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CENTRAL SUFFOLK HOSPITAL FOUNDATION: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
CENTRAL SUFFOLK HOSPITAL FOUNDATION (EIN 20-0714587)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-15
IRS object ID
201823199349315487
Schema version
2017v2.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-15T16:08:26-06:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN131517563PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LOEB & TROPER LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1655 THIRD AVENUE 12TH FLOORAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10017ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN200714587EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CENTRAL SUFFOLK HOSPITAL FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCENTBusinessNameControlTxt
Phone6315486064PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1Txt
CityRIVERHEADCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11901ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHAEL O'DONNELLPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone6315486064PhoneNum
Signature2018-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAARON SHAPIROPreparerPersonNm
PTINP01333816PTIN
Phone2128674000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address64.22.227.161IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-15IPDt
IP Tm16:37:17IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id4275C7E7C8129915C35F764424C97B97C01C68F2AtSubmissionCreationDeviceId
At Submission Filing Device Id988419C5643A1C0877F6823E03E3852E0B43B763AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1PECONIC BAY MEDICAL CENTER FOUNDATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerANDREW J MITCHELLPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1Txt
CityRIVERHEADCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11901ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,712,367GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PBMCHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTHE MISSION OF THE CENTRAL SUFFOLK HOSPITAL FOUNDATION (THE FOUNDATION) IS TO SEEK PHILANTHROPIC SUPPORT ON BEHALF OF CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER (CSH).ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,688,063PYContributionsGrantsAmt
CY Contributions Grants$7,383,258CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$20,566PYInvestmentIncomeAmt
CY Investment Income$23,761CYInvestmentIncomeAmt
PY Other Revenue-$172,248PYOtherRevenueAmt
CY Other Revenue$186,704CYOtherRevenueAmt
PY Total Revenue$3,536,381PYTotalRevenueAmt
CY Total Revenue$7,593,723CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$204,930PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$430,899CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$1,543,488CYTotalFundraisingExpenseAmt
PY Other Expenses$1,074,988PYOtherExpensesAmt
CY Other Expenses$1,118,480CYOtherExpensesAmt
PY Total Expenses$1,279,918PYTotalExpensesAmt
CY Total Expenses$1,549,379CYTotalExpensesAmt
PY Revenues Less Expenses$2,256,463PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$6,044,344CYRevenuesLessExpensesAmt
Total Assets BOY$6,374,289TotalAssetsBOYAmt
Total Assets EOY$21,558,722TotalAssetsEOYAmt
Total Liabilities BOY$454,626TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,590,458TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,919,663NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$11,968,264NetAssetsOrFundBalancesEOYAmt
MissionTHE FOUNDATION'S MISSION IS TO DEVELOP AND CULTIVATE PHILANTHROPIC AND COLLABORATIVE RELATIONSHIPS THAT FOSTER PROGRAMS AND SERVICES OFFERED THROUGH CSH WHICH IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTHE SUPPORT OF HOSPITAL SERVICES OF CSH.Desc
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document7IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHAEL F O'DONNELLBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6315486074PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1Txt
CityRIVERHEADCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11901ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt
EMILIE ROY COREY MSW
BOARD CHAIR10.00Yes (X)Yes (X)$0$0$0
J GORDON HUSZAGH
VICE CHAIR10.00Yes (X)Yes (X)$0$0$015.00
RICHARD ISRAEL
VICE CHAIR1.00Yes (X)Yes (X)$0$0$01.00
JOAN S LEVAN
SECRETARY/TREASURER1.00Yes (X)Yes (X)$0$0$01.00
ANDREW J MITCHELL FACHE
PRESIDENT/CEO15.00Yes (X)Yes (X)$0$1,051,786$34,96622.50
BRUCE BARNET
BOARD MEMBER1.00Yes (X)$0$0$0
MARY ANN ALEXANDER
BOARD MEMBER1.00Yes (X)$0$0$0
JUDITH JEDLICKA
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD L WINSLOW PHD
BOARD MEMBER1.00Yes (X)$0$0$01.00
MICHAEL SCHWENK
BOARD MEMBER1.00Yes (X)$0$0$01.00
STANLEY ZINBERG
BOARD MEMBER1.00Yes (X)$0$0$01.00
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$1,051,786TotReportableCompRltdOrgAmt
Total Other Compensation$34,966TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CENTRAL SUFFOLK HOSPITAL
1300 ROANOKE AVENUERIVERHEADNY11901ADMINISTRATIVE SERVICES$629,756
COMMUNITY COUNSELING CO LLC
461 FIFTH AVENUENEW YORKNY10017FUNDRAISING COUNSEL$422,500
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Fundraising$503,511FundraisingAmt
All Other Contributions$6,879,747AllOtherContributionsAmt
Total Contributions$7,383,258TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,312TotalRevenueColumnAmt
Exclusion$23,312ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$33,290RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$33,290RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$33,290TotalRevenueColumnAmt
Exclusion$33,290ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$6,579SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$6,130SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$449SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$449TotalRevenueColumnAmt
Exclusion$449ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$265,928FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$503,511ContriRptFundraisingEventAmt
Fundraising Direct Expenses$112,514FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$153,414TotalRevenueColumnAmt
Exclusion$153,414ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,593,723TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$210,465ExclusionAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$629,756TotalAmt
Fundraising$629,756FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$430,899TotalAmt
Fundraising$430,899FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$5,891TotalAmt
Management And General$5,891ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$14,769TotalAmt
Fundraising$14,769FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,865TotalAmt
Fundraising$2,865FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$285,840TotalAmt
Fundraising$285,840FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$30,883TotalAmt
Fundraising$30,883FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$17,788TotalAmt
Fundraising$17,788FundraisingAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescCOMMUNITY OUTREACHDesc
Total$4,600TotalAmt
Fundraising$4,600FundraisingAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$126,088TotalAmt
Fundraising$126,088FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,549,379TotalAmt
Program Services$0ProgramServicesAmt
Management And General$5,891ManagementAndGeneralAmt
Fundraising$1,543,488FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$119,051BOYAmt
EOY$110,405EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,201,995BOYAmt
EOY$1,624,871EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,986,303BOYAmt
EOY$6,442,449EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$9,375BOYAmt
EOY$194,703EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$12,123,786LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$12,123,786EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,057,565BOYAmt
EOY$1,062,508EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,374,289BOYAmt
EOY$21,558,722EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$70,269BOYAmt
EOY$5,283EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$121,568BOYAmt
EOY$110,479EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
EOY$8,600,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$262,789BOYAmt
EOY$874,696EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$454,626BOYAmt
EOY$9,590,458EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,194,082BOYAmt
EOY$7,128,133EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,725,581BOYAmt
EOY$4,840,131EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,919,663BOYAmt
EOY$11,968,264EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,374,289BOYAmt
EOY$21,558,722EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$6,044,344ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$4,257NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,318,620CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,071,944CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,408,832CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,688,063CurrentTaxYearMinus1YearAmt
Current Tax Year$7,383,258CurrentTaxYearAmt
Total$16,870,717TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,318,620CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,071,944CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,408,832CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,688,063CurrentTaxYearMinus1YearAmt
Current Tax Year$7,383,258CurrentTaxYearAmt
Total$16,870,717TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$3,525,574SubstantialContributorsTotAmt
Public Support Total170$13,345,143PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,091CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,311CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,575CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$19,995CurrentTaxYearMinus1YearAmt
Current Tax Year$56,602CurrentTaxYearAmt
Total$91,574TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year$153,414CurrentTaxYearAmt
Total$153,414TotalAmt
FieldValueIRS element (for citing)
Total Support$17,115,705TotalSupportAmt
Public Support CY1700.77970PublicSupportCY170Pct
Public Support PY1700.67300PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$240,500OtherCostOrOtherBasisAmt
Book Value$240,500BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,883,286OtherCostOrOtherBasisAmt
Book Value$11,883,286BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$12,123,786TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTERDesc
Amt$874,696Amt
FieldValueIRS element (for citing)
Total Liability$874,696TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$7,597,980TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$4,257NetUnrealizedGainsInvstAmt
Revenue Not Reported$4,257RevenueNotReportedAmt
Revenue Subtotal$7,593,723RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$7,593,723TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,549,379TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$1,549,379ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,549,379TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, THE FOUNDATION HAS REFLECTED AS A LIABILITY FOR THOSE CONTRIBUTIONS BEING HELD ON BEHALF OF WOMEN'S HEALTH PARTNERSHIP.
PART X, LINE 2:THE FOUNDATION HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2014 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Email SolicitationsYes (X)EmailSolicitationsInd
Phone SolicitationsYes (X)PhoneSolicitationsInd
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising ActyYes (1)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdActivityActivityTxtFundraiser Control Of FundsFundraiserControlOfFundsIndGross ReceiptsGrossReceiptsAmtRetained By ContractorRetainedByContractorAmtNet To OrganizationNetToOrganizationAmt
THE GOBEL GROUP
16 WEST MARKET STREET 2ND FLOORWEST CHESTERPA19382FUNDRAISING COUNSEL0$0$8,399$0
COMMUNITY COUNSELING CO LLC
461 FIFTH AVENUENEW YORKNY10017FUNDRAISING COUNSEL0$0$422,500$0
FieldValueIRS element (for citing)
Total Retained By Contractors$430,899TotalRetainedByContractorsAmt
Licensed StatesNYLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1BLACK AND WHITEEvent1Nm
Gross Receipts Event1$480,778GrossReceiptsEvent1Amt
Charitable Contri Event1$346,475CharitableContriEvent1Amt
Gross Revenue Event1$134,303GrossRevenueEvent1Amt
Rent Facility Costs Event1$13,141RentFacilityCostsEvent1Amt
Food And Beverage Event1$25,168FoodAndBeverageEvent1Amt
Entertainment Event1$2,000EntertainmentEvent1Amt
Other Direct Expenses Event1$5,964OtherDirectExpensesEvent1Amt
Event2GOLF EVENTEvent2Nm
Gross Receipts Event2$179,725GrossReceiptsEvent2Amt
Charitable Contri Event2$48,100CharitableContriEvent2Amt
Gross Revenue Event2$131,625GrossRevenueEvent2Amt
Rent Facility Costs Event2$15,000RentFacilityCostsEvent2Amt
Food And Beverage Event2$32,983FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$5,367OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$108,936GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$108,936CharitableContriOtherEventsAmt
Rent Fclty Costs Other Events$8,440RentFcltyCostsOtherEventsAmt
Food And Beverage Other Events$3,438FoodAndBeverageOtherEventsAmt
Oth Direct Expnss Other Events$1,013OthDirectExpnssOtherEventsAmt
Gross Receipts Total$769,439GrossReceiptsTotalAmt
Charitable Contributions Tot$503,511CharitableContributionsTotAmt
Gross Revenue Total Events$265,928GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$36,581RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$61,589FoodAndBeverageTotalEventsAmt
Entertainment Total Events$2,000EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$12,344OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$112,514DirectExpenseSummaryEventsAmt
Net Income Summary$153,414NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonANDREW J MITCHELL FACHEPersonNm
TitlePRESIDENT/CEOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$807,795CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$243,991BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$18,500DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$16,466NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$1,086,752TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationCSH UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2017.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE CEO/PRESIDENT, AND CHIEF FINANCIAL OFFICER OF CSH, A RELATED ORGANIZATION, REVIEW THE FORM 990. A COPY OF THE FORM 990 IS ALSO PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. THE BOARD REVIEWS THE DOCUMENT AND REACHES OUT TO CSH SHOULD THEY HAVE ANY QUESTIONS. IF NO QUESTIONS ARE RAISED, THE FORM 990 IS SUBMITTED FOR FILING.
FORM 990, PART VI, SECTION B, LINE 12THE FOUNDATION FOLLOWS CSH'S CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15CSH UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2017.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XII, LINE 2C:THIS PROCESS DID NOT CHANGE FROM THAT OF THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1CENTRAL SUFFOLK HOSPITAL DBA PECONIC BAY MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVEAddressLine1Txt
CityRIVERHEADCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11901ZIPCd
FieldValueIRS element (for citing)
EIN111661359EIN
Primary ActivitiesHOSPITAL CAREPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity Status3PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1PECONIC HEALTH CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd