROWITZ 2.0 X 0 0 0 RICHARD A HOROWITZ 2.0 X 0 0 0 M ALLAN HYMAN 2.0 X 0 0 0 MARK JACOBSON 2.0 X 0 0 0 JEFFREY JURICK 2.0 X 0 0 0 DAVID M KATZ 2.0 X 0 0 0 MICHAEL KATZ 2.0 X 0 0 0 SAUL B KATZ 2.0 X 0 0 0 LISA A KAUFMAN 2.0 X 0 0 0 ROBERT KAUFMAN 2.0 X 0 0 0 CARY KRAVET 2.0 X 0 0 0 STANLEY KREITMAN 2.0 X 0 0 0 SETH KUPFERBERG 2.0 X 0 0 0 JEFFREY B LANE 2.0 X 0 0 0 CURT N LAUNER 2.0 X 0 0 0 LAURA LAURIA 2.0 X 0 0 0 KEVIN F LAWLOR 50.0 X 0 799176 280574 DAVID W LEHR 2.0 X 0 0 0 JONATHAN W LEIGH 2.0 X 0 0 0 SYLVIA LESTER 2.0 X 0 0 0 ARTHUR S LEVINE 2.0 X 0 0 0 STUART R LEVINE 2.0 X 0 0 0 SETH LIPSAY 2.0 X 0 0 0 DAVID S MACK 2.0 X 0 0 0 WILLIAM L MACK 2.0 X 0 0 0 LINDA MANFREDI 2.0 X 0 0 0 JAMES S MARCUS 2.0 X 0 0 0 BRADLEY MARSH DPM 2.0 X 0 0 0 JEFFREY S MAURER 2.0 X 0 0 0 RONALD J MAZZUCCO 2.0 X 0 0 0 F J MCCARTHY 2.0 X 0 0 0 PATRICK F MCDERMOTT 2.0 X 0 0 0 JAMES MCMULLEN 2.0 X 0 0 0 CHARLES MERINOFF 2.0 X 0 0 0 RICHARD D MONTI 2.0 X 0 0 0 RICHARD MURCOTT 2.0 X 0 0 0 RALPH A NAPPI 50.0 X 0 2276546 60770 RICHARD B NYE 2.0 X 0 0 0 CLYDE I PAYNE ED D 2.0 X 0 0 0 ARNOLD S PENNER 2.0 X 0 0 0 JOHN J RAGGIO 2.0 X 0 0 0 LEWIS S RANIERI 2.0 X 0 0 0 JAY R RAUBVOGEL 2.0 X 0 0 0 DENNIS RIESE 2.0 X 0 0 0 TERRY P RIFKIN MD 2.0 X 0 0 0 ROBERT F ROSE 2.0 X 0 0 0 ROBERT A ROSEN 2.0 X 0 0 0 MARCIE ROSENBERG 2.0 X 0 0 0 ROBERT D ROSENTHAL 2.0 X 0 0 0 BERNARD M ROSOF MD 2.0 X 0 0 0 JACK J ROSS 2.0 X 0 0 0 BARRY RUBENSTEIN 2.0 X 0 0 0 HERBERT RUBIN 2.0 X 0 0 0 SCOTT RUDOLPH 2.0 X 0 0 0 MICHAEL H SAHN 2.0 X 0 0 0 FRANK W SCARANGELLO SR 2.0 X 0 0 0 LOIS C SCHLISSEL 2.0 X 0 0 0 JOHN M SHALL 2.0 X 0 0 0 MARC V SHAW 2.0 X 0 0 0 SEAN G SIMON 2.0 X 0 0 0 RICHARD SIMS 2.0 X 0 0 0 MICHAEL C SLADE 2.0 X 0 0 0 PHYLLIS HILL SLATER 2.0 X 0 0 0 HOWARD D STAVE 2.0 X 0 0 0 RUSSELL STERN 2.0 X 0 0 0 JOHN B THOMSON JR 2.0 X 0 0 0 PETER TILLES 2.0 X 0 0 0 SANDRA TYTEL 2.0 X 0 0 0 FREDERICK A VOLK 2.0 X 0 0 0 NANCY WALDBAUM 2.0 X 0 0 0 EMMETT F WALKER JR 2.0 X 0 0 0 GARY WALTER 2.0 X 0 0 0 LEWIS M WESTON 2.0 X 0 0 0 BARBARA HRBEK ZUCKER 2.0 X 0 0 0 DONALD ZUCKER 2.0 X 0 0 0 ROY J ZUCKERBERG 2.0 X 0 0 0 ARTHUR KLEIN 50.0 X 0 1075608 288200 KEITH C THOMPSON 50.0 X 0 2868822 533031 HARRY E GINDI 50.0 X 0 284558 42600 MARK P JARRETT MD 8.0 42.0 X 68884 596396 47159 ROBERT S SHAPIRO 50.0 X 0 1139453 231819 THOMAS RECA 50.0 X 530046 100000 40776 DONNA PROSKE 50.0 X 564508 0 34578 GREGORY RADINSKY 50.0 X 0 309590 42200 JOSEPH T MCGINN MD 50.0 X 1495993 0 35682 JONATHON DEITCH MD 50.0 X 998849 0 21386 MICHAEL L COOPER MD 50.0 X 936524 0 35422 PHILIP M VIGNERI MD 50.0 X 919968 0 37494 CHRISTOPHER DEMAS MD 50.0 X 915959 0 30899 6430731 13322545 3278035 798 false true false MORRISON MANAGEMENT SPECIALISTS 12975 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 FOOD 6902713 ADVANTEDGE HEALTHCARE SOLUTIONS INC 30 TECHNOLOGY DRIVE WARREN NJ 07059 BILLING 3459800 UNIVERSITY PHYSICIANS GROUP PC ONE EDGEWATER PLAZA STATEN ISLAND NY 10305 MEDICAL 3349940 MCKESSON INFORMATION SOLUTIONS INC 5995 WINDWARD PARKWAY ALPHARETTA GA 30005 IT CONSULTANTS 3246002 QUEST DIAGNOSTICS INC 1 MALCOLM AVENUE TETERBORO NJ 07608 LABORATORY 2279351 86 X 74514 3711795 185474 3971783 NET PATIENT SERVICE REVENUE 621500 781278630 772290882 8987748 PROFESSIONAL SERVICES REVENUE 621110 2004721 2004721 OTHER HEALTHCARE RELATED REVENUE 621990 41979505 41979505 825262856 4082763 4082763 0 0 1813032 1813032 0 1813032 1813032 350 350 350 350 0 0 0 CAFETERIA AND DIETARY 722514 2422977 2422977 PARKING REVENUE 812930 533405 533405 REBATES 812900 344602 344602 449495 449495 3750479 838881263 816275108 8987748 9646624 0 0 0 0 1243351 1243351 200620 0 200620 0 400463510 359907302 40556208 25391566 23540562 1851004 69104313 64058341 5045972 29083240 26959239 2124001 0 776287 776287 986781 986781 99071 99071 0 0 13295739 13295739 944158 944158 14750934 10699935 4050999 2536806 1840132 696674 0 9335128 3408463 5926665 335984 243714 92270 0 705780 511954 193826 7796775 5655573 2141202 0 32616205 23658927 8957278 30035466 29206933 828533 MEDICAL EXPENSES 83198234 60349785 22848449 CONTRACTED SERVICES 45252826 44944458 308368 UTILITIES 8791063 250000 8541063 CENTRALIZED ADMIN. SVCS. 17716410 12851012 4865398 1111947 809147 302800 795772194 683135374 112636820 0 X 60201 60984 108844454 35565305 1906377 1522765 88732941 83763758 0 0 0 0 0 0 7975381 9156502 1378627 1053041 685542830 451415489 226591836 234127341 0 0 0 0 122727420 267590947 27870431 22195105 90142922 89522626 676230590 744558374 94261683 99378036 0 0 0 0 62626865 61359786 0 0 0 0 52396935 54861388 25902787 18300000 252258788 265053673 487447058 498952883 X 178518820 232262508 8780523 11858794 1484189 1484189 188783532 245605491 676230590 744558374 X 43109069 5496809 8216081 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 99071 false 99071 false LOBBYING ACTIVITIES SCHEDULE C, PART II-B; LINES 1G AND 1H THE ORGANIZATION IS A MEMBER OF THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. IS A MEMBER OF THE GREATER NEW YORK HOSPITAL ASSOCIATION ("GNYHA"), THE HEALTH CARE ASSOCIATION OF NEW YORK STATE and THE AMERICAN HOSPITAL ASSOCIATION WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. PAYS DUES TO THESE ASSOCIATIONS ON BEHALF OF THIS ORGANIZATION. ADDITIONALLY, THROUGH GNYHA, THE ORGANIZATION PAYS DUES TO THE 1199 JOB SECURITY FUND. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $99,071. 1484189 1484189 1484189 1484189 1484189 1484189 1484189 1484189 1484189 1484189 1.00000 false false 4107673 4107673 351657008 197417675 154239333 247563 18654 228909 289743765 241714168 48029597 39786821 12264992 27521829 234127341 INVESTMENT IN HEALTHFIRST 10467815 F INVESTMENT IN VERIZON - AT&T 10143 F U.S. GOVERNMENT OBLIGATIONS 17403000 F CORPORATE BONDS 3371000 F ACCRUED INTEREST RECEIVABLE 430000 F FIXED INCOME MUTUAL FUNDS 7442000 F COMMINGLED FIXED INCOME FUNDS 2870000 F EQUITY SECURITIES 12103000 F EQUITY MUTUAL FUNDS 3419000 F FUNDS OF HEDGE FUNDS 3341000 F LIMITED USE 27502000 F CASH AND CASH EQUIVALENTS 179231989 F 267590947 DUE FROM RELATED PARTIES 0 OTHER ASSETS 232794 OTHER RECEIVABLES 935224 DEPOSITS 139417 ASU 2010-04 88215191 89522626 0 PARTY PAYERS; CURRENT 22476845 LIABILITIES; CURRENT 6839142 INTEREST PAYABLE 921276 OTHER LONG TERM LIABILITIES 45233378 LIABILITIES; NON-CURRENT 67187666 LIABILITIES; CURRENT 5438260 LIABILITIES; NON-CURRENT 23951091 INSURANCE PAYABLE 88215191 DUE TO RELATED PARTIES; NET 4790824 265053673 X 836050171 924051 924051 835126120 3755143 3755143 838881263 790227194 790227194 5545000 5545000 795772194 ENDOWMENT FUNDS SCHEDULE D, PART V, QUESTION 4 ENDOWMENT FUNDS INCLUDED IN PERMANENTLY RESTRICTED NET ASSETS ARE USED TO SUPPORT THE CHARITABLE ACTIVITIES AND PROGRAMS OF THE ORGANIZATION AND ITS AFFILIATES. TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTE SCHEDULE D, PART X 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 PER AUDITED FINANCIAL STATEMENTS SCHEDULE D, PART XI; LINE 2D OTHER RECONCILIATION ITEMS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12 INCLUDE: - NET ASSETS RELEASED FROM RESTRICTION USED FOR OPERATIONS - $924,051. RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTS SCHEDULE D, PART XI; LINE 4B OTHER RECONCILIATION ITEMS INCLUDED ON FORM 990, PART VIII, LINE 12 BUT NOT ON LINE 1 INCLUDE: - INVESTMENT INCOME - $3,755,143. RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTS SCHEDULE D, PART XII; LINE 4B OTHER RECONCILIATION ITEMS INCLUDED ON FORM 990, PART IX, LINE 25 BUT NOT ON LINE 1 INCLUDE: - AMORTIZATION OF INTANGIBLE ASSET - $5,545,000. true Central America and the Caribbean 1 Investments 3364982 Central America and the Caribbean 1 Investments 12043338 2 2 15408320 15408320 false false false false false false true true X true X true X 500. true true true false true true 1 7468 12862000 5282000 7580000 0.00950 1 367918 153393427 128810613 24582814 0.03130 2 375386 166255427 134092613 32162814 0.04080 140 128604 6393259 6393259 0.00810 10 1845 52010974 15635155 36375819 0.04630 1 14220 5203000 3330000 1873000 0.00240 11 228 234332 234332 0.00030 162 144897 63841565 18965155 44876410 0.05710 164 520283 230096992 153057768 77039224 0.09790 2 53 8224 8224 3 1050 2443 2443 6 1366 10667 10667 false 7774000 188724591 171133423 17591168 X true true 2 1 STATEN ISLAND UNIV HOSPITAL - NORTH

475 SEAVIEW AVENUE STATEN ISLAND NY 10305

WWW.SIUH.EDU X X X X 1 2 STATEN ISLAND UNIV HOSPITAL - SOUTH

375 SEGUINE AVENUE STATEN ISLAND NY 10309

WWW.SIUH.EDU X X X X 1 STATEN ISLAND UNIV HOSPITAL 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 10 SOUTH BEACH PSYCHIATRIC CENTER

777 SEAVIEW AVENUE STATEN ISLAND NY 10305

CLINIC NEW DORP HIGH SCHOOL

465 NEW DORP LANE STATEN ISLAND NY 10306

CLINIC AUDIOSPEECH PATHOLOGY CENTER

500 SEAVIEW AVENUE STATEN ISLAND NY 10305

CLINIC CHEMICAL DEPENDENCE TREATMENT PROGRAM

111 WATER STREET STATEN ISLAND NY 10304

CLINIC THE BAY STREET HEALTH CENTER

57 BAY STREET STATEN ISLAND NY 10301

CLINIC PSYCHALCOHOLISM TREATMENT PROGRAM

450 SEAVIEW AVENUE STATEN ISLAND NY 10305

CLINIC CANARSIE MULTI SERVICE CENTER

567 E 10TH STREET BROOKLYN NY 11218

CLINIC SANFORD R NALITT INSTITUTUE FOR CANCER

256 MASON AVENUE STATEN ISLAND NY 10305

CLINIC CONEY ISLAND MULTIPLE SERVICE CENTER

425-427 CONEY ISLAND AVENUE BROOKYLN NY 11218

CLINIC CENTER FOR WOMENS HEALTH

440 SEAVIEW AVENUE STATEN ISLAND NY 10305

CLINIC ELIGIBILITY FOR DISCOUNTED CARE 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. COMMUNITY BENEFIT REPORT SCHEDULE H, PART I; QUESTION 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. SUBSIDIZED HEALTH SERVICES SCHEDULE H, PART I; QUESTION 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. COMMUNITY BUILDING ACTIVITIES SCHEDULE H, 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. BAD DEBT EXPENSE SCHEDULE H, PART III, SECTION A; QUESTION 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. COMMUNITY BENEFIT SCHEDULE H, PART III, SECTION B; QUESTION 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. COLLECTION POLICY SCHEDULE H, PART III, SECTION B; QUESTION 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. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTIONS 1J, 3, 4, 5C, 6I & 7 NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 9 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. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 10 NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 11 NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 12H The hospital also uses household size. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTIONS 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. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 16E NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 17E NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 18E Before initiating any of the actions, the hospital facility sends letters, makes telephone calls and utilizes presumptive eligibility. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTIONS 19C & 19D NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 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). FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 21 NOT APPLICABLE. FACILITY INFORMATION SCHEDULE H, PART V, SECTION B, QUESTION 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. NEEDS ASSESSMENT SCHEDULE H, PART VI; QUESTION 2 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. Multi-year analyses, trends and projections are developed, which identify areas of need for the continuum of health care services. Primary data is obtained through a combination of qualitative analysis of community-based organization (CBO), informant interviews and surveys, individual community member surveys, and participation in collaborative partner meetings. These meetings include representatives from the Departments of Health, CBOs, academic institutions, government agencies, and hospitals. Ongoing input concerning our communities' needs is also obtained through: our Board of Trustees/Directors who are all area residents and leaders in their respective communities; facility based advisory boards and councils, and; the feedback received by our facility administrators and clinicians that serve on local community agency boards. Secondary data analysis includes: internal hospital data, including Prevention Quality Indicators (PQI); Department of Health Community Health Assessments; local regional NYS Prevention Agenda data sources; E-BRFSS; 2010 US Census data and Statewide Planning and Research System (SPARCS) data. The Committee on Community Health, a committee of the Board of Trustees, provides recommendations that concern North Shore-LIJ's community health priorities and interventions based on the CHNA. Committee discussions focus on New York State (NYS) Prevention Agenda Priority Areas, including strategies and intervention outcomes related to chronic disease prevention, women and children's health, healthy safe environments, health access, mental health and substance abuse, HIV/AIDS/STDs and community immunizations. Regional departments of health (I.E. Nassau County Department of Health, Suffolk County Department of Health Services, and NYC Department of Health and Mental Hygiene) perform additional community health assessments (CHA) with the input of hospital and community stakeholders. These regional partners use strategies such as community member surveys, CBO surveys, and public listening sessions to solicit information on community needs. Together with other healthcare organizations and CBOs, North Shore-LIJ participates in meetings organized by these regional departments of health academic organizations to discuss the shared responsibility of public health planning within the NYS Prevention Agenda. These meetings provide an opportunity for general discussion regarding the public health goals of the NYS Prevention Agenda and the selection of shared priorities for collaborative regional planning. The partnership among local health departments, hospitals and CBOs, enables region wide leveraging of resources, consensus on health priorities and collaboration on health promotion strategies. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE SCHEDULE H, PART VI; QUESTION 3 North Shore-LIJ is a regional leader in the development of financial assistance programs for the uninsured. The System's financial assistance policy provides a uniformly-administered system of reduced fees for the uninsured residents of our service area. The current fee schedule includes patients with household incomes up to 500% of the FPL. While the fee schedule serves as a guide, all hardship cases are evaluated on a case-by-case basis, taking into account the individual's financial and personal circumstances. All medically necessary services are covered under the financial assistance program and the public is notified of the availability of the program through: multilingual signage and educational brochures; centralized program administration accessible via phone ; staff outreach, and all bills include a notice about the financial assistance program. Soft credit scoring software is used to facilitate the application process, but is not used to deny an applicant. The Healthcare Access Center (HAC), staffed by bilingual employees, assists community residents' with referrals for enrollment into government-subsidized insurance programs such as Medicaid, Child Health Plus and Family Health Plus. In addition, the HAC staff refers patients to the Medicaid Prenatal Care Program and to the Senior Navigator Program within North Shore-LIJ for assistance with Medicaid for pregnant women and Medicare enrollment for seniors. COMMUNITY INFORMATION SCHEDULE H, PART VI; QUESTION 4 The North Shore-LIJ has a service area of more than approximately 7.2 million people covering Long Island (Nassau and Suffolk counties) and the Metropolitan area covering the boroughs of Manhattan, Queens, and Staten Island. The demographics of the community show a broad range of cultural and ethnic diversity, particularly in Queens, the most multi-ethnic county in the country. Overall the area has shown an increase in the number of uninsured and underinsured. The other counties in the service area continue to show trends of increasing diversity, as well. By 2018, our service area population 65 and older will grow by 14.5%, while residents under 65 will decline less than 1% (Thomson Reuters, Market Planner Plus). The service area has also shown high rates of obesity, diabetes, asthma and heart/cerebrovascular disease mortality. PROMOTION OF COMMUNITY HEALTH SCHEDULE H, PART VI; QUESTION 5 North Shore-LIJ works to promote community health through education, community advocacy, partnerships, and programs that result in improved access to care and health outcomes. The activities and strategies for achieving this goal include: establishing collaborative partnerships with local CBOs, health-related organizations, business, and government to identify and address community health needs; advocating for policies that benefit the broader community at state and local levels; providing community health programs and services based on identified community health needs/priorities; delivering preventive care services and education; conducting community outreach and engagement activities and expanding community member representation and involvement on committees/boards for programming and educational events. North Shore-LIJ provides community residents with a broad array of community health programs, such as: access to healthcare services and caring for the medically underserved; screenings and immunizations; health forums and health fairs; community education and outreach programs; support groups and counseling and emergency medical services. A comprehensive list of programs can be found in the Community Service Plans located on the North Shore-LIJ public website. North Shore-LIJ recognizes that, to have an impact on community health status, it must collaborate, to the extent possible, with multiple partners who can address different components of program design, including: providing trust and "reach" into a community; access to capital and funding; policy guidance and best practices for program development. With thousands of community programs, our partners are many and varied; some of our partners include: government, national/professional associations, area businesses, other area health care providers, philanthropies, civic organizations and CBOs. AFFILIATED HEALTHCARE SYSTEM SCHEDULE H, PART VI; QUESTION 6 The organization is an affiliate of the North Shore-LIJ Health System Inc., an integrated health care delivery system which includes 16 hospitals, 3 skilled nursing facilities, a world renowned children's hospital, post-acute services, ambulatory network, rehabilitation network and a freestanding research institute, which is chartered to confer doctoral (PhD) degrees through its Elmezzi Graduate School of Molecular Medicine. All North Shore-LIJ entities are considered to be under common control for antitrust and other legal purposes. Each hospital facility shares a common board and management in the North Shore-LIJ Health System and as such is referred to as being commonly managed. Also, in a joint venture, the Hofstra North Shore-LIJ School of Medicine at Hofstra University provides an allopathic medical school for the benefit of the community. In keeping with its mission to improve the health and caring for the communities it serves, regardless of the ability to pay, North Shore-LIJ established the Office of Community and Public Health (OCPH) to promote health and wellness. The OCPH plays a key role in leading many of the mission-critical initiatives of the System and operates in alignment with the National Prevention Strategy and NYS Prevention Agenda. The OCPH is guided by the Committee on Community Health, a committee composed of the Board of Trustees, which is charged with identifying the overall health needs of the community and making recommendations for the population the System serves. The objectives of the Committee include: promoting a dialogue about the obligations of a large health system in addressing critical health issues of the public; reviewing information which assesses the health status of the communities served; promoting activities which have been shown to positively impact health; proposing policy recommendations to guide current programs or develop new ones; identifying opportunities to meet health care needs through improved delivery of health care; and recommending community health interventions to be provided by the System. North Shore-LIJ has established comprehensive and coordinated clinical programs that span across the enterprise. These programs not only provide a full continuum of services and seamless delivery of care, but offer community health activities, outreach and education as well; they include: Behavioral Health, Cancer, Cardiovascular Services, Dental Medicine, Emergency Medicine, Family Medicine, Hospice Care, Imaging/Radiology, Laboratory Medicine and Pathology, Medicine, Neurology, Neurosurgery, Obstetrics/Gynecology, Ophthalmology, Orthopedic Surgery, Otolaryngology, Pediatrics, Physical Medicine & Rehabilitation, Population Health, Senior Services, Surgery, Urology, and Women's Health. The System's hospitals, programs and services support one of the largest resident and fellowship training programs in the United States. It directly sponsors approximately 120 accredited graduate medical education (GME) programs and trains more than 1,500 medical residents and fellows annually. Our hospitals and facilities collectively serve as teaching sites for more than 1,200 rotations for medical students from five medical schools. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI; QUESTION 7 New York FACILITY REPORTING GROUP(S) SCHEDULE H, PART VI; QUESTION 8 For any facility reported in Section B, the answers provided in Question 1 are identical. X X X X false true false true false false false true false MICHAEL J DOWLING 0 1172902 0 1628000 0 22448 0 1107110 0 21125 0 3951585 0 0 ANTHONY C FERRERI 0 873896 0 155000 0 20150 0 372110 0 15100 0 1436256 0 0 KEVIN F LAWLOR 0 665596 0 104400 0 29180 0 263381 0 17193 0 1079750 0 0 RALPH A NAPPI 0 672087 0 150000 0 1454459 0 41995 0 18775 0 2337316 0 1389266 ARTHUR KLEIN 0 871740 0 169000 0 34868 0 273100 0 15100 0 1363808 0 0 KEITH C THOMPSON 0 724852 0 113000 0 2030970 0 511950 0 21081 0 3401853 0 313468 HARRY E GINDI 0 280027 0 0 0 4531 0 27500 0 15100 0 327158 0 0 ROBERT S SHAPIRO 0 921947 0 190000 0 27506 0 209519 0 22300 0 1371272 0 0 THOMAS RECA 468317 0 42443 0 19286 100000 27000 0 13776 0 570822 100000 0 0 MARK P JARRETT MD 67485 544552 0 0 1399 51844 3654 27500 905 15100 73443 638996 0 0 DONNA PROSKE 496339 0 44443 0 23726 0 27000 0 7578 0 599086 0 0 0 GREGORY RADINSKY 0 269330 0 21756 0 18504 0 27500 0 14700 0 351790 0 0 JOSEPH T MCGINN MD 1495219 0 0 0 774 0 15000 0 20682 0 1531675 0 0 0 JONATHON DEITCH MD 898849 0 100000 0 0 0 15000 0 6386 0 1020235 0 0 0 MICHAEL L COOPER MD 936524 0 0 0 0 0 15000 0 20422 0 971946 0 0 0 PHILIP M VIGNERI MD 728016 0 175000 0 16952 0 25000 0 12494 0 957462 0 0 0 CHRISTOPHER DEMAS MD 795959 0 120000 0 0 0 11077 0 19822 0 946858 0 0 0 COMPENSATION INFORMATION CORE FORM, PART VII and SCHEDULE J, PART II; QUESTION 4B TWO individuals' participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. THE AMOUNTS REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES PARTICIPATION IN A SERP FOR WHICH AMOUNTS ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNT OUTLINED HEREIN WAS INCLUDED IN EACH INDIVIDUAL'S 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: RALPH A. NAPPI, $1,389,266 AND KEITH C. THOMPSON, $313,468. SEVEN individuals' participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. Accordingly, the individualS 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, AS TAXABLE MEDICARE WAGES. These amounts are included in Schedule J-II, Column C for Michael J. DowlinG, $1,079,610; ANTHONY C. FERRERI, $344,610; KEVIN F. LAWLOR, $233,853; Ralph A. Nappi, $14,495; ARTHUR KLEIN, $245,600; KEITH C. THOMPSON, $484,450 AND ROBERT S. SHAPIRO, $182,019. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 5A PURSUANT TO THE PERSONS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A, THERE IS NO CONTRACTUAL OBLIGATION TO PAY OR ACCRUE ANY COMPENSATION TO OFFICERS OF THE NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM BASED ON THE REVENUE OF THE ORGANIZATION. A LISTED PERSON(S) THAT MAY QUALIFY UNDER THIS CONDITION COULD BE ONE OR MORE OF THE PHYSICIANS LISTED AS A HIGHLY COMPENSATED EMPLOYEE. COMPENSATION INFORMATION SCHEDULE J, PART I; QUESTION 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-1, PART I, B (II). COMPENSATION INFORMATION SCHEDULE J, PART II, COLUMN F THE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUALS INCLUDE VESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH AMOUNTS ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THESE AMOUNTS WERE REPORTED IN SCHEDULE J, PART II, COLUMN C AS RETIREMENT AND OTHER DEFERRED COMPENSATION ON PRIOR YEAR'S FORMS 990. THE AMOUNTS WERE TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: RALPH A. NAPPI, $1,389,266 AND KEITH C. THOMPSON, $313,468. A DORMITORY AUTHORITY - STATE OF NEW YORK 146000293 649906JT2 2011-10-06 62381682 CAPITAL IMPROVEMENT false false false B DORMITORY AUTHORITY - STATE OF NEW YORK 146000293 2009-08-19 4744692 LEASE OF EQUIPMENT false false false A 909984 0 62439590 5021231 517772 0 1104871 0 0 10277334 36053483 0 true true false true B 770782 0 4744692 0 0 0 83250 0 0 4661442 0 0 2010 false false true true A false false false false 0 false false false true B false false false false 0 false false false true A false true true false false false 0 false 0 false true B false true true false false false 0 false 0 false true A true B true TONI A SPINELLA DAUGHTER OF OFFICER 34131 EMPLOYEE false TARA MAZZUCCO DAUGHTER OF TRUSTEE 39942 EMPLOYEE false SCARAN OIL COMPANY/FAMILY OF TRUSTEE 333874 OIL/UTILITY PRODUCT false DONNA FERRERI FAMILY MEMBER of officer 20976 EMPLOYEE false JAMES R WELLER SON OF OFFICER 79088 EMPLOYEE false BUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONS SCHEDULE L, PART IV FRANK W. SCARANGELLO, SR. IS A TRUSTEE OF THE ORGANIZATION. THE ORGANIZATION UTILIZED THE SERVICES OF HIS COMPANY, SCARAN OIL, DURING 2012. TOTAL FEES PAID TO SCARAN OIL WERE $333,874. SERVICES WERE RENDERED AT FAIR MARKET VALUE RATES PURSUANT TO ARM'S LENGTH NEGOTIATIONS. STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS CORE FORM, PART III; LINE 4D EXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. BUSINESS AND FAMILY RELATIONSHIPS CORE FORM, PART VI, SECTION A; QUESTION 2 FORM 990 SCHEDULE A, PART III STATEMENT ABOUT ACTIVITY ====================================================== 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. William Achenbaum ----------------- has a business relationship with Eric Blumencranz and Roger Blumencranz. John Alexander -------------- has a business relationship with John Shall. Philip Altheim -------------- has a business relationship with Eric Blumencranz. Stanley Applebaum ----------------- has a business relationship with John Shall. Michael Ashner -------------- has a business relationship with William Mack and Scott Rudolph. Eric Blumencranz ---------------- has as a family relationship with Roger Blumencranz. He has a business relationship with Roger Blumencranz, William Achenbaum, Philip Altheim, Arlene Lane Fisher, Richard Goldstein, Lloyd Goldman, Alan Greene, James Greene, Stanley Grey, Richard Guarasci, Richard Horowitz, M. Allen Hyman, Jeffrey Jurick, Arthur Levine, Stuart Levine, David Mack, Bradley Marsh, Charles Merinoff, Ralph Nappi, Dennis Riese and Michael Slade. Roger Blumencranz ----------------- has a family relationship with Eric Blumencranz. He has a business relationship with Eric Blumencranz, William Achenbaum, mark claster, Alan Greene, James Greene, Stanley Grey, Richard Goldstein, Richard Horowitz, Jeffrey Jurick, Stuart Levine, David Mack, Ralph Nappi, Donald Zucker, Barbara Zucker. David Blumenfeld ---------------- has a family relationship with Edward Blumenfeld. Edward Blumenfeld ----------------- has a family relationship with David Blumenfeld. He has a business relationship with William Mack. Steve Braun ----------- has a family relationship with Richard Sims. he has a business relationship with cary kravet. Robert w. Chasanoff ------------------- has a business relationship with Michael h. Sahn. Alan Chopp ---------- has a business relationship with Patrick Mc Dermott. Mark Claster ------------ has a business relationship with Roger A. Blumencranz, Richard Goldstein, Saul Katz, robert d. rosenthal and Barry Rubenstein. Philippe Dauman --------------- has a business relationship with thomas dooley. Daniel de Roulet ---------------- has a family relationship with Lorinda de Roulet. Lorinda de Roulet ---------------- has a family relationship with Daniel de Roulet. thomas dooley ------------- has a business relationship with philippe dauman. Leonard Feinstein ----------------- has a business relationship with William Mack. Anthony Ferreri --------------- has a family and business relationship with John Shall. Arlene Lane Fisher ------------------ has a business relationship with eric blumencranz. Lloyd Goldman ---------------- has a business relationship with Eric Blumencranz, Richard Goldstein and William Mack. RICHARD GOLDSTEIN ----------------- has a business relationship with Roger Blumencranz, Eric Blumencranz, Mark Claster, Lloyd Goldman, William Mack, and Barry Rubenstein. Joaquin Gonzalez ---------------- has a business relationship with John Shall. Alan I. Greene -------------- has a family relationship with James R. Greene. He has a business relationship with Eric blumencranz and Roger Blumencranz. James R. Greene --------------- has a family relationship with Alan I. Green. He has a business relationship with Eric blumencranz and Roger Blumencranz. Stanley Grey ------------ has a business relationship with eric blumencranz and Roger Blumencranz. Richard Guarasci ---------------- has a business relationship with Eric Blumencranz. William Hiltz ------------- has a business relationship with jeff maurer. Richard Horowitz ---------------- has a business relationship with Eric blumencranz, Roger Blumencranz and m. allen hyman. m. allen hyman -------------- has a business relationship with eric blumencranz, richard horowitz, saul katz and donald zucker. Jeffrey Jurick -------------- has a business relationship with Eric blumencranz and Roger Blumencranz. David Katz ---------- has a family relationship with Saul Katz and Michael Katz. He has a business relationship with saul katz and seth lipsay. Michael Katz ------------ has a family relationship with Saul Katz and David Katz. He has a business relationship with Saul Katz, Curt Launer and Michael Slade. Saul Katz --------- has a family relationship with Michael Katz and David Katz. He has a business relationship with Mark Claster, Michael Katz, Curt Launer, Michael Slade, m. allen hyman and david katz. cary kravet ----------- has a business relationship with steve braun. Jeffrey Lane ------------ has a business relationship with William Mack. Curt Launer ----------- has a business relationship with Michael Katz and Saul Katz. David Lehr ---------- has a business relationship with Ronald Mazzucco. Arthur Levine ------------- has a business relationship with Eric Blumencranz. Stuart Levine ------------- has a business relationship with Eric blumencranz and Roger blumencranz. David MACK ---------- has a family relationship with William Mack. He has a business relationship with William Mack, Eric Blumencranz, and Roger Blumencranz. William Mack ------------ has a family relationship with David Mack. He has business relationships with David Mack, Michael Ashner, Edward Blumenfeld, Leonard Feinstein, Lloyd Goldman, Jeffrey Lane, Barry Rubenstein, Richard Goldstein and Roy Zuckerberg. Bradley Marsh ------------- has a family relationship with Jack Ross. He has a business relationship with Eric Blumencranz. jeffrey maurer -------------- has a business relationship with william hiltz. Ronald Mazzucco --------------- has a business relationship with David Lehr. F.J. McCarthy ------------- has a business relationship with Robert Rosenthal. Patrick McDermott ----------------- has a business relationship with Alan Chopp and John Shall. Charles Merinoff ---------------- has a business relationship with Eric Blumencranz. richard murcott --------------- has a business relationship with barry rubenstein. Ralph Nappi ----------- has a business relationship with Eric Blumencranz and roger blumencranz. Dennis Riese ------------ has a business relationship with Eric Blumencranz. Robert Rosenthal ---------------- has a business relationship with Mark Claster, F.J. McCarthy and nancy waldenbaum. Jack Ross --------- has a family relationship with Bradley Marsh. Barry Rubenstein ---------------- has a business relationship with mark claster, richard goldstein, william mack and Saul Katz. Scott Rudolph ------------- has a business relationship with michael ashner. John Shall ---------- has a family relationship with Anthony Ferreri. He has a business relationship with Anthony Ferreri, Patrick McDermott, John Alexander, Stanley Applebaum, and Joaquin Gonzalez. Richard Sims ------------ has a family relationship with Steve Braun. Michael Slade ------------- has a business relationship with Eric Blumencranz, Saul Katz and Michael Katz. nancy waldenbaum ---------------- has a business relationship with robert rosenthal. Barbara Hrbek Zucker -------------------- has a family relationship with Donald Zucker. She has a business relationship with Roger Blumencranz. Donald Zucker ------------- has a family relationship with Barbara Hrbek Zucker. He has a business relationship with Roger Blumencranz and m. allen hyman. Roy Zuckerberg -------------- has a business relationship with William Mack. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION A; QUESTION 7 North Shore-Long Island Jewish Health Care, Inc. ("Health Care") is the sole corporate member of the organization. Health Care has the right to elect or appoint members of the organization's governing body and has the right to approve or ratify certain corporate decisions. This organization and Health Care are part of the North Shore - long Island Jewish Health System, an integrated healthcare delivery system. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION b; QUESTION 11b All North Shore-LONG ISLAND JEWISH 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. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 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 filed 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. DISCLOSURE INFORMATION CORE FORM, PART VI, SECTION B; QUESTION 15 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 INFORMATION CORE FORM, PART VI, SECTION C; QUESTION 19 CURRENTLY THE ORGANIZATION PROVIDES GOVERNANCE DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. RELATED HOURS INFORMATION CORE FORM, PART VII, SECTION A This organization is affiliated with the North Shore - Long Island Jewish Health System (the "Health System"). The Officers, Directors and Trustees listed on Schedule J hold similar positions with both this organization and other affiliates of the Health System, and they do not separately allocate their time to this organization and such other affiliates. The hours shown for all such persons reflect time devoted to the entire Health System and its affiliates, including this organization. For Directors and Trustees, the hours shown reflect the estimated average weekly time. For officers, Key Employees and Highest Compensated Employees, the hours shown reflect the weekly hours used when determining compensation payments for services rendered and are, generally, less than the actual weekly hours devoted to the Health System and its affiliates. OFFICER DISCLOSURE CORE FORM, PART VII AND SCHEDULE J MARK P. JARRETT, M.D., WAS EMPLOYEED AS THE CHIEF MEDICAL OFFICER OF THIS ORGANIZATION FROM JANUARY 1, 2012 THROUGH FEBRUARY 28, 2012. AS OF MARCH 1, 2013 MARK P. JARRETT, M.D. BECAME THE VICE PRESIDENT CHIEF QUALITY OFFICER AT NORTH SHORE - LONG ISLAND JEWISH. THEREFORE THIS RETURN SHOWS COMPENSATION FROM THIS ORGANIZATION AS WELL AS A TAX-EXEMPT RELATED CODE SECTION 501(C)(3) ORGANIZATION. RECONCILIATION OF NET ASSETS CORE FORM, PART XI; QUESTION 9 OTHER CHANGES IN FUND BALANCE INCLUDE: - NET ASSETS RELEASED FROM RESTRICTIONS USED FOR OPERATIONS - $924,051; - CHANGE IN VALUE ON EQUITY METHOD INVESTMENTS - $3,171,541; - CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS DESIGNATED AS DERIVATIVE INSTRUMENTS - $172,273; - NET ASSETS RELEASED FROM RESTRICTION FOR CAPITAL ASSET ACQUISITIONS - $2,087,532; - PENSION AND OTHER POSTRETIREMENT LIABILITY ADJUSTMENTS - ($1,217,587); and - NET CHANGE IN TEMPORARILY RESTRICTED NET ASSETS - $3,078,271. AUDITED FINANCIAL STATEMENTS CORE FORM, PART XII; QUESTION 2 THE ORGANIZATION IS AN AFFILIATE WITHIN THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. ("SYSTEM"), A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH INCLUDES STATEN ISLAND UNIVERSITY HOSPITAL. THE SYSTEM'S PARENT ENTITY IS NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. AND ITS AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2012 AND DECEMBER 31, 2011; RESPECTIVELY. THESE CONSOLIDATED AUDITED FINANCIAL STATEMENTS INCLUDE CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE NORTH SHORE - LONG ISLAND JEWISH HEALTHCARE SYSTEM, INC. EXECUTIVE COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR. CASTLETON AVENUE ASSOCIATES LLC 475 SEAVIEW AVENUE STATEN ISLAND NY 10305 133943199 INACTIVE NY 0 0 SIUH CHAPS Community Health Center Inc 1 Edgewater Plaza 6th Floor Staten Island NY 10305 113345477 Inactive NY 501(C)(3) 9 SIUH true Feinstein Institute for Medical Research 972 Brush Hollow Rd Westbury NY 11590 112673595 Research NY 501(C)(3) 4 NS-LIJ HS false Forest Hills Hospital 972 Brush Hollow Rd Westbury NY 11590 112163522 HealthCare NY 501(C)(3) 3 NS-LIJ HC false Franklin Hospital 972 Brush Hollow Rd Westbury NY 11590 112296824 HealthCare NY 501(C)(3) 3 NS-LIJ HC false Glen Cove Hospital 972 Brush Hollow Rd Westbury NY 11590 111633487 HealthCare NY 501(C)(3) 3 NS-LIJ HC false Hillside Hospital Houses Inc 972 Brush Hollow Rd Westbury NY 11590 112113949 Housing Comp NY 501(C)(2) N/A NS-LIJ HS false Hospice Care Network 99 Sunnyside Blvd Woodbury NY 11797 112925757 Hospice NY 501(C)(3) 9 NS-LIJ HS false Huntington Hospital 270 Park Avenue Huntington NY 11743 111630914 HealthCare NY 501(C)(3) 3 NS-LIJ HC false Huntington Hosp Dolan Family Health Ctr 284 Pulaski Rd Greenlawn NY 11740 113368503 HealthCare NY 501(C)(3) 3 Huntington false LIJ Foundation 972 Brush Hollow Rd Westbury NY 11590 112661239 support org NY 501(C)(3) 11, TYPE I NS-LIJ HS false Long Island Jewish Medical Center 972 Brush Hollow Rd Westbury NY 11590 112241326 HealthCare NY 501(C)(3) 3 NS-LIJ HC false LIJ Medical Center at Home Pharmacy 972 Brush Hollow Rd Westbury NY 11590 113251128 support org NY 501(C)(3) 11, TYPE I NS-LIJ HS false North Shore Community Services Inc 972 Brush Hollow Rd Westbury NY 11590 237273200 Housing Comp NY 501(C)(2) N/A NS-LIJ HS false North Shore University Hospital 972 Brush Hollow Rd Westbury NY 11590 111562701 HealthCare NY 501(C)(3) 3 NS-LIJ HC false NS Univ Hospital at Glen Cove Housing 972 Brush Hollow Rd Westbury NY 11590 237010468 Housing Comp NY 501(C)(2) N/A NS-LIJ HS false North Shore University Hospital Housing 972 Brush Hollow Rd Westbury NY 11590 112171903 Housing Comp NY 501(C)(2) N/A NS-LIJ HS false NSLIJ STERN FAMILY CENTER FOR REHAB 972 Brush Hollow Rd Westbury NY 11590 237007485 Nursing Home NY 501(C)(3) 9 NS-LIJ HC false North Shore-LIJ Health Care Inc 972 Brush Hollow Rd Westbury NY 11590 112965586 support org NY 501(C)(3) 11, TYPE I NS-LIJ HS false North Shore-LIJ Health System 972 Brush Hollow Rd Westbury NY 11590 113418133 support org NY 501(C)(3) 11, TYPE I NA false North Shore-LIJ Health System Foundation 972 Brush Hollow Rd Westbury NY 11590 112965575 Fundraising NY 501(C)(3) 7 NS-LIJ HS false North Shore-LIJ Health Sys Laboratories 972 Brush Hollow Rd Westbury NY 11590 113412370 Support Org NY 501(C)(3) 11, TYPE I NS-LIJ HS false North Shore-LIJ Medical Care Centers 972 Brush Hollow Rd Westbury NY 11590 113473923 support org NY 501(C)(3) 11, TYPE I NS-LIJ HS false Plainview Hospital 972 Brush Hollow Rd Westbury NY 11590 113241243 HealthCare NY 501(C)(3) 3 NS-LIJ HC false SIUH Systems Inc 475 Seaview Avenue Staten Island NY 10305 061074604 Fundraising NY 501(C)(3) 7 NS-LIJ HC false Southside Hospital 972 Brush Hollow Rd Westbury NY 11590 111667761 HealthCare NY 501(C)(3) 3 NS-LIJ HC false SSH Inc 972 Brush Hollow Rd Westbury NY 11590 112774102 support org NY 501(C)(3) 11, TYPE I SOUTHSIDE false Staten Island Univ Hospital Foundation 360 Seaview Avenue Staten Island NY 10305 870765787 Fundraising NY 501(C)(3) 7 SIUH true THE HEART INSTITUTE 475 SEAVIEW AVENUE STATEN ISLAND NY 10305 311757254 inactive NY 501(C)(3) 11, TYPE I NA false PHYSICIANS OF UNIVERSITY HOSPITAL PC 1 EDGEWATER PLAZA 6th floor STATEN ISLAND NY 10305 200096809 HEALTHCARE NY 501(C)(3) 11, TYPE I SIUH true LENOX HILL HOSPITAL 100 EAST 77 STREET NEW YORK NY 10021 131624070 HEALTHCARE NY 501(C)(3) 3 NS-LIJ HC false LHH CORPORATION 100 EAST 77TH STREET NEW YORK NY 10021 133272016 SUPPORT ORG NY 501(C)(3) 11, TYPE I NS-LIJ HS false THE ELMEZZI GRAD SCHOOL OF MOLECULAR MED 972 BRUSH HOLLOW RD WESTBURY NY 11590 113284934 GRADUATE SCH NY 501(C)(3) 2 NS-LIJ HS false SPORTS PHYSICAL THERAPY AND REHAB SVCS 972 BRUSH HOLLOW RD WESTBURY NY 11590 061655704 HEALTHCARE NY 501(C)(3) 9 LIJ false NORTH SHORE - LIJ ALLIANCE 972 BRUSH HOLLOW RD WESTBURY NY 11590 263727582 HEALTHCARE NY 501(C)(3) 3 NA false THE LONG ISLAND HOME 400 SUNRISE HIGHWAY AMITYVILLE NY 11701 112837244 HEALTHCARE NY 501(c)(3) 3 LHH CORP false THE LONG ISLAND HOME FOUNDATION 400 SUNRISE HIGHWAY AMITYVILLE NY 11701 112049038 SUPPORT NY 501(C)(3) 11, TYPE 1 LHH CORP false KRASNOFF CONS SVCS 972 Brush Hollow ROAD WESTBURY NY 11590 262838027 CONSULTING NY CARE MGT GROUP N/A false LONG ISL BEHAV HLTH 972 BRUSH HOLLOW RD WESTBURY NY 11590 453572263 STATISTICS NY NS-LIJ HC RELATED false Adv Heart Phys & Surgeons Network PC 130 East 77th St 4th Floor New York NY 10021 133853125 Medical Services NY LENOX HILL C CORPORATION false Adv Imag & Rad of Lenox Hill Hosp PC 100 East 77th St New York NY 10021 200719612 Medical ServiCES NY LENOX HILL C CORPORATION false Aletta Corporation 972 Brush Hollow Rd Westbury NY 11590 112622371 Physician svcs. NY SOUTHSIDE C CORPORATION false Autoimmune Research Therapeutics 972 Brush Hollow Rd Westbury NY 11590 270701489 Inactive NY RESEARCH C CORPORATION false Care Management Group of Greater NY 972 Brush Hollow Rd Westbury NY 11590 113336381 Business Services NY NSH ENTERPRISES C CORPORATION false Emergency Med Svcs of Staten Island PC 1 Edgewater Plaza 6th floor Staten Island NY 10305 134200899 Medical ServiCES NY SIUH C CORPORATION 76689 8799 1.00000 true Goethals Radiology PC 500 Seaview Ave Staten Island NY 10305 200010287 Radiology SVCs. NY SIUH C CORPORATION 8425 10264 1.00000 true Lenox Hill Cardiology Associates PC 100 East 77th St New York NY 10021 133385163 Medical ServiCES NY LENOX HILL C CORPORATION false Lenox Hill Int Card & Vasc Svcs PC 130 East 77th St 9th floor New York NY 10021 201435770 Medical ServiCES NY LENOX HILL C CORPORATION false Lenox Hill Pathology PC 100 East 77th St New York NY 10021 133644370 Medical ServiCES NY LENOX HILL C CORPORATION false Lenox Hill Phy Hospital Org Inc 122 East 76th St suite 3-a New York NY 100212834 133775996 Managed Care NY LENOX HILL C CORPORATION false Lenox otolaryngology head & neck surgery 186 East 76th St 2nd floor New York NY 10021 208784395 Medical Services NY LENOX HILL C CORPORATION false Manhattan Min Inv and Bar Surgery PC 186 East 76th St 1st Floor New York NY 10021 200250107 Medical Services NY LENOX HILL C CORPORATION false North Shore Health Enterprises 972 Brush Hollow Rd Westbury NY 11590 061605319 Holding Comp NY NSHS ENTERPRISE C CORPORATION false NS Health System Enterprises 972 Brush Hollow Rd Westbury NY 11590 113316922 Holding Comp NY NS-LIJ HS C CORPORATION false North Shore IPA 5 Inc 972 Brush Hollow Rd Westbury NY 11590 113383468 Business Services NY NS-LIJ HC C CORPORATION false NS Radiology at Glen Cove PC 972 Brush Hollow Rd Westbury NY 11590 113301179 Medical Services NY NSUH C CORPORATION false NS-LIJ Health System IPA #1 972 Brush Hollow Rd Westbury NY 11590 113533659 Health Care NY LIJ C CORPORATION false NS-LIJ Health System IPA #2 972 Brush Hollow Rd Westbury NY 11590 113533670 Health Care NY LIJ C CORPORATION false NS-LIJ Health System IPA #3 972 Brush Hollow Rd Westbury NY 11590 113533678 Health Care NY LIJ C CORPORATION false NS-LIJ Health System IPA #4 972 Brush Hollow Rd Westbury NY 11590 113533677 Health Care NY LIJ C CORPORATION false NS-LIJ Health System IPA #5 972 Brush Hollow Rd Westbury NY 11590 113533675 Health Care NY LIJ C CORPORATION false NS-LIJ Medical Gr at Huntington PC 972 Brush Hollow Rd Westbury NY 11590 274384049 Medical Services NY NSUH C CORPORATION false NS-LIJ Medical Gr at North Nassau PC 972 Brush Hollow Rd Westbury NY 11590 274384146 Medical Services NY NSUH C CORPORATION false NS-LIJ Medical Group at Syosset PC 972 Brush Hollow Rd Westbury NY 11590 273957752 Medical Services NY NSUH C CORPORATION false NS-LIJ Medical Group PC 972 Brush Hollow Rd Westbury NY 11590 274384249 Medical Services NY NSUH C CORPORATION false NS-LIJ Network Inc 972 Brush Hollow Rd Westbury NY 11590 320257193 Support Services NY NS-LIJ HS C CORPORATION false NS-LIJ Phys Insurance Co Risk Ret Group 100 Bank St Burlington VT 05401 261487515 INSURANCE VT NS-LIJ HC C CORPORATION false North Shore-LIJ Physicians Group PC 972 Brush Hollow Rd Westbury NY 11590 274384326 Medical Services NY NSUH C CORPORATION false North Shore-LIJ Radiology Services PC 972 Brush Hollow Rd Westbury NY 11590 223970667 Medical Services NY NSUH C CORPORATION false North Shore-LIJ Service Alliance Inc 972 Brush Hollow Rd Westbury NY 11590 263651575 Support Services NY NA C CORPORATION false Ocean Breeze Home Care Agency 1 Edgewater Plaza 6th Floor Staten Island NY 10305 133773601 Inactive NY OVM C CORPORATION false Ocean View Management inc 1 Edgewater Plaza 6th Floor Staten Island NY 10305 133138888 Management Svcs. NY SIUH C CORPORATION 211365 1106061 1.00000 true Palliative Care Medical Services PC 99 Sunnyside Blvd Woodbury NY 11797 273957835 Medical Services NY HOSPICE C CORPORATION false Park Lenox Emergency Medicine PC 100 East 77th St New York NY 10021 262661082 Medical Services NY LENOX HILL C CORPORATION false Park Lenox Medical PC 100 East 77th St New York NY 10021 133575380 Medical Services NY LENOX HILL C CORPORATION false Park Lenox OBGYN PC 130 East 77th St 2nd Floor New York NY 10021 133596988 Medical Services NY LENOX HILL C CORPORATION false Park Lenox Orthopedics PC 100 East 77th St New York NY 10021 264634966 Medical Services NY LENOX HILL C CORPORATION false Park Lenox Pediatrics PC 100 East 77th St New York NY 10021 133755683 Medical Services NY LENOX HILL C CORPORATION false Park Lenox Surgical PC 130 East 77th St 13th Floor New York NY 10021 133397814 Medical Services NY LENOX HILL C CORPORATION false Regency Alliance Services Inc 1 Edgewater Plaza 6th Floor Staten Island NY 10305 133277698 inactive NY OVM C CORPORATION false Regional Insurance Company LTD 41 Cedar Ave Hamilton BERMUDA BD HM 12 insurance BD NS-LIJ HC C CORPORATION false Regioncare Inc 972 Brush Hollow Rd Westbury NY 11590 113052191 Homecare NY NSHS ENTERPRISE C CORPORATION false Staten Island Hospitalists PC 475 Seaview Ave Staten Island NY 10305 331010283 Medical Services NY SIUH C CORPORATION 9599 164109 1.00000 true Staten Island Imaging Corp 1 Edgewater Plaza 6th Floor Staten Island NY 10305 133615474 Inactive NY OVM C CORPORATION false Staten Island Medical Intensivist PC 501 Seaview Ave Suite 102 Staten Island NY 10305 043716494 Medical Services NY SIUH C CORPORATION 278391 2110 1.00000 true Staten Island Neonatology PC 500 Seaview Ave Staten Island NY 10305 133375474 Medical Services NY SIUH C CORPORATION 29438 5100 1.00000 true SIUH Perinatology PC 475 Seaview Ave Staten Island NY 10305 134107082 Medical Services NY SIUH C CORPORATION 1.00000 true United Medical Surgical PC 256 Mason Ave BLDG B 2nd FL Staten Island NY 10305 134038780 Surgical Services NY SIUH C CORPORATION 10039871 548848 1.00000 false Univ Ph OncHematology Gp PC 500 Seaview Ave Staten Island NY 10305 133642729 Medical Services NY SIUH s CORPORATION 808 16051 1.00000 true Verrazano Radiology Associates PC 500 Seaview Ave Suite 200 Staten Island NY 10305 200011201 Radiology Svcs. NY SIUH C CORPORATION 9114742 2010280 1.00000 true Vivohealth Inc 972 Brush Hollow Rd Westbury NY 11590 264118016 Inactive NY NSH ENTERPRISE C CORPORATION false PARK LENOX PSYCHIATRY PC 130 EAST 77TH STREET NEW YORK NY 10021 133424466 Medical Services NY LENOX HILL C CORPoration false NS-LIJ CARDIOVASCULAR MEDICINE PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 275078717 Medical Services NY NSUH C CORPORATION false NS-LIJ CARDIOLOGY PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 275078531 Medical Services NY NSUH C CORPORATION false NS-LIJ HEART SURGERY PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 275078838 Medical Services NY NSUH C CORPORATION false NS-LIJ INTERNAL MEDICINE PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 275078361 Medical Services NY NSUH C CORPORATION false NS-LIJ MEDICAL GROUP URGENT MED CARE PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 275078426 Medical Services NY NSUH C CORPORATION false LENOX HILL HOSPITAL MEDICAL PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 452661543 Medical Services NY lenox C CORPORATION false NS-LIJ MEDICAL PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 453023019 Medical Services NY NSUH C CORPORATION false NS-LIJ OCCUPATIONAL MEDICINE PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 451004103 Medical Services NY NSUH C CORPORATION false NS-LIJ OB-GYN PC 972 Brush Hollow Rd Westbury NY 11590 461382916 Medical Services NY nsuh c corporation false NS-LIJ ANESTHESIOLOGY PC 972 BRUSH HOLLOW RD WESTBURY NY 11590 461617561 Medical Services NY NSUH C CORPORATION false NS-LIJ HEALTH PLANS INC 972 Brush Hollow Rd Westbury NY 11590 461617516 Medical Services NY NS-LIJ HC c corporation false false false true false false false false false false false false false false true false false false false TRANSACTIONS WITH RELATED ORGANIZATIONS SCHEDULE R, PART V THIS ORGANIZATION IS AN AFFILIATE OF North Shore - long Island Jewish Health System ("sYSTEM"). ORGANIZATIONS WITHIN THE SYSTEM ROUTINELY PAY EXPENSES FOR VARIOUS AFFILIATES IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.