ST CHARLES HOSPITAL CORP: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ST CHARLES HOSPITAL CORP (EIN 11-1871039)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-11
- IRS object ID
- 202233159349306758
- Schema version
- 2021v4.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-11T16:25:37-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 Madison Avenue | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10017 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 111871039 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CHARLES HOSPITAL CORP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % CHS SERVICES INC | InCareOfNm |
| Business Name Control | STCH | BusinessNameControlTxt |
| Phone | 6314746116 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BELLE TERRE ROAD | AddressLine1Txt |
| City | PORT JEFFERSON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11777 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES O'CONNOR | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5167051937 | PhoneNum |
| Signature | 2022-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JAMES | PersonFirstNm |
| Person Last | OCONNOR | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAURA J PARELLO | PreparerPersonNm |
| PTIN | P01080295 | PTIN |
| Phone | 6464713000 | PhoneNum |
| Preparation | 2022-11-04 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CHARLES HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PATRICK O'SHAUGHNESSY DO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BELLE TERRE RD | AddressLine1Txt |
| City | PORT JEFFERSON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11777 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $247,574,717 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | http://stcharleshospital.chsli.org/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1907 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | WE, AT CH, HUMBLY JOIN TOGETHER TO BRING CHRIST'S HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 20 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 1893 | TotalEmployeeCnt |
| Total Volunteers | 27 | TotalVolunteersCnt |
| Total Gross UBI | $7,721 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $3,246 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $33,167,126 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,352,943 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $209,038,060 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $240,913,457 | CYProgramServiceRevenueAmt |
| PY Investment Income | $139,745 | PYInvestmentIncomeAmt |
| CY Investment Income | $116,934 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,611,732 | PYOtherRevenueAmt |
| CY Other Revenue | $4,191,383 | CYOtherRevenueAmt |
| PY Total Revenue | $245,956,663 | PYTotalRevenueAmt |
| CY Total Revenue | $247,574,717 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,149,253 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $86,842 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $130,372,941 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $126,570,596 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $105,712,710 | PYOtherExpensesAmt |
| CY Other Expenses | $103,389,849 | CYOtherExpensesAmt |
| PY Total Expenses | $237,234,904 | PYTotalExpensesAmt |
| CY Total Expenses | $230,047,287 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,721,759 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $17,527,430 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $137,852,980 | TotalAssetsBOYAmt |
| Total Assets EOY | $126,136,330 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $156,661,164 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $130,122,854 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$18,808,184 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$3,986,524 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $191,796,117 | ExpenseAmt |
| Grant | $86,842 | GrantAmt |
| Revenue | $243,142,095 | RevenueAmt |
| Desc | ST. CHARLES HOSPITAL CORP (D/B/A ST. CHARLES HOSPITAL) IS A 243 BED REHABILITATION AND ACUTE CARE HOSPITAL THAT ALSO OPERATES OUTPATIENT FACILITIES IN BOTH NASSAU AND SUFFOLK COUNTIES. FOUNDED BY THE DAUGHTERS OF WISDOM IN 1907, ST. CHARLES PROVIDES A FULL RANGE OF HEALTHCARE SERVICES. IN 2021 ST. CHARLES HAD 11,080 DISCHARGED AND PROVIDED 20,139 EMERGENCY ROOM VISITS. ST. CHARLES PROVIDES CARE REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY AND ALONG WITH OTHER COMMUNITY SERVICE AND CHARITABLE ACTIVITIES. | Desc |
| Total Program Service Expenses | $191,796,117 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 139 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1893 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 20 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHS SERVICES INC | PersonNm |
| Phone | 5167053700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 992 NORTH VILLAGE AVENUE | AddressLine1Txt |
| City | ROCKVILLE CENTRE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11570 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| DANIEL DEBARBA | |||||||||
| EVP & CFO | 50.0 | 0.0 | Yes (X) | $0 | $2,785,285 | $368,329 | |||
| ALAN D GUERCI MD | |||||||||
| PRESIDENT & CEO THRU 6/30/21 | 50.0 | 0.0 | Yes (X) | $0 | $2,194,532 | $279,930 | Yes (X) | ||
| PATRICK O'SHAUGHNESSY DO | |||||||||
| PRESIDENT & CEO AS OF 4/16/21 | 50.0 | 0.0 | Yes (X) | $0 | $1,561,701 | $350,019 | Yes (X) | ||
| Vlada Frankenburger | |||||||||
| PHYSICIAN | 50.0 | 0.0 | $1,001,720 | $0 | $30,876 | Yes (X) | |||
| JAMES O'CONNOR | |||||||||
| PRESIDENT/CAO | 50.0 | 0.0 | Yes (X) | $810,400 | $0 | $120,777 | |||
| Anil Sangwan | |||||||||
| PHYSICIAN | 50.0 | 0.0 | $823,483 | $0 | $43,909 | Yes (X) | |||
| Sanjay Sangwan | |||||||||
| PHYSICIAN | 50.0 | 0.0 | $758,190 | $0 | $29,922 | Yes (X) | |||
| Derek Mattimoe | |||||||||
| PHYSICIAN | 50.0 | 0.0 | $652,919 | $0 | $73,202 | Yes (X) | |||
| Matthew Wagner | |||||||||
| PHYSICIAN | 50.0 | 0.0 | $632,683 | $0 | $70,621 | Yes (X) | |||
| SUNIL DHUPER MD | |||||||||
| CMO | 50.0 | 0.0 | $439,207 | $0 | $41,693 | Yes (X) | |||
| RONALD WEINGARTNER | |||||||||
| COO | 50.0 | 0.0 | $394,426 | $0 | $42,505 | Yes (X) | |||
| SALVATORE SODANO | |||||||||
| CHAIR | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| BRIAN MCGUIRE | |||||||||
| VICE CHAIR | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JEROME POLLER | |||||||||
| SECRETARY | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ROBERT ZUCCARO | |||||||||
| TREASURER | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CHRIS PASCUCCI | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| VIRGINIA EWEN | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| FRANK L KURRE | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| REV MSGR ROBERT MORRISEY | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| DANIEL T ROWE | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| REV JOHN MCCARTNEY | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| KEVIN J CONWAY | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| PETER D'ANGELO | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| REV PETER DUGANDZIC | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| HON ANTHONY MARANO | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| STEPHEN F MCLOUGHLIN | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| JOHN FRANCFORT MD | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| ROBERT COUGHLAN | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| WILLIAM WARD | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| PETER QUICK | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| THOMAS CHRISTMAN | |||||||||
| TRUSTEE | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,513,028 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,541,518 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,451,783 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 321 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ORTHOPEDIC ASSOC OF LI PHYS MED | |||||
| 6 TECHNOLOGY DRIVE SUITE 1000 | EAST SETAUKET | NY | 11733 | PHYSICIAN SERVICES | $2,900,942 |
| LI MINIMALLY INVASIVE SURG PC | |||||
| 3003 NEW HYDE PARK RD SUITE 307 | NEW HYDE PARK | NY | 11042 | PHYSICIAN SERVICES | $648,951 |
| ISLAND NEONATOLOGY LLC | |||||
| PO BOX 272 | EAST ISLIP | NY | 11730 | PHYSICIAN SERVICES | $598,593 |
| REMI HOLDINGS LLC | |||||
| 11325 N COMMUNITY HOUSE ROAD SUITE | CHARLOTTE | SC | 28277 | EQUIPMENT SERVICES | $468,683 |
| LI PULMONARY REHAB PC | |||||
| 326 West Neck Road | HUNTINGTON | NY | 11743 | PHYSICIAN ON-CALL SV | $300,564 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 25 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $978,049 | RelatedOrganizationsAmt |
| Government Grants | $1,356,176 | GovernmentGrantsAmt |
| All Other Contributions | $18,718 | AllOtherContributionsAmt |
| Total Contributions | $2,352,943 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $240,913,457 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $240,905,736 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $7,721 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $240,913,457 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $116,934 | TotalRevenueColumnAmt |
| Exclusion | $116,934 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,567,615 | RealAmt |
| Personal | $0 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,567,615 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,567,615 | TotalRevenueColumnAmt |
| Exclusion | $1,567,615 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| REHAB SERVICES | 624310 | $866,196 | $866,196 | |
| COFFEE SHOP | 722514 | $387,409 | $387,409 | |
| PHARMACY INCOME | 446110 | $166,685 | $166,685 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,203,478 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,203,478 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,623,768 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $247,574,717 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $243,142,095 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $7,721 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,071,958 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,842 | TotalAmt |
| Program Services | $86,842 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,849,008 | TotalAmt |
| Program Services | $480,900 | ProgramServicesAmt |
| Management And General | $1,368,108 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,697,741 | TotalAmt |
| Program Services | $85,948,301 | ProgramServicesAmt |
| Management And General | $7,749,440 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,763,114 | TotalAmt |
| Program Services | $6,117,744 | ProgramServicesAmt |
| Management And General | $645,370 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,823,025 | TotalAmt |
| Program Services | $14,313,113 | ProgramServicesAmt |
| Management And General | $1,509,912 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,437,708 | TotalAmt |
| Program Services | $7,632,540 | ProgramServicesAmt |
| Management And General | $805,168 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $303,552 | TotalAmt |
| Program Services | $280,141 | ProgramServicesAmt |
| Management And General | $23,411 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,667 | TotalAmt |
| Management And General | $8,667 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Management And General | $10,000 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,139 | TotalAmt |
| Management And General | $97,139 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,855,071 | TotalAmt |
| Program Services | $6,899,389 | ProgramServicesAmt |
| Management And General | $3,955,682 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,381 | TotalAmt |
| Program Services | $2,327 | ProgramServicesAmt |
| Management And General | $25,054 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,408,590 | TotalAmt |
| Program Services | $2,107,826 | ProgramServicesAmt |
| Management And General | $1,300,764 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,795,090 | TotalAmt |
| Program Services | $1,795,328 | ProgramServicesAmt |
| Management And General | $2,999,762 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,886 | TotalAmt |
| Program Services | $87,290 | ProgramServicesAmt |
| Management And General | $6,596 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $584,059 | TotalAmt |
| Program Services | $584,059 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,472,090 | TotalAmt |
| Program Services | $5,454,124 | ProgramServicesAmt |
| Management And General | $2,017,966 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,807,642 | TotalAmt |
| Program Services | $4,807,642 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $26,782,476 | $26,782,476 | |
| CHS SERVICES | $22,146,417 | $8,879,623 | $13,266,794 |
| PHYSICIAN PRACTICE SUBSIDY | $11,948,730 | $11,948,730 | |
| HOME OFFICE | $2,418,841 | $2,418,841 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,630,218 | TotalAmt |
| Program Services | $7,587,722 | ProgramServicesAmt |
| Management And General | $42,496 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230,047,287 | TotalAmt |
| Program Services | $191,796,117 | ProgramServicesAmt |
| Management And General | $38,251,170 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,352,507 | BOYAmt |
| EOY | $332,261 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,412,608 | BOYAmt |
| EOY | $3,455,954 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,769,635 | BOYAmt |
| EOY | $25,899,380 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,349,853 | BOYAmt |
| EOY | $4,360,310 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,676,647 | BOYAmt |
| EOY | $1,925,098 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $241,629,338 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $189,359,655 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,491,689 | BOYAmt |
| EOY | $52,269,683 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $378,442 | BOYAmt |
| EOY | $481,506 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,421,599 | BOYAmt |
| EOY | $37,412,138 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,852,980 | BOYAmt |
| EOY | $126,136,330 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,412,871 | BOYAmt |
| EOY | $31,477,016 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,058,902 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,189,391 | BOYAmt |
| EOY | $98,645,838 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $156,661,164 | BOYAmt |
| EOY | $130,122,854 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$19,993,471 | BOYAmt |
| EOY | -$5,153,554 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,185,287 | BOYAmt |
| EOY | $1,167,030 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$18,808,184 | BOYAmt |
| EOY | -$3,986,524 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,852,980 | BOYAmt |
| EOY | $126,136,330 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $17,527,430 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $99,360 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$2,805,130 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $97,139 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $97,139 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1 - LOBBYING ACTIVITIES | FormAndLineReferenceDesc |
| Explanation | AMOUNT REFLECTS PORTION OF TRADE ASSOCIATION DUES WHICH WERE USED FOR LEGISLATIVE LOBBYING ON BEHALF OF THE HEALTHCARE INDUSTRY THOSE TRADE ASSOCIATIONS REPRESENT. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $775,960 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $906 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $906 | AdministrativeExpensesAmt |
| End Year Balance | $775,960 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $775,960 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $7,201 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $7,201 | AdministrativeExpensesAmt |
| End Year Balance | $775,960 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $775,960 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $19,391 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $19,391 | AdministrativeExpensesAmt |
| End Year Balance | $775,960 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $775,960 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $10,430 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $10,430 | AdministrativeExpensesAmt |
| End Year Balance | $775,960 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $775,960 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,198 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $1,198 | AdministrativeExpensesAmt |
| End Year Balance | $775,960 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,000 | OtherCostOrOtherBasisAmt |
| Book Value | $38,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $117,693,963 | OtherCostOrOtherBasisAmt |
| Depreciation | $87,115,087 | DepreciationAmt |
| Book Value | $30,578,876 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $593,839 | OtherCostOrOtherBasisAmt |
| Depreciation | $157,238 | DepreciationAmt |
| Book Value | $436,601 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $116,038,256 | OtherCostOrOtherBasisAmt |
| Depreciation | $96,747,738 | DepreciationAmt |
| Book Value | $19,290,518 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,265,280 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,339,592 | DepreciationAmt |
| Book Value | $1,925,688 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $52,269,683 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM RELATED PARTIES, NET | $6,738,000 |
| OTHER RECEIVABLES, NET | $832,882 |
| OTHER ASSETS | $113,478 |
| INSURANCE CLAIMS RECEIVABLE | $22,974,859 |
| RIGHT OF USE ASSETS | $6,752,919 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $37,412,138 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (7 entries)
| DescDesc | AmtAmt |
|---|---|
| SELF INSURANCE LIABILITIES | $14,976,215 |
| DUE TO RELATED PARTIES | $21,270,237 |
| THIRD PARTY PAYOR LIABILITIES | $30,774,592 |
| ESTIMATED MALPRACTICE | $22,248,880 |
| OTHER LIAB-POST RETIREMENT | $183,000 |
| OTHER LIAB-457B PLAN | $2,288,924 |
| OPERATING LEASE LIABILITIES | $6,903,990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $98,645,838 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4 - ENDOWMENT FUNDS | THE ENDOWMENT INVESTMENTS ARE TO BE HELD IN PERPETUITY, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT HEALTHCARE SERVICES. |
| PART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTE | CH AND MOST OF ITS SUBSIDIARIES ARE 501(C)(3) ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. THESE ENTITIES ARE ALSO EXEMPT FROM NEW YORK STATE INCOME TAXES. THERE ARE VARIOUS SUBSIDIARIES OF CH THAT ARE FOR-PROFIT ENTITIES. TAXABLE OPERATIONS AND THE POTENTIAL FOR INCOME TAXES FROM THESE ENTITIES AND FROM UNRELATED BUSINESS ACTIVITIES OF THE TAX EXEMPT ENTITIES ARE NOT SIGNIFICANT TO THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,297,038 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,399 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,281,639 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00990 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $39,265,459 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $22,949,933 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,315,526 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07090 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $812,759 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $513,603 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $299,156 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,375,256 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,478,935 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,896,321 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08210 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $655,519 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $655,519 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00280 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,183,645 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $400,271 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,783,374 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00780 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $24,738 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $24,738 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $98,125 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $98,125 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,962,027 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $400,271 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,561,756 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01110 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $45,337,283 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,879,206 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $21,458,077 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09320 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $8,285,119 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $57,355,792 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $53,578,257 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $3,777,535 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CHARLES HOSPITAL CORP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BELLE TERRE ROAD | AddressLine1Txt |
| City | PORT JEFFERSON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11777 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.STCHARLESHOSPITAL.CHSLI.ORG/ | WebsiteAddressTxt |
| State License | 5149001H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | REHABILITATIVE SERVICES | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CHARLES HOSPITAL CORP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | STCHARLESHOSPITAL.CHSLI.ORG/ | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | WWW.CHSLI.ORG | OtherWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.CHSLI.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.CHSLI.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.CHSLI.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.CHSLI.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B, LINE 3E | IN 2019, MEMBERS OF THE LONG ISLAND HEALTH COLLABORATIVE REVIEWED EXTENSIVE DATA SETS SELECTED FROM BOTH PRIMARY AND SECONDARY DATA SOURCES TO IDENTIFY AND CONFIRM HEALTH NEEDS PRIORITIES FOR THE 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT CYCLE. DATA ANALYSIS EFFORTS WERE COORDINATED THROUGH THE LONG ISLAND POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP), WITH THE PHIP SERVING AS THE CENTRALIZED DATA RETURN AND ANALYSIS HUB. COMMUNITY PARTNERS SELECTED THE FOLLOWING AREAS OF FOCUS FOR LONG ISLAND FROM THE NEW YORK STATE PREVENTION AGENDA PRIORITIES: (1) PREVENT CHRONIC DISEASE, FOCUS AREA 4: CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT, AND (2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS, FOCUS AREA 2: MENTAL AND SUBSTANCE USE DISORDERS PREVENTION. |
| PART V, SECTION B, LINE 5 | ST. CHARLES HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ASSOCIATION WITH LONG ISLAND HEALTH COLLABORATIVE (LIHC) MEMBERS. THE LIHC IS A PARTNERSHIP OF LONG ISLAND'S HOSPITALS, COUNTY HEALTH DEPARTMENTS, HEALTH PROVIDERS, COMMUNITY-BASED SOCIAL AND HUMAN SERVICE ORGANIZATIONS, ACADEMIC INSTITUTIONS, HEALTH PLANS, LOCAL GOVERNMENT, AND THE BUSINESS SECTOR, ALL ENGAGED IN IMPROVING THE HEALTH OF LONG ISLANDERS. THE LIHC IS THE MAIN WORKING GROUP ASSOCIATED WITH CARRYING OUT THE GOALS OF THE LONG ISLAND POPULATION HEALTH IMPROVEMENT PROGRAM. IN 2019, MEMBERS OF THE LIHC REVIEWED EXTENSIVE DATA SETS SELECTED FROM BOTH PRIMARY AND SECONDARY DATA SOURCES TO IDENTIFY AND CONFIRM PREVENTION AGENDA PRIORITIES FOR THE 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT CYCLE. DATA ANALYSIS EFFORTS WERE COORDINATED THROUGH THE LIHC, WHICH SERVED AS THE CENTRALIZED DATA RETURN AND ANALYSIS HUB. PRIMARY DATA SOURCES INCLUDE THE LONG ISLAND AND EASTERN QUEENS COMMUNITY HEALTH ASSESSMENT SURVEY (CHAS) AND THE RESULTS FROM FOCUS GROUPS AND KEY COMMUNITY-BASED ORGANIZATION LEADER INTERVIEWS. SECONDARY DATA SOURCES COMPRISED PUBLICALLY-AVAILABLE DATA SETS WHICH WERE REVIEWED TO DETERMINE CHANGE IN HEALTH STATUS AND EMERGING ISSUES WITHIN SUFFOLK COUNTY. SOURCES OF SECONDARY DATA INCLUDED STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS), NEW YORK STATE PREVENTION AGENDA DASHBOARD, PREVENTION QUALITY INDICATORS (PQI), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), EXTENDED BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (EBRFSS), NEW YORK STATE COMMUNITY HEALTH INDICATOR REPORTS (CHIRS) AND NEW YORK STATE VITAL STATISTICS. THE ENGAGEMENT OF THE BROADER COMMUNITY, FOR ASSESSMENT PROCESSES, IS ACHIEVED THROUGH THE LIHC AND ITS PARTNERS' ONGOING DISTRIBUTION OF THE LONG ISLAND AND EASTERN QUEENS COMMUNITY HEALTH ASSESSMENT (CHAS) SURVEY. THIS SURVEY IS OFFERED ONLINE VIA A SURVEYMONKEY LINK AND IS AVAILABLE TO RESIDENTS AT PUBLIC EVENTS, WORKSHOPS, EDUCATIONAL PROGRAMS, INTERVENTIONS, ETC., WHICH ARE OFFERED BY LIHC PARTNERS. IT IS ALSO DISTRIBUTED AMONG PHYSICIAN OFFICES, HOSPITAL WAITING AREAS, LIBRARIES, SCHOOLS, FEDERALLY-QUALIFIED HEALTH CLINICS, AND INSURANCE ENROLLMENT SITES, AMONG OTHER PUBLIC VENUES. THE LIHC AGGRESSIVELY PROMOTES THE SURVEY THROUGH SOCIAL MEDIA AND A LINK TO THE SURVEY IS ALSO AVAILABLE ON THE ST. CHARLES HOSPITAL'S WEBSITE. RESULTS FROM THE CHAS ARE ANALYZED TWICE A YEAR. FINDINGS ARE SHARED WITH ALL LIHC PARTICIPANTS, WITH THE MEDIA, AND POSTED ON THE LIHC WEBSITE. SURVEYS WERE DISTRIBUTED BY PAPER AND ELECTRONICALLY, THROUGH SURVEY MONKEY, TO COMMUNITY MEMBERS FROM JANUARY 1, 2018 THROUGH DECEMBER 31, 2018 WITH 810 SURVEYS COLLECTED IN SUFFOLK COUNTY. A CERTIFIED TRANSLATION OF THE SURVEY IS AVAILABLE IN THE FOLLOWING LANGUAGES: SPANISH, POLISH AND HAITIAN CREOLE. LARGE PRINT COPIES ARE ALSO AVAILABLE TO THOSE LIVING WITH VISION IMPAIRMENT. FOR THIS ASSESSMENT CYCLE, THE LIHC ALSO ENGAGED THE COMMUNITY THROUGH FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH LEADERS OF COMMUNITY-BASED ORGANIZATIONS (CBO). THE RESEARCH FIRM EUREKAFACTS, LLC CONDUCTED THE FOCUS GROUPS AND CBO INTERVIEWS, INTERPRETED THE RESULTS, AND PRODUCED THE REPORT. FOCUS GROUPS WERE HELD IN LOW-INCOME COMMUNITIES, RIVERHEAD, AND WYANDANCH. |
| PART V, SECTION B, LINE 6A | LONG ISLAND COMMUNITY HOSPITAL, NORTHWELL HEALTH SYSTEM (HUNTINGTON HOSPITAL, SOUTHSIDE HOSPITAL, JOHN T. MATHER MEMORIAL HOSPITAL, PECONIC BAY MEDICAL CENTER), GOOD SAMARITAN HOSPITAL, ST. CATHERINE OF SIENA HOSPITAL, STONY BROOK SOUTHAMPTON HOSPITAL, STONY BROOK UNIVERSITY HOSPITAL AND VETERANS AFFAIRS MEDICAL CENTER. |
| PART V, SECTION B, LINE 6B | THE HOSPITAL'S CHNA WAS CONDUCTED WITH NASSAU AND SUFFOLK HEALTH DEPARTMENTS, STONY BROOK UNIVERSITY, AND MORE THAN 40 COMMUNITY-BASED ORGANIZATIONS, COLLECTIVELY KNOWN AS THE LONG ISLAND HEALTH COLLABORATIVE (LIHC). |
| PART V, SECTION B, LINE 11 | COMMUNITY PARTNERS SELECTED THE FOLLOWING AREAS OF FOCUS FOR LONG ISLAND FROM THE NEW YORK STATE PREVENTION AGENDA PRIORITIES: (1) PREVENT CHRONIC DISEASE, FOCUS AREA 4: CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT AND (2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS, FOCUS AREA 2: MENTAL AND SUBSTANCE USE DISORDERS PREVENTION. THE WORK PLAN FOR ADDRESSING THE IDENTIFIED NEEDS CAN BE FOUND IN THE CHNA APPENDIX E, PUBLICLY AVAILABLE ON THE HOSPITAL WEBSITE, HTTPS://STCHARLESHOSPITAL.CHSLI.ORG/. PRIORITY 1: PREVENT CHRONIC DISEASE: ST. CHARLES CENTER OFFERS REGULARLY SCHEDULED PREVENTIVE HEALTH SCREENINGS IN LOCAL COMMUNITIES, PARTICULARLY THOSE IN MEDICALLY-UNDERSERVED COMMUNITIES, INCLUDING BLOOD PRESSURE, BODY MASS INDEX (BMI), ORAL, HEAD AND NECK CANCER, AND COLON CANCER. NINE EDUCATIONAL PROGRAMS WERE HELD, MOST VIRTUALLY, WITH APPROXIMATELY 300 INDIVIDUALS PARTICIPATING. THE LIBRARY PROGRAMS PIVOTED TO VIRTUAL LECTURES, AND ST. CHARLES WILL RESUME ITS PARTNERSHIP WITH SENIOR CENTERS WHEN THESE RE-OPEN. HEALTHY SUNDAYS' COMMUNITY OUTREACH EVENTS ARE HELD IN COLLABORATION WITH CHURCHES, HOUSES OF WORSHIP, AND COMMUNITY ORGANIZATIONS. HEALTHY SUNDAYS INCLUDES HEALTH SCREENINGS, EDUCATION AND REFERRALS TO CARE, ALONG WITH SELECT PARTNERS OFFERING FREE OR DISCOUNTED SERVICES. HEALTHY SUNDAYS RESUMED WITH AN EVENT IN JUNE WHERE 35 COMMUNITY MEMBERS ATTENDED. TWENTY-TWO BLOOD PRESSURE SCREENINGS AND FOUR REFERRALS TO FREE FOLLOW-UP CARE WERE MADE. ST. CHARLES HOSTED NINE EDUCATION EVENTS AND LECTURES, MOSTLY VIRTUALLY, FROM JANUARY THROUGH SEPTEMBER 2021 ON A VARIETY OF TOPICS, INCLUDING SUBSTANCE ABUSE AND PREVENTION, STROKE, COLON CANCER AND DIGESTIVE HEALTH, FALLS PREVENTION, SMOKING CESSATION, AND NUTRITION. MORE THAN 400 COMMUNITY MEMBERS PARTICIPATED IN THESE EDUCATIONAL EVENTS. AN ADDITIONAL EDUCATION PRESENTATION ON NUTRITION WAS HELD ON NOVEMBER 2 AT THE ST. JAMES ROSARY ALTAR SOCIETY IN SETAUKET. 30 PERSONS ATTENDED. SMOKING CESSATION PROGRAMS ARE OFFERED IN COLLABORATION WITH STAFF FROM THE SUFFOLK COUNTY DEPARTMENT OF HEALTH (DOH), WHO FACILITATE THE PROGRAM. AN IN-PERSON LEARN TO BE TOBACCO-FREE PROGRAM WAS HELD IN JULY AND AUGUST 2021, WITH EIGHT REGISTRANTS. AS PART OF A CATHOLIC HEALTH SYSTEM-WIDE INITIATIVE, FREE PROSTATE CANCER SCREENINGS FOR THE COMMUNITY WERE OFFERED ON SEPTEMBER 10TH IN CONJUNCTION WITH PROSTATE CANCER AWARENESS MONTH. SEVEN REGISTRANTS ATTENDED AND ONE FOLLOW-UP APPOINTMENT WAS MADE FOR A MALE WITH AN ABNORMAL DRE. PRIORITY 2: PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS: PROMOTION OF ALL PROGRAMS, EVENTS, AND EDUCATION OFFERED BY LIHC MEMBERS THAT SPEAK TO THE PREVENTION OF MENTAL AND SUBSTANCE USE DISORDERS. PARTICIPATION IN LOCAL TASK FORCES ADDRESSING OPIOID USE DISORDERS. ST. CHARLES HOSPITAL OFFERS FREE SUPPORT GROUPS OPEN TO ALL COMMUNITY MEMBERS, INCLUDING MONTHLY BARIATRIC SUPPORT GROUP, BRAIN INJURY SUPPORT GROUP, EPILEPSY SUPPORT GROUP, PARKINSON'S DISEASE SUPPORT GROUP, MONTHLY AND SPINAL CORD INJURY SUPPORT GROUP; BI-MONTHLY MUSCULAR DYSTROPHY SUPPORT GROUP (MDA); WEEKLY SPEECH COMMUNICATION SUPPORT GROUP, AND WEEKLY BREASTFEEDING SUPPORT GROUP; AND BI-WEEKLY STROKE SUPPORT GROUP. IN 2021 ST. CHARLES CONTINUED TO OFFER VIRTUAL SUPPORT GROUPS FOR STROKE, PARKINSON'S DISEASE, LACTATION, MOTHER CIRCLE OF HOPE (POSTPARTUM DEPRESSION), AND BARIATRICS. FIFTY PERSONS WERE ENROLLED IN THE STROKE SUPPORT GROUP AND 634 ATTENDED THE PARKINSON'S SUPPORT GROUP. THE VIRTUAL LACTATION CLASS HAD 88 PARTICIPANTS, THERE WERE 2 PERSONS IN THE MOTHERS CIRCLE OF HOPE, 5 IN THE BREASTFEEDING SUPPORT GROUP, 12 IN THE VIRTUAL CHILDBIRTH CLASS, AND 4 IN THE NEWBORN PARENTING SUPPORT GROUP. THE BARIATRICS SUPPORT GROUP INCREASED IN 2021 TO 333 PARTICIPANTS. ST. CHARLES HOSPITAL DISTRIBUTES CH'S MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES GUIDE TO CH PARTNERS WITHIN THE HOSPITAL AND IS AVAILABLE FOR DOWNLOAD ON THE HOSPITAL WEBSITE. TO FURTHER THE CONTINUUM OF CARE FOR PATIENTS POST-DISCHARGE FROM BOTH THE DETOXIFICATION PROGRAM AND THE REHABILITATION PROGRAM, ST. CHARLES OFFERS NUMEROUS SUPPORT GROUPS POST-DISCHARGE, INCLUDING MONTHLY AL-ANON FAMILY SUPPORT GROUP MEETING-STEP MEETING; WEEKLY: AL-ANON FAMILY SUPPORT GROUP-BEGINNERS' MEETING, ALCOHOLICS ANONYMOUS BACK-TO-BASICS, ALCOHOLICS ANONYMOUS-LIVING SOBER, AND WEEKLY NARCOTICS ANONYMOUS. THE HOSPITAL ALSO PARTICIPATES IN COMMUNITY OUTREACH ACTIVITIES THAT ADDRESS OTHER NEW YORK STATE PREVENTION AGENDA PRIORITIES. ST. CHARLES, IN COLLABORATION WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH, OFFERED FREE LECTURES FOR SENIORS ON FALLS PREVENTION. THESE ARE HELD AT VARIOUS COMMUNITY LIBRARIES, FIRE DEPARTMENTS, SENIOR GROUPS, AND TOWN SENIOR CENTERS. ST. CHARLES HOSTS A BREASTFEEDING SUPPORT GROUP TO PROMOTE THE HEALTH BENEFITS OF BREASTFEEDING AND PROVIDE PEER SUPPORT TO NURSING MOTHERS. THE GROUP CONTINUES TO MEET VIRTUALLY FOUR TIMES A MONTH. THROUGH SEPTEMBER, THERE HAVE BEEN 45 PARTICIPANTS IN THE CLASS. THE VIRTUAL CHILDBIRTH CLASS IS HELD THREE TIMES PER MONTH SINCE ITS START IN AUGUST 2021. THROUGH SEPTEMBER, THERE HAVE BEEN 45 PARTICIPANTS IN THE CLASS. CPR CLASSES ARE OFFERED ONCE A MONTH IN-PERSON WITH LIMITED ATTENDANCE AND SOCIAL DISTANCING. THE HOSPITAL OFFERS THE THINK SMART! CONCUSSION MANAGEMENT PROGRAM WHICH PROVIDES BASELINE TESTING AND CONCUSSION EDUCATION TO PARENTS, SPORTS COACHES, AND SCHOOL DISTRICT ADMINISTRATORS ACROSS LONG ISLAND. FREE, EVIDENCE-BASED FALL PREVENTION PROGRAMS DESIGNED TO IMPROVE BALANCE AND STRENGTH AND HELP REDUCE FALLS AND BUILD CONFIDENCE IN OLDER ADULTS. A 7-WEEK EVIDENCED-BASED FALLS PREVENTION PROGRAM WAS HELD ON CAMPUS IN SEPTEMBER AND OCTOBER 2021. SAFE DISTANCING GUIDELINES WERE FOLLOWED WITH REDUCTION IN USUAL ATTENDANCE NUMBERS. AS A MEMBER OF CATHOLIC HEALTH, ST. CHARLES HOSPITAL STAFF PARTICPATED IN THE AMERICAN HEART ASSOCIATION WALK DIGITAL MOVE MORE CHALLENGE ON SEPTEMBER 12TH AND IN THE AMERICAN CANCER SOCIETY MAKING STRIDES AGAINST BREAST CANCER WALK ON OCTOBER 17TH. THE CATHOLIC HEALTH SUFFOLK COUNTY MARATHON BENIFITTING VETERANS WAS HELD IN PERSON ON OCTOBER 24. THE ST. CHARLES HOSPITAL EMPLOYEE RUNNING CLUB PARTICIPATED IN THE EVENT. ST. CHARLES' SPORTS MEDICINE TEAM OFFERED STRETCHING AND MASSAGING AT THE POST MARATHON RECOVERY AREA. ST. CHARLES HOSTED 2 BLOOD DRIVES COLLECTING 140 PINTS OF BLOOD IN SUPPORT OF LONG ISLAND BLOOD SERVICES. THE HOSPITAL CONDUCTS COLLECTION DRIVES FOR FOOD, CLOTHING, AND SCHOOL SUPPLIES, SUPPORTING LOCAL CHURCHES AND COMMUNITY CENTERS IN UNDERSERVED AREAS. |
| PART V, SECTION B, LINE 20E | ST. CHARLES HOSPITAL HAS POSTED MULTILINGUAL NOTICES ABOUT ITS CHARITY CARE POLICIES IN SEVERAL PROMINENT LOCATIONS WITHIN ST. CHARLES HOSPITAL INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREAS, SAID NOTICES ARE PUBLISHED IN ENGLISH AND SPANISH AND ARE CLEARLY VISIBLE TO THE PUBLIC. ST. CHARLES HOSPITAL HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 - RATIO OF PATIENT CARE COST TO CHARGES WORKSHEET | RATIO OF PATIENT CARE COST TO CHARGES WORKSHEET (WORKSHEET 2) AS PRESCRIBED BY THE IRS INSTRUCTIONS TO SCHEDULE H FORM 990 WAS THE METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN PART I, LINE 7 CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST LINES 7A, 7B AND 7C AND 7D. ALL OTHER LINES INCLUDE COSTS THAT WERE DERIVED BASED ON THE RCC METHODOLOGY OR ACTUAL COSTS FOR THEIR SERVICES AS TRACKED BY HOSPITAL PERSONNNEL UTILIZING DIRECT HOURLY LABOR COSTS, FRINGES AND SUPPLY COSTS. |
| PART I, LINE 7A, COLUMN (D) | DIRECT OFFSETTING REVENUES REPRESENT DISTRIBUTIONS FROM THE NEW YORK STATE (NYS) INDIGENT CARE POOL (ICP) WHICH IS SHOWN NET OF HOSPITAL CONTRIBUTIONS TO THE STATEWIDE POOL. THE FORMULA EMPLOYED BY NYS TO DETERMINE DISTRIBUTIONS TO HOSPITALS FROM THE ICP IS COMPLEX AND IS DERIVED FROM A HOSPITAL'S "NEED" CALCULATION. THIS CALCULATION CONSIDERS 100% OF A HOSPITAL'S "NEED" BASED ON A "UNITS OF SERVICE" METHODOLOGY FOR UNINSURED PATIENTS. THE CALCULATION ALSO MAKES ADJUSTMENTS BASED ON THE PROPORTION OF MEDICAID ELIGIBLE PATIENTS TREATED AT THE FACILITY. THE HOSPITAL HAS APPORTIONED THE ICP REVENUE BETWEEN BAD DEBT AND CHARITY CARE FOR REPORTING ON LINE 7A BASED ON THE PROPORTION OF EACH TO THE TOTAL OF ACTUAL BAD DEBT AND CHARITY CARE FOR 2021. |
| PART III, LINES 2,3 - BAD DEBT AS COMMUNITY BENEFIT | AS PART OF ITS TAX EXEMPT PURPOSE THE HOSPITAL PROVIDES ACCESS TO MEDICALLY NECESSARY CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, OR CULTURAL BACKGROUND. THE HOSPITAL TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF WHETHER THEY HAVE THIRD-PARTY COVERAGE OR THE ABILITY TO PAY. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE HOSPITAL IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE FROM THE HOSPITAL SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT SINCE CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR TAX EXEMPT PURPOSE, WHICH IS MEETING THE NEED FOR EMERGENCY AND NON-ELECTIVE MEDICAL CARE SERVICES IN THE COMMUNITY. |
| PART III, LINES 2 AND 4 - TEXT OF FOOTNOTE DISCUSSING BAD DEBT | PAGES 19 TO 24 OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS INCLUDE A FOOTNOTE ON PATIENT ACCOUNTS RECEIVABLE. THE FINANCIAL STATEMENTS ARE ATTACHED TO THIS RETURN. |
| PART III LINE 8 - COSTING METHODOLOGY | THE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 2021 CMS-2552 (MEDICARE COST REPORT). MEDICARE REVENUE IS BASED ON THE MEDICARE PROVIDER STATISTICAL AND REIMBURSEMENT REPORT AND MEDICARE COSTS ARE DEVELOPED UTILIZING A RATIO OF MEDICARE ALLOWABLE COSTS TO CHARGES METHODOLOGY. AMOUNTS SHOWN FOR TOTAL REVENUE RECEIVED AND MEDICARE ALLOWABLE COSTS ARE NET OF ANY AMOUNTS ALREADY INCLUDED WITHIN PART I, LINE 7, PRIMARILY IN SUBSIDIZED HEALTH SERVICES. |
| PART III, LINE 9B | THE HOSPITAL'S CHARITY CARE POLICY DESCRIBES THE POLICIES AND PROCEDURES RELATING TO THE PROVISION OF CHARITY CARE TO PERSONS WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THEIR BILL. NO INDIVIDUAL WILL BE DENIED MEDICALLY NECESSARY HOSPITAL SERVICES BASED ON A DEMONSTRATED INABILITY TO PAY FOR THOSE SERVICES. IN ADDITION, UPON APPLYING FOR CHARITY CARE, EACH PATIENT AND PATIENT GUARANTOR'S ABILITY TO PAY WILL BE ASSESSED. ELIGIBILITY FOR ASSISTANCE: A REASONABLE REVIEW SHALL BE PERFORMED PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (I.E., MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE HOSPITAL'S CHARITY CARE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY ACCOUNT THAT SUBSEQUENTLY IS DETERMINED TO MEET THE CHARITY CARE CRITERIA SHALL BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT FOR APPROPRIATE FOLLOW-UP. THE THIRD-PARTY COLLECTION AGENT SHALL ADVISE THE PATIENT/GUARANTOR OF THE HOSPITAL'S CHARITY CARE POLICY AND RETURN THE ACCOUNT IMMEDIATELY IF IT IS DETERMINED THAT THE QUALIFICATIONS ARE MET. |
| PART VI, LINE 2 - ASSESSMENT OF COMMUNITY NEEDS AND GOALS | COMMUNITY HEALTH NEEDS ARE ASSESSED ON A CONTINUAL BASIS, DURING MEETINGS OF THE HOSPITAL'S BOARD OF TRUSTEES AND EXECUTIVE LEADERSHIP COUNCIL, COMMUNITY HEALTH AND EDUCATION DEPARTMENT MEETINGS, AT COLLABORATIVE SESSIONS WITH MEMBER HOSPITALS OF CATHOLIC HEALTH (CH), AND WITH PARTNERS AT COMMUNITY AGENCIES AND ORGANIZATIONS THAT ARE PART OF THE LONG ISLAND HEALTH COLLABORATIVE(LIHC). THE LIHC COMMUNITY HEALTH ASSESSMENT SURVEYS ARE OFFERED YEAR-ROUND AT MULTIPLE OUTREACH SITES IN THE COMMUNITY. BY DISTRIBUTING COMMUNITY NEEDS SURVEYS (AVAILABLE IN ENGLISH, SPANISH, POLISH, HAITAIN CREOLE AND LARGE PRINT) TO PARTICIPANTS AT SCREENING SITES, EVERY POINT OF CONTACT SERVES AS AN OPPORTUNITY TO REQUEST FEEDBACK ON HOW THE HOSPITAL CAN BETTER MEET THE NEEDS OF THE COMMUNITY. THESE EVENTS ARE PROMOTED IN THE COMMUNITY SURROUNDING THE OUTREACH SITE AND ON CH'S WEBSITE. ST. CHARLES HOSPITAL CONTINUES TO COLLABORATE WITH OTHER HOSPITALS, LOCAL HEALTH DEPARTMENTS, HEALTH CARE PROVIDERS, PUBLIC HEALTH SPECIALISTS FROM ACADEMIC INSTITUTIONS AND COMMUNITY-BASED ORGANIZATIONS AT LIHC EVENTS. LIHC'S WEBSITE OFFERS COMPREHENSIVE INFORMATION TO PROMOTE GOOD HEALTH AND PREVENT CHRONIC DISEASE. IN ADDITION TO PROVIDING NUMEROUS RESOURCES SUCH AS HEALTH PROGRAM INVENTORIES, HEALTH INSURANCE INFORMATION AND EDUCATIONAL VIDEOS, LIHC AND ITS MEMBERS HAVE ORGANIZED WALKING PROGRAMS, AND DEVELOPED A UNIVERSAL SCREENING TOOL TO HELP MEASURE THE EFFECTIVENESS OF COMMUNITY HEALTH EFFORTS. MORE INFORMATION CAN BE FOUND AT WWW.LIHEALTHCOLLAB.ORG. |
| PART VI, LINE 3 - COMMUNICATION OF FINANCIAL ASSISTANCE POLICY | 1. SINCE IT IS THE DUTY OF THE HOSPITAL TO ENSURE THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF ITS CHARITY CARE POLICY, ALL EMPLOYEES IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS ARE FULLY VERSED IN THE CHARITY CARE POLICY, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ARE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE HOSPITAL REPRESENTATIVES. 2. THE HOSPITAL HAS POSTED MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN THE HOSPITAL INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREA. SAID NOTICES ARE PUBLISHED IN ENGLISH AND SPANISH, AND ARE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. 3. THE HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS OF APPLYING FOR ASSISTANCE. THIS SUMMARY IS WRITTEN AT OR BELOW A SIXTH GRADE READING LEVEL. 4. THE HOSPITAL HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE. 5. THE HOSPITAL PROVIDES ALL PATIENTS ACCESS TO INTERPRETERS TO ASSIST THEM IN UNDERSTANDING ITS CHARITY CARE PROGRAM IN THE PRIMARY LANGUAGE SPOKEN BY THE PATIENT DURING ANY PRE-ADMISSION, ADMISSION, AND DISCHARGE PROCESS. 6. ON ALL BILLS AND STATEMENTS SENT TO PATIENTS, A STATEMENT IS INCLUDED REGARDING THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING CHARITY CARE, AND A CONTACT NUMBER TO CALL TO OBTAIN FURTHER INFORMATION. THIS INFORMATION IS AVAILABLE AT OR BELOW A SIXTH GRADE READING LEVEL. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | ST. CHARLES HOSPITAL IS LOCATED ON THE NORTH SHORE OF SUFFOLK COUNTY IN THE TOWN OF BROOKHAVEN. A NOT-FOR-PROFIT HOSPITAL WITH 243 BEDS, ST. CHARLES IS A MEMBER OF CATHOLIC HEALTH SERVICES. THE POPULATION IN THE HOSPITAL'S PRIMARY CATCHMENT AREA IS MORE THAN 386,000 RESIDENTS, REPRESENTING 81% OF THE HOSPITAL'S ADMISSIONS. THE HOSPITAL'S SECONDARY CATCHMENT AREA HAS MORE THAN 200,000 RESIDENTS AND ACCOUNTS FOR ANOTHER 16% OF PATIENT ADMISSIONS. THIS SERVICE AREA INCLUDES ECONOMICALLY CHALLENGED COMMUNITIES, SUCH AS PORT JEFFERSON STATION, FARMINGVILLE, AND CORAM. ST. CHARLES HOSPITAL'S PRIMARY SERVICE AREA IS SHARED WITH AN ACUTE CARE HOSPITAL, JOHN T. MATHER MEMORIAL HOSPITAL IN PORT JEFFERSON, AND A TERTIARY CARE HOSPITAL, STONY BROOK UNIVERSITY MEDICAL CENTER. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | ST. CHARLES HAS PARTNERED WITH ORGANIZATIONS IN THE COMMUNITY TO FACILITATE OPTIMAL ACCESS TO HEALTH CARE AND THE PREVENTION OF FUTURE ILLNESS OR INJURY. THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY TAKING AN ACTIVE ROLE IN PROMOTING THE HEALTH OF THE COMMUNITY. THE HOSPITAL HAS IDENTIFIED AREAS OF NEED IN THE SURROUNDING COMMUNITIES AND HAS RESPONDED BY ESTABLISHING SERVICES THAT MEET THOSE NEEDS. ST. CHARLES HOSPITAL'S SPECIALTY CARE CENTER PROVIDES COMPREHENSIVE CARE FOR PATIENTS WITH SPECIALIZED DIAGNOSES. ST. CHARLES PARTICIPATES IN CATHOLIC HEALTH SERVICES HEALTHY SUNDAYS AT LOCAL PARISHES PROVIDING PARISHIONERS WITH FREE HEALTH CARE SERVICES SUCH AS CHOLESTEROL AND BLOOD PRESSURE SCREENING. THE HOSPITAL'S PEDIATRIC PULMONARY SPECIALTY CENTER IS AN EXTENSION OF ITS OUTPATIENT SPECIALTY CARE CENTER. THE MOVEMENTS DISORDERS CENTER AT ST. CHARLES HOSPITAL OFFERS TECHNOLOGICALLY ADVANCED, COMPREHENSIVE SERVICES FOR THOSE EXPERIENCING UNEXPLAINED DIFFICULTY WITH MOVEMENT. THE CENTER SPECIALIZES IN THE EVALUATION AND TREATMENT OF PARKINSON'S DISEASE. THE HOSPITAL PROVIDES COMMUNITY HEALTH PROGRAMS, SCREENINGS, AND SUPPORT GROUPS, INCLUDING A PARKINSON'S DISEASE SUPPORT GROUP PROVIDES SUPPORT INFORMATION AND AN OPPORTUNITY TO SHARE EXPERIENCES FOR INDIVIDUALS AFFECTED BY PARKINSON'S DISEASE. IN 2021 THERE WERE 70 ATTENDEES. |
| PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEM | ST. CHARLES HOSPITAL (ST. CHARLES OR HOSPITAL) OPERATES A 243-BED ACUTE CARE AND PHYSICAL REHABILITATION MEDICAL HOSPITAL LOCATED IN PORT JEFFERSON, NEW YORK, WITH OUTPATIENT FACILITIES IN NASSAU AND SUFFOLK COUNTIES. ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS, ST. CHARLES, THROUGH ITS DAILY OPERATION, PROVIDES ACUTE, EMERGENT AND OUTPATIENT CARE. ST. CHARLES IS A MEMBER OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A CATHOLIC HEALTH) (CH) WHICH IS A NEW YORK, NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CH IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE. AS OF DECEMBER 31, 2021, CH COMPRISED SIX HOSPITALS (MERCY HOSPITAL, ST. FRANCIS HOSPITAL & HEART CENTER AND ST. JOSEPH HOSPITAL IN NASSAU COUNTY, AND GOOD SAMARITAN HOSPITAL, ST. CHARLES HOSPITAL AND ST. CATHERINE OF SIENA NURSING & REHABILITATION, GOOD SAMARITAN NURSING & REHABILITATION AND OUR LADY OF CONSOLATION NURSING & REHABILITATION, ALL IN SUFFOLK COUNTY), GOOD SHEPHERD HOSPICE, AND A COMMUNITY-BASED AGENCY FOR PERSONS WITH SPECIAL NEEDS. WITH MORE THAN 16,000 STAFF AND 4,600 MEDICAL STAFF WORKING THROUGHOUT THE SYSTEM, CH PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES. OUR MISSION STATES: WE, AT CATHOLIC HEALTH, HUMBLY JOIN TOGETHER TO BRING CHRIST'S HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES. MEMBER ORGANIZATIONS OF CH OFFER VIRTUALLY EVERY MEDICAL SPECIALTY AND CLINICAL SERVICES, AND SHARE A DEDICATION TO CONTINUOUSLY UPGRADE THE SCOPE, QUALITY AND ACCESSIBILITY OF CARE. ALL OF CH'S MEMBER ORGANIZATIONS HAVE RETAINED THEIR INDIVIDUAL LINKS TO THEIR HISTORY AND THEIR DISTINCTIVE PERSONALITIES, AS WELL AS THE SERVICE SPECIALTIES WHICH THEY ARE KNOWN FOR, THUS EMBEDDING THE ORGANIZATION IN THE COMMUNITY AND SERVING IT EFFECTIVELY. CH ENTITIES PROVIDE AN ABUNDANCE OF EDUCATION AND SUPPORT GROUPS AS WELL AS FREE HEALTH SCREENINGS THROUGH ITS HEALTHY SUNDAYS PROGRAM, HEALTH FAIRS, AND OTHER PROGRAMS. SINCE 1907, CATHOLIC HEALTH CARE ON LONG ISLAND HAS BUILT A DISTINGUISHED TRADITION OF OPERATING COMMUNITY-BASED HOSPITALS AND ORGANIZATIONS WITH THE PRIMARY OBJECTIVE OF IMPROVING THE COMMUNITY'S HEALTH. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CATHOLIC HEALTH SERVICES OF LONG ISLAND | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 992 N VILLAGE AVE ROCKVILLE CENTRE | AddressLine1Txt |
| City | ROCKVILLE CENTRE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11570 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 113403968 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $86,842 | CashGrantAmt |
| Valuation Method Used | NONE | ValuationMethodUsedDesc |
| Non Cash Assistance | NONE | NonCashAssistanceDesc |
| Purpose Of Grant | MISSION SPONSORSHIP, OUTPATIENT CENTERS, GRANTS TO UNDERSERVED COMMUNITY AND CAPITAL SUPPORT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE | CHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR ST. CHARLES HOSPITAL AND CATHOLIC HEALTH SERVICES OF LONG ISLAND AND IS THEREFORE ABLE TO MONITOR THAT CATHOLIC HEALTH SERVICES OF LONG ISLAND USES THE GRANT FUNDS FOR MISSION SPONSORSHIP, OUTPATIENT CENTERS, GRANTS TO UNDERSERVED COMMUNITIES AND CAPITAL SUPPORT. |
| PART II, LINE 1, COLUMN (H) | NAME OF ORGANIZATION OR GOVERNMENT: CATHOLIC HEALTH SYSTEM OF LONG ISLAND (H) PURPOSE OF GRANT: 1) SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND AS A PASS THROUGH TO PROVIDE GENERAL SUPPORT TO THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD; 2) PROVIDE SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND TO FUND OUTPATIENT CENTERS THAT PROVIDE CHARITY CARE TO THOSE CENTERS' COMMUNITIES; AND 3) TO FUND SUPPORT PROVIDED THROUGH THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CAREGIVERS FUND. THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CAREGIVERS FUND WAS FORMED WITH THE MISSION TO ASSIST OUR FELLOW CAREGIVERS ON THE FRONT LINES, HERE AND ABROAD, WHO STRUGGLE JUST TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANIEL DEBARBA | ||||||||||||||
| EVP & CFO | $0 | $945,176 | $0 | $327,000 | $0 | $1,513,109 | $0 | $314,390 | $0 | $53,939 | $0 | $3,153,614 | $0 | $1,290,000 |
| ALAN D GUERCI MD | ||||||||||||||
| PRESIDENT & CEO THRU 6/30/21 | $0 | $839,770 | $0 | $783,000 | $0 | $571,762 | $0 | $257,390 | $0 | $22,540 | $0 | $2,474,462 | $0 | $0 |
| PATRICK O'SHAUGHNESSY DO | ||||||||||||||
| PRESIDENT & CEO AS OF 4/16/21 | $0 | $1,217,997 | $0 | $315,000 | $0 | $28,704 | $0 | $303,390 | $0 | $46,629 | $0 | $1,911,720 | $0 | $0 |
| Vlada Frankenburger | ||||||||||||||
| PHYSICIAN | $1,001,000 | $0 | $0 | $0 | $720 | $0 | $26,796 | $0 | $4,080 | $0 | $1,032,596 | $0 | $0 | $0 |
| JAMES O'CONNOR | ||||||||||||||
| PRESIDENT/CAO | $589,938 | $0 | $170,000 | $0 | $50,462 | $0 | $86,796 | $0 | $33,981 | $0 | $931,177 | $0 | $26,022 | $0 |
| Anil Sangwan | ||||||||||||||
| PHYSICIAN | $512,363 | $0 | $309,035 | $0 | $2,085 | $0 | $26,796 | $0 | $17,113 | $0 | $867,392 | $0 | $0 | $0 |
| Sanjay Sangwan | ||||||||||||||
| PHYSICIAN | $514,938 | $0 | $241,192 | $0 | $2,060 | $0 | $26,796 | $0 | $3,126 | $0 | $788,112 | $0 | $0 | $0 |
| Derek Mattimoe | ||||||||||||||
| PHYSICIAN | $534,590 | $0 | $115,823 | $0 | $2,506 | $0 | $26,796 | $0 | $46,406 | $0 | $726,121 | $0 | $0 | $0 |
| Matthew Wagner | ||||||||||||||
| PHYSICIAN | $631,693 | $0 | $0 | $0 | $990 | $0 | $26,796 | $0 | $43,825 | $0 | $703,304 | $0 | $0 | $0 |
| SUNIL DHUPER MD | ||||||||||||||
| CMO | $394,455 | $0 | $40,000 | $0 | $4,752 | $0 | $26,796 | $0 | $14,897 | $0 | $480,900 | $0 | $0 | $0 |
| RONALD WEINGARTNER | ||||||||||||||
| COO | $339,674 | $0 | $40,000 | $0 | $14,752 | $0 | $26,796 | $0 | $15,709 | $0 | $436,931 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN | THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. ALAN GUERCI $231,000 PARTICIPATION IN THE PLAN DANIEL DEBARBA $288,000 PARTICIPATION IN THE PLAN PATRICK O'SHAUGHNESSY $277,000 PARTICIPATION IN THE PLAN JAMES O'CONNOR $60,000 PARTICIPATION IN THE PLAN THE DEFERRED COMPENSATION IN COLUMN C FOR THESE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NON-QUALIFIED RETIREMENT PLANS. THE FOLLOWING INDIVIDUALS VESTED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III). THESE AMOUNTS INCLUDE A TAX GROSS UP. DANIEL DEBARBA $1,482,138 VESTED IN PLAN JAMES O'CONNOR $26,022 VESTED IN PLAN THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2021 FORM W-2, BOX 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. |
| PART II, REPORTING OF TOP FINANCIAL OFFICIAL | EFFECTIVE 2/23/18, JAMES O'CONNOR SERVES AS PRESIDENT/CAO OF BOTH ST. CATHERINE OF SIENA HOSPITAL AND ST. CHARLES HOSPITAL, A RELATED ENTITY. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION | THE SOLE MEMBER OF ST. CHARLES HOSPITAL IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH) (CH). CH IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS. CH IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER (DIOCESE). |
| FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODY | CH IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF ST. CHARLES HOSPITAL AND AS SUCH HAS THE RIGHT TO APPOINT THE GOVERNING BODY ST. CHARLES HOSPITAL. |
| FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY | AS THE SOLE MEMBER OF ST. CHARLES HOSPITAL, CH IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERNING BODY OF ST. CHARLES HOSPITAL. THE GOVERNING BODY OF ST. CHARLES HOSPITAL IS THE SAME AS THAT OF CH. |
| FORM 990, PART VI, LINE 11B - REVIEW PROCESS FOR FORM 990 | THE FORM 990 AND RELATED SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD, AND PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS OF CH, WHICH HAS BEEN DELEGATED THE FORM 990 REVIEW FUNCTION BY THE BOARD. UPON REVIEW AND RECOMMENDATION OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO THE BOARD FOR APPROVAL. UPON BOARD APPROVAL, THE FORM 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST POLICY | 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 CH COMPLIANCE AND AUDIT COMMITTEE BY CH'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE IS GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE CH COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE CH BOARD OF DIRECTORS. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. 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 CH AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE BOARD OF DIRECTORS SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CH 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 CH, CERTIFIES THAT CH CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. THE PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIM/HERSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. |
| FORM 990, PART VI, LINE 15 - COMPENSATION POLICY | THE CHIEF ADMINISTRATIVE OFFICER SUBMITS FOR APPROVAL TO THE SYSTEM CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE CH EXECUTIVE COMPENSATION POLICY (COMPENSATION POLICY). THE COMPENSATION POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CH 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 (CEO), AND CHIEF OPERATING OFFICERS (COO) OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS (CFO); D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CH OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CH OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CH OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CH OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CH OR AN 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. ONCE APPROVED BY THE CH CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE OF THE CH BOARD OF DIRECTORS FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE PERFORMED ANNUALLY BY AN INDEPENDENT CONSULTANT. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION PROVIDED, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE CH BOARD OF DIRECTORS. |
| FORM 990, PART VI, LINE 19 - DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION | GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CH CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND. |
| FORM 990, PART VII, SECTION A - LINE 1A | HOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. ALAN D. GUERCI, PRESIDENT & CEO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY, INC. (20-8067039); CATHOLIC HEALTH SYSTEM OF LONG ISLAND (11-3403968); ST. FRANCIS HOSPITAL (11-2050523); ST. FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST. FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL CORP (11-1871039) AND ST. JOSEPH HOSPITAL FOUNDATION (47-2353387). JAMES O'CONNOR, PRESIDENT/CAO - THE TOTAL HOURS REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. CHARLES HOSPITAL CORP (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); ST. CHARLES CORPORATION (11-2983148); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION (27-1459941). DANIEL DEBARBA, EVP & CFO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); ST. FRANCIS HOSPITAL (11-2050523); ST. FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST. FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL CORP (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240); ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION (27-1459941); CATHOLIC HEALTH SYSTEM OF LONG ISLAND (11-3403968) AND RVC INSURANCE COMPANY INC. (20-8067039). PATRICK O'SHAUGHNESSY, PRESIDENT & CEO AS OF 4/16/2021 - THE TOTAL HOURS WORKED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY, INC. (20-8067039); CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968); ST. FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11- 1888924); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL CORP (11-1871039) AND ST. JOSEPH HOSPITAL FOUNDATION (47-2353387). |
| FORM 990, PART XI, LINE 9 - CHANGE IN NET ASSETS | RELATED PARTY EMPLOYEE BENEFIT SERVICES ($3,209,306) CHANGE IN POST RETIREMENT BENEFIT ($ 100,000) GAIN ON DEBT EXTINGUISHMENT $ 504,176 ----------- TOTAL: ($2,805,130) |
| FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION | ST CHARLES HOSPITAL IS A MEMBER OF CATHOLIC HEALTH WE, AT CATHOLIC HEALTH, HUMBLY JOIN TOGETHER TO BRING CHRIST'S HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES. I-CARE VALUES INTEGRITY: WE ARE WHO WE SAY WE ARE AND ACT IN ACCORDANCE WITH THE SPLENDOR OF TRUTH OF OUR CATHOLIC MORAL TEACHING AND OUR CATHOLIC VALUES. COMPASSION: WE HAVE COMPASSION FOR OUR PATIENTS, SEE THE SUFFERING CHRIST IN THEM, STRIVE TO ALLEVIATE SUFFERING AND SERVE THE SPIRITUAL, PHYSICAL AND EMOTIONAL NEEDS OF OUR PATIENTS. ACCOUNTABILITY: WE TAKE RESPONSIBILITY FOR OUR ACTIONS AND THEIR CONSEQUENCES. RESPECT: WE HONOR THE SANCTITY OF LIFE AT EVERY STAGE OF LIFE AND THE DIGNITY OF EVERY PERSON, AND INCORPORATE ALL THE PRINCIPLES OF CATHOLIC SOCIAL TEACHING IN OUR RELATIONSHIPS AND ADVOCACY. EXCELLENCE: WE SEEK THE GLORY OF GOD IN THE COMPASSIONATE SERVICE OF OUR PATIENTS, AND WE STRIVE TO DO THE BEST THAT CAN BE DONE, WHATEVER OUR ROLE. |
| FORM 990, PART VIII, LINE 1E - CARES ACT FUNDING | ON MARCH 11, 2020, THE WORLD HEALTH ORGANIZATION DESIGNATED THE CORONAVIRUS DISEASE 2019 (COVID-19) OUTBREAK AS A GLOBAL PANDEMIC. FEDERAL, STATE AND LOCAL GOVERNMENT POLICIES RESULTED IN A SUBSTANTIAL PORTION OF THE POPULATION REMAINING AT HOME AND FORCED THE CLOSURE OF CERTAIN BUSINESSES, WHICH HAD AN IMPACT ON PATIENT VOLUMES AND FINANCIAL OPERATIONS FOR MOST SERVICES BEGINNING IN MARCH 2020. IN RESPONSE TO COVID-19, THE CORONAVIRUS AID, RELIEF AND ECONOMIC SECURITY ACT (THE CARES ACT) WAS SIGNED INTO LAW ON MARCH 27, 2020. THE CARES ACT AUTHORIZED FUNDING TO HOSPITALS AND OTHER HEALTHCARE PROVIDERS TO BE DISTRIBUTED THROUGH THE PUBLIC HEALTH AND SOCIAL SERVICES EMERGENCY FUND (RELIEF FUND). PAYMENTS FROM THE RELIEF FUND ARE TO BE USED TO PREVENT, PREPARE FOR, AND RESPOND TO CORONAVIRUS, AND SHALL REIMBURSE THE RECIPIENT FOR HEALTH CARE RELATED EXPENSES AND/OR LOST REVENUES ATTRIBUTABLE TO CORONAVIRUS AND ARE NOT REQUIRED TO BE REPAID EXCEPT WHERE RELIEF FUNDS RECEIVED EXCEED THE ACTUAL AMOUNTS OF ELIGIBLE HEALTH CARE RELATED EXPENSES AND/OR LOST REVENUES AS DEFINED BY THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (HHS), PROVIDED THE RECIPIENTS ATTEST TO AND COMPLY WITH THE TERMS AND CONDITIONS. HHS DISTRIBUTIONS FROM THE RELIEF FUND INCLUDE GENERAL DISTRIBUTIONS AND TARGETED DISTRIBUTIONS, TO SUPPORT PROVIDERS IN HIGH IMPACT AREAS AND RURAL PROVIDERS, FOR SERVICE PERIODS THROUGH DECEMBER 31, 2021. ADDITIONALLY, FUNDS ARE AVAILABLE TO REIMBURSE PROVIDERS FOR COVID-19 RELATED TREATMENT OF UNINSURED PATIENTS. FUNDING RECEIVED DURING 2021 IS REPORTED AS GOVERNMENT GRANTS ON PART VIII, LINE 1E, AS WELL AS ON SCHEDULE B. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (34 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CATHOLIC HEALTH SYSTEM OF LONG ISLAND | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 113403968 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | NA | false |
| CHS SERVICES INC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 113555766 | SUPPORT ORG | NY | 501(C)(3) | 12B-II | CHSLI | Yes (true) |
| CHS AMBULANCE SERVICES INC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 141801961 | DORMANT | NY | 501(C)(3) | 3 | CHSLI | false |
| GOOD SAMARITAN HOSPITAL MEDICAL CENTER | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 111888924 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| GOOD SAMARITAN SELF INSURANCE AGAINST | ||||||||||
| MALPRACTICE 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 112537396 | SELF INSURANC | NY | 501(C)(3) | 12A-I | GOOD SAMARTN | Yes (true) |
| MARYHAVEN TRANSPORTATION SERVICES | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 113434776 | TRANSPORTATIO | NY | 501(C)(3) | 12A-I | MARYHAVENCTR | false |
| MARYHAVEN CENTER OF HOPE | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 112861698 | Prgm-disabled | NY | 501(C)(3) | 10 | CHSLI | false |
| MARYHAVEN SCHOOL CORPORATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 112861690 | Schl-disabled | NY | 501(C)(3) | 2 | MARYHAVENCTR | false |
| THE CENTER OF HOPE FOUNDATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 113638367 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | MARYHAVENCTR | false |
| MERCY MEDICAL CENTER | ||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CTR | NY | 11570 | 111635088 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| CATHOLIC HOME CARE | ||||||||||
| 110 Bi-County Blvd Suite 114 | FARMINGDALE | NY | 11735 | 112126736 | HOME CARE | NY | 501(C)(3) | 10 | CHSLI | false |
| OUR LADY OF CONSOLATION GERIATRIC CARE | ||||||||||
| 111 BEACH DRIVE | WEST ISLIP | NY | 11795 | 113284066 | LT NURSE CARE | NY | 501(C)(3) | 10 | CHSLI | false |
| RIVERHEAD HOSTEL HOLDING CORPORATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 112499790 | RENTING | NY | 501(C)(2) | MARYHAVENCTR | false | |
| ST CATHERINE OF SIENA MEDICAL CENTER | ||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 061562701 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| ST FRANCIS HOSPITAL | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 112050523 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| ST FRANCIS HOSPITAL FOUNDATION | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 112916033 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | ST FRANCIS | false |
| ST FRANCIS HOSPITAL RESEARCH & EDUCATIO | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113090867 | RESEARCH ORG | NY | 501(C)(3) | 12A-I | ST FRANCIS | Yes (true) |
| WSNCHS NORTH INC | ||||||||||
| 4295 HEMPSTEAD TURNPIKE | BETHPAGE | NY | 11714 | 113438973 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| THE ST CHARLES CORPORATION | ||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSN ST | NY | 11777 | 112983148 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | CHSLI | false |
| THE SAMARITAN CORPORATION | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 112716640 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | CHSLI | false |
| WISDOM GARDENS HOUSING DEVELOPMENT FUND | ||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 113559713 | SR HOUSING | NY | 501(C)(3) | 10 | ST CHARLES | Yes (true) |
| GOOD SHEPHERD HOSPICE | ||||||||||
| 110 Bi-County Blvd Suite 114 | FARMINGDALE | NY | 11735 | 112958438 | HOSPICE SVC | NY | 501(C)(3) | 10 | CHSLI | false |
| ST CHARLES HOSPITAL FOUNDATION | ||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 412076312 | SUPPORT ORG | NY | 501(C)(3) | 12A-1 | ST CHARLES | Yes (true) |
| GOOD SAMARITAN HOSPITAL FOUNDATION | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 770611240 | SUPPORT ORG | NY | 501(C)(3) | 12A-1 | GOOD SAMARTN | false |
| MERCY MEDICAL CENTER FOUNDATION | ||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 550813603 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | MERCY MEDCTR | false |
| ST CATHERINE OF SIENA MEDICAL CTR FDN | ||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 271459941 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | STCATHERINE | Yes (true) |
| CHS HOME CARE AND HOSPICE FOUNDATION | ||||||||||
| 110 Bi-County Blvd Suite 114 | FARMINGDALE | NY | 11735 | 452907761 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | CATHHOMECARE | false |
| GOOD SHEPHERD HOSPICE FOUNDATION | ||||||||||
| 110 Bi-County Blvd Suite 114 | FARMINGDALE | NY | 11735 | 263169427 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | GOODSHEPHERD | false |
| OUR LADY OF CONSOLATION FOUNDATION | ||||||||||
| 111 BEACH DRIVE | WEST ISLIP | NY | 11795 | 450517566 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | OURLADYOFC | false |
| RVC SUPPORT | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 271531084 | REAL ESTATE | NY | 501(C)(3) | 12A-I | CHSLI | false |
| CHS PHYSICIAN PARTNERS PC | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113613997 | HEALTHCARESVC | NY | 501(C)(3) | 12A-I | ST FRANCIS | false |
| RVC INSURANCE COMPANYINC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 208067039 | CAPTIVE INS | NY | 501(C)(3) | 12B-II | CHSLI | false |
| SAMARITAN EMERGENCY MEDICAL SERVICES PC | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208243412 | HEALTHCARESVC | NY | 501(C)(4) | GOOD SAMARTN | false | |
| ST JOSEPH HOSPITAL FOUNDATION | ||||||||||
| 992 N VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 472353387 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | WSNCHS NORTH | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | UBI Code VUBICodeVAmt | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BIPO HOLDINGS LLC | ||||||||||||||
| 992 N VILLAGE AVE ROCKVILLE CENTRE | ROCKVILLE CENTRE | NY | 11570 | 464763720 | PHYSICIAN ASSN | NY | NA | N/A | ||||||
| IDHC LLC | ||||||||||||||
| 2500 YORK RD JAMISONPA 18929 | JAMISON | PA | 18929 | 452411095 | HEALTH SERVICES | PA | NA | N/A | ||||||
| BEACON HEALTH PTNRS | ||||||||||||||
| 992 N VILLAGE AVE ROCKVILLE CENTRE | ROCKVILLE CENTRE | NY | 11570 | 454229842 | HEALTHCARE | NY | NA | N/A | ||||||
| WISDOM GARDENS LP | ||||||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 113567947 | SR HOUSING | NY | MCH-WISDOM LLC | RELATED | -$3,531 | $2,603,947 | false | $0 | false | 0.99991 |
| CHS PHYSICIAN PARTNERS ACO LLC | ||||||||||||||
| 992 N Village Ave Rockville Centr | ROCKVILLE CENTRE | NY | 11570 | 999999999 | HEALTHCARE | NY | NA | N/A | ||||||
| LONG ISLAND HEALTHCARE NETWORK | ||||||||||||||
| 992 N VILLAGE AVE ROCKVILLE CENTRE | ROCKVILLE CENTRE | NY | 11570 | 113465837 | CONTRACTING | NY | NA | N/A | ||||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| RADIOLOGY CONSULTING OF LONG ISLANDPLLC | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 421646134 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| SAMARITAN PEDIATRIC SERVICES PC | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208180263 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| SAMARITAN MEDICAL SERVICES PC | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208088453 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| SOUTHWEST SUFFOLK MEDICAL PC | |||||||||
| 580 UNION BOULEVARD | WEST ISLIP | NY | 11795 | 061603195 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| CARDIAC EKG INTERPRETATION PC | |||||||||
| 992 N VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 112924518 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208964140 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| SAMARITAN MANAGEMENT SERVICES | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 112838185 | HEALTHCARE SVC | NY | CHSLI | C-CORP | false |
| ADVANCED REHABILIATION MEDICINE PLLC | |||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 113640709 | HEALTHCARE SVC | NY | STCHARLES HOSP | C-CORP | false |
| ST FRANCIS CARDIAC PREVENTION SERVICES | |||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113224885 | HEALTHCARE SVC | NY | STFRANCIS HOSP | C-CORP | false |
| SOUTH SHORE PRACTICE MANAGEMENT | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 113307977 | HEALTHCARE SVC | NY | SAMARITAN MGMT | C-CORP | false |
| SAMARITAN HOME CARE AMERICA | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 113319259 | HEALTHCARE SVC | NY | SAMARITAN MGMT | C-CORP | false |
| MERCY INTERNAL MEDICINE PC | |||||||||
| 992 N VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 510639649 | HEALTHCARE SVC | NY | MERCY MED CTR | C-CORP | false |
| LONG ISLAND EMERGENCY CARE PC | |||||||||
| 1000 N VILLAGE AVE | ROCKVILLE | NY | 11571 | 113633515 | PHYSICIAN SVC | NY | MERCY MED CTR | S-CORP | false |
| MY CHS RX INC | |||||||||
| 992 N VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 842359236 | PHARMACY | NY | CHSLI | C-CORP | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CHS SERVICES | ||
| LMPR | $4,104,958 | COST |
| GOOD SAMARITAN HOSPITAL MEDICAL CENTER | ||
| LM | $6,073,149 | COST |
| MERCY MEDICAL CENTER | ||
| LM | $1,320,007 | COST |
| ST FRANCIS HOSPITAL | ||
| LM | $246,932 | COST |
| ST CATHERINE OF SIENA MEDICAL CENTER | ||
| LM | $292,283 | COST |
| WSNCHS NORTH INC (ST JOSEPH HOSPITAL) | ||
| LM | $95,953 | COST |
| ST CHARLES HOSPITAL FOUNDATION | ||
| C | $197,672 | COST |
| ST CHARLES HOSPITAL FOUNDATION | ||
| LMNOQ | $735,851 | COST |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART IV | FormAndLineReferenceDesc |
| Explanation | FOR ALL PROFESSIONAL CORPORATIONS REPORTED ON SCHEDULE R, PART IV, THE PHYSICIAN IS THE SOLE SHAREHOLDER OF THE ENTITY AND THE DIRECT CONTROLLING ENTITY REPORTED IN COLUMN (D) IS THE BENEFICIAL OWNER. THIS STRUCTURE IS CONSISTENT WITH THE NEW YORK CORPORATE PRACTICE OF MEDICINE. | ExplanationTxt |