ST CHARLES HOSPITAL CORP: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- ST CHARLES HOSPITAL CORP (EIN 11-1871039)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-15
- IRS object ID
- 201833199349315783
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-15T16:19:42-06:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 Madison Avenue | AddressLine1Txt |
| City | New York | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10017 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 111871039 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CHARLES HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % CHS SERVICES INC | InCareOfNm |
| Business Name Control | STCH | BusinessNameControlTxt |
| Phone | 6314746116 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BELLE TERRE ROAD | AddressLine1Txt |
| City | PORT JEFFERSON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11777 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES O'CONNOR | PersonNm |
| Person Title | EXEC VP & CAO | PersonTitleTxt |
| Phone | 5167051937 | PhoneNum |
| Signature | 2018-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAURA J PARELLO | PreparerPersonNm |
| PTIN | P01080295 | PTIN |
| Phone | 6464713000 | PhoneNum |
| Preparation | 2018-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 155.201.188.32 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 13049920183195000159 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2018-11-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 618ACE5A638F5610B23A87A01F7C418F45FC2D61 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 618ACE5A638F5610B23A87A01F7C418F45FC2D61 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALAN D GUERCI MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BELLE TERRE RD | AddressLine1Txt |
| City | PORT JEFFERSON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11777 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $218,672,666 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | http://stcharleshospital.chsli.org/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1907 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | WE, 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 Body | 23 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 22 | VotingMembersIndependentCnt |
| Total Employee | 2105 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $32,604 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $16,664 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,281,707 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,124,056 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $227,864,292 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $210,394,228 | CYProgramServiceRevenueAmt |
| PY Investment Income | $86,186 | PYInvestmentIncomeAmt |
| CY Investment Income | $84,518 | CYInvestmentIncomeAmt |
| PY Other Revenue | $4,696,240 | PYOtherRevenueAmt |
| CY Other Revenue | $5,069,864 | CYOtherRevenueAmt |
| PY Total Revenue | $235,928,425 | PYTotalRevenueAmt |
| CY Total Revenue | $218,672,666 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $707,329 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $685,195 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $133,760,943 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $117,206,921 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $99,609,796 | PYOtherExpensesAmt |
| CY Other Expenses | $103,626,638 | CYOtherExpensesAmt |
| PY Total Expenses | $234,078,068 | PYTotalExpensesAmt |
| CY Total Expenses | $221,518,754 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,850,357 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,846,088 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $136,225,216 | TotalAssetsBOYAmt |
| Total Assets EOY | $129,935,381 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $149,794,761 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $146,196,781 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$13,569,545 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$16,261,400 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $190,328,652 | ExpenseAmt |
| Grant | $685,195 | GrantAmt |
| Revenue | $213,913,948 | RevenueAmt |
| Desc | ST. CHARLES HOSPITAL 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 2017 ST. CHARLES HAD 11,031 DISCHARGED AND PROVIDED 22,624 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 | $190,328,652 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 153 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 2105 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 23 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 22 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHS SERVICES INC | PersonNm |
| Phone | 5167053700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 992 NORTH VILLAGE AVENUE | AddressLine1Txt |
| City | ROCKVILLE CENTRE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11570 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SALVATORE SODANO | ||||||||||
| CHAIRMAN | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| BRIAN MCGUIRE | ||||||||||
| VICE CHAIR | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JEROME POLLER | ||||||||||
| SECRETARY | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| CHRIS PASCUCCI | ||||||||||
| TREASURER | 2.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| BARBARA ELLEN BLACK | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| VIRGINIA EWEN | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| FRANK L KURRE | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| REV MSGR ROBERT MORRISEY | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| DANIEL T ROWE | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN WAGNER | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| REV JAMES VLAUN | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| KEVIN J CONWAY | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| PETER D'ANGELO | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| REV PETER DUGANDZIC | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| HON ANTHONY MARANO | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| STEPHEN F MCLOUGHLIN | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| JOHN FRANCFORT MD | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| ALEXANDER HAZELTON | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| WILLIAM WARD | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT ZUCCARO | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| PETER QUICK | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| THOMAS CHRISTMAN | ||||||||||
| TRUSTEE | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||||
| ALAN D GUERCI MD | ||||||||||
| PRESIDENT & CEO | 50.0 | 0.0 | Yes (X) | Yes (X) | $0 | $3,776,985 | $400,495 | |||
| DANIEL DEBARBA | ||||||||||
| EVP & CFO | 50.0 | 0.0 | Yes (X) | $0 | $1,024,580 | $369,985 | ||||
| JAMES O'CONNOR | ||||||||||
| CAO | 50.0 | 0.0 | Yes (X) | $566,397 | $0 | $124,179 | ||||
| SUNIL DHUPER | ||||||||||
| CMO | 50.0 | 0.0 | $361,130 | $0 | $23,557 | Yes (X) | ||||
| SATHISH SUBBAIAH MD | ||||||||||
| PHYSICIAN | 50.0 | 0.0 | $4,054,986 | $0 | $23,449 | Yes (X) | ||||
| MORGAN CHEN MD | ||||||||||
| PHYSICIAN | 50.0 | 0.0 | $3,840,001 | $0 | $54,861 | Yes (X) | ||||
| DOUGLAS PETRACO MD | ||||||||||
| PHYSICIAN | 50.0 | 0.0 | $2,120,435 | $0 | $57,264 | Yes (X) | ||||
| STEVEN PUOPOLO MD | ||||||||||
| PHYSICIAN | 50.0 | 0.0 | $1,905,812 | $0 | $54,980 | Yes (X) | ||||
| PHILIP SCHRANK MD | ||||||||||
| PHYSICIAN | 50.0 | 0.0 | $1,823,540 | $0 | $23,449 | Yes (X) | ||||
| WILLIAM C ARMSTRONG | ||||||||||
| SVP FINANCE | 0.0 | 50.0 | $0 | $890,381 | $227,844 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $14,672,301 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,691,946 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,360,063 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 280 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ISLAND NEONATOLOGY LLC | |||||
| PO BOX 272 | EAST ISLIP | NY | 11730 | PHYSICIAN SERVICES | $556,004 |
| REMI HOLDINGS LLC | |||||
| 11325 N COMMUNITY HOUSE ROAD SUITE | CHARLOTTE | NC | 28277 | EQUIPMENT SERVICES | $395,448 |
| 1895 WWA LLC | |||||
| 1895 WALT WHITMAN ROAD SUITE 1 | EAST ISLIP | NY | 11730 | RENT | $295,449 |
| MCKESSON CORPORATION DBA MACRO HE | |||||
| PO BOX 742256 | ATLANTA | GA | 30374 | SOFTWARE SUBSCR | $280,377 |
| VETERANS BUILDINGS LLC | |||||
| 411 HACKENSACK AVE FLOOR 8 SUITE | HACKENSACK | NJ | 07601 | RENT | $203,907 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $45 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $3,031,725 | RelatedOrganizationsAmt |
| Government Grants | $22,794 | GovernmentGrantsAmt |
| All Other Contributions | $69,492 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $3,124,056 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $210,394,228 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $210,361,624 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $32,604 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $210,394,228 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $84,518 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $84,518 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $970,374 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $970,374 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $970,374 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $970,374 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| COFFEE SHOP | 722514 | $547,166 | $0 | $0 | $547,166 |
| MEANINGFUL USE | 900099 | $342,898 | $342,898 | $0 | $0 |
| PHYSICIAN SERVICES REVENUE | 621110 | $616,650 | $616,650 | $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,592,776 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,592,776 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,099,490 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $218,672,666 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $213,913,948 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $32,604 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,602,058 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $685,195 | TotalAmt |
| Program Services | $685,195 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,075,263 | TotalAmt |
| Program Services | $384,687 | ProgramServicesAmt |
| Management And General | $690,576 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,405,340 | TotalAmt |
| Program Services | $81,295,612 | ProgramServicesAmt |
| Management And General | $8,109,728 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,348,653 | TotalAmt |
| Program Services | $7,536,648 | ProgramServicesAmt |
| Management And General | $812,005 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,824,316 | TotalAmt |
| Program Services | $8,588,719 | ProgramServicesAmt |
| Management And General | $1,235,597 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,553,349 | TotalAmt |
| Program Services | $7,721,435 | ProgramServicesAmt |
| Management And General | $831,914 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,244 | TotalAmt |
| Program Services | $263,407 | ProgramServicesAmt |
| Management And General | $110,837 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,000 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $6,000 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,804 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $3,804 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,268 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $120,268 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,582,216 | TotalAmt |
| Program Services | $5,292,802 | ProgramServicesAmt |
| Management And General | $2,289,414 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,447 | TotalAmt |
| Program Services | $6,262 | ProgramServicesAmt |
| Management And General | $396,185 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,772,241 | TotalAmt |
| Program Services | $2,056,091 | ProgramServicesAmt |
| Management And General | $1,716,150 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,166,745 | TotalAmt |
| Program Services | $3,363,423 | ProgramServicesAmt |
| Management And General | $803,322 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,203 | TotalAmt |
| Program Services | $120,006 | ProgramServicesAmt |
| Management And General | $15,197 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,628,549 | TotalAmt |
| Program Services | $1,628,549 | ProgramServicesAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,045,336 | TotalAmt |
| Program Services | $4,045,336 | ProgramServicesAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,881,478 | TotalAmt |
| Program Services | $5,112,514 | ProgramServicesAmt |
| Management And General | $1,768,964 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,417,845 | TotalAmt |
| Program Services | $4,417,845 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $25,311,331 | $25,311,331 | $0 | $0 |
| FINANCE & TECHNOLOGY | $16,889,267 | $7,560,353 | $9,328,914 | $0 |
| EQUIPMENT SERVICE CONTRACTS | $2,079,683 | $2,079,683 | $0 | $0 |
| PHYSICIAN PRACTICE SUBSIDY | $21,087,862 | $21,087,862 | $0 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,722,119 | TotalAmt |
| Program Services | $1,770,892 | ProgramServicesAmt |
| Management And General | $2,951,227 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,518,754 | TotalAmt |
| Program Services | $190,328,652 | ProgramServicesAmt |
| Management And General | $31,190,102 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,482,273 | BOYAmt |
| EOY | $2,738,194 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,652,338 | BOYAmt |
| EOY | $1,845,299 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,438,612 | BOYAmt |
| EOY | $22,940,178 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,842,905 | BOYAmt |
| EOY | $3,872,098 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,238,759 | BOYAmt |
| EOY | $2,161,646 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $205,770,926 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $153,151,749 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,515,060 | BOYAmt |
| EOY | $52,619,177 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,090 | BOYAmt |
| EOY | $312,018 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,804,179 | BOYAmt |
| EOY | $43,446,771 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,225,216 | BOYAmt |
| EOY | $129,935,381 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,666,670 | BOYAmt |
| EOY | $31,548,477 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,690,027 | BOYAmt |
| EOY | $37,950,962 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,438,064 | BOYAmt |
| EOY | $76,697,342 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,794,761 | BOYAmt |
| EOY | $146,196,781 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$14,765,569 | BOYAmt |
| EOY | -$17,466,448 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $420,064 | BOYAmt |
| EOY | $429,088 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $775,960 | BOYAmt |
| EOY | $775,960 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$13,569,545 | BOYAmt |
| EOY | -$16,261,400 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,225,216 | BOYAmt |
| EOY | $129,935,381 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,846,088 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $58,233 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $96,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $120,268 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $120,268 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1 - LOBBYING ACTIVITIES | FormAndLineReferenceDesc |
| Explanation | AMOUNT 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $775,960 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,198 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,198 | OtherExpendituresAmt |
| End Year Balance | $775,960 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $775,960 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $479 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $479 | OtherExpendituresAmt |
| End Year Balance | $775,960 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $775,960 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $477 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $477 | OtherExpendituresAmt |
| End Year Balance | $775,960 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $775,960 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $477 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $477 | OtherExpendituresAmt |
| End Year Balance | $775,960 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $775,960 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $1,319 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $1,319 | OtherExpendituresAmt |
| End Year Balance | $775,960 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | false | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,000 | OtherCostOrOtherBasisAmt |
| Book Value | $38,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $100,009,616 | OtherCostOrOtherBasisAmt |
| Depreciation | $68,370,735 | DepreciationAmt |
| Book Value | $31,638,881 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,000 | OtherCostOrOtherBasisAmt |
| Depreciation | $175 | DepreciationAmt |
| Book Value | $6,825 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $98,357,900 | OtherCostOrOtherBasisAmt |
| Depreciation | $80,351,457 | DepreciationAmt |
| Book Value | $18,006,443 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,358,410 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,429,382 | DepreciationAmt |
| Book Value | $2,929,028 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $52,619,177 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM RELATED PARTIES, NET | $14,619,000 |
| OTHER RECEIVABLES, NET | $1,005,593 |
| OTHER ASSETS | $112,436 |
| INSURANCE CLAIMS RECEIVABLE | $27,709,742 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $43,446,771 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| SELF INSURANCE LIABILITIES | $17,390,469 |
| DUE TO RELATED PARTIES | $23,084,458 |
| THIRD PARTY PAYOR LIABILITIES | $8,448,942 |
| ESTIMATED MALPRACTICE | $26,137,222 |
| OTHER LIAB-POST RETIREMENT | $996,000 |
| OTHER LIAB-457B PLAN | $640,251 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $76,697,342 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4 - ENDOWMENT FUNDS | THE 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 FOOTNOTE | CHS AND MOST OF ITS SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CHS ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE ACCOUNTING STANDARDS CODIFICATION 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 300. | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,066,690 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,832,907 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $233,783 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00110 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,507,452 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,871,126 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $14,636,326 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06610 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,465,784 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $780,616 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $685,168 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $36,039,926 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,484,649 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $15,555,277 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07030 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $358,029 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $358,029 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00160 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,098,832 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $428,363 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $670,469 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $79,083 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $79,083 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00040 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,535,944 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $428,363 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,107,581 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00500 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $37,575,870 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,913,012 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,662,858 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07530 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,019,369 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $54,391,365 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $51,801,991 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $2,589,374 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CHARLES HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 BELLE TERRE ROAD | AddressLine1Txt |
| City | PORT JEFFERSON | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11777 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.STCHARLESHOSPITAL.CHSLI.ORG/ | WebsiteAddressTxt |
| State License | 5149001H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | REHABILITATIVE SERVICES | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CHARLES HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | STCHARLESHOSPITAL.CHSLI.ORG/ | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | WWW.CHSLI.ORG | OtherWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.CHSLI.ORG | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 300. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400. | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.CHSLI.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.CHSLI.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.CHSLI.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Prospective Medicare Medicaid | Yes (X) | ProspectiveMedicareMedicaidInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B, LINE 3E | IN 2016, 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 2016-2018 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. AS DIRECTED BY THE DATA RESULTS, COMMUNITY PARTNERS SELECTED CHRONIC DISEASE AS THE PRIORITY AREA WITH A FOCUS ON (1) OBESITY AND (2) PREVENTIVE CARE AND MANAGEMENT FOR THE 2016-2018 CYCLE. THE GROUP ALSO AGREED THAT A STRONG EMPHASIS ON MENTAL WITH INTEGRATION THROUGHOUT INTERVENTION STRATEGIES BE PERFORMED. |
| PART V, SECTION B, LINE 5 | ST. 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 2016, MEMBERS OF LIHC REVIEWED EXTENSIVE DATA SETS SELECTED FROM BOTH PRIMARY AND SECONDARY DATA SOURCES TO IDENTIFY AND CONFIRM PREVENTION AGENDA PRIORITIES FOR THE 2016-2018 COMMUNITY HEALTH NEEDS ASSESSMENT CYCLE. PRIMARY DATA SOURCES COLLECTED AND ANALYZED INCLUDE THE LONG ISLAND COMMUNITY HEALTH ASSESSMENT SURVEY, QUALITATIVE DATA FROM COMMUNITY-BASED ORGANIZATION SUMMIT EVENTS, AND THE LIHC WELLNESS SURVEY. THE BROAD COMMUNITY WAS ENGAGED IN ASSESSMENT EFFORTS THROUGH THE DISTRIBUTION AND COMPLETION OF THE PREVENTION AGENDA COMMUNITY MEMBER SURVEYS. THIS TOOL WAS DEVELOPED IN COLLABORATION WITH COMMUNITY PARTNERS FROM THE LIHC. DATA FROM THIS SURVEY WERE COLLECTED AUGUST 1, 2015 THROUGH APRIL 30, 2016 THROUGH DISTRIBUTION AND PROMOTION OF THIS SURVEY THROUGHOUT A WIDE RANGE OF SOCIAL SERVICE LOCATIONS, INCLUDING ST. CHARLES HOSPITAL, DOCTOR'S OFFICES, HEALTH DEPARTMENTS, LIBRARIES, SCHOOLS, INSURANCE ENROLLMENT SITES AND COMMUNITY-BASED ORGANIZATIONS. THIS INCLUDES THE UNDERSERVED COMMUNITIES OF CORAM, FARMINGVILLE, PATCHOGUE, PORT JEFFERSON STATION AND SOUND BEACH. ST. CHARLES HOSPITAL PROMOTES THE SURVEY THROUGH SOCIAL MEDIA LINKS, ON ITS WEBSITE, AND BY DISTRIBUTING SURVEYS AT HEALTH FAIRS AND OTHER CONSUMER-ORIENTED EVENTS. |
| PART V, SECTION B, LINE 6A | BROOKHAVEN MEMORIAL HOSPITAL, HUNTINGTON HOSPITAL, JOHN T. MATHER MEMORIAL HOSPITAL, PECONIC BAY MEDICAL CENTER (NOW PART OF NORTHWELL HEALTH), GOOD SAMARITAN HOSPITAL MEDICAL CENTER, ST. CATHERINE OF SIENA MEDICAL CENTER, SOUTHAMPTON HOSPITAL, SOUTHSIDE HOSPITAL, STONY BROOK UNIVERSITY HOSPITAL AND VETERANS AFFAIRS MEDICAL CENTER. |
| PART V, SECTION B, LINE 6B | THE 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 11 | ST. CHARLES HOSPITAL AND LIHC COMMUNITY PARTNERS SELECTED CHRONIC DISEASE AS THE PRIORITY AREA WITH A FOCUS ON (1) OBESITY AND (2) PREVENTIVE CARE AND MANAGEMENT FOR THE 2016-2018 CYCLE. MENTAL HEALTH WILL BE HIGHLIGHTED WITHIN ALL INTERVENTION STRATEGIES. PRIORITY 1: OBESITY ST. CHARLES HOSPITAL IS WORKING TO PREVENT OBESITY IN CHILDREN THROUGH A FOCUS ON NUTRITION AND EXERCISE. ST. CHARLES HOSPITAL HELD THINKHEALTHY! HEALTHY NUTRITION/EXERCISE PROGRAMS FOR CHILDREN IN 2017. IN FEBRUARY 2017, ST. CHARLES HOSPITALS EXECUTIVE CHEF AND DIRECTOR, NUTRITIONAL SERVICES DEPARTMENT, PROVIDED EDUCATION AND TRAINING TO 15 CHEFS EMPLOYED BY THE SACHEM SCHOOL DISTRICT. EDUCATION CONSISTED OF NUTRITIONAL CONTENT IN HEALTHY FOODS AND TRAINING CONSISTED OF COOKING HEALTHY RECIPES WITH THESE FOODS. IN MARCH 2017, A REGISTERED DIETITIAN FROM ST. CHARLES PRESENTED TWO SEMINARS (ONE HOUR EACH) TO A TOTAL OF 500 STUDENTS AND TEACHERS AT CLINTON AVENUE ELEMENTARY SCHOOL (COMSEWOGUE SCHOOL DISTRICT). THE EAT THE RAINBOW EDUCATION CONSISTED OF INFORMING CHILDREN OF HEALTHY FOOD CHOICES THAT MATCHED THE COLOR OF THE RAINBOW. IN JUNE 2017, ST. CHARLES HOSPITALS EXECUTIVE CHEF AND THE DIRECTOR OF THE NUTRITIONAL SERVICES DEPARTMENT, PROVIDED AN EATING THE RAINBOW PRESENTATION TO 100 STUDENTS AND 20 ADULTS AT THE WENONAH ELEMENTARY SCHOOL IN THE SACHEM SCHOOL DISTRICT. EDUCATION CONSISTED OF NUTRITIONAL CONTENT IN HEALTHY FOODS AND INFORMING CHILDREN OF HEALTHY FOOD CHOICES THAT MATCHED THE COLOR OF THE RAINBOW. ST. CHARLES HOSPITAL PARTNERED WITH THE PORT JEFFERSON CHAMBER OF COMMERCE, JOHN T. MATHER MEMORIAL HOSPITAL AND STONY BROOK UNIVERSITY MEDICAL CENTER TO OFFER A HEALTH FAIR FOR RESIDENTS OF THE THREE VILLAGE COMMUNITY. THE HOSPITAL PROVIDED A HEALTHY FOOD COURT WHERE THE EXECUTIVE CHEF DEMONSTRATED COOKING A HEALTHY BREAKFAST, LUNCH AND SNACKS. RECIPES FOR THE HEALTHY FOOD WERE DISTRIBUTED. A TOTAL OF 400 ADULTS AND CHILDREN ATTENDED. ST. CHARLES'S BARIATRIC SURGERY SUPPORT GROUP PROVIDES INFORMATION AND ENCOURAGEMENT FOR THOSE WHO SHARE THE WEIGHT-LOSS SURGERY EXPERIENCE. FREE MONTHLY EDUCATION SESSIONS ARE OFFERED TO THE COMMUNITY. THE OVEREATERS ANONYMOUS SUPPORT GROUP PROVIDES FELLOWSHIP FOR INDIVIDUALS WHO, THROUGH SHARED EXPERIENCE, STRENGTH, AND HOPE, ARE RECOVERING FROM COMPULSIVE OVEREATING. ST. CHARLES HOSPITAL ACTIVELY PROMOTES THE LONG ISLAND HEALTH COLLABORATIVE'S (LIHC) WALKING PROGRAM, BY DISTRIBUTING PROMOTIONAL MATERIALS AT COMMUNITY EVENTS AND THROUGH SOCIAL MEDIA. ST. CHARLES HOSPITAL ALSO SHARES PROGRAM INFORMATION WITH CHS-AFFILIATED PHYSICIANS AND MID-LEVEL PRACTITIONERS TO ENCOURAGE MORE PEOPLE TO WALK AND CHOOSE A HEALTHIER LIFESTYLE. THIRTY ST. CHARLES HOSPITAL EMPLOYEES PARTICIPATED IN THE LONG ISLAND MARCUM WORKPLACE CHALLENGE - A 3.5-MILE RUN-WALK FOR CHARITY - AND THE AMERICAN CANCER SOCIETY'S MAKING STRIDES AGAINST BREAST CANCER WALK. THESE EVENTS ENCOURAGE WALKING FOR PHYSICAL ACTIVITY AND GOOD HEALTH FOR EMPLOYEES AND THE COMMUNITY. EDUCATIONAL MATERIALS ARE OFFERED TO PARTICIPANTS AT EACH EVENT. PRIORITY 2: PREVENTIVE CARE AND MANAGEMENT ST. CHARLES IS WORKING TO INCREASE ACCESS TO HIGH-QUALITY DISEASE PREVENTIVE CARE AND MANAGEMENT FOR CARDIOVASCULAR DISEASE, DIABETES, AND ORTHOPEDIC CARE THROUGH ITS SPEAKERS TO GO PROGRAM. THE PROGRAM PROVIDES FREE EDUCATION TO THE COMMUNITY ON VARIOUS HEALTH AND WELLNESS PROGRAMS AND PROMOTES HEALTHIER LIFESTYLES. ST. CHARLES PROMOTED "SPEAKERS TO GO" LECTURES AND SEMINARS ON SOCIAL MEDIA, INCLUDING FACEBOOK, TWITTER, AND INSTAGRAM. IN ADDITION, AN ONLINE REGISTRATION FORM WAS DEVELOPED AND WAS AVAILABLE THROUGH SOCIAL MEDIA POSTS. IN 2017, ST. CHARLES PROVIDED NEARLY 40 FREE COMMUNITY LECTURES ON A VARIETY OF TOPICS HELD AT THE HOSPITAL AND AT ST. CHARLES'S OUTPATIENT REHABILITATION SITES AS WELL AS LOCAL SCHOOLS, SENIOR CITIZEN CENTERS, COMMUNITY/SCHOOL HEALTH FAIRS, AND LIBRARIES. ATTENDANCE RANGED FROM 15 PEOPLE TO 500 PEOPLE. TOPICS INCLUDED SLEEP BETTER, LIVE BETTER, STRIKING OUT STROKES, SMOKING CESSATION, BLOOD PRESSURE SCREENINGS, TAI CHI FOR ARTHRITIS, FALLS PREVENTION, MINIMIZING STRESS/MAXIMIZING LIFE, HEALTHY EATING FOR A HEALTHY HEART, BONE HEALTHY DIET, GET SHARP-STAY SHARP, ACL INJURY PREVENTION, ORAL CANCER SCREENINGS, AND SING A SONG OF HEALTH: BENEFITS OF MUSIC THERAPY. THERE IS A GREAT NEED FOR ORAL HYGIENE AND DENTAL SERVICES FOR VETERANS. ST. CHARLES HOSPITAL HELD A CLINIC FOR VETERANS IN NOVEMBER 2017, PROVIDING FREE SERVICES FOR ONE DAY. DENTAL SERVICES WERE DELIVERED TO 26 VETERANS, WITH MORE THAN 100 PROCEDURES PERFORMED. IN 2017, ST. CHARLES HOSPITAL OFFERED FREE MONTHLY SUPPORT GROUPS. A GROUP FOR WEIGHT-LOSS SURGERY PATIENTS HAD AN AVERAGE OF 15 PARTICIPANTS, A BI-WEEKLY SUPPORT GROUP FOR OVEREATERS ANONYMOUS HAD AN AVERAGE OF 20 PARTICIPANTS, AND A BI-WEEKLY STROKE SUPPORT GROUP HAD AN AVERAGE OF 12 PARTICIPANTS. ST. CHARLES STAFF VOLUNTEER AT CHS HEALTHY SUNDAYS COMMUNITY OUTREACH EVENTS HELD IN UNDERSERVED CHURCHES, OFFERING FREE HEALTH SCREENINGS AND PROVIDING EDUCATIONAL MATERIALS ON PREVENTIVE HEALTH. FOUR HEALTHY SUNDAYS EVENTS WERE HELD IN 2017: JANUARY 2017: ST. JOHN THE EVANGELIST CHURCH, RIVERHEAD - 46 INDIVIDUALS WERE PROVIDED BLOOD PRESSURE AND BMI SCREENINGS, AND 35 FREE FLU VACCINATIONS WERE ADMINISTERED. FOUR WERE REFERRED TO THE BISHOP MCHUGH HEALTH CENTER IN BABYLON FOR FREE FOLLOW-UP CARE. APRIL 2017: CHURCH OF ST. ROSALIE, HAMPTON BAYS, 30 INDIVIDUALS WERE PROVIDED BLOOD PRESSURE AND BMI SCREENINGS ALONG WITH HEALTH EDUCATION MATERIALS. ONE INDIVIDUAL WAS REFERRED TO THE BISHOP MCHUGH HEALTH CENTER IN BABYLON FOR FREE FOLLOW-UP CARE. JULY 2017: ST. FRANCES CABRINI CHURCH, CORAM. ST. CHARLES PARTNERED WITH LONG ISLAND DIGESTIVE DISEASE CONSULTANTS WHOSE CLINICAL STAFF OFFERED FREE SCREENINGS FOR INDIVIDUALS WITH GASTROINTESTINAL ISSUES. FREE HEALTH EDUCATION MATERIALS WERE OFFERRED TO ALL ATTENDEES. NOVEMBER 2017: CHURCH OF ST. ROSALIE, HAMPTON BAYS, 75 INDIVIDUALS ATTENDED, ALL RECEIVED A FLU SHOT AND WERE PROVIDED WITH HEALTH EDUCATION MATERIALS. ST. CHARLES HOSPITAL OFFERED THREE FREE, EVIDENCE-BASED,SEVEN-WEEK STEPPING ON PROGRAMS AT THE ROSE CARACAPPA SENIOR CENTER IN MT. SINAI. A TOTAL OF 45 INDIVIDUALS COMPLETED THE PROGRAM IN 2017. THIS PROGRAM EMPOWERS OLDER ADULTS TO LEARN HEALTH BEHAVIORS THAT REDUCE THE RISK OF FALLS, IMPROVE SELF-MANAGEMENT, AND INCREASE QUALITY OF LIFE. PRIORITY 3: MENTAL HEALTH ST. CHARLES HOSPITAL HAS COMPLETED THE NECESSARY WORK TO OPEN AN ADDITIONAL 10 BEDS FOR MEDICALLY SUPERVISED DETOXIFICATION. AS OF YEAR END 2017, THE HOSPITAL HAS NOT YET RECEIVED A CERTIFICATE OF OCCUPANCY FROM THE NEW YORK STATE DEPARTMENT OF HEALTH. ST. CHARLES HOSPITAL IS A DESIGNATED DISTRIBUTOR OF INTRANASAL NARCAN. THIS MEDICATION IS PROVIDED AS PREVENTION FOR POTENTIAL OVERDOSE INCIDENTS ONLY FOR INDIVIDUALS WHO PRESENT AT THE EMERGENCY DEPARTMENT SEEKING DETOXIFICATION. THE FREE CHS MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES GUIDE IS AVAILABLE THROUGHOUT THE HOSPITAL AND AT ALL COMMUNITY OUTREACH EVENTS. IN MAY 2017, ST. CHARLES HOSPITAL HOSTED A MULTIDISCIPLINARY SYMPOSIUM ON SUBSTANCE ABUSE. THE PROGRAM WAS FILLED TO CAPACITY AT 125 ATTENDEES. EXPERT CLINICIANS AND PROFESSIONALS PROVIDED CURRENT, EVIDENCE-BASED RESOURCES AND MATERIAL ON ALL ASPECTS OF ADDICTION, RECOVERY AND RELAPSE FOR PATIENTS ACROSS THE LIFESPAN: BIRTH TO GERIATRICS. 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 - STEP MEETING, WEEKLY AL-ANON FAMILY SUPPORT GROUP BEGINNERS MEETING, WEEKLY ALCOHOLICS ANONYMOUS - BACK TO BASICS, WEEKLY ALCOHOLICS ANONYMOUS - LIVING SOBER AND WEEKLY NARCOTICS ANONYMOUS. |
| PAER V, SECTION B, LINE 20E | ST. CHARLES HOSPITAL HAS POSTED MULTILINGUAL NOTICES ABOUT ITS CHARITY CARE POLICIES IN SEVERAL PROMINENT LOCATIONS WITHIN ST. CHARLES HOSPITAL 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 HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE. |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7 - RATIO OF PATIENT CARE COST TO CHARGES WORKSHEET | RATIO 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 2017. |
| PART III, LINES 2,3 - BAD DEBT AS COMMUNITY BENEFIT | AS 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 DEBT | THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THIS ALLOWANCE BASED UPON HISTORICAL COLLECTION AND WRITE- OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, CHS FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY CHS POLICY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE. CHS DOES NOT HAVE ANY OFF-BALANCE-SHEET CREDIT EXPOSURE RELATED TO ITS PATIENT ACCOUNTS RECEIVABLE. |
| PART III LINE 8 - COSTING METHODOLOGY | THE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 2017 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 9B | THE 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 GOALS | COMMUNITY 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 AND HAITAIN CREOLE) TO PARTICIPANTS AT SCREENING SITES, EVERY POINT OF CONTACT SERVES AS AN OPPORTUNITY 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 CHS'S WEBSITE. ST. CHARLES HOSPITAL 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 POLICY | 1. 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 INFORMATION | ST. 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 PRIMARY CATCHMENT AREA REPRESENTS 81% OF THE HOSPITAL'S ADMISSIONS. THE HOSPITAL'S SECONDARY CATCHMENT AREA HAS MORE THAN 200,000 RESIDENTS AND ACCOUNTS FOR ANOTHER 16% OF PATIENT ADMISSIONS. THIS SERVICE AREA (WHICH HAS NOT CHANGED SINCE 2008) COMPRISES SOME ECONOMICALLY CHALLENGED COMMUNITIES. ST. CHARLES HOSPITAL'S 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 HEALTH | ST. 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 HOSPITAL'S 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 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 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). ST. CHARLES HOSPITAL PARTICIPATES IN THE COMPREHENSIVE CARE FOR JOINT REPLACEMENT (CJR) MODEL. THE CJR MODEL AIMS TO SUPPORT BETTER AND MORE EFFICIENT CARE FOR BENEFICIARIES UNDERGOING THE MOST COMMON INPATIENT SURGERIES FOR MEDICARE BENEFICIARIES: HIP AND KNEE REPLACEMENTS (ALSO CALLED LOWER EXTREMITY JOINT REPLACEMENTS OR LEJR). |
| PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEM | ST. CHARLES HOSPITAL (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, 2017, 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 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 HOME 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 18,400 STAFF AND 4,600 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 CHRISTS 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. TO FURTHER THE MISSION OF BRINGING CARE TO THE COMMUNITY, CHS AND ITS MEMBER HOSPITALS, TOGETHER WITH A NUMBER OF OTHER HEALTH CARE PROVIDERS ON LONG ISLAND, ENTERED INTO A PARTNERSHIP AGREEMENT WHICH OPERATES AS THE LONG ISLAND HEALTH NETWORK (LIHN). LIHN WAS CREATED TO ESTABLISH A COMPREHENSIVE AND EFFICIENT HOSPITAL NETWORK IN NASSAU AND SUFFOLK COUNTIES WORKING TO, AMONG OTHER THINGS, IMPROVE QUALITY OF CARE, FACILITATE CLINICAL INTEGRATION, BENCHMARK BEST PRACTICES, AND REDUCE LENGTH OF STAY AND COSTS. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CATHOLIC HEALTH SERVICES OF LONG ISLAND | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 992 N VILLAGE AVE ROCKVILLE CENTRE | AddressLine1Txt |
| City | ROCKVILLE CENTRE | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11570 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 113403968 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $685,195 | CashGrantAmt |
| Valuation Method Used | NONE | ValuationMethodUsedDesc |
| Non Cash Assistance | NONE | NonCashAssistanceDesc |
| Purpose Of Grant | OUTPATIENT CENTERS | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE | CHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR ST CHARLES HOSPITAL 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALAN D GUERCI MD | ||||||||||||||
| PRESIDENT & CEO | $0 | $1,422,720 | $0 | $750,000 | $0 | $1,604,265 | $0 | $365,382 | $0 | $35,113 | $0 | $4,177,480 | $0 | $1,568,553 |
| DANIEL DEBARBA | ||||||||||||||
| EVP & CFO | $0 | $845,561 | $0 | $150,000 | $0 | $29,019 | $0 | $335,382 | $0 | $34,603 | $0 | $1,394,565 | $0 | $0 |
| JAMES O'CONNOR | ||||||||||||||
| CAO | $434,329 | $0 | $107,000 | $0 | $25,068 | $0 | $99,977 | $0 | $24,202 | $0 | $690,576 | $0 | $0 | $0 |
| SUNIL DHUPER | ||||||||||||||
| CMO | $318,096 | $0 | $40,000 | $0 | $3,034 | $0 | $22,977 | $0 | $580 | $0 | $384,687 | $0 | $0 | $0 |
| SATHISH SUBBAIAH MD | ||||||||||||||
| PHYSICIAN | $3,750,001 | $0 | $304,445 | $0 | $540 | $0 | $22,977 | $0 | $472 | $0 | $4,078,435 | $0 | $0 | $0 |
| MORGAN CHEN MD | ||||||||||||||
| PHYSICIAN | $3,743,740 | $0 | $95,721 | $0 | $540 | $0 | $22,977 | $0 | $31,884 | $0 | $3,894,862 | $0 | $0 | $0 |
| DOUGLAS PETRACO MD | ||||||||||||||
| PHYSICIAN | $1,791,337 | $0 | $327,856 | $0 | $1,242 | $0 | $22,977 | $0 | $34,287 | $0 | $2,177,699 | $0 | $0 | $0 |
| STEVEN PUOPOLO MD | ||||||||||||||
| PHYSICIAN | $1,693,739 | $0 | $210,993 | $0 | $1,080 | $0 | $22,977 | $0 | $32,003 | $0 | $1,960,792 | $0 | $0 | $0 |
| PHILIP SCHRANK MD | ||||||||||||||
| PHYSICIAN | $1,649,999 | $0 | $172,731 | $0 | $810 | $0 | $22,977 | $0 | $472 | $0 | $1,846,989 | $0 | $0 | $0 |
| WILLIAM C ARMSTRONG | ||||||||||||||
| SVP FINANCE | $0 | $698,726 | $0 | $170,000 | $0 | $21,655 | $0 | $195,382 | $0 | $32,462 | $0 | $1,118,225 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4B, SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN | THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. ALAN GUERCI $342,000 PARTICIPATION IN THE PLAN WILLIAM ARMSTRONG $172,000 PARTICIPATION IN THE PLAN DANIEL DEBARBA $312,000 PARTICIPATION IN THE PLAN JAMES O'CONNOR $77,000 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 $1,568,553 VESTED IN PLAN. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2017 FORM W-2, BOX 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. |
| PART II, REPORTING OF TOP FINANCIAL OFFICIAL | WILLIAM ARMSTRONG WAS REPORTED AS AN OFFICER IN 2015 AS THE TOP FINANCIAL OFFICIAL IN HIS ROLE AS INTERIM CFO. EFFECTIVE 2016, DANIEL DEBARBA IS THE TOP FINANCIAL OFFICER AS CFO, AND WILLIAM ARMSTRONG HAS RESUMED HIS ROLE AS SVP OF FINANCE. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION | THE SOLE MEMBER OF ST. CHARLES HOSPITAL 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 BODY | CHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF ST CHARLES HOSPITAL AND AS SUCH HAS THE RIGHT TO APPOINT THE GOVERNING BODY ST CHARLES HOSPITAL. |
| FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY | AS THE SOLE MEMBER OF ST. CHARLES HOSPITAL, CHS IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERNING BODY OF ST. CHARLES HOSPITAL. THE GOVERNING BODY OF ST. CHARLES HOSPITAL IS THE SAME AS THAT OF CHS. |
| FORM 990, PART VI, LINE 11B - REVIEW PROCESS FOR FORM 990 | THE FORM 990 AND RELATED SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD, AND PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS OF CHS, WHICH HAS BEEN DELEGATED THE FORM 990 REVIEW FUNCTION BY THE BOARD. UPON REVIEW AND RECOMMENDATION OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO THE BOARD FOR APPROVAL. UPON BOARD APPROVAL, THE FORM 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST POLICY | DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE CHS COMPLIANCE AND AUDIT COMMITTEE BY CHS' COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE IS GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE CHS BOARD OF DIRECTORS. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE BOARD OF DIRECTORS SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. THE PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIM/HERSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. |
| FORM 990, PART VI, LINE 15 - COMPENSATION POLICY | THE 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 INSPECTION | GOVERNING 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 1A | HOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. ALAN D. GUERCI, 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 (11-1871039) AND ST. JOSEPH HOSPITAL FOUNDATION (47-2353387). JAMES O'CONNOR EXECUTIVE DIRECTOR - THE TOTAL HOURS REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST CHARLES HOSPITAL & REHAB (11-1871039); ST CHARLES FOUNDATION (41-2076312); ST CHARLES CORPORATION (11-2983148). 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 (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 LIABILITIES | THE 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 ASSETS | CHANGE IN POST RETIREMENT BENEFIT: $96,000 --------- TOTAL: $96,000 |
| FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION | ST 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 (35 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CATHOLIC HEALTH SYSTEM OF LONG ISLAND | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 113403968 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | NA | false |
| CHS SERVICES INC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 113555766 | SUPPORT ORG | NY | 501(C)(3) | 12B-II | CHSLI | Yes (true) |
| CHS AMBULANCE SERVICES INC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 141801961 | DORMANT | NY | 501(C)(3) | 3 | CHSLI | false |
| GOOD SAMARITAN HOSPITAL MEDICAL CENTER | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 111888924 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| GOOD SAMARITAN SELF INSURANCE AGAINST | ||||||||||
| MALPRACTICE 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 112537396 | SELF INSURANC | NY | 501(C)(3) | 12A-I | GOOD SAMARTN | Yes (true) |
| MARYHAVEN TRANSPORTATION SERVICES | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 113434776 | TRANSPORTATIO | NY | 501(C)(3) | 12A-I | MARYHAVENCTR | false |
| MARYHAVEN CENTER OF HOPE | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 112861698 | Prgm-disabled | NY | 501(C)(3) | 10 | CHSLI | false |
| MARYHAVEN SCHOOL CORPORATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 112861690 | Schl-disabled | NY | 501(C)(3) | 2 | MARYHAVENCTR | false |
| THE CENTER OF HOPE FOUNDATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 113638367 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | MARYHAVENCTR | false |
| MERCY MEDICAL CENTER | ||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CTR | NY | 11570 | 111635088 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| CATHOLIC HOME CARE | ||||||||||
| 110 Bi-County Blvd Suite 114 | FARMINGDALE | NY | 11735 | 112126736 | HOME CARE | NY | 501(C)(3) | 10 | CHSLI | false |
| OUR LADY OF CONSOLATION GERIATRIC CARE | ||||||||||
| 111 BEACH DRIVE | WEST ISLIP | NY | 11795 | 113284066 | LT NURSE CARE | NY | 501(C)(3) | 10 | CHSLI | false |
| RIVERHEAD HOSTEL HOLDING CORPORATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 112499790 | RENTING | NY | 501(C)(2) | MARYHAVENCTR | false | |
| ST CATHERINE OF SIENA MEDICAL CENTER | ||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 061562701 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| CHS HOME SUPPORT SERVICES INC | ||||||||||
| 15 POWER DRIVE | HAUPPAGE | NY | 11788 | 113594561 | RESP THERAPY | NY | 501(C)(3) | 10 | CATHHOMECARE | false |
| ST FRANCIS HOSPITAL | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 112050523 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| ST FRANCIS HOSPITAL FOUNDATION | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 112916033 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | ST FRANCIS | false |
| ST FRANCIS HOSPITAL RESEARCH & EDUCATIO | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113090867 | RESEARCH ORG | NY | 501(C)(3) | 12A-I | ST FRANCIS | Yes (true) |
| WSNCHS NORTH INC | ||||||||||
| 4295 HEMPSTEAD TURNPIKE | BETHPAGE | NY | 11714 | 113438973 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| THE ST CHARLES CORPORATION | ||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSN ST | NY | 11777 | 112983148 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | CHSLI | false |
| THE SAMARITAN CORPORATION | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 112716640 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | CHSLI | false |
| WISDOM GARDENS HOUSING DEVELOPMENT FUND | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSN ST | NY | 11776 | 113559713 | SR HOUSING | NY | 501(C)(3) | 10 | MARYHAVENCTR | false |
| GOOD SHEPHERD HOSPICE | ||||||||||
| 110 Bi-County Blvd Suite 114 | FARMINGDALE | NY | 11735 | 112958438 | HOSPICE SVC | NY | 501(C)(3) | 10 | CHSLI | false |
| ST CHARLES HOSPITAL FOUNDATION | ||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 412076312 | SUPPORT ORG | NY | 501(C)(3) | 12A-1 | ST CHARLES | Yes (true) |
| GOOD SAMARITAN HOSPITAL FOUNDATION | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 770611240 | SUPPORT ORG | NY | 501(C)(3) | 12A-1 | GOOD SAMARTN | false |
| MERCY MEDICAL CENTER FOUNDATION | ||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 550813603 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | MERCY MEDCTR | false |
| ST CATHERINE OF SIENA MEDICAL CTR FDN | ||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 271459941 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | STCATHERINE | Yes (true) |
| CHS HOME CARE AND HOSPICE FOUNDATION | ||||||||||
| 110 Bi-County Blvd Suite 114 | FARMINGDALE | NY | 11735 | 452907761 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | CATHHOMECARE | false |
| GOOD SHEPHERD HOSPICE FOUNDATION | ||||||||||
| 110 Bi-County Blvd Suite 114 | FARMINGDALE | NY | 11735 | 263169427 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | GOODSHEPHERD | false |
| OUR LADY OF CONSOLATION FOUNDATION | ||||||||||
| 111 BEACH DRIVE | WEST ISLIP | NY | 11795 | 450517566 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | OURLADYOFC | false |
| RVC SUPPORT | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 271531084 | REAL ESTATE | NY | 501(C)(3) | 12A-I | CHSLI | false |
| ST FRANCIS CARDIOVASCULAR PHYSICIANS P | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113613997 | HEALTHCARESVC | NY | 501(C)(3) | 12A-I | ST FRANCIS | false |
| RVC INSURANCE COMPANYINC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 208067039 | CAPTIVE INS | NY | 501(C)(3) | 12B-II | CHSLI | false |
| SAMARITAN EMERGENCY MEDICAL SERVICES PC | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208243412 | HEALTHCARESVC | NY | 501(C)(4) | GOOD SAMARTN | false | |
| ST JOSEPH HOSPITAL FOUNDATION | ||||||||||
| 992 N VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 472353387 | SUPPORT ORG | NY | 501(C)(3) | 12A-I | WSNCHS NORTH | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt |
|---|---|---|---|---|---|---|---|---|
| BIPO HOLDINGS LLC | ||||||||
| 992 N VILLAGE AVE ROCKVILLE CENTRE | ROCKVILLE CENTRE | NY | 11570 | 464763720 | PHYSICIAN ASSN | NY | NA | N/A |
| IDHC LLC | ||||||||
| 2500 YORK RD JAMISONPA 18929 | JAMISON | PA | 18929 | 452411095 | HEALTH SERVICES | PA | NA | N/A |
| BEACON HEALTH PTNRS | ||||||||
| 992 N VILLAGE AVE ROCKVILLE CENTRE | ROCKVILLE CENTRE | NY | 11570 | 454229842 | HEALTHCARE | NY | NA | N/A |
| WISDOM GARDENS LP | ||||||||
| 51 TERRYVILLE RD | PORT JEFFERSON | NY | 11776 | 113567947 | SR HOUSING | NY | NA | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| RADIOLOGY CONSULTING OF LONG ISLANDPLLC | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 421646134 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| SAMARITAN PEDIATRIC SERVICES PC | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208180263 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| SAMARITAN MEDICAL SERVICES PC | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208088453 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| SOUTHWEST SUFFOLK MEDICAL PC | |||||||||
| 580 UNION BOULEVARD | WEST ISLIP | NY | 11795 | 061603195 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| CARDIAC EKG INTERPRETATION PC | |||||||||
| 992 N VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 112924518 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 208964140 | HEALTHCARE SVC | NY | GOOD SAMARITAN | C-CORP | false |
| SAMARITAN MANAGEMENT SERVICES | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 112838185 | HEALTHCARE SVC | NY | CHSLI | C-CORP | false |
| ADVANCED REHABILIATION MEDICINE PLLC | |||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 113640709 | HEALTHCARE SVC | NY | STCHARLES HOSP | C-CORP | false |
| ST FRANCIS CARDIAC PREVENTION SERVICES | |||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113224885 | HEALTHCARE SVC | NY | STFRANCIS HOSP | C-CORP | false |
| SOUTH SHORE PRACTICE MANAGEMENT | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 113307977 | HEALTHCARE SVC | NY | SAMARITAN MGMT | C-CORP | false |
| SAMARITAN HOME CARE AMERICA | |||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 113319259 | HEALTHCARE SVC | NY | SAMARITAN MGMT | C-CORP | false |
| MERCY INTERNAL MEDICINE PC | |||||||||
| 992 N VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 510639649 | HEALTHCARE SVC | NY | MERCY MED CTR | C-CORP | false |
| LONG ISLAND EMERGENCY CARE PC | |||||||||
| 1000 N VILLAGE AVE | ROCKVILLE | NY | 11571 | 113633515 | PHYSICIAN SVC | NY | MERCY MED CTR | S-CORP | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (true) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (true) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (true) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CHS SERVICES | ||
| LMPR | $129,050 | COST |
| ST FRANCIS HOSPITAL | ||
| LM | $102,496 | COST |
| ST CATHERINE OF SIENA MEDICAL CENTER | ||
| LM | $574,708 | COST |
| ST JOSEPH HOSPITAL | ||
| LM | $102,489 | COST |
| MERCY MEDICAL CENTER | ||
| LM | $172,080 | COST |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART IV | FormAndLineReferenceDesc |
| Explanation | FOR 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 |