HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH CENTER INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH CENTER INC (EIN 11-3368503)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-12-13
- IRS object ID
- 201233489349300803
- Schema version
- 2011v1.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-12-13T12:12:51-06:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 113368503 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH CEN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % MICHAEL FAGAN | InCareOfName |
| Name Control | HUNT | NameControl |
| Phone | 6314254262 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 284 PULASKI ROAD | AddressLine1 |
| City | GREENLAWN | City |
| State | NY | State |
| ZIP Code | 11740 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KEVIN LAWLOR | Name |
| Title | PRESIDENT & CEO | Title |
| Date Signed | 2012-12-12 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | KEVIN LAWLOR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 284 PULASKI ROAD | AddressLine1 |
| City | GREENLAWN | City |
| State | NY | State |
| ZIP Code | 11740 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 6689945 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | THE HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH CENTER ("THE HEALTH CENTER") IS A FREE-STANDING HOSPITAL-OWNED FACILITY DEDICATED TO PROVIDING MEDICAL CARE TO THE UNINSURED AND UNDER INSURED. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 57 | TotalNbrEmployees |
| Total Nbr Volunteers | 20 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 285245 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 108015 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 6717107 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6533233 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 443595 | InvestmentIncomePriorYear |
| Investment Income Current Year | 38329 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 9213 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7445947 | TotalRevenuePriorYear |
| Total Revenue Current Year | 6688790 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5025659 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4831382 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 5695 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2037901 | OtherExpensePriorYear |
| Other Expenses Current Year | 2306487 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7063560 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7137869 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 382387 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -449079 | RevenuesLessExpensesCY |
| Total Assets BOY | 8246895 | TotalAssetsBOY |
| Total Assets EOY | 7625643 | TotalAssetsEOY |
| Total Liabilities BOY | 8655572 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 8577076 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -408677 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -951433 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF THE HEALTH CENTER IS TO PROVIDE COMPREHENSIVE CARE & OB SERVICES TO THE MEDICALLY INDIGENT AND UNDERSERVED RESIDENTS FROM NORTHWESTERN SUFFOLK COUNTRY. THE CENTER SERVES AS THE ENTRY POINT INTO THE HEALTH SYSTEM FOR INDIVIDUALS AND FAMILIES SEEKING SUCH CARE. EVERY PATIENT WILL BE PROVIDED COMPREHENSIVE AND CONTINUOUS PREVENTIVE CARE, PRIMARY DIAGNOSTIC AND TREATMENT SERVICES AND EFFECTIVE COORDINATION OF CARE WITH SPECIALISTS AND SERVICES IN THE LARGER HEALTHCARE SYSTEM. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 6693855 | Expense |
| Grants | 0 | Grants |
| Revenue | 6533233 | Revenue |
| Description | THE HEALTH CENTER IS A COMPREHENSIVE COMMUNITY HEALTH CENTER WHICH PROVIDES PRIMARY, PEDIATRIC, PRENATAL, AND OBSTETRICAL CARE SERVICES TO THE POOR AND UNDERSERVED RESIDENTS IN THE COMMUNITY. IT IS THE ONLY SUCH CENTER BOTH OWNED AND OPERATED BY A HOSPITAL ON LONG ISLAND. ALL PATIENTS HAVE ACCESS TO A SUFFOLK COUNTY FACILITATED ENROLLER FOR MEDICAID MANAGED CARE, CHILD HEALTH PLUS, AND FAMILY HEALTH PLUS THROUGH A PARTNERSHIP WITH THE NASSAU SUFFOLK HOPSITAL COUNCIL. IN ADDITION, THE DOLAN CENTER'S SOCIAL WORK DEPARTMENT ASSISTS PATIENTS WITH ACCESS TO INSURANCE FOR PREGNANT WOMEN THROUGH NEW YORK STATE'S PRENATAL CARE ASSISTANCE PROGRAM. THE DOLAN FAMILY HEALTH CENTER PROVIDED 31,044 PATIENT VISITS IN 2011. | Description |
| Total Program Service Expense | 6693855 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 57 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MICHAEL FAGAN | NamePerson |
| Telephone Number | 6314254262 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 270 PARK AVENUE | AddressLine1 |
| City | HUNTINGTON | City |
| State | NY | State |
| ZIP Code | 11743 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| CARMELA ANGLIM | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| MICHAEL ABOFF | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| MICHAEL J DOWLING | ||||||||
| BOARD MEMBER/NSLIJHS PRES &CEO | 50.0 | X | 0 | 2521221 | 742813 | |||
| NICK FITTERMAN MD | ||||||||
| BOARD MEMBER | 50.0 | X | 0 | 438364 | 48226 | |||
| WILLIAM FRAZIER | ||||||||
| TREASURER | 1.0 | X | 0 | 0 | 0 | |||
| L KEITH FRIEDLANDER ESQ | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| ANTHONY GIACCONE | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| ROSALYN GORDON | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| THOMAS LEDERER | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| EUGENE LEVITT ESQ | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| HARRY MARIANI | ||||||||
| SECRETARY | 1.0 | X | 0 | 0 | 0 | |||
| JOHN MCCUSKER | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| LEWIS MELTZER ESQ | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| ROBERT MYERS | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| BERNARD M ROSOF MD | ||||||||
| CHAIRMAN | 1.0 | X | 0 | 0 | 0 | |||
| KEVIN LAWLOR | ||||||||
| PRESIDENT & CEO | 50.0 | X | 0 | 744807 | 313444 | X | ||
| MICHAEL GROSSO | ||||||||
| SENIOR VP OF MEDICAL AFFAIRS | 50.0 | X | 0 | 442520 | 48226 | X | ||
| MARTHA CARLSTROM | ||||||||
| BOARD MEMBER | 1.0 | X | 0 | 0 | 0 | |||
| FRED BUCKHOLZ | ||||||||
| TREASURER | 1.0 | X | 0 | 0 | 0 | X | ||
| TERENCE SMITH | ||||||||
| ADMINSTRATOR | 37.5 | 177680 | 0 | 33059 | X | |||
| WILLIAM GEHRHARDT MD | ||||||||
| PHYSICIAN | 37.5 | 216347 | 0 | 45173 | X | |||
| ROGELIO CO MD | ||||||||
| PHYSICIAN | 37.5 | 197160 | 0 | 43433 | X | |||
| ROBERTO BLANDO MD | ||||||||
| PHYSICIAN | 37.5 | 195383 | 0 | 17716 | X | |||
| SAILI DESAI MD | ||||||||
| PHYSICIAN | 37.5 | 149725 | 0 | 13576 | X | |||
| KATHY GIFFUNI | ||||||||
| NURSE MANAGER | 37.5 | 131652 | 0 | 37948 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1067947 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 4146912 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1343614 | TotalOtherCompensation |
| Number Individuals GT100 K | 11 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | NONE | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Of Contractor | AddressOfContractor |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| All Other Contributions | 108015 | AllOtherContributions |
| Total Contributions | 108015 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT REVENUE | 621300 | 3920670 | 3920670 |
| SUFFOLK COUNTY CONTRACT | 621300 | 2612563 | 2612563 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6533233 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 39484 | TotalRevenueColumn |
| Exclusion | $39,484 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1155 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -1155 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -1155 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MURCOTT CENTER FEE | 900099 | 6170 | 6170 |
| MEDICAL RECORDS | 900099 | 2771 | 2771 |
| MISCELLANEOUS OTHER | 900099 | 272 | 272 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 9213 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6688790 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6542446 | RelatedOrExemptFunctionIncome |
| Exclusion | $39,484 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 177680 | Total |
| Program Services | 177680 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3504417 | Total |
| Program Services | 3302562 | ProgramServices |
| Management And General | 198605 | ManagementAndGeneral |
| Fundraising | 3250 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 136305 | Total |
| Program Services | 128454 | ProgramServices |
| Management And General | 7725 | ManagementAndGeneral |
| Fundraising | 126 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 927818 | Total |
| Program Services | 874376 | ProgramServices |
| Management And General | 52582 | ManagementAndGeneral |
| Fundraising | 860 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 85162 | Total |
| Program Services | 80257 | ProgramServices |
| Management And General | 4826 | ManagementAndGeneral |
| Fundraising | 79 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87416 | Total |
| Management And General | 87416 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 875080 | Total |
| Program Services | 824675 | ProgramServices |
| Management And General | 49593 | ManagementAndGeneral |
| Fundraising | 812 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 209401 | Total |
| Program Services | 197340 | ProgramServices |
| Management And General | 11867 | ManagementAndGeneral |
| Fundraising | 194 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 393129 | Total |
| Program Services | 370484 | ProgramServices |
| Management And General | 22280 | ManagementAndGeneral |
| Fundraising | 365 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8382 | Total |
| Program Services | 8382 | ProgramServices |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18222 | Total |
| Program Services | 18222 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49712 | Total |
| Program Services | 46849 | ProgramServices |
| Management And General | 2863 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 213000 | Total |
| Program Services | 213000 | ProgramServices |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBT | 3736 | 3736 | ||
| PURCHASED SERVICES | 438496 | 438496 | ||
| DUES & SUBSCRIPTIONS | 875 | 825 | 49 | 1 |
| OTHER EXPENSES | 9038 | 8517 | 513 | 8 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7137869 | Total |
| Program Services | 6693855 | ProgramServices |
| Management And General | 438319 | ManagementAndGeneral |
| Fundraising | 5695 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 200 | BOY |
| EOY | 450 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 383683 | BOY |
| EOY | 185458 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 237904 | BOY |
| EOY | 279008 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 751245 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 74382 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 715426 | BOY |
| EOY | 676863 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3208935 | BOY |
| EOY | 5723248 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2542079 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1158668 | BOY |
| EOY | 760616 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8246895 | BOY |
| EOY | 7625643 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 633777 | BOY |
| EOY | 536294 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8021795 | BOY |
| EOY | 8040782 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8655572 | BOY |
| EOY | 8577076 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -5498422 | BOY |
| EOY | -6029449 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 689752 | BOY |
| EOY | 676494 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4399993 | BOY |
| EOY | 4401522 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -408677 | BOY |
| EOY | -951433 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8246895 | BOY |
| EOY | 7625643 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -449079 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -93677 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | false | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4399993 | BeginningOfYearBalance |
| Contributions | 1530 | Contributions |
| End Of Year Balance | 4401523 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4398363 | BeginningOfYearBalance |
| Contributions | 1630 | Contributions |
| End Of Year Balance | 4399993 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4388426 | BeginningOfYearBalance |
| Contributions | 9937 | Contributions |
| End Of Year Balance | 4398363 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 4372670 | BeginningOfYearBalance |
| Contributions | 15756 | Contributions |
| End Of Year Balance | 4388426 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Land | Land | |
| Buildings | Buildings |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 751245 | OtherCostOrOtherBasis |
| Depreciation | 74382 | Depreciation |
| Book Value | 676863 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Equipment | Equipment | |
| Other Land Buildings | OtherLandBuildings | |
| Total Of Book Value Land Buildings | 676863 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | SUFFOLK COUNTRY CONTRACT | Description |
| Book Value | 760616 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 760616 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ADVANCED FROM HUNTINGTON HOSPT | $7,945,200 |
| EST. NET PAYABLE DUE THIRD PAR | $95,582 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 8040782 | TotalOfAmounts |
| Total Revenue | 6688790 | TotalRevenue |
| Total Expenses | 7137869 | TotalExpenses |
| Excess Or Deficit For Year | -449079 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -93677 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -93677 | TotalAdjustments |
| Excess Or Deficit Per FS | -542756 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 6595992 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -93677 | NetUnrealizedGainsInvestments |
| Other Revenues | 39359 | OtherRevenues |
| Revenue Not Rptd F990 | -54318 | RevenueNotRptdF990 |
| Revenue Subtotal | 6650310 | RevenueSubtotal |
| Other Revenues Not Included | 38480 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 38480 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 6688790 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 7137869 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 7137869 | ExpensesSubtotal |
| Total Expenses Per Form990 | 7137869 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| USES OF ENDOWMENT FUNDS | PART V, LINE 4 | THE INVESTMENT INCOME OF THE ENDOWMENT FUNDS IS UNRESTRIECTED AND IS THEREFORE USED TO HELP SUPPORT THE OPERATION OF THE HUNTINGTON HOSPITAL DOLAN FMAILY HEALTH CENTER. |
| 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. |
| REVENUE RECONCILIATION | PART XII - LINE 2D AND LINE 4B | REVENUE ON BOOKS NOT ON RETURN NET ASSETS RELEASED FROM RESTRICTIONS 39,359 REVENUE ON RETURN NOT ON BOOKS TEMPORARILY/PERMANENTLY RESTRICTED CONTRIBUTIONS 38,480 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL J DOWLING | |||||||||||||
| 0 | 1173096 | 0 | 1328000 | 0 | 20125 | 0 | 721638 | 0 | 21175 | 0 | 3264034 | 0 | 0 |
| NICK FITTERMAN MD | |||||||||||||
| 0 | 418319 | 0 | 20000 | 0 | 45 | 0 | 22215 | 0 | 26011 | 0 | 486590 | 0 | 0 |
| KEVIN LAWLOR | |||||||||||||
| 0 | 597817 | 0 | 119000 | 0 | 27990 | 0 | 296193 | 0 | 17251 | 0 | 1058251 | 0 | 0 |
| MICHAEL GROSSO | |||||||||||||
| 0 | 378718 | 0 | 38212 | 0 | 25590 | 0 | 22215 | 0 | 26011 | 0 | 490746 | 0 | 0 |
| TERENCE SMITH | |||||||||||||
| 168837 | 0 | 5033 | 0 | 3810 | 0 | 16111 | 0 | 16948 | 0 | 210739 | 0 | 0 | 0 |
| WILLIAM GEHRHARDT MD | |||||||||||||
| 211391 | 0 | 0 | 0 | 4956 | 0 | 19617 | 0 | 25556 | 0 | 261520 | 0 | 0 | 0 |
| ROGELIO CO MD | |||||||||||||
| 191093 | 0 | 0 | 0 | 6067 | 0 | 17877 | 0 | 25556 | 0 | 240593 | 0 | 0 | 0 |
| ROBERTO BLANDO MD | |||||||||||||
| 189529 | 0 | 0 | 0 | 5854 | 0 | 17716 | 0 | 0 | 0 | 213099 | 0 | 0 | 0 |
| SAILI DESAI MD | |||||||||||||
| 147523 | 0 | 0 | 0 | 2202 | 0 | 13576 | 0 | 0 | 0 | 163301 | 0 | 0 | 0 |
| KATHY GIFFUNI | |||||||||||||
| 125934 | 0 | 4605 | 0 | 1113 | 0 | 11937 | 0 | 26011 | 0 | 169600 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART 1 - 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 Kevin Lawlor 457(F)($273,978)and Michael J. Dowling 457(F)($694,688). |
| PART 1 - LINE 3 | COMPENSATION OF THE PRESIDENT AND CEO IS PAID BY HUNTINGTON HOSPITAL WHICH UTILIZES THE FOLLOWING TO ESTABLISH THE COMPENSATION OF THE CEO: A) COMPENSATION COMMITTEE B) INDEPENDENT COMPENSATION CONSULTANT C) WRITTEN EMPLOYMENT CONTRACTS D) COMPENSATION SURVEY OR STUDY E) APPROVAL BY THE BOARD |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (33 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990 - PART I - LINE 5 PART V - LINE 2A/2B | THE STAFF OF THE HEALTH CENTER IS EMPLOYED BY HUNTINGTON HOSPITAL ASSOCIATION (THE "HOSPTIAL") AND THEIR SALARY AND RELATED COSTS ARE ALLOCATED TO THE HEALTH CENTER. NO SALARY COSTS ARE PAID DIRECTLY BY THE HEALTH CENTER. THE W-2S FOR THE NUMBER OF EMPLOYEES LISTED ON THESE LINES ARE ISSUED BY THE HOSPITAL ON BEHALF OF THE HEALTH CENTER. AS SUCH, THE HEALTH CENTER IS NOT REQUIRED TO FILE ANY FEDERAL EMPLOYMENT TAX RETURNS. | |
| FORM 990 - PART IV - LINE 12 AND PART XII - LINES 2 B/C | THE FINANCIAL STATEMENTS FOR THE HOSPITAL AND THE HEALTH CENTER ARE AUDITED ON A CONSOLIDATED BASIS WITH INDIVIDUAL CONSOLIDATING STATEMENTS FOR EACH ENTITY INCLUDED AS SUPPLEMENTAL SCHEDULES. A RECONCILIATION OF AMOUNTS PER THE CONSOLIDATING STATEMENTS FOR THE HEALTH CENTER INCLUDED IN THE AUDITED CONSOLIDATED FINANCIAL STATEMENTS, TO THE AMOUNTS REPORTED IN THE FORM 990 IS INCLUDED IN THE SUPPLEMENTAL SECTION OF SCHEDULE D. THE HOSPTIAL HAS AN AUDIT COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS. | |
| FORM 990 - PART VI - LINES 6, 7 A/B | THE SOLE MEMBER OF THE HEALTH CENTER IS THE HOSPITAL. BOTH THE HEALTH CENTER AND THE HOSPITAL ARE MEMBERS OF THE NORTH SHORE LONG ISLAND JEWISH HEALTH SYSTEM, INC. (THE "SYSTEM"). THE SYSTEM AND ITS MEMBER ORGANIZATIONS AND OTHER AFFILIATED ENTITIES ARE AN INTEGRATED HEALTH DELIVERY SYSTEM IN THE NY METRO AREA. THE SYSTEM IS THE SOLE MEMBER OF THE NORTH SHORE LONG ISLAND JEWISH HEALTH CARE, INC. ("HEALTH CARE, INC."). HEALTH CARE, INC. IS THE SOLE MEMBER OF THE HOSPITAL AND THE SOLE MEMBER OF OTHER HEALTH CARE ORGANIZATIONS THAT ARE NOT PART OF THE HOSPTIAL. THE BOARD OF DIRECTORS FOR THE HEALTH CENTER IS COMPRISED OF THE EXECUTIVE COMMITTEE OF THE BOARD OF THE HOSPTIAL. THE SYSTEM HAS THE RIGHT TO ELECT THE MEMEBERS OF THE HOSPITAL'S BOARD OF DIRECTORS, INCLUDING THE RIGHT TO APPOINT 3 PERSONS TO THE BOARD WHO ARE TRUSTEES OR EMPLOYED CORPORATE OFFICERS OF THE SYSTEM. THE MAJORITY OF THE HOSPITAL'S BOARD OF DIRECTORS MUST BE RESIDENTS OF THE PRIMARY SERVICE AREA SERVED BY THE HOSPITAL. CERTAIN DECISIONS OF THE BOARD REQUIRE THE APPROVAL OF THE SYSTEM AS OUTLINED IN THE CORPORATED BY-LAWS. | |
| FORM 990 PART VI - LINE 11A | THE 990 IS COMPLETED BY THE FINANCE DEPARTMENT OF THE HOSPITAL WITH INPUT FROM SENIOR MANAGEMENT AND OTHERS WITHIN THE ORGANIZATION. A COPY OF THE 990 IS MADE AVAILABLE TO SENIOR MANAGMENT AND THE BOARD OF DIRECTORS PRIOR TO FILING, FOR THEIR REVIEW AND COMMENTS. | |
| FORM 990 PART VI - LINE 12 C | AS MEMBERS OF THE NORTH SHORE LING ISLAND JEWISH HEALTH SYSTEM, THE HEALTH CENTER AND AFFILIATED ENTITIES HAVE SEVERAL CONTROL MECHANISMS TO MITIGATE CONFLICTS OF INTEREST. THE CODE OF ETHICAL CONDUCT POLICY CONTAINS A DETAILED SECTION EDUCATING INDIVIDUALS ABOUT HOW TO AVOID POTENTIAL CONFLICTS OF INTEREST. SPECIFICALLY, THE CODE OF ETHICAL CONDUCT REQUIRES INDIVIDUALS TO CONDUCT BUSINESS IN A MANNER THAT PLACES THE INTEREST OF THE ORGANIZATION AHEAD OF PERSONAL INTERSTS. IN ADDITION, THE ORGANIZATION HAS A CONFLICTS OF INTEREST POLICY STATEMENT FURTHER ELABORATING UPON INDIVIDUAL'S DISCLOSURE AND RECUSAL OBLIGATIONS. INDIVIDUALS THAT ARE IN A POSITION TO INFLUENCE THE BUSINESS OR OTHER DECISIONS ARE REQUIRED TO FILL OUT A CONFLICTS OF INTEREST DISCLOSURE FORM ON A REGULAR BASIS. THE CORPORATE COMPLIANCE OFFICER 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 AUDIT AND CORPORATE COMPLIANCE COMMITTEE AND OTHER APPLICABLE COMMITTEES. IN ADDITION, THE ORGANIZATION 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 ACTIONS IS TAKEN BASED UPON THE FACTS AND CIRCUMSTANCES OF THE SITUATION. | |
| FORM 990 - PART VI - LINE 15 | THE BOARD OF DIRECTORS OF THE HOSPTIAL APPOINTED A COMPENSATION COMMITTEE WITH THE RESPONSIBILTY FOR REVIEWING AND APPROVING THE WAGES AND BENEFITS OF THE ORGANIZATION'S OFFICERS AND KEY EMPLOYEES. THE COMMITTEE CONSITS OF AT LEAST THREE INDIVIDUALS, WHO THEMSELVES ARE MEMBERS OF THE BOARD OF DIRECTORS. THE COMMITTEE DEVELOPED AN EXECUTIVE COMPENSATION POLICY THAT INCLUDES THE USE OF INDEPENDENT COMPENSATION SURVEYS COMPLIED BY INDEPENDENT FIRMS. THE COMMITTEE MEETS AT LEAST ANNUALLY. MINUTES OF THOSE MEETINGS ARE MAINTAINED BY HUMAN RESOURCES. COMPENSATION IS NOT PAID DIRECTLY BY THE HEALTH CENTER. | |
| FORM 990 - PART VI - LINE 19 | THE HOSPITAL AND THE HEALTH CENTER MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND CONSOLIDATED AUDITED FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS ARE ALSO AVAILABLE ONLINE. | |
| RECONCILIATION OF NET ASSETS | NET UNREALIZED GAINS ON INVESTMENTS | PART XI, LINE 5 OTHER CHANGES |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:CARMELA ANGLIM TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:MICHAEL ABOFF TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:MICHAEL J. DOWLING TITLE:BOARD MEMBER/NSLIJHS PRES &CEO HOURS:50 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:NICK FITTERMAN, MD TITLE:BOARD MEMBER HOURS:50 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:WILLIAM FRAZIER TITLE:TREASURER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:L. KEITH FRIEDLANDER, ESQ. TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:ANTHONY GIACCONE TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:ROSALYN GORDON TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:THOMAS LEDERER TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:EUGENE LEVITT, ESQ. TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:HARRY MARIANI TITLE:SECRETARY HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:JOHN MCCUSKER TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:LEWIS MELTZER, ESQ. TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:ROBERT MYERS TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:BERNARD M. ROSOF, MD TITLE:CHAIRMAN HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:KEVIN LAWLOR TITLE:PRESIDENT & CEO HOURS:50 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:MICHAEL GROSSO TITLE:SENIOR VP OF MEDICAL AFFAIRS HOURS:50 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:MARTHA CARLSTROM TITLE:BOARD MEMBER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:FRED BUCKHOLZ TITLE:TREASURER HOURS:1 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:TERENCE SMITH TITLE:ADMINSTRATOR HOURS:38 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:WILLIAM GEHRHARDT, MD TITLE:PHYSICIAN HOURS:38 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:ROGELIO CO, MD TITLE:PHYSICIAN HOURS:38 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:ROBERTO BLANDO, MD TITLE:PHYSICIAN HOURS:38 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:SAILI DESAI, MD TITLE:PHYSICIAN HOURS:38 | FORM 990 PART VII |
| HOURS DEVOTED FOR RELATED ORGANIZATION | NAME:KATHY GIFFUNI TITLE:NURSE MANAGER HOURS:38 | FORM 990 PART VII |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| HUNTINGTON HOSPITAL ASSOCIATION | ||||||||||
| 270 PARK AVENUE | HUNTINGTON | NY | 11743 | 111630914 | HOSPTIAL | NY | 501(c)(3) | 3 | NA | false |
| NORTH SHORE LIJ HEALTH SYSTEM | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 113418133 | SUPPORTING OR | NY | 501(c)(3) | 11, TYPE 1 | NA | false |
| NORTH SHORE LIJ HEALTH SYSTEM LABORATORI | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 113412370 | SUPPORTING OR | NY | 501(c)(3) | 11, TYPE 1 | NA | false |
| NORTH SHORE LIJ HEALTH CARE INC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 112965586 | SUPPORTING OR | NY | 501(c)(3) | 11, TYPE 1 | NA | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
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