2021-11-23T10:48:55-06:00 2020-12-31 PricewaterhouseCoopers LLP 300 Madison Avenue New York NY 10017 990 2020-01-01 208067039 RVC INSURANCE COMPANY INC % CHS SERVICES INC RVCI 5167053700 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 Brian McGuire PRESIDENT 5167053700 2021-11-08 true Brian McGuire 999009999 LAURA J PARELLO P01080295 6464713000 2 2020 2022-09-23 18:48:47Z PATRICK O'SHAUGHNESSY DO 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 63426226 false X N/A X 2004 NY WE, AT CHS, HUMBLY JOIN TOGETHER TO BRING CHRIST'S HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES. 5 3 0 0 0 0 0 0 26258848 26110442 9167864 4189135 0 0 35426712 30299577 0 20000000 0 0 0 0 0 0 0 9226824 6332083 9226824 26332083 26199888 3967494 222305762 232882192 150364643 147360663 71941119 85521529 X RVC INSURANCE COMPANY INC. IS A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND. WE, AT CATHOLIC HEALTH SERVICES, HUMBLY JOIN TOGETHER TO BRING CHRIST'S HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES. I-CARE VALUES INTEGRITY: WE ARE WHO WE SAY WE ARE AND ACT IN ACCORDANCE WITH THE SPLENDOR OF TRUTH OF OUR CATHOLIC MORAL TEACHING AND OUR CATHOLIC VALUES. COMPASSION: WE HAVE COMPASSION FOR OUR PATIENTS, SEE THE SUFFERING CHRIST IN THEM, STRIVE TO ALLEVIATE SUFFERING AND SERVE THE SPIRITUAL, PHYSICAL AND EMOTIONAL NEEDS OF OUR PATIENTS. ACCOUNTABILITY: WE TAKE RESPONSIBILITY FOR OUR ACTIONS AND THEIR CONSEQUENCES. RESPECT: WE HONOR THE SANCTITY OF LIFE AT EVERY STAGE OF LIFE AND THE DIGNITY OF EVERY PERSON, AND INCORPORATE ALL THE PRINCIPLES OF CATHOLIC SOCIAL TEACHING IN OUR RELATIONSHIPS AND ADVOCACY. EXCELLENCE: WE SEEK THE GLORY OF GOD IN THE COMPASSIONATE SERVICE OF OUR PATIENTS, AND WE STRIVE TO DO THE BEST THAT false false 26332083 20000000 26110442 RVC PROVIDES EXCESS PROFESSIONAL LIABILITY, GENERAL LIABILITY (INCLUDING TERRORISM COVERAGE), AND EMPLOYERS LIABILITY INSURANCE COVERAGE SOLELY TO CERTAIN CATHOLIC HEALTH SERVIES OF LONG ISLAND (CHS) ENTITIES. BEGINNING NOVEMBER 1, 2013, RVC PROVIDES PRIMARY COVERAGE TO CERTAIN CHS ENTITIES FOR GENERAL LIABILITY, DIRECTORS AND OFFICERS LIABILITY AND EMPLOYMENT PRACTICES LIABILITY. 26332083 true false false false false false false false false false false false false true true true true true false false false false false false false false false true false true false false false false false false false false false false false false false true false false false true 5 0 true 0 false false false false false false false false false false false false X 5 3 false false false false true true true true true false false true true true true true true false false false X CHS SERVICES INC 5167053700 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 X ALAN D GUERCI MD DIRECTOR 2.0 50.0 X 0 1900476 457415 DANIEL DEBARBA TREASURER 0.0 50.0 X X 0 1119150 410475 BRIAN MCGUIRE PRESIDENT 2.0 0.0 X X 0 0 0 ALEXANDER HAZELTON VICE PRESIDENT 2.0 0.0 X X 0 0 0 DANIEL ROWE SECRETARY 2.0 0.0 X X 0 0 0 0 3019626 867890 0 false true false PHALANX HEALTHCARE SOLUTIONS 14 WALL STREET NEW YORK NY 10005 INSURANCE 1185000 BERTELSMANN LEARNING LLC 111 CORNING ROAD CARY NC 27518 EDUC&ANALYTICS SOFTW 271761 RELIAS LEARNING LLC DEPT CH 16894 PALATINE IL 60055 EDUC&ANALYTICS SOFTW 194208 3 0 PREMIUMS EARNED 524298 26110442 26110442 26110442 2404647 2404647 0 0 0 0 0 34911137 33126649 1784488 1784488 1784488 0 0 0 0 0 0 0 0 0 0 30299577 26110442 4189135 20000000 20000000 0 0 0 0 0 0 0 0 0 72500 72500 0 60000 60000 0 0 135188 135188 665863 665863 0 0 0 0 0 0 0 0 0 0 0 0 0 0 LOSSES NET OF SALVAGE 4818042 4818042 CORPORATE TAXES 305669 305669 MALPRACTICE CLAIMS HANDLING 156820 156820 DOMESTIC CAPTIVE CONSULT 55000 55000 63001 63001 26332083 26332083 0 0 2773818 5132742 0 0 0 0 24786613 23191675 0 0 0 0 0 0 0 0 3266609 1511021 0 0 133097529 146899579 0 0 0 0 0 0 58381193 56147175 222305762 232882192 882076 1255452 0 0 0 0 0 0 0 0 0 0 0 0 0 0 149482567 146105211 150364643 147360663 X 100000 100000 2150000 2150000 69691119 83271529 71941119 85521529 222305762 232882192 3967494 9612916 X false true X true false X X X 10 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 111888924 3 false 0 0 MERCY MEDICAL CENTER 111635088 3 false 0 0 ST CHARLES HOSPITAL CORP 111871039 3 false 0 0 ST FRANCIS HOSPITAL 112050523 3 false 0 0 ST CATHERINE OF SIENA MEDICAL CENTER 061562701 3 false 0 0 WSNCHS NORTH INC 113438973 3 false 0 0 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 113284066 10 false 0 0 CATHOLIC HOME CARE 112126736 10 false 0 0 GOOD SHEPHERD HOSPICE 112958438 10 false 0 0 MARYHAVEN CENTER OF HOPE 112861698 10 false 0 0 10 0 0 false false false false false false false false false false false false false false false false PART IV, SECTION A, LINE 1 THE COMPANY IS RESPONSIBLE FOR THE ADMINISTRATION AND PROTECTION OF THE TEMPORAL GOODS OF THE ROMAN CATHOLIC CHURCH OF ROCKVILLE CENTER, WHICH IS SUPPORT BY CHSLI AND ITS SUBSIDIARIES. THE SUPPORTED ORGANIZATIONS ARE DETERMINED AS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A CATHOLIC HEALTH SERVICES OF LONG ISLAND) AND ALL ENTITIES FOR WHICH CATHOLIC HEALTH SERVICES OF LONG ISLAND IS THE SOLE CORPORATE MEMBER AND CERTAIN OTHER PUBLIC CHARITIES CONTROLLED BY SUCH ENTITIES. PART IV, SECTION C, LINE 1 THE SHAREHOLDERS OF RVC INSURANCE CO ARE NOMINEE SHAREHOLDERS AS APPOINTED BY CATHOLIC HEALTH SERVICES OF LONG ISLAND. AS SUCH, CONTROL IS VESTED WITH THE BOARD OF TRUSTEES OF CATHOLIC HEALTH SERVICES OF LONG ISLAND, WHICH DIRECTLY OR INDIRECTLY CONTROLS ALL OF THE SUPPORTED ORGANIZATION OF RVC INSURANCE CO. LOANS TO RELATED PARTIES 40000000 INSURANCE CLAIMS RECEIVABLE 16147175 56147175 0 ESTIMATED MALPRACTICE LIABILITY 115841328 UNEARNED PREMIUMS 23274395 ESTIMATED OTHER SELF INSURANCE 6938629 DUE TO RELATED PARTIES 50859 146105211 X 39777305 9612916 9612916 30164389 135188 135188 30299577 26196895 26196895 135188 135188 26332083 PART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTE AS A CAPTIVE INSURANCE COMPANY, THE COMPANY IS EXEMPT FROM NEW YORK STATE CORPORATION INCOME TAX; HOWEVER, THE COMPANY IS REQUIRED TO PAY A NEW YORK STATE PREMIUM TAX AND OTHER ASSESSMENTS. THE COMPANY'S 2020 AND 2019 NEW YORK STATE PREMIUM TAX OF $306,000 AND $310,000, RESPECTIVELY, IS INCLUDED IN THE CAPTION POLICY ACQUISITION COSTS INCURRED IN THE ACCOMPANYING STATEMENTS OF OPERATIONS. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE FINANCIAL STATEMENTS. true CATHOLIC HEALTH SERVICES OF LI 992 N VILLAGE AVEROCKVILLE CTRNY1 ROCKVILLE CENTRE NY 11570 113403968 501(C)(3) 20000000 DIVIDEND 1 0 SCHEDULE I, PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE CHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR RVC INSURANCE COMPANY, INC. AND CATHOLIC HEALTH SERVICES OF LONG ISLAND AND IS THEREFORE ABLE TO MONITOR THAT CATHOLIC HEALTH SERVICES OF LONG ISLAND USES THE GRANT FUNDS FOR MISSION SPONSORSHIP, OUTPATIENT CENTERS, GRANTS TO UNDESERVED COMMUNITIES AND CAPITAL SUPPORT. false true false false false false false false false DANIEL DEBARBA TREASURER 0 923822 0 164000 0 31328 0 366935 0 43540 0 1529625 0 0 ALAN D GUERCI MD DIRECTOR 0 1556421 0 308000 0 36055 0 426935 0 30480 0 2357891 0 0 PART I, LINE 3 - METHODS TO ESTABLISH COMPENSATION BY RELATED ORGANIZATION THE FOLLOWING METHODS ARE USED BY A RELATED ORGANIZATION TO ESTABLISH COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. ALAN D. GUERCI, MD $401,000 PARTICIPATION IN PLAN DANIEL DEBARBA $341,000 PARTICIPATION IN PLAN THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THESE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NON-QUALIFIED RETIREMENT PLANS. FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION THE SHAREHOLDERS OF RVC INSURANCE CO, ARE NOMINEE SHAREHOLDERS AS APPOINTED BY CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS) AND CAN BE REPLACED AT WILL. CHS IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER (DIOCESE). FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODY CHS HAS THE RIGHT TO APPOINT THE SHAREHOLDERS OF RVC INSURANCE CO. FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY CHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF RVC INSURANCE COMPANY, INC, IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERNING BODY OF RVC INSURANCE COMPANY, INC. FORM 990, PART VI, LINE 11B - REVIEW PROCESS OF FORM 990 THE FORM 990 AND RELATED SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD, AND PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS OF CHS, WHICH HAS BEEN DELEGATED THE FORM 990 REVIEW FUNCTION BY THE BOARD. UPON REVIEW AND RECOMMENDATION OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO THE BOARD FOR APPROVAL. UPON BOARD APPROVAL, THE FORM 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST POLICY DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE CHS COMPLIANCE AND AUDIT COMMITTEE BY CHS' COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE IS GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE CHS BOARD OF DIRECTORS. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE BOARD OF DIRECTORS SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. THE PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIM/HERSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. FORM 990, PART VI, LINE 15 - COMPENSATION POLICY (OF CHS, A RELATED ORG) THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE SYSTEM CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE CHS EXECUTIVE COMPENSATION POLICY (COMPENSATION POLICY). THE COMPENSATION POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER (CEO), AND CHIEF OPERATING OFFICERS (COO) OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS (CFO); D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AN OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. ONCE APPROVED BY THE CHS CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE OF THE CHS BOARD OF DIRECTORS FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE PERFORMED ANNUALLY BY AN INDEPENDENT CONSULTANT. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION PROVIDED, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE CHS BOARD OF DIRECTORS. FORM 990, PART VI, LINE 19 - DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION IS FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND. FORM 990, PART VII, SECTION A - LINE 1A HOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. ALAN D. GUERCI, M.D. DIRECTOR - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: RVC INSURANCE COMPANY (20-8067039); CHS SERVICES, INC. (11-3555766); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); CATHOLIC HEALTH SYSTEM OF LONG ISLAND (11-3403968); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL CORP (11-1871039) AND ST. JOSEPH HOSPITAL FOUNDATION (47-2353387). DANIEL DEBARBA, TREASURER - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL CORP (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240); ST. CATHERINE OF SIENA MEDICAL CENTER FDOUNDATION (27-1459941); CATHOLIC HEALTH SYSTEM OF LONG ISLAND (11-3403968) AND RVC INSURANCE COMPANY INC. (20-8067039) CATHOLIC HEALTH SYSTEM OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113403968 SUPPORT ORG NY 501(C)(3) 12A- I NA false CHS SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113555766 SUPPORT ORG NY 501(C)(3) 12B- II CHSLI false CHS AMBULANCE SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 141801961 DORMANT NY 501(C)(3) 3 CHSLI false GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 111888924 HOSPITAL NY 501(C)(3) 3 CHSLI false GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112537396 SELF INSURANC NY 501(C)(3) 12A- I GOOD SAMARTN false MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113434776 TRANSPORTATIO NY 501(C)(3) 12A- I MARYHAVENCTR false MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861698 Prgm-disabled NY 501(C)(3) 10 CHSLI false MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT 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PORT JEFFERSON NY 11777 412076312 SUPPORT ORG NY 501(C)(3) 12A- I ST CHARLES false GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 770611240 SUPPORT ORG NY 501(C)(3) 12A- I GOOD SAMARTN false MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 550813603 SUPPORT ORG NY 501(C)(3) 12A- I MERCY MEDCTR false ST CATHERINE OF SIENA MEDICAL CTR FDN 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 271459941 SUPPORT ORG NY 501(C)(3) 12A- I STCATHERINE false CHS HOME CARE AND HOSPICE FOUNDATION 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 452907761 SUPPORT ORG NY 501(C)(3) 12A- I CATHHOMECARE false GOOD SHEPHERD HOSPICE FOUNDATION 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 263169427 SUPPORT ORG NY 501(C)(3) 11A- I GOODSHEPHERD false OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP NY 11795 450517566 SUPPORT ORG NY 501(C)(3) 12A- I OURLADYOFC false RVC SUPPORT 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 271531084 REAL ESTATE NY 501(C)(3) 12A- I CHSLI false CHS PHYSICIAN PARTNERS PC 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113613997 HEALTHCARESVC NY 501(C)(3) 12A- I ST FRANCIS false SAMARITAN EMERGENCY MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208243412 HEALTHCARESVC NY 501(C)(4) GOOD SAMARTN false ST JOSEPH HOSPITAL FOUNDATION 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 472353387 SUPPORT ORG NY 501(C)(3) 12A- I WSNCHS NORTH false BIPO HOLDINGS LLC 992 N VILLAGE AVE ROCKVILLE CENTRE ROCKVILLE CENTRE NY 11570 464763720 PHYSICIAN ASSN NY NA N/A IDHC LLC 2500 YORK RDJAMISONPA 18929 JAMISON PA 18929 452411095 HEALTH SERVICES PA NA N/A BEACON HEALTH PTNRS 992 N VILLAGE AVE ROCKVILLE CENTRE ROCKVILLE CENTRE NY 11570 454229842 HEALTHCARE NY NA N/A WISDOM GARDENS LP 51 TERRYVILLE RD PORT JEFFERSON NY 11776 113567947 SR HOUSING NY NA N/A CHS PHYSICIAN PARTNERS ACO LLC 992 N Village Ave Rockville Centr ROCKVILLE CENTRE NY 11570 999999999 HEALTHCARE NY NA N/A RADIOLOGY 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THIS STRUCTURE IS CONSISTENT WITH THE NEW YORK CORPORATE PRACTICE OF MEDICINE.