CALVARY HOSPITAL INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
CALVARY HOSPITAL INC (EIN 13-1740274)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-14
IRS object ID
201143189349303259
Schema version
2010v3.4
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

FieldValueIRS element (for citing)
Timestamp2011-11-14T11:10:19-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1TWO JERICHO PLAZAAddressLine1
CityJERICHOCity
StateNYState
ZIP Code11753ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN131740274EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CALVARY HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCALVNameControl
Phone7185182069Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11740 EASTCHESTER ROADAddressLine1
CityBRONXCity
StateNYState
ZIP Code104612392ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameANDREW V GRECOName
TitleCFOTitle
Phone7185182069Phone
Date Signed2011-11-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone5169187000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonFRANK A CALAMARINameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11740 EASTCHESTER ROADAddressLine1
CityBRONXCity
StateNYState
ZIP Code10461ZIPCode
FieldValueIRS element (for citing)
Gross Receipts115733793GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteWWW.CALVARYHOSPITAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1899YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionCALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees1029TotalNbrEmployees
Total Nbr Volunteers170TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year6352838ContributionsGrantsPriorYear
Contributions Grants Current Year3916697ContributionsGrantsCurrentYear
Program Service Revenue Prior Year93606436ProgramServiceRevenuePriorYear
Program Service Revenue CY96290400ProgramServiceRevenueCY
Investment Income Prior Year993253InvestmentIncomePriorYear
Investment Income Current Year4983798InvestmentIncomeCurrentYear
Other Revenue Prior Year814008OtherRevenuePriorYear
Other Revenue Current Year898098OtherRevenueCurrentYear
Total Revenue Prior Year101766535TotalRevenuePriorYear
Total Revenue Current Year106088993TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year74039100SalariesEtcPriorYear
Salaries Etc Current Year76677997SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year30246900OtherExpensePriorYear
Other Expenses Current Year30597606OtherExpensesCurrentYear
Total Expenses Prior Year104286000TotalExpensesPriorYear
Total Expenses Current Year107275603TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-2519465RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1186610RevenuesLessExpensesCY
Total Assets BOY98734242TotalAssetsBOY
Total Assets EOY102903101TotalAssetsEOY
Total Liabilities BOY41688016TotalLiabilitiesBOY
Total Liabilities EOY41466701TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY57046226NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY61436400NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense78053461Expense
Revenue78340100Revenue
DescriptionADVANCED CANCER CARE INPATIENT - CALVARY SERVES ABOUT 12% OF ALL INDIVIDUALS WHO DIE OF CANCER IN THE NEW YORK METROPOLITAN AREA EACH YEAR. PATIENTS ARE REFERRED TO CALVARY FROM EVERY MAJOR HOSPITAL AND MEDICAL CENTER IN NEW YORK CITY. IN 2010, CALVARY CARED FOR MORE THAN 5,300 PATIENTS AND FAMILIES AS INPATIENTS IN OUR 200-BED BRONX CAMPUS AND OUR 25-BED SATELLITE AT LUTHERAN MEDICAL CENTER IN BROOKLYN, AS OUTPATIENTS, THROUGH OUR CENTER FOR CURATIVE AND PALLIATIVE WOUND CARE; AND THROUGH HOSPICE AND HOME CARE. THE AVERAGE LENGTH OF INPATIENT STAY IS 23 DAYS.OUR PATIENTS CAME FROM ACROSS THE NEW YORK TRI-STATE AREA: THE BRONX, QUEENS, MANHATTAN WESTCHESTER, BROOKLYN, AND LONG ISLAND AS WELL AS FROM OTHER LOCATIONS. THEY RANGED IN AGE FROM 20 TO 108, WITH A MAJORITY (82%) OVER AGE THE AGE OF 55. MINORITIES (INCLUDING ASIAN, AFRICAN AMERICAN, AND HISPANIC) MADE UP 46% OF ALL INPATIENTS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense13445725Expense
Revenue15654200Revenue
DescriptionCALVARY HOSPITAL HOSPICE IS A MEDICARE-CERTIFIED HOSPICE PROGRAM, WHICH PROVIDES AN INTERDISCIPLINARY CARE TEAM FOR PATIENTS WITH A TERMINAL PROGNOSIS FOR ALL END-STAGE DISEASES. CALVARY HOSPITAL HOSPICE EMBRACES AND IMPLEMENTS THE BASIC ASSUMPTIONS OF THE HOSPICE CONCEPT, INCLUDING THE FOLLOWING:- HOSPICE PROVIDES PALLIATIVE MEDICAL CARE, TREATING THE PHYSICAL, EMOTIONAL AND SPIRITUAL PAIN OF THE PATIENT AND FAMILY.- HOSPICE TREATS THE PATIENT AND LOVED ONES TOGETHER AS A WHOLE UNIT OF CARE AND OFFERS BEREAVEMENT COUNSELING FOR SURVIVING CAREGIVERS AFTER THE PATIENT'S DEATH.- HOSPICE PATIENTS REMAIN IN THE FAMILIAR, COMFORTING SURROUNDINGS OF HOME, WHETHER IT'S A PRIVATE RESIDENCE, NURSING HOME, HOSPITAL OR AN ASSISTED LIVING FACILITY.- HOSPICE CARE PROVIDES THE FOLLOWING FOUR LEVELS OF CARE: ROUTINE CARE, GENERAL INPATIENT CARE (IF NEEDED), CONTINUOUS CARE (DURING A CRISIS), AND RESPITE CARE.HOSPICE SERVICES- NURSING CARE, AS NECESSARY TO MAINTAIN THE PATIENT AT HOME- 24 HOURS A DAY, 7 DAYS A WEEK ON-CALL NURSE- PHYSICIAN SERVICES- MEDICAL SOCIAL SERVICES- PASTORAL CARE- COUNSELING SERVICES- NUTRITIONAL COUNSELING- SHORT-TERM INPATIENT AND RESPITE CARE- MEDICAL SUPPLIES RELATED TO TERMINALLY ILL- PERSONAL CARE PROVIDED BY CERTIFIED HOME HEALTH AIDES- THERAPIES (E.G., PHYSICAL, OCCUPATIONAL AND SPEECH)- MEDICATIONS FOR SYMPTOM MANAGEMENT AND PAIN CONTROL RELATED TO THETERMINALLY ILL- BEREAVEMENT COUNSELING FOR FAMILY MEMBERS- VOLUNTEER SERVICESDescription

Activity3 Activity3

FieldValueIRS element (for citing)
Expense2863603Expense
Revenue1539500Revenue
DescriptionCALVARY'S HOME HEALTH AGENCY SERVES PATIENTS IN THE BRONX, QUEENS, NORTHERN MANHATTAN, AND SOUTHERN WESTCHESTER COUNTY. CALVARY OFFERS HOME CARE TO PATIENTS WITH ALL DIAGNOSES. MOST PATIENTS RETURN TO PRE-ILLNESS FUNCTION AND ARE DISCHARGED TO SELF-CARE WITHIN SIX TO EIGHT WEEKS. ALL OF OUR PATIENTS WHO WE CARE FOR AT HOME GET THE SAME LEVEL OF HIGH-QUALITY AND UNIQUE "CALVARY CARE" AS ALL OF OUR INPATIENTS.THE FOLLOWING SERVICES ARE AVAILABLE TO PATIENTS AND THEIR FAMILIES THROUGH CALVARY'S CERTIFIED HOME HEALTH AGENCY:NURSING SERVICES- OUR COMMUNITY HEALTH NURSES PROVIDE NURSING VISITS TO PATIENTS IN THEIR HOMES.- SPECIALIZED NURSING IS AVAILABLE SUCH AS ENTEROSTOMAL THERAPY.- 24-HOUR TELEPHONE ACCESS TO RN (REGISTERED NURSE) ON-CALL.HOME HEALTH AIDE- PROVIDES ASSISTANCE WITH PERSONAL CARE AND OTHER ACTIVITIES RELATED TO HEALTH CARE.NUTRITIONAL SERVICES- CALVARY'S DIETITIANS ARE AVAILABLE BY PHONE TO HELP IN PLANNINGTHERAPEUTIC NUTRITIONAL MANAGEMENT.THERAPY SERVICES- PHYSICAL THERAPY- OCCUPATIONAL THERAPY- SPEECH THERAPYMEDICAL CARE- CALVARY HOME CARE STAFF WILL WORK CLOSELY WITH THE PATIENT'S OWN PHYSICIAN TO MEET HOME HEALTH NEEDS.- OUR STAFF HAS EXTENSIVE KNOWLEDGE OF PAIN MANAGEMENT.MEDICAL SOCIAL WORKA FULL RANGE OF SOCIAL WORK SERVICES ARE AVAILABLE TO HELP PATIENTS AND FAMILIES COPE WITH THE PROBLEMS OF ILLNESS.- ASSISTANCE IN MEDICAID APPLICATION- ASSISTANCE IN LONG-TERM PLANNINGREFERRING PATIENTS- REFERRALS MAY BE MADE BY PATIENTS, FAMILY MEMBERS, FRIENDS, HOSPITALS, CLINICS, PHYSICIANS, OTHER HEALTH CARE PROFESSIONALS AND COMMUNITY AGENCIES.- TO MAKE A REFERRAL OR TO LEARN MORE ABOUT OUR SERVICES, PLEASE CALL (718) 430-9540.PART OF THE CALVARY CONTINUUM- FACILITATE ADMISSION TO INPATIENT CARE FOR SYMPTOM MANAGEMENT- REFERRAL TO OUTPATIENT AND WOUND CARE CLINICS- PROVIDE INFORMATION ON CALVARY PROGRAMS INCLUDING BEREAVEMENT SUPPORTDescription

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense2291579Expense
Revenue906403Revenue
DescriptionADVANCED CANCER CARE OUTPATIENT/OTHER PROGRAMSTHE OUTPATIENT CLINIC PROVIDES CARE THROUGH A MULTIDISCIPLINARY APPROACH, WHICH ENCOMPASSES THE PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS OF THE PATIENT AND THEIR FAMILY. THE AIM OF THE CLINIC IS TO PROVIDE COMPREHENSIVE HEALTH CARE FOR THE ADVANCED CANCER PATIENT.OUTPATIENT SERVICES1. THE OUTPATIENT CLINIC SPECIALIZES IN PAIN CONTROL, WOUND CARE AND OTHER SERVICES SPECIFIC TO THE ADVANCED CANCER PATIENT.2. EACH PATIENT IS ASSIGNED A PRIMARY PHYSICIAN, REGISTERED NURSE, SOCIAL WORKER AND DIETITIAN.3. THE SERVICES OF PASTORAL CARE, THERAPEUTIC RECREATION, RADIOLOGY, LABORATORY, ENTEROSTOMAL THERAPY AND OTHER SERVICES ARE AVAILABLE IF NEEDED.4. THE OUTPATIENT NURSES PROVIDE ADDITIONAL SUPPORT TO PATIENTS AND FAMILIES THROUGH FREQUENT TELEPHONE CALLS.5. ASSISTANCE WITH TRANSPORTATION ARRANGEMENTS WILL BE PROVIDED IF NEEDED.6. TWENTY-FOUR HOUR TELEPHONE COVERAGE WITH A NURSE AND PHYSICIAN FOR ADVICE OR REASSURANCE IS AVAILABLE.7. CONSULTATION WITH MEDICAL SPECIALISTS CAN BE ARRANGED AND COORDINATED.8. COORDINATION OF SERVICES IS PROVIDED AMONG THE PATIENT'S PHYSICIAN, HOME CARE AGENCY AND OTHER PROVIDERS TO ASSURE APPROPRIATE AND CONTINUAL CARE.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp2291579TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev906403TotalOfOtherProgramServiceRev
Total Program Service Expense96654368TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest1ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached0FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity1DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109670NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees1029NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ANDREW GRECOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7185182069TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11740 EASTCHESTER ROADAddressLine1
CityBRONXCity
StateNYState
ZIP Code104612069ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MANFRED ALTSTADT
TREASURER2.00X000
JOHN P BERTSCH
SECRETARY2.00X000
JOHN A DECINA
DIRECTOR2.00X000
THOMAS J FAHEY JR MD
CHAIRMAN OF BOARD2.00X000
THOMAS G FERRARA
DIRECTOR2.00X000
TERENCE GALLAGHER-EMERITUS
DIRECTOR2.00X000
STEVEN J GOLUB
DIRECTOR2.00X000
EDWARD D HEBEN
DIRECTOR2.00X000
RALPH V JOHNSON
DIRECTOR2.00X000
MSGR EDWARD H BARRY
DIRECTOR2.00X000
JAMES E INTRONE
DIRECTOR2.00X07958618935
RENA M MURTHA RN
DIRECTOR2.00X000
AMIT SIKDAR
DIRECTOR2.00X000
MINTO L SOARES
DIRECTOR2.00X000
JOSEPH A TARANTINO
DIRECTOR2.00X000
ANNE COTE TAYLOR
DIRECTOR2.00X000
RICHARD E MEYER
VICE CHAIRMAN2.00X000
MICHAEL J BRESCIA MD
EXECUTIVE MEDICAL DIRECTOR36.00464817023897X
FRANK A CALAMARI
PRESIDENT/ EXECUTIVE DIREC36.00868487035503X
CHRISTOPHER COMFORT MD
MED DIRECTOR36.00410970050883X
RICHARD KUTILEK
CHIEF OPERATIONS OFFICER36.00330651048723X
FRANK J LOCAPARRA
CHIEF FINANCIAL OFFICER36.00130673040573X
ANDREW V GRECO
CHIEF FINANCIAL OFFICER36.00252861023438X
SALLY UMBRO RN
VP FOR PATIENT CARE SERVIC26.00214115040025X
ANTHONY TARANTO
ASST. ADMIN. ENVIRONMENT C36.00170168028497X
NANCY D'AGOSTINO RN
DIRECTOR HOME CARE/HOSPICE36.00191495046523X
ROBERT BRESCIA MD
DIRECTOR PAL CR36.00337386033502X
DEVMANI JAITLY MD
ATTENDING PHYSICIAN36.00463217048883X
GAIL CHRZANOWSKI MD
ATTENDING PHYSICIAN36.00264405041369X
OSCAR ALVAREZ PHD
ADMINISTRATOR/DIR. OF RESE36.00241693048676X
SREENIVASA PATIBANDLA MD
STAFF PHYSICIAN36.00335486025670X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4676424TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs795861TotalReportableCompFrmRltdOrgs
Total Other Compensation545097TotalOtherCompensation
Number Individuals GT100 K108NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
AMERISOURCEBERGEN CORP
PO BOX 5188NEW YORKNY100875188PHARMACEUTICAL VENDOR1983173
MMS
PO BOX 643925CINCINNATIOH45264MEDICAL SUPPLIES1033524
FARRELL MEDIA GROUP
887 KINDERKAMACK RD 1ST FLRIVER EDGENJ07661ADVERTISING988778
US FOOD SERVICE INC
PO BOX 642554PITTSBURGHPA152642554FOOD VENDOR575161
EXTENDED CARE CONCEPTS
125 NEWTOWN RD SUITE 300PLAINVIEWNY11803HOME HEALTH AIDE AGENCY489011
FieldValueIRS element (for citing)
Number Of Contractors GT100 K52NumberOfContractorsGT100K
Related Organizations1370003RelatedOrganizations
All Other Contributions2546694AllOtherContributions
Total Contributions3916697TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE REVENUE9000996672563766725637
MEDICAID REVENUE9000991679231416792314
PATIENT SERVICE REVENU9000991277244912772449
FieldValueIRS element (for citing)
Total Program Service Revenue96290400TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1040098TotalRevenueColumn
Exclusion$1,040,098ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real42000Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real42000Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column42000TotalRevenueColumn
Exclusion$42,000ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities13588500Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities9621500Securities
Other23300Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3967000Securities
Other-23300Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3943700TotalRevenueColumn
Exclusion$3,943,700ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
PARKING LOT REVENUE900099249095$249,095
CAFETERIA900099231497$231,497
MISCELLANEOUS INCOME900099225703$225,703

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column149803TotalRevenueColumn
Related Or Exempt Function Income149803RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue856098TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column106088993TotalRevenueColumn
Related Or Exempt Function Income96440203RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$5,732,093ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3066439Total
Program Services2762831ProgramServices
Management And General303608ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total52361361Total
Program Services47177063ProgramServices
Management And General5184298ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total6397697Total
Program Services5764325ProgramServices
Management And General633372ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total10975600Total
Program Services9888906ProgramServices
Management And General1086694ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3876900Total
Program Services3493048ProgramServices
Management And General383852ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total962000Total
Management And General962000ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total391600Total
Management And General391600ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total316000Total
Management And General316000ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total5528800Total
Program Services5528800ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total1293800Total
Program Services1165701ProgramServices
Management And General128099ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2657400Total
Program Services2394291ProgramServices
Management And General263109ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2429200Total
Program Services2188685ProgramServices
Management And General240515ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3847100Total
Program Services3466199ProgramServices
Management And General380901ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total558800Total
Program Services503473ProgramServices
Management And General55327ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
OTHER ANCILLARY MED EXP57513005751300
PROVISION FOR BAD DEBT21608002160800
MISCELLANEOUS20921001924577167523
MAINTENANCE AND REPAIRS12558001131463124337
FOOD EXPENSE962200962200

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total390706Total
Program Services390706ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total107275603Total
Program Services96654368ProgramServices
Management And General10621235ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY-821062BOY
EOY-1791088EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4699285BOY
EOY2900297EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY18641313BOY
EOY19021098EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY30699BOY
EOY192799EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY412047BOY
EOY399297EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis77551200LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec61177300LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY16980700BOY
EOY16373900EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY21390483BOY
EOY24099496EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY17200200BOY
EOY19899515EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY20200577BOY
EOY21807787EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY98734242BOY
EOY102903101EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY15085633BOY
EOY15111098EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY26602383BOY
EOY26355603EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY41688016BOY
EOY41466701EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY34129640BOY
EOY35702000EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY21122386BOY
EOY23901500EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1794200BOY
EOY1832900EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY57046226BOY
EOY61436400EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY98734242BOY
EOY102903101EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1186610ReconcilationRevenueExpenses
Reconcilation Other Changes5576784ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement BothXFinancialStatementBoth
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$23,232OtherActivitiesAmount
Total Lobbying Expenditures IIB23232TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF OTHER LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1I:ReturnReference
ExplanationCALVARY HOSPITAL, INC. DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES; HOWEVER, IT DOES BEAR INDIRECT COSTS THAT HAVE LOBBYING IMPLICATIONS. THE $23,232 REPORTED ON PART II-B, LINE 1(I) REPRESENTS THAT PORTION OF ITS MEMBERSHIP DUES THE HOSPITAL PAYS TO THE HOSPITAL ASSOCIATION OF NEW YORK STATE (HANYS) AND THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA) THAT RELATES TO LOBBYING EXPENSES. THIS AMOUNT HAS BEEN DETERMINED IN ACCORDANCE WITH MEDICARE PROVIDER REIMBURSEMENT MANUAL, PART I, SECTION 2139.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance22916700BeginningOfYearBalance
Contributions1901600Contributions
Investment Earnings Or Losses2815700InvestmentEarningsOrLosses
Other Expenditures1899600OtherExpenditures
End Of Year Balance25734400EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance20492500BeginningOfYearBalance
Contributions1747600Contributions
Investment Earnings Or Losses2610800InvestmentEarningsOrLosses
Other Expenditures1934200OtherExpenditures
End Of Year Balance22916700EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.00000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.07120PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.92880TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis538000OtherCostOrOtherBasis
Book Value538000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis27751100OtherCostOrOtherBasis
Depreciation19948800Depreciation
Book Value7802300BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis3552800OtherCostOrOtherBasis
Depreciation2440600Depreciation
Book Value1112200BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis45669000OtherCostOrOtherBasis
Depreciation38787900Depreciation
Book Value6881100BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis40300OtherCostOrOtherBasis
Book Value40300BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings16373900TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionBENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUNDDescription
Book Value19899515BookValue
Method Of ValuationFMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related19899515TotalOfBookValueProgramRelated

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM THIRD PARTIES620000
CAPITAL IMPROVEMENTS5072700
SELF INSURANCE FUND ASSETS2060500
EQUIPMENT ESCROW FUND7540100
DONOR RESTRICTED ASSETS4837100
DEFERRED COMPENSATION ASSET1481900
OTHER ASSETS10487
DUE FROM AFFILIATES185000
FieldValueIRS element (for citing)
Total Book Value Other Assets21807787TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
ACCRUED PENSION LIABILITY$20,507,500
DUE TO THIRD PARTIES$4,731,303
MALPRACTICE LIABILITY$1,116,800
FieldValueIRS element (for citing)
Total Of Amounts26355603TotalOfAmounts
Total Revenue106088993TotalRevenue
Total Expenses107275603TotalExpenses
Excess Or Deficit For Year-1186610ExcessOrDeficitForYear
Net Unrealized GL On Investments525900NetUnrealizedGLOnInvestments
Other$5,050,884OtherAmount
Total Adjustments5576784TotalAdjustments
Excess Or Deficit Per FS4390174ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt106614900TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments525900NetUnrealizedGainsInvestments
Other Revenues7OtherRevenues
Revenue Not Rptd F990525907RevenueNotRptdF990
Revenue Subtotal106088993RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form990106088993TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt107275600TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal107275600ExpensesSubtotal
Other Expenses Not Included3OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt3ExpensesNotRptdOnFinStmt
Total Expenses Per Form990107275603TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:Identifier
Return ReferencePART V, LINE 4:ReturnReference
ExplanationAT DECEMBER 31, 2010, TEMPORARILY RESTRICTED NET ASSETS WERE AS FOLLOWS: BUILDING FUNDS $ 7,425,800 SPECIFIC PURPOSE FUNDS 7,379,000 HOSPITAL PROGRAMS 9,096,700 TOTAL $ 23,901,500 NET ASSETS DESIGNATED AS A BUILDING FUNDS ARE RESTRICTED FOR THE PURPOSE OF CAPITAL ADDITIONS. NET ASSETS DESIGNATED AS SPECIFIC-PURPOSE FUNDS ARE DESIGNATED FOR THE OPERATIONAL SUPPORT OF HOSPITAL-SPONSORED PROGRAMS, INCLUDING COMMUNITY OUTREACH, BEREAVEMENT, AND PALLIATIVE EDUCATION. DURING 2010, NET ASSETS WERE RELEASED FROM DONOR RESTRICTIONS BY INCURRING EXPENSES SATISFYING THE FOLLOWING: MEDIA ADVERTISING $ 1,217,400 PALLIATIVE CARE INSITUTE PROGRAMS 41,300 HOME HEALTH AND HOSPICE PROGRAMS 120,000 WOUND CLINIC 200,000 PASTORAL CARE 80,000 MISCELLANEOUS PROGRAM EXPENSES 240,900 TOTAL $ 1,899,600 PERMANENTLY RESTRICTED NET ASSETS AT DECEMBER 31, 2010, ARE RESTRICTED TO THE FOLLOWING: INVESTMENTS HELD IN PERPETUITY - THE INCOME TO WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES $ 850,000 BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND, INC. 982,900 TOTAL $ 1,832,900 PERMANENTLY RESTRICTED NET ASSETS ARE ENDOWMENT INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT HEALTH SERVICES AS IS REPORTED AS NONOPERATING GAINS IN THE STATEMENT OF OPERATIONS. THE BOARD OF DIRECTORS HAS DETERMINED THAT DONOR-RESTRICTED ENDOWMENT FUNDS WILL BE GOVERNED BY SPECIFIC POLICIES WITH THE OBJECTIVE THAT THE ORIGINAL GIFT SHALL BE PROTECTED IN PERPETUITY AS THE ENDOWED CORPUS AND DISTRIBUTIONS WILL NOT BE MADE IF THEY WILL BRING THE VALUE BELOW THAT THRESHOLD. POLICIES HAVE BEEN DEVELOPED REGARDING THE EXPENDITURE OF FUNDS IN ACCORDANCE WITH DONOR-IMPOSED RESTRICTIONS.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy0WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense117100TotalCommunityBenefitExpense
Net Community Benefit Expense117100NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense821526TotalCommunityBenefitExpense
Net Community Benefit Expense821526NetCommunityBenefitExpense
Percent Of Total Expense0.00780PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense938626TotalCommunityBenefitExpense
Net Community Benefit Expense938626NetCommunityBenefitExpense
Percent Of Total Expense0.00890PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense938626TotalCommunityBenefitExpense
Net Community Benefit Expense938626NetCommunityBenefitExpense
Percent Of Total Expense0.00890PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs16NumberOfActivitiesOrPrograms
Total Community Building Expense228979TotalCommunityBuildingExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Building Expense228979NetCommunityBuildingExpense
Percent Of Total Expense0.00220PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense2000TotalCommunityBuildingExpense
Net Community Building Expense2000NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense5000TotalCommunityBuildingExpense
Net Community Building Expense5000NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Total Community Building Expense65628TotalCommunityBuildingExpense
Net Community Building Expense65628NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs21NumberOfActivitiesOrPrograms
Total Community Building Expense301607TotalCommunityBuildingExpense
Net Community Building Expense301607NetCommunityBuildingExpense
Percent Of Total Expense0.00280PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense$2,160,800BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare41650838AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare43843844CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2193006MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalCritical Access HospitalCriticalAccessHospital
CALVARY HOSPITAL INC
11740 EASTCHESTER ROADBRONXNY10461XXX
CALVARY HOSPITAL INC (BROOKLYN CAMPUS)
2150 55TH STREETBROOKLYNNY11220XXX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained0EligibilityCriteriaExplained
Uses FPG Free0UsesFPGFree
Uses FPG Discounted0UsesFPGDiscounted
Explains Basis0ExplainsBasis
Explains Application Method0ExplainsApplicationMethod
Includes Publicity Measures0IncludesPublicityMeasures
Actions On Nonpayment0ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy0NondiscrimEmergencyCarePolicy
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: CALVARY HOSPITAL, INC. USES THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE TO LOW-INCOME PATIENTS.
PART I, LINE 6A: CALVARY HOSPITAL, INC. IS REQUIRED TO PREPARE AN ANNUAL COMMUNITY SERVICE PLAN (CSP) A.K.A., THE COMPREHENSIVE COMMUNITY SERVICE PLAN FOR THE NYS DEPARTMENT OF HEALTH. THIS REPORT IS FILED WITH THE NYS DOH. THE COMMUNITY SERVICE PLAN IS AVAILABLE ON THE ORGANIZATION'S WEB SITE (WWW.CALVARYHOSPITAL.ORG). ADDITIONALLY, CALVARY POSTS INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS AND HAS A CALENDAR ON PROGRAMMATIC INFORMATION AS IT BECOMES AVAILABLE REGARDING BEREAVEMENT GROUPS AND SUPPORT NETWORKS ON THE ORGANIZATION'S WEB SITE.
PART I, LINE 7: CALVARY HOSPITAL, INC. HAS UTILIZED NET REALIZABLE VALUE OF THE SERVICES RENDERED FOR THE CHARITY CARE AMOUNT LISTED ON PART I LINE 7. CALVARY UTILIZED THE AMOUNT REPORTED IN ITS COST REPORT PREPARED FOR THE NYS DOH.
PART I, LINE 7G: CALVARY HOSPITAL, INC. HAS INCLUDED CHARITY CARE SERVICES IN THE AMOUNT OF $117,100 ON THE FORM 990, PART VIII, LINE 2G. THIS AMOUNT IS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7(F) AS PER THE INSTRUCTIONS.CALVARY HOSPITAL, INC. IS A NOT-FOR PROFIT SPECIALTY HOSPITAL THAT PROVIDES SERVICES FOR THE CARE OF TERMINALLY ILL CANCER PATIENTS. CALVARY HOSPITAL, INC. IS OPERATED IN CONNECTION WITH THE ROMAN CATHOLIC ARCHDIOCESE OF NEW YORK.THE MISSION OF CALVARY HOSPITAL, INC. IS AS FOLLOWS:FROM ITS INCEPTION IN 1899, CALVARY HOSPITAL HAS BEEN FAITHFULLY DEVOTED TO PROVIDING PALLIATIVE CARE TO ADULT PATIENTS IN THE ADVANCED STAGES OF CANCER, ADDRESSING THE SYMPTOMS OF THE DISEASE, NOT ITS CURE. A VOLUNTARY, NOT-FOR-PROFIT HOSPITAL, OPERATED IN CONNECTION WITH THE ARCHDIOCESE OF NEW YORK, CALVARY CONTINUES TO EMBODY THIS TRADITION OF CARING THROUGH THE SERVICES AND PROGRAMS OFFERED BY AND THROUGH THE DEDICATION AND CONCERN SHOWN BY ITS STAFF MEMBERS.THE HOSPITAL WILL CONTINUE TO BE FAITHFUL TO THIS TRADITION THROUGH A TWOFOLD COMMITMENT. CALVARY WILL STRIVE PRIMARILY TO EXPAND ITS PROGRAMS AND SERVICES TO MEET THE EMERGING PHYSICAL, PSYCHOSOCIAL, AND SPIRITUAL NEEDS OF BOTH PATIENTS AND FAMILIES THROUGH THE PROVISION OF ACUTE INPATIENT, OUTPATIENT, HOME CARE, HOSPICE, AND SATELLITE SERVICES. IN ADDITION, THROUGH THE THE PALLIATIVE CARE INSTITUTE, THE HOSPITAL ENDEAVORS TO TRANSMIT TO OTHER HEALTH CARE PROFESSIONALS, THROUGH RESEARCH AND EDUCATION, THE KNOWLEDGE AND COMPETENCE WHICH IT HAS DEVELOPED IN THE CARE OF THE ADVANCED CANCER PATIENT.THROUGH THIS TWOFOLD COMMITMENT, CALVARY HOSPITAL WILL DEEPEN AND STRENGTHEN THE PHILOSOPY OF COMPASSIONATE CARE WHICH HAS BEEN THE CORNERSTONE OF ITS PROGRAM OF SERVICE, AND WILL OFFER TO THOSE IN OUR EXPANDED COMMUNITY AND OTHERS, A TRADITION OF SUCCESSFUL EXPEDRIENCE IN THE CARE OF THE ADVANCED CANCER PATIENT.CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. WITH 225 BEDS IN THE BRONX AND BROOKLYN AND MORE THAN 1029 EMPLOYEES, CALVARY SERVES MORE THAN 5,500 PATIENTS ANNUALLY. CALVARY PROVIDES PALLIATIVE CARE, WHICH IS THE ACTIVE TREATMENT OF THE SYMPTOMS, NOT THE CURE OF THE DISEASE, IN ORDER TO MAKE OUR PATIENTS AS COMFORTABLE AS POSSIBLE. CALVARY'S PROGRAMS INCLUDE INPATIENT CARE, CASE MANAGEMENT, OUTPATIENT CARE, HOSPICE, HOME CARE AND SUPPORT PROGRAMS FOR FAMILIES AND FRIENDS.AS CALVARY APPROACHES THE FUTURE WITH A SENSE OF HOPE AND PROMISE, CALVARY IS EVER MINDFUL OF THE LEGACY OF OUR FOUNDERS, THE WOMEN OF CALVARY, TO PROVIDE COMPREHENSIVE CARE WHILE RECOGNIZING THE INDIVIDUALITY AND DIGNITY OF EVERY PATIENT. AT THE SAME TIME, CALVARY WILL CONTINUE TO DEVELOP NEW PROGRAMS AND SERVICES TO MEET THE NEEDS OF TODAY'S WORLD.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2160800.
PART II: CALVARY HOSPITAL MAKES A NUMBER OF DIFFERENT SUPPORT GROUPS AVAILABLE TO THE COMMUNITY. THESE SUPPORT GROUPS ARE ADVERTISED ON CALVARY HOSPITAL'S WEBSITE, WWW.CALVARYHOSPITAL.ORG, ON ITS CALENDAR OF EVENTS. ALL GROUPS ARE FREE AND ARE OPEN TO THE COMMUNITY.CALVARY HOSPITAL PROVIDES BEREAVEMENT SUPPORT FOR ADULTS WHO HAVE LOST LOVED ONES AT CALVARY HOSPITAL OR CALVARY@HOME, AND THOSE FROM THE COMMUNITY AT LARGE WHO HAVE LOST SOMEONE BECAUSE OF ILLNESS, ACCIDENTS, VIOLENCE, OR ANY OTHER CAUSE. GROUPS ARE OFFERED IN THE BRONX AND BROOKLYN.THE HOSPITAL OFFERS AGE-APPROPRIATE SUPPORT GROUPS FOR CHILDREN, AGES 6 THROUGH 11, AND FOR ADOLESCENTS, AGES 12 TO 18.CALVARY IN TOUCH, A BI-MONTHLY NEWSLETTER ABOUT BEREAVEMENT ISSUES IS AVAILABLE THROUGH THE HOSPITAL'S WELBSITE.THESE COMMUNITY SUPPORT GROUPS INCLUDE BUT ARE NOT LIMITED TO:- SUPPORT GROUPS FOR BEREAVED PARENTS- PRECIOUS MOMENTS SUPPORT GROUP FOR CHILDREN AGES 6 TO 11- TEEN BEREAVEMENT GROUP- DEATH OF A SPOUSE BEREAVEMENT GROUP- DEATH OF A PARENT BEREAVEMENT GROUP- CAMP COURAGEOUS DAY CAMP FOR BEREAVED CHILDRENGROUPS ARE OPEN TO ALL, ARE FREE OF CHARGE, AND ARE LED BY CALVARY HOSPITAL STAFF. REGISTRATION IN ADVANCE OF PARTICIPATION IS REQUIRED.CALVARY HOSPITAL ALSO MAKES AVAILABLE A NUMBER OF DIFFERENT WELLNESS ACTIVITIES TO THE COMMUNITY. THESE WELLNESS ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO YOGA CLASSES AND RECREATIONAL THERAPY.CALVARY HOSPITAL'S THERAPEUTIC RECREATION AND MUSIC THERAPY PROGRAMS WERE CREATED TO GIVE PATIENTS A SENSE OF ACCOMPLISMENT AND TO RELIEVE THE SUFFERING OF OUR OUR PATIENTS AND THEIR FAMILIES. THERAPEUTIC RECREATION ACTIVITIES INCLUDE DRAWING, SCULPTURE, AND CERAMICS PROJECTS; HORTICULTURE; A GAMES AND DISCUSSION HOUR; AND HOLIDAY PARTIES. MUSIC THERAPY OFTEN HELPS SOOTHE PATIENTS AND HELPS THEM FOCUS ON LIFE.OUR BOARD CERTIFIED MUSIC THERAPISTS USE MUSIC THERAPY INTERVENTIONS TO SOOTHE PATIENTS, RELIEVE ANXIETY, REMINISCE, AND EASE PAIN AND SUFFERING. MUSIC THERAPY INTERVENTIONS MAY ALSO PROVIDE RELEASE IN THE LAST HOURS OR MOMENTS OF LIFE. PATIENTS RECEIVING MUSIC THERAPY SOMETIMES WRITE SONGS ASSISTED BY THE MUSIC THERAPISTS TO LEAVE FOR LOVED ONES, OR FIND OTHER WAYS TO OPEN THEIR HEARTS THROUGH MUSIC. OUR CLINICIANS REPORT THAT IN SOME CASES, THE ONLY TIME A PATIENT LAUGHS OR SMILES IS DURING A MUSIC THERAPY SESSION. WE ALSO FIND THAT MUSIC THERAPY IS AVAILABLE AT BOTH INPATIENT LOCATIONS AND IS ALSO ONE OF THE SERVICES WE OFFER THROUGH CALVARY@HOME.IN KEEPING WITH OUR MISSION TO SHARE OUR KNOWLEDGE AND EXPERIENCE WITH OTHERS, CALVARY OFFERS INTERNSHIP PROGRAMS IN THE FOLLOWING AREAS: PALLIATIVE CARE AND MUSIC THERAPY, WHICH IS RECOGNIZED AS A NATIONAL CLINICAL TRAINING SITE BY THE AMERICAN MUSIC THERAPY ASSOCIATION.THROUGH ITS EDDIE HIGGINS SCHOLARSHIP PROGRAM, CALVARY HOSPITAL PROVIDES LEADERSHIP DEVELOPMENT AND TRAINING. THE EDDIE HIGGINS SCHOLARSHIP IS NAMED AFTER A CHERISHED MEMBER OF THE CALVARY FAMILY WHO CAME TO THE HOSPITAL AS A YOUNG BOY. EDDIE WAS HOSPITALIZED INTERMITTENTLY FOR 15 YEARS AT CALVARY UNTIL HIS DEATH IN 1982 AT THE AGE OF 29. EDDIE IS REMEMBERED FOR HIS LOVE OF GOD AND HIS REMARKABLE COURAGE DESPITE HIS ILLNESS. CALVARY HAS GIVEN THE ANNUAL SCHOLARSHIP SINCE 1985.CALVARY HOSPITAL IS VERY ACTIVE IN THE COMMUNITY AND PARTICIPATES IN ANNUAL EVENTS SUCH AS THE COMMUNITY COLUMBUS DAY PARADE AND THE ANNUAL ORCHARD BEACH BREAST CANCER WALK.
PART III, LINE 4: THE CALVARY HOSPITAL, INC. AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE REGARDING BAD DEBT.COSTING METHODOLOGY USED FOR BAD DEBT:THE METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED IN LINE 2 IS BASED ON THE HOSPITAL'S COLLECTION/BAD DEBT WRITE-OFF POLICY WHICH STATES THAT ALL REASONABLE EFFORTS WILL BE MADE TO OBTAIN PAYMENTS AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. COLLECTION EFFORTS ARE MADE ON THE NET REALIZABLE AMOUNT.
PART III, LINE 8: CALVARY HOSPITAL, INC. HAS REPORTED A SHORTFALL IN PART III SECTION B LINE 7. THE EXPENSES, REVENUES AND SHORTFALL REPORTED IN PART III LINES 5-7 WERE DEVELOPED FROM THE 2010 CALVARY HOSPITAL, INC. COST REPORTS FILED WITH THE NYS DOH AND NATIONAL GOVERNMENT SERVICES (MEDICARE INTERMEDIARY).
PART III, LINE 9B: CALVARY HOSPITAL, INC.'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE.CALVARY HOSPITAL'S COLLECTION: BAD DEBT WRITE-OFFS POLICY INDICATES THAT ALL REASONABLE EFFORTS WILL BE MADE BY PATIENT ACCOUNTS REPRESENTATIVES TO OBTAIN PAYMENT AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. THE PATIENT ACCOUNTING SYSTEM WILL BEAR ENTRIES OF SUCH ATTEMPTS, INCLUDING THE DATE AND THE REPRESENTATIVE'S INITIALS. ACCOUNTS RESISTING SETTLEMENT MAY BE REFERRED TO A COLLECTION AGENCY.
PART V, SECTION A: CALVARY HOSPITAL, INC. IS A NOT-FOR-PROFIT SPECIALTY HOSPITAL THAT PROVIDES SERVICES FOR THE CARE OF TERMINALLY ILL CANCER PATIENTS. ARCHCARE, A NOT-FOR-PROFIT CORPORATION, IS THE SOLE CORPORATE MEMBER OF THE HOSPITAL.THE HOSPITAL HAS TWO LOCATIONS, THE MAIN LOCATION IN THE BRONX, NEW YORK, AND THE BRANCH LOCATION IN BROOKLYN, NEW YORK. THE AUDITED FINANCIAL STATEMENTS FOR CALVARY HOSPITAL, INC. CONTAIN THE OPERATIONS OF BOTH LOCATIONS AND ONE TAX RETURN IS FILED.CALVARY HOSPITAL, INC. IS AFILIATED WITH CALVARY HOLDING COMPANY, INC., A NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER SECTION 402 OF THE NOT-FOR-PROFIT CORPORATION LAW OF THE STATE OF NEW YORK. THE COMPANY IS RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE IRC AND ENGAGES IN CHARITABLE, SCIENTIFIC, AND MEDICAL ACTIVITIES TO SUPPORT CALVARY HOSPITAL AND ITS AFFILIATED ORGANIZATIONS. THIS ENTITY RECEIVES A SEPARATE FINANCIAL STATEMENT AND FILES A SEPARATE TAX RETURN.THE CALVARY FUND, INC. WAS INCORPORATED ON JANUARY 7, 1985, AS A NOT-FOR PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW YORK. THE FUND'S PURPOSE IS TO SOLICIT, ACCEPT AND RECEIVE REAL AND PERSONAL PROPERTY AND TO COLLECT INCOME THEREFROM TO BE APPLIED EXCLUSIVELY FOR ANY HEALTH-RELATED CHARITABLE ORGANIZATION OR CORPORATION AFFILIATED WITH THE ROMAN CATHOLIC ARCHDIOCESE OF NEW YORK. HOWEVER, THE CURRENT AND HISTORIC INTENT HAS BEEN TO PROVIDE EXCLUSIVE SUPPORT TO CALVARY HOSPITAL, INC. THIS ENTITY RECEIVES A SEPARATE FINANCIAL STATEMENT AND FILES A SEPARATE TAX RETURN.
PART VI, LINE 2: CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED ACCUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADULT ADVANCED CANCER PATIENTS IN THE UNITED STATES, LOCATED IN THE BRONX AND BROOKLYN.CALVARY HOSPITAL USES A VARIETY OF METHODS AND SERVICES TO GATHER COMMUNITY INPUT, ASSESS THE NEEDS OF THE COMMUNITY, AND TO ASSURE INPUT IN THE COMMUNITY SERVICE PLAN. SOME OF THESE METHODS ARE:A. COMMUNITY OUTREACH SERVICES -COMMUNITY OUTREACH SERVICES FUNCTIONS AS A LIAISON WITH THE COMMUNITY, REFERRERS, PHYSICIANS, PATIENTS, AND FAMILIES AND FACILITATES ADMISSION TO CALVARY HOSPITAL. THE DEPARTMENT OUTREACHES THROUGH THE TRI-STATE REGION AND EDUCATES THE HEALTH CARE AND PATIENT COMMUNITIES AS TO THE CONTINUUM OF SERVICES CALVARY PROVIDES (INPATIENT, OUTPATIENT, HOME CARE, HOSPICE, NURSING HOME HOSPICE, AND WOUND CARE). THROUGH ON-SITE VISITS, PUBLIC PRESENTATIONS AND PARTICIPATION IN COMMUNITY AND PROVIDER ACTIVITIES, THE OUTREACH STAFF CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY.B. PROFESSIONAL ADVISORY BOARD -THE PROFESSIONAL ADVISORY BOARD WAS ESTABLISHED IN 1992 TO OBTAIN INPUT FROM THE COMMUNITY. THE ADVISORY BOARD MEETS AT LEAST ANNUALLY AND IS COMPRISED OF PHYSICIANS, NURSES, AND SOCIAL WORKERS, REPRESENTING HOSPITALS, AND HOME CARE AGENCIES, AS WELL AS THE COMMUNITY. THIS GROUP HAS CONTRIBUTED A VARIETY OF IDEAS FOR ENHANCING SERVICES TO THE COMMUNITY.C. COMMUNITY PLANNING BOARD -EACH YEAR THE HOSPITAL INVITES THE HEALTH COMMITTEE OF COMMUNITY PLANNING BOARD #11 AND #10 TO VISIT THE HOSPITAL AND MEET WITH SENIOR STAFF.D. OUTREACH REPRESENTATION (OPEN HOUSE) FOR HEALTH CARE PROFESSIONALS -COMMUNITY OUTREACH HOSTS OPEN HOUSES AT BOTH THE BRONX AND BROOKLYN LOCATIONS TO PROVIDE INFORMATION TO AND RECEIVE INFORMATION FROM ITS REFERRERS.CALVARY HOSPITAL, INC. ALSO HAS PUBLIC PARTICIPATION IN THE EXTENDED COMMUNITY THROUGH PARTICIPATION IN:- GREATER NEW YORK HOSPITAL ASSOCIATION- HOSPITAL ASSOCIATION OF NEW YORK STATE- AMERICAN HOSPITAL ASSOCIATION- NEW YORK CITY DEPARTMENT OF HEALTH- NEW YORK STATE DEPARTMENT OF HEALTH- CATHOLIC HEALTHCARE ASSOCIATION- CMSTHROUGH ONGOING PARTICIPATION IN THE GROUPS ABOVE, CALVARY HOSPITAL CONTINUALLY MONITORS THE TRENDS IN THE HEALTHCARE NEEDS OF THE LARGER COMMUNITY. ALTHOUGH THE NATURE OF ITS SERVICES IS LIMITED BY ITS SPECIALIZED MISSION, CALVARY HAS IDENTIFIED A VARIETY OF ACTIVITIES TO PARTICIPATE IN IMPROVING THE HEALTH OF ITS EXTENDED COMMUNITY.
PART VI, LINE 3: EACH PERSON REQUESTING CALVARY'S SERVICES MUST BE MADE AWARE OF CALVARY'S UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES PROGRAM AS FOLLOWS:1. DISTRIBUTE AN INDIVIDUAL NOTICE TO EACH PERSON WHO IS SEEKING SERVICES ON BEHALF OF HIMSELF OR ANOTHER. THIS NOTICE IS PASSED TO THE INDIVIDUAL USUALLY AT THE POINT OF ADMISSION OR REGISTRATION WHEN FINANCIAL ARRANGEMENTS ARE BEING DISCUSSED. THE "NOTICE OF AVAILABILITY OF UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES" IS UPDATED ANNUALLY.2. POST SIGNS PROVIDED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES CONSPICUOUSLY IN THE ADMITTING OFFICE, BUSINESS OFFICE, CLINICS, HOME HEALTH AGENCY, AND HOSPICE AREAS. THE SIGNS ARE TO BE IN ENGLISH AND SPANISH. ADDITIONALLY, CALVARY HAS ACCESS TO A LANGUAGE TELEPHONE SERVICE THAT ADDS 58 ADDITIONAL LANGUAGES TO ENGLISH AND SPANISH.3. PUBLISH NOTICE OF HILL-BURTON UNCOMPENSATED SERVICES OBLIGATION ANNUALLY IN LOCAL NEWSPAPER IN SERVICE AREA (NEW YORK TIMES LEGAL).
PART VI, LINE 4: CALVARY HOSPITAL'S MAIN CAMPUS IS LOCATED IN THE BRONX, NY. THE BRONX IS CONSIDERED THE PRIMARY COMMUNITY FOR THE PURPOSES OF PUBLIC HEALTH PLANNING, AND 59% OF ITS EMPLOYEES RESIDE IN THE PRIMARY SERVICE AREA. IN ADDITION, AS A TERTIARY REFERRAL CENTER FOR ADVANCED DISEASE, CALVARY HOSPITAL SERVES THE ENTIRE TRI-STATE REGION. THE SECONDARY SERVICE IS DETERMINED BASED ON CURRENT REFERRAL PATTERNS.THE PRIMARY REFERRAL SOURCES FOR ADMISSIONS CONTINUE TO BE THE ACUTE CARE HOSPITALS. CURRENTLY 76% OF ADMISSIONS ARE REFERRED BY HOSPITALS LOCATED WITHIN THE BOROUGHS OF NEW YORK CITY, ROCKLAND, AND WESTCHESTER COUNTIES, LONG ISLAND, AND THE STATES OF NEW JERSEY AND CONNECTICUT. OTHER REFERRAL SOURCES ARE CALVARY HOSPITAL HOME CARE, HOSPICE, AND OTHER HOME CARE AND HOSPICE AGENCIES. CALVARY OUTPATIENT SERVICES, FAMILIES, PHYSICIANS, NURSING HOMES, AND COMMUNITY AGENCIES.IN 2001, CALVARY EXPANDED ITS SERVICES WITH THE OPENING OF CALVARY HOSPITAL - THE BROOKLYN CAMPUS, AT LUTHERAN MEDICAL CENTER.
NYREPORTS FILED WITH STATESPART VI, LINE 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses0WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
JAMES E INTRONE
065196803000001138930008935080479600
MICHAEL J BRESCIA MD
388563020000056254016170077270488714000
FRANK A CALAMARI
4353350300000403152025670098330903990000
CHRISTOPHER COMFORT MD
3292300175000642400256700252130461853000
RICHARD KUTILEK
2519940175000611570256700230530379374000
FRANK J LOCAPARRA
248760001057970256700149030171246000
ANDREW V GRECO
23960000013261000234380276299000
SALLY UMBRO RN
21002400040910236770163480254140000
ANTHONY TARANTO
1615420008626020771077260198665000
NANCY D'AGOSTINO RN
18783000036650222700242530238018000
ROBERT BRESCIA MD
301957017500017929025670078320370888000
DEVMANI JAITLY MD
45727600059410256700232130512100000
GAIL CHRZANOWSKI MD
26017200042330256700156990305774000
OSCAR ALVAREZ PHD
23718700045060254630232130290369000
SREENIVASA PATIBANDLA MD
3324280003058025670000361156000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1AEFFECTIVE JUNE 1, 1998, THE HOSPITAL ESTABLISHED THE CALVARY HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO PROVIDE PENSION BENEFITS FOR WAGES EARNED BY CERTAIN PHYSICIANS AND SENIOR EXECUTIVE STAFF WITH COMPENSATION IN EXCESS OF THE IRS LIMITS AND ALSO ESTABLISHED THE CALVARY HOSPITAL KEY EMPLOYEE SHARE OPTION PLAN (KEYSOP) TO PROVIDE ADDITIONAL AND ALTERNATIVE FORMS OF COMPENSATION TO KEY EMPLOYEES. PRIOR TO 2002, THE HOSPITAL UTILIZED THE KEYSOP TO FUND THE SERP. AS A RESULT OF THE IRS 457 REGULATIONS WHICH WERE ISSUED DURING 2002, THE UTILIZATION OF THE KEYSOP TO FUND THE SERP BECAME UNFEASIBLE. AFTER CONSIDERATION OF VARIOUS REPLACEMENT OPTIONS, IN 2003, CALVARY HOSPITAL CHOSE THE TAX GROSS-UP OPTION, WHEREBY, INDIVIDUAL PARTICIPANTS' DEFERRALS WOULD BE GROSSED-UP TO DUPLICATE THE BENEFITS HE WOULD RECEIVE IN A TAX-DEFERRED ARRANGEMENT AND PAID THEM OUT DIRECTLY TO THE PARTICIPANTS. THE FOLLOWING EXECUTIVES RECEIVED TAX GROSS-UP PAYMENTS IN 2010 IN ORDER TO DUPLICATE A TAX DEFERRED VEHICLE: (THE AMOUNTS WERE CALCULATED BY DELOITTE CONSULTING LLP UTILIZING EXPECTED TAX RATES TO CALCULATE THE NET AMOUNTS.) THE FOLLOWING TAX EXECUTIVES ALSO RECEIVED KEYSOP DIVIDENDS AS TAX GROSS-UP PAYMENTS IN 2010: - FRANK A. CALAMARI - RICHARD KUTILEK THE ORGANIZATION PROVIDED SOCIAL CLUB DUES IN 2010 FOR FRANK CALAMARI AND THE DUES WERE INCLUDED AS TAXABLE COMPENSATION.
PART I, LINE 4BTHE FOLLOWING CALVARY HOSPITAL OFFICERS PARTICPATE IN A NOW-DEFUNCT SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: FRANK CALAMARI, MICHAEL BRESCIA, FRANK LOCAPARRA, AND RICHARD KUTILEK.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6.THE SOLE MEMBER OF CALVARY HOSPITAL IS ARCHCARE
FORM 990, PART VI, SECTION A, LINE 7ATHE CALVARY HOSPITAL BYLAWS RESERVE CERTAIN RIGHTS TO ARCHCARE AS THE SOLE MEMBER OF THE HOSPITAL. THESE RIGHTS ARE ENUMERATED IN ARTICLE IV AND INCLUDE THE RIGHT TO AMEND THE HOSPITAL'S BYLAWS AND ORGANIZING DOCUMENTS, APPOINT AND REMOVE BOARD MEMBERS AND APPROVE CERTAIN DECISIONS OF THE HOSPITAL'S BOARD OF DIRECTORS, INCLUDING BUT NOT LIMITED TO, THE ADOPTION OF A STRATEGIC PLAN, ACQUISITION OF ANOTHER ORGANIZATION, REAL ESTATE TRANSACTIONS EXCEEDING A CERTAIN DOLLAR THRESHOLD, ADOPTION OF CRITERIA FOR MANAGED CARE CONTRACTING, AND ADOPTION OF SYSTEM-WIDE MEASURES.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 WAS PRESENTED AND DRAFTS WERE MADE AVAILABLE TO THE BOARD OF DIRECTORS ON 10/05/2011. A COPY OF THE FORM 990 WAS PROVIDED TO EACH MEMBER OF THE CALVARY HOSPITAL BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE IN ELECTRONIC FORMAT.
EACH OFFICER, DIRECTOR, TRUSTEE AND KEY EMPLOYEE IS REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THAT ARISE BY VIRTUE OF THEIR EMPLOYMENT AND POSITION WITH CALVARY HOSPITAL OR CALVARY FUND. CALVARY MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL QUESTIONNAIRE SUBMITTED TO THESE INDIVIDUALS. POTENTIAL CONFLICTS ARE INVESTIGATED IMMEDIATELY AND, IF ANY ARE UNCOVERED, THERE ARE POLICIES IN PLACE TO ENSURE THAT THOSE INDIVIDUALS RECUSE THEMSELVES FROM PARTICIPATING IN ANY DECISIONMAKING RELATED TO SUCH CONFLICT.FORM 990, PART VI, SECTION B, LINE 12C
CALVARY HOSPITAL, INC UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS TO ITS TOP MANAGEMENT OFFICIALS AND ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS REASONABLE. IN RELEVANT PART, THE BOARD OF DIRECTORS HAS ESTABLISHED A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN THE PROPOSED COMPENSATION ARRANGEMENT. THE BOARD OF DIRECTORS USES AN INDEPENDENT COMPENSATION CONSULTANT TO HELP ADVISE ON THE APPROPRIATE COMPENSATION LEVELS FOR THE AFOREMENTIONED INDIVIDUALS. THAT COMPENSATION CONSULTANT WILL USE COMPARABILITY OR BENCHMARKLNG DATA (BASED ON INDUSTRY SURVEYS) THAT DOCUMENTS THE COMPENSATION OF PERSONS HOLDING SIMILAR PERSONS IN SIMILAR ORGANIZATIONS. ONCE THE COMPENSATION CONSULTANT HAS MADE ITS RECOMMENDATIONS, THE CALVARY COMPENSATION COMMITTEE MUST APPROVE THE COMPENSATION, WITHOUT INPUT OR VOTING PARTICIPATION BY THE PERSON WHOSE COMPENSATION IS BEING APPROVED OR BY ANY OTHER INDIVIDUAL WITH A CONFLICT OF INTEREST THE FINAL DETERMINATION IS THEN DOCUMENTED IN COMMITTEE MINUTES THOSE MINUTES WILL CONTAIN THE TERMS OF THE PROPOSED COMPENSATION, THE DECISIONS OF THOSE INDIVIDUALS WHO VOTED ON THE COMPENSATION, AND THE COMPARABILITY DATA THAT WAS RELIED UPON.FORM 990, PART VI, SECTION B, LINE 15
CALVARY HOSPITAL MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC BY RETAINING A COPY AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION.FORM 990, PART VI, SECTION C, LINE 19
CHANGES IN NET ASSETS OR FUND BALANCES:NET UNREALIZED GAINS ON INVESTMENTS: 525,900. PENSION-RELATED ADJUSTMENTS 2,352,000. INTEREST IN NET ASSETS OF CALVARY FUND, INC. 2,699,300. ROUNDING -416. TOTAL TO FORM 990, PART XI, LINE 5: 5,576,784.FORM 990, PART XI, LINE 5:

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodePrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsDirect Controlling Entity NADirectControllingEntityNA
CALVARY PALLIATIVE CARE NETWORK LLC
1740 EASTCHESTER ROADBRONXNY10461HEALTHCARENY00N/A
NETWORK INDEPENDENT PRACTICE ASSOCIATION
1740 EASTCHESTER ROADBRONXNY10461HEALTHCARENY00N/A
CALVARY NETWORK MANAGEMENT SERVICES LLC
1740 EASTCHESTER ROADBRONXNY10461MGMT SERVICESNY00N/A

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
CALVARY FUND INC
1740 EASTCHESTER ROADBRONXNY10461133259649FUNDRAISINGNY501(C)(3)LINE 11A, IN/A0
CALVARY HOLDING COMPANY
1740 EASTCHESTER ROADBRONXNY10461061531426HOLDING CONY501(C)(3)LINE 9N/A0
ARCHCARE
155 EAST 56TH STREET FLOOR 2NEW YORKNY10022133896624HEALTHCARENY501(C)(3)LINE 9N/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

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