ST CATHERINE OF SIENA MEDICAL CENTER: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- ST CATHERINE OF SIENA MEDICAL CENTER (EIN 06-1562701)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-13
- IRS object ID
- 201723179349307277
- Schema version
- 2016v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- 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 | 2017-11-13T15:40:18-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | 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 | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061562701 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CATHERINE OF SIENA MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % CHS SERVICES INC | InCareOfNm |
| Business Name Control | STCA | BusinessNameControlTxt |
| Phone | 6318623000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 ROUTE 25A | AddressLine1Txt |
| City | SMITHTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11787 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAUL ROWLAND | PersonNm |
| Person Title | EXEC VP & CAO | PersonTitleTxt |
| Phone | 5167051937 | PhoneNum |
| Signature | 2017-11-06 | 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 |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 155.201.188.12 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 13049920173175000063 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2017-11-13 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | A47FF8DD5715699DF48307C25ACEE32075633D08 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 061919171EF570F7EF91D6556883685BED3C11EB | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | 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 | 50 ROUTE 25A | AddressLine1Txt |
| City | SMITHTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11787 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $354,125,601 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://STCATHERINES.CHSLI.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | CHSLI AND ITS MEMBERS, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUE CHRIST'S HEALING MISSION, BY PROMOTING EXCELLENCE IN CARE AND COMMITTING ITSELF TO THOSE IN NEED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 23 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 22 | VotingMembersIndependentCnt |
| Total Employee | 2274 | TotalEmployeeCnt |
| Total Volunteers | 255 | TotalVolunteersCnt |
| Total Gross UBI | $186,594 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$26,802 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $49,810,203 | PYContributionsGrantsAmt |
| CY Contributions Grants | $12,645,433 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $220,724,403 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $240,876,446 | CYProgramServiceRevenueAmt |
| PY Investment Income | $244,760 | PYInvestmentIncomeAmt |
| CY Investment Income | $511,810 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,782,993 | PYOtherRevenueAmt |
| CY Other Revenue | $547,358 | CYOtherRevenueAmt |
| PY Total Revenue | $272,562,359 | PYTotalRevenueAmt |
| CY Total Revenue | $254,581,047 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $123,418 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $788,108 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $140,819,843 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $145,981,776 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $60,000 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $93,308,482 | PYOtherExpensesAmt |
| CY Other Expenses | $100,102,824 | CYOtherExpensesAmt |
| PY Total Expenses | $234,311,743 | PYTotalExpensesAmt |
| CY Total Expenses | $246,872,708 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $38,250,616 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,708,339 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $191,338,461 | TotalAssetsBOYAmt |
| Total Assets EOY | $203,136,491 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $219,070,882 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $223,128,519 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$27,732,421 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$19,992,028 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ST. CATHERINE OF SIENA MEDICAL CENTER, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED. CHS AFFIRMS THE SANCTITY OF LIFE, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $188,787,704 | ExpenseAmt |
| Grant | $788,108 | GrantAmt |
| Revenue | $205,627,649 | RevenueAmt |
| Desc | ST. CATHERINE OF SIENA MEDICAL CENTER IS A 306 BED ACUTE CARE HOSPITAL DEVOTED TO PROVIDING ADVANCED HEALTHCARE IN AN ENVIRONMENT OF COMPASSION. IN 2016, THE MEDICAL CENTER HAD 11,219 DISCHARGES AND PROVIDED CARE FOR 28,993 EMERGENCY ROOM VISITS. IN ACCORDANCE WITH ITS MISSION AND PHILOSOPHY, THE MEDICAL CENTER PROVIDES CARE REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY AND ALONG WITH OTHER COMMUNITY SERVICE AND CHARITABLE ACTIVITIES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $30,191,241 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $35,062,203 | RevenueAmt |
| Desc | ST. CATHERINE OF SIENA NURSING HOME IS LOCATED ON THE CAMPUS OF ST.CATHERINE OF SIENA MEDICAL CENTER. CONSISTING OF 240 BEDS, THE NURSING HOME PROVIDED 76,178 DAYS OF CARE IN 2016. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $218,978,945 | 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 | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (true) | 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 | Yes (true) | 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 | 176 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 2274 | 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 | 5167051919 | 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 (34 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 | |||
| JOSEPH TANTILLO | ||||||||||
| 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 | ||||
| BRIAN P HEHIR | ||||||||||
| 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 | ||||
| JEROME POLLER | ||||||||||
| 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 | ||||
| ALAN D GUERCI MD | ||||||||||
| PRESIDENT & CEO | 50.0 | 0.0 | Yes (X) | Yes (X) | $0 | $2,595,065 | $360,447 | |||
| DANIEL DEBARBA | ||||||||||
| EVP & CFO (Effective 6/6/16) | 50.0 | 0.0 | Yes (X) | $0 | $591,354 | $37,422 | ||||
| PAUL ROWLAND | ||||||||||
| EXEC VP & CAO | 50.0 | 0.0 | Yes (X) | $463,819 | $0 | $36,808 | ||||
| WILLIAM C ARMSTRONG | ||||||||||
| SVP FINANCE | 50.0 | 0.0 | Yes (X) | $0 | $1,552,126 | $188,843 | ||||
| JASON GOLBIN | ||||||||||
| CMO | 50.0 | 0.0 | $396,524 | $0 | $41,998 | Yes (X) | ||||
| BRUCE MAYERSEN MD | ||||||||||
| PHYSICIAN | 50.0 | 0.0 | $785,239 | $0 | $53,155 | Yes (X) | ||||
| SCHENLEY QUE MD | ||||||||||
| PHYSICIAN | 50.0 | 0.0 | $598,553 | $0 | $41,149 | Yes (X) | ||||
| JUNE LEE MD | ||||||||||
| PHYSICIAN | 50.0 | 0.0 | $459,708 | $0 | $30,058 | Yes (X) | ||||
| MICKEL KHLAT | ||||||||||
| PROGRAM DIRECTOR - HOSPITALIST | 50.0 | 0.0 | $448,333 | $0 | $50,326 | Yes (X) | ||||
| NARINDER DAWAR | ||||||||||
| HOSPITALIST | 50.0 | 0.0 | $439,061 | $0 | $25,229 | Yes (X) | ||||
| PATRICK O'SHAUGHNESSY | ||||||||||
| FORMER CMO | 0.0 | 50.0 | $0 | $908,577 | $315,184 | Yes (X) | ||||
| DENNIS VERZI | ||||||||||
| FORMER CAO | 0.0 | 50.0 | $0 | $1,739,844 | $235,641 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,591,237 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $7,386,966 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,416,260 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 279 | 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 |
|---|---|---|---|---|---|
| PHARMACY CORPORATION OF AMERICA | |||||
| PO Box 409251 | ATLANTA | GA | 30384 | PHARMACY | $697,437 |
| ISLAND NEONATOLOGY LLC | |||||
| PO BOX 272 | EAST ISLIP | NY | 11730 | PHYSICIAN SERVICES | $556,000 |
| HORIZON HEALTHCARE STAFFING | |||||
| 20 JERUSALEM AVE 3RD FL | HICKSVILLE | NY | 11801 | NURSING AGENCY FEES | $348,831 |
| LIZARDOS ENGINEERING ASSOC PC | |||||
| 200 Old Country Rd | MINEOLA | NY | 11501 | ENGINEERING | $243,019 |
| B MARGOLIS MD A SPADARO MD PC | |||||
| 373 RT 111 SUITE 5 | SMITHTOWN | NY | 11787 | PHYSICIAN SERVICES | $179,520 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 15 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $17 | FederatedCampaignsAmt |
| Related Organizations | $12,538,124 | RelatedOrganizationsAmt |
| Government Grants | $39,666 | GovernmentGrantsAmt |
| All Other Contributions | $67,626 | AllOtherContributionsAmt |
| Total Contributions | $12,645,433 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| NET PATIENT REV-HOSPITAL | 621990 | $205,814,243 | $205,627,649 | $186,594 |
| NET PATIENT REV-NURSING HOME | 623000 | $35,062,203 | $35,062,203 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $240,876,446 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $510,896 | TotalRevenueColumnAmt |
| Exclusion | $510,896 | 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 | $1,648,402 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,311,618 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $336,784 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $336,784 | TotalRevenueColumnAmt |
| Exclusion | $336,784 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $98,233,850 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $98,232,936 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $914 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $914 | TotalRevenueColumnAmt |
| Exclusion | $914 | ExclusionAmt |
| 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 (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 722514 | $44,459 | $44,459 |
| ALL OTHER REVENUE | 900099 | $166,115 | $166,115 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $210,574 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $254,581,047 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $240,689,852 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $186,594 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,059,168 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $788,108 | TotalAmt |
| Program Services | $788,108 | 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 | $939,149 | TotalAmt |
| Program Services | $438,522 | ProgramServicesAmt |
| Management And General | $500,627 | ManagementAndGeneralAmt |
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 | $106,612,569 | TotalAmt |
| Program Services | $99,439,276 | ProgramServicesAmt |
| Management And General | $7,173,293 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,950,348 | TotalAmt |
| Program Services | $7,383,083 | ProgramServicesAmt |
| Management And General | $567,265 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,488,608 | TotalAmt |
| Program Services | $19,744,697 | ProgramServicesAmt |
| Management And General | $1,743,911 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,991,102 | TotalAmt |
| Program Services | $8,349,578 | ProgramServicesAmt |
| Management And General | $641,524 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $286,371 | TotalAmt |
| Program Services | $96,374 | ProgramServicesAmt |
| Management And General | $189,997 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,150 | TotalAmt |
| Management And General | $39,150 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,792 | TotalAmt |
| Management And General | $27,792 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,756 | TotalAmt |
| Management And General | $54,756 | ManagementAndGeneralAmt |
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 | $7,283,517 | TotalAmt |
| Program Services | $5,410,381 | ProgramServicesAmt |
| Management And General | $1,873,136 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $310,284 | TotalAmt |
| Program Services | $2,850 | ProgramServicesAmt |
| Management And General | $307,434 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,614,318 | TotalAmt |
| Program Services | $2,697,188 | ProgramServicesAmt |
| Management And General | $917,130 | ManagementAndGeneralAmt |
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 | $2,604,334 | TotalAmt |
| Program Services | $2,208,027 | ProgramServicesAmt |
| Management And General | $396,307 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,578 | TotalAmt |
| Program Services | $70,630 | ProgramServicesAmt |
| Management And General | $21,948 | ManagementAndGeneralAmt |
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 | $3,610,704 | TotalAmt |
| Program Services | $3,610,704 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,707,408 | TotalAmt |
| Program Services | $4,707,408 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,638,532 | TotalAmt |
| Program Services | $5,415,626 | ProgramServicesAmt |
| Management And General | $1,222,906 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,355,449 | TotalAmt |
| Program Services | $6,353,379 | ProgramServicesAmt |
| Management And General | $2,070 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $32,720,214 | $32,720,214 | |
| CHS SERVICES | $15,161,706 | $6,787,024 | $8,374,682 |
| SERVICE/MAINTENANCE CONTRACTS | $2,495,481 | $2,495,481 | |
| PHYSICIAN PRACTICE SUBSIDY | $5,428,002 | $5,428,002 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,672,228 | TotalAmt |
| Program Services | $4,832,393 | ProgramServicesAmt |
| Management And General | $3,839,835 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,872,708 | TotalAmt |
| Program Services | $218,978,945 | ProgramServicesAmt |
| Management And General | $27,893,763 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,015,656 | BOYAmt |
| EOY | $5,332,836 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,195,373 | BOYAmt |
| EOY | $770,367 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,449 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,037,157 | BOYAmt |
| EOY | $29,420,163 | 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 | $3,409,876 | BOYAmt |
| EOY | $3,863,511 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,740,610 | BOYAmt |
| EOY | $2,576,316 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $175,243,663 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $99,510,247 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,142,179 | BOYAmt |
| EOY | $75,733,416 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,401,068 | BOYAmt |
| EOY | $7,516,154 | 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 | $42,350,705 | BOYAmt |
| EOY | $45,041,093 | 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 | $28,995,388 | BOYAmt |
| EOY | $32,882,635 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $191,338,461 | BOYAmt |
| EOY | $203,136,491 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,726,003 | BOYAmt |
| EOY | $31,991,133 | 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 | $66,069,464 | BOYAmt |
| EOY | $64,081,775 | 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 | $126,275,415 | BOYAmt |
| EOY | $127,055,611 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $219,070,882 | BOYAmt |
| EOY | $223,128,519 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$28,602,732 | BOYAmt |
| EOY | -$20,670,774 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $870,311 | BOYAmt |
| EOY | $678,746 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$27,732,421 | BOYAmt |
| EOY | -$19,992,028 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $191,338,461 | BOYAmt |
| EOY | $203,136,491 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $7,708,339 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$121,946 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $154,000 | 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
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
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 | $54,756 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $54,756 | 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 Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,126,496 | OtherCostOrOtherBasisAmt |
| Book Value | $10,126,496 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $92,135,348 | OtherCostOrOtherBasisAmt |
| Depreciation | $47,294,725 | DepreciationAmt |
| Book Value | $44,840,623 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $68,557,811 | OtherCostOrOtherBasisAmt |
| Depreciation | $51,153,095 | DepreciationAmt |
| Book Value | $17,404,716 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,424,008 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,062,427 | DepreciationAmt |
| Book Value | $3,361,581 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $75,733,416 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | TRUSTEE HELD ASSETS | Desc |
| Book Value | $45,041,093 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $45,041,093 | TotalBookValueProgramRltdAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INSURANCE CLAIMS RECEIVABLE | $32,766,243 |
| OTHER ASSETS | $116,392 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $32,882,635 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)
| DescDesc | AmtAmt |
|---|---|
| RESIDENT FUNDS AND SECURITY DEPOSIT | $91,621 |
| THIRD PARTY PAYOR LIABILITIES | $21,704,307 |
| RETIREMENT LIABILITY - PENSION | $1,282,000 |
| RETIREMENT LIABILITY - 457B FUNDS | $264,160 |
| RETIREMENT LIABILITY-POST RETIREMNT | $2,107,000 |
| ESTIMATED MALPRACTICE LIABILITY | $33,691,797 |
| SELF INSURED LIABILITY | $24,582,992 |
| DUE TO RELATED PARTIES | $43,331,734 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $127,055,611 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTE | FormAndLineReferenceDesc |
| Explanation | 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. | ExplanationTxt |
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 | false | ExpensesExceedBudgetInd |
| 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 | $2,656,559 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,058,120 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,598,439 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00650 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,058,059 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $19,483,744 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,574,315 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01040 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $618,206 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $461,792 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $156,415 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $25,332,824 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,003,656 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,329,169 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01750 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $550,241 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $550,241 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $8,460 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,460 | NetCommunityBenefitExpnsAmt |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $193,712 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $193,712 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $752,413 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $752,413 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00300 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $26,085,237 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $21,003,656 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,081,582 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02050 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,569,929 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $65,497,610 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $75,636,154 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$10,138,544 | 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 CATHERINE OF SIENA HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 ROUTE 25A | AddressLine1Txt |
| City | SMITHTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11787 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://STCATHERINES.CHSLI.ORG/ | WebsiteAddressTxt |
| State License | 5157003H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | PSYCHIATRIC UNIT | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CATHERINE OF SIENA MEDICAL CENTER | 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 | STCATHERINES.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 |
| 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 |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, SECTION B, LINE 5 | ST. CATHERINE OF SIENA MEDICAL CENTER 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. CATHERINE OF SIENA MEDICAL CENTER, DOCTORS OFFICES, HEALTH DEPARTMENTS, LIBRARIES, SCHOOLS, INSURANCE ENROLLMENT SITES AND COMMUNITY-BASED ORGANIZATIONS. THIS INCLUDES THE MEDICALLY UNDERSERVED COMMUNITIES OF HUNTINGTON STATION, HUNTINGTON CENTRAL ISLIP, BRENTWOOD AND RONKONKOMA. ST. CATHERINE OF SIENA MEDICAL CENTER 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, 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 HOSPITALS 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. CATHERINE OF SIENA MEDICAL CENTER 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 THE HOSPITAL IS WORKING TO INCREASE EDUCATION AND SUPPORT SERVICES TO HELP REDUCE OBESITY IN ADULTS AND CHILDREN IN SUFFOLK COUNTY, ESPECIALLY WITHIN THE HOSPITALS SERVICE AREAS, INCLUDING THE DISADVANTAGED AND UNDERSERVED COMMUNITIES. THROUGH COMMUNITY OUTREACH PROGRAMS, IT IS ADDRESSING THE NEED FOR IMPROVED AWARENESS AND EDUCATION ABOUT HEALTHY LIFESTYLE OPTIONS. PROGRAMS INCLUDE THE BOARD "WALK" TO WELLNESS WALKING PROGRAM AND ORGANIZED COMMUNITY WALKS IN PARTNERSHIP WITH OTHER GROUPS. FREE INFORMATION ON NUTRITION, WELLNESS, CHRONIC DISEASE PREVENTION, AND FREE BLOOD PRESSURE AND BMI SCREENINGS ARE OFFERED. THE HOSPITAL PARTICIPATED IN SEVERAL COMMUNITY WALKING EVENTS TO ENCOURAGE PHYSICAL ACTIVITY, INCLUDING THE AMERICAN CANCER SOCIETYS RELAY FOR LIFE AT COMMACK HIGH SCHOOL IN WHICH 3 EMPLOYEES PARTICIPATED, A KINGS PARK COMMUNITY PARADE IN WHICH 4 EMPLOYEES PARTICIPATED, AND A ST. JAMES COMMUNITY PARADE AT WHICH 10 EMPLOYEES PARTICIPATED. EDUCATIONAL MATERIALS ARE OFFERED TO PARTICIPANTS AT EACH EVENT. ST. CATHERINE OF SIENA MEDICAL CENTER PARTICIPATED IN THE AMERICAN HEART ASSOCIATION HEART WALK, THE LONG ISLAND MARCUM WORKPLACE CHALLENGE-A 3.5 MILE RUN-WALK FOR CHARITY-AND AMERICAN CANCER SOCIETY'S MAKING STRIDES AGAINST BREAST CANCER WALK. THESE EVENTS PROMOTE WALKING FOR PHYSICAL ACTIVITY AND GOOD HEALTH FOR COMMUNITY. ST. CATHERINE OF SIENA IS ACTIVELY PARTICIPATING WITH THE LONG ISLAND HEALTH COLLABORATIVE'S (LIHC) ARE YOU READY FEET? WALKING PROGRAM FOR LONG ISLANDERS. ST. CATHERINE COMMUNTIY OUTREACH STAFF WORKED WITH THE DIETICIAN AT THE LOCAL SHOPRITE OF COMMACK TO EDUCATE AND DISTRIBUTE MATERIALS RELATED TO WEIGHT MANAGEMENT, AND HEALTHY FOOD AND BEVERAGE CHOICES. BMI AND BLOOD PRESSURE SCREENINGS ARE OFFERED AT THE LOCAL SHOPRITE GROCERY STORE THREE TIMES ANNUALLY. THIS STORE IS LOCATED NEAR THE UNDERSERVED COMMUNITIES OF CENTRAL ISLIP AND BRENTWOOD. IN 2016, A TOTAL OF 57 BLOOD PRESSURE SCREENINGS WERE PROVIDED ALONG WITH THE DISTRIBUTION OF EDUCATIONAL MATERIALS. LECTURES ON PHYSICIAN-DRIVEN PROGRAMS ON TOPICS RELATED TO WEIGHT MANAGEMENT AND NUTRITION FOUR TIMES ANNUALLY. IN 2016, THERE WERE A TOTAL OF 410 ATTENDEES AT THE 3 SCHEDULED LECTURES. FOR PATIENTS WHO HAVE UNDERGONE A BARIATRIC SURGICAL PROCEDURE, ST. CATHERINE OF SIENA OFFERS A FREE BARIATRIC SUPPORT GROUP TO ASSIST WITH THE TRANSITION AND ENCOURAGE HEALTHY EATING AND PHYSICAL FITNESS FOR OPTIMAL HEALTH. IN 2016, 24 SESSIONS WERE HELD WITH 160 PARTICIPANTS. THE MEDICAL CENTER CONTINUES TO COORDINATE FREE OR LOW-COST EVENTS FOR THE COMMUNITY, AND PROVIDES FREE BODY MASS INDEX (BMI) SCREENINGS AND INFORMATION ON NUTRITION, HEALTHY EATING, AND WELLNESS INITIATIVES. THE COMMUNITY OUTREACH PROGRAM ENCOMPASSES ALL EVENTS THE HOSPITAL PARTICIPATES IN, SUCH AS LOCAL COMMUNITY FESTIVALS AND HEALTH FAIRS AND HOSPITAL-SPONSORED EVENTS, INCLUDING THE ANNUAL FALL HEALTH FAIR. CHS WAS THE MEDAL OF HONOR TITLE SPONSOR FOR THE SECOND CONSECUTIVE YEAR SERVING AGAIN AS THE OFFICIAL RACE MEDICINE PROVIDER FOR THE 2016 CHS SUFFOLK COUNTY MARATHON AND FREEDOM FEST. THE NET PROCEEDS FROM THE ANNUAL EVENT BENEFITS LOCAL VETERANS SERVICES ORGANIZATIONS. THERE WERE 2 ST. CATHERINE EMPLOYEES WHO PARTICIPATED IN THE MARATHON. PRIORITY 2: PREVENTIVE CARE AND MANAGEMENT THE HOSPITAL IS WORKING TO INCREASE ACCESS TO HIGH-QUALITY DISEASE PREVENTIVE CARE AND MANAGEMENT FOR CARDIOVASCULAR DISEASE AND DIABETES IN CLINICAL AND COMMUNITY SETTINGS. ST. CATHERINES VOLUNTEER STAFF PROVIDED DISEASE EDUCATION, BLOOD PRESSURE AND BMI SCREENINGS, DERMATOLOGY AND CHOLESTEROL SCREENINGS, AND FREE FLU VACCINATIONS AT LOCAL COMMUNITY FESTIVALS AND HEALTH FAIRS AND HOSPITAL-SPONSORED EVENTS, INCLUDING THE ANNUAL FALL HEALTH FAIR. IN 2016, A TOTAL OF 6,868 PEOPLE WERE IN ATTENDANCE AT COMMUNITY EVENTS IN WHICH THE HOSPITAL COORDINATED OR PARTICIPATED, FOR A TOTAL OF 722 BLOOD PRESSURE SCREENINGS WERE PROVIDED, 285 FLU VACCINATIONS WERE ADMINISTERED, AND 191 CHOLESTEROL AND GLUCOSE SCREENINGS WERE COMPLETED. ST. CATHERINE OF SIENA OFFERS A VARIETY OF FREE COMMUNITY SUPPORT GROUPS RELATED TO THE PREVENTION OR MANAGEMENT OF CHRONIC DISEASES, INCLUDING DIABETES, LUPUS, STROKE, AND PARKINSON'S DISEASE. IN 2016, A TOTAL OF 881 PEOPLE WERE IN ATTENDANCE AT SUPPORT GROUPS RELATED TO DIABETES, LUPUS, AND PARKINSONS DISEASE. THE SEVEN-WEEK STEPPING ON PROGRAM IS AN EVIDENCE-BASED FALL PREVENTION PROGRAM DESIGNED TO REDUCE FALLS AND BUILD CONFIDENCE IN OLDER ADULTS. IN 2016, THE PROGRAM WAS OFFERED 3 TIMES WITH ALMOST 40 PARTICIPANTS. ADDITIONAL SESSIONS ARE BEING PLANNED AT ST. CATHERINE OF SIENA MEDICAL CENTER FOR 2017. ST. CATHERINES STAFF VOLUNTEERED AT CHS HEALTHY SUNDAYS COMMUNITY OUTREACH EVENTS HELD IN UNDERSERVED COMMUNITIES, OFFERING FREE HEALTH SCREENINGS AND PROVIDING EDUCATIONAL MATERIALS ON PREVENTIVE CARE AND MANAGEMENT. IN 2016, ST. CATHERINE PARTICIPATED IN 5 EVENTS AND SCREENED 222 INDIVIDUALS IN MEDICALLY UNDERSERVED AREAS. A TOTAL OF 143 FLU VACCINATIONS, 97 BLOOD PRESSURE SCREENINGS AND 30 BMI ASSESSMENTS WERE COMPLETED. A REFERAL FOR FREE FOLLOW-UP CARE WAS PROVIDED TO 37 INDIVUDALS; 36 WERE REFERRED TO THE BISHOP MCHUGH HEALTH CENTER IN BABYLON, AND 1 WAS REFERRED TO CHSS SOUTH BAY CARDIOLOGY. ALL ATTENDEES WERE OFFERED A VARIETY OF HEALTH EDUCATION MATERIALS. ST. CATHERINE PARTICIPATED IN THE SUFFOLK COUNTY RETIRED SENIOR VOLUNTEER PROGRAM (RSVP), LEGISLATOR TROTTAS SENIOR FAIR, AND OTHER ORGANIZATIONAL EMPLOYEE WELLNESS PROGRAMS, OFFERING FREE BLOOD PRESSURE AND BMI SCREENINGS TO INCREASE AWARENESS AND EDUCATION ABOUT CHRONIC DISEASE IN UNDERSERVED COMMUNITIES. IN 2016, A TOTAL OF 750 ATTENDEES RECEIVED EDUCATIONAL MATERIALS, AND 45 BLOOD PRESSURE SCREENINGS WERE PROVIDED. ST. CATHERINE OF SIENA OFFERS A FREE EMERGENCY RESPONSE APPRECIATION DINNER FOR LOCAL EMERGENCY RESPONSE PERSONNEL WHO ALSO COLLABORATE WITH ST. CATHERINE OF SIENA AS COMMUNITY BENEFIT ORGANIZATIONS. THE EVENT INCREASES COMMUNICATION AMONG EMERGENCY RESPONDERS AND THE HOSPITALS EMERGENCY DEPARTMENT. IN MARCH 2016, THERE WERE 70 PARTICIPANTS AT THE EVENT WHICH FOCUSED ON "CARDIAC ARRHYTHMIA AND EKG INTERPRETATION"EMS MANAGEMENT OF ACUTE SURGICAL ISSUES". PRIORITY 3: MENTAL HEALTH THE HOSPITAL PROVIDED EDUCATION ABOUT PRESCRIPTION DRUG USE AND SAFE DRUG DISPOSAL AT HORIZONS COUNSELING CENTER AND THE TWO SMITHTOWN HIGH SCHOOLS. IN 2016, THREE OFF-CAMPUS EVENTS WERE COORDINATED BY THE HOSPITAL IN COLLABORATION WITH COMMUNITY PARTNERS. A TOTAL OF 165 ATTENDEES RECEIVED MENTAL HEALTH AND SUBSTANCE USE EDUCATIONAL MATERIALS. THE ST. CATHERINE OF SIENA COMMUNITY OUTREACH COORDINATOR PARTICIPATED IN THE MENTAL HEALTH FIRST AID TRAINING AT ST. FRANCIS HOSPITAL IN NOVEMBER 2016, PRESENTED BY THE MENTAL HEALTH ASSOCIATION OF NASSAU COUNTY. THIS FREE, EIGHT-HOUR TRAINING IS DESIGNED FOR CAREGIVERS OF THOSE WHO LIVE WITH CHRONIC DISEASE AS WELL AS HOSPITAL STAFF WHO WORK WITH CAREGIVERS OR RUN HOSPITAL SUPPORT GROUPS. THE FREE CHS MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES GUIDE IS AVAILABLE THROUGHOUT THE HOSPITAL AND AT ALL COMMUNITY OUTREACH EVENTS. |
| PART V, SECTION B, LINE 20E | ST. CATHERINE OF SIENA MEDICAL CENTER HAS POSTED MULTILINGUAL NOTICES ABOUT ITS CHARITY CARE POLICIES 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. ST. CATHERINE OF SIENA MEDICAL CENTER HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST CATHERINE OF SIENA NURSING HOME | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 25 ROUTE 25A | AddressLine1Txt |
| City | SMITHTOWN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11787 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | SKILLED NURSING FACILITY | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (13 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 ON THE RCC METHODOLOGY OR ACTUAL COSTS FOR THE SERVICES AS TRACKED BY HOSPITAL PERSONNEL 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 2016. |
| PART I, LINE 7 | REFLECTS HOSPITAL INFORMATION ONLY. |
| PART III, LINE 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 HEALTH CARE 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, THE MEDICAL CENTER 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 2016 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 8 - MEDICARE SHORTFALL AS COMMUNITY BENEFIT | LOSSES ON TREATING MEDICARE BENEFICIARIES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT IN THEIR ENTIRETY. THIS REPRESENTS THE AMOUNT BY WHICH COSTS TO DELIVER CARE TO MEDICARE RECIPIENTS EXCEEDS THE LEVEL OF PAYMENT. ST. CATHERINE BEARS THE BURDEN OF NOT ONLY PROVIDING THE BEST AND MOST ADVANCED MEDICAL CARE POSSIBLE TO THE COMMUNITY, BUT ALSO DOING SO WITH NO RECOURSE IN OBTAINING PAYMENT FOR THE COST OF PROVIDING CARE IN EXCESS OF THE MEDICARE PAYMENT. AS MEDICARE REVENUE DECLINES AND THE COST TO PROVIDE CUTTING-EDGE CARE TO THE COMMUNITY INCREASES, THE HOSPITAL WILL CARRY THE BURDEN. AS A PARTICIPATING PROVIDER AND A CHARITABLE ORGANIZATION, MEDICARE PATIENTS, THE MAJORITY OF WHOM ARE ELDERLY AND DISABLED ARE NOT TURNED AWAY, SO ST. CATHERINE WILL CONTINUE TO BEAR THE LOSS IN PROVIDING THE BEST CARE POSSIBLE TO THE LOCAL COMMUNITY. |
| 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 INANBILITY 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 MEDICAL CENTER'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. CATHERINE 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 MEDICAL CENTER 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 ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE MEDICAL CENTER REPRESENTATIVES. 2. THE MEDICAL CENTER HAS POSTED MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN THE MEDICAL CENTER 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 FROM THE LOCATION AT WHICH THEY ARE POSTED. 3. THE MEDICAL CENTER 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 MEDICAL CENTER POSTS ITS CHARITY CARE POLICY SUMMARY ON ITS WEBSITE. 5. THE MEDICAL CENTER 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 PROVIDED AT OR BELOW A SIXTH GRADE READING LEVEL. |
| PART VI, LINE 4 - COMMUNITY INFORMATION | ST. CATHERINE OF SIENA MEDICAL CENTER IS LOCATED ON 110 ACRES ON THE NORTH SHORE OF LONG ISLAND IN SMITHTOWN, NEW YORK. THIS 558-BED, NOT-FOR-PROFIT COMMUNITY HOSPITAL, INCLUDES 240 NURSING/REHAB BEDS AND A MEDICAL OFFICE BUILDING. ST. CATHERINES SERVICE AREA CONSISTS OF 21 COMMUNITIES LOCATED IN WESTERN SUFFOLK COUNTY. APPROXIMATELY 648,000 PEOPLE RESIDE IN THE SERVICE AREA. ST. CATHERINES PRIMARY CATCHMENT AREA HAS A POPULATION OF APPROXIMATELY 248,000 AND INCLUDES SMITHTOWN, ST. JAMES, HAUPPAUGE, KINGS PARK, COMMACK, NESCONSET, NORTHPORT, AND EAST NORTHPORT. THE SECONDARY SERVICE AREA COMPRISES LAKE GROVE, CENTERPORT, GREENLAWN, HUNTINGTON STATION, HUNTINGTON, AND COLD SPRING HARBOR. IN ADDITION, ST. CATHERINE SEES PATIENTS FROM CENTRAL ISLIP, BRENTWOOD, AND RONKONKOMA. THESE ARE PRIMARILY UNDERSERVED COMMUNITIES. |
| PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH | ST. CATHERINE OF SIENA MEDICAL CENTER OFFERS A WIDE AND COMPREHENSIVE ARRAY OF COMMUNITY SERVICE PROGRAMS THAT ADDRESS CRITICAL HEALTH ISSUES TO A DIVERSE GROUP OF PATIENTS. THE FOLLOWING ARE COMMUNITY SERVICE PROGRAMS OFFERED BY ST. CATHERINE OF SIENA MEDICAL CENTER: ST. CATHERINE'S COMMUNITY OUTREACH INCLUDES FREE COMMUNITY LECTURES, BLOOD PRESSURE, BODY MASS INDEX (BMI) AND OTHER SCREENINGS, SMOKING CESSATION ASSISTANCE, FOOD AND CLOTHING DRIVES, AND FALL PREVENTION PROGRAMS FOR SENIORS IN PARTNERSHIP WITH ASSISTED LIVING FACILITIES, CHAMBERS OF COMMERCE, LIBRARIES, AND OTHER LOCAL ORGANIZATIONS. ST. CATHERINE PUBLISHES A COMMUNITY NEWSLETTER, THE SIENA VOICE, WHICH IS MAILED TO MORE THAN 107,000 LOCAL HOUSEHOLDS. THE VOICE IS A PRIMARY METHOD OF EDUCATING THE COMMUNITY ABOUT HEALTH-RELATED ISSUES ADVISING ABOUT FREE SUPPORT GROUPS AND OTHER NO-CHARGE SERVICES AND KEEPING THEM INFORMED OF UPCOMING EVENTS AND HOSPITAL SERVICES. THE HOSPITALS MATERNITY DEPARTMENT OFFERS THE "YOU AND YOUR BABY" EDUCATIONAL SERIES WHICH INCLUDES A VARIETY OF SUPPORT GROUPS AND WORKSHOPS FOR NEW MOTHERS AND FAMILY MEMBERS. SOME GROUPS ARE THE BREAST-FEEDING, CHILDBIRTH EDUCATION, EARLY PREGNANCY, FAMILY AND FRIENDS CPR, INFANT ONLY, GRANDPARENTS CLASSES, INFANT CARE CLASSES, PRENATAL BREAST-FEEDING CLASSES, LACTATION SUPPORT GROUP, SIBLING CLASSES, MOTHER'S CIRCLE OF HOPE AND A POSTPARTUM SUPPORT GROUP. ST. CATHERINE'S IS DEDICATED TO EDUCATING THE COMMUNITY AND PROUDLY OFFERS MEDICAL COMMUNITY EDUCATION THROUGH FREE LECTURES AND PRESENTATIONS ON A VARIETY OF HEALTH AND WELLNESS TOPICS. OTHER SUPPORT GROUPS OFFERED INCLUDE BARIATRIC, DIABETES, STROKE, PARKINSON'S DISEASE, LUPUS, CAREGIVERS OF A CHRONICALLY ILL OR DISABLED PARTNER, AND CAREGIVERS OF PEOPLE WITH DEMENTIA. THROUGH A COMBINATION OF LECTURES AND PRESENTATIONS, ST. CATHERINE'S HOPES TO IMPROVE THE QUALITY OF LIFE AND PROMOTE WELLNESS AND HEALTHY LIVING. ST. CATHERINE, IN COLLABORATION WITH SMITHTOWN AND COMMACK HIGH SCHOOLS, CONDUCTS A 16-WEEK HEALTH CARE CAREER EXPLORATION AND INTERNSHIP PROGRAM (HCEIP) THAT INCLUDES A SEMINAR AND HANDS-ON WORKSHOP FOR STUDENTS INTERESTED IN CAREERS IN HEALTH CARE. PROFESSIONALS FROM VARIOUS CLINICAL DEPARTMENTS LECTURE/TEACH AND PROVIDE SKILL-BASED TRAINING ALONG WITH INFORMATION REGARDING COLLEGE CHOICES AND DEGREE REQUIREMENTS TO HELP STUDENTS MAKE CAREER CHOICES. UPON COMPLETION OF THE PROGRAM AND 30 HOURS OF VOLUNTEER SERVICE IN EITHER THE HOSPITAL OR NURSING AND REHABILITATION CARE CENTER, STUDENTS ARE ELIGIBLE TO RECEIVE HALF A HEALTH CREDIT. ST. CATHERINE OF SIENA MEDICAL CENTER 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. CATHERINE OF SIENA MEDICAL CENTER (ST. CATHERINE OR THE HOSPITAL OR THE MEDICAL CENTER) AND ST. CATHERINE OF SIENA NURSING AND REHABILITATION CARE CENTER ARE LOCATED ON A SINGLE CAMPUS IN SMITHTOWN, NEW YORK. ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS, ST. CATHERINE, THROUGH ITS DAILY OPERATION, PROVIDES TO THE AREA ACUTE, EMERGENT AND OUTPATIENT CARE, AS WELL AS LONG-TERM CARE AND HOUSING. ST. CATHERINE 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, 2016, 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 CARE 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 17,500 STAFF AND 4,300 MEDICAL STAFF WORKING THROUGHOUT THE SYSTEM, CHS PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES. OUR MISSION STATES: CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE AND COMMITS ITSELF TO THOSE IN NEED. CHS AFFIRMS THE SANCTITY OF LIFE, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTH CARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. 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 SERVICES HAS BUILT A DISTINGUISHED TRADITION OF OPERATING COMMUNITY-BASED HOSPITALS AND HUMAN SERVICE 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 BY 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 | 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 | $788,108 | 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 |
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 CATHERINE OF SIENA MEDICAL CENTER 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 (12 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 | $1,382,345 | $0 | $410,000 | $0 | $802,720 | $0 | $327,174 | $0 | $33,273 | $0 | $2,955,512 | $0 | $767,223 |
| DANIEL DEBARBA | ||||||||||||||
| EVP & CFO (Effective 6/6/16) | $0 | $460,115 | $0 | $115,000 | $0 | $16,239 | $0 | $21,174 | $0 | $16,248 | $0 | $628,776 | $0 | $0 |
| PAUL ROWLAND | ||||||||||||||
| EXEC VP & CAO | $384,411 | $0 | $56,000 | $0 | $23,408 | $0 | $34,617 | $0 | $2,191 | $0 | $500,627 | $0 | $0 | $0 |
| JASON GOLBIN | ||||||||||||||
| CMO | $365,706 | $0 | $30,000 | $0 | $818 | $0 | $20,617 | $0 | $21,381 | $0 | $438,522 | $0 | $0 | $0 |
| BRUCE MAYERSEN MD | ||||||||||||||
| PHYSICIAN | $677,058 | $0 | $106,706 | $0 | $1,475 | $0 | $20,617 | $0 | $32,538 | $0 | $838,394 | $0 | $0 | $0 |
| SCHENLEY QUE MD | ||||||||||||||
| PHYSICIAN | $597,143 | $0 | $0 | $0 | $1,410 | $0 | $20,617 | $0 | $20,532 | $0 | $639,702 | $0 | $0 | $0 |
| JUNE LEE MD | ||||||||||||||
| PHYSICIAN | $349,847 | $0 | $109,500 | $0 | $361 | $0 | $20,617 | $0 | $9,441 | $0 | $489,766 | $0 | $0 | $0 |
| MICKEL KHLAT | ||||||||||||||
| PROGRAM DIRECTOR - HOSPITALIST | $298,305 | $0 | $40,793 | $0 | $109,235 | $0 | $20,617 | $0 | $29,709 | $0 | $498,659 | $0 | $0 | $0 |
| NARINDER DAWAR | ||||||||||||||
| HOSPITALIST | $396,290 | $0 | $28,500 | $0 | $14,271 | $0 | $15,171 | $0 | $10,058 | $0 | $464,290 | $0 | $0 | $0 |
| WILLIAM C ARMSTRONG | ||||||||||||||
| SVP FINANCE | $0 | $665,953 | $0 | $200,000 | $0 | $686,173 | $0 | $158,174 | $0 | $30,669 | $0 | $1,740,969 | $0 | $664,661 |
| PATRICK O'SHAUGHNESSY | ||||||||||||||
| FORMER CMO | $0 | $715,731 | $0 | $175,000 | $0 | $17,846 | $0 | $285,174 | $0 | $30,010 | $0 | $1,223,761 | $0 | $0 |
| DENNIS VERZI | ||||||||||||||
| FORMER CAO | $0 | $873,389 | $0 | $200,000 | $0 | $666,455 | $0 | $225,174 | $0 | $10,467 | $0 | $1,975,485 | $0 | $190,000 |
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 $306,000 participation in the plan William Armstrong $137,000 participation in the plan Dennis Verzi $204,000 participation in the plan Patrick O'Shaughnessy $264,000 participation in the plan Paul Rowland $14,000 Participation in 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 $767,223, vested in plan. William Armstrong $664,661, vested in plan. Dennis Verzi $632,427 vested in plan. The amounts outlined herein were included in each individual's 2016 Form W-2, Box 5 as taxable wages because they are vested, but are not distributed until retirement. Part II - Former officers and directors Effective 7/1/2013, Dennis Verzi was transferred to Catholic Health Services of Long Island, a related entity, to serve as the COO. Effective 6/1/2013, Patrick O'Shaughnessy was transferred to Catholic Health Services of Long Island, a related entity, to serve as the CMO. |
| 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 6/6/16, DANIEL DEBARBA BECAME THE TOP FINANCIAL OFFICER AS CFO, AND WILLIAM ARMSTRONG 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. CATHERINE OF SIENA MEDICAL CENTER 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. |
| FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODY | CHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF ST CATHERINE OF SIENA MEDICAL CENTER, AND HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF ST. CATHERINE. |
| FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY | AS THE SOLE MEMBER OF ST. CATHERINE OF SIENA MEDICAL CENTER, CHS IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERING BODY OF ST. CATHERINE OF SIENA MEDICAL CENTER. THE GOVERNING BODY OF ST. CATHERINE MEDICAL CENTER 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 GUERCI, M.D. PRESIDENT AND CEO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); RVC INSURANCE COMPANY (20-8067039); 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); SIENNA VILLAGE (06-1569129) AND ST. CHARLES HOSPITAL (11-1871039). PAUL ROWLAND, EXECUTIVE VP AND CAO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); SIENA VILLAGE (06-1569129). WILLIAM ARMSTRONG, SR VP FINANCE - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER OR HIGHEST PAID EMPLOYEE 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); SIENA VILLAGE, INC. (06-1569129); AND GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396). 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); SIENA VILLAGE, INC. (06-1569129); 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) 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), NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE AND FINANCING CORPORATION (SERIES 2011 NASSAU BOND) AND SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION (SERIES 2014c SUFFOLK BONDS). THE BONDS ARE REPORTED ON SCHEDULE K OF THE PARENT ORGANIZATION, CATHOLIC HEALTH SERVICES OF LONG ISLAND. |
| FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS | CHANGES IN POST RETIREMENT BENEFITS: $154,000 |
| SCHEDULE B, PART I, LINE 2 | ST. CATHERINE OF SIENA MEDICAL CENTER IS THE SOLE MEMBER OF SIENA VILLAGE. EFFECTIVE DECEMBER 15, 2015, SIENA VILLAGE SOLD SUBSTANTIALLY ALL OF ITS ASSETS AND CEASED OPERATIONS. SIENA VILLAGE TRANSFERRED $42,728,649 OF THE PROCEEDS OF THE SALE TO ST. CATHERINE OF SIENA MEDICAL CENTER IN 2015. IN 2016, SIENA VILLAGE TRANSFERRED ITS REMAINING ASSETS OF $5,038,124 TO ST. CATHERINE OF SIENA MEDICAL CENTER. BOTH THE PROCEEDS OF THE SALE AND THE REMAINING ASSETS TRANSFERRED ARE RESTRICTED FOR THE PAYMENT OF ST. CATHERINE OF SIENA MEDICAL CENTER BOND PRINCIPAL PAYMENTS AS PAYMENTS BECOME DUE. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Total IncomeTotalIncomeAmt | End Of Year AssetsEndOfYearAssetsAmt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|
| SIENA RETIREMENT REALTY CCRC | |||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 061569102 | RETIRE COMMUN | NY | $0 | $3,477,302 | STCATHERINE |
| SIENA MEDICAL REALTY | |||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 061568934 | MED BUILDING | NY | $1,360,975 | $7,225,857 | STCATHERINE |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (36 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 | |
| SIENA VILLAGE INC | ||||||||||
| 2000 BISHOPS ROAD | SMITHTOWN | NY | 11787 | 061569129 | SR HOUSING | NY | 501(C)(3) | 10 | STCATHERINE | Yes (true) |
| ST CHARLES HOSPITAL | ||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSN ST | NY | 11777 | 111871039 | HOSPITAL | NY | 501(C)(3) | 3 | CHSLI | Yes (true) |
| CHS HOME SUPPORT SERVICES INC | ||||||||||
| 15 POWER DRIVE | HAUPPAUGE | 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- I | ST CHARLES | false |
| GOOD SAMARITAN HOSPITAL FOUNDATION | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 770611240 | SUPPORT ORG | NY | 501(C)(3) | 12A- I | GOOD SAMARTN | false |
| MERCY MEDICAL CENTER FOUNDATION | ||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 550813603 | SUPPORT ORG | NY | 501(C)(3) | 12A- I | MERCY MEDCTR | false |
| ST CATHERINE OF SIENA MEDICAL CTR FDN | ||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 271459941 | SUPPORT ORG | NY | 501(C)(3) | 12A- I | STCATHERINE | Yes (true) |
| CATHOLIC HOME CARE 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 | ||||||||
| 1600 STEWART AVE WESTBURY NY | WESTBURY | NY | 11590 | 464763720 | PHYSICIAN ASSN | NY | NA | |
| IDHC LLC | ||||||||
| 2500 YORK RD JAMISONPA 18929 | JAMISON | PA | 18929 | 452411095 | HEALTH SERVICES | PA | NA | |
| BEACON HEALTH PTNRS | ||||||||
| 1600 STEWART AVE WESTBURY NY | WESTBURY | NY | 11590 | 454229842 | HEALTHCARE | NY | NA | |
| 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 | Yes (true) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | 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 (8 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SIENA VILLAGE | ||
| C | $5,038,124 | COST |
| CHS SERVICES INC | ||
| LMPR | $669,233 | COST |
| GOOD SAMARITAN HOSPITAL MEDICAL CENTER | ||
| LM | $606,805 | COST |
| SIENA VILLAGE | ||
| LQ | $556,082 | COST |
| ST FRANCIS HOSPITAL | ||
| LM | $325,374 | COST |
| MERCY MEDICAL CENTER | ||
| LM | $284,582 | COST |
| ST JOSEPH HOSPITAL | ||
| LM | $100,382 | COST |
| ST CHARLES HOSPITAL | ||
| LM | $80,668 | 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 |