2020-11-02T08:08:33-06:00 2019-12-31 990 2019-01-01 111661359 Central Suffolk Hospital % NORTHWELL HEALTH INC CENT 6315486074 1 HEROES WAY RIVERHEAD NY 11901 MICHAEL F O'DONNELL SVP & CFO 6315486074 2020-11-02 8.25.157.165 11046820203075000000 2020-11-02 P 01FFBBAC11E76842625487E98750409A353038DD A8E867FBD87B7B19EACF155E00BCAC716138C3E7 2019 2021-01-29 14:40:06Z X PECONIC BAY MEDICAL CENTER MICHAEL O'DONNELL 1 HEROES WAY RIVERHEAD NY 11901 230860131 false X WWW.PBMCHEALTH.ORG X NY CENTRAL SUFFOLK HOSPITAL ("CSH") IS A NOT-FOR-PROFIT HOSPITAL, A SKILLED NURSING FACILITY, AND A CERTIFIED HOME CARE AGENCY. 22 16 1432 170 0 22167813 1825013 199992496 219414487 356106 1380245 1724431 1253984 224240846 223873729 0 0 0 0 117532406 130433736 0 0 242368 84287709 91664430 201820115 222098166 22420731 1775563 200846927 251031020 109819400 137103332 91027527 113927688 CENTRAL SUFFOLK HOSPITAL ("CSH") D/B/A PECONIC BAY MEDICAL CENTER ("PBMC") IS A NOT-FOR-PROFIT HOSPITAL CONSISTING OF 122 ACUTE CARE BEDS, A 60-BED SKILLED NURSING FACILITY AND A CERTIFIED HOME CARE AGENCY. CSH PROVIDES A FULL RANGE OF HEALTH CARE SERVICES TO THE LOCAL COMMUNITY. false false 184067172 219414487 CENTRAL SUFFOLK HOSPITAL ("CSH") IS A PROVIDER OF COMPREHENSIVE HEALTHCARE SERVICES INCLUDING EMERGENCY, SURGICAL, MEDICAL, ICU AND OBSTETRICS/GYNECOLOGICAL. IN 2019, CSH HAD 8,536 INPATIENT DISCHARGES, DELIVERED 389 BABIES, PROVIDED 35,931 EMERGENCY DEPARTMENT VISTS, AND PERFORMED 3,864 AMBULATORY SURGERIES INCLUDING ENDOSCOPIES AND CARDIAC CATHETERIZATIONS. 184067172 true true false true false false false true false true true false false true true false false true false false false false false false true false true true false false true true false false false false false false false false false true false false false false false true false false false true 82 1 true 1432 true false false false false false true true false false false false false false false false false true false X 22 16 false false false false true true true true true false false true true true true true true true false false NY X X NORTHWELL HEALTH INC 5163216058 972 BRUSH HOLLOW RD 5TH FL WESTBURY NY 11590 ANDREW MITCHELL President & CEO 50.0 0.0 X X 1130652 0 53335 RALPH NAPPI Trustee/EVC Northwell 0.0 50.0 X 0 951213 53335 MICHAEL O'DONNELL CFO 50.0 0.0 X 468758 0 64303 STEPHEN JOHN Physician/Hospitalist 50.0 0.0 X 429926 0 42351 AMY LOEB CNO 50.0 0.0 X X 377837 0 64254 SUSAN SOMERVILLE VP, Strategic Initiatives 0.0 50.0 X 0 386635 53335 STEVEN OUZOUNIAN Trustee/Physician 0.0 50.0 X 0 391249 30800 AGOSTINO CERVONE Trustee/Physician 0.0 50.0 X 0 374999 30800 LAWRENCE WALSER Dir, Critical Care 50.0 0.0 X 333705 0 48825 ARTHUR CROWE COO 50.0 0.0 X 303935 0 53724 MARIE DORVAL-DORCELY Physician/Hospitalist 50.0 0.0 X 291420 0 52103 APRIL CAPERNA Dir, Geriatric & Palliative Md 50.0 0.0 X 276186 0 64254 MAHMOOD AFGHANI Physician/Hospitalist 50.0 0.0 X 264733 0 64254 RONALD MCMANUS Former COO 0.0 0.0 X 318238 0 10651 SAMANTHA VIGLIOTTA VP, Foundation & Extnl Affairs 50.0 0.0 X 238843 0 64254 MONICA RAULS VP, Human Resources 50.0 0.0 X 234732 0 31400 SHARON PATTERSON Chairman 0.0 3.0 X X 0 0 0 ANDREW MENDELSON Vice Chairman 0.0 2.0 X X 0 0 0 J GORDON HUSZAGH Vice Chairman, Treasurer 0.0 2.0 X X 0 0 0 REV GEORGE SUMMERS Secretary 0.0 2.0 X X 0 0 0 NON COMPENSATED TRUSTE SEE SCHEDULE O 0.0 2.0 X 0 0 0 4668965 2104096 781978 255 true true false Sodexo Inc Affiliates 135 Santilli Highway EVERETT MA 02149 Cafeteria Services 1783273 Partners in Critical Care LLP 32 Cedar Avenue Ext ISLIP NY 11751 Physicians 1120765 Eugene S Krauss MD PC 20 Horseshoe Road OLD WESTBURY NY 11568 Consulting Svcs 1084584 Titan Global LLC 1757 Veterans Memorial Highway ISLANDIA NY 11749 Security Svcs 1069593 Crothall Facilities Management Inc 1500 Liberty Ridge Drive Ste 210 WAYNE PA 19087 Facility Mgmt Svcs 1009814 50 346433 149641 807472 521467 1825013 PATIENT SERVICE REVENUE 621300 125125860 125125860 PHYSICIAN PRACTICE REVENUE 621300 4908213 4908213 MEDICARE/MEDICAID PAYMENTS 621300 89380414 89380414 219414487 1288658 1288658 0 0 116376 0 116376 0 116376 116376 7004805 6913218 91587 91587 91587 128533 346433 73184 55349 0 0 0 0 0 0 CAFETERIA 624210 622000 622000 CLINIC 900099 220806 220806 MEDICAL SCHOOL 900099 55053 55053 184400 184400 1082259 223873729 219770316 2223051 0 0 0 0 3072995 3072995 0 96160413 78639962 17520451 7242471 5922891 1319580 16713703 13668462 3045241 7244154 5924267 1319887 674845 674845 31432 31432 321005 321005 0 0 0 10917925 8928676 1989249 942884 700516 242368 38348610 31361484 6987126 0 0 2663932 2178563 485369 281914 281914 0 302629 302629 1735972 1735972 0 6926820 5664752 1262068 2404493 2404493 PURCHASED SERVICES 17268720 17268720 BAD DEBT 4577873 4577873 CENTRALIZED ADMIN EXPENSE 391028 391028 DUES & SUBSCRIPTIONS 155711 127340 28371 3718637 3041635 677002 222098166 184067172 37788626 242368 10143000 8379717 3059201 3059201 0 0 21605943 27251373 0 0 0 0 0 0 4441195 4297067 1702609 129866 157911083 23076948 114964990 134834135 23320064 29890134 549311 0 0 0 5230000 5230000 15830614 37959527 200846927 251031020 35595179 37466229 0 0 0 0 25565000 24245000 0 0 0 0 0 0 11295092 13556838 37364129 61835265 109819400 137103332 X 83274520 101965327 7753007 11962361 91027527 113927688 200846927 251031020 X 1775563 7795 21116803 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false true 10491 false 10491 LOBBYING ACTIVITY CENTRAL SUFFOLK HOSPITAL IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION AND OTHER HEALTH CARE ASSOCIATIONS WHICH ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. X false 786908 349092 349092 786908 765857 213986 192935 786908 777416 21460 -33019 765857 786908 20485 22979 52956 777416 786908 786908 1.00000 false false 16205000 16205000 55810249 10751763 45058486 3291741 846899 2444842 30570283 11305764 19264519 52033810 172522 51861288 134834135 EQUITY INTEREST IN THE CSH FDN 14447057 SECURITY DEPOSITS 169971 OTHER RECEIVABLES 3218270 INSURANCE CLAIM RECEIVABLE 601889 RIGHT OF USE ASSET 19458418 OTHER ASSETS 63922 37959527 0 MALPRACTICE INSURANCE 15753894 ESTIMATED THIRD PARTY PAYABLES 5739937 DUE TO AFFILIATES 19983184 INSURANCE CLAIMS LIABILITY 601889 OPERATING LEASE LIABILITY 19458418 OTHER LIABILITIES 297943 61835265 X 221116105 7795 -2838603 -2830808 223946913 -73184 -73184 223873729 218210454 73184 73184 218137270 3960896 3960896 222098166 PART III, LINE 4 - DESCRIPTION OF ORGANIZATION'S COLLECTIONS THE DONATED ARTWORK PROVIDES A SOOTHING AND CALMING ENVIRONMENT TO THE PATIENTS AND THEIR FAMILIES WHEN THEY ATTEND CSH FOR MEDICAL SERVICES. CSH HOPES THAT WITH A GOOD EXPERIENCE, THEIR PATIENTS CONTINUE TO UTILIZE CSH TO PROVIDE MEDICAL SERVICES. PART V, LINE 4 - INTENDED USE OF ENDOWMENTS ENDOWMENT FUNDS HAVE BEEN RESTRICTED BY DONORS TO BE MAINTAINED BY CSH IN PERPETUITY. PART X, LINE 2 - FIN 48 Certain entities included in Northwell's consolidated financial statements are taxable entities under Federal or state laws. U.S. generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations and for unrelated business activities of the tax-exempt entities included in Northwell's consolidated financial statements. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. At December 31, 2019 and 2018, Northwell has a deferred tax asset of approximately $112,000,000 and $118,000,000, respectively, both of which have been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to net operating loss (NOL) carryforwards. Certain entities have NOL carryforwards aggregating approximately $540,000,000 at December 31, 2019. NOL carryforwards generated prior to 2018 will expire in varying amounts through 2037 and are available to offset future taxable income of the respective entity. NOLs generated after 2017 can be carried forward indefinitely, but with limitations. PART XI, LINE 2D & 4B - RECONCILIATION OF REVENUE REVENUE ON BOOKS NOT ON RETURN NON-OPERATING NET BENEFIT COST 71,196 PROVISION FOR BAD DEBT (4,577,873) NET ASSETS RELEASED FROM RESTRICTION 1,668,074 TOTAL (2,838,603) REVENUE ON RETURN NOT ON BOOKS SPECIAL EVENTS RECLASS (73,184) TOTAL (73,184) Part XII, Line 2D & 4B - RECONCILIATION OF EXPENSES EXPENSE ON BOOKS NOT ON RETURN SPECIAL EVENTS RECLASS 73,184 TOTAL 73,184 EXPENSE ON RETURN NOT ON BOOKS PROVISION FOR BAD DEBT 4,577,873 ADDITIONAL MINIMUM PENSION LIAB ADJ (616,977) TOTAL 3,960,896 SPRING GALA 346433 217900 128533 15000 13643 17922 8000 18619 0 346433 217900 128533 15000 13643 17922 8000 18619 73184 55349 true true X true X true X 500. true true true false true true 4229849 -252802 4482651 0.01870 32654651 17803237 14851414 0.06190 36884500 17550435 19334065 0.08060 146554 146554 0.00060 5811897 4035697 1776200 0.00740 24751161 24751161 0 865 865 140337 140337 0.00060 30850814 28786858 2063956 0.00860 67735314 46337293 21398021 0.08920 38581 38581 0.00020 2 2 2701 2701 229 229 3151 3151 44664 44664 0.00020 true 1470038 69100844 78152248 -9051404 X true true 1 1 Peconic Bay Medical Center 1300 Roanoke Avenue Riverhead NY 11901 X X X X X Trauma unit Peconic Bay Medical Center false false true X X X X X X X X X 19 true true true true X www.northwell.edu/education-and-resource X true 19 true www.northwell.edu/education-and-resources/com false true X 100 500. X X X X true true X X X true X www.pbmchealth.org/admissions/bil X www.pbmchealth.org/admissions/billin X www.pbmchealth.org/admission X X X X X X X true X false X X X X X true X false false Part V Section C - Supplemental Information Part V, Section B, line 2: N/A Part V, Section B, line 3j: N/A Part V, Section B, line 5: The CHNA was facilitated by committees established within each of the six county served by Northwell and its hospitals. External stakeholders included representatives from county health departments, area hospitals, academia, business, government agencies and community based organizations with an emphasis on those who serve communities with health disparities. Quantitative and qualitative data was collected from diverse community organizations that serve the population-at-large, as well as those communities with significant health disparities. Community partners were invited to participate via community member and community-based organization/provider surveys, facilitated focus groups and community-based organization summits. Part V, Section B, line 6a: For a detailed listing of other hospital facilities go to web link: https://www.northwell.edu/doctors-and-care/locations?type=hospitals Part V, Section B, line 6b: For a detailed listing of other organizations go to web link: https://www.northwell.edu/sites/northwell.edu/files/2019-12/Northwell-Heal th-2019-CHNA-FINAL.pdf Part V, Section B, line 7d: N/A Part V, Section B, line 11: The Northwell Health Implementation Plan for 2019-2021 includes the goals, objectives, activities, and performance measures planned to address the chosen New York State Prevention Agenda Priority Areas. The hospital identified and addressed primary needs based on an assessment of the highest ranked health priorities of the community, regulatory input and resources available. For further information go to web link: https://www.northwell.edu/sites/northwell.edu/files/2019-12/Northwell-NYSD OH-2019-chip-workplan.pdf Part V, Section B, line 13b: N/A Part V, Section B, line 13h: The hospital also uses household size. Part V, Section B, line 15e: N/A Part V, Section B, line 16j: The policy is included in the hospital's Community Service Plan and provided at health fairs and presentations open to the community at no cost, in addition to mailing financial policy summary brochures. Part V, Section B, line 18e: N/A Part V, Section B, line 19e: N/A Part V, Section B, line 20e: Before initiating any of the actions, the hospital facility sends letters, makes telephone calls and utilizes presumptive eligibility. Part V, Section B, line 21c: N/A Part V, Section B, line 21d: N/A Part V, Section B, line 23: N/A Part V, Section B, line 24: N/A 1 Peconic Bay Physical Therapy & Rehab Cen 64 Commerce Drive Riverhead NY 11901 Outpatient Physician Clinic Part VI - Supplemental Information Question 1: Part I, Line 3c: This hospital is an affiliated entity of Northwell Health Inc. ("Northwell"). Northwell uses FPG to determine eligibility and utilizes the New York State Department of Health (NYSDOH) guidelines regarding the consideration of resources. Resource tests cannot be used to deny financial assistance, but only to "upgrade" a patient's level of obligation, up to the legal maximum permitted under the financial assistance law. Part I, Line 6a: The Community Benefit report is prepared by the hospital, in conjunction with an affiliated entity (Northwell) of the hospital. The Community Benefit Report is accessible to the public and can be accessed on the Northwell website https://www.northwell.edu/sites/northwell.edu/files/2020-10/nwh_community2 019-FINAL.pdf Part I, 7: Row (a) The cost of charity care was determined by utilizing the ratio of cost to charges (RCC) calculated on Worksheet 2 applied to gross charges written off for patients qualifying for charity under the hospital's financial assistance policy. Bad Debt was not reported in any row of Part I, Line 7. Row (b) The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. A RCC is developed from these costs, and that RCC is applied to total Medicaid gross ancillary services charges to determine the cost of services provided to Medicaid patients. Row (e) Costs associated with Community Health Improvement Services were determined by adding indirect or overhead costs to the direct costs of the activity. Indirect costs were calculated as a percentage of direct costs. Direct costs for staff expenses were calculated using average system hourly rates, and were adjusted to account for fringe benefits, using a blended rate based on the ratio of total employee benefit expenses to total salary and wages. Row (f) The Bad Debt Expense that appears on Form 990, Part IX, Line 25 column (A), but not included for purposes of calculating the percentage in this column is equal to the amount reported on Form 990, Part X. The costs related to health professions education were determined by utilizing the step down method of cost finding. Row (h) Costs associated with research activities were determined by adding indirect, or overhead, costs to the direct costs of the activity. Indirect costs were calculated as a percentage of costs. Row (i) The cost of in-kind contributions to community groups is comprised of the direct costs of personnel whose compensated time was donated to various charities and community groups. The salaries and wages were adjusted to include benefits using a rate based on the ratio of total employee benefit expenses to total salary and wages. Indirect costs were calculated as a percentage of direct costs. Column (f) for Rows (c)-(k) The percentage of Net Community Benefit Expense divided by Total Expense for the hospital (to calculate the percent of total expense). Note: For the entire Northwell Health Inc. and affiliates, Part I, Line 7 (Row K, Column F) is approximately 12.7 as a percentage of expenses. Part II: All community building activities improve access to health services and address federal, state, or local public health priorities, as well as leverage public health department activities, and in doing so, they provide relief of government burden. These activities broadly serve low-income, underserved patients, and include: collaboration with various community coalitions, system-wide recycling initiative, organizational response to worldly disasters, and bioterrorism efforts. Northwell has taken the lead in increasing awareness of gun violence as a public health issue. The Gun Violence Prevention Forum brought together physicians, researchers, policy experts, health care executives, NYPD counterterrorism and victims' advocates to share their thoughts on how leaders in health care can address this national public health crisis. Northwell's bioterrorism & disaster preparedness includes Center for Emergency Medical Services, has a designated Bioterrorism Resource Center, and has conducted staff training for more than 100 hospitals and area first responders and invested heavily in the infrastructure needed for large-scale emergencies. During catastrophes (both natural and terrorism), Northwell provides a safe haven for thousands of patients, outside nursing home residents, and community members seeking shelter. Northwell assists with the transport of patients and stand ready to contribute food, medicine, and blankets for both affiliated and non-affiliated hospital patients. Investment in a field hospital has furthered the public health infrastructure needed for mass casualties that could result from a terrorist attack, natural attack, or large-scale emergency. Part III, Line 2: For patients who were determined by Northwell to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. The amount of gross charges written off is reduced by any charity care or other discounts provided to the patient, as well as any payments received. Bad debt expense reported on this line is reported net of governmental or private offsetting funds. Part III, Line 3: N/A Part III, Line 4: For patients who were determined by Northwell to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. Part III, Line 8: Medicare costs are determined utilizing a combination of the step down method of cost findings and a cost per unit of service. Cost per unit of service is used to calculate the routine cost of services provided to Medicare patients. The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. An RCC is developed from these costs, and that RCC is applied to total Medicare gross ancillary services charges to determine the cost of services provided to Medicare patients. Part III, Line 9b: The organization's collection policy is standard to all accounts regardless of insurance status (e.g. insured, underinsured, and uninsured). The hospital's collection policy states that they will not send patient accounts to collection if a decision on a financial assistance application is pending, or if a patient is determined to be eligible for Medicaid at the time services were rendered and for which services Medicaid payment is available. Question 2: NEEDS ASSESSMENT: The Community Health Needs Assessment (CHNA) is performed on an ongoing basis. Northwell conducts and participates in population, demographic, and health status evaluations of our respective hospitals' service areas based on county regions and the communities we serve. There is a special effort to include individuals with health disparities and organizations who serve these communities in the CHNA process. The CHNA includes the analysis of primary and secondary data. Multi-year analyses, trends and projections are developed, which identify areas of need for the continuum of health care services. Primary data is obtained through a combination of qualitative analysis of community-based organization (CBO), informant interviews and surveys, individual community member surveys, and participation in collaborative partner meetings. These meetings include representatives from the Departments of Health, CBOs, academic institutions, government agencies, and hospitals. Ongoing input concerning our communities' needs is also obtained through: our Board of Trustees/Directors who are all area residents and leaders in their respective communities; facility based advisory boards and councils, and; the feedback received by our facility administrators and clinicians that serve on local community agency boards. Secondary data analysis includes: internal hospital data, including Prevention Quality Indicators (PQI); Department of Health Community Health Assessments; local regional NYS Prevention Agenda data sources; and Statewide Planning and Research System (SPARCS) data. The Committee on Community Health, a committee of the Board of Trustees, provides recommendations that concern Northwell's community health priorities and interventions based on the CHNA. Committee discussions focus on New York State (NYS) Prevention Agenda Priority Areas, including strategies and intervention outcomes related to chronic disease prevention especially in at risk and diverse communities (Cancer, Diabetes, CVD, Obesity), healthy safe environments, health access, changes in the built environment - housing and access to affordable food, mental health and substance abuse and need for better health literacy. Regional departments of health (I.E. Nassau County Department of Health, Suffolk County Department of Health Services, and NYC Department of Health and Mental Hygiene) perform additional community health assessments (CHA) with the input of hospital and community stakeholders. These regional partners use strategies such as community member surveys, CBO surveys, and public listening sessions to solicit inform X X X X X true false false false false false false true false AGOSTINO CERVONE Trustee/Physician 0 374999 0 0 0 30800 0 0 405799 0 0 STEVEN OUZOUNIAN Trustee/Physician 0 391249 0 0 0 30800 0 0 422049 0 0 RALPH NAPPI Trustee/EVC Northwell 0 754221 0 164063 0 32929 0 30800 0 22535 0 1004548 0 0 SUSAN SOMERVILLE VP, Strategic Initiatives 0 290061 0 86780 0 9794 0 30800 0 22535 0 439970 0 0 ANDREW MITCHELL President & CEO 820432 0 286912 0 23308 0 30800 0 22535 0 1183987 0 0 0 MICHAEL O'DONNELL CFO 370423 0 70084 0 28251 0 30800 0 33503 0 533061 0 0 0 AMY LOEB CNO 287385 0 86780 0 3672 0 30800 0 33454 0 442091 0 0 0 RONALD MCMANUS Former COO 8291 0 0 309947 0 0 10651 0 328889 0 0 0 ARTHUR CROWE COO 262619 0 36780 0 4536 0 30800 0 22924 0 357659 0 0 0 SAMANTHA VIGLIOTTA VP, Foundation & Extnl Affairs 209315 0 26348 0 3180 0 30800 0 33454 0 303097 0 0 0 MONICA RAULS VP, Human Resources 204124 0 27820 0 2788 0 30800 0 600 0 266132 0 0 0 STEPHEN JOHN Physician/Hospitalist 201121 0 0 228805 0 30800 0 11551 0 472277 0 0 0 LAWRENCE WALSER Dir, Critical Care 327032 0 0 6673 0 30800 0 18025 0 382530 0 0 0 MARIE DORVAL-DORCELY Physician/Hospitalist 206129 0 0 85291 0 30800 0 21303 0 343523 0 0 0 APRIL CAPERNA Dir, Geriatric & Palliative Md 264526 0 9600 0 2060 0 30800 0 33454 0 340440 0 0 0 MAHMOOD AFGHANI Physician/Hospitalist 201291 0 0 63442 0 30800 0 33454 0 328987 0 0 0 PART I, LINE 4A - SEVERANCE PAY INCLUDED IN THIS YEAR'S COMPENSATION IS SEVERANCE PAY FOR THE FOLLOWING LISTED EMPLOYEES: RONALD MCMANUS ($294,403). PART I, LINE 7 On Form 990, Part VII, Section A, line 1A, the organization may provide non-fixed payments, not described on lines 5 and 6, to certain listed persons. The organization bases such payments on many performance based factors. Payments of this type appear on Schedule J, Part II, B (ii). A TOWN OF RIVERHEAD INDUSTRIAL DEVELOPMENT 112560077 000000000 2015-05-06 34070000 REFUND BONDS (6/23/06 & 6/27/07) false false false A 8505000 0 34070000 0 0 0 0 0 0 0 34070000 0 true false true true A false false false false 0 true false false false A false false true true true true HSBC 17.2 false false false 0 false false A false STEVEN OUZOUNIAN MD BOARD MEMBER 75000 DIRECTORSHIP AGREEMENT false RICHARD ISRAEL BOARD MEMBER 531331 RENTAL PROPERTY false PART VI, SECTION A - GOVERNING BODY, LINE 6 & 7 NORTHWELL HEALTHCARE, INC. ("NORTHWELL HEALTHCARE") IS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION. NORTHWELL HEALTHCARE HAS THE RIGHT TO ELECT OR APPOINT MEMBERS OF THE ORGANIZATION'S GOVERNING BODY AND HAS THE RIGHT TO APPROVE OR RATIFY CERTAIN CORPORATE DECISIONS. THIS ORGANIZATION AND NORTHWELL HEALTHCARE ARE PART OF NORTHWELL HEALTH, INC., AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. PART VI, SECTION B - POLICIES, LINE 11 THE ANNUAL RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) FOR NORTHWELL HEALTH, INC. AND AFFILIATED ENTITIES ARE PREPARED WITH INPUT FROM VARIOUS DEPARTMENTS INCLUDING CORPORATE COMPLIANCE, FINANCE, HUMAN RESOURCES, AND LEGAL. BEFORE FILING THE RETURNS, THE DOCUMENTS ARE ELECTRONICALLY MADE AVAILABLE TO ALL TRUSTEES THROUGH A SECURE ONLINE PORTAL. MEMBERS OF THE EXECUTIVE COMMITTEE ARE THEN INFORMED THE RETURNS ARE READY FOR REVIEW. THE EXECUTIVE COMMITTEE, WHICH IS A COMMITTEE MADE UP OF MEMBERS FROM THE BOARD OF TRUSTEES, MAY EXERCISE ALL OF THE AUTHORITY OF THE BOARD OF TRUSTEES EXCEPT AS SUCH AUTHORITY IS LIMITED BY APPLICABLE LAW AND EXCEPT TO THE EXTENT, IF ANY, THAT SUCH AUTHORITY WOULD BE INCONSISTENT WITH ANY PROVISION OF THESE BY-LAWS OR IS LIMITED BY ANY RESOLUTION TO SUCH EFFECT ADOPTED BY THE BOARD OF TRUSTEES. PART VI, SECTION B - POLICIES, LINE 12C THE CONFLICTS OF INTEREST POLICY APPLIES TO MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, VICE PRESIDENTS, ASSISTANT VICE PRESIDENTS, DEPARTMENT HEADS, CLINICAL DIRECTORS OF DEPARTMENTS AND OTHER EMPLOYEES (INCLUDING PHYSICIANS) WHO ARE IN A POSITION TO INFLUENCE ANY SUBSTANTIVE BUSINESS DECISIONS BETWEEN CSH AND VENDORS. THE DIRECTOR OF CORPORATE COMPLIANCE CONTINUOUSLY MONITORS ALL TRANSACTIONS TO DETERMINE IF ANY POTENTIAL CONFLICT EXISTS. IF IT IS DETERMINED THAT A POTENTIAL CONFLICT EXISTS, THE INDIVIDUAL IS PROHIBITED FROM PARTICIPATING IN THE DECISION OF THE TRANSACTION. PART VI, SECTION B - POLICIES, LINE 15A CENTRAL SUFFOLK HOSPITAL UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2018. PART VI, SECTION C - DISCLOSURES, LINE 19 CURRENTLY THE ORGANIZATION PROVIDES GOVERNANCE DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. PART VII, SECTION A - LINE 1A Marc Alessi, Esq Andrew J. Mitchell Agostino Cervone, MD Richard Musto Emilie Roy Corey, MSW Anne K. Nolon Michael Dempsey, MD Steven Ouzounian, MD Father Larry Duncklee Sharon Patterson J. Gordon Huszagh Rev. George Summers Richard Israel Carol Aspinall Joan Levan Richard Winslow, PHD Kareem Massoud Stanley Zinberg, MD Amy Loeb Ralph Nappi Andrew S. Mendelson Robert F. Rose PART XI, LINE 9 - RECONCILIATION OF NET ASSETS NET ASSETS RELEASED FROM RESTRICTION 468,074 TRANSFER FROM AFFILIATES 15,899,413 CHANGE IN FAIR VALUE OF DERIVATIVES (579,820) CHANGE IN EQUITY UNDER FAS 136 5,478,780 PRIOR PERIOD ADJUSTMENT (149,644) TOTAL 21,116,803 Brightwaters Gynecology PC 972 Brush Hollow Rd Westbury NY 11590 821883445 Medical Servi NY 501(C)(3) 10 NSUH false Brooklyn Ambulatory Care PC 972 Brush Hollow Rd Westbury NY 11590 474447289 Medical Servi NY 501(C)(3) 12, Type I NSUH false Carnegie Cardiovascular PC 972 Brush Hollow Rd Westbury NY 11590 474377825 Medical Servi NY 501(C)(3) 12, Type I Lenox Hill false CLNY Alliance Inc 972 Brush Hollow Rd Westbury NY 11590 463146870 Laboratory NY 501(C)(3) 3 NW Labs false Community Drive Surgery PC 972 Brush Hollow Rd Westbury NY 11590 821672429 Medical Servi NY 501(C)(3) 12, Type I NSUH false Glen Cove Hospital 972 Brush Hollow Rd Westbury NY 11590 111633487 Health Care NY 501(C)(3) 3 Northwell He false Harbor View Medical Services PC 75 North Country Rd Port Jefferson NY 11777 264517010 Supporting Or NY 501(C)(3) 12, Type I Mather false Hillside Hospital Houses Inc 972 Brush Hollow Rd Westbury NY 11590 112113949 Housing Comp NY 501(C)(2) N/A Northwell He false Hospice Care in Westchester and Putnam 540 White Plains Rd Tarrytown NY 10591 133882602 Hospice Care NY 501(C)(3) 10 VNA Hudson false Hospice Care Network 99 Sunnyside Blvd Woodbury NY 11797 112925757 Hospice NY 501(C)(3) 9 Northwell He false Huntington Hospital Association 270 Park Avenue Huntington NY 11743 111630914 Health Care NY 501(C)(3) 3 Northwell He false Huntington Hospital Dolan Family Health 284 Pulaski Rd Greenlawn NY 11740 113368503 Health Care NY 501(C)(3) 3 Huntington false John T Mather Memorial Hospital 75 North Country Rd Port Jefferson NY 11777 111639818 Health Care NY 501(C)(3) 3 Healthcare false Lakeville Surgery PC 972 Brush Hollow Rd Westbury NY 11590 474377760 Medical Servi NY 501(C)(3) 10 Lenox Hill false Lenox Hill Hospital 972 Brush Hollow Rd Westbury NY 11590 131624070 Health Care NY 501(C)(3) 3 Northwell He false Lenox Hill Hospital Medical PC 972 Brush Hollow Rd Westbury NY 11590 452661543 Medical Servi NY 501(C)(3) 10 Lenox Hill false Lenox Hill Pathology PC 972 Brush Hollow Rd Westbury NY 11590 133644370 Medical Servi NY 501(C)(3) 12, Type I Lenox Hill false Lenox Otolaryngology Head & Neck Surgery 972 Brush Hollow Rd Westbury NY 11590 208784395 Medical Servi NY 501(C)(3) 12, Type I Lenox Hill false LHH Corporation 972 Brush Hollow Rd Westbury NY 11590 133272016 Supporting Or NY 501(C)(3) 12, Type I Northwell He false LIJ Foundation 972 Brush Hollow Rd Westbury NY 11590 112661239 Supporting Or NY 501(C)(3) 12, Type I Northwell He false Long Island Jewish Medical Center 972 Brush Hollow Rd Westbury NY 11590 112241326 Health Care NY 501(C)(3) 3 Northwell He false Long Island Jewish Medical Center at Hom 972 Brush Hollow Rd Westbury NY 11590 113251128 Supporting Or NY 501(C)(3) 12, Type I Northwell He false Marcus Avenue Medical PC 972 Brush Hollow Rd Westbury NY 11590 810861452 Medical Servi NY 501(C)(3) 12, Type I NSUH false Medical Care of Queens PC 972 Brush Hollow Rd Westbury NY 11590 474377679 Medical Servi NY 501(C)(3) 12, Type I Lenox Hill false NORCORP Inc 400 East Main Street Mount Kisco NY 10549 133366748 Support Org NY 501(C)(3) 12, Type I NWHA false North Shore Community Services Inc 972 Brush Hollow Rd Westbury NY 11590 237273200 Housing Comp NY 501(C)(2) N/A Northwell He false North Shore-LIJ Medical Care Centers 972 Brush Hollow Rd Westbury NY 11590 113473923 Supporting Or NY 501(C)(3) 12, Type I Northwell He false North Shore University Hospital 972 Brush Hollow Rd Westbury NY 11590 111562701 Health Care NY 501(C)(3) 3 Northwell He false North Shore University Hospital at Glen 972 Brush Hollow Rd Westbury NY 11590 237010468 Housing Comp NY 501(C)(2) N/A Northwell He false North Shore University Hospital Housing 972 Brush Hollow Rd Westbury NY 11590 112171903 Housing Comp NY 501(C)(2) N/A Northwell He false North Shore-LIJ Anesthesiology PC 972 Brush Hollow Rd Westbury NY 11590 461617561 Medical Servi NY 501(C)(3) 12, Type I SSIDE false North Shore-LIJ Cardiology at Deer Park 972 Brush Hollow Rd Westbury NY 11590 275078531 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ Cardiovascular Medicine 972 Brush Hollow Rd Westbury NY 11590 275078717 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ Health Plan Inc 972 Brush Hollow Rd Westbury NY 11590 461617516 Insurance NY 501(C)(3) 9 Health Plan false Northwell Health Plans Holding Company 972 Brush Hollow Rd Westbury NY 11590 462478147 Holding Compa NY 501(C)(3) 12, Type II Northwell He false North Shore-LIJ Heart Surgery PC 972 Brush Hollow Rd Westbury NY 11590 275078838 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ Internal Medicine at Lyn 972 Brush Hollow Rd Westbury NY 11590 463475908 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ Internal Medicine at New 972 Brush Hollow Rd Westbury NY 11590 462822879 Medical Servi NY 501(C)(3) 10 NSUH false North Shore-LIJ Internal Medicine PC 972 Brush Hollow Rd Westbury NY 11590 275078631 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ Medical Group at Hunting 972 Brush Hollow Rd Westbury NY 11590 274384049 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ Medical Group at North N 972 Brush Hollow Rd Westbury NY 11590 274384146 Medical Servi NY 501(C)(3) 10 NSUH false North Shore-LIJ Medical Group at Syosset 972 Brush Hollow Rd Westbury NY 11590 273957752 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ Medical Group PC 972 Brush Hollow Rd Westbury NY 11590 274384249 Medical Servi NY 501(C)(3) 10 NSUH false North Shore-LIJ Medical Group Urgent Med 972 Brush Hollow Rd Westbury NY 11590 275078426 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ Medical PC 972 Brush Hollow Rd Westbury NY 11590 453023019 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ OB-GYN at Garden City P 972 Brush Hollow Rd Westbury NY 11590 462886776 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ OB-GYN at New Hyde Park 972 Brush Hollow Rd Westbury NY 11590 473722278 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ OB-GYN PC 972 Brush Hollow Rd Westbury NY 11590 461382916 Medical Servi NY 501(C)(3) 10 LIJMC false North Shore-LIJ Occupational Medicine PC 972 Brush Hollow Rd Westbury NY 11590 451004103 Medical Servi NY 501(C)(3) 10 NSUH false North Shore-LIJ Pediatrics of Suffolk Co 972 Brush Hollow Rd Westbury NY 11590 465746956 Medical Servi NY 501(C)(3) 12, Type I NSUH false North Shore-LIJ Radiology Services PC 972 Brush Hollow Rd Westbury NY 11590 223970667 Medical Servi NY 501(C)(3) 12, Type I NSUH false Northern Westchester Hospital Associatio 400 East Main Street Mount Kisco NY 10549 131740118 Health Care NY 501(C)(3) 3 Northwell He false Northern Westchester Hospital Center Fou 400 East Main Street Mount Kisco NY 10549 134067064 Foundation NY 501(C)(3) 9 NWHA false Northern Westchester Realty Holding Comp 400 East Main Street Mount Kisco NY 10549 912134215 Holding Compa NY 501(C)(2) N/A NWHA false Northwell Health Alliance Inc 972 Brush Hollow Rd Westbury NY 11590 263727582 Health Care NY 501(C)(3) 3 NA false Northwell Health Foundation 972 Brush Hollow Rd Westbury NY 11590 112965575 Fundraising NY 501(C)(3) 7 Northwell He false Northwell Health Laboratories 972 Brush Hollow Rd Westbury NY 11590 113412370 Supporting Or NY 501(C)(3) 12, Type I Northwell He false Northwell Health Stern Family Center for 972 Brush Hollow Rd Westbury NY 11590 237007485 Nursing Home NY 501(C)(3) 9 Northwell He false Northwell Health Inc 972 Brush Hollow Rd Westbury NY 11590 113418133 Supporting Or NY 501(C)(3) 12, Type I NA false Northwell Healthcare Inc 972 Brush Hollow Rd Westbury NY 11590 112965586 Supporting Or NY 501(C)(3) 12, Type I Northwell He false Northwell Proton Therapy PC 972 Brush Hollow Rd Westbury NY 11590 812766298 Medical Servi NY 501(C)(3) 10 NSUH false Northwell Quality and Medical Affairs I 972 Brush Hollow Rd Westbury NY 11590 824113233 Supporting Or NY 501(C)(3) 12, Type I Healthcare false Peconic Cardiology PC 972 Brush Hollow Rd Westbury NY 11590 813149464 Medical Servi NY 501(C)(3) 12, Type I NSUH false Phelps Medical Services PC 701 North Broadway Sleepy Hollow NY 10591 274416017 Medical Servi NY 501(C)(3) 12, Type I Phelps Memor false Phelps Memorial Hospital Association 701 North Broadway Sleepy Hollow NY 10591 131725076 Health Care NY 501(C)(3) 3 Northwell He false Physicians of Univeristy Hospital PC 1 Edgewater Plaza 6th Fl Staten Island NY 10305 200096809 Health Care NY 501(C)(3) 12, Type I SIUH false Plainview Hospital 972 Brush Hollow Rd Westbury NY 11590 113241243 Health Care NY 501(C)(3) 3 Northwell He false SIUH Systems Inc 475 Seaview Avenue Staten Island NY 10305 061074604 Fundraising NY 501(C)(3) 7 Northwell He false Southside Hospital 972 Brush Hollow Rd Westbury NY 11590 111667761 Health Care NY 501(C)(3) 3 Northwell He false Sports Physical Therapy Occupational Th 972 Brush Hollow Rd Westbury NY 11590 061655704 Health Care NY 501(C)(3) 9 LIJ false Staten Island Performing Provider System 972 Brush Hollow Rd Westbury NY 11590 472544659 DSRIP NY 501(C)(3) 10 NA false Staten Island University Hospital 475 Seaview Avenue Staten Island NY 10305 112868878 Health Care NY 501(C)(3) 3 Northwell He false Staten Island University Hospital Founda 360 Seaview Avenue Staten Island NY 10305 870765787 Fundraising NY 501(C)(3) 7 SIUH false Suite 130 Plastic Surgery PC 972 Brush Hollow Rd Westbury NY 11590 821772747 Medical Servi NY 501(C)(3) 12, Type I LIJ false The Calverton Foundation Inc 972 Brush Hollow Rd Westbury NY 11590 831118138 Medical Servi NY 501(C)(3) Applied For HCI false The Elmezzi Graduate School of Molecular 972 Brush Hollow Rd Westbury NY 11590 113284934 Graduate Scho NY 501(C)(3) 2 Research false The Feinstein Institute for Medical Rese 972 Brush Hollow Rd Westbury NY 11590 112673595 Research NY 501(C)(3) 4 Northwell He false The Heart Institute 475 Seaview Avenue Staten Island NY 10305 311757254 Inactive NY 501(C)(3) 12, Type I NA false The Long Island Home 400 Sunrise Hghwy Amityville NY 11701 112837244 Health Care NY 501(C)(3) 3 LHH Corporat false True North Flexstaff Inc 972 Brush Hollow Rd Westbury NY 11590 821446568 Medical Servi NY 501(C)(3) Applied For HCI false True North Patient Safety Organization 972 Brush Hollow Rd Westbury NY 11590 831429773 Medical Servi NY 501(C)(3) Applied For Northwell He false Virtual Health Medicine PC 972 Brush Hollow Rd Westbury NY 11590 274384326 Medical Servi NY 501(C)(3) 10 NSUH false Visiting Nurse Association of Hudson Val 540 White Plains Rd Tarrytown NY 10591 131739952 Home Health C NY 501(C)(3) 10 NW Healthcar false VNA Home Health Services Inc 540 White Plains Rd Tarrytown NY 10591 133690105 Home Health C NY 501(C)(3) 10 VNA Hudson false Westchester Health Medical PC 972 Brush Hollow Rd Westbury NY 11590 474539584 Medical Servi NY 501(C)(3) 12, Type I NSUH false True North Health Management Inc 972 Brush Hollow Rd Westbury NY 11590 813428274 Supporting Or NY 501(C)(3) 12, Type I Healthcare false Wellbridge Psychiatry PC 972 Brush Hollow Rd Westbury NY 11590 465495054 Medical Servi NY 501(C)(3) 12, Type I NSUH false Peconic Bay Medical Center Foundation 1 HEROES WAY RIVERHEAD NY 11901 200714587 FUNDRAISING/P NY 501(C)(3) 7 Peconic Bay false Brooklyn Ambulatory Services LLC 972 Brush Hollow Rd Westbury NY 11590 812910850 Medical Svcs NY Northwell Healt DHCH LLC 972 Brush Hollow Rd Westbury NY 11590 811030907 Medical Svcs NY Endoscopy Ventu Endo Group LLC 972 Brush Hollow Rd Westbury NY 11590 200248148 Medical Svcs NY Ventures GCSC Endoscopy Center of Long Island 972 Brush Hollow Rd Westbury NY 11590 260000980 Medical Svcs NY NS-LIJ Ventures Formativ Health Intermediate LLC 972 Brush Hollow Rd Westbury NY 11590 814614788 Holding Co DE Formativ Health Formativ Health LLC 972 Brush Hollow Rd Westbury NY 11590 813121231 Holding Co DE TN Health Svcs Hospital City LLC 972 Brush Hollow Rd Westbury NY 11590 474091780 Inactive DE Northwell Healt Krasnoff Consultative Services LLC 972 Brush Hollow Rd Westbury NY 11590 262838027 Consulting NY Care Mgmt Grp Melville SC LLC 1895 Walt Whitman Rd Melville NY 11747 203487522 Medical Svcs NY Melville ASC North Shore-LIJ and Yale New Haven Medic 972 Brush Hollow Rd Westbury NY 11590 464858222 Air Transport NY NSUH North Shore-LIJ Contract Research Organi 972 Brush Hollow Rd Westbury NY 11590 464469806 Research NY Health Care Northwell Genomics Alliance LLC 972 Brush Hollow Rd Westbury NY 11590 810826710 Inactive DE NWH Labs Northwell Health Sleep Lab LLC 972 Brush Hollow Rd Westbury NY 11590 821516748 Medical Svcs NY Sleep Holdings Phelps Professional Building Corp LP 777 North Broadway Sleepy Hollow NY 10591 133645137 Real Estate NY PMHA South Shore Surgery Center LLC 972 Brush Hollow Rd Westbury NY 11590 341997077 Medical Svcs NY Multispecialty Suffolk Surgery Center 972 Brush Hollow Rd Westbury NY 11590 200080609 Medical Svcs NY Multispecialty Technopath Northwell Health North Americ 972 Brush Hollow Rd Westbury NY 11590 822869458 Lab Services NY Technopath USA True North II DC LLC 972 Brush Hollow Rd Westbury NY 11590 352568005 Medical Svcs NY DC Holding True North IV DC LLC 972 Brush Hollow Rd Westbury NY 11590 611816900 Medical Svcs NY DC Holding True North Urgent Care LLC 972 Brush Hollow Rd Westbury NY 11590 464113494 Medical Svcs NY NSLIJ Urgent Ca True North V DC LLC 972 Brush Hollow Rd Westbury NY 11590 320518811 Medical Svcs NY DC Holding True North Rad-Onc MSO LLC 972 Brush Hollow Rd Westbury NY 11590 834660846 Medical Svcs NY Northwell Rad-O Regional Insurance Company LTD c/o Cedar House 41 Cedar Ave Hamilton BD HM 12 000000000 Insurance BD Healthcare C false false false false false false false false false false true false false true true true true true false false