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ST CHARLES HOSPITAL CORP: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
ST CHARLES HOSPITAL CORP (EIN 11-1871039)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-11-11
IRS object ID
202033169349305368
Schema version
2019v5.1
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)
Return2020-11-11T16:18:26-06:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1300 Madison AvenueAddressLine1Txt
CityNew YorkCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10017ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN111871039EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST CHARLES HOSPITAL CORPBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% CHS SERVICES INCInCareOfNm
Business Name ControlSTCHBusinessNameControlTxt
Phone6314746116PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 BELLE TERRE ROADAddressLine1Txt
CityPORT JEFFERSONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11777ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJAMES O'CONNORPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone5167051937PhoneNum
Signature2020-11-09SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAURA J PARELLOPreparerPersonNm
PTINP01080295PTIN
Phone6464713000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address155.201.35.69IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id13049920203165000084FederalOriginalSubmissionId
Federal Original Submission Id2020-11-11FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id3B584E6C6EC03F54C23492763082C94E75791172AtSubmissionCreationDeviceId
At Submission Filing Device IdBB937A9EAF0258E2900CA48AEBB9445B27FAB226AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerALAN D GUERCI MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 BELLE TERRE RDAddressLine1Txt
CityPORT JEFFERSONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11777ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$251,455,163GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttp://stcharleshospital.chsli.org/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1907FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionWE, AT CHS, HUMBLY JOIN TOGETHER TO BRING CHRISTS HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES.ActivityOrMissionDesc
Voting Members Governing Body23VotingMembersGoverningBodyCnt
Voting Members Independent22VotingMembersIndependentCnt
Total Employee2156TotalEmployeeCnt
Total Volunteers55TotalVolunteersCnt
Total Gross UBI$24,152TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$11,678NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$23,254,225PYContributionsGrantsAmt
CY Contributions Grants$24,281,075CYContributionsGrantsAmt
PY Program Service Revenue$225,563,472PYProgramServiceRevenueAmt
CY Program Service Revenue$222,651,806CYProgramServiceRevenueAmt
PY Investment Income$64,822PYInvestmentIncomeAmt
CY Investment Income$169,715CYInvestmentIncomeAmt
PY Other Revenue$4,457,071PYOtherRevenueAmt
CY Other Revenue$4,352,567CYOtherRevenueAmt
PY Total Revenue$253,339,590PYTotalRevenueAmt
CY Total Revenue$251,455,163CYTotalRevenueAmt
PY Grants And Similar Paid$708,030PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$1,114,697CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$124,982,409PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$129,279,072CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$113,118,188PYOtherExpensesAmt
CY Other Expenses$113,186,393CYOtherExpensesAmt
PY Total Expenses$238,808,627PYTotalExpensesAmt
CY Total Expenses$243,580,162CYTotalExpensesAmt
PY Revenues Less Expenses$14,530,963PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$7,875,001CYRevenuesLessExpensesAmt
Total Assets BOY$128,665,447TotalAssetsBOYAmt
Total Assets EOY$118,974,822TotalAssetsEOYAmt
Total Liabilities BOY$151,840,389TotalLiabilitiesBOYAmt
Total Liabilities EOY$140,844,633TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$23,174,942NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$21,869,811NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$211,599,386ExpenseAmt
Grant$1,114,697GrantAmt
Revenue$225,293,488RevenueAmt
DescST. CHARLES HOSPITAL CORP IS A 243 BED REHABILITATION AND ACUTE CARE HOSPITAL THAT ALSO OPERATES OUTPATIENT FACILITIES IN BOTH NASSAU AND SUFFOLK COUNTIES. FOUNDED BY THE DAUGHTERS OF WISDOM IN 1907, ST. CHARLES PROVIDES A FULL RANGE OF HEALTHCARE SERVICES. IN 2019 ST. CHARLES HAD 11,583 DISCHARGED AND PROVIDED 20,932 EMERGENCY ROOM VISITS. ST. CHARLES PROVIDES CARE REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY AND ALONG WITH OTHER COMMUNITY SERVICE AND CHARITABLE ACTIVITIES.Desc
Total Program Service Expenses$211,599,386TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document161IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee2156EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members23GoverningBodyVotingMembersCnt
Independent Voting Member22IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCHS SERVICES INCPersonNm
Phone5167053700PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1992 NORTH VILLAGE AVENUEAddressLine1Txt
CityROCKVILLE CENTRECityNm
State AbbreviationNYStateAbbreviationCd
ZIP11570ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (33 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndKey EmployeeKeyEmployeeInd
ALAN D GUERCI MD
PRESIDENT & CEO50.00.0Yes (X)Yes (X)$0$2,421,964$388,984
MORGAN CHEN MD
PHYSICIAN50.00.0$2,276,840$0$49,902Yes (X)
SATHISH SUBBAIAH MD
PHYSICIAN50.00.0$2,276,840$0$49,901Yes (X)
DIMTRIOS CHRISTOFOROU
PHYSICIAN50.00.0$1,638,418$0$40,293Yes (X)
DANIEL DEBARBA
EVP & CFO50.00.0Yes (X)$0$1,192,885$386,743
DOUGLAS PETRACO MD
PHYSICIAN50.00.0$1,284,850$0$48,674Yes (X)
STEVEN PUOPOLO MD
PHYSICIAN50.00.0$1,178,630$0$51,728Yes (X)
WILLIAM ARMSTRONG
SVP FINANCE0.050.0$0$895,555$205,430Yes (X)
JAMES O'CONNOR
CAO50.00.0Yes (X)$671,852$0$155,756
RONALD WEINGARTNER
COO50.00.0$360,519$0$50,211Yes (X)
SUNIL DHUPER MD
CMO50.00.0$359,098$0$37,777Yes (X)
SALVATORE SODANO
CHAIR2.00.0Yes (X)Yes (X)$0$0$0
BRIAN MCGUIRE
VICE CHAIR2.00.0Yes (X)Yes (X)$0$0$0
JEROME POLLER
SECRETARY2.00.0Yes (X)Yes (X)$0$0$0
ROBERT ZUCCARO
TREASURER2.00.0Yes (X)Yes (X)$0$0$0
CHRIS PASCUCCI
TRUSTEE2.00.0Yes (X)$0$0$0
BARBARA ELLEN BLACK
TRUSTEE2.00.0Yes (X)$0$0$0
VIRGINIA EWEN
TRUSTEE2.00.0Yes (X)$0$0$0
FRANK L KURRE
TRUSTEE2.00.0Yes (X)$0$0$0
REV MSGR ROBERT MORR
TRUSTEE2.00.0Yes (X)$0$0$0
DANIEL T ROWE
TRUSTEE2.00.0Yes (X)$0$0$0
JOHN WAGNER
TRUSTEE2.00.0Yes (X)$0$0$0
REV JOHN MCCARTNEY
TRUSTEE2.00.0Yes (X)$0$0$0
KEVIN J CONWAY
TRUSTEE2.00.0Yes (X)$0$0$0
PETER D'ANGELO
TRUSTEE2.00.0Yes (X)$0$0$0
REV PETER DUGANDZIC
TRUSTEE2.00.0Yes (X)$0$0$0
HON ANTHONY MARANO
TRUSTEE2.00.0Yes (X)$0$0$0
STEPHEN F MCLOUGHLIN
TRUSTEE2.00.0Yes (X)$0$0$0
JOHN FRANCFORT MD
TRUSTEE2.00.0Yes (X)$0$0$0
ALEXANDER HAZELTON
TRUSTEE2.00.0Yes (X)$0$0$0
WILLIAM WARD
TRUSTEE2.00.0Yes (X)$0$0$0
PETER QUICK
TRUSTEE2.00.0Yes (X)$0$0$0
THOMAS CHRISTMAN
TRUSTEE2.00.0Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$10,047,047TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$4,510,404TotReportableCompRltdOrgAmt
Total Other Compensation$1,465,399TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K292IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ORTHOPEDIC ASSOC OF LI PHYS MED
6 TECHNOLOGY DRIVE SUITE 1000EAST SETAUKETNY11733PHYSICIAN SERVICES$817,614
LI MINIMALLY INVASIVE SURG PC
3003 NEW HYDE PARK RD SUITE 307NEW HYDE PARKNY11042PHYSICIAN SERVICES$671,654
ISLAND NEONATOLOGY LLC
PO BOX 272EAST ISLIPNY11730PHYSICIAN SERVICES$626,713
REMI HOLDINGS LLC
11325 N COMMUNITY HOUSE ROAD SUITECHARLOTTESC28277EQUIPMENT SERVICES$504,813
INTERBORO SURGICAL ASSOCIATION
8318 4TH AVEBROOKLYNNY11209PHYSICIAN SERVICES$423,333
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K26CntrctRcvdGreaterThan100KCnt
Related Organizations$24,027,327RelatedOrganizationsAmt
Government Grants$211,917GovernmentGrantsAmt
All Other Contributions$41,831AllOtherContributionsAmt
Total Contributions$24,281,075TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Business622110BusinessCd
Total Revenue Column$222,651,806TotalRevenueColumnAmt
Related Or Exempt Func Income$222,627,654RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$24,152UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$222,651,806TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$169,715TotalRevenueColumnAmt
Exclusion$169,715ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,101,555RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$1,101,555RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,101,555TotalRevenueColumnAmt
Exclusion$1,101,555ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
COFFEE SHOP722514$585,178$585,178
PHARMACY INCOME446110$367,729$367,729
REHAB SERVICES624310$832,936$832,936

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,465,169TotalRevenueColumnAmt
Related Or Exempt Func Income$1,465,169RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$3,251,012OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$251,455,163TotalRevenueColumnAmt
Related Or Exempt Func Income$225,293,488RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$24,152UnrelatedBusinessRevenueAmt
Exclusion$1,856,448ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$1,114,697TotalAmt
Program Services$1,114,697ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,635,213TotalAmt
Program Services$396,875ProgramServicesAmt
Management And General$1,238,338ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$92,995,504TotalAmt
Program Services$85,724,102ProgramServicesAmt
Management And General$7,271,402ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$8,585,974TotalAmt
Program Services$7,811,949ProgramServicesAmt
Management And General$774,025ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$17,376,822TotalAmt
Program Services$15,500,814ProgramServicesAmt
Management And General$1,876,008ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$8,685,559TotalAmt
Program Services$7,902,556ProgramServicesAmt
Management And General$783,003ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$387,070TotalAmt
Program Services$309,129ProgramServicesAmt
Management And General$77,941ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$14,714TotalAmt
Management And General$14,714ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$122,814TotalAmt
Management And General$122,814ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$9,173,816TotalAmt
Program Services$7,583,397ProgramServicesAmt
Management And General$1,590,419ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$566,033TotalAmt
Program Services$3,975ProgramServicesAmt
Management And General$562,058ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,437,367TotalAmt
Program Services$1,777,201ProgramServicesAmt
Management And General$1,660,166ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,349,940TotalAmt
Program Services$3,655,765ProgramServicesAmt
Management And General$694,175ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$177,198TotalAmt
Program Services$163,258ProgramServicesAmt
Management And General$13,940ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,438,969TotalAmt
Program Services$1,438,969ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$2,739,852TotalAmt
Program Services$2,739,852ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$7,041,574TotalAmt
Program Services$5,139,876ProgramServicesAmt
Management And General$1,901,698ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,086,920TotalAmt
Program Services$5,086,920ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$24,846,076$24,846,076
CHS SERVICES$25,789,667$15,213,814$10,575,853
HOME OFFICE$2,780,584$2,780,584
PHYSICIAN PRACTICE SUBSIDY$20,998,721$20,998,721

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$4,235,078TotalAmt
Program Services$4,191,440ProgramServicesAmt
Management And General$43,638ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$243,580,162TotalAmt
Program Services$211,599,386ProgramServicesAmt
Management And General$31,980,776ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,653,153BOYAmt
EOY$1,716,127EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,901,149BOYAmt
EOY$2,089,182EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$28,321,890BOYAmt
EOY$23,023,623EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,036,029BOYAmt
EOY$4,107,234EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,151,492BOYAmt
EOY$1,759,596EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$222,860,482LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$166,548,660LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$54,469,310BOYAmt
EOY$56,311,822EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$288,628BOYAmt
EOY$366,809EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$35,843,796BOYAmt
EOY$29,600,429EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$128,665,447BOYAmt
EOY$118,974,822EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$30,990,494BOYAmt
EOY$26,347,427EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$36,079,106BOYAmt
EOY$31,767,660EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$84,770,789BOYAmt
EOY$82,729,546EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$151,840,389BOYAmt
EOY$140,844,633EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$24,365,226BOYAmt
EOY-$23,059,550EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,190,284BOYAmt
EOY$1,189,739EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$23,174,942BOYAmt
EOY-$21,869,811EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$128,665,447BOYAmt
EOY$118,974,822EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$7,875,001ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$74,686NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$6,644,556OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$122,814OtherActivitiesAmt
Total Lobbying Expenditures$122,814TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1 - LOBBYING ACTIVITIESFormAndLineReferenceDesc
ExplanationAMOUNT REFLECTS PORTION OF TRADE ASSOCIATION DUES WHICH WERE USED FOR LEGISLATIVE LOBBYING ON BEHALF OF THE HEALTHCARE INDUSTRY THOSE TRADE ASSOCIATIONS REPRESENT.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$775,960BeginningYearBalanceAmt
Investment Earnings Or Losses$19,391InvestmentEarningsOrLossesAmt
Other Expenditures$19,391OtherExpendituresAmt
End Year Balance$775,960EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$775,960BeginningYearBalanceAmt
Investment Earnings Or Losses$10,430InvestmentEarningsOrLossesAmt
Other Expenditures$10,430OtherExpendituresAmt
End Year Balance$775,960EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$775,960BeginningYearBalanceAmt
Investment Earnings Or Losses$1,198InvestmentEarningsOrLossesAmt
Other Expenditures$1,198OtherExpendituresAmt
End Year Balance$775,960EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$775,960BeginningYearBalanceAmt
Investment Earnings Or Losses$479InvestmentEarningsOrLossesAmt
Other Expenditures$479OtherExpendituresAmt
End Year Balance$775,960EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$775,960BeginningYearBalanceAmt
Investment Earnings Or Losses$477InvestmentEarningsOrLossesAmt
Other Expenditures$477OtherExpendituresAmt
End Year Balance$775,960EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$38,000OtherCostOrOtherBasisAmt
Book Value$38,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$106,660,517OtherCostOrOtherBasisAmt
Depreciation$73,778,812DepreciationAmt
Book Value$32,881,705BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$338,008OtherCostOrOtherBasisAmt
Depreciation$8,325DepreciationAmt
Book Value$329,683BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$107,402,006OtherCostOrOtherBasisAmt
Depreciation$87,853,626DepreciationAmt
Book Value$19,548,380BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,421,951OtherCostOrOtherBasisAmt
Depreciation$4,907,897DepreciationAmt
Book Value$3,514,054BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$56,311,822TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (4 entries)

DescDescBook ValueBookValueAmt
DUE FROM RELATED PARTIES, NET$928,000
OTHER RECEIVABLES, NET$1,348,534
OTHER ASSETS$113,652
INSURANCE CLAIMS RECEIVABLE$27,210,243
FieldValueIRS element (for citing)
Total Book Value Other Assets$29,600,429TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)

DescDescAmtAmt
SELF INSURANCE LIABILITIES$15,985,241
DUE TO RELATED PARTIES$32,041,711
THIRD PARTY PAYOR LIABILITIES$7,418,293
ESTIMATED MALPRACTICE$26,244,858
OTHER LIAB-POST RETIREMENT$140,000
OTHER LIAB-457B PLAN$899,443
FieldValueIRS element (for citing)
Total Liability$82,729,546TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4 - ENDOWMENT FUNDSTHE ENDOWMENT INVESTMENTS ARE TO BE HELD IN PERPETUITY, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT HEALTHCARE SERVICES.
PART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTECHS AND MOST OF ITS SUBSIDIARIES ARE 501(C)(3) ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. THESE ENTITIES ARE ALSO EXEMPT FROM NEW YORK STATE INCOME TAXES. THERE ARE VARIOUS SUBSIDIARIES OF CHS THAT ARE FOR PROFIT ENTITIES. TAXABLE OPERATIONS AND THE POTENTIAL FOR INCOME TAXES FROM THESE ENTITIES AND FROM UNRELATED BUSINESS ACTIVITIES OF THE TAX EXEMPT ENTITIES ARE NOT SIGNIFICANT TO THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. CHS ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE ACCOUNTING STANDARDS CODIFICATION (ASC) TOPIC 740, INCOME TAXES. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS, USING A THRESHOLD OF MORE LIKELY THAN NOT OF BEING SUSTAINED.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,521,750TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,685,264DirectOffsettingRevenueAmt
Total Expense0.00000TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$35,678,216TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,277,334DirectOffsettingRevenueAmt
Net Community Benefit Expns$19,400,882NetCommunityBenefitExpnsAmt
Total Expense0.07960TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,132,169TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$728,624DirectOffsettingRevenueAmt
Net Community Benefit Expns$403,545NetCommunityBenefitExpnsAmt
Total Expense0.00170TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$39,332,135TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$19,691,222DirectOffsettingRevenueAmt
Net Community Benefit Expns$19,804,427NetCommunityBenefitExpnsAmt
Total Expense0.08130TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$721,509TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$721,509NetCommunityBenefitExpnsAmt
Total Expense0.00300TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,466,166TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$527,514DirectOffsettingRevenueAmt
Net Community Benefit Expns$938,652NetCommunityBenefitExpnsAmt
Total Expense0.00390TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,568,096TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,708,753DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,859,343NetCommunityBenefitExpnsAmt
Total Expense0.00760TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$76,871TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$76,871NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,832,642TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,236,267DirectOffsettingRevenueAmt
Net Community Benefit Expns$3,596,375NetCommunityBenefitExpnsAmt
Total Expense0.01480TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$48,164,777TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$24,927,489DirectOffsettingRevenueAmt
Net Community Benefit Expns$23,400,802NetCommunityBenefitExpnsAmt
Total Expense0.09610TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$4,133,427BadDebtExpenseAmt
Reimbursed By Medicare$51,226,707ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$58,132,704CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$6,905,997MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST CHARLES HOSPITAL CORPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 BELLE TERRE ROADAddressLine1Txt
CityPORT JEFFERSONCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11777ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.STCHARLESHOSPITAL.CHSLI.ORG/WebsiteAddressTxt
State License5149001HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherREHABILITATIVE SERVICESOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST CHARLES HOSPITAL CORPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted19CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSTCHARLESHOSPITAL.CHSLI.ORG/OwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLWWW.CHSLI.ORGOtherWebsiteURLTxt
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt19ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.CHSLI.ORGStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.CHSLI.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.CHSLI.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.CHSLI.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Prospective Medicare MedicaidYes (X)ProspectiveMedicareMedicaidInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, SECTION B, LINE 3EIN 2019, MEMBERS OF THE LONG ISLAND HEALTH COLLABORATIVE REVIEWED EXTENSIVE DATA SETS SELECTED FROM BOTH PRIMARY AND SECONDARY DATA SOURCES TO IDENTIFY AND CONFIRM HEALTH NEEDS PRIORITIES FOR THE 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT CYCLE. DATA ANALYSIS EFFORTS WERE COORDINATED THROUGH THE LONG ISLAND POPULATION HEALTH IMPROVEMENT PROGRAM (PHIP), WITH THE PHIP SERVING AS THE CENTRALIZED DATA RETURN AND ANALYSIS HUB. COMMUNITY PARTNERS SELECTED THE FOLLOWING AREAS OF FOCUS FOR LONG ISLAND FROM THE NEW YORK STATE PREVENTION AGENDA PRIORITIES: (1) PREVENT CHRONIC DISEASE, FOCUS AREA 4: CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT, AND (2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS, FOCUS AREA 2: MENTAL AND SUBSTANCE USE DISORDERS PREVENTION.
PART V, SECTION B, LINE 5ST. CHARLES HOSPITAL CONDUCTED A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IN ASSOCIATION WITH LONG ISLAND HEALTH COLLABORATIVE (LIHC) MEMBERS. THE LIHC IS A PARTNERSHIP OF LONG ISLAND'S HOSPITALS, COUNTY HEALTH DEPARTMENTS, HEALTH PROVIDERS, COMMUNITY-BASED SOCIAL AND HUMAN SERVICE ORGANIZATIONS, ACADEMIC INSTITUTIONS, HEALTH PLANS, LOCAL GOVERNMENT, AND THE BUSINESS SECTOR, ALL ENGAGED IN IMPROVING THE HEALTH OF LONG ISLANDERS. THE LIHC IS THE MAIN WORKING GROUP ASSOCIATED WITH CARRYING OUT THE GOALS OF THE LONG ISLAND POPULATION HEALTH IMPROVEMENT PROGRAM. IN 2019, MEMBERS OF THE LIHC REVIEWED EXTENSIVE DATA SETS SELECTED FROM BOTH PRIMARY AND SECONDARY DATA SOURCES TO IDENTIFY AND CONFIRM PREVENTION AGENDA PRIORITIES FOR THE 2019-2021 COMMUNITY HEALTH NEEDS ASSESSMENT CYCLE. DATA ANALYSIS EFFORTS WERE COORDINATED THROUGH THE LIHC, WHICH SERVED AS THE CENTRALIZED DATA RETURN AND ANALYSIS HUB. PRIMARY DATA SOURCES INCLUDE THE LONG ISLAND AND EASTERN QUEENS COMMUNITY HEALTH ASSESSMENT SURVEY (CHAS) AND THE RESULTS FROM FOCUS GROUPS AND KEY COMMUNITY-BASED ORGANIZATION LEADER INTERVIEWS. SECONDARY DATA SOURCES COMPRISED PUBLICALLY-AVAILABLE DATA SETS WHICH WERE REVIEWED TO DETERMINE CHANGE IN HEALTH STATUS AND EMERGING ISSUES WITHIN SUFFOLK COUNTY. SOURCES OF SECONDARY DATA INCLUDED STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS), NEW YORK STATE PREVENTION AGENDA DASHBOARD, PREVENTION QUALITY INDICATORS (PQI), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS), EXTENDED BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (EBRFSS), NEW YORK STATE COMMUNITY HEALTH INDICATOR REPORTS (CHIRS) AND NEW YORK STATE VITAL STATISTICS. THE ENGAGEMENT OF THE BROADER COMMUNITY, FOR ASSESSMENT PROCESSES, IS ACHIEVED THROUGH THE LIHC AND ITS PARTNERS' ONGOING DISTRIBUTION OF THE LONG ISLAND AND EASTERN QUEENS COMMUNITY HEALTH ASSESSMENT (CHAS) SURVEY. THIS SURVEY IS OFFERED ONLINE VIA A SURVEYMONKEY LINK AND IS AVAILABLE TO RESIDENTS AT PUBLIC EVENTS, WORKSHOPS, EDUCATIONAL PROGRAMS, INTERVENTIONS, ETC., WHICH ARE OFFERED BY LIHC PARTNERS. IT IS ALSO DISTRIBUTED AMONG PHYSICIAN OFFICES, HOSPITAL WAITING AREAS, LIBRARIES, SCHOOLS, FEDERALLY-QUALIFIED HEALTH CLINICS, AND INSURANCE ENROLLMENT SITES, AMONG OTHER PUBLIC VENUES. THE LIHC AGGRESSIVELY PROMOTES THE SURVEY THROUGH SOCIAL MEDIA AND A LINK TO THE SURVEY IS ALSO AVAILABLE ON THE ST. CHARLES HOSPITAL's WEBSITE. RESULTS FROM THE CHAS ARE ANALYZED TWICE A YEAR. FINDINGS ARE SHARED WITH ALL LIHC PARTICIPANTS, WITH THE MEDIA, AND POSTED ON THE LIHC WEBSITE. SURVEYS WERE DISTRIBUTED BY PAPER AND ELECTRONICALLY, THROUGH SURVEY MONKEY, TO COMMUNITY MEMBERS FROM JANUARY 1, 2018 THROUGH DECEMBER 31, 2018 WITH 810 SURVEYS COLLECTED IN SUFFOLK COUNTY. A CERTIFIED TRANSLATION OF THE SURVEY IS AVAILABLE IN THE FOLLOWING LANGUAGES: SPANISH, POLISH AND HAITIAN CREOLE. LARGE PRINT COPIES ARE ALSO AVAILABLE TO THOSE LIVING WITH VISION IMPAIRMENT. FOR THIS ASSESSMENT CYCLE, THE LIHC ALSO ENGAGED THE COMMUNITY THROUGH FOCUS GROUPS AND KEY INFORMANT INTERVIEWS WITH LEADERS OF COMMUNITY-BASED ORGANIZATIONS (CBO). THE RESEARCH FIRM EUREKAFACTS, LLC CONDUCTED THE FOCUS GROUPS AND CBO INTERVIEWS, INTERPRETED THE RESULTS, AND PRODUCED THE REPORT. FOCUS GROUPS WERE HELD IN LOW-INCOME COMMUNITIES, RIVERHEAD, AND WYANDANCH.
PART V, SECTION B, LINE 6ALONG ISLAND COMMUNITY HOSPITAL, NORTHWELL HEALTH SYSTEM (HUNTINGTON HOSPITAL, SOUTHSIDE HOSPITAL, JOHN T. MATHER MEMORIAL HOSPITAL, PECONIC BAY MEDICAL CENTER), GOOD SAMARITAN HOSPITAL MEDICAL CENTER, ST. CATHERINE OF SIENA MEDICAL CENTER, STONY BROOK SOUTHAMPTON HOSPITAL, STONY BROOK UNIVERSITY HOSPITAL AND VETERANS AFFAIRS MEDICAL CENTER.
PART V, SECTION B, LINE 6BTHE HOSPITAL'S CHNA WAS CONDUCTED WITH NASSAU AND SUFFOLK HEALTH DEPARTMENTS, STONY BROOK UNIVERSITY, AND MORE THAN 40 COMMUNITY-BASED ORGANIZATIONS, COLLECTIVELY KNOWN AS THE LONG ISLAND HEALTH COLLABORATIVE (LIHC).
PART V, SECTION B, LINE 11COMMUNITY PARTNERS SELECTED THE FOLLOWING AREAS OF FOCUS FOR LONG ISLAND FROM THE NEW YORK STATE PREVENTION AGENDA PRIORITIES: (1) PREVENT CHRONIC DISEASE, FOCUS AREA 4: CHRONIC DISEASE PREVENTIVE CARE AND MANAGEMENT AND (2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS, FOCUS AREA 2: MENTAL AND SUBSTANCE USE DISORDERS PREVENTION. THE WORK PLAN FOR ADDRESSING THE IDENTIFIED NEEDS CAN BE FOUND IN THE CHNA APPENDIX E, PUBLICLY AVAILABLE ON THE HOSPITAL WEBSITE, HTTPS://STCHARLESHOSPITAL.CHSLI.ORG/. PRIORITY 1: PREVENT CHRONIC DISEASE, INTERVENTIONS INCLUDE CULTURAL COMPETENCY HEALTH LITERACY TRAIN-THE-TRAINER PROGRAM AND THE LIVE BETTER PUBLIC INFORMATION CAMPAIGN, BOTH DEVELOPED AND MANAGED BY LIHC. ST. CHARLES CENTER ALSO OFFERS REGULARLY SCHEDULED PREVENTIVE HEALTH SCREENINGS IN LOCAL COMMUNITIES, PARTICULARLY THOSE IN MEDICALLY-UNDERSERVED COMMUNITIES, INCLUDING BLOOD PRESSURE, BODY MASS INDEX (BMI), ORAL, HEAD AND NECK CANCER, AND COLON CANCER. FREE BLOOD PRESSURE SCREENINGS WERE OFFERED TO COMMUNITY MEMBERS IN COLLABORATION WITH THE ST. GERARD MAJELLA R.C. CHURCH, PORT JEFFERSON LIBRARY, LONGWOOD LIBRARY, AND THE EAST SETAUKET STOP AND SHOP; 140 INDIVIDUALS WERE SCREENED. COMMUNITY HEALTH EDUCATION PRESENTATIONS WERE HELD ON HEALTH TOPICS SUCH AS DIABETES, NUTRITION, FALLS PREVENTION, AND DEALING WITH STRESS; 65 PEOPLE PARTICIPATED IN THESE SESSIONS. HEALTHY SUNDAYS COMMUNITY OUTREACH EVENTS ARE HELD IN COLLABORATION WITH CHURCHES, HOUSES OF WORSHIP, AND COMMUNITY ORGANIZATIONS. FIVE EVENTS WERE HELD IN 2019 SERVING MORE THAN 200 COMMUNITY MEMBERS WITH 25 REFERRALS TO FREE FOLLOW-UP CARE. HEALTHY SUNDAYS INCLUDES HEALTH SCREENINGS, EDUCATION AND REFERRALS TO CARE, ALONG WITH SELECT PARTNERS OFFERING FREE OR DISCOUNTED SERVICES. SMOKING CESSATION PROGRAMS ARE OFFERED TO REDUCE THE RISK OF DISEASES CAUSED BY OR AFFECTED BY SMOKING. ST. CHARLES HOSTED A FREE ANNUAL HEALTH FAIR AT THE HOSPITAL OFFERING EDUCATION, FREE SCREENINGS, AND FLU VACCINATIONS. ST. CHARLES ALSO PARTICIPATED IN THE PORT JEFFERSON COMMUNITY HEALTH AND WELLNESS FAIR, PROVIDING HEALTH EDUCATION ON A VARIETY OF TOPICS. THE FAIR WAS ATTENDED BY MORE THAN 400 COMMUNITY MEMBERS. ST. CHARLES STAFF PARTICIPATED IN THE SUFFOLK COUNTY COMMUNITY COLLEGE HEALTH FAIR, PROVIDING EDUCATION MATERIAL FOR STUDENTS, INCLUDNG INFORMATION ON SPORTS MEDICINE AND INJURY PREVENTION AS WELL AS CONCUSSION MANAGEMENT. A FREE SEMINAR, COVERING STROKE EDUCATION AND INFORMATION ON HOW TO COPE AFTER A STROKE, WAS PRESENTED TO 270 COMMUNITY MEMBERS. PRIORITY 2: PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS, INTERVENTIONS INCLUDE: PROMOTION OF ALL PROGRAMS, EVENTS, AND EDUCATION OFFERED BY LIHC MEMBERS THAT SPEAK TO THE PREVENTION OF MENTAL AND SUBSTANCE USE DISORDERS. PARTICIPATION IN LOCAL TASK FORCES ADDRESSING OPIOID USE DISORDERS. ST. CHARLES HOSPITAL OFFERS FREE SUPPORT GROUPS OPEN TO ALL COMMUNITY MEMBERS, INCLUDING MONTHLY BARIATRIC SUPPORT GROUP, BRAIN INJURY SUPPORT GROUP, EPILEPSY SUPPORT GROUP, PARKINSONs DISEASE SUPPORT GROUP, MONTHLY AND SPINAL CORD INJURY SUPPORT GROUP; BI-MONTHLY MUSCULAR DYSTROPHY SUPPORT GROUP (MDA); WEEKLY SPEECH COMMUNICATION SUPPORT GROUP, AND WEEKLY BREASTFEEDING SUPPORT GROUP; AND BI-WEEKLY STROKE SUPPORT GROUP. ST. CHARLES HOSPITAL DISTRIBUES CHSS MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES GUIDE TO CHS PARTNERS WITHIN THE HOSPITAL AND AT HOSPITAL OUTREACH EVENTS. TO FURTHER THE CONTINUUM OF CARE FOR PATIENTS POST-DISCHARGE FROM BOTH THE DETOXIFICATION PROGRAM AND THE REHABILITATION PROGRAM, ST. CHARLES OFFERS NUMEROUS SUPPORT GROUPS POST-DISCHARGE, INCLUDING MONTHLY AL-ANON FAMILY SUPPORT GROUP MEETING-STEP MEETING; WEEKLY: AL-ANON FAMILY SUPPORT GROUP-BEGINNERS' MEETING, ALCOHOLICS ANONYMOUS BACK-TO-BASICS, ALCOHOLICS ANONYMOUS-LIVING SOBER, AND WEEKLY NARCOTICS ANONYMOUS. A FREE LECTURE WAS OFFERED TO SENIORS AND COVERED THE HEALTH EFFECTS OF STREE AND STRAGTEGIES FOR MANAGEMENT STRESS; 25 SENIORS PARTICIPATED. THE HOSPITAL ALSO PARTICIPATES IN COMMUNITY OUTREACH ACTIVITIES THAT ADDRESS OTHER NEW YORK STATE PREVENTION AGENDA PRIORITIES. ST. CHARLES, IN COLLABORATION WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH, OFFERED FREE LECTURES FOR SENIORS ON FALLS PREVENTION. THESE ARE HELD AT VARIOUS COMMUNITY LIBRARIES, FIRE DEPARTMENTS, SENIOR GROUPS, AND TOWN SENIOR CENTERS. IN 2019, 192 COMMUNITY MEMBERS ATTENDED THESE LECTURES. A FREE COMMUNITY LECTURE ENTITLED SING A SONG OF HEALTH WAS HELD AT A SENIOR CENTER AND DISCUSSED THE HEALTH BENEFITS OF MUSIC, INCLUDING REDUCED BLOOOD PRESSURE AND HEART RATE, REDUCED STRESS AND SOCIALIATION. THIRTY COMMUNITY MEMBERS PARTICIPATED. A FREE COMMUNITY LECTURE GEARED TOWARD CHILDREN AND THEIR PARENTS WAS OFFERED, COVERING NUTRITION AND HOW TO MAKE EATING NUTRITIOUS FOODS MORE EXCITING. THE SLEEP CLINIC AT ST. CHARLES HOSTED A LECTURE TO EDUCATE THE COMMUNITY ON THE SYMPTOMS AND TREATMENT FOR SLEEP DISPODERS; 22 COMMUNITY MEMBERS PARTICIPATED. THE HOSPITAL OFFERS THE THINK SMART! CONCUSSION MANAGEMENT PROGRAM WHICH PROVIDES BASELINE TESTING AND CONCUSSION EDUCATION TO PARENTS, SPORTS COACHES, AND SCHOOL DISTRICT ADMINISTRATORS ACROSS LONG ISLAND. ST. CHARLES OFFERS PACE CLASSES, WHICH IS AN EXERCISE PROGRAM FOR PERSONS LIVING WITH ARTHRITIS. THE CLASS ALSO ADDRESSES HOME SAFETY AND BALANCE, IN ADDITION TO EVIDENCE-BASED EXERCISES. AS A MEMBER OF CATHOLIC HEALTH SERVICES, HOSPITAL STAFF PARTICPATED IN THE AMERICAN CANCER SOCIETY MAKING STRIDES AGAINST BREAST CANCER WALK, THE SUFFOLK COUNTY MARATHON, SUPPORTING LOCAL VETERANS SERVICES, AND THE LONG ISLAND MARCUM WORKPLACE CHALLENGE, SUPPORTING SELECT LONG ISLAND CHARITIES. THE ST. CHARLES HOSPITAL DENTAL CLINIC OFFERS AN ANNUAL GIVE A VET A SMILE EVENT, OFFERING FREE DENTAL CLEANING, EXAMINATION, AND ANY REQUIRED DENTAL PROCEDURE. FOURTEEN COMMUNITY MEMBERS WERE PROVIDED FREE DENTAL SERVICES IN 2019. THE CLINICAL ALSO OFFERED FREE ORAL CANCER SCREENINGS TO COMMUNITY MEMBERS; 40 PERSONS WERE SERVED. THE ST. CHARLES SLEEP THERAPIST GAVE A LECTURE TO 18 COMMUNITY DENTISTS TO PROVIDE EDUCATION ON SLEEP APNEA, SLEEP TREATMENTS, AND THE ROLE OF THE DENTIST IN SLEEP MEDICINE. HOSPITAL STAFF PARTICIPATED IN THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SENIOR CELEBRATION, PROVIDING HEALTH RESOURCES INFORMATION TO SENIORS FOCUSING ON LONG-TERM CHRONIC DISEASE PREVENT, STROKE AND FALLS PREVENTION. MORE THAN 600 COMMUNITY MEMBERS ATTENDED THIS EVENT. ST. CHARLES HOSTS A BREASTFEEDING SUPPORT GROUP TO PROMOTE THE HEALTH BENEFITS OF BREASTFEEDING AND PROVIDE PEER SUPPORT TO NURSING MOTHERS. PROGRAMS THAT SUPPORT STAFF RESILIENCY SUCH AS DAILY PRAYER ARE OFFERED TO ALL EMPLOYEES. ST. CHARLES HOSTED 3 BLOOD DRIVES COLLECTING 353 PINTS OF BLOOD IN SUPPORT OF LONG ISLAND BLOOD SERVICES. THREE EDUCATION EVENTS FOR LOCAL EMS AND EMT PROVIDERS WERE HOSTED BY THE HOSPITAL. THE EVENT PROVIDES EDUCTION AND HONORS VOLUNTEERS WHO WORK FOR LOCAL EMS CREWS IN THE ST. CHARLES VICINITY. THE HOSPITAL CONDUCTS COLLECTION DRIVES FOR FOOD, CLOTHING, AND SCHOOL SUPPLIES, SUPPORTING LOCAL CHURCHES AND COMMUNITY CENTERS IN UNDERSERVED AREAS, AND ADOPT-A-FAMILY COLLECTIONS AT EASTER AND CHRISTMAS.
PART V, SECTION B, LINE 20EST. CHARLES HOSPITAL CORP HAS POSTED MULTILINGUAL NOTICES ABOUT ITS CHARITY CARE POLICIES IN SEVERAL PROMINENT LOCATIONS WITHIN ST. CHARLES HOSPITAL CORP INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREAS, SAID NOTICES ARE PUBLISHED IN ENGLISH AND SPANISH AND ARE CLEARLY VISIBLE TO THE PUBLIC. ST. CHARLES HOSPITAL CORP HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE.

Supplemental Information Detail SupplementalInformationDetail (11 entries)

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PART I, LINE 7 - RATIO OF PATIENT CARE COST TO CHARGES WORKSHEETRATIO OF PATIENT CARE COST TO CHARGES WORKSHEET (WORKSHEET 2) AS PRESCRIBED BY THE IRS INSTRUCTIONS TO SCHEDULE H FORM 990 WAS THE METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN PART I, LINE 7 CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST LINES 7A, 7B AND 7C AND 7D. ALL OTHER LINES INCLUDE COSTS THAT WERE DERIVED BASED ON THE RCC METHODOLOGY OR ACTUAL COSTS FOR THEIR SERVICES AS TRACKED BY HOSPITAL PERSONNNEL UTILIZING DIRECT HOURLY LABOR COSTS, FRINGES AND SUPPLY COSTS.
PART I, LINE 7A, COLUMN (D)DIRECT OFFSETTING REVENUES REPRESENT DISTRIBUTIONS FROM THE NEW YORK STATE (NYS) INDIGENT CARE POOL (ICP) WHICH IS SHOWN NET OF HOSPITAL CONTRIBUTIONS TO THE STATEWIDE POOL. THE FORMULA EMPLOYED BY NYS TO DETERMINE DISTRIBUTIONS TO HOSPITALS FROM THE ICP IS COMPLEX AND IS DERIVED FROM A HOSPITAL'S "NEED" CALCULATION. THIS CALCULATION CONSIDERS 100% OF A HOSPITAL'S "NEED" BASED ON A "UNITS OF SERVICE" METHODOLOGY FOR UNINSURED PATIENTS. THE CALCULATION ALSO MAKES ADJUSTMENTS BASED ON THE PROPORTION OF MEDICAID ELIGIBLE PATIENTS TREATED AT THE FACILITY. THE HOSPITAL HAS APPORTIONED THE ICP REVENUE BETWEEN BAD DEBT AND CHARITY CARE FOR REPORTING ON LINE 7A BASED ON THE PROPORTION OF EACH TO THE TOTAL OF ACTUAL BAD DEBT AND CHARITY CARE FOR 2019.
PART III, LINES 2,3 - BAD DEBT AS COMMUNITY BENEFITAS PART OF ITS TAX EXEMPT PURPOSE THE HOSPITAL PROVIDES ACCESS TO MEDICALLY NECESSARY CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, OR CULTURAL BACKGROUND. THE HOSPITAL TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF WHETHER THEY HAVE THIRD-PARTY COVERAGE OR THE ABILITY TO PAY. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE HOSPITAL IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE FROM THE HOSPITAL SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT SINCE CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR TAX EXEMPT PURPOSE, WHICH IS MEETING THE NEED FOR EMERGENCY AND NON-ELECTIVE MEDICAL CARE SERVICES IN THE COMMUNITY.
PART III, LINES 2 AND 4 - TEXT OF FOOTNOTE DISCUSSING BAD DEBTPAGES 22 TO 27 OF THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS INCLUDE A FOOTNOTE ON PATIENT ACCOUNTS RECEIVABLE. THE FINANCIAL STATEMENTS ARE ATTACHED TO THIS RETURN.
PART III LINE 8 - COSTING METHODOLOGYTHE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 2019 CMS-2552 (MEDICARE COST REPORT). MEDICARE REVENUE IS BASED ON THE MEDICARE PROVIDER STATISTICAL AND REIMBURSEMENT REPORT AND MEDICARE COSTS ARE DEVELOPED UTILIZING A RATIO OF MEDICARE ALLOWABLE COSTS TO CHARGES METHODOLOGY. AMOUNTS SHOWN FOR TOTAL REVENUE RECEIVED AND MEDICARE ALLOWABLE COSTS ARE NET OF ANY AMOUNTS ALREADY INCLUDED WITHIN PART I, LINE 7, PRIMARILY IN SUBSIDIZED HEALTH SERVICES.
PART III, LINE 9BTHE HOSPITAL'S CHARITY CARE POLICY DESCRIBES THE POLICIES AND PROCEDURES RELATING TO THE PROVISION OF CHARITY CARE TO PERSONS WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THEIR BILL. NO INDIVIDUAL WILL BE DENIED MEDICALLY NECESSARY HOSPITAL SERVICES BASED ON A DEMONSTRATED INABILITY TO PAY FOR THOSE SERVICES. IN ADDITION, UPON APPLYING FOR CHARITY CARE, EACH PATIENT AND PATIENT GUARANTOR'S ABILITY TO PAY WILL BE ASSESSED. ELIGIBILITY FOR ASSISTANCE: A REASONABLE REVIEW SHALL BE PERFORMED PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (I.E., MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE HOSPITAL'S CHARITY CARE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY ACCOUNT THAT SUBSEQUENTLY IS DETERMINED TO MEET THE CHARITY CARE CRITERIA SHALL BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT FOR APPROPRIATE FOLLOW-UP. THE THIRD-PARTY COLLECTION AGENT SHALL ADVISE THE PATIENT/GUARANTOR OF THE HOSPITAL'S CHARITY CARE POLICY AND RETURN THE ACCOUNT IMMEDIATELY IF IT IS DETERMINED THAT THE QUALIFICATIONS ARE MET.
PART VI, LINE 2 - ASSESSMENT OF COMMUNITY NEEDS AND GOALSCOMMUNITY HEALTH NEEDS ARE ASSESSED ON A CONTINUAL BASIS, DURING MEETINGS OF THE HOSPITAL'S BOARD OF TRUSTEES AND EXECUTIVE LEADERSHIP COUNCIL, COMMUNITY HEALTH AND EDUCATION DEPARTMENT MEETINGS, AT COLLABORATIVE SESSIONS WITH MEMBER HOSPITALS OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AND WITH PARTNERS AT COMMUNITY AGENCIES AND ORGANIZATIONS THAT ARE PART OF THE LONG ISLAND HEALTH COLLABORATIVE(LIHC). THE LIHC COMMUNITY HEALTH ASSESSMENT SURVEYS ARE OFFERED YEAR-ROUND AT MULTIPLE OUTREACH SITES IN THE COMMUNITY. BY DISTRIBUTING COMMUNITY NEEDS SURVEYS(AVAILABLE IN ENGLISH, SPANISH, POLISH, HAITAIN CREOLE AND LARGE PRINT) TO PARTICIPANTS AT SCREENING SITES, EVERY POINT OF CONTACT SERVES AS ANOPPORTUNITY TO REQUEST FEEDBACK ON HOW THE HOSPITAL CAN BETTER MEET THE NEEDS OF THE COMMUNITY. THESE EVENTS ARE PROMOTED IN THE COMMUNITY SURROUNDING THE OUTREACH SITE AND ON CHSS WEBSITE. ST. CHARLES HOSPITAL CORP CONTINUES TO COLLABORATE WITH OTHER HOSPITALS, LOCAL HEALTH DEPARTMENTS, HEALTH CARE PROVIDERS, PUBLIC HEALTH SPECIALISTS FROM ACADEMIC INSTITUTIONS AND COMMUNITY-BASED ORGANIZATIONS AT LIHC EVENTS. LIHC'S WEBSITE OFFERS COMPREHENSIVE INFORMATION TO PROMOTE GOOD HEALTH AND PREVENT CHRONIC DISEASE. IN ADDITION TO PROVIDING NUMEROUS RESOURCES SUCH AS HEALTH PROGRAM INVENTORIES, HEALTH INSURANCE INFORMATION AND EDUCATIONAL VIDEOS, LIHC AND ITS MEMBERS HAVE ORGANIZED WALKING PROGRAMS, AND DEVELOPED A UNIVERSAL SCREENING TOOL TO HELP MEASURE THE EFFECTIVENESS OF COMMUNITY HEALTH EFFORTS. MORE INFORMATION CAN BE FOUND AT WWW.LIHEALTHCOLLAB.ORG.
PART VI, LINE 3 - COMMUNICATION OF FINANCIAL ASSISTANCE POLICY1. SINCE IT IS THE DUTY OF THE HOSPITAL TO ENSURE THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF ITS CHARITY CARE POLICY, ALL EMPLOYEES IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS ARE FULLY VERSED IN THE CHARITY CARE POLICY, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ARE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE HOSPITAL REPRESENTATIVES. 2. THE HOSPITAL HAS POSTED MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN THE HOSPITAL INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREA. SAID NOTICES ARE PUBLISHED IN ENGLISH AND SPANISH, AND ARE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. 3. THE HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS OF APPLYING FOR ASSISTANCE. THIS SUMMARY IS WRITTEN AT OR BELOW A SIXTH GRADE READING LEVEL. 4. THE HOSPITAL HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE. 5. THE HOSPITAL PROVIDES ALL PATIENTS ACCESS TO INTERPRETERS TO ASSIST THEM IN UNDERSTANDING ITS CHARITY CARE PROGRAM IN THE PRIMARY LANGUAGE SPOKEN BY THE PATIENT DURING ANY PRE-ADMISSION, ADMISSION, AND DISCHARGE PROCESS. 6. ON ALL BILLS AND STATEMENTS SENT TO PATIENTS, A STATEMENT IS INCLUDED REGARDING THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING CHARITY CARE, AND A CONTACT NUMBER TO CALL TO OBTAIN FURTHER INFORMATION. THIS INFORMATION IS AVAILABLE AT OR BELOW A SIXTH GRADE READING LEVEL.
PART VI, LINE 4 - COMMUNITY INFORMATIONST. CHARLES HOSPITAL IS LOCATED ON THE NORTH SHORE OF SUFFOLK COUNTY IN THE TOWN OF BROOKHAVEN. A NOT-FOR-PROFIT HOSPITAL WITH 243 BEDS, ST. CHARLES IS A MEMBER OF CATHOLIC HEALTH SERVICES. THE POPULATION IN THE HOSPITALS PRIMARY CATCHMENT AREA IS MORE THAN 386,000 RESIDENTS, REPRESENTING 81% OF THE HOSPITALS ADMISSIONS. THE HOSPITALS SECONDARY CATCHMENT AREA HAS MORE THAN 200,000 RESIDENTS AND ACCOUNTS FOR ANOTHER 16% OF PATIENT ADMISSIONS. THIS SERVICE AREA INCLUDES ECONOMICALLY CHALLENGED COMMUNITIES, SUCH AS PORT JEFFERSON STATION, FARMINGVILLE, AND CORAM. ST. CHARLES HOSPITALS PRIMARY SERVICE AREA IS SHARED WITH AN ACUTE CARE HOSPITAL, JOHN T. MATHER MEMORIAL HOSPITAL IN PORT JEFFERSON, AND A TERTIARY CARE HOSPITAL, STONY BROOK UNIVERSITY MEDICAL CENTER.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTHST. CHARLES HAS PARTNERED WITH ORGANIZATIONS IN THE COMMUNITY TO FACILITATE OPTIMAL ACCESS TO HEALTH CARE AND THE PREVENTION OF FUTURE ILLNESS OR INJURY. THE HOSPITAL FURTHERS ITS EXEMPT PURPOSE BY TAKING AN ACTIVE ROLE IN PROMOTING THE HEALTH OF THE COMMUNITY. THE HOSPITAL HAS IDENTIFIED AREAS OF NEED IN THE SURROUNDING COMMUNITIES AND HAS RESPONDED BY ESTABLISHING SERVICES THAT MEET THOSE NEEDS. ST. CHARLES HOSPITALS SPECIALTY CARE CENTER PROVIDES COMPREHENSIVE CARE FOR PATIENTS WITH SPECIALIZED DIAGNOSES. ST. CHARLES PARTICIPATES IN CATHOLIC HEALTH SERVICES HEALTHY SUNDAYS AT LOCAL PARISHES PROVIDING PARISHIONERS WITH FREE HEALTH CARE SERVICES SUCH AS CHOLESTEROL AND BLOOD PRESSURE SCREENING. THE HOSPITAL'S PEDIATRIC PULMONARY SPECIALTY CENTER IS AN EXTENSION OF ITS OUTPATIENT SPECIALTY CARE CENTER. THE MOVEMENTS DISORDERS CENTER AT ST. CHARLES HOSPITAL CORP OFFERS TECHNOLOGICALLY ADVANCED, COMPREHENSIVE SERVICES FOR THOSE EXPERIENCING UNEXPLAINED DIFFICULTY WITH MOVEMENT. THE CENTER SPECIALIZES IN THE EVALUATION AND TREATMENT OF PARKINSON'S DISEASE. THE HOSPITAL PROVIDES COMMUNITY HEALTH PROGRAMS, SCREENINGS, AND SUPPORT GROUPS, INCLUDING, BUT NOT LIMITED TO: AN AL-ANON FAMILY SUPPORT GROUP WHICH PROVIDES SUPPORT FOR FAMILY MEMBERS OF ALCOHOLICS. ALCOHOLICS ANONYMOUS SUPPORT GROUPS PROVIDE A PLACE FOR RECOVERING ALCOHOLICS TO HOLD WEEKLY MEETINGS. THE BRAIN INJURY SUPPORT GROUP IS OFFERED TO INDIVIDUALS WHOSE LIVES HAVE BEEN AFFECTED BY A BRAIN INJURY. INDIVIDUALS AND THEIR CAREGIVERS MEET TO DISCUSS RESOURCES, PROVIDE INFORMATION, AND SHARE EXPERIENCES. AN EPILEPSY SUPPORT GROUP OFFERS SUPPORT TO INDIVIDUALS DIAGNOSED WITH EPILEPSY AND THEIR FAMILIES. THE HOSPITAL PROVIDES FAMILY EDUCATION CLASSES, INCLUDING A BREASTFEEDING CLASS AND A BREASTFEEDING MOTHERS GROUP, NEW MOTHER'S SUPPORT GROUP, NEWBORN PARENTING 101, SIBLING CLASS AND LAMAZE CLASS. NARCOTICS ANONYMOUS PROVIDES ASSISTANCE AND INFORMATION FOR INDIVIDUALS RECOVERING FROM NARCOTICS ADDICTION. THE PARKINSON'S DISEASE SUPPORT GROUP PROVIDES SUPPORT INFORMATION AND AN OPPORTUNITY TO SHARE EXPERIENCES FOR INDIVIDUALS AFFECTED BY PARKINSON'S DISEASE. A WEEKLY SPEECH COMMUNICATION SUPPORT GROUP IS OFFERED TO THOSE LIVING WITH A SPEECH DISORDER OR IMPEDIMENT. A SPINAL CORD INJURY SUPPORT GROUP HELPS THOSE WHO HAVE SUFFERED A SPINAL CORD INJURY (SUPPORT GROUPS HELD IN PORT JEFFERSON AND ALBERTSON ON A MONTHLY BASIS).
PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEMST. CHARLES HOSPITAL CORP (ST. CHARLES OR HOSPITAL) OPERATES A 243-BED ACUTE CARE AND PHYSICAL REHABILITATION MEDICAL HOSPITAL LOCATED IN PORT JEFFERSON, NEW YORK, WITH OUTPATIENT FACILITIES IN NASSAU AND SUFFOLK COUNTIES. ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS, ST. CHARLES, THROUGH ITS DAILY OPERATION, PROVIDES ACUTE, EMERGENT AND OUTPATIENT CARE. ST. CHARLES IS A MEMBER OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS) WHICH IS A NEW YORK, NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE. AS OF DECEMBER 31, 2019, CHS COMPRISED SIX HOSPITALS (MERCY MEDICAL CENTER, ST. FRANCIS HOSPITAL AND ST. JOSEPH HOSPITAL IN NASSAU COUNTY, AND GOOD SAMARITAN HOSPITAL MEDICAL CENTER, ST. CHARLES HOSPITAL CORP AND ST. CATHERINE OF SIENA MEDICAL CENTER IN SUFFOLK COUNTY), AS WELL AS THREE NURSING HOMES (ST. CATHERINE OF SIENA NURSING AND REHABILITATION CENTER, GOOD SAMARITAN NURSING AND REHABILITATION CARE CENTER AND OUR LADY OF CONSOLATION NURSING AND REHABILITATIVE CARE CENTER, ALL IN SUFFOLK COUNTY), A REGIONAL HOME CARE AND HOSPICE NETWORK, AND A COMMUNITY-BASED AGENCY FOR PERSONS WITH SPECIAL NEEDS. WITH MORE THAN 18,000 STAFF AND 4,300 MEDICAL STAFF WORKING THROUGHOUT THE SYSTEM, CHS PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES. OUR MISSION STATES: 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. MEMBER ORGANIZATIONS OF CHS OFFER VIRTUALLY EVERY MEDICAL SPECIALTY AND CLINICAL SERVICES, AND SHARE A DEDICATION TO CONTINUOUSLY UPGRADE THE SCOPE, QUALITY AND ACCESSIBILITY OF CARE. ALL OF CHS'S MEMBER ORGANIZATIONS HAVE RETAINED THEIR INDIVIDUAL LINKS TO THEIR HISTORY AND THEIR DISTINCTIVE PERSONALITIES, AS WELL AS THE SERVICE SPECIALTIES WHICH THEY ARE KNOWN FOR, THUS EMBEDDING THE ORGANIZATION IN THE COMMUNITY AND SERVING IT EFFECTIVELY. CHS ENTITIES PROVIDE AN ABUNDANCE OF EDUCATION AND SUPPORT GROUPS AS WELL AS FREE HEALTH SCREENINGS THROUGH ITS HEALTHY SUNDAYS PROGRAM, HEALTH FAIRS, AND OTHER PROGRAMS. SINCE 1907, CATHOLIC HEALTH CARE ON LONG ISLAND HAS BUILT A DISTINGUISHED TRADITION OF OPERATING COMMUNITY-BASED HOSPITALS AND ORGANIZATIONS WITH THE PRIMARY OBJECTIVE OF IMPROVING THE COMMUNITY'S HEALTH.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTH SERVICES OF LONG ISLANDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1992 N VILLAGE AVE ROCKVILLE CENTREAddressLine1Txt
CityROCKVILLE CENTRECityNm
State AbbreviationNYStateAbbreviationCd
ZIP11570ZIPCd
FieldValueIRS element (for citing)
Recipient EIN113403968RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$1,114,697CashGrantAmt
Valuation Method UsedNONEValuationMethodUsedDesc
Non Cash AssistanceNONENonCashAssistanceDesc
Purpose Of GrantMISSION SPONSORSHIP, OUTPATIENT CENTERS, GRANTS TO UNDERSERVED COMMUNITY AND CAPITAL SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USECHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR ST CHARLES HOSPITAL CORP AND CATHOLIC HEALTH SERVICES OF LONG ISLAND AND IS THEREFORE ABLE TO MONITOR THAT CATHOLIC HEALTH SERVICES OF LONG ISLAND USES THE GRANT FUNDS FOR MISSION SPONSORSHIP, OUTPATIENT CENTERS, GRANTS TO UNDERSERVED COMMUNITIES AND CAPITAL SUPPORT.
PART II, LINE 1, COLUMN (H)NAME OF ORGANIZATION OR GOVERNMENT: CATHOLIC HEALTH SYSTEM OF LONG ISLAND (H) PURPOSE OF GRANT: 1) SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND AS A PASS THROUGH TO PROVIDE GENERAL SUPPORT TO THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD; 2) PROVIDE SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND TO FUND OUTPATIENT CENTERS THAT PROVIDE CHARITY CARE TO THOSE CENTERS COMMUNITIES; AND 3) TO FUND SUPPORT PROVIDED THROUGH THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CAREGIVERS FUND. THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CAREGIVERS FUND WAS FORMED WITH THE MISSION TO ASSIST OUR FELLOW CAREGIVERS ON THE FRONT LINES, HERE AND ABROAD, WHO STRUGGLE JUST TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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
ALAN D GUERCI MD
PRESIDENT & CEO$0$1,511,307$0$550,000$0$360,657$0$360,480$0$28,504$0$2,810,948$0$325,113
MORGAN CHEN MD
PHYSICIAN$2,276,487$0$0$0$353$0$25,872$0$24,030$0$2,326,742$0$0$0
SATHISH SUBBAIAH MD
PHYSICIAN$2,276,487$0$0$0$353$0$25,872$0$24,029$0$2,326,741$0$0$0
DIMTRIOS CHRISTOFOROU
PHYSICIAN$728,889$0$909,155$0$374$0$25,872$0$14,421$0$1,678,711$0$0$0
DANIEL DEBARBA
EVP & CFO$0$897,154$0$264,000$0$31,731$0$346,480$0$40,263$0$1,579,628$0$0
DOUGLAS PETRACO MD
PHYSICIAN$1,089,433$0$194,605$0$812$0$25,872$0$22,802$0$1,333,524$0$0$0
STEVEN PUOPOLO MD
PHYSICIAN$1,027,933$0$149,991$0$706$0$25,872$0$25,856$0$1,230,358$0$0$0
WILLIAM ARMSTRONG
SVP FINANCE$0$743,045$0$131,000$0$21,510$0$179,480$0$25,950$0$1,100,985$0$0
JAMES O'CONNOR
CAO$571,056$0$75,000$0$25,796$0$127,872$0$27,884$0$827,608$0$0$0
RONALD WEINGARTNER
COO$320,767$0$25,000$0$14,752$0$25,872$0$24,339$0$410,730$0$0$0
SUNIL DHUPER MD
CMO$335,002$0$21,000$0$3,096$0$25,872$0$11,905$0$396,875$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4B, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANTHE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. ALAN GUERCI $335,000 PARTICIPATION IN THE PLAN WILLIAM ARMSTRONG $154,000 PARTICIPATION IN THE PLAN DANIEL DEBARBA $321,000 PARTICIPATION IN THE PLAN JAMES O'CONNOR $102,000 PARTICIPATION IN THE PLAN THE DEFERRED COMPENSATION IN COLUMN C FOR THESE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NON-QUALIFIED RETIREMENT PLANS. THE FOLLOWING INDIVIDUALS VESTED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B (III). THESE AMOUNTS INCLUDE A TAX GROSS UP. ALAN GUERCI $325,113 VESTED IN PLAN. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2019 FORM W-2, BOX 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT.
PART II, REPORTING OF TOP FINANCIAL OFFICIALWILLIAM ARMSTRONG WAS REPORTED AS AN OFFICER IN 2015 AS THE TOP FINANCIAL OFFICIAL IN HIS ROLE AS INTERIM CFO. IN 2016, DANIEL DEBARBA IS THE TOP FINANCIAL OFFICER AS CFO, AND WILLIAM ARMSTRONG HAS RESUMED HIS ROLE AS SVP OF FINANCE. EFFECTIVE 2/23/18, JAMES O'CONNOR SERVES AS PRESIDENT/CAO OF BOTH ST. CATHERINE OF SIENA MEDICAL CENTER AND ST. CHARLES HOSPITAL CORP, A RELATED ENTITY.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATIONTHE SOLE MEMBER OF ST. CHARLES HOSPITAL CORP IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS). 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 BODYCHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF ST CHARLES HOSPITAL CORP AND AS SUCH HAS THE RIGHT TO APPOINT THE GOVERNING BODY ST CHARLES HOSPITAL CORP.
FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODYAS THE SOLE MEMBER OF ST. CHARLES HOSPITAL CORP, CHS IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERNING BODY OF ST. CHARLES HOSPITAL CORP. THE GOVERNING BODY OF ST. CHARLES HOSPITAL CORP IS THE SAME AS THAT OF CHS.
FORM 990, PART VI, LINE 11B - REVIEW PROCESS FOR FORM 990THE 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 POLICYDISCLOSURE 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 POLICYTHE CHIEF ADMINISTRATIVE OFFICER SUBMITS FOR APPROVAL TO THE SYSTEM CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE 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 INSPECTIONGOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION 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 1AHOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. ALAN D. GUERCI, PRESIDENT & CEO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY, INC. (20-8067039); CATHOLIC HEALTH SYSTEM OF LONG ISLAND (11-3403968); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST CHARLES HOSPITAL CORP (11-1871039) AND ST. JOSEPH HOSPITAL FOUNDATION (47-2353387). JAMES O'CONNOR, CAO - THE TOTAL HOURS REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. CHARLES HOSPITAL CORP (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); ST. CHARLES CORPORATION (11-2983148); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CATHERINE OF SIENA MEDICAL CENTER FDOUNDATION (27-1459941). DANIEL DEBARBA, EVP & CFO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST CHARLES HOSPITAL CORP (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240); ST. CATHERINE OF SIENA MEDICAL CENTER FDOUNDATION (27-1459941); CATHOLIC HEALTH SYSTEM OF LONG ISLAND (11-3403968) AND RVC INSURANCE COMPANY INC. (20-8067039).
FORM 990, PART X, LINE 20 - TAX-EXEMPT BOND LIABILITIESTHE TAX-EXEMPT BOND ISSUANCES REFLECTED ON PART X, LINE 20 ARE ISSUED ON BEHALF OF THE CATHOLIC HEALTH SERVICES OF LONG ISLAND OBLIGATED GROUP PROJECT WHICH INCLUDES THE FILING ENTITY AND RELATED ENTITIES. THREE BONDS WERE ISSUED TO THE OBLIGATED GROUP, SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION (SERIES 2011 SUFFOLK BONDS), SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION (SERIES 2014C SUFFOLK BONDS) AND NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE AND FINANCING CORPORATION (SERIES 2011 NASSAU BONDS). THE BONDS ARE REPORTED ON SCHEDULE K OF THE PARENT ORGANIZATION, CATHOLIC HEALTH SERVICES OF LONG ISLAND.
FORM 990, PART XI, LINE 9 - CHANGE IN NET ASSETSRELATED PARTY EMPLOYEE BENEFIT SERVICES $ (6,611,556) CHANGE IN POST RETIREMENT BENEFIT (33,000) ----------- TOTAL: $ (6,644,556)
FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSIONST CHARLES HOSPITAL IS A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND. WE, AT CATHOLIC HEALTH SERVICES, HUMBLY JOIN TOGETHER TO BRING CHRISTS HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES. I-CARE VALUES INTEGRITY: WE ARE WHO WE SAY WE ARE AND ACT IN ACCORDANCE WITH THE SPLENDOR OF TRUTH OF OUR CATHOLIC MORAL TEACHING AND OUR CATHOLIC VALUES. COMPASSION: WE HAVE COMPASSION FOR OUR PATIENTS, SEE THE SUFFERING CHRIST IN THEM, STRIVE TO ALLEVIATE SUFFERING AND SERVE THE SPIRITUAL, PHYSICAL AND EMOTIONAL NEEDS OF OUR PATIENTS. ACCOUNTABILITY: WE TAKE RESPONSIBILITY FOR OUR ACTIONS AND THEIR CONSEQUENCES. RESPECT: WE HONOR THE SANCTITY OF LIFE AT EVERY STAGE OF LIFE AND THE DIGNITY OF EVERY PERSON, AND INCORPORATE ALL THE PRINCIPLES OF CATHOLIC SOCIAL TEACHING IN OUR RELATIONSHIPS AND ADVOCACY. EXCELLENCE: WE SEEK THE GLORY OF GOD IN THE COMPASSIONATE SERVICE OF OUR PATIENTS, AND WE STRIVE TO DO THE BEST THAT CAN BE DONE, WHATEVER OUR ROLE.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (34 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CATHOLIC HEALTH SYSTEM OF LONG ISLAND
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113403968SUPPORT ORGNY501(C)(3)12A-INAfalse
CHS SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113555766SUPPORT ORGNY501(C)(3)12B-IICHSLIYes (true)
CHS AMBULANCE SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570141801961DORMANTNY501(C)(3)3CHSLIfalse
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
1000 MONTAUK HIGHWAYWEST ISLIPNY11795111888924HOSPITALNY501(C)(3)3CHSLIYes (true)
GOOD SAMARITAN SELF INSURANCE AGAINST
MALPRACTICE 1000 MONTAUK HIGHWAYWEST ISLIPNY11795112537396SELF INSURANCNY501(C)(3)12A-IGOOD SAMARTNYes (true)
MARYHAVEN TRANSPORTATION SERVICES
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113434776TRANSPORTATIONY501(C)(3)12A-IMARYHAVENCTRfalse
MARYHAVEN CENTER OF HOPE
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112861698Prgm-disabledNY501(C)(3)10CHSLIfalse
MARYHAVEN SCHOOL CORPORATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112861690Schl-disabledNY501(C)(3)2MARYHAVENCTRfalse
THE CENTER OF HOPE FOUNDATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113638367SUPPORT ORGNY501(C)(3)12A-IMARYHAVENCTRfalse
MERCY MEDICAL CENTER
1000 NORTH VILLAGE AVENUEROCKVILLE CTRNY11570111635088HOSPITALNY501(C)(3)3CHSLIYes (true)
CATHOLIC HOME CARE
110 Bi-County Blvd Suite 114FARMINGDALENY11735112126736HOME CARENY501(C)(3)10CHSLIfalse
OUR LADY OF CONSOLATION GERIATRIC CARE
111 BEACH DRIVEWEST ISLIPNY11795113284066LT NURSE CARENY501(C)(3)10CHSLIfalse
RIVERHEAD HOSTEL HOLDING CORPORATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112499790RENTINGNY501(C)(2)MARYHAVENCTRfalse
ST CATHERINE OF SIENA MEDICAL CENTER
50 ROUTE 25ASMITHTOWNNY11787061562701HOSPITALNY501(C)(3)3CHSLIYes (true)
ST FRANCIS HOSPITAL
100 PORT WASHINGTON BLVDROSLYNNY11576112050523HOSPITALNY501(C)(3)3CHSLIYes (true)
ST FRANCIS HOSPITAL FOUNDATION
100 PORT WASHINGTON BLVDROSLYNNY11576112916033SUPPORT ORGNY501(C)(3)12A-IST FRANCISfalse
ST FRANCIS HOSPITAL RESEARCH & EDUCATIO
100 PORT WASHINGTON BLVDROSLYNNY11576113090867RESEARCH ORGNY501(C)(3)12A-IST FRANCISYes (true)
WSNCHS NORTH INC
4295 HEMPSTEAD TURNPIKEBETHPAGENY11714113438973HOSPITALNY501(C)(3)3CHSLIYes (true)
THE ST CHARLES CORPORATION
200 BELLE TERRE ROADPORT JEFFERSN STNY11777112983148SUPPORT ORGNY501(C)(3)12A-ICHSLIfalse
THE SAMARITAN CORPORATION
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570112716640SUPPORT ORGNY501(C)(3)12A-ICHSLIfalse
WISDOM GARDENS HOUSING DEVELOPMENT FUND
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113559713SR HOUSINGNY501(C)(3)10MARYHAVENCTRfalse
GOOD SHEPHERD HOSPICE
110 Bi-County Blvd Suite 114FARMINGDALENY11735112958438HOSPICE SVCNY501(C)(3)10CHSLIfalse
ST CHARLES HOSPITAL FOUNDATION
200 BELLE TERRE ROADPORT JEFFERSONNY11777412076312SUPPORT ORGNY501(C)(3)12A-1ST CHARLESYes (true)
GOOD SAMARITAN HOSPITAL FOUNDATION
1000 MONTAUK HIGHWAYWEST ISLIPNY11795770611240SUPPORT ORGNY501(C)(3)12A-1GOOD SAMARTNfalse
MERCY MEDICAL CENTER FOUNDATION
1000 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570550813603SUPPORT ORGNY501(C)(3)12A-IMERCY MEDCTRfalse
ST CATHERINE OF SIENA MEDICAL CTR FDN
50 ROUTE 25ASMITHTOWNNY11787271459941SUPPORT ORGNY501(C)(3)12A-ISTCATHERINEYes (true)
CHS HOME CARE AND HOSPICE FOUNDATION
110 Bi-County Blvd Suite 114FARMINGDALENY11735452907761SUPPORT ORGNY501(C)(3)12A-ICATHHOMECAREfalse
GOOD SHEPHERD HOSPICE FOUNDATION
110 Bi-County Blvd Suite 114FARMINGDALENY11735263169427SUPPORT ORGNY501(C)(3)12A-IGOODSHEPHERDfalse
OUR LADY OF CONSOLATION FOUNDATION
111 BEACH DRIVEWEST ISLIPNY11795450517566SUPPORT ORGNY501(C)(3)12A-IOURLADYOFCfalse
RVC SUPPORT
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570271531084REAL ESTATENY501(C)(3)12A-ICHSLIfalse
CHS PHYSICIAN PARTNERS PC
100 PORT WASHINGTON BLVDROSLYNNY11576113613997HEALTHCARESVCNY501(C)(3)12A-IST FRANCISfalse
RVC INSURANCE COMPANYINC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570208067039CAPTIVE INSNY501(C)(3)12B-IICHSLIfalse
SAMARITAN EMERGENCY MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208243412HEALTHCARESVCNY501(C)(4)GOOD SAMARTNfalse
ST JOSEPH HOSPITAL FOUNDATION
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570472353387SUPPORT ORGNY501(C)(3)12A-IWSNCHS NORTHfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
BIPO HOLDINGS LLC
992 N VILLAGE AVE ROCKVILLE CENTREROCKVILLE CENTRENY11570464763720PHYSICIAN ASSNNYNA
IDHC LLC
2500 YORK RD JAMISONPA 18929JAMISONPA18929452411095HEALTH SERVICESPANA
BEACON HEALTH PTNRS
992 N VILLAGE AVE ROCKVILLE CENTREROCKVILLE CENTRENY11570454229842HEALTHCARENYNA
WISDOM GARDENS LP
51 TERRYVILLE RDPORT JEFFERSONNY11776113567947SR HOUSINGNYNA

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
RADIOLOGY CONSULTING OF LONG ISLANDPLLC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795421646134HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN PEDIATRIC SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208180263HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208088453HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SOUTHWEST SUFFOLK MEDICAL PC
580 UNION BOULEVARDWEST ISLIPNY11795061603195HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
CARDIAC EKG INTERPRETATION PC
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570112924518HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208964140HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN MANAGEMENT SERVICES
1000 MONTAUK HIGHWAYWEST ISLIPNY11795112838185HEALTHCARE SVCNYCHSLIC-CORPfalse
ADVANCED REHABILIATION MEDICINE PLLC
200 BELLE TERRE ROADPORT JEFFERSONNY11777113640709HEALTHCARE SVCNYSTCHARLES HOSPC-CORPfalse
ST FRANCIS CARDIAC PREVENTION SERVICES
100 PORT WASHINGTON BLVDROSLYNNY11576113224885HEALTHCARE SVCNYSTFRANCIS HOSPC-CORPfalse
SOUTH SHORE PRACTICE MANAGEMENT
1000 MONTAUK HIGHWAYWEST ISLIPNY11795113307977HEALTHCARE SVCNYSAMARITAN MGMTC-CORPfalse
SAMARITAN HOME CARE AMERICA
1000 MONTAUK HIGHWAYWEST ISLIPNY11795113319259HEALTHCARE SVCNYSAMARITAN MGMTC-CORPfalse
MERCY INTERNAL MEDICINE PC
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570510639649HEALTHCARE SVCNYMERCY MED CTRC-CORPfalse
LONG ISLAND EMERGENCY CARE PC
1000 N VILLAGE AVEROCKVILLENY11571113633515PHYSICIAN SVCNYMERCY MED CTRS-CORPfalse
MY CHS RX INC
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570842359236PHARMACYNYCHSLIC-CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
CHS SERVICES
LMPR$301,951COST
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
LM$353,336COST
MERCY MEDICAL CENTER
LM$341,721COST
ST CATHERINE OF SIENA MEDICAL CENTER
LM$463,799COST
ST CHARLES HOSPITAL FOUNDATION
LMNOQ$735,708COST

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE R, PART IVFormAndLineReferenceDesc
ExplanationFOR ALL PROFESSIONAL CORPORATIONS REPORTED ON SCHEDULE R, PART IV, THE PHYSICIAN IS THE SOLE SHAREHOLDER OF THE ENTITY AND THE DIRECT CONTROLLING ENTITY REPORTED IN COLUMN (D) IS THE BENEFICIAL OWNER. THIS STRUCTURE IS CONSISTENT WITH THE NEW YORK CORPORATE PRACTICE OF MEDICINE.ExplanationTxt