CENTRAL SUFFOLK HOSPITAL: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL SUFFOLK HOSPITAL (EIN 11-1661359)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201743199349303834
- Schema version
- 2016v3.0
- 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 G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-15T13:30:20-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 131517563 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOEB & TROPER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 655 THIRD AVENUE 12TH FLOOR | 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 | 111661359 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL SUFFOLK HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 6315486074 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1Txt |
| City | RIVERHEAD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL O'DONNELL | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6315486064 | PhoneNum |
| Signature | 2017-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AARON SHAPIRO | PreparerPersonNm |
| PTIN | P01333816 | PTIN |
| Phone | 2128674000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 38.98.118.70 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-15 | IPDt |
| IP Tm | 12:09:54 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D7076C0EC39B17C3336BFEA465ABF20A32036F2A | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 73A2BDB4DEE3E1301F7FB9DCBA9193E2BC5F7900 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PECONIC BAY MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL O'DONNELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1Txt |
| City | RIVERHEAD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $173,488,648 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PBMEDICALCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1951 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | CSH IS A NOT-FOR-PROFIT HOSPITAL, A SKILLED NURSING FACILITY, AND A CERTIFIED HOME CARE AGENCY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 23 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 1450 | TotalEmployeeCnt |
| Total Volunteers | 148 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,978,117 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,123,873 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $157,038,154 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $166,771,248 | CYProgramServiceRevenueAmt |
| PY Investment Income | $155,383 | PYInvestmentIncomeAmt |
| CY Investment Income | $295,683 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,706,564 | PYOtherRevenueAmt |
| CY Other Revenue | $1,190,935 | CYOtherRevenueAmt |
| PY Total Revenue | $163,878,218 | PYTotalRevenueAmt |
| CY Total Revenue | $172,381,739 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $84,994,439 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $90,856,131 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $171,590 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $76,894,175 | PYOtherExpensesAmt |
| CY Other Expenses | $68,207,516 | CYOtherExpensesAmt |
| PY Total Expenses | $161,888,614 | PYTotalExpensesAmt |
| CY Total Expenses | $159,063,647 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,989,604 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $13,318,092 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $129,946,015 | TotalAssetsBOYAmt |
| Total Assets EOY | $154,621,810 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $105,482,981 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $103,283,827 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $24,463,034 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $51,337,983 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CENTRAL SUFFOLK HOSPITAL (CSH) D/B/A PECONIC BAY MEDICAL CENTER (PBMC) IS A NOT-FOR-PROFIT HOSPITAL CONSISTING OF 140 ACUTE CARE BEDS, A 60-BED SKILLED NURSING FACILITY AND A CERTIFIED HOME CARE AGENCY. CSH PROVIDES A FULL RANGE OF HEALTH CARE SERVICES TO THE LOCAL COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $122,292,391 | ExpenseAmt |
| Revenue | $166,771,248 | RevenueAmt |
| Desc | COMPREHENSIVE HEALTHCARE SERVICES INCLUDING EMERGENCY, SURGICAL, MEDICAL, ICU AND OBSTETRICS/GYNECOLOGICAL. TOTAL PATIENT DAYS FOR ALL INPATIENT SERVICES WERE 49,484. TOTAL OUTPATIENT VISITS WERE 86,293. | Desc |
| Total Program Service Expenses | $122,292,391 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | Yes (1) | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 57 | IRPDocumentCnt |
| IRP Document W2 G | 1 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 1450 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 23 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL F O'DONNELL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6315486074 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1Txt |
| City | RIVERHEAD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (36 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 |
|---|---|---|---|---|---|---|---|---|---|
| ANDREW J MITCHELL | |||||||||
| CEO / PRESIDENT | 22.50 | 15.00 | Yes (X) | Yes (X) | $1,098,832 | $0 | $54,872 | ||
| SHARON PATTERSON | |||||||||
| BOARD CHAIR | 15.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ANDREW S MENDELSON | |||||||||
| VICE CHAIR | 15.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| J GORDON HUSZAGH | |||||||||
| VICE CHAIR & TREASURER | 15.00 | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| REV GEORGE SUMMERS | |||||||||
| SECRETARY | 15.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| MARC ALESSI ESQ | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| THELMA BOOKER | |||||||||
| PRESIDENT OF AUXILIARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| AGOSTINO CERVONE MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| MICHAEL DEMPSEY MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| FATHER LARRY DUNCKLEE | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT GAFFNEY ESQ | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD D GOLDSTEIN | |||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD ISRAEL | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOAN LEVAN | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| AMY LOEB EDD | |||||||||
| BOARD MEMBER/CHIEF NURSING OFFICER | 37.50 | Yes (X) | Yes (X) | $223,024 | $0 | $40,281 | |||
| KAREEM MASSOUD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD V MUSTO MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RALPH NAPPI | |||||||||
| BOARD MEMBER | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ANNE K NOLON | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| STEVEN OUZOUNIAN MD | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| GEORGE RUGGIERO DO | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| RICHARD L WINSLOW PHD | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STANLEY ZINBERG MD | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GERARD ZUNNO RN | |||||||||
| COO / SVP OF PATIENT CARE | 37.50 | Yes (X) | $124,978 | $0 | $19,027 | ||||
| MICHAEL F O'DONNELL | |||||||||
| CHIEF FINANCIAL OFFICER | 37.50 | Yes (X) | $387,955 | $0 | $45,916 | ||||
| SAMANTHA VIGLIOTTA | |||||||||
| VP FOUNDATION & EXTERNAL AFFAIRS | 18.75 | 18.75 | Yes (X) | $152,258 | $0 | $37,303 | |||
| RONALD MCMANUS | |||||||||
| SVP OF PECONIC BAY MEDICAL | 27.50 | 10.00 | $282,402 | $0 | $27,253 | Yes (X) | |||
| RICHARD KUBIAK | |||||||||
| CHIEF MEDICAL OFFICER | 37.50 | $340,611 | $0 | $36,036 | Yes (X) | ||||
| ARTHUR CROWE | |||||||||
| CIO / VP OF HOSPITAL SERVI | 37.50 | $252,112 | $0 | $44,372 | Yes (X) | ||||
| MONICA RAULS | |||||||||
| VP OF HUMAN RESOURCES | 37.50 | $193,321 | $0 | $13,386 | Yes (X) | ||||
| CHERYL MAKOSKE | |||||||||
| VP FINANCE | 37.50 | $235,886 | $0 | $31,100 | Yes (X) | ||||
| PETER SULTAN MD | |||||||||
| PHYSICIAN | 37.50 | $960,051 | $0 | $73,308 | Yes (X) | ||||
| DAVID PRENTISS MD | |||||||||
| PHYSICIAN | 37.50 | $301,791 | $0 | $15,900 | Yes (X) | ||||
| MAHMOOD AFGHANI MD | |||||||||
| PHYSICIAN | 37.50 | $275,517 | $0 | $33,674 | Yes (X) | ||||
| STEPHEN JOHN MD | |||||||||
| PHYSICIAN | 37.50 | $348,186 | $0 | $23,304 | Yes (X) | ||||
| KENNETH MAYER MD | |||||||||
| PHYSICIAN | 37.50 | $231,998 | $0 | $41,243 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,408,922 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $536,975 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 126 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CERNER HEALTH | |||||
| PO BOX 959167 | ST LOUIS | MO | 63195 | INFORMATION TECHNOLOGY | $2,444,013 |
| SODEXO | |||||
| 500 ROSS STREET | PITTSBURGH | PA | 15262 | CAFETERIA SERVICES | $1,851,999 |
| KRAUSS EUGENE | |||||
| 20 HORSESHOE ROAD | OLD WESTBURY | NY | 11568 | PROFESSIONAL MEDICAL SERVICES | $962,878 |
| CROTHALL FACILITIES | |||||
| 955 CHESTERBROOK BOULEVARD | WAYNE | PA | 19087 | HOUSEKEEPING SERVICES | $734,952 |
| AXIS | |||||
| 125 LASER COURT | HAUPPAUGE | NY | 11788 | CONSTRUCTION SERVICES | $579,376 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 29 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $175,650 | FundraisingAmt |
| Government Grants | $1,683,223 | GovernmentGrantsAmt |
| All Other Contributions | $2,265,000 | AllOtherContributionsAmt |
| Total Contributions | $4,123,873 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT CARE | 621400 | $166,627,075 | $166,627,075 |
| PROVISION OF MEDICAL SERVICES BY | 621110 | $144,173 | $144,173 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $166,771,248 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $102,377 | TotalRevenueColumnAmt |
| Exclusion | $102,377 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,200,299 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,006,993 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $193,306 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $193,306 | TotalRevenueColumnAmt |
| Exclusion | $193,306 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $104,440 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $175,650 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $99,916 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,524 | TotalRevenueColumnAmt |
| Exclusion | $4,524 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA | 624210 | $601,137 | $601,137 |
| NASSAU SUFFOLK WAGE INDEX | 900099 | $328,810 | $328,810 |
| CLINIC REVENUE | 621110 | $256,464 | $256,464 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,186,411 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $172,381,739 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $166,771,248 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,486,618 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,640,925 | TotalAmt |
| Management And General | $3,640,925 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,584,416 | TotalAmt |
| Program Services | $53,941,526 | ProgramServicesAmt |
| Management And General | $15,642,890 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,707,470 | TotalAmt |
| Program Services | $3,624,752 | ProgramServicesAmt |
| Management And General | $1,082,718 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,090,536 | TotalAmt |
| Program Services | $6,227,098 | ProgramServicesAmt |
| Management And General | $1,863,438 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,832,784 | TotalAmt |
| Program Services | $3,720,256 | ProgramServicesAmt |
| Management And General | $1,112,528 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $839,500 | TotalAmt |
| Management And General | $839,500 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,004 | TotalAmt |
| Management And General | $219,004 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,376 | TotalAmt |
| Management And General | $9,376 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,142 | TotalAmt |
| Management And General | $71,142 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,180,660 | TotalAmt |
| Program Services | $15,160,699 | ProgramServicesAmt |
| Management And General | $2,019,961 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $656,824 | TotalAmt |
| Program Services | $485,234 | ProgramServicesAmt |
| Fundraising | $171,590 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,176,921 | TotalAmt |
| Program Services | $17,842,827 | ProgramServicesAmt |
| Management And General | $5,334,094 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,357,067 | TotalAmt |
| Management And General | $2,357,067 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,368,447 | TotalAmt |
| Program Services | $2,368,447 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,175 | TotalAmt |
| Program Services | $74,035 | ProgramServicesAmt |
| Management And General | $22,140 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,554,934 | TotalAmt |
| Program Services | $1,554,934 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,371,198 | TotalAmt |
| Program Services | $5,371,198 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,089,125 | TotalAmt |
| Program Services | $3,089,125 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NEW YORK STATE ASSESSME | Desc |
| Total | $857,285 | TotalAmt |
| Program Services | $857,285 | ProgramServicesAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,359,858 | TotalAmt |
| Program Services | $7,974,975 | ProgramServicesAmt |
| Management And General | $2,384,883 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,063,647 | TotalAmt |
| Program Services | $122,292,391 | ProgramServicesAmt |
| Management And General | $36,599,666 | ManagementAndGeneralAmt |
| Fundraising | $171,590 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,099,939 | BOYAmt |
| EOY | $30,648,824 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,440,565 | BOYAmt |
| EOY | $1,414,879 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000,000 | BOYAmt |
| EOY | $3,624,618 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,774,061 | BOYAmt |
| EOY | $13,392,599 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,155,951 | BOYAmt |
| EOY | $1,510,721 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,299,772 | BOYAmt |
| EOY | $3,926,870 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,563,089 | BOYAmt |
| EOY | $600,846 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $85,940,763 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,431,028 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,773,543 | BOYAmt |
| EOY | $80,509,735 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,986,461 | BOYAmt |
| EOY | $4,113,560 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,352,452 | BOYAmt |
| EOY | $1,366,262 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,230,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,500,182 | BOYAmt |
| EOY | $8,282,896 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,946,015 | BOYAmt |
| EOY | $154,621,810 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,646,835 | BOYAmt |
| EOY | $28,377,389 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,765,000 | BOYAmt |
| EOY | $29,355,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,907,562 | BOYAmt |
| EOY | $9,458,540 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,163,584 | BOYAmt |
| EOY | $36,092,898 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,482,981 | BOYAmt |
| EOY | $103,283,827 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,177,844 | BOYAmt |
| EOY | $43,950,876 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,498,282 | BOYAmt |
| EOY | $6,600,199 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $786,908 | BOYAmt |
| EOY | $786,908 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,463,034 | BOYAmt |
| EOY | $51,337,983 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,946,015 | BOYAmt |
| EOY | $154,621,810 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $13,318,092 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $13,556,857 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
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) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $9,376 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $9,376 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE PORTION OF MEMBERSHIP DUES TO TRADE ASSOCIATIONS THAT ARE ASSOCIATED WITH LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Collection Used Pub Exhibition | Yes (X) | CollectionUsedPubExhibitionInd |
| Solicited Assets Sale | 0 | SolicitedAssetsSaleInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $786,908 | BeginningYearBalanceAmt |
| End Year Balance | $786,908 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $786,908 | BeginningYearBalanceAmt |
| End Year Balance | $786,908 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $786,908 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $10,306 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $10,306 | OtherExpendituresAmt |
| End Year Balance | $786,908 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $786,908 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $100,483 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $100,483 | OtherExpendituresAmt |
| End Year Balance | $786,908 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $786,908 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $36,084 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $36,084 | OtherExpendituresAmt |
| End Year Balance | $786,908 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,235,739 | OtherCostOrOtherBasisAmt |
| Book Value | $14,235,739 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,467,721 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,585,730 | DepreciationAmt |
| Book Value | $27,881,991 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,847,182 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,425,298 | DepreciationAmt |
| Book Value | $33,421,884 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,390,121 | OtherCostOrOtherBasisAmt |
| Depreciation | $420,000 | DepreciationAmt |
| Book Value | $4,970,121 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $80,509,735 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| EQUITY INTEREST IN THE CENTRAL SUFFOLK HOSPITAL FOUNDATION/ DBA PECONIC BAY | $5,919,663 |
| ESTIMATED DUE FROM THIRD PARTY PAYORS | $2,363,233 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $8,282,896 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED MALPRACTICE COSTS | $11,756,766 |
| ESTIMATED DUE TO THIRD-PARTY PAYORS | $10,075,497 |
| DUE TO AFFILIATE | $3,991,735 |
| SWAP LIABILTY | $6,055,752 |
| ACCRUED PENSION COSTS | $3,605,914 |
| DUE TO NORTHWELL HEALTH | $607,234 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $36,092,898 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $190,085,732 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $17,775,135 | OtherRevenueAmt |
| Revenue Not Reported | $17,775,135 | RevenueNotReportedAmt |
| Revenue Subtotal | $172,310,597 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $71,142 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $71,142 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $172,381,739 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $159,063,647 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $159,063,647 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $159,063,647 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 4: | THE DONATED ARTWORK PROVIDES A SOOTHING AND CALMING ENVIRONMENT TO THE PATIENTS AND THEIR FAMILIES WHEN THEY ATTEND CSH FOR MEDICAL SERVICES. CSH HOPES THAT WITH A GOOD EXPERIENCE, THEIR PATIENTS CONTINUE TO UTILIZE CSH TO PROVIDE MEDICAL SERVICES. |
| PART V, LINE 4: | ENDOWMENT FUNDS HAVE BEEN RESTRICED BY DONORS TO BE MAINTAINED BY CSH IN PERPETUITY. |
| PART X, LINE 2: | CSH HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2013 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PENSION ADJUSTMENTS 225,410. CHANGE IN EQUITY INTEREST IN CENTRAL SUFFOLK HOSPITAL FOUNDATION 2,270,541. NET ASSETS RELEASED FROM RESTRICTIONS -1,000,000. GAIN ON SWAP 1,189,345. PUSHDOWN ACCOUNTING ADJUSTMENT 15,089,839. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SPRING GALA | Event1Nm |
| Gross Receipts Event1 | $280,090 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $175,650 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $104,440 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $15,000 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $690 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $10,000 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $32,272 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $12,450 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $29,504 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $280,090 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $175,650 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $104,440 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $15,000 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $690 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $10,000 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $32,272 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $12,450 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $29,504 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $99,916 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $4,524 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent100 | Yes (X) | Percent100Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 500.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,186,078 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,336,669 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,849,409 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02420 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,872,928 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $16,020,699 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $12,852,229 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08080 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $34,059,006 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $17,357,368 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $16,701,638 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10500 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,030,914 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,935,671 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,095,243 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00690 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $22,699,687 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $20,322,197 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,377,490 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01490 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $27,730,601 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $24,257,868 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,472,733 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02180 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $61,789,607 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $41,615,236 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $20,174,371 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.12680 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,158,669 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $50,125,340 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $61,923,731 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$11,798,391 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | PECONIC BAY MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1Txt |
| City | RIVERHEAD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTP://WWW.PBMCHEALTH.ORG | WebsiteAddressTxt |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PECONIC BAY MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.NORTHWELL.EDU | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.NORTHWELL.EDU/ABOUT/OUR-ORGANIZATION/OFFICE-COMMUNITY-AND-PUBLIC-HEALTH | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 100.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 500.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.PBMCHEALTH.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.PBMCHEALTH.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.PBMCHEALTH.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 |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Other Actions Taken | Yes (X) | OtherActionsTakenInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicaid Medcr Prvt | Yes (X) | LookBackMedicaidMedcrPrvtInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PECONIC BAY MEDICAL CENTER | PART V, SECTION B, LINE 5: THE CHNA WAS FACILITATED BY COMMITTEES ESTABLISHED WITHIN EACH COUNTY SERVED BY NORTHWELL AND ITS HOSPITALS. THESE WERE COMPRISED OF PARTICIPANTS SUCH AS DEPARTMENTS OF HEALTH; COMMUNITY BASED ORGANIZATIONS (CBOS); NORTHWELL; LOCAL BUSINESSES; AND FAITH-BASED ORGANIZATIONS; AND A "VOICE OF THE COMMUNITY" (I.E. THE COMMUNITY'S PERCEPTION OF NEED). QUALITATIVE DATA WAS COLLECTED FROM DIVERSE COMMUNITY ORGANIZATIONS THAT SERVE THE POPULATION-AT-LARGE, AS WELL AS THOSE COMMUNITIES WITH SIGNIFICANT HEALTH DISPARITIES. COMMUNITY PARTNERS WERE INVITED TO PARTICIPATE VIA SURVEYS AND KEY INFORMANT INTERVIEWS. EMPHASIS WAS PLACED ON THE FOLLOWING POPULATIONS: MINORITIES/UNDERSERVED COMMUNITIES, SENIORS, WOMEN AND CHILDREN, SPECIAL POPULATIONS, AND INDIVIDUALS WITH DISEASE-SPECIFIC CONDITIONS. PRIMARY DATA WAS OBTAINED THROUGH QUALITATIVE ANALYSIS OF CBO INFORMANT INTERVIEWS, CBO SURVEYS, INDIVIDUAL COMMUNITY MEMBER SURVEYS, AND PARTICIPATION IN THE COLLABORATIVE PARTNER LISTENING SESSIONS. FOR FURTHER DETAIL GO TO WEB LINK: HTTPS://WWW.NORTHWELL.EDU/ABOUT/OUR-ORGANIZATION/OFFICE-COMMUNITY-AND-PUBLIC-HEALTH/REPORTS. |
| PECONIC BAY MEDICAL CENTER | PART V, SECTION B, LINE 6A: FOR A DETAILED LISTING OF OTHER HOSPITAL FACILITIES GO TO WEB LINK: HTTPS://WWW.NORTHWELL.EDU/ABOUT/OUR-ORGANIZATION/OFFICE-COMMUNITY-AND-PUBLIC-HEALTH/REPORTS |
| PECONIC BAY MEDICAL CENTER | PART V, SECTION B, LINE 6B: FOR A DETAILED LISTING OF OTHER THAN HOSPITAL FACILITIES GO TO WEB LINK: HTTPS://WWW.NORTHWELL.EDU/ABOUT/OUR-ORGANIZATION/OFFICE-COMMUNITY-AND-PUBLIC-HEALTH/REPORTS |
| PECONIC BAY MEDICAL CENTER | PART V, SECTION B, LINE 11: THE HOSPITAL IDENTIFIED AND ADDRESSED PRIMARY NEEDS BASED ON AN ASSESSMENT OF THE HIGHEST RANKED HEALTH PRIORITIES OF THE COMMUNITY, REGULATORY INPUT (I.E. THE NYC DEPARTMENT OF HEALTH PREVENTION PRIORITY AGENDA), AND RESOURCES AVAILABLE. FOR FURTHER INFORMATION GO TO WEB LINK: HTTPS://WWW.NORTHWELL.EDU/ABOUT/OUR-ORGANIZATION/OFFICE-COMMUNITY-AND-PUBL IC-HEALTH/REPORTS |
| PECONIC BAY MEDICAL CENTER | PART V, SECTION B, LINE 13H: THE HOSPITAL ALSO USES HOUSEHOLD SIZE. |
| PECONIC BAY MEDICAL CENTER | PART V, SECTION B, LINE 16J: THE POLICY IS INCLUDED IN THE HOSPITAL'S COMMUNITY SERVICE PLAN AND PROVIDED AT HEALTH FAIRS AND PRESENTATIONS OPEN TO THE COMMUNITY AT NO COST, IN ADDITION TO MAILING FINANCIAL POLICY SUMMARY BROCHURES. |
| PECONIC BAY MEDICAL CENTER | PART V, SECTION B, LINE 20E: BEFORE INITIATING ANY OF THE ACTIONS, THE HOSPITAL FACILITY SENDS LETTERS, MAKES TELEPHONE CALLS AND UTILIZES PRESUMPTIVE ELIGIBILITY. |
| 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 | 1 - RIVERHEAD MANAGEMENT CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1Txt |
| City | REVERHEAD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | MANAGEMENT SERVICE ORGANIZATION | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THIS HOSPITAL IS AN AFFILIATED ENTITY OF NORTHWELL HEALTH INC. ("NORTHWELL"). NORTHWELL USES FPG TO DETERMINE ELIGIBILITY AND UTILIZES THE NEW YORK STATE DEPARTMENT OF HEALTH (NYSDOH) GUIDELINES REGARDING THE CONSIDERATION OF ASSETS. ASSET TESTS CANNOT BE USED TO DENY FINANCIAL ASSISTANCE, BUT ONLY TO "UPGRADE" A PATIENT'S LEVEL OF OBLIGATION, UP TO THE LEGAL MAXIMUM PERMITTED UNDER THE FINANCIAL ASSISTANCE LAW. |
| PART I, LINE 6A: | THE COMMUNITY BENEFIT REPORT IS PREPARED BY THE HOSPITAL, IN CONJUNCTION WITH AN AFFILIATED ENTITY (NORTHWELL) OF THE HOSPITAL. THE COMMUNITY BENEFIT REPORT IS ACCESSIBLE TO THE PUBLIC AND CAN BE ACCESSED ON THE NORTHWELL WEBSITE: HTTP://WWW.NORTHWELL.EDU. |
| PART I, LINE 7: | ROW (A) THE COST OF CHARITY CARE WAS DETERMINED BY UTILIZING THE RATIO OF COST TO CHARGES (RCC) CALCULATED ON WORKSHEET 2 APPLIED TO GROSS CHARGES WRITTEN OFF FOR PATIENTS QUALIFYING FOR CHARITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. BAD DEBT WAS NOT REPORTED IN ANY ROW OF PART I, LINE 7. ROW (B) THE RATIO OF COST TO CHARGES METHOD (OR RCC) IS USED TO DETERMINE THE COST OF ANCILLARY SERVICES. A RCC IS DEVELOPED FROM THESE COSTS, AND THAT RCC IS APPLIED TO TOTAL MEDICAID GROSS ANCILLARY SERVICES CHARGES TO DETERMINE THE COST OF SERVICES PROVIDED TO MEDICAID PATIENTS. ROW (E) COSTS ASSOCIATED WITH COMMUNITY HEALTH IMPROVEMENT SERVICES WERE DETERMINED BY ADDING INDIRECT OR OVERHEAD COSTS TO THE DIRECT COSTS OF THE ACTIVITY. INDIRECT COSTS WERE CALCULATED AS A PERCENTAGE OF DIRECT COSTS. DIRECT COSTS FOR STAFF EXPENSES WERE CALCULATED USING AVERAGE SYSTEM HOURLY RATES, AND WERE ADJUSTED TO ACCOUNT FOR FRINGE BENEFITS, USING A BLENDED RATE BASED ON THE RATIO OF TOTAL EMPLOYEE BENEFIT EXPENSES TO TOTAL SALARY AND WAGES. ROW (F) THE BAD DEBT EXPENSE THAT APPEARS ON FORM 990, PART IX, LINE 25 COLUMN (A), BUT NOT INCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS EQUAL TO THE AMOUNT REPORTED ON FORM 990, PART X. THE COSTS RELATED TO HEALTH PROFESSIONS EDUCATION WERE DETERMINED BY UTILIZING THE STEP DOWN METHOD OF COST FINDING. ROW (H) COSTS ASSOCIATED WITH RESEARCH ACTIVITIES WERE DETERMINED BY ADDING INDIRECT, OR OVERHEAD, COSTS TO THE DIRECT COSTS OF THE ACTIVITY. INDIRECT COSTS WERE CALCULATED AS A PERCENTAGE OF COSTS. ROW (I) THE COST OF IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS IS COMPRISED OF THE DIRECT COSTS OF PERSONNEL WHOSE COMPENSATED TIME WAS DONATED TO VARIOUS CHARITIES AND COMMUNITY GROUPS. THE SALARIES AND WAGES WERE ADJUSTED TO INCLUDE BENEFITS USING A RATE BASED ON THE RATIO OF TOTAL EMPLOYEE BENEFIT EXPENSES TO TOTAL SALARY AND WAGES. INDIRECT COSTS WERE CALCULATED AS A PERCENTAGE OF DIRECT COSTS. COLUMN (F) FOR ROWS (C)-(K) THE PERCENTAGE OF NET COMMUNITY BENEFIT EXPENSE DIVIDED BY TOTAL EXPENSE FOR THE HOSPITAL (TO CALCULATE THE PERCENT OF TOTAL EXPENSE).NOTE: FOR THE ENTIRE NORTHWELL HEALTH INC. AND AFFILIATES, PART I, LINE 7 (ROW K, COLUMN F) IS APPROXIMATELY 11.29 AS A PERCENTAGE OF EXPENSES. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | NORTHWELL WORKS TO PROMOTE COMMUNITY HEALTH THROUGH EDUCATION, COMMUNITY ADVOCACY, PARTNERSHIPS, AND PROGRAMS THAT RESULT IN IMPROVED ACCESS TO CARE AND HEALTH OUTCOMES. THE ACTIVITIES AND STRATEGIES FOR ACHIEVING THIS GOAL INCLUDE: ESTABLISHING COLLABORATIVE PARTNERSHIPS WITH LOCAL CBOS, HEALTH-RELATED ORGANIZATIONS, BUSINESS, AND GOVERNMENT TO IDENTIFY AND ADDRESS COMMUNITY HEALTH NEEDS; ADVOCATING FOR POLICIES THAT BENEFIT THE BROADER COMMUNITY AT STATE AND LOCAL LEVELS; PROVIDING COMMUNITY HEALTH PROGRAMS AND SERVICES BASED ON IDENTIFIED COMMUNITY HEALTH NEEDS/PRIORITIES; DELIVERING PREVENTIVE CARE SERVICES AND EDUCATION; CONDUCTING COMMUNITY OUTREACH AND ENGAGEMENT ACTIVITIES AND EXPANDING COMMUNITY MEMBER REPRESENTATION AND INVOLVEMENT ON COMMITTEES/BOARDS FOR PROGRAMMING AND EDUCATIONAL EVENTS. NORTHWELL HOSPITALS PARTICIPATE IN THE DELIVERY SYSTEM REFORM INCENTIVE PAY (DSRIP) PROGRAM WHOSE PRIMARY GOAL IS TO ALLOCATE MEDICAID PAYOUTS BASED UPON ACHIEVING PREDEFINED RESULTS IN THE TRANSFORMATION, CLINICAL MANAGEMENT, AND POPULATION HEALTH. NORTHWELL PROVIDES COMMUNITY RESIDENTS WITH A BROAD ARRAY OF COMMUNITY HEALTH PROGRAMS, SUCH AS: ACCESS TO HEALTHCARE SERVICES AND CARING FOR THE MEDICALLY UNDERSERVED; SCREENINGS AND IMMUNIZATIONS; HEALTH FORUMS AND HEALTH FAIRS; COMMUNITY EDUCATION AND OUTREACH PROGRAMS; SUPPORT GROUPS AND COUNSELING AND EMERGENCY MEDICAL SERVICES. A COMPREHENSIVE LIST OF PROGRAMS CAN BE FOUND IN THE COMMUNITY SERVICE PLANS LOCATED ON THE NORTHWELL PUBLIC WEBSITE. NORTHWELL RECOGNIZES THAT, TO HAVE AN IMPACT ON COMMUNITY HEALTH STATUS, IT MUST COLLABORATE, TO THE EXTENT POSSIBLE, WITH MULTIPLE PARTNERS WHO CAN ADDRESS DIFFERENT COMPONENTS OF PROGRAM DESIGN, INCLUDING: PROVIDING TRUST AND "REACH" INTO A COMMUNITY; ACCESS TO CAPITAL AND FUNDING; POLICY GUIDANCE AND BEST PRACTICES FOR PROGRAM DEVELOPMENT. SOME OF OUR PARTNERS INCLUDE: GOVERNMENT, NATIONAL/PROFESSIONAL ASSOCIATIONS, AREA BUSINESSES, OTHER AREA HEALTH CARE PROVIDERS, PHILANTHROPIES, CIVIC ORGANIZATIONS AND CBOS. |
| PART III, LINE 2: | FOR PATIENTS WHO WERE DETERMINED BY NORTHWELL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE RECORDED AS BAD DEBT EXPENSE. THE AMOUNT OF GROSS CHARGES WRITTEN OFF IS REDUCED BY ANY CHARITY CARE OR OTHER DISCOUNTS PROVIDED TO THE PATIENT, AS WELL AS ANY PAYMENTS RECEIVED. BAD DEBT EXPENSE REPORTED ON THIS LINE IS REPORTED NET OF GOVERNMENTAL OR PRIVATE OFFSETTING FUNDS. |
| PART III, LINE 3: | FOR PATIENTS WHO WERE DETERMINED BY NORTHWELL TO HAVE THE ABILITY TO PAY BUT DID NOT, THE UNCOLLECTED AMOUNTS ARE RECORDED AS BAD DEBT EXPENSE. |
| PART III, LINE 4: | BAD DEBT EXPENSES ON ACCOUNTS RECEIVABLE AND CONTRIBUTIONS RECEIVABLE ARE CHARGED IF THE RECEIVABLE IS DETERMINED TO BE UNCOLLECTIBLE BASED ON PERIODIC REVIEW BY MANAGEMENT. FACTORS USED TO DETERMINE WHETHER AN ALLOWANCE SHOULD BE RECORDED INCLUDE THE AGE OF THE RECEIVABLE AND A REVIEW OF PAYMENTS SUBSEQUENT TO YEAR END. |
| PART III, LINE 8: | MEDICARE COSTS ARE DETERMINED UTILIZING A COMBINATION OF THE STEP DOWN METHOD OF COST FINDINGS AND A COST PER UNIT OF SERVICE. COST PER UNIT OF SERVICE IS USED TO CALCULATE THE ROUTINE COST OF SERVICES PROVIDED TO MEDICARE PATIENTS. THE RATIO OF COST TO CHARGES METHOD (OR RCC) IS USED TO DETERMINE THE COST OF ANCILLARY SERVICES. AN RCC IS DEVELOPED FROM THESE COSTS, AND THAT RCC IS APPLIED TO TOTAL MEDICARE GROSS ANCILLARY SERVICES CHARGES TO DETERMINE THE COST OF SERVICES PROVIDED TO MEDICARE PATIENTS. |
| PART III, LINE 9B: | THE ORGANIZATION'S COLLECTION POLICY IS STANDARD TO ALL ACCOUNTS REGARDLESS OF INSURANCE STATUS (E.G. INSURED, UNDERINSURED, AND UNINSURED). THE HOSPITAL'S COLLECTION POLICY STATES THAT THEY WILL NOT SEND PATIENT ACCOUNTS TO COLLECTION IF A DECISION ON A FINANCIAL ASSISTANCE APPLICATION IS PENDING, OR IF A PATIENT IS DETERMINED TO BE ELIGIBLE FOR MEDICAID AT THE TIME SERVICES WERE RENDERED AND FOR WHICH SERVICES MEDICAID PAYMENT IS AVAILABLE. |
| PART VI, LINE 2: | THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) IS PERFORMED ON AN ONGOING BASIS. NORTHWELL CONDUCTS AND PARTICIPATES IN POPULATION, DEMOGRAPHIC, AND HEALTH STATUS EVALUATIONS OF OUR RESPECTIVE HOSPITALS' SERVICE AREAS BASED ON COUNTY REGIONS AND THE COMMUNITIES WE SERVE. THERE IS A SPECIAL EFFORT TO INCLUDE INDIVIDUALS WITH HEALTH DISPARITIES AND ORGANIZATIONS WHO SERVE THESE COMMUNITIES IN THE CHNA PROCESS. THE CHNA INCLUDES THE ANALYSIS OF PRIMARY AND SECONDARY DATA. MULTI-YEAR ANALYSES, TRENDS AND PROJECTIONS ARE DEVELOPED, WHICH IDENTIFY AREAS OF NEED FOR THE CONTINUUM OF HEALTH CARE SERVICES. PRIMARY DATA IS OBTAINED THROUGH A COMBINATION OF QUALITATIVE ANALYSIS OF COMMUNITY-BASED ORGANIZATION (CBO), INFORMANT INTERVIEWS AND SURVEYS, INDIVIDUAL COMMUNITY MEMBER SURVEYS, AND PARTICIPATION IN COLLABORATIVE PARTNER MEETINGS. THESE MEETINGS INCLUDE REPRESENTATIVES FROM THE DEPARTMENTS OF HEALTH, CBOS, ACADEMIC INSTITUTIONS, GOVERNMENT AGENCIES, AND HOSPITALS. ONGOING INPUT CONCERNING OUR COMMUNITIES' NEEDS IS ALSO OBTAINED THROUGH: OUR BOARD OF TRUSTEES/DIRECTORS WHO ARE ALL AREA RESIDENTS AND LEADERS IN THEIR RESPECTIVE COMMUNITIES; FACILITY BASED ADVISORY BOARDS AND COUNCILS, AND; THE FEEDBACK RECEIVED BY OUR FACILITY ADMINISTRATORS AND CLINICIANS THAT SERVE ON LOCAL COMMUNITY AGENCY BOARDS. SECONDARY DATA ANALYSIS INCLUDES: INTERNAL HOSPITAL DATA, INCLUDING PREVENTION QUALITY INDICATORS (PQI); DEPARTMENT OF HEALTH COMMUNITY HEALTH ASSESSMENTS; LOCAL REGIONAL NYS PREVENTION AGENDA DATA SOURCES; AND STATEWIDE PLANNING AND RESEARCH SYSTEM (SPARCS) DATA.THE COMMITTEE ON COMMUNITY HEALTH, A COMMITTEE OF THE BOARD OF TRUSTEES, PROVIDES RECOMMENDATIONS THAT CONCERN NORTHWELL'S COMMUNITY HEALTH PRIORITIES AND INTERVENTIONS BASED ON THE CHNA. COMMITTEE DISCUSSIONS FOCUS ON NEW YORK STATE (NYS) PREVENTION AGENDA PRIORITY AREAS, INCLUDING STRATEGIES AND INTERVENTION OUTCOMES RELATED TO CHRONIC DISEASE PREVENTION, WOMEN AND CHILDREN'S HEALTH, HEALTHY SAFE ENVIRONMENTS, HEALTH ACCESS, MENTAL HEALTH AND SUBSTANCE ABUSE, HIV/AIDS/STDS AND COMMUNITY IMMUNIZATIONS. REGIONAL DEPARTMENTS OF HEALTH (I.E. NASSAU COUNTY DEPARTMENT OF HEALTH, SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES, AND NYC DEPARTMENT OF HEALTH AND MENTAL HYGIENE) PERFORM ADDITIONAL COMMUNITY HEALTH ASSESSMENTS (CHA) WITH THE INPUT OF HOSPITAL AND COMMUNITY STAKEHOLDERS. THESE REGIONAL PARTNERS USE STRATEGIES SUCH AS COMMUNITY MEMBER SURVEYS, CBO SURVEYS, AND PUBLIC LISTENING SESSIONS TO SOLICIT INFORMATION ON COMMUNITY NEEDS. TOGETHER WITH OTHER HEALTHCARE ORGANIZATIONS AND CBOS, NORTHWELL PARTICIPATES IN MEETINGS ORGANIZED BY THESE REGIONAL DEPARTMENTS OF HEALTH ACADEMIC ORGANIZATIONS TO DISCUSS THE SHARED RESPONSIBILITY OF PUBLIC HEALTH PLANNING WITHIN THE NYS PREVENTION AGENDA. THESE MEETINGS PROVIDE AN OPPORTUNITY FOR GENERAL DISCUSSION REGARDING THE PUBLIC HEALTH GOALS OF THE NYS PREVENTION AGENDA AND THE SELECTION OF SHARED PRIORITIES FOR COLLABORATIVE REGIONAL PLANNING. THE PARTNERSHIP AMONG LOCAL HEALTH DEPARTMENTS, HOSPITALS AND CBOS, ENABLES REGION WIDE LEVERAGING OF RESOURCES, CONSENSUS ON HEALTH PRIORITIES AND COLLABORATION ON HEALTH PROMOTION STRATEGIES. IN COMPLIANCE WITH IRS CODE 501(R)(3), A CHNA IS FILED WITH THE IRS EVERY THREE YEARS. |
| PART VI, LINE 3: | NORTHWELL HEALTH IS COMPLIANT WITH IRS CODE 501(R) AND HAS DEVELOPED OF FINANCIAL ASSISTANCE POLICY FOR THE UNINSURED AND UNDERINSURED IN ITS SERVICE AREA. NORTHWELL'S FINANCIAL ASSISTANCE POLICY PROVIDES REDUCED FEES FOR PATIENTS WITH HOUSEHOLD INCOMES UP TO 500% OF THE FPL. WHILE THE FEE SCHEDULE SERVES AS A GUIDE, ALL HARDSHIP CASES ARE EVALUATED ON A CASE-BY-CASE BASIS, TAKING INTO ACCOUNT THE INDIVIDUAL'S FINANCIAL AND PERSONAL CIRCUMSTANCES. ALL MEDICALLY NECESSARY SERVICES ARE COVERED UNDER THE FINANCIAL ASSISTANCE POLICY AND THE PUBLIC IS NOTIFIED OF THE AVAILABILITY OF THE POLICY THROUGH: MULTILINGUAL SIGNAGE AND EDUCATIONAL BROCHURES; CENTRALIZED PROGRAM ADMINISTRATION ACCESSIBLE VIA PHONE; STAFF OUTREACH, AND ALL BILLS INCLUDE A NOTICE ABOUT THE FINANCIAL ASSISTANCE POLICY. THE HEALTHCARE ACCESS CENTER (HAC), STAFFED BY BILINGUAL EMPLOYEES, ASSISTS COMMUNITY RESIDENTS' WITH REFERRALS FOR ENROLLMENT INTO GOVERNMENT-SUBSIDIZED INSURANCE PROGRAMS SUCH AS MEDICAID, CHILD HEALTH PLUS AND FAMILY HEALTH PLUS. IN ADDITION, THE HAC STAFF REFERS PATIENTS TO THE MEDICAID PRENATAL CARE PROGRAM AND TO THE SENIOR NAVIGATOR PROGRAM WITHIN NORTHWELL FOR ASSISTANCE WITH MEDICAID FOR PREGNANT WOMEN AND MEDICARE ENROLLMENT FOR SENIORS. |
| PART VI, LINE 4: | THE NORTHWELL'S SERVICE AREA COVERS LONG ISLAND AND THE METROPOLITAN AREA BOROUGHS OF BROOKLYN, MANHATTAN, QUEENS, AND STATEN ISLAND, AND PARTS OF WESTCHESTER COUNTY. THE DEMOGRAPHICS OF THE COMMUNITY SHOW A BROAD RANGE OF CULTURAL AND ETHNIC DIVERSITY AND INCREASE IN THE UNDERINSURED AND UNINSURED. BY 2018, OUR SERVICE AREA POPULATION 65 AND OLDER WILL GROW BY 14.5%, WHILE RESIDENTS UNDER 65 WILL DECLINE LESS THAN 1% (THOMSON REUTERS, MARKET PLANNER PLUS). THE SERVICE AREA HAS ALSO SHOWN HIGH RATES OF OBESITY, DIABETES, ASTHMA AND HEART/CEREBROVASCULAR DISEASE MORTALITY. |
| PART VI, LINE 6: | THE HOSPITAL IS AN AFFILIATE OF NORTHWELL HEALTH INC., AN INTEGRATED HEALTH CARE DELIVERY SYSTEM WHICH INCLUDES 22 HOSPITALS, 3 SKILLED NURSING FACILITIES, A WORLD RENOWNED CHILDREN'S HOSPITAL, URGENT CARE CENTERS, POST-ACUTE SERVICES, AMBULATORY NETWORK, REHABILITATION NETWORK AND A FREESTANDING RESEARCH INSTITUTE, WHICH IS CHARTERED TO CONFER DOCTORAL (PHD) DEGREES THROUGH ITS ELMEZZI GRADUATE SCHOOL OF MOLECULAR MEDICINE. ALL NORTHWELL ENTITIES ARE CONSIDERED TO BE UNDER COMMON CONTROL FOR ANTITRUST AND OTHER LEGAL PURPOSES. EACH HOSPITAL FACILITY SHARES A COMMON BOARD AND MANAGEMENT IN NORTHWELL AND AS SUCH IS REFERRED TO AS BEING COMMONLY MANAGED. IN ADDITION, IN A JOINT VENTURE, THE DONALD AND BARBARA ZUCKER SCHOOL OF MEDICINE AT HOFSTRA/NORTHWELL PROVIDE AN ALLOPATHIC MEDICAL SCHOOL FOR THE BENEFIT OF THE COMMUNITY. IN KEEPING WITH ITS MISSION TO IMPROVE THE HEALTH AND CARING FOR THE COMMUNITIES IT SERVES, REGARDLESS OF THE ABILITY TO PAY, NORTHWELL ESTABLISHED THE OFFICE OF COMMUNITY HEALTH AND HEALTH SERVICES TO PROMOTE HEALTH AND WELLNESS BY IDENTIFYING THE OVERALL HEALTH NEEDS OF THE COMMUNITY AND MAKE RECOMMENDATIONS FOR THE POPULATION NORTHWELL SERVES. IN ADDITION, NORTHWELL HAS ESTABLISHED COMPREHENSIVE AND COORDINATED CLINICAL PROGRAMS THAT NOT ONLY PROVIDE A FULL CONTINUUM OF SERVICES AND SEAMLESS DELIVERY OF CARE, BUT OFFER COMMUNITY HEALTH ACTIVITIES, OUTREACH AND EDUCATION AS WELL; THEY INCLUDE: BEHAVIORAL HEALTH, CANCER, CARDIOVASCULAR SERVICES, DENTAL MEDICINE, EMERGENCY MEDICINE, FAMILY MEDICINE, HOSPICE CARE, IMAGING/RADIOLOGY, LABORATORY MEDICINE AND PATHOLOGY, MEDICINE, NEUROLOGY, NEUROSURGERY, OBSTETRICS/GYNECOLOGY, OPHTHALMOLOGY, ORTHOPEDIC SURGERY, OTOLARYNGOLOGY, PEDIATRICS, PHYSICAL MEDICINE & REHABILITATION, POPULATION HEALTH, SENIOR SERVICES, SURGERY, UROLOGY, AND WOMEN'S HEALTH. IN 2015, NORTHWELL EXPANDED INTO WESTCHESTER COUNTY THROUGH AFFILIATION AGREEMENTS WITH PHELPS MEMORIAL HOSPITAL ASSOCIATION AND NORTHERN WESTCHESTER HOSPITAL ASSOCIATION. AND BEGINNING IN 2016, NORTHWELL EXPANDED ITS PRESENCE IN SUFFOLK COUNTY THROUGH AN AFFILIATION AGREEMENT WITH PECONIC BAY MEDICAL CENTER. NORTHWELL'S HOSPITALS, PROGRAMS AND SERVICES SUPPORT ONE OF THE LARGEST RESIDENT AND FELLOWSHIP TRAINING PROGRAMS IN THE UNITED STATES. IT DIRECTLY SPONSORS APPROXIMATELY 120 ACCREDITED GRADUATE MEDICAL EDUCATION (GME) PROGRAMS AND TRAINS MORE THAN 1,600 MEDICAL RESIDENTS AND FELLOWS ANNUALLY. OUR HOSPITALS AND FACILITIES COLLECTIVELY SERVE AS TEACHING SITES FOR MEDICAL STUDENTS FROM SIX MEDICAL SCHOOLS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANDREW J MITCHELL | ||||||||||||||
| CEO / PRESIDENT | $774,771 | $0 | $323,287 | $0 | $774 | $0 | $33,900 | $0 | $20,972 | $0 | $1,153,704 | $0 | $0 | $0 |
| AMY LOEB EDD | ||||||||||||||
| BOARD MEMBER/CHIEF NURSING OFFICER | $201,515 | $0 | $21,347 | $0 | $162 | $0 | $12,265 | $0 | $28,016 | $0 | $263,305 | $0 | $0 | $0 |
| MICHAEL F O'DONNELL | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $338,209 | $0 | $49,332 | $0 | $414 | $0 | $15,900 | $0 | $30,016 | $0 | $433,871 | $0 | $0 | $0 |
| SAMANTHA VIGLIOTTA | ||||||||||||||
| VP FOUNDATION & EXTERNAL AFFAIRS | $152,158 | $0 | $0 | $0 | $100 | $0 | $9,480 | $0 | $27,823 | $0 | $189,561 | $0 | $0 | $0 |
| RONALD MCMANUS | ||||||||||||||
| SVP OF PECONIC BAY MEDICAL | $281,628 | $0 | $0 | $0 | $774 | $0 | $15,900 | $0 | $11,353 | $0 | $309,655 | $0 | $0 | $0 |
| RICHARD KUBIAK | ||||||||||||||
| CHIEF MEDICAL OFFICER | $339,423 | $0 | $0 | $0 | $1,188 | $0 | $15,900 | $0 | $20,136 | $0 | $376,647 | $0 | $0 | $0 |
| ARTHUR CROWE | ||||||||||||||
| CIO / VP OF HOSPITAL SERVI | $248,198 | $0 | $3,500 | $0 | $414 | $0 | $14,870 | $0 | $29,502 | $0 | $296,484 | $0 | $0 | $0 |
| MONICA RAULS | ||||||||||||||
| VP OF HUMAN RESOURCES | $192,623 | $0 | $0 | $0 | $698 | $0 | $11,740 | $0 | $1,646 | $0 | $206,707 | $0 | $0 | $0 |
| CHERYL MAKOSKE | ||||||||||||||
| VP FINANCE | $235,616 | $0 | $0 | $0 | $270 | $0 | $11,964 | $0 | $19,136 | $0 | $266,986 | $0 | $0 | $0 |
| PETER SULTAN MD | ||||||||||||||
| PHYSICIAN | $415,481 | $0 | $544,300 | $0 | $270 | $0 | $45,900 | $0 | $27,408 | $0 | $1,033,359 | $0 | $0 | $0 |
| DAVID PRENTISS MD | ||||||||||||||
| PHYSICIAN | $296,902 | $0 | $4,475 | $0 | $414 | $0 | $15,900 | $0 | $0 | $0 | $317,691 | $0 | $0 | $0 |
| MAHMOOD AFGHANI MD | ||||||||||||||
| PHYSICIAN | $271,980 | $0 | $3,393 | $0 | $144 | $0 | $6,266 | $0 | $27,408 | $0 | $309,191 | $0 | $0 | $0 |
| STEPHEN JOHN MD | ||||||||||||||
| PHYSICIAN | $308,960 | $0 | $38,812 | $0 | $414 | $0 | $5,946 | $0 | $17,358 | $0 | $371,490 | $0 | $0 | $0 |
| KENNETH MAYER MD | ||||||||||||||
| PHYSICIAN | $230,659 | $0 | $1,015 | $0 | $324 | $0 | $13,835 | $0 | $27,408 | $0 | $273,241 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | CSH UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2016. |
| PART I, LINE 4B | ANDREW MITCHELL (NON-QUALIFIED RETIREMENT PLAN) - $18,000 |
| PART I, LINE 5 | CSH HAS A CONTRACTUAL ARRANGEMENT FOR A PHYSICIAN ENTITLING THE PHYSICIAN TO ADDITIONAL COMPENSATION BASED UPON CASH COLLECTIONS. |
| PART I, LINE 7 | PERFORMANCE BASED ON BOARD DISCRETION. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TOWN OF RIVERHEAD INDUSTRIAL DEVELOPMENT AGENCY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 112560077 | BondIssuerEIN |
| CUSIP | 000000000 | CUSIPNum |
| Bond Issued | 2015-05-06 | BondIssuedDt |
| Issue Price | $34,070,000 | IssuePriceAmt |
| Purpose | REFUND BONDS (06/23/06 & 06/27/07) | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $4,715,000 | RetiredAmt |
| Total Proceeds | $34,070,000 | TotalProceedsAmt |
| Other Spent Proceeds | $34,070,000 | OtherSpentProceedsAmt |
| Substantial Completion | 2009 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HSBC BANK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 17.200000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| RICHARD ISRAEL | |||
| BOARD MEMBER | $417,353 | RENTAL OF PROPERTY | 0 |
| STEVEN OUZOUNIAN MD | |||
| BOARD MEMBER | $75,000 | AGREEMENT FOR DIRECTORSHIP | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | ON JANUARY 15, 2016, CSH ENTERED INTO AN AFFILIATION AGREEMENT WITH NORTHWELL HEALTH (NORTHWELL) ESTABLISHING NORTHWELL AS THE SOLE MEMBER OF CSH. |
| FORM 990, PART VI, SECTION A, LINE 6 | NORTHWELL HEALTH IS THE SOLE MEMBER OF CSH. |
| FORM 990, PART VI, SECTION A, LINE 7A | AS THE SOLE MEMBER OF CSH, NORTHWELL HEALTH HAS THE RIGHT TO ELECT OR ELECT ONE OR MORE MEMBERS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CEO / PRESIDENT, COO AND CHIEF FINANCIAL OFFICER REVIEW THE FORM 990. A COPY OF THE FORM 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. IN THE EVENT OF ANY ISSUES WITH THE FORM 990, THE MATTERS ARE BROUGHT TO THE ATTENTION OF THE CHIEF FINANCIAL OFFICER. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICTS OF INTEREST POLICY APPLIES TO MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, VICE PRESIDENTS, ASSISTANT VICE PRESIDENTS, DEPARTMENT HEADS, CLINICAL DIRECTORS OF DEPARTMENTS, AND OTHER EMPLOYEES (INCLUDING PHYSICIANS) WHO ARE IN A POSITION TO INFLUENCE ANY SUBSTANTIVE BUSINESS DECISION BETWEEN CSH AND A VENDOR. THE DIRECTOR OF CORPORATE COMPLIANCE CONTINUOUSLY MONITORS ALL TRANSACTIONS TO DETERMINE IF ANY POTENTIAL CONFLICT EXISTS. IF IT IS DETERMINED THAT A POTENTIAL CONFLICT EXISTS, THE INDIVIDUAL IS PROHIBITED FROM PARTICIPATING IN THE DECISIONS OF THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | CSH UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2016. |
| FORM 990, PART VI, SECTION C, LINE 19 | CSH MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 802,382. MANAGEMENT AND GENERAL EXPENSES 159,431. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 961,813. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 10,245,137. MANAGEMENT AND GENERAL EXPENSES 1,063,767. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,308,904. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 2,664,348. MANAGEMENT AND GENERAL EXPENSES 796,763. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,461,111. TEMPORARY AGENCIES: PROGRAM SERVICE EXPENSES 1,448,832. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,448,832. |
| FORM 990, PART XI, LINE 9: | GAIN ON SWAP 1,189,345. PENSION ADJUSTMENT TO REFLECT FUNDED STATUS 225,410. PUSHDOWN ACCOUNTING ADJUSTMENT 15,089,839. CHANGE IN EQUITY INTEREST IN CENTRAL SUFFOLK HOSPITAL FOUNDATION 2,270,541. NET ASSETS RELEASED FROM RESTRICTIONS -1,000,000. PHYSICIANS PRACTICES -4,218,278. |
| FORM 990, PART XI, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THAT OF THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTHWELL HEALTH | |||||||||||
| 972 BRUSH HOLLOW RD | WESTBURY | NY | 11590 | 113418133 | AFFILIATION AGREEMENT | NY | 501(C)(3) | LINE 7 | N/A | 0 | |
| PECONIC BAY MEDICAL CENTER FOUNDATION | |||||||||||
| 1300 ROANOKE AVE | RIVERHEAD | NY | 11901 | 200714587 | FUNDRAISING/PHILANTHROPIC | NY | 501(C)(3) | LINE 7 | 0 | PECONIC BAY HEALTH SYSTEM | |
| PECONIC BAY HEALTH SYSTEM | |||||||||||
| 1300 ROANOKE AVE | RIVERHEAD | NY | 11901 | 112761795 | PARENT COMPANY OF PBMC | NY | 0 | ||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERHEAD MANAGEMENT CORPORATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1Txt |
| City | RIVERHEAD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 112800287 | EIN |
| Primary Activities | MANAGEMENT SERVICE ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |