STRATEGY STUDIO / PUBLIC DATA EXPLORER

DOMINICAN SISTERS FAMILY HEALTH SERVICE INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
DOMINICAN SISTERS FAMILY HEALTH SERVICE INC (EIN 13-1740242)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-11-15
IRS object ID
202143199349325379
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 ReturnHeader

FieldValueIRS element (for citing)
Return2021-11-15T16:52:14-06:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN271728945PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PKF O'CONNOR DAVIES LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 MAMARONECK AVENUEAddressLine1Txt
CityHARRISONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP105281633ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN131740242EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DOMINICAN SISTERS FAMILY HEALTH SERVICEBusinessNameLine1Txt
Business Name Line2INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlDOMIBusinessNameControlTxt
Phone9149411710PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1299 NORTH HIGHLAND AVENUEAddressLine1Txt
CityOSSININGCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10562ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANNMARIE COVONEPersonNm
Person TitleEXECUTIVE VP & CFOPersonTitleTxt
Phone9149411710PhoneNum
Signature2021-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstANNMARIEPersonFirstNm
Person LastCOVONEPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGARRETT M HIGGINSPreparerPersonNm
PTINP00543209PTIN
Phone9143818900PhoneNum
Preparation2021-11-10PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1ARCHCARE AT HOMEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerSCOTT P LA RUEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1299 NORTH HIGHLAND AVENUEAddressLine1Txt
CityOSSININGCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10562ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$22,884,531GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.DSFHS.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1974FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionDSFHS PROVIDES COMPREHENSIVE AND FAMILY FOCUSED CARE TO PERSONS IN NEED AS A CERTIFIED COMMUNITY BASED, NON-PROFIT HOME HEALTH AGENCY. OUR PROGRAMS AND SERVICES PROMOTE HEALTH, INDEPENDENCE AND QUALITY OF LIFE.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee230TotalEmployeeCnt
Total Volunteers19TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$7,707,567PYContributionsGrantsAmt
CY Contributions Grants$3,732,097CYContributionsGrantsAmt
PY Program Service Revenue$16,661,780PYProgramServiceRevenueAmt
CY Program Service Revenue$19,087,316CYProgramServiceRevenueAmt
PY Investment Income$1,850PYInvestmentIncomeAmt
CY Investment Income$1,228CYInvestmentIncomeAmt
PY Other Revenue$95,657PYOtherRevenueAmt
CY Other Revenue$63,890CYOtherRevenueAmt
PY Total Revenue$24,466,854PYTotalRevenueAmt
CY Total Revenue$22,884,531CYTotalRevenueAmt
PY Grants And Similar Paid$1,908PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$15,000,477PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$15,082,531CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,673,635PYOtherExpensesAmt
CY Other Expenses$6,666,488CYOtherExpensesAmt
PY Total Expenses$20,676,020PYTotalExpensesAmt
CY Total Expenses$21,749,019CYTotalExpensesAmt
PY Revenues Less Expenses$3,790,834PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,135,512CYRevenuesLessExpensesAmt
Total Assets BOY$14,564,435TotalAssetsBOYAmt
Total Assets EOY$10,427,294TotalAssetsEOYAmt
Total Liabilities BOY$16,497,413TotalLiabilitiesBOYAmt
Total Liabilities EOY$11,224,760TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$1,932,978NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$797,466NetAssetsOrFundBalancesEOYAmt
MissionDSFHS IS A NON-PROFIT HOME HEALTH AGENCY THAT PROVIDES COMPASSIONATE AND FAMILY FOCUSED HOME CARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$11,642,490ExpenseAmt
Revenue$18,068,342RevenueAmt
DescTHE CERTIFIED HOME HEALTH AGENCY PROVIDES CARE AND SUPPORT TO THOSE WHO HAVE HOME HEALTH CARE NEEDS THAT ARE FOR LIMITED DURATION. CARE MAY INVOLVE SKILLED NURSING, CASE MANAGEMENT, MEDICAL SOCIAL WORKER, HOME HEALTH AIDES, PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES. ADDITIONAL SPECIALTY SERVICES PROVIDED ARE MATERIAL/CHILD HEALTH, WOUND CARE PAIN MANAGEMENT, HEALTH EDUCATION AND SUPERVISION AND SCREENING FOR NURSING HOME PLACEMENT. PASTORAL CARE COUNSELING IS PROVIDED IN BOTH ENGLISH AND SPANISH TO HELP PATIENTS AND FAMILIES OF ALL FAITHS COPE SPIRITUALLY AND EMOTIONALLY WITH ILLNESS AND HEALING.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$274,369ExpenseAmt
Revenue$1,018,974RevenueAmt
DescADJUNCT PROGRAMS PROVIDE NON-MEDICAL SERVICES, WHICH ARE GRANT FUNDED, TO THE MOST VULNERABLE MEMBERS OF SOCIETY IN THE SOUTH BRONX AND SUFFOLK COUNTY. IN THE SOUTH BRONX, THE RYAN WHITE PROGRAM ADDRESSES THE NEEDS OF THE HIV/AIDS POPULATION, OFFERING TESTING AND COUNSELING SERVICES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$11,916,859TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document23IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee230EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANNMARIE COVONEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6466334700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1205 LEXINGTON AVENUE 2ND FLOORAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10016ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
FRANCIS J SERBAROLI ESQ
CHAIRMAN0.101.70Yes (X)Yes (X)$0$0$0
THOMAS M O'BRIEN
VICE-CHAIR0.101.70Yes (X)Yes (X)$0$0$0
TARA A CORTES
SECRETARY0.101.70Yes (X)Yes (X)$0$0$0
THOMAS E ALBERTO
BOARD MEMBER0.101.70Yes (X)$0$0$0
JOHN CAHILL
BOARD MEMBER0.101.70Yes (X)$0$0$0
JOHN T DUNLAP
BOARD MEMBER0.101.70Yes (X)$0$0$0
MSGR CHARLES J FAHEY
BOARD MEMBER0.101.70Yes (X)$0$0$0
THOMAS J FAHEY JR MD
BOARD MEMBER0.101.70Yes (X)$0$0$0
ERIC P FELDMANN
BOARD MEMBER0.101.70Yes (X)$0$0$0
KAREN GRAY
BOARD MEMBER0.101.70Yes (X)$0$0$0
JEFFREY J HODGMAN
BOARD MEMBER0.101.70Yes (X)$0$0$0
GEORGE IRISH
BOARD MEMBER0.101.70Yes (X)$0$0$0
CLARION E JOHNSON MD
BOARD MEMBER0.101.70Yes (X)$0$0$0
RORY KELLEHER
BOARD MEMBER0.101.70Yes (X)$0$0$0
REV MSGR JOSEPH LAMORTE
BOARD MEMBER0.101.70Yes (X)$0$0$0
KATHRYN ROONEY
BOARD MEMBER0.101.70Yes (X)$0$0$0
GT SWEENEY
BOARD MEMBER0.101.70Yes (X)$0$0$0
GENNARO VASILE PDD
BOARD MEMBER0.101.70Yes (X)$0$0$0
BISHOP GERALD WALSH
BOARD MEMBER0.101.70Yes (X)$0$0$0
SCOTT P LA RUE
PRESIDENT/CEO0.1038.70Yes (X)$0$1,406,730$343,704
ANNMARIE COVONE
EXECUTIVE VICE PRESIDENT/C0.1038.70Yes (X)$0$873,596$195,331
TAMI A SIEDLER
VP HOME & COMMUNITY SERVICE37.50$370,536$0$84,837Yes (X)
REGINA E TANCREDI
DIRECTOR OF BUSINESS OPERATION37.50$159,240$0$59,338Yes (X)
ANN CRANE
REGIONAL ADMINISTRATOR37.50$133,487$0$44,238Yes (X)
JACQUELYN D AUGUSTO
COMMUNITY HEALTH NURSE37.50$128,681$0$25,781Yes (X)
STEPHANIE CANALES
LAIAISON NURSE37.50$127,456$0$10,420Yes (X)
ZHANNA KARLIK
COMMUNITY HEALTH NURSE37.50$126,752$0$11,683Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,046,152TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,280,326TotReportableCompRltdOrgAmt
Total Other Compensation$775,332TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K40IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
THERADYNAMICS REHAB LLC
225 CROSSWAYS PARK DRWOODBURYNY11797REHABILITATION SERVICES$1,230,847
HOMECARE HOMEBASE LLC
PO BOX 678637DALLASTX75267HOME HEALTH CARE SERVICES$512,220
BLACKTREE HEALTHCARE CONSULTING LLC
1030 CONTINENTAL DRIVEKING OF PRUSSIAPA19406BILLING SERVICES$401,513
GHP STEVENS LLC
4 WEST RED OAK LANE SUITE 200WHITE PLAINSNY10604REAL ESTATE SERVICES$369,780
PKF O'CONNOR DAVIES LLP
500 MAMARONECK AVE SUITE 300HARRISONNY10528AUDITING & CONSULTING SERVICES$120,800
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K6CntrctRcvdGreaterThan100KCnt
Government Grants$2,924,996GovernmentGrantsAmt
All Other Contributions$807,101AllOtherContributionsAmt
Total Contributions$3,732,097TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE623000$17,955,006$17,955,006
CARE MANAGEMENT & HEALTH HOME623000$1,018,974$1,018,974
RENTAL INCOME FROM RELATED PARTY532000$113,336$113,336
FieldValueIRS element (for citing)
Total Program Service Revenue$19,087,316TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,228TotalRevenueColumnAmt
Exclusion$1,228ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
FORGIVENESS OF DEBT900099$34,300$34,300
REIMBURSEMENT FROM AFFILIATES900099$15,608$15,608
OTHER REVENUE900099$7,316$7,316

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,666TotalRevenueColumnAmt
Exclusion$6,666ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$63,890OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,884,531TotalRevenueColumnAmt
Related Or Exempt Func Income$19,087,316RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$65,118ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$381,801TotalAmt
Management And General$381,801ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,480,102TotalAmt
Program Services$7,651,811ProgramServicesAmt
Management And General$3,828,291ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$29,590TotalAmt
Program Services$29,590ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,226,690TotalAmt
Program Services$1,447,571ProgramServicesAmt
Management And General$779,119ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$964,348TotalAmt
Program Services$623,558ProgramServicesAmt
Management And General$340,790ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$606,123TotalAmt
Management And General$606,123ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$21,061TotalAmt
Management And General$21,061ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$90,000TotalAmt
Program Services$6,250ProgramServicesAmt
Management And General$83,750ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,742,643TotalAmt
Program Services$1,145,695ProgramServicesAmt
Management And General$596,948ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$631TotalAmt
Program Services$631ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$279,115TotalAmt
Program Services$132,530ProgramServicesAmt
Management And General$146,585ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$855,837TotalAmt
Program Services$56,078ProgramServicesAmt
Management And General$799,759ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$508,118TotalAmt
Program Services$130,080ProgramServicesAmt
Management And General$378,038ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$286,129TotalAmt
Program Services$157,572ProgramServicesAmt
Management And General$128,557ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$7,763TotalAmt
Program Services$7,763ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$52,016TotalAmt
Management And General$52,016ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$455,936TotalAmt
Management And General$455,936ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$96,700TotalAmt
Management And General$96,700ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
BAD DEBT EXPENSE$986,354$986,354
MEDICAL SUPPLIES$287,805$287,805
REPAIRS & MAINTENANCE$118,014$106,941$11,073
OTHER DIRECT EXPENSE$103,970$39,972$63,998

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$168,273TotalAmt
Program Services$164,854ProgramServicesAmt
Management And General$3,419ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$21,749,019TotalAmt
Program Services$11,916,859ProgramServicesAmt
Management And General$9,832,160ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,021,882BOYAmt
EOY$1,871,185EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$524,708BOYAmt
EOY$1,522,526EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,229,102BOYAmt
EOY$448,709EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,222,244BOYAmt
EOY$2,984,117EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$329,345BOYAmt
EOY$345,541EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,929,705LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,676,546LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,574,313BOYAmt
EOY$1,253,159EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,662,841BOYAmt
EOY$2,002,057EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$14,564,435BOYAmt
EOY$10,427,294EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$6,120,571BOYAmt
EOY$4,795,627EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$700,000EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$5,484BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,371,358BOYAmt
EOY$5,729,133EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,497,413BOYAmt
EOY$11,224,760EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$1,995,597BOYAmt
EOY-$860,085EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$62,619BOYAmt
EOY$62,619EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$1,932,978BOYAmt
EOY-$797,466EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,564,435BOYAmt
EOY$10,427,294EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,135,512ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,748,613CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,616,421CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,739,783CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,707,567CurrentTaxYearMinus1YearAmt
Current Tax Year$3,732,097CurrentTaxYearAmt
Total$18,544,481TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$33,286,016CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$32,749,284CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$16,332,081CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,661,780CurrentTaxYearMinus1YearAmt
Current Tax Year$19,087,316CurrentTaxYearAmt
Total$118,116,477TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$35,034,629CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$34,365,705CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$20,071,864CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,369,347CurrentTaxYearMinus1YearAmt
Current Tax Year$22,819,413CurrentTaxYearAmt
Total$136,660,958TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$136,660,958PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$46,213CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,940CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,854CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,850CurrentTaxYearMinus1YearAmt
Current Tax Year$1,228CurrentTaxYearAmt
Total$69,085TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$46,213CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$16,940CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,854CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,850CurrentTaxYearMinus1YearAmt
Current Tax Year$1,228CurrentTaxYearAmt
Total$69,085TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,580CurrentTaxYearMinus4YearsAmt
Total$8,580TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$63,180CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$286,118CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$223,066CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$95,657CurrentTaxYearMinus1YearAmt
Current Tax Year$63,890CurrentTaxYearAmt
Total$731,911TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$35,152,602CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$34,668,763CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$20,297,784CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$24,466,854CurrentTaxYearMinus1YearAmt
Current Tax Year$22,884,531CurrentTaxYearAmt
Total$137,470,534TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99410PublicSupportCY509Pct
Public Support PY5090.99470PublicSupportPY509Pct
Investment Income CY0.00050InvestmentIncomeCYPct
Investment Income PY0.00050InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER REVENUE - 2016 AMOUNT: $ 37,143. 2017 AMOUNT: $ 72,224. 2018 AMOUNT: $ 9,156. 2019 AMOUNT: $ 5,501. 2020 AMOUNT: $ 7,316. MEDICAL RECORD - 2016 AMOUNT: $ 12,978. 2017 AMOUNT: $ 7,966. 2018 AMOUNT: $ 8,112. 2019 AMOUNT: $ 8,391. 2020 AMOUNT: $ 6,666. FLU IMMUNIZATIONS - 2016 AMOUNT: $ 13,059. 2017 AMOUNT: $ 130. FORGIVENESS OF DEBT - 2017 AMOUNT: $ 205,798. 2018 AMOUNT: $ 205,798. 2019 AMOUNT: $ 81,765. 2020 AMOUNT: $ 34,300. REIMBURSEMENT FORM AFFILIATES - 2020 AMOUNT: $ 15,608.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$74,819OtherCostOrOtherBasisAmt
Depreciation$74,819DepreciationAmt
Book Value$0BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$647,330OtherCostOrOtherBasisAmt
Depreciation$604,800DepreciationAmt
Book Value$42,530BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,875,199OtherCostOrOtherBasisAmt
Depreciation$2,664,114DepreciationAmt
Book Value$211,085BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,332,357OtherCostOrOtherBasisAmt
Depreciation$2,332,813DepreciationAmt
Book Value$999,544BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,253,159TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
DEPOSITS$110,742
INSURANCE RECOVERY RECEIVABLE$753,315
DUE FROM RELATED PARTY$1,138,000
FieldValueIRS element (for citing)
Total Book Value Other Assets$2,002,057TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
DUE TO THIRD PARTY PAYORS$664,799
PROFESSIONAL LIABILITIES$1,138,000
DUE TO RELATED PARTY$1,969,419
DEFERRED RENT$372,115
PAYCHECK PROTECTION PROGRAM LOAN$1,584,800
FieldValueIRS element (for citing)
Total Liability$5,729,133TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$38,190,278TotalRevEtcAuditedFinclStmtAmt
Other Revenue$16,525,681OtherRevenueAmt
Revenue Not Reported$16,525,681RevenueNotReportedAmt
Revenue Subtotal$21,664,597RevenueSubtotalAmt
Other Revenues Not Included$1,219,934OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$1,219,934RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$22,884,531TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$37,412,745TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$16,883,660OtherExpensesIncludedAmt
Expenses Not Reported$16,883,660ExpensesNotReportedAmt
Expenses Subtotal$20,529,085ExpensesSubtotalAmt
Other Expenses Not Included$1,219,934OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,219,934ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$21,749,019TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE AGENCY RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE AGENCY HAS NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE AGENCY IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR PERIODS PRIOR TO DECEMBER 31, 2017.
PART XI, LINE 2D - OTHER ADJUSTMENTS:REVENUE ATTRIBUTED TO RELATED PARTY: 16,525,681.
PART XI, LINE 4B - OTHER ADJUSTMENTS:ELIMINATIONS FROM CONSOLIDATED ENTITY 217,972. RECLASS OF BAD DEBT EXPENSES TO PART IX, LINE 24 986,354. RECLASS OF REIMBURSEMENT FORM AFFILIATES TO PART VIII, LINE 11 15,608.
PART XII, LINE 2D - OTHER ADJUSTMENTS:EXPENSES ATTRIBUTED TO RELATED PARTY: 16,883,660.
PART XII, LINE 4B - OTHER ADJUSTMENTS:ELIMINATIONS FROM CONSOLIDATED ENTITY 217,972. RECLASS OF BAD DEBT EXPENSES TO PART IX, LINE 24 986,354. RECLASS OF REIMBURSEMENT FORM AFFILIATES TO PART VIII, LINE 11 15,608.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
SCOTT P LA RUE
PRESIDENT/CEO$0$991,770$0$273,779$0$141,181$0$321,656$0$22,048$0$1,750,434$0$283,210
ANNMARIE COVONE
EXECUTIVE VICE PRESIDENT/C$0$671,748$0$127,877$0$73,971$0$161,663$0$33,668$0$1,068,927$0$127,877
TAMI A SIEDLER
VP HOME & COMMUNITY SERVICE$302,296$0$55,000$0$13,240$0$82,650$0$2,187$0$455,373$0$0$0
REGINA E TANCREDI
DIRECTOR OF BUSINESS OPERATION$158,840$0$400$0$0$0$25,670$0$33,668$0$218,578$0$0$0
ANN CRANE
REGIONAL ADMINISTRATOR$133,087$0$400$0$0$0$22,836$0$21,402$0$177,725$0$0$0
JACQUELYN D AUGUSTO
COMMUNITY HEALTH NURSE$124,948$0$3,733$0$0$0$3,733$0$22,048$0$154,462$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BSCOTT P. LA RUE AND ANNMARIE COVONE ALSO PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE DISTRIBUTED $134,281 TO SCOTT AND $60,731 TO ANNMARIE IN THEIR 2020 W-2S.
PART I, LINE 7THE FOLLOWING EMPLOYEES RECEIVED TAXABLE BOARD DISCRETIONARY BONUS IN THEIR 2020 W-2'S FOR THE ORGANIZATION: - TAMI A SIEDLER $55,000 - REGINA E TANCREDI $400 - ANN CRANE $400 - JACQUELYN D AUGUSTO $3,733 - STEPHANIE CANALES $8,233 - ZHANNA KARLIK $300

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION HAS A MANAGEMENT AGREEMENT FOR CERTAIN ADMINISTRATIVE AND CONSULTING SERVICES WITH CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE. CATHOLIC HEALTH CARE SYSTEM SHALL PROVIDE HUMAN RESOURCES, IT SERVICES, FINANCE SERVICES, LEGAL SERVICES, COMPLIANCE, AND SUPPLY CHAIN MANAGEMENT TO THE ORGANIZATION. ANNMARIE COVONE AND SCOTT LA RUE (OFFICERS OF THE FILING ORGANIZATION) WERE PAID BY CATHOLIC HEALTH CARE SYSTEM. THEIR 2020 COMPENSATION IS REPORTED IN PART VII, SECTION A AND SCHEDULE J, PART II. CATHOLIC HEALTH CARE SYSTEM WAS PAID $450,000 FOR SERVICES IN 2020.
FORM 990, PART VI, SECTION A, LINE 6THE MEMBER OF THE CORPORATION SHALL BE CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER OF THE ORGANIZATION SHALL NOMINATE AND APPOINT TWO DIRECTORS TO SERVE ON THE DSFHS BOARD. OTHER THAN THE MEMBER'S TWO APPOINTMENTS TO THE DSFHS BOARD OF DIRECTORS, DSFHS SHALL HAVE THE SOLE RIGHT TO NOMINATE DIRECTORS TO SERVE ON THE DSFHS BOARD, SUBJECT TO ARCHCARE'S FINAL APPROVAL. ARCHCARE SHALL ALSO HAVE THE RIGHT TO REMOVE ANY DIRECTOR FROM THE CORPORATION'S BOARD AT ANY TIME FOR THE FOLLOWING REASONS: 1. FAILURE TO TAKE APPROPRIATE ACTION(S) TO MEET WITH THE APPROVED BUDGET AND/OR OVERALL CHCS HEALTH SYSTEM STRATEGY; OR 2. INTERFERING WITH THE PROMPT INTEGRATION OF THE CORPORATION INTO THE MEMBER'S HEALTH CARE SYSTEM, INCLUDING FAILING TO TAKE ADVANTAGE OF SYNERGIES AMONG THE CHCS INSTITUTIONS; OR 3. FAILURE TO RECUSE ONESELF FROM DISCUSSION/VOTING RELATED TO A MATTER WHICH CREATES A POTENTIAL CONFLICT OF INTEREST OR THE APPEARANCE OF IMPROPRIETY.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING POWERS ARE RESERVED TO THE MEMBER OF THE CORPORATION: A) APPROVAL, UPON RECOMMENDATION FROM THE CORPORATION'S BOARD, OF ANY AMENDMENT TO THE BYLAWS AND CERTIFICATE OF INCORPORATION OF THE CORPORATION; B) APPROVAL, UPON RECOMMENDATION OF THE CORPORATION'S BOARD, OF THE OPERATING AND CAPITAL BUDGETS OF CORPORATION; C) APPROVAL, UPON RECOMMENDATION OF THE CORPORATION'S BOARD, OF THE BUSINESS AND STRATEGIC PLAN FOR THE CORPORATION OR ANY AMENDMENT THERETO; D) APPROVAL, UPON RECOMMENDATION OF THE CORPORATION'S BOARD, OF THE FORMATION OR PURCHASE OF AN ENTITY THAT IS A RELATED ENTITY OF THE CORPORATION; E) NOMINATE AND APPOINT TWO DIRECTORS TO SERVE ON THE DSFHS BOARD. OTHER THAN THE MEMBER'S TWO APPOINTMENTS TO THE DSFHS BOARD OF DIRECTORS, DSFHS SHALL HAVE THE SOLE RIGHT TO NOMINATE DIRECTORS TO SERVE ON THE DSFHS BOARD, SUBJECT TO ARCHCARE'S FINAL APPROVAL. ARCHCARE SHALL ALSO HAVE THE RIGHT TO REMOVE ANY DIRECTOR FROM THE CORPORATION'S BOARD AT ANY TIME FOR THE FOLLOWING REASONS: (I) FAILURE TO TAKE APPROPRIATE ACTION(S) TO MEET WITH THE APPROVED BUDGET AND/OR OVERALL CHCS HEALTH SYSTEM STRATEGY; OR (II) INTERFERING WITH THE PROMPT INTEGRATION OF THE CORPORATION INTO THE MEMBER'S HEALTH CARE SYSTEM, INCLUDING FAILING TO TAKE ADVANTAGE OF SYNERGIES AMONG THE CHCS INSTITUTIONS; OR (III)FAILURE TO RECUSE ONESELF FROM DISCUSSION/VOTING RELATED TO A MATTER WHICH CREATES A POTENTIAL CONFLICT OF INTEREST OR THE APPEARANCE OF IMPROPRIETY. F) APPROVAL OF ANY REAL ESTATE TRANSACTION INVOLVING THE SALE, PLEDGE OR TRANSFER OF REAL PROPERTY WITH A VALUE ABOVE $30,000 AND BELOW $400,000 OR ANY CAPITAL PROJECT INVOLVING THE SALE, PLEDGE OR TRANSFER OF FIXED ASSETS WITH A VALUE ABOVE $30,000 AND BELOW $400,000; G) APPROVAL OF ANY PROGRAM OR SERVICE CHANGES BY THE CORPORATION THAT RESULT IN: (A) CLOSURE OR ESTABLISHMENT OF A LICENSED SERVICE OR PROGRAM; OR (B) CHANGE IN LOCATION OF A LICENSED SERVICE OR LICENSED PROGRAM OUTSIDE THE SERVICE AREA OF THE CORPORATION; AND H) APPROVAL OF ANY MERGER, PURCHASE, JOINT OPERATING AGREEMENT OR OTHER AFFILIATION (EACH AN "AFFILIATION") BY THE CORPORATION WITH A THIRD PARTY, OR WITHDRAWAL FROM, DISPOSITION OF AN INTEREST IN, OR DISSOLUTION OF ANY SUCH AFFILIATION.
FORM 990, PART VI, SECTION B, LINE 11BDOMINICAN SISTERS FAMILY HEALTH SERVICE, INC. HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM AND HAS ESTABLISHED THE FOLLOWING REVIEW PROCESS TO ENSURE THAT THE INFORMATION REPORTED IS COMPLETE AND ACCURATE. WHEN THE FORM 990 HAS BEEN PREPARED, REVIEWED BY MANAGEMENT AND IS READY TO BE FILED WITH THE INTERNAL REVENUE SERVICE, IT IS ELECTRONICALLY SENT TO THE BOARD MEMBERS OF THE ORGANIZATION FOR ANY COMMENTS. ANY COMMENTS ARE THEN GROUPED, SUMMARIZED AND PROVIDED TO THE OUTSIDE ACCOUNTANTS. EACH ISSUE IS DOCUMENTED AND ADDRESSED UNTIL THE RETURN IS FINALIZED AND APPROVED FOR FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATIONS CONFLICT OF INTEREST POLICY APPLIES TO ALL DIRECTORS, OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. AN INTERESTED PERSON WITH A POTENTIAL CONFLICT OF INTEREST IN A PARTICULAR MATTER SHALL PROMPTLY AND FULLY DISCLOSE THE POTENTIAL CONFLICT TO HIS SUPERVISOR. THE INTERESTED PERSON SHALL THEREAFTER REFRAIN FROM PARTICIPATING IN DELIBERATIONS AND DISCUSSION, AS WELL AS ANY DECISIONS, RELATING TO THE MATTER. THE PRESIDENT SHALL BE RESPONSIBLE FOR DETERMINING THE PROPER WAY FOR THE ORGANIZATION TO HANDLE DECISIONS WHICH INVOLVE UNRESOLVED CONFLICTS OF INTEREST. THE POLICY SHALL BE OVERSEEN AND ADMINISTERED BY THE BOARD OF DIRECTORS WITH ONLY INDEPENDENT DIRECTORS PARTICIPATING OR BY A COMMITTEE OF THE BOARD COMPRISED OF AT LEAST THREE MEMBERS AND OF WHICH ALL COMMITTEE MEMBERS SHALL BE DIRECTORS WHO ARE INDEPENDENT DIRECTORS. THIS PROCESS IS CONDUCTED ANNUALLY, AND IS GIVEN OVERSIGHT BY THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15BTHE EXECUTIVE COMMITTEE DETERMINES ADMINISTRATIVE COMPENSATION BASED UPON AN INDEPENDENT STUDY OF CERTIFIES HOME HEALTHCARE COMPANIES OF COMPARABLE SIZE IN THE NEW YORK METROPOLITAN AREA. IN 2020, AN EXECUTIVE SESSION OF THE BOARD WAS HELD TO DISCUSS AND APPROVE THE OTHER OFFICERS AND KEY EMPLOYEES COMPENSATION. THE BOARD'S APPROVAL WAS DOCUMENTED IN THE BOARD MINUTES WHEN THE BUDGET FOR THE ORGANIZATION WAS APPROVED.
FORM 990, PART VI, SECTION C, LINE 19THE CORPORATION MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE BY POSTING IT ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, ARTICLES OF INCORPORATION AND BY-LAWS ARE ALSO AVAILABLE UPON WRITTEN REQUEST AT 299 NORTH HIGHLAND AVENUE, OSSINING, NY 10562 OR BY CALLING THE ORGANIZATION DIRECTLY AT (914)-941-1710.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THE OVERSIGHT PROCESS DID NOT CHANGE FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (28 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
BENEFICE ADVANTAGE INC
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016134201050DORMANT/PROVIDE ADMIN., BENFITS COORDINATING AND OTHER SERVICES TO ARCHCARENY501(C)(3)LINE 1CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
CALVARY FUND INC
1740 EASTCHESTER ROADBRONXNY10461133259649SUPPORT CALVARY HOSPITALNY501(C)(3)LINE 12A, ICALVARY HOLDING COMPANY INC0
CALVARY HOLDING COMPANY
1740 EASTCHESTER ROADBRONXNY10461061531426SUPPORT THE CALVARY HOSPITAL AND ITS AFFILIATED ORGANIZATIONSNY501(C)(3)LINE 12A, ICATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
CALVARY HOSPITAL INC
1740 EASTCHESTER ROADBRONXNY10461131740274OPERATE A TAX EXEMPT HOSPITALNY501(C)(3)LINE 3CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
CARMEL RICHMOND NURSING HOME INC
88 OLD TOWN ROADSTATEN ISLANDNY103044229132720248OPERATE SKILLED NURSING FACILITY & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
KATERI RESIDENCE
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016133086309DORMANT/OPERATE SKILLED NURSING & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016133896624MGT SVCS FOR HEALTH-RELATED FACILITIES IN THE ARCHDIOCESENY501(C)(3)LINE 10PROVIDENCE HEALTH SERVICES0
CATHOLIC HEALTH CARE FOUNDATION OF THE ARCHDIOCESE OF NY
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016134054158PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIESNY501(C)(3)LINE 7CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
CATHOLIC MANAGED LONG TERM CARE INC
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016208180809OPERATE A MANAGED LONG-TERM CARE PLANNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
CATHOLIC RESOURCES INC
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016261306110SUPPORT CATHOLIC MANAGED LONG TERM CARE, INC.NY501(C)(3)LINE 1CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
EMPIRE STATE HOME CARE SERVICES INC
15 METROTECH CENTER 11 FLBROOKLYNNY11201113618585HOME HEALTH CARE SERVICESNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
FERNCLIFF NURSING HOME COMPANY INC
21 FERNCLIFF DRIVERHINEBECKNY12572141514053OPERATE SKILLED NURSING FACILITY & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
MARY MANNING WALSH NURSING HOME COMPANY INC
1339 YORK AVENUENEW YORKNY100214707136220617OPERATE SKILLED NURSING FACILITY & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
OUR LADY OF MERCY FUND OF NEW YORK NY
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016133452084DORMANT/PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIESNY501(C)(3)LINE 7CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
OUR LADY OF MERCY HEALTHCARE SYSTEM INC
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016133395946DORMANT/PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIESNY501(C)(3)LINE 12A, IOUR LADY OF MERCY HEALTHCARE SYSTEM INC0
PROVIDENCE HEALTH SERVICES
1011 1ST AVENUENEW YORKNY10022133354940SPONSOR OF CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARENY501(C)(3)LINE 30N/A
ST TERESA'S NURSING HOME INC
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016237012219OPERATE SKILLED NURSING FACILITY & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
ST THERESA'S RESIDENCE
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016133110063INTERMEDIATE CARE FACILITY FOR DEVELOPMENTALLY DISABLEDNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
ST VINCENT DE PAUL RESIDENCE
900 INTERVALE AVENUEBRONXNY10459133598842OPERATE SKILLED NURSING FACILITY & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
TERENCE CARDINAL COOKE HEALTH CARE CENTER
1249 FIFTH AVENUENEW YORKNY10029133007801OPERATE SKILLED NURSING FACILITY & REHABILITATION FACILITYNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
VISITING NURSE REGIONAL HEALTH CARE SYSTEM INC
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016113574017DORMANT/SUPPORT AND MANAGEMENT SERVICES FOR ITS AFFILIATESNY501(C)(3)LINE 10CATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
VISITING NURSE ASSOCIATION OF BROOKLYN INC
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016111977434DORMANT/HOME HEALTH CARENY501(C)(3)LINE 10VISITING NURSE REGIONAL HEALTH CARE SYSTEM INC0
BROOKLYN VISITING NURSE FOUNDATION
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016113312248DORMANT/RAISE FUNDS FOR AFFILIATED ORGANIZATIONSNY501(C)(3)LINE 12B, IIVISITING NURSE REGIONAL HEALTH CARE SYSTEM INC0
ARCHCARE COMMUNITY SERVICES INC
205 LEXINGTON AVE 2ND FLOORNEW YORKNY10016813563801PROVIDE COMMUNITY AND PASTORAL SERVICES AND SUPPORTIVE HOUSINGNY501(C)(3)LINE 12B, IICATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
FAMILY HOME HEALTH CARE INC
65 SOUTH BROADWAYTARRYTOWNNY10591133831377HOME CARENY501(C)(3)LINE 10DOMINICAN SISTERS FAMILY HEALTH SERVICE INCYes (1)
ULSTER HOME HEALTH SERVICES INC
PO BOX 1850KINGSTONNY12402141513989HOME CARENY501(C)(3)LINE 10UMC INC0
UMC INC
PO BOX 1850KINGSTONNY12402141701702MANAGEMENT SERVICESNY501(C)(3)LINE 12B, IICATHOLIC HEALTHCARE SYSTEM DBA ARCHCARE0
ULSTER HOME CARE INC
PO BOX 1850KINGSTONNY12402141702962HOME CARENY501(C)(3)LINE 10UMC INC0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ST AGNES HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1305 NORTH STREETAddressLine1Txt
CityWHITE PLAINSCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10605ZIPCd
FieldValueIRS element (for citing)
EIN131740121EIN
Primary ActivitiesDORMANT/OPERATE A HOSPITALPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTHCARE SYSTEM DBA ARCHCAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (1)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
FAMILY HOME HEALTH CARE INC
M$217,972COST
FAMILY HOME HEALTH CARE INC
A$53,916COST

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART V, LINE 1A:FormAndLineReferenceDesc
ExplanationDOMINICAN SISTERS FAMILY HEALTH SERVICE, INC. RECEIVED RENTAL INCOME, WHICH ARE SPECIFIED PAYMENTS, FROM ITS CONTROLLED SUBSIDIARY. THESE PAYMENTS WERE MADE AT ARM'S LENGTH AND MEETS THE FAIR MARKET VALUE STANDARD.ExplanationTxt