CENTRAL SUFFOLK HOSPITAL FOUNDATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL SUFFOLK HOSPITAL FOUNDATION (EIN 20-0714587)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-12
- IRS object ID
- 202133169349310103
- Schema version
- 2020v4.1
- 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 D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-11-12T13:55:44-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1155 Avenue of the Americas 1200 | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200714587 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL SUFFOLK HOSPITAL Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % MICHAEL F O'DONNELL | InCareOfNm |
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 6315486152 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 Heros Way | AddressLine1Txt |
| City | Riverhead | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREW J MITCHELL | PersonNm |
| Person Title | PRESIDENT/CEO | PersonTitleTxt |
| Phone | 6315486064 | PhoneNum |
| Signature | 2021-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Jackie | PersonFirstNm |
| Person Last | Smith | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Aaron Shapiro | PreparerPersonNm |
| PTIN | P01333816 | PTIN |
| Phone | 2128674000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Peconic Bay Medical Center Foundatio | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANDREW J MITCHELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 HEROS WAY | AddressLine1Txt |
| City | RIVERHEAD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,360,556 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PBMCHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF CENTRAL SUFFOLK HOSPITAL FOUNDATION IS TO SEEK PHILANTHROPIC SUPPORT ON BEHALF OF CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $6,285,524 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,267,036 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $29,901 | PYInvestmentIncomeAmt |
| CY Investment Income | $60,881 | CYInvestmentIncomeAmt |
| PY Other Revenue | $483,273 | PYOtherRevenueAmt |
| CY Other Revenue | -$135,459 | CYOtherRevenueAmt |
| PY Total Revenue | $6,798,698 | PYTotalRevenueAmt |
| CY Total Revenue | $6,192,458 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $2,410,434 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,347,218 | PYOtherExpensesAmt |
| CY Other Expenses | $2,061,789 | CYOtherExpensesAmt |
| PY Total Expenses | $1,347,218 | PYTotalExpensesAmt |
| CY Total Expenses | $4,472,223 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,451,480 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,720,235 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,842,052 | TotalAssetsBOYAmt |
| Total Assets EOY | $41,952,205 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,739,619 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,112,717 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,102,433 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,839,488 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE FOUNDATIONS MISSION IS TO DEVELOP AND CULTIVATE PHILANTHROPIC AND COLLABORATIVE RELATIONSHIPS THAT FOSTER PROGRAMS AND SERVICES OFFERED THROUGH CENTRAL SUFFOLK HOSPITAL WHICH IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,466,001 | ExpenseAmt |
| Desc | TO SUPPORT THE SERVICES PROVIDED AT PECONIC BAY MEDICAL CENTER. | Desc |
| Total Program Service Expenses | $4,466,001 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | 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 | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| 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 | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 1 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| 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 |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | 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 | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL F O'DONNELL | PersonNm |
| Phone | 6315486074 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13OO ROANOKE AVENUE | AddressLine1Txt |
| City | RIVERHEAD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| ANDREW J MITCHELL | |||||||
| PRESIDENT/CEO | 15.0 | 22.0 | Yes (X) | Yes (X) | $0 | $3,050,820 | $55,274 |
| EMILIE ROY COREY MSW | |||||||
| BOARD CHAIR | 10.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| J GORDON HUSZAGH | |||||||
| VICE CHAIR | 10.0 | 15.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RICHARD ISREAL | |||||||
| VICE CHAIR | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOAN S LEVAN | |||||||
| SECRETARY/TREASURER | 1.0 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KAREEN MASSOUD | |||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| MARY ANN ALEXANDER | |||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| JUDITH JEDLICKA | |||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |
| RICHARD WINSLOW | |||||||
| BOARD MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL SCHWENK | |||||||
| BOARD MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| STANLEY ZINBERG | |||||||
| BOARD MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| SHERRY PATTERSON | |||||||
| BOARD MEMBER | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,050,820 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $55,274 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | central suffolk hospital | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 Roanoke Avenue | AddressLine1Txt |
| City | RIVERHEAD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Administrative | ServicesDesc |
| Compensation | $819,279 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $812,559 | FundraisingAmt |
| All Other Contributions | $5,454,477 | AllOtherContributionsAmt |
| Total Contributions | $6,267,036 | TotalContributionsAmt |
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,252 | TotalRevenueColumnAmt |
| Exclusion | $59,252 | 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 | $1,000,983 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,130,036 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$129,053 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$129,053 | TotalRevenueColumnAmt |
| Exclusion | -$129,053 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,185 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,556 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,629 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,629 | TotalRevenueColumnAmt |
| Exclusion | $1,629 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $23,100 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $812,559 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $29,506 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$6,406 | TotalRevenueColumnAmt |
| Exclusion | -$6,406 | ExclusionAmt |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,192,458 | TotalRevenueColumnAmt |
| Exclusion | -$74,578 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,410,434 | TotalAmt |
| Program Services | $2,410,434 | 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 | $0 | TotalAmt |
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 | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $819,279 | TotalAmt |
| Program Services | $819,279 | ProgramServicesAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,088 | TotalAmt |
| Program Services | $174,088 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $6,222 | TotalAmt |
| Management And General | $6,222 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,075 | TotalAmt |
| Program Services | $25,075 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $630 | TotalAmt |
| Program Services | $630 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,884 | TotalAmt |
| Program Services | $205,884 | ProgramServicesAmt |
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 | $481,055 | TotalAmt |
| Program Services | $481,055 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $1,433 | TotalAmt |
| Program Services | $1,433 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| STEWARDSHIP | $56,360 | $56,360 |
| EDUCATION REIMBURSEMENT | $8,568 | $8,568 |
| COMMUNITY OUTREACH | $225 | $225 |
| MISCELLANEOUS | $282,970 | $282,970 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,472,223 | TotalAmt |
| Program Services | $4,466,001 | ProgramServicesAmt |
| Management And General | $6,222 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,910,606 | BOYAmt |
| EOY | $12,091,890 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,064,357 | BOYAmt |
| EOY | $2,852,317 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $778,205 | BOYAmt |
| EOY | $734,156 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,954 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $25,894,427 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,003,237 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,735,400 | BOYAmt |
| EOY | $24,891,190 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,174,102 | BOYAmt |
| EOY | $1,207,504 | 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 | $144,428 | BOYAmt |
| EOY | $175,148 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,842,052 | BOYAmt |
| EOY | $41,952,205 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $176,600 | BOYAmt |
| EOY | $68,001 | 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 | $0 | 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 | $7,808,915 | BOYAmt |
| EOY | $18,268,337 | 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 | $754,104 | BOYAmt |
| EOY | $2,776,379 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,739,619 | BOYAmt |
| EOY | $21,112,717 | 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 | $14,447,055 | BOYAmt |
| EOY | $18,175,295 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,655,378 | BOYAmt |
| EOY | $2,664,193 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,102,433 | BOYAmt |
| EOY | $20,839,488 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,842,052 | BOYAmt |
| EOY | $41,952,205 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,720,235 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $16,820 | NetUnrlzdGainsLossesInvstAmt |
| 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) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,688,063 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,383,258 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,832,846 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,285,524 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,267,036 | CurrentTaxYearAmt |
| Total | $26,456,727 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,688,063 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,383,258 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,832,846 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,285,524 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,267,036 | CurrentTaxYearAmt |
| Total | $26,456,727 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $8,921,318 | SubstantialContributorsTotAmt |
| Public Support Total170 | $17,535,409 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,995 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $56,602 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,084,375 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,028,094 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,060,235 | CurrentTaxYearAmt |
| Total | $3,239,301 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $29,696,028 | TotalSupportAmt |
| Public Support CY170 | 0.59050 | PublicSupportCY170Pct |
| Public Support PY170 | 0.64573 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,740,500 | OtherCostOrOtherBasisAmt |
| Book Value | $1,740,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,153,927 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,003,237 | DepreciationAmt |
| Book Value | $23,150,690 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $24,891,190 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO CENTRAL SUFFOLK HOSPITAL | $2,706,648 |
| OTHER | $69,731 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,776,379 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $7,333,092 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $16,820 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $1,130,036 | OtherRevenueAmt |
| Revenue Not Reported | $1,146,856 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,186,236 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $6,222 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $6,222 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,192,458 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,596,037 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $1,130,036 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,130,036 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,466,001 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $6,222 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $6,222 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,472,223 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, Line 2 | ASC 740 FOOTNOTE MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTITFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| PART XI, LINE 2B | RENT EXPENSE: $1,130,036 |
| Part XII, Line 2B | RENT EXPENSE: $1,130,036 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA | Event1Nm |
| Gross Receipts Event1 | $624,984 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $624,984 | CharitableContriEvent1Amt |
| Food And Beverage Event1 | $5,410 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $2,500 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $3,750 | OtherDirectExpensesEvent1Amt |
| Event2 | GOLF | Event2Nm |
| Gross Receipts Event2 | $102,250 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $79,150 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $23,100 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $10,628 | FoodAndBeverageEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $108,425 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $108,425 | CharitableContriOtherEventsAmt |
| Oth Direct Expnss Other Events | $7,218 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $835,659 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $812,559 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $23,100 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $16,038 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $2,500 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $10,968 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $29,506 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$6,406 | NetIncomeSummaryAmt |
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 | Peconic Bay Medical Center | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 Roanoke Ave | AddressLine1Txt |
| Address Line2 | Riverhead | AddressLine2Txt |
| City | New York | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 111661359 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $2,410,434 | CashGrantAmt |
| Purpose Of Grant | Hospital care | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I DESCRIPTION OF PROCEDURE FOR MONITORING USE OF FUNDS | FormAndLineReferenceDesc |
| Explanation | THIS GRANT WAS BETWEEN RELATED ORGANIZATIONS AND ALL SUCH TRANSACTIONS ARE CLOSELY MONITORED BY THE BOARD OF DIRECTORS TO ENSURE COMPLIANCE WITH THE GRANT PURPOSE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANDREW J MITCHELL | PersonNm |
| Title | PRESIDENT/CEO | TitleTxt |
| Base Compensation Filing Org | $0 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $837,857 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $2,185,494 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $27,469 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $31,350 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $23,924 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $0 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $3,106,094 | TotalCompensationRltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE CEO AND CFO OF CENTRAL SUFFOLK HOSPITAL (CSH), A RELATED ORGANIZATION, REVIEW THE 990. A COPY OF THE 990 IS ALSO PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. THE BOARD REVIEWS THE DOCUMENT AND REACHES OUT TO CSH SHOULD THEY HAVE ANY QUESTIONS. IF NO QUESTIONS ARE RAISED THE 990 IS SUBMITTED FOR FILING. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, SECTION B, LINE 12 | THE FOUNDATION FOLLOWS CSH'S CONFLICT OF INTEREST POLICY. |
| FORM 990 , PART VI, SECTION B, LINE 15A | CSH UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2020. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central Suffolk Hospital DBA Peconic Bay | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1Txt |
| City | RIVERHEAD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 111661359 | EIN |
| Primary Activities | HOSPITAL CARE | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHWELL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (true) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | 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 | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |