2012-12-13T12:12:54-06:00 2011-12-31 990 2011-01-01 237007485 NORTH SHORE UNIVERSITY HOSPITAL STERN FAMILY CENTER FOR EXTENDED CARE AND REHABILITATION % NORTH SHORE-LIJ HEALTH SYSTE NORT 5168766061 972 BRUSH HOLLOW RD 5TH FL 972 BRUSH HOLLOW RD WESTBURY NY 11590 ROBERT S SHAPIRO 2012-12-12 2011 2016-02-24 21:20:13Z MICHAEL J DOWLING 145 COMMUNITY DRIVE GREAT NECK NY 11021 57400557 false X WWW.NORTHSHORELIJ.COM X 1968 NY THE MISSION IS TO ENABLE RESIDENTS TO BE INDEPENDENT THROUGH SHORT-TERM REHABILITATION, AND TO PROVIDE EXTENDED CARE TO THOSE WHO NEED IT REGARDLESS OF ABILITY TO PAY. 152 144 537 25 0 0 0 35352194 47447838 224972 290249 516014 498724 36093180 48236811 0 0 0 0 26983418 33001986 0 0 0 8478948 10247259 35462366 43249245 630814 4987566 41303048 46084198 22720190 22625897 18582858 23458301 THE MISSION IS TO ENABLE RESIDENTS TO BE INDEPENDENT THROUGH SHORT-TERM REHABILITATION, AND TO PROVIDE EXTENDED CARE TO THOSE WHO NEED IT REGARDLESS OF ABILITY TO PAY. false false 39961902 0 47447838 NORTH SHORE UNIVERSITY HOSPITAL STERN FAMILY CENTER FOR EXTENDED CARE AND REHABILITATION IS A 256 BED SKILLED NURSING FACILITY THAT SPECIALIZES IN SHORT TERM REHABILITATION AND EXTENDED CARE SERVICES. 39961902 true false false true false false false false false false true false false true true true false true false false false false false false false false false false false true true false false false false false false false false false false false false false false false true false false false false true 9 0 true 537 true false false false false false false false false false false false false false false false X 152 144 true false false false false true true true true false false true true true true true true true true false NY X X NORTH SHORE-LIJ HEALTH SYSTE 5168766061 972 BRUSH HOLLOW ROAD WESTBURY NY 11590 X MICHAEL DOWLING 50.0 X X 0 2521221 742813 RALPH NAPPI 50.0 X 0 774818 534580 RICHARD D GOLDSTEIN 3.0 X X 0 0 0 WILLIAM L MACK 2.0 X X 0 0 0 BARRY RUBENSTEIN 2.0 X X 0 0 0 ALAN I GREENE 2.0 X X 0 0 0 DONALD ZUCKER 2.0 X X 0 0 0 MARK CLASTER 2.0 X X 0 0 0 NON COMPENSATED TRUSTEES 2.0 X 0 0 0 ANTHONY C FERRERI 50.0 X 0 1041142 291142 KEVIN F LAWLOR 50.0 X 0 744807 313444 HOWARD GOLD 50.0 X 0 1039768 351634 MARK J SOLAZZO 50.0 X 0 1312802 138838 ROBERT S SHAPIRO 50.0 X 0 1047340 262780 LAWRENCE G SMITH MD 50.0 X 0 774723 43937 KEITH THOMPSON 50.0 X 0 856803 356015 JEFFREY KRAUT 50.0 X 0 767349 221731 KATHLEEN GALLO MD PHD 50.0 X 0 712494 347598 EUGENE TANGNEY 50.0 X 0 705151 93957 HARRY GINDI 50.0 X 0 304339 42050 MAUREEN MCCLUSKY 50.0 X 291675 0 42050 JAMES LOLIS 50.0 X 223657 0 34700 JOANNE NEWCOMBE 50.0 X 175009 0 42050 YAKOV IOFEL 50.0 X 155485 0 34700 AMANSHAH BABWAH 50.0 X 133780 0 42050 BARBARA GERAGHTY 50.0 X 118028 0 34700 1097634 12602757 3970769 16 false true false CIRRUS ALLIED LLC 309 EAST MOREHEAD ST STE 200 CHARLOTTE NC 28202 STAFFING 349837 SUPERIOR LAUNDRY SERVICES 72 ALBANY AVE FREEPORT NY 11520 CLEANING SERVICES 240000 NORTH SHORE CENTER FOR SPEECH LANGU 1165 NORTHERN BLVD MANHASSET NY 11030 MEDICAL SERVICES 109173 3 0 NET PATIENT SERVICE REVENUE 621300 21255956 21255956 MEDICARE/MEDICAID PAYMENTS 621300 26191882 26191882 47447838 234059 234059 10537 10537 0 9209399 9163746 45653 45653 0 0 0 SALARY RECOVERY 900099 156720 156720 EMPLOYEE CAFETERIA 900099 74103 74103 PAY TELEPHONE COM. 900099 54159 54159 213742 186383 27359 498724 48236811 47790941 400217 0 0 0 0 291675 291675 0 24286733 22924247 1362486 0 2312199 2182485 129714 4344154 4100447 243707 1767225 1668084 99141 0 0 0 0 0 0 1607437 1517260 90177 626 591 35 4331179 4088200 242979 0 0 667429 629986 37443 11577 11577 0 14433 14433 493615 493615 0 1199262 1131983 67279 140713 140713 BAD DEBT 287719 287719 PURCHASED SERVICES 835626 835626 CENTRALIZED ADMIN EXP 512632 512632 OTHER EXPENSE 145011 136876 8135 43249245 39961902 3287343 0 72610 318200 0 0 0 0 6310898 6861267 0 0 0 0 0 0 32389 34889 0 8535 20856936 8047300 12937845 12809636 14886513 15085094 0 0 0 0 0 0 7062793 10966577 41303048 46084198 4639427 4537394 0 0 0 0 8846987 8066340 0 0 0 0 0 0 0 0 9233776 10022163 22720190 22625897 X 17794054 22702007 788804 756294 0 0 18582858 23458301 41303048 46084198 X 4987566 -112123 X false true true X false X 0 0 0 0 0 0 32832144 34815225 36304443 35868208 47946562 187766582 32832144 34815225 36304443 35868208 47946562 187766582 187766582 808405 2170105 1175475 224972 290249 4669206 808405 2170105 1175475 224972 290249 4669206 33640549 36985330 37479918 36093180 48236811 192435788 0.97574 0.97102 0.02426 0.02898 X false false false false false false false true 7440 false 7440 false false 575000 575000 14504218 6091257 8412961 5324432 1780960 3543472 453286 175083 278203 12809636 AMORTIZED BOND FINANCING COSTS 175864 PATIENT SECURITY DEPOSIT 27103 DUE FROM AFFILIATES 9686933 INTEREST IN FOUNDATION 161942 INSURANCE CLAIMS RECEIVABLE 901548 OTHER ASSETS 13187 10966577 0 DUE TO THIRD-PARTY PAYORS 4218982 ACCRUED RETIREMENT BENEFITS 4049138 OTHER LIABILITIES 852495 INSURANCE CLAIMS LIABILITY 901548 10022163 48236811 43249245 4987566 -80121 -32002 -112123 4875443 48156690 -80121 -80121 48236811 48236811 42278648 42278648 970597 970597 43249245 FIN 48 PART X, LINE 2 Certain organizations included in the System's consolidated financial statements are taxable entities under Federal or state laws. 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, 2011 and 2010, 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. The System has net operating loss carry forwards of approximately $113,555,000, which expire in varying amounts through 2031, and are available to offset future taxable income. OTHER CHANGES IN NET ASSETS PART XI, LINE 8 CHANGE IN EQUITY UNDER FAS 136 (32,002) TOTAL OTHER (32,002) EXPENSE ON RETURN BUT NOT ON BOOKS PART XIII, LINE 4B ADDITIONAL MINIMUM PENSION LIABILITY 970,597 X X X X X false true false false false false false true false MICHAEL DOWLING 0 1173096 0 1328000 0 20125 0 721638 0 21175 0 3264034 0 0 HOWARD GOLD 0 870612 0 140520 0 28636 0 333605 0 18029 0 1391402 0 0 MARK J SOLAZZO 0 975957 0 300000 0 36845 0 120413 0 18425 0 1451640 0 0 ROBERT S SHAPIRO 0 869950 0 155520 0 21870 0 244560 0 18220 0 1310120 0 0 LAWRENCE G SMITH MD 0 675150 0 75780 0 23793 0 26950 0 16987 0 818660 0 0 KEITH THOMPSON 0 697420 0 130000 0 29383 0 340418 0 15597 0 1212818 0 0 JEFFREY KRAUT 0 622817 0 120520 0 24012 0 203691 0 18040 0 989080 0 0 KATHLEEN GALLO MD PHD 0 574034 0 109780 0 28680 0 332498 0 15100 0 1060092 0 0 EUGENE TANGNEY 0 589571 0 105780 0 9800 0 74095 0 19862 0 799108 0 0 RALPH NAPPI 0 649111 0 100000 0 25707 0 515655 0 18925 0 1309398 0 0 HARRY GINDI 0 272365 0 28591 0 3383 0 26950 0 15100 0 346389 0 0 MAUREEN MCCLUSKY 237657 0 28928 0 25090 0 26950 0 15100 0 333725 0 0 0 JAMES LOLIS 196237 0 9933 0 17487 0 19600 0 15100 0 258357 0 0 0 JOANNE NEWCOMBE 153811 0 10184 0 11014 0 26950 0 15100 0 217059 0 0 0 YAKOV IOFEL 148683 0 5469 0 1333 0 19600 0 15100 0 190185 0 0 0 AMANSHAH BABWAH 116752 0 6780 0 10248 0 26950 0 15100 0 175830 0 0 0 BARBARA GERAGHTY 110372 0 7030 0 626 0 19600 0 15100 0 152728 0 0 0 ANTHONY C FERRERI 0 880730 0 140660 0 19752 0 273335 0 17807 0 1332284 0 0 KEVIN F LAWLOR 0 597817 0 119000 0 27990 0 296193 0 17251 0 1058251 0 0 SUPPLEMENTAL NON QUALIFIED 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 Michael J Dowling ($694,688), Mark Solazzo ($93,463), Robert Shapiro ($217,610), Howard Gold ($306,655), Keith Thompson ($313,468), Jeffrey Kraut ($176,741), Kathleen Gallo ($305,548), Eugene Tangney ($47,145), Ralph Nappi ($488,705), Anthony Ferreri ($235,564) and Kevin Lawlor ($273,978). 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 I, B (ii). DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649903LC3 2007-05-31 3093951 2007 A&B BONDS-CAP IMPROV & REFUND true false false DORMITORY AUTHORITY OF THE STATE OF NEW YORK 146000293 649905QX7 2009-09-17 1528339 2009 A&E BONDS-CAP IMPROV & REFI 2 false false false 509899 0 1946609 131560 38348 608168 19424 0 0 460880 449407 0 true true false true 0 0 1524879 166670 118184 0 24775 0 0 673693 250391 0 true false false true false false false false 0 true false false false false 0 true false false true CITIBANK NA 25.9 false false true MBIA 18.1 true false true false false false 0 false 0 false true X PART II, LINE 3 - PROCEEDS, THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUE PRICE IN PART I, COLUMN (E) DUE TO INVEST EARNINGS & TRANSFERRED PROCEEDS BOARD MEMBER RELATIONS PART VI, SECTION A - GOVERNING BODY, 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. William Achenbaum has a business relationship with Eric and Roger Blumencranz. John Alexander has a business relationship with John Shall and Stanley Applebaum. Philip Altheim has a business relationship with Eric Blumencranz. Stanley Applebaum has a business relationship with John Alexander and John Shall. Michael Ashner has a business relationship with William Mack. Morton Bass has a family relationship with Sandra Atlas Bass. Eric Blumencranz has as a family relationship with Roger Blumencranz. He has a business relationship with Roger Blumencranz, William Achenbaum, Philip Altheim, Richard D. Goldstein, Lloyd Goldman, Alan Greene, James Greene, Richard Guarasci, Richard Horowitz, Jeffrey Jurick, Lyn Jurick, Seth Kupferberg, Arthur Levine, Stuart Levine, David Mack, Bradley Marsh, Charles Merinoff, Ralph Nappi, Dennis Riese. Roger Blumencranz has a family relationship with Eric Blumencranz. He has a business relationship with Eric Blumencranz, William Achenbaum, Alan Greene, James Greene, Stanley Grey, Richard D. Goldstein, Richard Horowitz, Jeffrey Jurick, Lyn Jurick, Stuart Levine, David Mack, Bradley Marsh, Charles Merinoff, Ralph Nappi, Mark Solazzo, 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. Alan Chopp has a business relationship with Patrick McDermott. Mark Claster has a business relationship with Robert Rosenthal, Richard Goldstein, Saul Katz. Philippe Dauman has a business relationship with Michael Hoffman. Daniel deRoulet has a family relationship with Lorinda deRoulet. Lorinda deRoulet has a family relationship with Daniel deRoulet. Leonard Feinstein has a business relationship with William Mack. Anthony Ferreri has a family and business relationship with John Shall. Lloyd Goldman has a business relationship with Eric Blumencranz, Richard Goldstein and William Mack. Richard D. 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 and Roger Blumencranz. James R. Greene has a family relationship with Alan I. Green. He has a business relationship with Eric and Roger Blumencranz. Stanley Grey has a business relationship with Roger Blumencranz. Richard Guarasci has a business relationship with Eric Blumencranz. Paul Guenther has a business relationship with Michael Hoffman. William Hiltz has a business relationship with Michael Hoffman and Jeff Maurer. Michael Hoffman has a business relationship with Phillipe Dauman, Paul Guenther, Marlene Hess, William Hiltz and Richard Nye. Richard Horowitz has a business relationship with Eric and Roger Blumencranz. Jeffrey Jurick has a family relationship with Lynn Jurick. He has a business relationship with Eric and Roger Blumencranz. Lynn Jurick has a family relationship with Jeffrey Jurick. She has a business relationship with Eric and Roger Blumencranz. David Katz has a family relationship with Saul Katz and Michael Katz. 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 and Michael Slade. Seth Kupferberg has a business relationship with Eric Blumencranz. Jeffrey Lane has a business relationship with William Mack. Curt Launer has a business relationship with Michael 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 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, Scott Rudolph, Richard Goldstein and Roy Zuckerberg. Bradley Marsh has a family relationship with Jack Ross. He has a business relationship with Eric and Roger Blumencranz. 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. Dennis Riese has a business relationship with Eric Blumencranz. Robert Rosenthal has a business relationship with Mark Claster and F.J. McCarthy. Dr Bernard Rosof has a business relationship with Huntington Hospital Trustees. Jack Ross has a family relationship with Bradley Marsh. Barry Rubenstein has a business relationship with Richard Goldstein, William Mack and Mark Claster. Scott Rudolph has a business relationship with William Mack. 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. 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. Roy Zuckerberg has a business relationship with William Mack. EXECUTIVE COMMITTEE PART VI, SECTION B - POLICIES, 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 POLICY PART VI, SECTION B - POLICIES, LINE 12C 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 filled 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. OFFICER COMPENSATION PART VI, SECTION B - POLICIES, LINE 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 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. DISCLOSURES PART VI, SECTION C - DISCLOSURES, LINE 19 CURRENTLY THE ORGANIZATION PROVIDES GOVERNANCE DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. NON-COMPENSATED TRUSTEES PART VII, SECTION A - LINE 1A Richard S. Abramson Albert L. Granger,DDSKatherine McEnroe William Achenbaum Alan I. Greene James McMullen John W. Alexander James R. Greene Charles Merinoff Ira I. Altfeder Stanley Grey Aimee Merszei Philip S. Altheim Richard Guarasci,PhD Richard D. Monti Stanley A. Applebaum Paul B. Guenther Tomas D. Morales, PhD Michael L. Ashner Henry L. Hackmann Richard Murcott Beverly VP. Banker Amy M. Hagedorn Ralph A. Nappi Ralph M. Baruch Stephen L. Hammerman Richard B. Nye Morton M. Bass Ira Hazan Clyde I. Payne, Ed.D. Frank J. Besignano Linda W. Heaney Arnold S. Penner Elise M. Bloom Marlene Hess John J. Raggio Eric S. Blumencranz William O. Hiltz Lewis S. Ranieri Roger A. Blumencranz Michael Hoffman Jay R. Raubvogel David Blumenfeld Gedale B. Horowitz Corey Ribotsky Edward Blumenfeld Richard A. Horowitz Dennis Riese E. Steve Braun M. Allan Hyman Terry P. Rifkin, M.D. Dayton T. Brown, Jr Mark Jacobson Robert A. Rosen Allen E. Busching Jeffrey Jurick Marcie Rosenberg Jonathan S. Canno Lyn Jurick Robert D. Rosenthal Michael Caridi Arthur Kalish Bernard M. Rosof, M.D. Rev. Carolina Sr, Ed.D Steven L. Kantor Jack J. Ross Rudolph C. Carryl David M. Katz Barry Rubenstein Robert W. Chasanoff Michael Katz Herbert Rubin Alan Chopp Saul B. Katz Scott Rudolph Mark Claster Lisa A. Kaufman Michael H. Sahn Diana F. Colgate Robert Kaufman Frank W. Scarangello, Sr. Daniel M. Crown Cary Kravet Norman Schlanger Philippe P. Dauman Stanley Kreitman Lois C. Schlissel Daniel C. de Roulet Seth Kupferberg John M. Shall Lorinda de Roulet Jeffrey B. Lane Robert F. Shapiro Thomas E. Dewey, Jr. Curt N. Launer Marc V. Shaw Thomas E. Dooley Laura Lauria Sean G. Simon Michael J. Dowling Kevin F. Lawlor Richard Sims Robert N. Downey Michale S. Leeds Michael C. Slade Melvin Dubin David W. Lehr Phyllis Hill Slater Patrick R. Edwards Jonathan W. Leigh Howard D. Stave Toni J. Elliott Sylvia Lester Russell Stern Michael A. Epstein Arthur S. Levine Maganlal Sutaria, M.D. Leonard Feinstein Stuart R. Levine John B. Thomson, Jr. Michael E. Feldman Seth Lipsay Peter Tilles Anthony C. Ferreri David S. Mack Sandra Tytel Arlene Lane Fisher William L. Mack Nancy Waldbaum Catherine C. Foster Howard S. Maier Gary Walter William H. Frazier Linda Manfredi Howard Weingrow Eugene B. Friedman, M.D.James S. Marcus Lewis M. Weston Sy Garfinkel Bradley Marsh, D.P.M.Jon A. Wurtzburger Lloyd Michael Goldman Jeffrey S. Maurer Barbara Hrbek Zucker Richard D. Goldstein Ronald J. Mazzucco Donald Zucker J. Joaquin Gonzalez F.J. McCarthy Roy J. Zuckerberg Michael Gould Patrick F. McDermott AVERAGE HOURS PART VII, SECTION A - LINE 1A, COLUMN (B) 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 and Key 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. GOVERNING BODY PART VI, LINE 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 health care delivery system. RECONCILIATION OF NET ASSETS PART XI, LINE 5 CHANGE IN NET UNREALIZED GAINS/LOSSES (80,121) CHANGE IN EQUITY UNDER FAS 136 (32,002) TOTAL (112,123) HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MICHAEL DOWLING TITLE:PRESIDENT & CEO HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RALPH NAPPI TITLE:TRUSTEE, PRES FOUNDATION HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:RICHARD D GOLDSTEIN TITLE:CHAIRMAN HOURS:3 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:WILLIAM L MACK TITLE:VICE CHAIRMAN HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:BARRY RUBENSTEIN TITLE:VICE CHAIRMAN HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ALAN I GREENE TITLE:TREASURER HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:DONALD ZUCKER TITLE:SECRETARY HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK CLASTER TITLE:VICE CHAIRMAN HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:NON COMPENSATED TRUSTEES TITLE:TRUSTEES HOURS:2 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ANTHONY C FERRERI TITLE:TRUSTEE, PRES & CEO SIUH HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KEVIN F LAWLOR TITLE:TRUSTEE, PRES & CEO HUNTINGTON HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:HOWARD GOLD TITLE:SR VP, REVENUE & BUSINESS DEV HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:MARK J SOLAZZO TITLE:EVP, CHIEF OPERATING OFFICER HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:ROBERT S SHAPIRO TITLE:SR VP, CHIEF FINANCIAL OFFICER HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:LAWRENCE G SMITH MD TITLE:EVP/PHYSICIAN IN CHIEF HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KEITH THOMPSON TITLE:SR VP & GENERAL COUNSEL HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:JEFFREY KRAUT TITLE:SR VP STRATEGIC PLAN HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:KATHLEEN GALLO MD PHD TITLE:CHF LEARNING OFFICER HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:EUGENE TANGNEY TITLE:REGIONAL EXECUTIVE DIRECTOR HOURS:50 HOURS DEVOTED FOR RELATED ORGANIZATION FORM 990 PART VII NAME:HARRY GINDI TITLE:ASSISTANT SECRETARY HOURS:50 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 NS-LIJHS false NORTH SHORE UNIVERSITY HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 111562701 HOSPITAL NY 501(c)(3) 3 NS-LIJ HCI false LONG ISLAND JEWISH MEDICAL CENTER 972 BRUSH HOLLOW RD WESTBURY NY 11590 112241326 HOSPITAL NY 501(c)(3) 3 NS-LIJ HCI false GLEN COVE HOSPITAL 972 BRUSH HOLLOW RD WESTBURY NY 11590 111633487 HOSPITAL NY 501(c)(3) 3 NS-LIJ HCI 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