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SIENA VILLAGE: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
SIENA VILLAGE (EIN 06-1569129)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-13
IRS object ID
201743179349307274
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-11-13T15:40:18-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1300 Madison AvenueAddressLine1Txt
CityNew YorkCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10017ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN061569129EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SIENA VILLAGEBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% CHS SERVICESInCareOfNm
Business Name ControlSIENBusinessNameControlTxt
Phone6318623000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12000 BISHOPS ROADAddressLine1Txt
CitySMITHTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11787ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPAUL ROWLANDPersonNm
Person TitleEXECUTIVE VP, CAOPersonTitleTxt
Phone5167051937PhoneNum
Signature2017-11-06SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

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

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address155.201.188.12IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id13049920173175000049FederalOriginalSubmissionId
Federal Original Submission Id2017-11-13FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdA47FF8DD5715699DF48307C25ACEE32075633D08AtSubmissionCreationDeviceId
At Submission Filing Device Id061919171EF570F7EF91D6556883685BED3C11EBAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Final ReturnYes (X)FinalReturnInd
Principal OfficerALAN D GUERCI MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line150 ROUTE 25AAddressLine1Txt
CitySMITHTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11787ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$28,215GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2000FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionCHSLI 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
Contract TerminationYes (X)ContractTerminationInd
Voting Members Governing Body23VotingMembersGoverningBodyCnt
Voting Members Independent22VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$3,990,285PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$49,700,863PYInvestmentIncomeAmt
CY Investment Income$25,292CYInvestmentIncomeAmt
PY Other Revenue$8,986PYOtherRevenueAmt
CY Other Revenue$2,923CYOtherRevenueAmt
PY Total Revenue$53,700,134PYTotalRevenueAmt
CY Total Revenue$28,215CYTotalRevenueAmt
PY Grants And Similar Paid$42,728,649PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$5,038,124CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$750,610PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,278,531PYOtherExpensesAmt
CY Other Expenses$10,485CYOtherExpensesAmt
PY Total Expenses$45,757,790PYTotalExpensesAmt
CY Total Expenses$5,048,609CYTotalExpensesAmt
PY Revenues Less Expenses$7,942,344PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$5,020,394CYRevenuesLessExpensesAmt
Total Assets BOY$5,152,919TotalAssetsBOYAmt
Total Assets EOY$0TotalAssetsEOYAmt
Total Liabilities BOY$120,595TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$5,032,324NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSIENA VILLAGE, 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$5,038,271ExpenseAmt
Grant$5,038,124GrantAmt
Revenue$0RevenueAmt
DescEffective December 15, 2015, Siena Village sold substantially all of its assets and has ceased operations.Desc
Total Program Service Expenses$5,038,271TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsYes (true)TerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members23GoverningBodyVotingMembersCnt
Independent Voting Member22IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCHS SERVICESPersonNm
Phone5167051919PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1992 NORTH VILLAGE AVEAddressLine1Txt
CityROCKVILLE CENTERCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11570ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
SALVATORE SODANO
CHAIR2.00.0Yes (X)Yes (X)$0$0$0
BRIAN MCGUIRE
VICE CHAIR2.00.0Yes (X)Yes (X)$0$0$0
JOSEPH TANTILLO
SECRETARY2.00.0Yes (X)Yes (X)$0$0$0
CHRIS PASCUCCI
TREASURER2.00.0Yes (X)Yes (X)$0$0$0
BARBARA ELLEN BLACK
TRUSTEE2.00.0Yes (X)$0$0$0
VIRGINIA EWEN
TRUSTEE2.00.0Yes (X)$0$0$0
FRANK L KURRE
TRUSTEE2.00.0Yes (X)$0$0$0
REV MSGR ROBERT MORRISEY
TRUSTEE2.00.0Yes (X)$0$0$0
DANIEL T ROWE
TRUSTEE2.00.0Yes (X)$0$0$0
JOHN WAGNER
TRUSTEE2.00.0Yes (X)$0$0$0
REV JAMES VLAUN
TRUSTEE2.00.0Yes (X)$0$0$0
KEVIN J CONWAY
TRUSTEE2.00.0Yes (X)$0$0$0
PETER D'ANGELO
TRUSTEE2.00.0Yes (X)$0$0$0
REV PETER DUGANDZIC
TRUSTEE2.00.0Yes (X)$0$0$0
BRIAN P HEHIR
TRUSTEE2.00.0Yes (X)$0$0$0
HON ANTHONY MARANO
TRUSTEE2.00.0Yes (X)$0$0$0
STEPHEN F MCLOUGHLIN
TRUSTEE2.00.0Yes (X)$0$0$0
JEROME POLLER
TRUSTEE2.00.0Yes (X)$0$0$0
JOHN FRANCFORT MD
TRUSTEE2.00.0Yes (X)$0$0$0
ALEXANDER HAZELTON
TRUSTEE2.00.0Yes (X)$0$0$0
WILLIAM WARD
TRUSTEE2.00.0Yes (X)$0$0$0
ROBERT ZUCCARO
TRUSTEE2.00.0Yes (X)$0$0$0
ALAN D GUERCI MD
PRESIDENT & CEO50.00.0Yes (X)Yes (X)$0$2,595,065$360,447
DANIEL DEBARBA
EVP & CFO (EFFECTIVE 6/6/16)50.00.0Yes (X)$0$591,354$37,422
PAUL ROWLAND
EXECUTIVE VP & CAO50.00.0Yes (X)$0$463,819$36,808
WILLIAM C ARMSTRONG
SVP FINANCE50.00.0Yes (X)$0$1,552,126$188,843
DENNIS VERZI
FORMER EXEC VP/CAO0.050.0$0$1,739,844$235,641Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,942,208TotReportableCompRltdOrgAmt
Total Other Compensation$859,161TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,292TotalRevenueColumnAmt
Exclusion$25,292ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

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

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

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

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business900099BusinessCd
Total Revenue Column$2,923TotalRevenueColumnAmt
Exclusion$2,923ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,923OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$28,215TotalRevenueColumnAmt
Exclusion$28,215ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$5,038,124TotalAmt
Program Services$5,038,124ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$10,338TotalAmt
Management And General$10,338ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$147TotalAmt
Program Services$147ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,048,609TotalAmt
Program Services$5,038,271ProgramServicesAmt
Management And General$10,338ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,721,098BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$59BOYAmt
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

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

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

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

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

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

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

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

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$642,417BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$789,345BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,152,919BOYAmt
EOY$0EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$120,595BOYAmt
EOY$0EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

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

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

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

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$120,595BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$5,032,324BOYAmt
EOY$0EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,032,324BOYAmt
EOY$0EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,152,919BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$5,020,394ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$11,930NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,810,877CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,818,326CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,857,133CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,990,285CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$15,476,621TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$12,207CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$20,517CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,821CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,986CurrentTaxYearMinus1YearAmt
Current Tax Year$2,923CurrentTaxYearAmt
Total$54,454TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,823,084CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,838,843CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,866,954CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,999,271CurrentTaxYearMinus1YearAmt
Current Tax Year$2,923CurrentTaxYearAmt
Total$15,531,075TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,474,147CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,486,601CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,524,174CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,642,148CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$10,127,070TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,474,147CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,486,601CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,524,174CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,642,148CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$10,127,070TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$5,404,005PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$60,860CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$64,029CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23,574CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$22,948CurrentTaxYearMinus1YearAmt
Current Tax Year$25,292CurrentTaxYearAmt
Total$196,703TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$60,860CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$64,029CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23,574CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$22,948CurrentTaxYearMinus1YearAmt
Current Tax Year$25,292CurrentTaxYearAmt
Total$196,703TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,883,944CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,902,872CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,890,528CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,022,219CurrentTaxYearMinus1YearAmt
Current Tax Year$28,215CurrentTaxYearAmt
Total$15,727,778TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.34360PublicSupportCY509Pct
Public Support PY5090.34372PublicSupportPY509Pct
Investment Income CY0.01251InvestmentIncomeCYPct
Investment Income PY0.01246InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp
LandLandGrp
BuildingsBuildingsGrp
Leasehold ImprovementsLeaseholdImprovementsGrp
EquipmentEquipmentGrp
Other Land BuildingsOtherLandBuildingsGrp
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt
Total Liability$0TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTEFormAndLineReferenceDesc
ExplanationCHS 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 I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1ST CATHERINE OF SIENA MEDICAL CENTERBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line150 ROUTE 25AAddressLine1Txt
CitySMITHTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11787ZIPCd
FieldValueIRS element (for citing)
Recipient EIN061562701RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$5,038,124CashGrantAmt
Valuation Method UsedNONEValuationMethodUsedDesc
Non Cash AssistanceNONENonCashAssistanceDesc
Purpose Of GrantTRANSFER PROCEEDSPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USECHS SERVICES, A RELATED ENTITY MAINTAINS THE BOOKS AND RECORDS FOR ST. CATHERINE OF SIENA MEDICAL CENTER AND SIENNA VILLAGE AND IS THEREFORE ABLE TO MONITOR THAT ST. CATHERINE OF SIENA MEDICAL CENTER USES THE GRANT FOR PAYMENT OF DEBT SERVICE.
PART II, LINE 1 COLUMN (H) - PURPOSE OF GRANT OR ASSISTANCETRANSFER PROCEEDS FROM SALE TO PARENT COMPANY. THE PROCEEDS OF THE SALE ARE RESTRICTED FOR THE PAYMENT OF ST. CATHERINE OF SIENA MEDICAL CENTER DEBT SERVICE AS PAYMENTS BECOME DUE.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ALAN D GUERCI MD
PRESIDENT & CEO$0$1,382,345$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
EXECUTIVE VP & CAO$0$384,411$0$56,000$0$23,408$0$34,617$0$2,191$0$500,627$0$0
DENNIS VERZI
FORMER EXEC VP/CAO$0$873,389$0$200,000$0$666,455$0$225,174$0$10,467$0$1,975,485$0$190,000
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

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3 - METHODS TO ESTABLISH COMPENSATION BY RELATED ORGANIZATIONThe following methods are used by a related organization to establish compensation of the CEO/Executive Director: A compensation committee, Independent Compensation Consultant, Written employment contract, Compensation survey or study, Form 990 of other organizations, and approval by the Board or Compensation Committee.
PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANThe following individuals participated in the supplemental non-qualified retirement plan. The amounts below are included on Schedule J, Part II, Column C. Alan Guerci $306,000 participation in the plan William Armstrong $137,000 participation in the plan Dennis Verzi $204,000 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 DIRECTORSEFFECTIVE 7/1/2013, DENNIS VERZI WAS TRANSFERRED TO CATHOLIC HEALTH SERVICES OF LONG ISLAND, A RELATED ENTITY, TO SERVE AS THE COO.
PART II - REPORTING OF TOP FINANCIAL OFFICIALWILLIAM ARMSTRONG WAS REPORTED AS AN OFFICER IN 2015 AS THE TOP FINANCIAL OFFICIAL IN HIS ROLE AS INTERIM CFO. EFFECTIVE 6/6/16, DANIEL DEBARBA BECAME THE TOP FINANCIAL OFFICER AS CFO, AND WILLIAM ARMSTRONG RESUMED HIS ROLE AS SVP OF FINANCE.

Schedule N IRS990ScheduleN

Liquidation Of Assets Table LiquidationOfAssetsTableGrp

Liquidation Of Assets Detail LiquidationOfAssetsDetail

FieldValueIRS element (for citing)
Assets Distri Or Expnss PaidCASH AND INVESTMENTSAssetsDistriOrExpnssPaidDesc
Distribution2016-12-31DistributionDt
Fair Market Value Of Asset$5,038,124FairMarketValueOfAssetAmt
Method Of FMV DeterminationFMVMethodOfFMVDeterminationTxt
EIN061562701EIN
PersonST CATHERINE OF SIENA MEDICAL CENTPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line150 ROUTE 25AAddressLine1Txt
CitySMITHTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11787ZIPCd
FieldValueIRS element (for citing)
IRC Section501c(3)IRCSectionTxt
FieldValueIRS element (for citing)
Director Of SuccessorfalseDirectorOfSuccessorInd
Employee Of SuccessorfalseEmployeeOfSuccessorInd
Owner Of SuccessorfalseOwnerOfSuccessorInd
Receive CompensationfalseReceiveCompensationInd
Assets DistributedYes (true)AssetsDistributedInd
Required To Notify AGYes (true)RequiredToNotifyAGInd
Attorney General NotifiedYes (true)AttorneyGeneralNotifiedInd
Liabilities PaidYes (true)LiabilitiesPaidInd
Bonds OutstandingfalseBondsOutstandingInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATIONTHE SOLE MEMBER OF SIENA VILLAGE IS ST. CATHERINE OF SIENA MEDICAL CENTER AND THE SOLE MEMBER OF ST. CATHERINE 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 (DIOCESE).
FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODYCHS 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 SIENA VILLAGE.
FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODYCHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF ST. CATHERINE IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERNING BODY OF SIENA VILLAGE.
FORM 990, PART VI, LINE 11B - REVIEW PROCESS FOR FORM 990THE FORM 990 AND RELATED SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD, AND PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS OF CHS, WHICH HAS BEEN DELEGATED THE FORM 990 REVIEW FUNCTION BY THE BOARD. UPON REVIEW AND RECOMMENDATION OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO THE BOARD FOR APPROVAL. UPON BOARD APPROVAL, THE FORM 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST POLICYDISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE CHS COMPLIANCE AND AUDIT COMMITTEE BY CHS' COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE IS GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE CHS BOARD OF DIRECTORS. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE BOARD OF DIRECTORS SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. THE PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIM/HERSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT.
FORM 990,PART VI,LINE 15-COMPENSATION POLICY OF CHS,A RELATED ORGTHE 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 AVAIL. FOR PUBLIC INSPECTIONGOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND.
FORM 990. PART VII, SECTION A - LINE 1AHOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. 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). 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 SYSTEM 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). 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 FOUNDATION (27-1459941); CATHOLIC HEALTH SYSTEM OF LONG ISLAND (11-3403968) AND RVC INSURANCE COMPANY INC. (20-8067039).

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (36 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CATHOLIC HEALTH SYSTEM OF LONG ISLAND
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113403968SUPPORT ORGNY501(C)(3)12A- INAfalse
CHS SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113555766SUPPORT ORGNY501(C)(3)12B- IICHSLIfalse
CHS AMBULANCE SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570141801961DORMANTNY501(C)(3)3CHSLIfalse
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
1000 MONTAUK HIGHWAYWEST ISLIPNY11795111888924HOSPITALNY501(C)(3)3CHSLIfalse
GOOD SAMARITAN SELF INSURANCE AGAINST
MALPRACTICE 1000 MONTAUK HIGHWAYWEST ISLIPNY11795112537396SELF INSURANCNY501(C)(3)12A- IGOOD SAMARTNYes (true)
MARYHAVEN TRANSPORTATION SERVICES
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113434776TRANSPORTATIONY501(C)(3)12A- IMARYHAVENCTRfalse
MARYHAVEN CENTER OF HOPE
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112861698Prgm-disabledNY501(C)(3)10CHSLIfalse
MARYHAVEN SCHOOL CORPORATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112861690Schl-disabledNY501(C)(3)2MARYHAVENCTRfalse
THE CENTER OF HOPE FOUNDATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113638367SUPPORT ORGNY501(C)(3)12A- IMARYHAVENCTRfalse
MERCY MEDICAL CENTER
1000 NORTH VILLAGE AVENUEROCKVILLE CTRNY11570111635088HOSPITALNY501(C)(3)3CHSLIfalse
CATHOLIC HOME CARE
110 BI-COUNTY BLVD SUITE 114FARMINGDALENY11735112126736HOME CARENY501(C)(3)10CHSLIfalse
OUR LADY OF CONSOLATION GERIATRIC CARE
111 BEACH DRIVEWEST ISLIPNY11795113284066LT NURSE CARENY501(C)(3)10CHSLIfalse
RIVERHEAD HOSTEL HOLDING CORPORATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112499790RENTINGNY501(C)(2)MARYHAVENCTRfalse
ST CATHERINE OF SIENA MEDICAL CENTER
50 ROUTE 25ASMITHTOWNNY11787061562701HOSPITALNY501(C)(3)3CHSLIfalse
ST CHARLES HOSPITAL
200 BELLE TERRE ROADPORT JEFFERSN STNY11777111871039HOSPITALNY501(C)(3)3CHSLIfalse
CHS HOME SUPPORT SERVICES INC
15 POWER DRIVEHAUPPAGENY11788113594561RESP THERAPYNY501(C)(3)10CATHHOMECAREfalse
ST FRANCIS HOSPITAL
100 PORT WASHINGTON BLVDROSLYNNY11576112050523HOSPITALNY501(C)(3)3CHSLIfalse
ST FRANCIS HOSPITAL FOUNDATION
100 PORT WASHINGTON BLVDROSLYNNY11576112916033SUPPORT ORGNY501(C)(3)12A- IST FRANCISfalse
ST FRANCIS HOSPITAL RESEARCH & EDUCATIO
100 PORT WASHINGTON BLVDROSLYNNY11576113090867RESEARCH ORGNY501(C)(3)12A- IST FRANCISYes (true)
WSNCHS NORTH INC
4295 HEMPSTEAD TURNPIKEBETHPAGENY11714113438973HOSPITALNY501(C)(3)3CHSLIfalse
THE ST CHARLES CORPORATION
200 BELLE TERRE ROADPORT JEFFERSN STNY11777112983148SUPPORT ORGNY501(C)(3)12A- ICHSLIfalse
THE SAMARITAN CORPORATION
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570112716640SUPPORT ORGNY501(C)(3)12A- ICHSLIfalse
WISDOM GARDENS HOUSING DEVELOPMENT FUND
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113559713SR HOUSINGNY501(C)(3)10MARYHAVENCTRfalse
GOOD SHEPHERD HOSPICE
110 BI-COUNTY BLVD SUITE 114FARMINGDALENY11735112958438HOSPICE SVCNY501(C)(3)10CHSLIfalse
ST CHARLES HOSPITAL FOUNDATION
200 BELLE TERRE ROADPORT JEFFERSONNY11777412076312SUPPORT ORGNY501(C)(3)12A- IST CHARLESfalse
GOOD SAMARITAN HOSPITAL FOUNDATION
1000 MONTAUK HIGHWAYWEST ISLIPNY11795770611240SUPPORT ORGNY501(C)(3)12A- IGOOD SAMARTNfalse
MERCY MEDICAL CENTER FOUNDATION
1000 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570550813603SUPPORT ORGNY501(C)(3)12A- IMERCY MEDCTRfalse
ST CATHERINE OF SIENA MEDICAL CTR FDN
50 ROUTE 25ASMITHTOWNNY11787271459941SUPPORT ORGNY501(C)(3)12A- ISTCATHERINEfalse
CHS HOME CARE AND HOSPICE FOUNDATION
110 BI-COUNTY BLVD SUITE 114FARMINGDALENY11735452907761SUPPORT ORGNY501(C)(3)12A- ICATHHOMECAREfalse
GOOD SHEPHERD HOSPICE FOUNDATION
110 BI-COUNTY BLVD SUITE 114FARMINGDALENY11735263169427SUPPORT ORGNY501(C)(3)12A- IGOODSHEPHERDfalse
OUR LADY OF CONSOLATION FOUNDATION
111 BEACH DRIVEWEST ISLIPNY11795450517566SUPPORT ORGNY501(C)(3)12A- IOURLADYOFCfalse
RVC SUPPORT
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570271531084REAL ESTATENY501(C)(3)12A- ICHSLIfalse
ST FRANCIS CARDIOVASCULAR PHYSICIANS P
100 PORT WASHINGTON BLVDROSLYNNY11576113613997HEALTHCARESVCNY501(C)(3)12A- IST FRANCISfalse
RVC INSURANCE COMPANYINC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570208067039CAPTIVE INSNY501(C)(3)12B- IICHSLIfalse
SAMARITAN EMERGENCY MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208243412HEALTHCARESVCNY501(C)(4)GOOD SAMARTNfalse
ST JOSEPH HOSPITAL FOUNDATION
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570472353387SUPPORT ORGNY501(C)(3)12A- IWSNCHS NORTHfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxt
BIPO HOLDINGS LLC
1600 STEWART AVE WESTBURY NYWESTBURYNY11590464763720PHYSICIAN ASSNNYNAN/A
IDHC LLC
2500 YORK RD JAMISONPA 18929JAMISONPA18929452411095HEALTH SERVICESPANAN/A
BEACON HEALTH PTNRS
1600 STEWART AVE WESTBURY NYWESTBURYNY11590454229842HEALTHCARENYNAN/A
WISDOM GARDENS LP
51 TERRYVILLE RDPORT JEFFERSONNY11776113567947SR HOUSINGNYNAN/A

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (13 entries)

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

Supplemental Information Detail SupplementalInformationDetail

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