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CENTRAL SUFFOLK HOSPITAL FOUNDATION: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
CENTRAL SUFFOLK HOSPITAL FOUNDATION (EIN 20-0714587)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-11-15
IRS object ID
201623209349315772
Schema version
2015v2.1
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)
Return2016-11-15T17:08:32-06:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN131517563PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1655 THIRD AVENUE 12TH FLOORAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10017ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN200714587EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANDREW J MITCHELLPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone6315486064PhoneNum
Signature2016-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonERIC GOLDFARBPreparerPersonNm
PTINP01277125PTIN
Phone2128674000PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1Txt
CityRIVERHEADCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11901ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,454,487GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PBMEDICALCENTER.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTHE MISSION OF THE CENTRAL SUFFOLK HOSPITAL FOUNDATION (THE FOUNDATION) IS TO SEEK PHILANTHROPIC SUPPORT ON BEHALF OF CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER (CSH).ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers13TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,071,944PYContributionsGrantsAmt
CY Contributions Grants$1,408,832CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$5,072PYInvestmentIncomeAmt
CY Investment Income$1,361CYInvestmentIncomeAmt
PY Other Revenue-$94,459PYOtherRevenueAmt
CY Other Revenue-$149,962CYOtherRevenueAmt
PY Total Revenue$2,982,557PYTotalRevenueAmt
CY Total Revenue$1,260,231CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$151,380PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$260,310CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$1,579,806CYTotalFundraisingExpenseAmt
PY Other Expenses$1,588,831PYOtherExpensesAmt
CY Other Expenses$1,323,671CYOtherExpensesAmt
PY Total Expenses$1,740,211PYTotalExpensesAmt
CY Total Expenses$1,583,981CYTotalExpensesAmt
PY Revenues Less Expenses$1,242,346PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$323,750CYRevenuesLessExpensesAmt
Total Assets BOY$4,239,308TotalAssetsBOYAmt
Total Assets EOY$4,091,319TotalAssetsEOYAmt
Total Liabilities BOY$250,847TotalLiabilitiesBOYAmt
Total Liabilities EOY$442,197TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,988,461NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,649,122NetAssetsOrFundBalancesEOYAmt
MissionTHE FOUNDATION'S MISSION IS TO DEVELOP AND CULTIVATE PHILANTHROPIC AND COLLABRATIVE RELATIONSHIPS THAT FOSTER PROGRAMS AND SERVICES OFFERED THROUGH CSH WHICH IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTHE SUPPORT OF HOSPITAL SERVICES OF CSH.Desc
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G1IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
J GORDON HUSZAGH
CHAIRMAN10.0015.00Yes (X)Yes (X)$0$0$0
IRWIN L GARSTEN
VICE CHAIR10.00Yes (X)Yes (X)$0$0$0
EMILIE ROY COREY MSW
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
RICHARD ISRAEL
SECRETARY1.001.00Yes (X)Yes (X)$0$0$0
JOAN S LEVAN
TREASURER1.001.00Yes (X)Yes (X)$0$0$0
ANDREW J MITCHELL FACHE
PRESIDENT/CEO15.0022.50Yes (X)Yes (X)$0$850,873$58,582
BRUCE BARNET
BOARD MEMBER1.00Yes (X)$0$0$0
KENN BARRA
BOARD MEMBER1.001.00Yes (X)$0$0$0
BARRY BRANDEIS
BOARD MEMBER1.00Yes (X)$0$0$0
ALISON GROSSMAN
BOARD MEMBER1.00Yes (X)$0$0$0
CAROLE G HANKIN PHD
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD RUBENSTEIN MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
JOSEPH VAN DE WETERING
BOARD MEMBER1.001.00Yes (X)$0$0$0
RICHARD L WINSLOW PHD
BOARD MEMBER1.001.00Yes (X)$0$0$0
STANLEY ZINBERG MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$850,873TotReportableCompRltdOrgAmt
Total Other Compensation$58,582TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CENTRAL SUFFOLK HOSPITAL
1300 ROANOKE AVENUERIVERHEADNY11901ADMINISTRATIVE SERVICES$1,331,305
THE GOBEL GROUP
16 WEST MARKET STREET 2ND FLOORWEST CHESTERPA19382FUNDRAISING COUNSEL$210,310
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Fundraising$692,734FundraisingAmt
All Other Contributions$716,098AllOtherContributionsAmt
Noncash Contributions$147,937NoncashContributionsAmt
Total Contributions$1,408,832TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,575TotalRevenueColumnAmt
Exclusion$8,575ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,120SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$8,334SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$7,214SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$7,214TotalRevenueColumnAmt
Exclusion-$7,214ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$35,960FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$692,734ContriRptFundraisingEventAmt
Fundraising Direct Expenses$185,922FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$149,962TotalRevenueColumnAmt
Exclusion-$149,962ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,260,231TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$148,601ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$260,310TotalAmt
Fundraising$260,310FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$4,175TotalAmt
Management And General$4,175ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$917,740TotalAmt
Fundraising$917,740FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$8,778TotalAmt
Fundraising$8,778FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$225,729TotalAmt
Fundraising$225,729FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$7,500TotalAmt
Fundraising$7,500FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$19,392TotalAmt
Fundraising$19,392FundraisingAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescCOMMUNITY OUTREACHDesc
Total$31,738TotalAmt
Fundraising$31,738FundraisingAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$108,619TotalAmt
Fundraising$108,619FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,583,981TotalAmt
Program Services$0ProgramServicesAmt
Management And General$4,175ManagementAndGeneralAmt
Fundraising$1,579,806FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$105,853BOYAmt
EOY$106,621EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,207,231BOYAmt
EOY$1,398,693EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,624,374BOYAmt
EOY$1,719,693EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$5,625BOYAmt
EOY$9,375EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$12,154BOYAmt
EOY$856,937EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$284,071BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,239,308BOYAmt
EOY$4,091,319EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
EOY$3,231EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$105,994BOYAmt
EOY$106,927EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$144,853BOYAmt
EOY$332,039EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$250,847BOYAmt
EOY$442,197EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,653,129BOYAmt
EOY$2,150,840EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,335,332BOYAmt
EOY$1,498,282EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,988,461BOYAmt
EOY$3,649,122EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,239,308BOYAmt
EOY$4,091,319EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$323,750ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$15,589NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,988,253CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,247,758CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,318,620CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,071,944CurrentTaxYearMinus1YearAmt
Current Tax Year$1,408,832CurrentTaxYearAmt
Total$11,035,407TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,988,253CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,247,758CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,318,620CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,071,944CurrentTaxYearMinus1YearAmt
Current Tax Year$1,408,832CurrentTaxYearAmt
Total$11,035,407TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$2,939,509SubstantialContributorsTotAmt
Public Support Total170$8,095,898PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$749CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$408CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,091CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,311CurrentTaxYearMinus1YearAmt
Current Tax Year$8,575CurrentTaxYearAmt
Total$16,134TotalAmt
FieldValueIRS element (for citing)
Total Support$11,051,541TotalSupportAmt
Public Support CY1700.73260PublicSupportCY170Pct
Public Support PY1700.73000PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Agent Trustee Etc0AgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabYes (1)InclEscrowCustodialAcctLiabInd
Explanation ProvidedYes (X)ExplanationProvidedInd
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTERDesc
Amt$332,039Amt
FieldValueIRS element (for citing)
Total Liability$332,039TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,244,642TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$15,589NetUnrealizedGainsInvstAmt
Revenue Not Reported-$15,589RevenueNotReportedAmt
Revenue Subtotal$1,260,231RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,260,231TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,583,981TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$1,583,981ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,583,981TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, THE FOUNDATION HAS REFLECTED AS A LIABILITY FOR THOSE CONTRIBUTIONS BEING HELD ON BEHALF OF WOMEN'S HEALTH PARTNERSHIP.
PART X, LINE 2:THE FOUNDATION HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2012 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES.

Schedule G IRS990ScheduleG

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

Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdActivityActivityTxtFundraiser Control Of FundsFundraiserControlOfFundsIndGross ReceiptsGrossReceiptsAmtRetained By ContractorRetainedByContractorAmtNet To OrganizationNetToOrganizationAmt
THE GOBEL GROUP
16 WEST MARKET STREET 2ND FLOORWEST CHESTERNY19382FUNDRAISING COUNSEL0$0$210,310$0
CLARE BISCEGLIA
PO BOX 1952QUOGUENY11959FUNDRAISING COUNSEL0$0$50,000$0
FieldValueIRS element (for citing)
Total Retained By Contractors$260,310TotalRetainedByContractorsAmt
Licensed StatesNYLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1BLACK AND WHITEEvent1Nm
Gross Receipts Event1$411,129GrossReceiptsEvent1Amt
Charitable Contri Event1$408,384CharitableContriEvent1Amt
Gross Revenue Event1$2,745GrossRevenueEvent1Amt
Cash Prizes Event1$17,938CashPrizesEvent1Amt
Rent Facility Costs Event1$18,957RentFacilityCostsEvent1Amt
Food And Beverage Event1$28,096FoodAndBeverageEvent1Amt
Entertainment Event1$1,750EntertainmentEvent1Amt
Other Direct Expenses Event1$14,372OtherDirectExpensesEvent1Amt
Event2GOLF EVENTEvent2Nm
Gross Receipts Event2$228,160GrossReceiptsEvent2Amt
Charitable Contri Event2$194,945CharitableContriEvent2Amt
Gross Revenue Event2$33,215GrossRevenueEvent2Amt
Rent Facility Costs Event2$40,300RentFacilityCostsEvent2Amt
Food And Beverage Event2$47,967FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$16,542OtherDirectExpensesEvent2Amt
Other Events Total1OtherEventsTotalCnt
Gross Receipts Other Events$89,405GrossReceiptsOtherEventsAmt
Charitable Contri Other Events$89,405CharitableContriOtherEventsAmt
Gross Receipts Total$728,694GrossReceiptsTotalAmt
Charitable Contributions Tot$692,734CharitableContributionsTotAmt
Gross Revenue Total Events$35,960GrossRevenueTotalEventsAmt
Cash Prizes Total Events$17,938CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$59,257RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$76,063FoodAndBeverageTotalEventsAmt
Entertainment Total Events$1,750EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$30,914OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$185,922DirectExpenseSummaryEventsAmt
Net Income Summary-$149,962NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonANDREW J MITCHELL FACHEPersonNm
TitlePRESIDENT/CEOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$734,513CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$100,000BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$16,360OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$33,900DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$24,682NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$909,455TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationCSH UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2015.ExplanationTxt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$147,937NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationNUMBER OF CONTRIBUTIONSExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE CEO/PRESIDENT, AND CHIEF FINANCIAL OFFICER OF CSH, A RELATED ORGANIZATION, REVIEW THE FORM 990. A COPY OF THE FORM 990 IS ALSO PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW.
FORM 990, PART VI, SECTION B, LINE 12THE FOUNDATION FOLLOWS CSH'S CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15CSH UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2015.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GADMINISTRATIVE SERVICE FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 856,205. TOTAL EXPENSES 856,205. CONSULTANTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 20,897. TOTAL EXPENSES 20,897. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 40,638. TOTAL EXPENSES 40,638.
FORM 990, PART XII, LINE 2C:THIS PROCESS DID NOT CHANGE FROM THAT OF THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
CENTRAL SUFFOLK HOSPITAL DBA PECONIC BAY MEDICAL CENTER
1300 ROANOKE AVERIVERHEADNY11901111661359HOSPITAL CARENY501(C)(3)3PECONIC HEALTH CORPORATION0
PECONIC BAY HEALTH SYSTEMS
1300 ROANOKE AVERIVERHEADNY11901112761795PARENT COMPANY OF PBMCNY0N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd