2024-11-14T16:24:52-06:00 2023-12-31 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2023-01-01 111667765 SOUTHAMPTON HOSPITAL ASSOCIATION SOUT 6317268301 240 MEETING HOUSE LANE SOUTHAMPTON NY 11968 CHRISTOPHER SCHULTHEIS CFO 6317268301 2024-11-13 1 1 THOMAS J GIUFRE P00841958 3154463600 2024-11-13 2023 2024-10-15 13:58:12Z EMILY MASTALER 240 MEETING HOUSE LANE SOUTHAMPTON NY 11968 23131087 0 X WWW.SOUTHAMPTON.STONYBROOKMEDICINE.EDU X 1909 NY TO PROMOTE THE HIGHEST QUALITY OF HEALTHCARE SERVICES FOR ITS ENTIRE COMMUNITY. 25 25 0 25 0 0 661976 21352944 4927203 1026538 318235 320686 0 1445 5907414 22701613 0 0 0 0 -577039 0 0 0 0 7024956 913193 6447917 913193 -540503 21788420 89731880 98627423 43422713 33693185 46309167 64934238 X SEE SCHEDULE OTHE MISSION OF THE SOUTHAMPTON HOSPITAL ASSOCIATION (SHA), A NOT FOR-PROFIT MEMBERSHIP CORPORATION ORGANIZED AND EXISTING UNDER THE LAWS OF NEW YORK STATE, IS TO PROMOTE THE HEALTH OF PEOPLE IN THE COMMUNITIES ON THE SOUTH FORK OF LONG ISLAND FROM WESTHAMPTON TO MONTAUK AND SHELTER ISLAND BY PARTICIPATING IN AN AFFILIATION WITH STATE UNIVERSITY OF NEW YORK (SUNY) ACTING THROUGH STONY BROOK UNIVERSITY HOSPITAL (SBUH) PURSUANT TO AN INTEGRATION AND AFFILIATION AGREEMENT AND A LEASE BETWEEN SHA AND SUNY/SBUH. 0 0 752534 1027983 TO PROMOTE THE HEALTH OF PEOPLE IN THE COMMUNITIES ON THE SOUTH FORK OF LONG ISLAND FROM WESTHAMPTON TO MONTAUK AND SHELTER ISLAND. 752534 1 1 0 0 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 248 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 X 25 25 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X CHRISTOPHER SCHULTHEIS 6317268301 240 MEETING HOUSE LANE SOUTHAMPTON NY 11968 X GEORGE F BIONDO ESQ TRUSTEE 1.25 X 0 0 0 BARBARA BORSACK TRUSTEE 1.25 X 0 0 0 HOWARD COX TRUSTEE 1.25 X 0 0 0 ANDREW DAVIS TRUSTEE 1.25 X 0 0 0 JAMES FORBES TRUSTEE 1.25 X 0 0 0 ELENA FORD TRUSTEE 1.25 X 0 0 0 GILBERT W HARRISON TRUSTEE 1.25 0.50 X 0 0 0 WAYNE ISOM MD TRUSTEE 1.25 X 0 0 0 GEORGE P KAZDIN TRUSTEE 1.25 X 0 0 0 JAY K LEVINE TRUSTEE 1.25 X 0 0 0 RICHARD LISMAN MD TRUSTEE 1.25 X 0 0 0 LAURA LOFARO FREEMAN TRUSTEE 1.25 X 0 0 0 HOWARD M LORBER TRUSTEE 1.25 0.50 X 0 0 0 JAMES MACGREGOR TRUSTEE 1.25 X 0 0 0 OSCAR MOLINA TRUSTEE 1.25 X 0 0 0 ALLISON MORROW TRUSTEE 1.25 X 0 0 0 LOUISE PHANSTIEL TRUSTEE 1.25 X 0 0 0 FLORENCE ROLSTON MD TRUSTEE 1.25 X 0 0 0 JEAN SHAFIROFF TRUSTEE 1.25 X 0 0 0 MICHAEL F SMITH TRUSTEE 1.25 X 0 0 0 JOHN WAMBOLD TRUSTEE 1.25 X 0 0 0 FREDRIC WEINBAUM MD TRUSTEE 1.25 X 0 0 0 LAWRENCE A WILLIS TREASURER 1.25 X X 0 0 0 KENNETH B WRIGHT CHAIRMAN 1.25 0.50 X X 0 0 0 ROBERT S CHALONER PRESIDENT & CEO 2.50 7.50 X X 0 0 0 CHRISTOPHER J SCHULTHEIS CHIEF FINANCIAL OFFICER 2.50 0.50 X 0 0 0 0 0 0 0 0 0 0 TURNER CONSTRUCTION CO 66 HUDSON BLVD EAST NEW YORK NY 10001 CONSTRUCTION SERVICES 10937647 PERKINS EASTMAN ARCHITECTS PC 115 FIFTH AVENUE NEW YORK NY 10003 ARCHITECTURAL SERVICES 552202 LIRO PROG & CONST MNGMT PE PC 3 AERIAL WAY SYOSSET NY 11791 CONSTRUCTION SERVICES 453338 BDO PO BOX 642743 PITTSBURGH PA 152642743 ACCOUNTING SERVICES 102859 4 16792120 4560824 21352944 LEASE INCOME 532000 1026538 1026538 1026538 314506 314506 435654 429474 6180 6180 6180 MISCELLANEOUS 900099 1445 1445 1445 22701613 1027983 0 320686 100000 100000 60659 60659 1221885 1221885 85726 85726 -568504 -568504 MISCELLANEOUS EXPENSES 13427 13427 913193 752534 160659 0 X 297231 652088 0 1650000 35626 39544 29928197 54443564 29928197 7598844 11029989 27356615 0 55327605 89731880 98627423 348647 142748 32798839 29690702 5000000 5275227 3859735 43422713 33693185 X 22439986 46721472 23869181 18212766 46309167 64934238 89731880 98627423 X 21788420 1963025 -2152837 -2973537 X X 0 1 X 1 0 X 238172 661976 21352944 22253092 6524750 5733175 5381386 4927203 1027983 23594497 6762922 5733175 5381386 5589179 22380927 45847589 0 0 0 45847589 325197 239187 228294 286512 314506 1393696 325197 239187 228294 286512 314506 1393696 7088119 5972362 5609680 5875691 22695433 47241285 0.97050 0.95510 0.02950 0.04490 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 13249736 2306472 20638 60659 15474911 15879472 -2629736 13249736 12889360 2990112 15879472 14996736 -2107377 12889359 6794600 8202136 14996736 0.81690 0.18310 0 0 4985951 4985951 24942246 24942246 29928197 OTHER INVESTMENTS 11029989 F 11029989 INTEREST IN SOUTHAMPTON HOSPITAL FOUNDATION 17961301 LEASE RECEIVABLE 32602739 ASSETS LIMITED TO USE 4763565 55327605 ACCRUED PENSION LIABILITY 2063735 MALPRACTICE SELF-INSURANCE LIABILITY 1796000 3859735 X PART V, LINE 4: SOUTHAMPTON HOSPITAL ASSOCIATION CURRENTLY REPORTS ENDOWMENT FUNDS WITHIN ITS DECEMBER 31, 2023 FINANCIAL STATEMENTS. THE GOVERNING BODY INTENDS TO USE THESE FUNDS TO SUPPORT THE MISSION OF STONY BROOK SOUTHAMPTON HOSPITAL. PART X, LINE 2: SOUTHAMPTON HOSPITAL ASSOCIATION (SHA) IS INCORPORATED IN THE STATE OF NEW YORK AND ARE EXEMPT FROM FEDERAL, STATE, AND LOCAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE), AND THEREFORE HAS MADE NO PROVISION FOR INCOME TAXES IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. IN ADDITION, SHA, HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE (IRS) NOT TO BE A "PRIVATE FOUNDATION" WITHIN THE MEANING OF SECTION 509(A) OF THE CODE. SHA HAS NOT TAKEN AN UNSUBSTANTIATED TAX POSITION THAT WOULD REQUIRE PROVISION OF A LIABILITY UNDER ASC 740, INCOME TAXES. UNDER ASC 740, AN ORGANIZATION MUST RECOGNIZE THE TAX EFFECTS ASSOCIATED WITH TAX POSITIONS TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE-LIKELY-THAN-NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION. SHA DOES NOT BELIEVE THERE ARE ANY MATERIAL UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, HAVE NOT RECOGNIZED ANY LIABILITY FOR UNRECOGNIZED TAX BENEFITS. SHA HAS FILED IRS FORM 990 TAX RETURNS, AS REQUIRED, AND ALL OTHER APPLICABLE RETURNS IN JURISDICTIONS WHEN IT IS REQUIRED. TAX YEARS OPEN TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES ARE 2020 THROUGH 2023. A SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION 273722095 2014-10-02 33500000 REFINANCE SERIES 1999A AND 1999B 0 0 0 B SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION 273722095 2017-11-30 14000000 CONSTRUCTION OF CANCER TREATMENT CENTER 0 0 0 A 33500000 28644501 607619 3931601 823269 1 0 1 1 B 14000000 280000 13564522 155478 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 0 1 0 0 0 0 0 B 0 0 0 1 0 0 0 0 0 A 0 B 0 PART IV, ARBITRAGE, LINE 2C, COLUMN A: IN 2019 THE REPORTING ORGANIZATION EVALUATED THE 10/2/14 BOND ISSUE (COLUMN A) AND DETERMINED THAT THERE WAS NO ARBITRAGE REBATE REQUIRED AS A RESULT OF UNSPENT PROCEEDS OF APPROXIMATELY $4 MILLION HELD IN A NON-INTEREST-BEARING ACCOUNT FOR APPROXIMATELY 6 TO 12 MONTHS IN 2014/2015. THOSE FUNDS HELD IN A NON-INTEREST BEARING ACCOUNT WERE EARNING SUBSTANTIALLY LESS THAN THE BOND INTEREST RATE OF 3.5%. PART IV, ARBITRAGE, LINE 2C, COLUMN B: THE REPORTING ORGANIZATION EVALUATED THE BOND ISSUED 11/30/17 (COLUMN B) AND DETERMINED THAT THERE WAS NO ARBITRAGE REBATE REQUIRED. UNSPENT PROCEEDS OF APPROXIMATELY $14 MILLION WERE HELD AT THE BANK OF NEW YORK IN A NON-INTEREST-BEARING ACCOUNT FROM NOVEMBER 2017 THROUGH JUNE 2019. THOSE FUNDS HELD IN A NON-INTEREST BEARING ACCOUNT WERE EARNING SUBSTANTIALLY LESS THAN THE BOND INTEREST RATE OF 3.5%. FORM 990, PART VI, SECTION B, LINE 11B SOUTHAMPTON HOSPITAL ASSOCIATION HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. UPON COMPLETION, THE FORM 990 IS REVIEWED BY MANAGEMENT AND IS THEN FORWARDED ELECTRONICALLY TO THE MEMBERS OF THE BOARD OF TRUSTEES FOR THEIR REVIEW. ANY QUESTIONS OR ISSUES ARE THEN ADDRESSED BY THE APPROPRIATE PARTIES PRIOR TO THE FILING OF THE RETURN. FORM 990, PART VI, SECTION B, LINE 12C SOUTHAMPTON HOSPITAL ASSOCIATION UTILIZES THE SOUTHAMPTON PROFESSIONAL EMPLOYER ORGANIZATION'S (PEO) EMPLOYEES TO CARRY OUT ITS MISSION. THEREFORE, THE ORGANIZATION FOLLOWS STONY BROOK SOUTHAMPTON'S CONFLICT OF INTEREST POLICY, AS WELL AS THEIR WHISTLEBLOWER POLICY. BOTH POLICIES ARE CURRENTLY IN PLACE. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION DOES NOT COMPENSATE ANY OFFICERS OR KEY EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 SOUTHAMPTON HOSPITAL'S FORM 990, AS WELL AS ITS FINANCIAL STATEMENTS AND CONFLICT OF INTEREST POLICY, ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST, AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. INTERESTED PARTIES MAY REQUEST THE DOCUMENTS AT 240 MEETINGHOUSE LANE, SOUTHAMPTON, NY 11968 OR BY CALLING THE ORGANIZATION DIRECTLY AT (631)726-8200. PART X, LINE 10A-10C IN 2023, IT WAS DETERMINED THAT ASSETS PREVIOUSLY RECORDED AS PROPERTY AND EQUIPMENT HAD BEEN TRANSFERRED TO SBUH FOR THE REMAINDER OF THEIR USEFUL LIVES. ADDITIONALLY, THE BOOK VALUE OF THE PROPERTY AND EQUIPMENT PREVIOUSLY RECORDED HAD EXCEEDED THE PRESENT VALUE OF ESTIMATED FUTURE LEASE PAYMENTS. NET ASSETS AT THE BEGINNING OF YEAR WERE DECREASED $2,152,837 AS A RESULT OF THE CORRECTION. FORM 990, PART XI, LINE 9: CHANGES IN PENSION OBLIGATION 862,617. CHANGE IN INTEREST IN NET ASSET WITHOUT DONOR RESTRICTIONS FOUNDATION 2,102,386. CHANGE IN INTEREST IN NET ASSET WITH DONOR RESTRICTIONS FOUNDATION -5,656,415. NET PERIODIC PENSION -282,125. PART XII, LINE 2C NO CHANGES FROM THE PRIOR YEAR. SOUTHAMPTON CARE CENTER 240 MEETING HOUSE LANE SOUTHAMPTON NY 11968 112658403 NURSING HOME NY 501(C)(3) LINE 10 N/A 0 THE SOUTHAMPTON HOSPITAL FOUNDATION 240 MEETING HOUSE LANE SOUTHAMPTON NY 11968 113466516 SERVICE PROVIDER NY 501(C)(3) LINE 7 SHA 1 SHA PROPERTIES 240 MEETING HOUSE LANE SOUTHAMPTON NY 11968 112563612 REAL ESTATE NY SHA C 13162 1.00000 1 OLD TOWN MEDICAL PRACTICE PC 240 MEETING HOUSE LANE SOUTHAMPTON NY 11968 452430883 MEDICAL PRACTICE NY SHA C 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 THE SOUTHAMPTON HOSPITAL FOUNDATION INC C 16792120