MARY HAVEN CENTER OF HOPE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MARY HAVEN CENTER OF HOPE (EIN 11-2861698)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201143199349302049
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)
Timestamp2011-11-15T09:18:04-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1JH COHN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14 BECKER FARM ROADAddressLine1
CityROSELANDCity
StateNJState
ZIP Code070681739ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN112861698EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MARYHAVEN CENTER OF HOPEBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMARYNameControl
Phone6314744120Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line151 TERRYVILLE RDAddressLine1
CityPORT JEFFERSON STATIONCity
StateNYState
ZIP Code117763097ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLEWIS GROSSMANName
TitleCHIEF EXECUTIVE OFFICERTitle
Phone6314744120Phone
Date Signed2011-11-15DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameTHOMAS LANNINGName
Phone9732283500Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLEWIS GROSSMANNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line151 TERRYVILLE RDAddressLine1
CityPORT JEFFERSON STATIONCity
StateNYState
ZIP Code117763097ZIPCode
FieldValueIRS element (for citing)
Gross Receipts55572519GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MARYHAVEN.CHSLI.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1987YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionMARYHAVEN CENTER OF HOPE, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, COMMITTED TO THOSE IN NEED, AFFIRMS THE SANCTITY OF LIFE, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON.ActivityOrMissionDescription
Nbr Voting Members Governing Body23NbrVotingMembersGoverningBody
Nbr Independent Voting Members21NbrIndependentVotingMembers
Total Nbr Employees924TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI21875TotalGrossUBI
Net Unrelated Business Txbl Income21875NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year291465ContributionsGrantsPriorYear
Contributions Grants Current Year313228ContributionsGrantsCurrentYear
Program Service Revenue Prior Year47616277ProgramServiceRevenuePriorYear
Program Service Revenue CY55097105ProgramServiceRevenueCY
Investment Income Prior Year60346InvestmentIncomePriorYear
Investment Income Current Year69737InvestmentIncomeCurrentYear
Other Revenue Prior Year26712OtherRevenuePriorYear
Other Revenue Current Year18532OtherRevenueCurrentYear
Total Revenue Prior Year47994800TotalRevenuePriorYear
Total Revenue Current Year55498602TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY14663GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year36947214SalariesEtcPriorYear
Salaries Etc Current Year43519502SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year162124TotalFundrsngExpCurrentYear
Other Expense Prior Year9907346OtherExpensePriorYear
Other Expenses Current Year11863634OtherExpensesCurrentYear
Total Expenses Prior Year46854560TotalExpensesPriorYear
Total Expenses Current Year55397799TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1140240RevenuesLessExpensesPriorYear
Revenues Less Expenses CY100803RevenuesLessExpensesCY
Total Assets BOY26452309TotalAssetsBOY
Total Assets EOY27319521TotalAssetsEOY
Total Liabilities BOY18557023TotalLiabilitiesBOY
Total Liabilities EOY19323432TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7895286NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7996089NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMARYHAVEN CENTER OF HOPE, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, COMMITTED TO THOSE IN NEED, AFFIRMS THE SANCTITY OF LIFE, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense25668132Expense
Revenue28728699Revenue
DescriptionRESIDENTIAL CARE PROGRAMS: RESIDENTIAL AND HOME BASED SERVICES FOR ADULTS AND CHILDREN WITH DISABILITIES. (862 INDIVIDUALS)Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense19717161Expense
Revenue20517550Revenue
DescriptionDAY PROGRAMS FOR THE DEVELOPMENTALLY DISABLED: PROVIDES COMMUNITY INTEGRATED EDUCATIONAL, RECREATIONAL, AND CLINICAL SERVICES TO ADULTS WITH DISABILITIES. (842 INDIVIDUALS)Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense4606894Expense
Revenue4539432Revenue
DescriptionVOCATIONAL REHABILITATION PROGRAMS: JOB PLACEMENT, TRAINING, AND WORKSHOP FOR ADULTS WITH DISABILITIES. (512 INDIVIDUALS)Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense1293757Expense
Revenue1311424Revenue
DescriptionCASE MANAGEMENT PROGRAMS: PROVIDES INDIVIDUAL SERVICE COORDINATION AND PASTORAL CARE TO INDIVIDUALS WITH SPECIAL NEEDS. (1,500 INDIVIDUALS)Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp1293757TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev1311424TotalOfOtherProgramServiceRev
Total Program Service Expense51285944TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
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 Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109677NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees924NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members23NbrVotingGoverningBodyMembers
Number Independent Voting Members21NumberIndependentVotingMembers
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 Approval1DecisionsSubjectToApproval
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 Line1SUSAN DICKINSONBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6314744120TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line151 TERRYVILLE RDAddressLine1
CityPORT JEFFERSON STATIONCity
StateNYState
ZIP Code117763097ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (31 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
ANGIE CARPENTER
CHAIRPERSON2.00XX000
BERNADETTE CURRY PHD
VICE CHAIRPERSON2.00XX000
CHARLES FALKNER
TREASURER2.00XX000
DOLORES CASTELLANO CIJ
SECRETARY2.00XX000
DONATO BALSAMO
BOARD MEMBER2.00X03360289
MARY BRAKEN
BOARD MEMBER2.00X000
ROBERT DOYLE
BOARD MEMBER2.00X000
PHILIP FAVA
BOARD MEMBER2.00X000
MARGARET KELLIHER DW
BOARD MEMBER2.00X000
WALTER LACE
BOARD MEMBER2.00X000
CAMPION LALLY OSF
BOARD MEMBER2.00X000
TIMOTHY MATTIMORE ESQ
BOARD MEMBER2.00X000
KATHLEEN MCCARTHY OP
BOARD MEMBER2.00X000
MSGR THOMAS MULVANERTY
BOARD MEMBER2.00X000
TAMMY RAFLE
BOARD MEMBER2.00X000
RICHARD ROMER
BOARD MEMBER2.00X000
DANIEL ROWE
BOARD MEMBER2.00X000
J TIMOTHY SHEA ESQ
BOARD MEMBER2.00X000
CHARLES SPENCER
BOARD MEMBER2.00X000
DEBBIE VAN BOURGONDIEN
BOARD MEMBER2.00X000
JEFFERY VOLLMUTH
BOARD MEMBER2.00X000
CHRISTOPHER REDMOND ESQ
BOARD MEMBER2.00X000
LEWIS GROSSMAN
CHIEF EXECUTIVE OFFICER50.00XX555926087558
DENNIS VERZI
EXECUTIVE VP CONTINUING CARE50.00X0814872189108
WILLIAM MEAD
CHIEF FINANCIAL OFFICER50.00X0323276106112
SUSAN DICKINSON
VICE PRESIDENT OF FINANCE50.00196470048095X
ROBIN DWYER
DIRECTOR OF RESIDENTIAL35.00149867021020X
EVA TARANTINO
DIRECTOR HUMAN RESOURCES35.00133276021572X
ROBERT MURPHY
DIRECTOR OF NASSAU BEHAVIORAL HEALTH35.00135422019619X
LINDA SCHREIBER
CLINICAL DIRECTOR OF CHILDRENS35.00113696018513X
PATRICIA FOGARTY
DIRECTOR OF ADULT SERVICES35.00118595018785X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1403252TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1171750TotalReportableCompFrmRltdOrgs
Total Other Compensation530471TotalOtherCompensation
Number Individuals GT100 K11NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
PORTER & CURTIS LLC
225 STATE ROADMEDIAPA19063INSURANCE1047899
KURUVILLA MP MD
15 CEDAR RIDGE LANEDIX HILLSNY11746PSYCHIATRIST171511
DELUCA CLEANING SYSTEMS
PO BOX 37WEST ISLIPNY11795CLEANING140328
KPMG
1PO BOX 12001 DEPT 0572DALLASTX753120572FINANCE/AUDIT123900
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Fundraising Events34835FundraisingEvents
All Other Contributions278393AllOtherContributions
Total Contributions313228TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
COMMUNITY RESIDENTIAL6230002872869928728699
DAY PROGRAMS6240002051755020517550
VOCATIONAL62431045394324539432
CARE MANAGEMENT62400013114241311424
FieldValueIRS element (for citing)
Total Program Service Revenue55097105TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column52376TotalRevenueColumn
Exclusion$52,376ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real26234Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real4359Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real21875Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column21875TotalRevenueColumn
Unrelated Business Revenue21875UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other17361Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other17361Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column17361TotalRevenueColumn
Exclusion$17,361ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events66215GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events34835CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses69558FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-3343TotalRevenueColumn
Exclusion-$3,343ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column55498602TotalRevenueColumn
Related Or Exempt Function Income55097105RelatedOrExemptFunctionIncome
Unrelated Business Revenue21875UnrelatedBusinessRevenue
Exclusion$66,394ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total14663Total
Program Services14663ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total752396Total
Management And General752396ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total28911464Total
Program Services27852808ProgramServices
Management And General1058656ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1599487Total
Program Services1519241ProgramServices
Management And General72177ManagementAndGeneral
Fundraising8069Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2137305Total
Program Services1629645ProgramServices
Management And General456615ManagementAndGeneral
Fundraising51045Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total10118850Total
Program Services10011622ProgramServices
Management And General96446ManagementAndGeneral
Fundraising10782Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total17088Total
Program Services224ProgramServices
Management And General16864ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total65800Total
Management And General65800ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1317367Total
Program Services1088695ProgramServices
Management And General226428ManagementAndGeneral
Fundraising2244Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total149729Total
Program Services114665ProgramServices
Management And General35064ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total29735Total
Program Services25314ProgramServices
Management And General4421ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4692252Total
Program Services4518185ProgramServices
Management And General174067ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total631759Total
Program Services625824ProgramServices
Management And General5935ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total86028Total
Program Services58225ProgramServices
Management And General27803ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total646377Total
Program Services603610ProgramServices
Management And General42767ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total663224Total
Management And General663224ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1700952Total
Program Services1567209ProgramServices
Management And General133743ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total234624Total
Program Services228218ProgramServices
Management And General6406ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PROGRAM SUPPLIES56433656430927
CLIENT CARE507668507347321
FOOD / MISCELLANEOUS4724873551081105716808
EVENTS & FUNDRAISING EX84208103283176

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total55397799Total
Program Services51285944ProgramServices
Management And General3949731ManagementAndGeneral
Fundraising162124Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2992318BOY
EOY2925650EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY949049BOY
EOY989293EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8223104BOY
EOY8690609EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY223593BOY
EOY231963EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY186572BOY
EOY197939EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY852437BOY
EOY663309EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis29249924LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec19142229LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY11244905BOY
EOY10107695EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY1505846BOY
EOY1106690EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY274485BOY
EOY2406373EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY26452309BOY
EOY27319521EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY6657763BOY
EOY5366897EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY1769680BOY
EOY2865185EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY5179585BOY
EOY3880384EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4022905BOY
EOY3666563EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY927090BOY
EOY3544403EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18557023BOY
EOY19323432EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7895286BOY
EOY7996089EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7895286BOY
EOY7996089EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY26452309BOY
EOY27319521EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses100803ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years362583CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1040541CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years371413CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year288540CurrentTaxYearMinus1Year
Current Tax Year316428CurrentTaxYear
Total2379505Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years36996989CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years42288609CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years49744671CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year48797446CurrentTaxYearMinus1Year
Current Tax Year56174030CurrentTaxYear
Total234001745Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years37359572CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years43329150CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years50116084CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year49085986CurrentTaxYearMinus1Year
Current Tax Year56490458CurrentTaxYear
Total236381250Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total509236381250PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years93641CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years264082CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years177559CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year87521CurrentTaxYearMinus1Year
Current Tax Year78585CurrentTaxYear
Total701388Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years93641CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years264082CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years177559CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year87521CurrentTaxYearMinus1Year
Current Tax Year78585CurrentTaxYear
Total701388Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years37453213CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years43593232CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years50293643CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year49173507CurrentTaxYearMinus1Year
Current Tax Year56569043CurrentTaxYear
Total237082638Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99700PublicSupportPercentage509
Prior Year Support Percentage0.99670PriorYearSupportPercentage
Investment Income Percentage0.00300InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00330PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

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 D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1953364OtherCostOrOtherBasis
Book Value1953364BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis13862502OtherCostOrOtherBasis
Depreciation9407990Depreciation
Book Value4454512BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1276866OtherCostOrOtherBasis
Depreciation1063086Depreciation
Book Value213780BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2676887OtherCostOrOtherBasis
Depreciation2198438Depreciation
Book Value478449BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9480305OtherCostOrOtherBasis
Depreciation6472715Depreciation
Book Value3007590BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings10107695TotalOfBookValueLandBuildings

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionDUE FROM RELATED COMPANIESDescription
Book Value2406373BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets2406373TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO RELATED COMPANIESDescription
Amount$3,544,403Amount
FieldValueIRS element (for citing)
Total Of Amounts3544403TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS.
SCHEDULE D, PART X - THE CENTER QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND QUALIFIES AS A NONPROFIT ORGANIZATION UNDER NEW YORK STATE LAW. ACCORDINGLY, THE INCOME OF THE ORGANIZATION IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1PONYNameOfEvent1
Gross Receipts Event144000GrossReceiptsEvent1
Charitable Contributions Event125200CharitableContributionsEvent1
Gross Revenue Event118800GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Rent Facility Costs Event116208RentFacilityCostsEvent1
Name Of Event2DINNER DANCENameOfEvent2
Gross Receipts Event230800GrossReceiptsEvent2
Charitable Contributions Event21760CharitableContributionsEvent2
Gross Revenue Event229040GrossRevenueEvent2
Cash Prizes Event23500CashPrizesEvent2
Rent Facility Costs Event229700RentFacilityCostsEvent2
Total Number Of Other Events1TotalNumberOfOtherEvents
Gross Receipts Other Events26250GrossReceiptsOtherEvents
Charitable Contrib Other Events7875CharitableContribOtherEvents
Gross Revenue Other Events18375GrossRevenueOtherEvents
Cash Prizes Other Events1000CashPrizesOtherEvents
Rent Facility Costs Other Events19150RentFacilityCostsOtherEvents
Gross Receipts Total101050GrossReceiptsTotal
Charitable Contributions Total34835CharitableContributionsTotal
Gross Revenue Total Events66215GrossRevenueTotalEvents
Cash Prizes Total Events4500CashPrizesTotalEvents
Rent Facility Costs Total Events65058RentFacilityCostsTotalEvents
Direct Expense Summary Events69558DirectExpenseSummaryEvents
Net Income Summary-3343NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained0RecordsMaintained
No Grant More Than5000XNoGrantMoreThan5000

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
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 (7 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
LEWIS GROSSMAN
3909870900000749390738360137220643484000
DENNIS VERZI
051517802810000186940180416086920100398000
WILLIAM MEAD
0242545070000010731084747021365042938800
SUSAN DICKINSON
169931019000075390343600137350244565000
ROBIN DWYER
13026501300006602076280133920170887000
EVA TARANTINO
1266910006585074700141020154848000
ROBERT MURPHY
1230620900003360069540126650155041000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUPPLEMENTAL INFORMATIONPART IIISCHEDULE J, PART 1, LINE 3 - THE SCOPE OF EXECUTIVE COMPENSATION CONSULTING SERVICES PROVIDED BY TOWERS PERRINS IS AS FOLLOWS: SUPPORT WITH ANNUAL INCENTIVE PAYOUTS EXECUTIVE CASH COMPENSATION REVIEW REASONABLENESS LETTER. THE COMPENSATION COMMITTEE RECOMMENDS TO THE BOARD, AND THE BOARD APPROVES ALL EXECUTIVE COMPENSATION.
SUPPLEMENTAL INFORMATIONPART IIIPART I LINE 4B : SERP ADJUSTMENTS WERE MADE AS FOLLOWS: LEWIS GROSSMAN SUSAN DICKINSON ROBERT MURPHY

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF MARYHAVEN CENTER OF HOPE IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (DBA CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS). CHS IS A NY NON-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER (DIOCESE).
FORM 990, PART VI, SECTION A, LINE 7ACHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF MARYHAVEN CENTER OF HOPE AND AS SUCH, HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF MARYHAVEN CENTER OF HOPE.
FORM 990, PART VI, SECTION A, LINE 7BCHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF MARYHAVEN CENTER OF HOPE IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY MARYHAVEN'S GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED (FORM 990), IS COMPLETED BY THE ACCOUNTING AND FINANCE STAFF OF THE ORGANIZATION AND REVIEWED INTERNALLY BY MANAGEMENT. IT IS THEN REVIEWED BY OUTSIDE TAX ADVISORS AND ANY NECESSARY ADJUSTMENTS ARE MADE, AFTER WHICH TIME IT IS CONSIDERED AN INITIAL DRAFT. THE FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF TRUSTEES (THE BOARD), WHICH HAS BEEN DELEGATED THE DETAILED REVIEW FUNCTION BY THE BOARD. ONCE THE COMMITTEE'S REVIEW IS COMPLETE, THE COMMITTEE RECOMMENDS THE APPROVAL OF THE FORM 990 TO THE BOARD (OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE). THE FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD. UPON APPROVAL BY THE BOARD (OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE), THE ORGANIZATION'S BOARD CHAIR AND CHIEF EXECUTIVE OFFICER COMMUNICATES, IN WRITING TO THE CHS COMPLIANCE AND AUDIT COMMITTEE AND CHS BOARD CHAIR, SUCH APPROVAL, RECOMMENDS APPROVAL TO THE CHS BOARD, AND CERTIFIES THAT THE CHS BOARD APPROVED FORM 990 REVIEW PROCESS HAS BEEN FOLLOWED. THE CHS COMPLIANCE AND AUDIT COMMITTEE REVIEWS THE ORGANIZATION'S CORRESPONDENCE REGARDING THE FORM 990 RECOMMENDED APPROVAL AND REVIEW PROCESS. THE CHS COMPLIANCE AND AUDIT COMMITTEE IS PROVIDED WITH THE ORGANIZATION'S FORM 990 AND REVIEWS THE FORM TO THE EXTENT IT DEEMS APPROPRIATE IN LIGHT OF THE ORGANIZATIONAL CERTIFICATIONS AND OTHER FACTORS AS DETERMINED BY THE COMMITTEE. UPON THE CHS COMPLIANCE AND AUDIT COMMITTEE'S REVIEW OF THE ORGANIZATION'S RECOMMENDED APPROVAL AND SATISFACTION OF THE FORM 990 REVIEW PROCESS, IT SHALL RECOMMEND THE APPROVAL OF THE FORM 990 TO THE CHS BOARD OF DIRECTORS (OR THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, AS APPROPRIATE). THE CHS BOARD OF DIRECTORS (OR THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, AS APPROPRIATE) REVIEWS THE CHS COMPLIANCE AND AUDIT COMMITTEE'S RECOMMENDATION AND PROVIDES THE FINAL APPROVAL OF THE FORM 990. THE FORM 990 IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE.
DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE BY THE ORGANIZATION'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFERRED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORTH WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILIAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT.FORM 990, PART VI, SECTION B, LINE 12C
THE EXECUTIVE COMPENSATION POLICY (THE "POLICY") APPLIES TO THOSE WHO ARE DEFINED AS "DISQUALIFIED PERSONS". THE POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER, AND CHIEF OPERATING OFFICERS OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS; D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OF FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AND OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE CORPORATE CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE POLICY. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW, AND THE COMMITTEE MAKES RECOMMENDATION TO THE BOARD OF TRUSTEES WITH RESPECT TO THE PROPOSED EXECUTIVE COMPENSATION. THE BOARD HAS RETAINED AN INDEPENDENT COMPENSATION CONSULTANT TO APPLY ITS STANDARD METHODOLOGY FOR DETERMINATION OF APPROPRIATE EXECUTIVE COMPENSATION AND BENEFIT LEVELS FOR "DISQUALIFIED PERSONS". IT IS POLICY TO TARGET THE TOTAL COMPENSATION (BASE SALARY, INCENTIVE COMPENSATION AND BENEFITS) OF "DISQUALIFIED PERSONS" AT THE MEDIAN OF THE DEFINED MARKETPLACE FOR SIMILARLY SITUATED EXECUTIVES IN CONSULTATION WITH AN INDEPENDENT COMPENSATION CONSULTANT IN A MANNER THAT COMPLIES WITH THE INTERMEDIATE SANCTION REGULATIONS AND OTHER FEDERAL AND STATE LAWS AND REGULATIONS. THE BOARD REVIEWS BASE SALARIES FOR "DISQUALIFIED PERSONS" BASED UPON THE MEDIAN AMOUNTS (50TH PERCENTILE) PAID TO SIMILARLY SITUATED EXECUTIVES WITHIN THE RELEVANT MARKETPLACE, WITH POSSIBLE ADJUSTMENTS MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE, AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. INCENTIVE COMPENSATION IS BASED ON A PERCENTAGE OF THE BASE SALARY AND AWARDED ONLY IF A "DISQUALIFIED PERSON" MEETS OBJECTIVE PERFORMANCE CRITERIA. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASURABLE, AND RELATED TO INDICATORS OF PERFORMANCE, WHICH SHALL INCLUDE BOTH THE PERFORMANCE OF THE OPERATING ENTITY THAT EMPLOYS THE "DISQUALIFIED PERSON" AND THE PERFORMANCE OF THE CHS SYSTEM AS A WHOLE. USING SUCH CRITERIA, THE CHS CEO SHALL RECOMMEND TO THE CHS EXECUTIVE COMPENSATION COMMITTEE INCENTIVE COMPENSATION FOR SYSTEM-LEVEL EXECUTIVES WHO ARE "DISQUALIFIED PERSONS", AND THE CEO OF EACH OPERATING ENTITY SHALL RECOMMEND TO THE OPERATING ENTITY EXECUTIVE COMPENSATION COMMITTEE INCENTIVE COMPENSATION FOR OPERATING ENTITY EXECUTIVES WHO ARE "DISQUALIFIED PERSONS", IF APPROVED BY THE CHS CEO. EXECUTIVES PARTICIPATE IN THE DIOCESAN PENSION PLAN AND OTHER BENEFIT PLANS AS APPROVED BY THE CHS CORPORATE BOARD OR CHS OPERATING ENTITY BOARD, AS THE CASE MAY BE.FORM 990, PART VI, SECTION B, LINE 15
CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.FORM 990, PART VI, SECTION C, LINE 19
REFLECTED IN PART VII, SECTION A, LINE 1A ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATION, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY FOR WHICH THEY RECEIVE NO COMPENSATION. PRESIDENT AND CEO-THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS OFFICER FOR ALL THE FOLLOWING RELATED ENTITIES: MARYHAVEN SCHOOL CORP (11-2861690); MARYHAVEN TRANSPORTATION SERVICES (11-3434776); RIVERHEAD HOSTEL HOLDING CORP (11-2499790); CENTER OF HOPE FOUNDATION (11-3638367).FORM 990, PART VII, SECTION A LINE 1A
ELLECTION TO ALLOCATE BUSINESS ASSET EXPENSETHE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS, AS DEFINED IN SECTION 179(D)(7), HEREBY CONSENT TO THE APPORTIONMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2010 ELECTION TO ALLOCATE $40,000 ALTERNATIVE MINIMUM TAX EXEMPTION THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS(WITHIN THE MEANING OF SECTION 1563(A)), HEREBY CONSENT UNDER REGULATION 1.58-1(C)(3) TO THE APPORTIONMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2010. ELECTION TO ALLOCATE $150,000 ALTERNATIVE MINIMUM TAX PHASE-OUT THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS (WITHIN THE MEANING OF SECTION 1563(A)), HEREBY CONSENT UNDER REGULATION 1.58-1(C(3) TO THE APPOINTMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2010. EMPLOYER ID NO. $128,00 $40,000 $150,000 11-3403968 NONE NONE NONE 14-1801961 NONE NONE NONE 11-3594561 NONE NONE NONE 11-3555766 NONE NONE NONE 11-1888924 NONE NONE NONE 77-0611240 NONE NONE NONE 11-2537396 NONE NONE NONE 11-2958438 NONE NONE NONE 11-3434776 NONE NONE NONE 11-2861698 NONE NONE NONE 11-2861690 NONE NONE NONE 11-3638367 NONE NONE NONE 11-1635088 NONE NONE NONE 11-2126736 NONE NONE NONE 11-3284066 NONE NONE NONE 20-8067039 NONE NONE NONE 11-2499790 NONE NONE NONE 06-1569129 NONE NONE NONE 06-1562701 NONE NONE NONE 11-1871039 NONE NONE NONE 41-2076312 NONE NONE NONE 11-3613997 NONE NONE NONE 11-2050523 NONE NONE NONE 11-2916033 NONE NONE NONE 11-3090867 NONE NONE NONE 11-2110488 NONE NONE NONE 11-2983148 NONE NONE NONE 11-2716640 NONE NONE NONE 11-3559713 NONE NONE NONE 11-1635088 NONE NONE NONE 55-0813603 NONE NONE NONE 27-1459941 NONE NONE NONE IN PROCESS NONE NONE NONE 26-3169427 NONE NONE NONE 45-0517566 NONE NONE NONE 27-1531084 NONE NONE NONE 11-2798383 NONE NONE NONE 11-2801136 NONE NONE NONE 11-2838185 $128,000 $40,000 $150,000 11-3319259 NONE NONE NONE 06-1568934 NONE NONE NONE 11-3307977 NONE NONE NONE 11-2126736 NONE NONE NONECONTROLLED GROUP ELECTION
CONTROLLED GROUP ELECTION - CONTINUEDEMPLOYER NAME, ADDRESS & TAX YEAR-END ID NO. 11-3403968 CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 14-1801961 CHS AMBULANCE SERVICES 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-3594561 CHS HOME SUPPORT SERVICES, INC. 15 POWER DRIVE HAUPPAUGUE, NY 11788 TAX YEAR END: 12/31/10 11-3555761 CHS SERVICES, INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-1888924 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 77-0611240 GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2537396 GOOD SAMARITAN HOSPITAL SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2958438 GOOD SHEPHERD HOSPICE 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 11-3434776 MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAX YEAR END: 12/31/10 11-2861698 MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-2861690 MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-3638367 THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAXABLE YEAR: 12/31/10 11-1635088 MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2126736 CATHOLIC HOME CARE 1150 PORTION BLVD. SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 11-3284066 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 20-8067039 RVC INSURANCE COMPANY, INC. 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2499790 RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 06-1569129 SIENA VILLAGE 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 06-1562701 ST. CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 11-1871039 ST. CHARLES HOSPITAL AND REHABILITATION CENTER 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 41-2076312 ST. CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-3613997 ST. FRANCIS CARDIOVASCULAR PHYSICIANS PC 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2050523 ST. FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2916033 ST. FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-3090867 ST. FRANCIS RESEARCH & EDUCATIONAL CORPORATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2110488 SUFFOLK HEARING & SPEECH 369 EAST MAIN STREET EAST ISLIP, NY 11730 TAX YEAR END: 12/31/10 11-2983148 THE ST. CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-2716640 THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 11-3559713 WISDOM GARDENS HOUSING DEVELOPMENT CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-1635088 ST. FRANCIS-MERCY CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 55-0813603 MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 27-1459941 ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 IN PROCESS CATHOLIC HOME CARE FOUNDATION 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 26-3169427 CATHOLIC HOME CARE FOUNDATION 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 45-0517566 OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 27-1531084 OUR LADY OF CONSOLATION FOUNDATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2798383 FAIRVIEW HILL MANAGEMENT CORP 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2801136 HEALTHCARE TEMP SERVICES 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2838185 SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-3319259 SAMARITAN HOME CARE AMERICA, INC. 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 06-1568934 SIENA MEDICAL REALTY 50 ROUTE 25A SMITHTOWN, NY 11787 TAXABLE YEAR: 12/31/10 11-3307977 SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-2126736 NURSING SISTERS HOME CARE, INC 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAXABLE YEAR: 12/31/10
STATEMENT OF TAX BRACKET ALLOCATIONTHE AMOUNTS IN EACH TAXABLE INCOME BRACKET IN THE TAX TABLE IN SECTION 11(B) HAVE BEEN ALLOCATED TO THE CORPORATIONS LISTED BELOW PURSUANT TO REGULATION 1.1561-3(A). THE ORIGINAL COPY OF THIS STATEMENT IS FILED WITH THE INTERNAL REVENUE SERVICE CENTER IN OGDEN, UTAH. AUTHORIZATION CONSENT FOR ALLOCATION ON BEHALF OF MEMBER COMPANIES ____________________________________________ EMPLOYER ID NO. $50,000 $25,000 $9,925,000 BRACKET BRACKET BRACKET 11-3403968 NONE NONE NONE 14-1801961 NONE NONE NONE 11-3594561 NONE NONE NONE 11-3555766 NONE NONE NONE 11-1888924 NONE NONE NONE 77-0611240 NONE NONE NONE 11-2537396 NONE NONE NONE 11-2958438 NONE NONE NONE 11-3434776 NONE NONE NONE 11-2861698 NONE NONE NONE 11-2861690 NONE NONE NONE 11-3638367 NONE NONE NONE 11-1635088 NONE NONE NONE 11-2126736 NONE NONE NONE 11-3284066 NONE NONE NONE 20-8067039 NONE NONE NONE 11-2499790 NONE NONE NONE 06-1569129 NONE NONE NONE 06-1562701 NONE NONE NONE 11-1871039 NONE NONE NONE 41-2076312 NONE NONE NONE 11-3613997 NONE NONE NONE 11-2050523 NONE NONE NONE 11-2916033 NONE NONE NONE 11-3090867 NONE NONE NONE 11-2110488 NONE NONE NONE 11-2983148 NONE NONE NONE 11-2716640 NONE NONE NONE 11-3559713 NONE NONE NONE 11-1635088 NONE NONE NONE 55-0813603 NONE NONE NONE 27-1459941 NONE NONE NONE IN PROCESS NONE NONE NONE 26-3169427 NONE NONE NONE 45-0517566 NONE NONE NONE 27-1531084 NONE NONE NONE 11-2798383 NONE NONE NONE 11-2801136 NONE NONE NONE 11-2838185 $50,000 $25,000 $9,925,000 11-3319259 NONE NONE NONE 06-1568934 NONE NONE NONE 11-3307977 NONE NONE NONE 11-2126736 NONE NONE NONE
STATEMENT OF TAX BRACKET ALLOCATION - CONTINUEDEMPLOYER NAME, ADDRESS & TAX YEAR-END ID NO. 11-3403968 CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 14-1801961 CHS AMBULANCE SERVICES 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-3594561 CHS HOME SUPPORT SERVICES, INC. 15 POWER DRIVE HAUPPAUGUE, NY 11788 TAX YEAR END: 12/31/10 11-3555761 CHS SERVICES, INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-1888924 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 77-0611240 GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2537396 GOOD SAMARITAN HOSPITAL SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2958438 GOOD SHEPHERD HOSPICE 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 11-3434776 MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAX YEAR END: 12/31/10 11-2861698 MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-2861690 MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-3638367 THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAXABLE YEAR: 12/31/10 11-1635088 MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2126736 CATHOLIC HOME CARE 1150 PORTION BLVD. SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 11-3284066 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 20-8067039 RVC INSURANCE COMPANY, INC. 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2499790 RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 06-1569129 SIENA VILLAGE 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 06-1562701 ST. CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 11-1871039 ST. CHARLES HOSPITAL AND REHABILITATION CENTER 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 41-2076312 ST. CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-3613997 ST. FRANCIS CARDIOVASCULAR PHYSICIANS PC 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2050523 ST. FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2916033 ST. FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-3090867 ST. FRANCIS RESEARCH & EDUCATIONAL CORPORATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2110488 SUFFOLK HEARING & SPEECH 369 EAST MAIN STREET EAST ISLIP, NY 11730 TAX YEAR END: 12/31/10 11-2983148 THE ST. CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-2716640 THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 11-3559713 WISDOM GARDENS HOUSING DEVELOPMENT CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-1635088 ST. FRANCIS-MERCY CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 55-0813603 MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 27-1459941 ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 IN PROCESS CATHOLIC HOME CARE FOUNDATION 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 26-3169427 CATHOLIC HOME CARE FOUNDATION 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 45-0517566 OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 27-1531084 OUR LADY OF CONSOLATION FOUNDATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2798383 FAIRVIEW HILL MANAGEMENT CORP 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2801136 HEALTHCARE TEMP SERVICES 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2838185 SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-3319259 SAMARITAN HOME CARE AMERICA, INC. 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 06-1568934 SIENA MEDICAL REALTY 50 ROUTE 25A SMITHTOWN, NY 11787 TAXABLE YEAR: 12/31/10 11-3307977 SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-2126736 NURSING SISTERS HOME CARE, INC 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAXABLE YEAR: 12/31/10

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (36 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
CATHOLIC HEALTH SYSTEM OF LONG ISLAND
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113403968SUPPORT ORGNY501(C)(3)LINE 11A, IN/A0
CHS SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113555766SUPPORT ORGNY501(C)(3)LINE 11A, I0CATHOLIC HEALTH SYSTEM OF LONG ISLAND
CHS AMBULANCE SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570141801961DORMANTNY501(C)(3)LINE 30CATHOLIC HEALTH SYSTEM OF LONG ISLAND
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
1000 MONTAUK HIGHWAYWEST ISLIPNY11795111888924HOSPITALNY501(C)(3)LINE 30CATHOLIC HEALTH SYSTEM OF LONG ISLAND
GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE
1000 MONTAUK HIGHWAYWEST ISLIPNY11795112537396SELF INSURANCENY501(C)(3)LINE 11A, I0GOOD SAMARITAN HOSPITAL
MARYHAVEN TRANSPORTATION SERVICES
51 TERRYVILLE ROADPORT JEFFERSON STATIONNY11776113434776TRANSPORTATION SERVICESNY501(C)(3)LINE 90MARYHAVEN CENTER OF HOPE
MARYHAVEN SCHOOL CORPORATION
51 TERRYVILLE ROADPORT JEFFERSON STATIONNY11776112861690SCHOOL FOR DEVELOPMENTALLY DISABLEDNY501(C)(3)LINE 90MARYHAVEN CENTER OF HOPE
THE CENTER OF HOPE FOUNDATION
51 TERRYVILLE ROADPORT JEFFERSON STATIONNY11776113638367SUPPORT ORGNY501(C)(3)LINE 11A, I0MARYHAVEN CENTER OF HOPE
MERCY MEDICAL CENTER
1000 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570111635088HOSPITALNY501(C)(3)LINE 30CATHOLIC HEALTH SYSTEM OF LONG ISLAND
CATHOLIC HOME CARE
1150 PORTION ROAD SUITE 1HOLTSVILLENY11742112126736HOME CARENY501(C)(3)LINE 90CATHOLIC HEALTH SYSTEM OF LONG ISLAND
OUR LADY OF CONSOLATION GERIATRIC CARE CENTER
111 BEACH DRIVEWEST ISLIPNY11795113284066LT NURSING CARENY501(C)(3)LINE 30CATHOLIC HEALTH SYSTEM OF LONG ISLAND
RIVERHEAD HOSTEL HOLDING CORPORATION
51 TERRYVILLE ROADPORT JEFFERSON STATIONNY11776112499790RENTINGNY501(C)(3)LINE 90MARYHAVEN CENTER OF HOPE
SIENA VILLAGE INC
50 ROUTE 25ASMITHTOWNNY11787061569129SENIOR HOUSINGNY501(C)(3)LINE 90ST CATHERINE OF SIENA MEDICAL CENTER
ST CATHERINE OF SIENA MEDICAL CENTER
50 ROUTE 25ASMITHTOWNNY11787061562701HOSPITALNY501(C)(3)LINE 30CATHOLIC HEALTH SYSTEM OF LONG ISLAND
ST CHARLES HOSPITAL
200 BELLE TERRE ROADPORT JEFFERSON STATIONNY11777111871039HOSPITALNY501(C)(3)LINE 30CATHOLIC HEALTH SYSTEM OF LONG ISLAND
CHS HOME SUPPORT SERVICES INC
15 POWER DRIVEHAUPPAUGENY11788113594561RESPIRATORY THERAPY SVC/MED. EQUIP.NY501(C)(3)LINE 90CATHOLIC HEALTH SYSTEM OF LONG ISLAND
ST FRANCIS HOSPITAL
100 PORT WASHINGTON BLVDROSLYNNY11576112050523HOSPITALNY501(C)(3)LINE 30CATHOLIC HEALTH SYSTEM OF LONG ISLAND
ST FRANCIS HOSPITAL FOUNDATION
100 PORT WASHINGTON BLVDROSLYNNY11576112916033SUPPORT ORGNY501(C)(3)LINE 11A, I0ST FRANCIS HOSPITAL
ST FRANCIS HOSPITAL RESEARCH & EDUCATIONAL CORP
100 PORT WASHINGTON BLVDROSLYNNY11576113090867RESEARCH ORGANIZATIONNY501(C)(3)LINE 90ST FRANCIS HOSPITAL
WSNCHS NORTH INC
4295 HEMPSTEAD TURNPIKEBETHPAGENY11714113438973HOSPITALNY501(C)(3)LINE 30CATHOLIC HEALTH SYSTEM OF LONG ISLAND
SUFFOLK HEARING & SPEECH CENTER INC
369 EAST MAIN STREETEAST ISLIPNY11730112110488DIAGNOSTIC TESTINGNY501(C)(3)LINE 30GOOD SAMARITAN HOSPITAL
THE ST CHARLES CORPORATION
200 BELLE TERRE ROADPORT JEFFERSONNY11777112983148SUPPORT ORGNY501(C)(3)LINE 11A, I0CATHOLIC HEALTH SYSTEM OF LONG ISLAND
THE SAMARITAN CORPORATION
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570112716640SUPPORT ORGNY501(C)(3)LINE 11A, I0CATHOLIC HEALTH SYSTEM OF LONG ISLAND
WISDOM GARDENS HOUSING DEVELOPMENT FUND INC
51 TERRYVILLE ROADPORT JEFFERSON STATIONNY11776113559713SENIOR HOUSINGNY501(C)(3)LINE 90MARYHAVEN CENTER OF HOPE
GOOD SHEPHERD HOSPICE
245 OLD COUNTRY ROADMELVILLENY11747112958438HOSPICE SERVICESNY501(C)(3)LINE 90CATHOLIC HEALTH SYSTEM OF LONG ISLAND
ST CHARLES HOSPITAL FOUNDATION
200 BELLE TERRE ROADPORT JEFFERSONNY11777412076312SUPPORT ORGNY501(C)(3)LINE 11A, I0ST CHARLES HOSPITAL
GOOD SAMARITAN HOSPITAL FOUNDATION
1000 MONTAUK HIGHWAYWEST ISLIPNY11795770611240SUPPORT ORGNY501(C)(3)LINE 11A, I0GOOD SAMARITAN HOSPITAL
ST FRANCIS-MERCY CORPORATION
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570111635088SUPPORT ORGNY501(C)(3)LINE 11A, I0CATHOLIC HEALTH SYSTEM OF LONG ISLAND
MERCY MEDICAL CENTER FOUNDATION
1000 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570550813603SUPPORT ORGNY501(C)(3)LINE 11A, I0MERCY MEDICAL CENTER
ST CATHERINE OF SIENA MEDICAL CENTER FOUNDATION
50 ROUTE 25ASMITHTOWNNY11787271459941SUPPORT ORGNY501(C)(3)LINE 11A, I0ST CATHERINE OF SIENA MEDICAL CENTER
CATHOLIC HOME CARE FOUNDATION
1150 PORTION ROAD SUITE 1HOLTSVILLENY11742SUPPORT ORGNY501(C)(3)LINE 11A, I0CATHOLIC HOME CARE
GOOD SHEPHERD HOSPICE FOUNDATION
245 OLD COUNTRY ROADMELVILLENY11747263169427SUPPORT ORGNY501(C)(3)LINE 11A, I0GOOD SHEPHERD HOSPICE
OUR LADY OF CONSOLATION FOUNDATION
111 BEACH DRIVEWEST ISLIPNY11795450517566SUPPORT ORGNY501(C)(3)LINE 11A, I0OUR LADY OF CONSOLATION
RVC SUPPORT
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570271531084REAL ESTATENY501(C)(3)LINE 11A, I0CATHOLIC HEALTH SYSTEM OF LONG ISLAND
ST FRANCIS CARDIOVASCULAR PHYSICIANS PC
100 PORT WASHINGTON BLVDROSLYNNY11576113613997HEALTHCARE SERVICESNY501(C)(3)LINE 30ST FRANCIS HOSPITAL
RVC INSURANCE COMPANYINC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570208067039CAPTIVE INSURANCE COMPANYNY501(C)(3)LINE 11A, I0CATHOLIC HEALTH SYSTEM OF LONG ISLAND

Form990 Schedule R Part IV Form990ScheduleRPartIV (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntity
RADIOLOGY CONSULTING OF LONG ISLAND PLLC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795421646134HEALTHCARE SERVICESNYGOOD SAMARITAN HOSPITALC
SAMARITAN EMERGENCY MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208243412DIAGNOSTIC TESTINGNYGOOD SAMARITAN HOSPITALC
SAMARITAN PEDIATRIC SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208180263HEALTHCARE SERVICESNYGOOD SAMARITAN HOSPITALC
SAMARITAN MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208088453DIAGNOSTIC TESTINGNYGOOD SAMARITAN HOSPITALC
SOUTHWEST SUFFOLK MEDICAL PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795061603195HEALTHCARE SERVICESNYGOOD SAMARITAN HOSPITALC
CARDIAC EKG INTERPRETATION PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795112924518HEALTHCARE SERVICESNYGOOD SAMARITAN HOSPITALC
LI REGIONAL ARTHRITIS & OSTEOPOROSIS CARE PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208964140HEALTHCARE SERVICESNYGOOD SAMARITAN HOSPITALC
SAMARITAN MANAGEMENT SERVICES INC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795112838185HEALTHCARE SERVICESNYCATHOLIC HEALTH SYSTEM OF LONG ISLANDC
FAIRVIEW HILL MANAGEMENT CO INC
200 BELLE TERRE ROADPORT JEFFERSONNY11777112798383SERVICESNYST CHARLES CORPORATIONC
ADVANCED REHABILIATION MEDICINE PLLC
200 BELLE TERRE ROADPORT JEFFERSONNY11777113640709HEALTHCARE SERVICESNYST CHARLES HOSPITALC
ST FRANCIS CARDIAC PREVENTION SERVICES PC
100 PORT WASHINGTON BLVDROSLYNNY11576113224885HEALTHCARE SERVICESNYST FRANCIS HOSPITALC
SOUTH SHORE PRACTICE MANAGEMENT
1000 MONTAUK HIGHWAYWEST ISLIPNY11795113307977HEALTHCARE SERVICESNYGOOD SAMARITAN HOSPITALC
MERCY INTERNAL MEDICINE PC
992 N VILLAGE AVENUEROCKVILLE CENTRENY11710510639649HEALTHCARE SERVICESNYMERCY MEDICAL CENTERC
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 Org0GiftGrantOrCapContrFrOtherOrg
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 Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
CATHOLIC HEALTH SERVICES OF LONG ISLAND 11-3405968
N-84782COST
ST FRANCIS HOSPITAL 11-2050523
K216133COST
ST CHARLES HOSPITAL AND REHABILITATION 11-1871059
L-443103COST
OUR LADY OF CONSOLATION GERIATRIC CARE 11-3284066
K-61056COST
MARYHAVEN TRANSPORTATION SERVICES 11-3434776
L-609362COST
MERCY MEDICAL CENTER
K522351COST

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