STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

ST CATHERINE OF SIENA MEDICAL CENTER: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ST CATHERINE OF SIENA MEDICAL CENTER (EIN 06-1562701)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-12
IRS object ID
201503169349306320
Schema version
2014v5.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2015-11-12T21:28:56-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1300 Madison AvenueAddressLine1Txt
CityNew YorkCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10017ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN061562701EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST CATHERINE OF SIENA MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% CHS SERVICES INCInCareOfNm
Business Name ControlSTCABusinessNameControlTxt
Phone6318623000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line150 ROUTE 25AAddressLine1Txt
CitySMITHTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11787ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPAUL ROWLANDPersonNm
Person TitleEXECUTIVE VP, CAOPersonTitleTxt
Phone6464713000PhoneNum
Signature2015-11-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAURA J PARELLOPreparerPersonNm
PTINP01080295PTIN
Phone6464713000PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerALAN D GUERCI MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line150 ROUTE 25AAddressLine1Txt
CitySMITHTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11787ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$249,017,670GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Group Exemption0928GroupExemptionNum
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTP://STCATHERINES.CHSLI.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2000FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionCHSLI AND ITS MEMBERS, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUE CHRIST'S HEALING MISSION, BY PROMOTING EXCELLENCE IN CARE AND COMMITTING ITSELF TO THOSE IN NEED.ActivityOrMissionDesc
Voting Members Governing Body23VotingMembersGoverningBodyCnt
Voting Members Independent22VotingMembersIndependentCnt
Total Employee2178TotalEmployeeCnt
Total Volunteers207TotalVolunteersCnt
Total Gross UBI$275,937TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$84,183NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$21,950,810PYContributionsGrantsAmt
CY Contributions Grants$13,742,698CYContributionsGrantsAmt
PY Program Service Revenue$224,856,949PYProgramServiceRevenueAmt
CY Program Service Revenue$219,908,893CYProgramServiceRevenueAmt
PY Investment Income$415,611PYInvestmentIncomeAmt
CY Investment Income$223,780CYInvestmentIncomeAmt
PY Other Revenue$9,923,443PYOtherRevenueAmt
CY Other Revenue$11,738,697CYOtherRevenueAmt
PY Total Revenue$257,146,813PYTotalRevenueAmt
CY Total Revenue$245,614,068CYTotalRevenueAmt
PY Grants And Similar Paid$314,580PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$311,197CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$157,936,736PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$154,261,164CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$97,335,400PYOtherExpensesAmt
CY Other Expenses$104,789,978CYOtherExpensesAmt
PY Total Expenses$255,586,716PYTotalExpensesAmt
CY Total Expenses$259,362,339CYTotalExpensesAmt
PY Revenues Less Expenses$1,560,097PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$13,748,271CYRevenuesLessExpensesAmt
Total Assets BOY$162,634,433TotalAssetsBOYAmt
Total Assets EOY$155,347,188TotalAssetsEOYAmt
Total Liabilities BOY$215,035,376TotalLiabilitiesBOYAmt
Total Liabilities EOY$221,580,267TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$52,400,943NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$66,233,079NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionST. CATHERINE OF SIENA MEDICAL CENTER, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED. CHS AFFIRMS THE SANCTITY OF LIFE, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$201,814,843ExpenseAmt
Grant$311,197GrantAmt
Revenue$198,202,790RevenueAmt
DescST. CATHERINE OF SIENA MEDICAL CENTER IS A 318 BED ACUTE CARE HOSPITAL DEVOTED TO PROVIDING ADVANCED HEALTHCARE IN AN ENVIRONMENT OF COMPASSION. IN 2014, THE MEDICAL CENTER HAD 11,616 DISCHARGES AND PROVIDED CARE FOR 30,092 EMERGENCY ROOM VISITS. IN ACCORDANCE WITH ITS MISSION AND PHILOSOPHY, THE MEDICAL CENTER PROVIDES CARE REGARDLESS OF THE INDIVIDUAL'S ABILITY TO PAY AND ALONG WITH OTHER COMMUNITY SERVICE AND CHARITABLE ACTIVITIES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$29,785,836ExpenseAmt
Grant$0GrantAmt
Revenue$31,102,138RevenueAmt
DescST. CATHERINE OF SIENA NURSING HOME IS LOCATED ON THE CAMPUS OF ST.CATHERINE OF SIENA MEDICAL CENTER. CONSISTING OF 240 BEDS, THE NURSING HOME PROVIDED 77,373 DAYS OF CARE IN 2014.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$231,600,679TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityYes (true)DisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document151IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee2178EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members23GoverningBodyVotingMembersCnt
Independent Voting Member22IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCHS SERVICES INCPersonNm
Phone5167051937PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1992 NORTH VILLAGE AVENUEAddressLine1Txt
CityROCKVILLE CENTRECityNm
State AbbreviationNYStateAbbreviationCd
ZIP11570ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (46 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
JEROME POLLER
CHAIRMAN THRU APR14/TRUSTEE2.00.0Yes (X)Yes (X)$0$0$0
RAYMOND BORSELLA
TREASURER THRU APRIL 20142.00.0Yes (X)Yes (X)$0$0$0
MICHAEL LAMBERT ESQ
SECRETARY THRU APRIL 20142.00.0Yes (X)Yes (X)$0$0$0
ROBERT CARLIN MD
TRUSTEE THRU APRIL 20142.00.0Yes (X)$0$0$0
JAMES DILTS
TRUSTEE THRU APRIL 20142.00.0Yes (X)$0$0$0
HON JEANNE GARANT
TRUSTEE THRU APRIL 20142.00.0Yes (X)$0$0$0
SISTER ANN GRAY DW
TRUSTEE THRU APRIL 20142.00.0Yes (X)$0$0$0
J ROBERT GROSS DC
TRUSTEE THRU APRIL 20142.00.0Yes (X)$0$0$0
JOHN HALLERON III ESQ
TRUSTEE THRU APRIL 20142.00.0Yes (X)$0$0$0
REV MSGR JAMES MCNAMARA
TRUSTEE THRU APRIL 20142.00.0Yes (X)$0$0$0
JERRY NINIA MD
TRUSTEE THRU APRIL 20142.00.0Yes (X)$0$0$0
RICHARD SCHMIDT
TRUSTEE THRU APRIL 20142.00.0Yes (X)$0$0$0
RICHARD J J SULLIVAN JR
CHAIRMAN AS OF APRIL 20142.00.0Yes (X)Yes (X)$0$0$0
BARBARA ELLEN BLACK
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
THOMAS DOWLING JR MD
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
VIRGINIA EWEN
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
SISTER AUDREY HARSEN
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
FRANK L KURRE
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
BRIAN MCGUIRE
VICE CHAIR AS OF APRIL 20142.00.0Yes (X)Yes (X)$0$0$0
REV MSGR ROBERT MORRISEY
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
PATRICIA NAZEMETZ
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
CHRIS PASCUCCI
TREASURER AS OF APRIL 20142.00.0Yes (X)Yes (X)$0$0$0
DANIEL T ROWE
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
JOSEPH TANTILLO
SECRETARY AS OF APRIL 20142.00.0Yes (X)Yes (X)$0$0$0
JOHN WAGNER
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
REV JAMES VLAUN
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
KEVIN J CONWAY
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
PETER D'ANGELO
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
REV PETER DUGANDZIC
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
BRIAN P HEHIR
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
HON ANTHONY MARANO
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
STEPHEN F MCLOUGHLIN
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
SALVATORE SODANO
TRUSTEE AS OF APRIL 20142.00.0Yes (X)$0$0$0
ALAN D GUERCI MD
PRESIDENT & CEO50.00.0Yes (X)Yes (X)$0$1,230,209$247,778
PAUL ROWLAND
EXC VP & CAO50.00.0Yes (X)$388,351$0$53,238
WILLIAM C ARMSTRONG
SVP FINANCE50.00.0Yes (X)$0$667,805$135,888
JASON GOLBIN
CMO50.00.0$340,591$0$36,990Yes (X)
BRUCE MAYERSEN MD
PHYSICIAN40.00.0$651,914$0$50,514Yes (X)
GARA EDELSTEIN
SR VP ADMIN & CNO50.00.0$483,888$0$100,871Yes (X)
MICHAEL WEBER MD
PHYSICIAN40.00.0$424,072$0$48,227Yes (X)
SCHENLEY QUE MD
PHYSICIAN40.00.0$618,319$0$37,926Yes (X)
DENNIS O'BRIEN
PHYSICIAN40.00.0$443,672$0$18,070Yes (X)
JAMES CALDAS
FORMER PRESIDENT & CEO0.00.0$0$1,939,643$198,703Yes (X)
DAN MACKSOOD
FORMER SVP FIN/CFO EASTERN DIV0.00.0$0$516,717$18,450Yes (X)
DENNIS VERZI
FORMER EXEC VP & CAO0.050.0$0$1,093,189$101,656Yes (X)
PATRICK O'SHAUGHNESSY
FORMER CMO0.050.0$0$699,045$318,134Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,350,807TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$6,146,608TotReportableCompRltdOrgAmt
Total Other Compensation$1,366,445TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K243IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CHEM RX PHARMACY SVCS LLC
750 PARK PLACELONG BEACHNY11561PHARMACY$544,691
ISLAND NEONATOLOGY PLLC
PO BOX 272EAST ISLIPNY11730PHYSICIAN SERVICES$544,000
HORIZON HEALTHCARE STAFFING
20 JERUSALEM AVE 3RD FLHICKSVILLENY11801NURSING AGENCY FEES$402,297
SMITHTOWN PSYCHIATRIC SVC
2 BROOKSITE DRIVESMITHTOWNNY11787PSYCHIATRIC SERVICES$233,643
BRIAN MARGOLIS MD ANTHONY
SPARADO MD LLPSMITHTOWNNY11787PHYSICIAN SERVICES$196,810
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K16CntrctRcvdGreaterThan100KCnt
Federated Campaigns$1,205FederatedCampaignsAmt
Fundraising$262,434FundraisingAmt
Related Organizations$13,400,000RelatedOrganizationsAmt
Government Grants$44,822GovernmentGrantsAmt
All Other Contributions$34,237AllOtherContributionsAmt
Total Contributions$13,742,698TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REV-HOSPITAL621990$188,806,755$188,530,818$275,937
NET PATIENT REV-NURSING HOME623000$31,102,138$31,102,138
FieldValueIRS element (for citing)
Total Program Service Revenue$219,908,893TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$216,782TotalRevenueColumnAmt
Exclusion$216,782ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,480,019RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$1,449,012RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$31,007RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,007TotalRevenueColumnAmt
Related Or Exempt Func Income$31,007RelatedOrExemptFuncIncomeAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$1,883,222SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,876,224SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$6,998SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,998TotalRevenueColumnAmt
Exclusion$6,998ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$53,981FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$262,434ContriRptFundraisingEventAmt
Fundraising Direct Expenses$78,366FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$24,385TotalRevenueColumnAmt
Exclusion-$24,385ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

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

Net Income Or Loss NetIncomeOrLossGrp

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

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
PHYSICIAN BILLING - RELATED PARTY900099$5,239,801$5,239,801
CONTRACTED SVCS-SWSM900099$4,401,164$4,401,164
TELEPHONE900099$52,627$52,627

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,038,483TotalRevenueColumnAmt
Exclusion$2,038,483ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$11,732,075OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$245,614,068TotalRevenueColumnAmt
Related Or Exempt Func Income$229,304,928RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$275,937UnrelatedBusinessRevenueAmt
Exclusion$2,290,505ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$311,197TotalAmt
Program Services$311,197ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$859,170TotalAmt
Program Services$392,581ProgramServicesAmt
Management And General$466,589ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$113,526,707TotalAmt
Program Services$106,926,093ProgramServicesAmt
Management And General$6,600,614ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$6,877,415TotalAmt
Program Services$6,452,502ProgramServicesAmt
Management And General$424,913ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$24,529,205TotalAmt
Program Services$22,851,458ProgramServicesAmt
Management And General$1,677,747ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$8,468,667TotalAmt
Program Services$7,945,440ProgramServicesAmt
Management And General$523,227ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$232,546TotalAmt
Management And General$232,546ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$10,250TotalAmt
Management And General$10,250ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$50,651TotalAmt
Management And General$50,651ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$6,936,040TotalAmt
Program Services$5,358,171ProgramServicesAmt
Management And General$1,577,869ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$131,189TotalAmt
Program Services$300ProgramServicesAmt
Management And General$130,889ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,749,528TotalAmt
Program Services$2,824,307ProgramServicesAmt
Management And General$925,221ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,796,747TotalAmt
Program Services$2,488,730ProgramServicesAmt
Management And General$308,017ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$89,340TotalAmt
Program Services$77,719ProgramServicesAmt
Management And General$11,621ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$3,862,001TotalAmt
Program Services$3,862,001ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$2,522,486TotalAmt
Program Services$2,522,486ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$20,432,019TotalAmt
Program Services$17,478,241ProgramServicesAmt
Management And General$2,953,778ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$5,857,977TotalAmt
Program Services$5,855,907ProgramServicesAmt
Management And General$2,070ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$33,833,110$33,833,110
CHS SERVICES$14,668,130$6,309,340$8,358,790
SERVICE/MAINTENANCE CONTRACTS$2,670,492$2,670,492
HOME OFFICE ALLOCATION$2,842,674$2,842,674

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$4,104,798TotalAmt
Program Services$3,440,604ProgramServicesAmt
Management And General$664,194ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$259,362,339TotalAmt
Program Services$231,600,679ProgramServicesAmt
Management And General$27,761,660ManagementAndGeneralAmt
Fundraising$0FundraisingAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XYes (X)InfoInScheduleOPartXInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,704,335BOYAmt
EOY$9,490,636EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,417,829BOYAmt
EOY$1,011,075EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$93,479BOYAmt
EOY$48,387EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$29,853,937BOYAmt
EOY$29,732,746EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$3,458,729BOYAmt
EOY$3,536,824EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,707,026BOYAmt
EOY$1,666,527EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$160,304,154LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$85,515,693LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$90,252,514BOYAmt
EOY$74,788,461EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$7,126,187BOYAmt
EOY$7,325,998EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$25,020,397BOYAmt
EOY$27,746,534EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$162,634,433BOYAmt
EOY$155,347,188EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$25,048,806BOYAmt
EOY$29,789,365EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$68,730,791BOYAmt
EOY$68,179,450EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$480,454EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$121,255,779BOYAmt
EOY$123,130,998EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$215,035,376BOYAmt
EOY$221,580,267EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$53,464,275BOYAmt
EOY-$66,973,741EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,063,332BOYAmt
EOY$740,662EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$52,400,943BOYAmt
EOY-$66,233,079EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$162,634,433BOYAmt
EOY$155,347,188EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$13,748,271ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$41,135NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$125,000OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$50,651OtherActivitiesAmt
Total Lobbying Expenditures$50,651TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1 - LOBBYING ACTIVITIESFormAndLineReferenceDesc
ExplanationAMOUNT REFLECTS PORTION OF TRADE ASSOCIATION DUES WHICH WERE USED FOR LEGISLATIVE LOBBYING ON BEHALF OF THE HEALTHCARE INDUSTRY THOSE TRADE ASSOCIATIONS REPRESENT.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,126,496OtherCostOrOtherBasisAmt
Book Value$10,126,496BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$87,903,433OtherCostOrOtherBasisAmt
Depreciation$41,017,477DepreciationAmt
Book Value$46,885,956BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$60,013,920OtherCostOrOtherBasisAmt
Depreciation$43,678,091DepreciationAmt
Book Value$16,335,829BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,260,305OtherCostOrOtherBasisAmt
Depreciation$820,125DepreciationAmt
Book Value$1,440,180BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$74,788,461TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
INSURANCE CLAIMS RECEIVABLE$25,419,656
OTHER ASSETS$1,305,963
DEFERRED FINANCING COSTS, NET$1,020,915
FieldValueIRS element (for citing)
Total Book Value Other Assets$27,746,534TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (8 entries)

DescDescAmtAmt
RESIDENT FUNDS AND SECURITY DEPOSIT$270,148
THIRD PARTY PAYOR LIABILITIES$22,553,355
RETIREMENT LIABILITY - PENSION$579,138
RETIREMENT LIABILITY - 457B FUNDS$456,778
RETIREMENT LIABILITY - POST RETIREMENT$2,292,000
ESTIMATED MALPRACTICE LIABILITY$26,110,968
SELF INSURED LIABILITY$26,067,030
DUE TO RELATED PARTIES$44,801,581
FieldValueIRS element (for citing)
Total Liability$123,130,998TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTEFormAndLineReferenceDesc
ExplanationCHS AND MOST OF ITS SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CHS ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE CODIFICATION TOPIC 740, INCOME TAXES. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS, USING A THRESHOLD OF MORE LIKELY THAN NOT OF BEING SUSTAINED.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1DINNER DANCEEvent1Nm
Gross Receipts Event1$226,415GrossReceiptsEvent1Amt
Charitable Contri Event1$193,751CharitableContriEvent1Amt
Gross Revenue Event1$32,664GrossRevenueEvent1Amt
Food And Beverage Event1$32,664FoodAndBeverageEvent1Amt
Entertainment Event1$4,750EntertainmentEvent1Amt
Other Direct Expenses Event1$15,880OtherDirectExpensesEvent1Amt
Event2GOLFEvent2Nm
Gross Receipts Event2$90,000GrossReceiptsEvent2Amt
Charitable Contri Event2$68,683CharitableContriEvent2Amt
Gross Revenue Event2$21,317GrossRevenueEvent2Amt
Rent Facility Costs Event2$13,765RentFacilityCostsEvent2Amt
Food And Beverage Event2$7,552FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$3,755OtherDirectExpensesEvent2Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$316,415GrossReceiptsTotalAmt
Charitable Contributions Tot$262,434CharitableContributionsTotAmt
Gross Revenue Total Events$53,981GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$13,765RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$40,216FoodAndBeverageTotalEventsAmt
Entertainment Total Events$4,750EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$19,635OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$78,366DirectExpenseSummaryEventsAmt
Net Income Summary-$24,385NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd
Percent400Yes (X)Percent400Ind
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,845,783TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$1,377,952DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,467,831NetCommunityBenefitExpnsAmt
Total Expense0.00570TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,861,881TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,134,002DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,727,879NetCommunityBenefitExpnsAmt
Total Expense0.01820TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$634,071TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$362,132DirectOffsettingRevenueAmt
Net Community Benefit Expns$271,939NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,341,735TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,874,086DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,467,649NetCommunityBenefitExpnsAmt
Total Expense0.02490TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$520,112TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$520,112NetCommunityBenefitExpnsAmt
Total Expense0.00200TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$6,025TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$6,025NetCommunityBenefitExpnsAmt

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$0TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$0NetCommunityBenefitExpnsAmt

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$110,222TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$110,222NetCommunityBenefitExpnsAmt
Total Expense0.00040TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$636,359TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$636,359NetCommunityBenefitExpnsAmt
Total Expense0.00240TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$23,978,094TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,874,086DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,104,008NetCommunityBenefitExpnsAmt
Total Expense0.02730TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$2,568,258BadDebtExpenseAmt
Reimbursed By Medicare$57,359,403ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$73,867,725CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$16,508,322MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST CATHERINE OF SIENA HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line150 ROUTE 25AAddressLine1Txt
CitySMITHTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11787ZIPCd
FieldValueIRS element (for citing)
Website AddressHTTP://STCATHERINES.CHSLI.ORGWebsiteAddressTxt
State License5157003HStateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherPSYCHIATRIC UNITOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ST CATHERINE OF SIENA MEDICAL CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSTCATHERINES.CHSLI.ORG/OwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLWWW.CHSLI.ORG - SEE PART V, SECTION COtherWebsiteURLTxt
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt13ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLWWW.CHSLI.ORGStrategyWebsiteURLTxt
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care300.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care400.FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLXFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLXFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLXFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Other Actions TakenYes (X)OtherActionsTakenInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, SECTION B, LINE 5SMITHTOWN AND COMMACK HIGH SCHOOL STUDENTS IN THE MEDICAL CENTER'S "HEALTH CARE EXPLORATION AND INTERNSHIP PROGRAM" HAND DELIVERED PAPER SURVEYS TO FAMILY MEMBERS IN THE COMMUNITY. VOLUNTEERS REPRESENTING 10 COMMUNITIES IN WESTERN SUFFOLK AND SIENA VILLAGE RESIDENTS WERE ALSO GIVEN THE PAPER SURVEY TO COMPLETE. ST. CATHERINE ALSO ROUTINELY SCREENS AND INTERVIEWS THE UNINSURED AND INDIVIDUALS FROM LOW INCOME COMMUNITIES THROUGH THE "HEALTHY SUNDAYS" PROGRAM. PUBLICLY REPORTED DATA FROM THE COUNTY HEALTH RANKINGS/ROADMAPS TO HEALTH AND THE COMMUNITY COMMONS' CHNA TOOLKIT, AN ONLINE RESOURCE FOR HOSPITAL, PUBLIC HEALTH DEPARTMENTS, ACADEMIC INSTITUTIONS AND THE GENERAL PUBLIC, PROVIDED A FRAMEWORK FOR SURVEY FINDINGS. IN ADDITION, THE NEW YORK STATE PREVENTION AGENDA FOR 2013-2017 WAS USED AS A RESOURCE. IN ORDER TO GAIN INPUT ON THE NEEDS OF MEDICALLY UNDERSERVED, LOW-INCOME AND MINORITY POPULATIONS, AND POPULATIONS WITH CHRONIC DISEASE NEEDS IN THE COMMUNITY, MEMBERS OF THE NASSAU-SUFFOLK HOSPITAL COUNCIL'S PUBLIC HEALTH WORKGROUP, NOW KNOWN AS THE LONG ISLAND HEALTH COLLABORATIVE (LIHC), WHICH INCLUDED REPRESENTATIVES OF LONG ISLAND'S HOSPITALS, HEALTH SYSTEMS, COUNTY HEALTH DEPARTMENTS, AND ACADEMIC INSTITUTIONS, CONDUCTED INTERVIEWS WITH REPRESENTATIVES OF FIVE COMMUNITY AGENCIES AND ORGANIZATIONS THAT SERVE THESE POPULATIONS. THESE INTERVIEWS WERE CONDUCTED IN MARCH OF 2013 IN PERSON. COLLABORATING ORGANIZATIONS INCLUDE: UNITED WAY OF LONG ISLAND AMERICAN HEART ASSOCIATION (AHA) AMERICAN DIABETES ASSOCIATION AMERICAN CANCER SOCIETY ISLAND HARVEST: FOUNDED IN 1992, THE MISSION OF ISLAND HARVEST HAS BEEN DEEPLY ROOTED TO HELPING PEOPLE IN NEED-WITH A GOAL TO END HUNGER AND REDUCE FOOD WASTE ON LONG ISLAND. IT IS LONG ISLAND'S LARGEST HUNGER RELIEF ORGANIZATION AND DELIVERS MILLIONS OF POUNDS OF GOODS AND SURPLUS FOODS ANNUALLY TO A NETWORK OF MORE THAN 470 LONG ISLAND BASED FOOD PANTRIES, KITCHENS, AND OTHER NON-PROFITS ORGANIZATIONS THAT OFFER FEEDING SERVICES TO THOSE IN NEED. IN ADDITIONAL TO HUNGER AWARENESS, THE ORGANIZATION HAS BEEN BUILDING RELATIONSHIPS WITH OTHER ORGANIZATIONS TO RAISE NUTRITION AWARENESS AS WELL. ST. CATHERINE OF SIENA HAS PARTNERED WITH THESE AGENCIES BECAUSE OF THEIR PROVEN SUCCESS IN WORKING WITH UNDERPRIVILEGED POPULATIONS AND CREDIBILITY IN THEIR AREAS OF EXPERTISE.
PART V, SECTION B, LINE 6AGOOD SAMARITAN HOSPITAL MEDICAL CENTER, ST. CHARLES HOSPITAL, STONY BROOK UNIVERSITY MEDICAL CENTER, BROOKHAVEN HOSPITAL, PECONIC BAY MEDICAL CENTER, SOUTHAMPTON HOSPITAL, JOHN T. MATHER MEMORIAL HOSPITAL AND THE NORTH SHORE-LIJ HEALTH SYSTEM.
PART V, SECTION B, LINE 6BNASSAU AND SUFFOLK HEALTH DEPARTMENTS, STONY BROOK UNIVERSITY AND VARIOUS COMMUNITY-BASED ORGANIZATIONS, NOW COLLECTIVELY KNOWN AS THE LONG ISLAND HEALTH COLLABORATIVE (LIHC).
PART V, SECTION B, LINE 7B - OTHER WEBSITENSHC.ORG/LONG-ISLAND-HEALTH-COLLABORATIVE/
PART V, SECTION B, LINE 11PRIORITY 1: OBESITY AND NUTRITION EDUCATION THE HOSPITAL IS WORKING TO INCREASE EDUCATION AND SUPPORT SERVICES TO HELP REDUCE OBESITY IN ADULTS AND CHILDREN IN SUFFOLK COUNTY, ESPECIALLY WITHIN THE HOSPITAL'S SERVICE AREAS, INCLUDING THE DISADVANTAGED AND UNDERSERVED COMMUNITIES. THROUGH COMMUNITY OUTREACH PROGRAMS, IT IS ADDRESSING THE NEED FOR IMPROVED AWARENESS/EDUCATION ON HEALTHY LIFESTYLE OPTIONS. PROGRAMS INCLUDE BOARD "WALK" TO WELLNESS WALKING PROGRAM"; ORGANIZED COMMUNITY WALKS IN PARTNERSHIP WITH OTHER GROUPS; AND OTHER EFFORTS. PRIORITY 2: CHRONIC DISEASE PREVENTION THE HOSPITAL IS PROMOTING IMPROVED MANAGEMENT OF HIGH BLOOD PRESSURE TO PREVENT HEART DISEASE AND STROKE, AND ENHANCING DIABETES AWARENESS THROUGH COMMUNITY OUTREACH PROGRAMS. PROGRAMS INCLUDE FREE HEALTH SCREENINGS THROUGH CHS HEALTHY SUNDAYS; EMERGENCY RESPONSE APPRECIATION AND EDUCATION DINNERS; AND FREE COMMUNITY SUPPORT GROUPS. PRIORITY 3: MENTAL HEALTH/SUBSTANCE ABUSE THE HOSPITAL IS WORKING TO IMPROVE ACCESS TO MENTAL HEALTH PROGRAMS AND RESOURCES FOR PATIENTS WITH MENTAL HEALTH OR SUBSTANCE ABUSE ISSUES, AND PROMOTE MENTAL, EMOTIONAL AND BEHAVIORAL WELL-BEING IN THE SURROUNDING COMMUNITIES THROUGH THE HOSPITAL'S ANNUAL COMMUNITY HEALTH FAIR; COLLABORATION WITH CLUBHOUSE OF SUFFOLK; LONG ISLAND COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE (LICADD) PARTNERSHIP; COLLABORATION WITH HORIZONS COUNSELING AND EDUCATION CENTER; AND SUPPORT GROUPS. THE TOP THREE HEALTH CHALLENGES IN THE MOST RECENT CHNA SURVEY WERE IDENTIFIED AS OVERWEIGHT/OBESITY, CHRONIC DISEASE (HIGH BLOOD PRESSURE, HEART DISEASE, DIABETES, CANCER, AND JOINT OR BACK PAIN) ALONG WITH MENTAL HEALTH ISSUES. THE HOSPITAL CONTINUES TO PROVIDE EDUCATION AND SUPPORT SERVICES THROUGH ITS ESTABLISHED PROGRAMS AS OUTLINED ABOVE. IN ADDITION THE FOLLOWING PROGRAMS HAVE BEEN ADDED TO THE COMMUNITY OUTREACH PROGRAM SCHEDULE: ST. CATHERINE OF SIENA MEDICAL CENTER AND SUFFOLK COUNTY DEPARTMENT OF HEALTH ARE SPONSORING A FREE DIABETES PREVENTION PROGRAM FOR THOSE WITH PRE-DIABETES OR AT HIGH RISK FOR DEVELOPING TYPE-2 DIABETES. THE PROGRAM WILL FOCUS ON LIFESTYLE CHANGES, INCLUDING ACTIVITY LEVEL AND FOOD CHOICES. PARTICIPANTS WORK TOWARD GOALS THAT LEAD TO THE PREVENTION OR DELAY OF DIABETES, A SUPPORT GROUP FOR CARE-GIVERS CHRONICALLY ILL OR DISABLED SPOUSE /PARTNER HAS BEEN DEVELOPED BY THE PASTORAL CARE DEPARTMENT, ST. CATHERINE HAS PARTNERED WITH RETIRED SENIOR VOLUNTEER PROGRAM (RSVP) FOR A HEALTH LIVING WITH CHRONIC DISEASE WORKSHOP. THE SURVEY INDICATED THE TOP FIVE AREAS AS HIGH BLOOD PRESSURE, JOINT PAIN OR BACK PAIN OVERWEIGHT/OBESITY, DIABETES AND HEART DISEASE. DUE TO THE SEVERITY AND URGENCY OF HEALTH NEEDS AND THE IMPORTANCE PLACED ON ADDRESSING THESE NEEDS IN THE COMMUNITY, ST. CATHERINE HAS CHOSEN TO ADDRESS THE FOLLOWING TWO TOP PRIORITIES: OVERWEIGHT AND OBESITY, AND CHRONIC DISEASE PREVENTION. ST. CATHERINE OF SIENA HAS DETERMINED THE HOSPITAL WILL BE ABLE TO PROVIDE SERVICES THAT WILL HAVE A GREATER IMPACT ON OVERWEIGHT/OBESITY AND CHRONIC DISEASE PREVENTION, WHICH INCLUDES HIGH BLOOD PRESSURE, HEART DISEASE AND DIABETES.
PART V, SECTION B, LINE 20EST. CATHERINE OF SIENA MEDICAL CENTER HAS POSTED MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN ST. CATHERINE OF SIENA MEDICAL CENTER INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREA. SAID NOTICES ARE PUBLISHED IN AT LEAST ENGLISH AND SPANISH, AND ARE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. ST. CATHERINE OF SIENA MEDICAL CENTER HAS POSTED ITS CHARITY CARE POLICY SUMMARY ON ITS INTERNET WEBSITE.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ST CATHERINE OF SIENA NURSING HOMEBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line125 ROUTE 25AAddressLine1Txt
CitySMITHTOWNCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11787ZIPCd
FieldValueIRS element (for citing)
FacilitySKILLED NURSING FACILITYFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 7 - RATIO OF PATIENT CARE COST TO CHARGES WORKSHEETRATIO OF PATIENT CARE COST TO CHARGES WORKSHEET (WORKSHEET 2) AS PRESCRIBED BY THE IRS INSTRUCTIONS TO SCHEDULE H FORM 990 WAS THE METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN PART I, LINE 7 CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST LINES 7A,7B AND 7C AND 7D. ALL OTHER LINES INCLUDE COSTS THAT WERE DERIVED ON THE RCC METHODOLOGY OR ACTUAL COSTS FOR THE SERVICES AS TRACKED BY HOSPITAL PERSONNEL UTILIZING DIRECT HOURLY LABOR COSTS, FRINGES AND SUPPLY COSTS.
PART I, LINE 7A COLUMN (D)DIRECT OFFSETTING REVENUES REPRESENT DISTRIBUTIONS FROM THE NEW YORK STATE (NYS) INDIGENT CARE POOL (ICP) WHICH IS SHOWN NET OF HOSPITAL CONTRIBUTIONS TO THE STATEWIDE POOL. THE FORMULA EMPLOYED BY NYS TO DETERMINE DISTRIBUTIONS TO HOSPITALS FROM THE ICP IS COMPLEX AND IS DERIVED FROM A HOSPITAL'S "NEED" CALCULATION. THIS CALCULATION CONSIDERS 100% OF A HOSPITAL'S "NEED" BASED ON A "UNITS OF SERVICE" METHODOLOGY FOR UNINSURED PATIENTS. THE CALCULATION ALSO MAKES ADJUSTMENTS BASED ON THE PROPORTION OF MEDICAID ELIGIBLE PATIENTS TREATED AT THE FACILITY. THE HOSPITAL HAS APPORTIONED THE ICP REVENUE BETWEEN BAD DEBT AND CHARITY CARE FOR REPORTING ON LINE 7A BASED ON THE PROPORTION OF EACH TO THE TOTAL OF ACTUAL BAD DEBT AND CHARITY CARE FOR 2014.
PART I, LINE 7REFLECTS HOSPITAL INFORMATION ONLY.
PART III, LINE 2,3 - BAD DEBT AS COMMUNITY BENEFITAS PART OF ITS TAX EXEMPT PURPOSE THE HOSPITAL PROVIDES ACCESS TO MEDICALLY NECESSARY CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, OR CULTURAL BACKGROUND. THE HOSPITAL TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF WHETHER THEY HAVE THIRD-PARTY COVERAGE OR THE ABILITY TO PAY. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, THE HOSPITAL IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE FROM THE HOSPITAL SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT SINCE CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR TAX EXEMPT PURPOSE, WHICH IS MEETING THE NEED FOR EMERGENCY AND NON-ELECTIVE MEDICAL CARE SERVICES IN THE COMMUNITY.
PART III, LINES 2 AND 4 - TEXT OF FOOTNOTE DISCUSSING BAD DEBTTHE ALLOWANCE FOR UNCOLLECTABLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THIS ALLOWANCE BASED UPON HISTORICAL COLLECTION AND WRITE-OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTABLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE MEDICAL CENTER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY CHS POLICY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE. CHS DOES NOT HAVE ANY OFF-BALANCE-SHEET CREDIT EXPOSURE RELATED TO ITS PATIENT ACCOUNTS RECEIVABLE.
PART III, LINE 8 - COSTING METHODOLOGYTHE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 2014 CMS-2552 (MEDICARE COST REPORT). MEDICARE REVENUE IS BASED ON THE MEDICARE PROVIDER STATISTICAL AND REIMBURSEMENT REPORT AND MEDICARE COSTS ARE DEVELOPED UTILIZING A RATIO OF MEDICARE ALLOWABLE COSTS TO CHARGES METHODOLOGY. AMOUNTS SHOWN FOR TOTAL REVENUE RECEIVED AND MEDICARE ALLOWABLE COSTS ARE NET OF ANY AMOUNTS ALREADY INCLUDED WITHIN PART I, LINE 7, PRIMARILY IN SUBSIDIZED HEALTH SERVICES. PART III, LINE 8 - MEDICARE SHORTFALL AS COMMUNITY BENEFIT LOSSES ON TREATING MEDICARE BENEFICIARIES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT IN THEIR ENTIRETY. THIS REPRESENTS THE AMOUNT BY WHICH COSTS TO DELIVER CARE TO MEDICARE RECIPIENTS EXCEEDS THE LEVEL OF PAYMENT. ST. CATHERINE BEARS THE BURDEN OF NOT ONLY PROVIDING THE BEST AND MOST ADVANCED MEDICAL CARE POSSIBLE TO THE COMMUNITY, BUT ALSO DOING SO WITH NO RECOURSE TO OBTAIN PAYMENT FOR THE COST OF PROVIDING CARE IN EXCESS OF THE MEDICARE PAYMENT. AS MEDICARE REVENUE DECLINES AND THE COST TO PROVIDE CUTTING EDGE CARE TO THE COMMUNITY INCREASES, THE HOSPITAL WILL CARRY THE BURDEN. AS A PARTICIPATING PROVIDER AND A CHARITABLE ORGANIZATION, MEDICARE PATIENTS, THE MAJORITY OF WHOM ARE ELDERLY AND DISABLED ARE NOT TURNED AWAY, SO ST. CATHERINE WILL CONTINUE TO BEAR THE LOSS IN PROVIDING THE BEST CARE POSSIBLE TO THE LOCAL COMMUNITY. LOSSES ON TREATING MEDICARE BENEFICIARIES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT IN THEIR ENTIRETY.
PART III, LINE 9BTHE HOSPITAL'S CHARITY CARE POLICY DESCRIBES THE POLICIES AND PROCEDURES RELATING TO THE PROVISION OF CHARITY CARE TO PERSONS WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THEIR BILL. NO INDIVIDUAL WILL BE DENIED MEDICALLY NECESSARY HOSPITAL SERVICES BASED ON A DEMONSTRATED INANBILITY TO PAY FOR THOSE SERVICES. IN ADDITION, UPON APPLYING FOR CHARITY CARE, EACH PATIENT AND PATIENT GUARANTOR'S ABILITY TO PAY WILL BE ASSESSED. ELIGIBILITY FOR ASSISTANCE: A REASONABLE REVIEW SHALL BE PERFORMED PRIOR TO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TO INSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENT AND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (I.E. MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE MEDICAL CENTER'S CHARITY CARE POLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT, ANY ACCOUNT THAT SUBSEQUENTLY IS DETERMINED TO MEET THE CHARITY CARE CRITERIA SHALL BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENT FOR APPROPRIATE FOLLOW-UP. THE THIRD-PARTY COLLECTION AGENT SHALL ADVISE THE PATIENT/GUARANTOR OF THE HOSPITAL'S CHARITY CARE POLICY AND RETURN THE ACCOUNT IMMEDIATELY IF IT IS DETERMINED THAT THE QUALIFICATIONS ARE MET.
PART VI, LINE 2 - ASSESSMENT OF COMMUNITY NEEDS AND GOALSST. CATHERINE'S PROVIDES HIGH QUALITY CARE WITH COMPASSION AND RESPECT FOR EACH PATIENT REGARDLESS OF AGE, RELIGION, RACE, GENDER OR ABILITY TO PAY. THE STANDARD OF CARE IS EQUAL FOR ALL PATIENTS. ST. CATHERINE'S IS CONTINUOUSLY EVALUATING THE SERVICE AREA NEEDS BY REVIEWING PATIENT SURVEYS, COMMUNITY FEEDBACK, DEMOGRAPHIC DATA, COMMUNITY HEALTH INDICATORS AND PATIENT CARE TRENDS TO DEVELOP AND REFINE ITS SCOPE OF SERVICES AND DELIVERY OF CARE. THE HEALTHY SUNDAYS PROGRAM, WHICH PROVIDES FREE HEALTH SCREENINGS AND EDUCATION TO THE UNDERSERVED FOLLOWING WORSHIP SERVICES, WAS THE RESULT OF A JOINT COMMUNITY NEEDS ASSESSMENT BY CHS HOSPITALS. THESE EVENTS ARE PROMOTED VIA CALENDAR LISTINGS IN PARISH BULLETINS AND FLYERS POSTED IN PLACES OF BUSINESS AND WORSHIP IN THE COMMUNITY SURROUNDING THE OUTREACH SITE AND ON CHS'S WEBSITE. THE NUTRITIONAL OPTIMAL WEIGHT WELLNESS PROGRAM (N.O.W.) WAS DEVELOPED IN COLLABORATION WITH THE YMCA AND WEIGHT WATCHERS FOR PATIENTS AT RISK FOR OBESITY AND CHRONIC DISEASES ASSOCIATED WITH BEING OVERWEIGHT. IN 2014, TO BETTER IDENTIFY AND ADDRESS THE REGION'S PREVALENT HEALTH NEEDS, ST. CATHERINE CONTINUED TO COLLABORATE WITH OTHER HOSPITALS, LOCAL HEALTH DEPARTMENTS, HEALTH CARE PROVIDERS, PUBLIC HEALTH SPECIALISTS FROM ACADEMIC INSTITUTIONS AND COMMUNITY-BASED ORGANIZATIONS IN THE LONG ISLAND HEALTH COLLABORATIVE (LIHC), ONE OF THE FIRST BI-COUNTY INITIATIVES OF ITS KIND IN NEW YORK. LIHC'S WEBSITE OFFERS COMPREHENSIVE INFORMATION TO PROMOTE GOOD HEALTH AND PREVENT CHRONIC DISEASE. IN ADDITION TO PROVIDING NUMEROUS RESOURCES SUCH AS HEALTH PROGRAM INVENTORIES, HEALTH INSURANCE INFORMATION AND EDUCATIONAL VIDEOS, LIHC AND ITS MEMBERS HAVE ORGANIZED WALKING PROGRAMS AND DEVELOPED A UNIVERSAL SCREENING TOOL TO HELP MEASURE THE EFFECTIVENESS OF COMMUNITY HEALTH EFFORTS. MORE INFORMATION CAN BE FOUND AT NSHC.ORG/LONG-ISLAND-HEALTH-COLLABORATIVE.
PART VI, LINE 3 - COMMUNICATION OF FINANCIAL ASSISTANCE POLICY1. SINCE IT IS THE DUTY OF THE MEDICAL CENTER TO ENSURE THAT EVERY PATIENT IS MADE AWARE OF THE EXISTENCE OF ITS CHARITY CARE POLICY, ALL EMPLOYEES IN THE SCHEDULING, PATIENT ACCESS, PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS ARE FULLY VERSED IN THE CHARITY CARE POLICY, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE MEDICAL CENTER REPRESENTATIVES. 2. THE MEDICAL CENTER HAS POSTED MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CARE IN SEVERAL PROMINENT LOCATIONS WITHIN THE MEDICAL CENTER INCLUDING, BUT NOT LIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FOR PURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATION AREAS. SAID NOTICES ARE PUBLISHED IN AT LEAST ENGLISH AND SPANISH, AND ARE CLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED. 3. THE MEDICAL CENTER PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITS CHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM, PROVIDES SPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY AND THE MEANS OF APPLYING FOR ASSISTANCE. THIS SUMMARY IS WRITTEN AT OR BELOW A SIXTH GRADE READING LEVEL. 4. THE MEDICAL CENTER POSTS ITS CHARITY CARE POLICY SUMMARY ON ITS INTERNET WEBSITE. 5. THE MEDICAL CENTER PROVIDES ALL PATIENTS ACCESS TO INTERPRETERS TO ASSIST THEM IN UNDERSTANDING ITS CHARITY CARE PROGRAM IN THE PRIMARY LANGUAGE SPOKEN BY THE PATIENT DURING ANY PRE-ADMISSION, ADMISSION, AND DISCHARGE PROCESS. 6. ON ALL BILLS AND STATEMENTS SENT TO PATIENTS, A STATEMENT IS INCLUDED REGARDING THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS, INCLUDING CHARITY CARE, AND A CONTACT NUMBER TO CALL TO OBTAIN FURTHER INFORMATION. THIS INFORMATION IS PROVIDED AT OR BELOW A SIXTH GRADE READING LEVEL.
PART VI, LINE 4 - COMMUNITY INFORMATIONST. CATHERINE'S SERVICE AREA CONSISTS OF 21 COMMUNITIES LOCATED IN WESTERN SUFFOLK COUNTY. ST. CATHERINE'S SERVICE AREA HAS A POPULATION OF APPROXIMATELY 648,000 AND INCLUDES: SMITHTOWN, LAKE GROVE, ST. JAMES, HAUPPAUGE, KINGS PARK, COMMACK, NESCONSET, NORTHPORT AND EAST NORTHPORT, HUNTINGTON AND HUNTINGTON STATION. THROUGH 2015, THERE IS A PROJECTED INCREASE OF RESIDENTS WHO ARE 65 YEARS OF AGE OR OLDER.
PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTHST. CATHERINE OF SIENA MEDICAL CENTER OFFERS A WIDE AND COMPREHENSIVE ARRAY OF COMMUNITY SERVICE PROGRAMS THAT ADDRESS CRITICAL HEALTH ISSUES TO A DIVERSITY OF PATIENTS, INCLUDING: COMMUNITY OUTREACH: ST. CATHERINE PROVIDES FREE COMMUNITY LECTURES AND BLOOD PRESSURE, BODY MASS INDEX (BMI) AND OTHER SCREENINGS, SMOKING CESSATION ASSISTANCE, FOOD AND CLOTHING DRIVES, AND FALL PREVENTION PROGRAMS FOR SENIORS, IN PARTNERSHIP WITH ASSISTED LIVING FACILITIES, CHAMBERS OF COMMERCE, LIBRARIES AND OTHER LOCAL ORGANIZATIONS. ANNUAL COMMUNITY HEALTH FAIR: ST. CATHERINE'S ANNUAL COMMUNITY HEALTH FAIR IS A PIVOTAL EDUCATION PORTAL AND WAS ATTENDED BY APPROXIMATELY 700 COMMUNITY MEMBERS IN 2014, WITH 345 FREE FLU SHOTS, 250 BLOOD PRESSURE SCREENINGS, 223 GLUCOSE AND CHOLESTEROL TESTS, 62 SKIN CANCER SCREENINGS AND FREE VISION SCREENINGS PROVIDED. IN ADDITION, 23 UNITS OF BLOOD WERE DONATED TO LONG ISLAND BLOOD SERVICES. VOLUNTEER DEPARTMENT: THE VOLUNTEERS OF ST. CATHERINE OF SIENA MEDICAL CENTER ARE A GROUP OF DEDICATED AND GENEROUS INDIVIDUALS, WHO OFFER THEIR TIME, TALENT AND SERVICES TO PATIENTS AND STAFF ON A DAILY BASIS. BLOOD DRIVES: ST. CATHERINE HOSTS FOUR BLOOD DRIVES ANNUALLY IN COLLABORATION WITH LONG ISLAND BLOOD SERVICES, A DIVISION OF NEW YORK BLOOD CENTER. COMMUNITY NEWSLETTER: ST. CATHERINE'S PUBLISHES A NEWSLETTER, THE VOICE, WHICH IS MAILED THROUGHOUT THE SERVICE AREA TO MORE THAN 100,000 HOUSEHOLDS. THE VOICE IS A PRIMARY METHOD OF EDUCATING THE COMMUNITY ABOUT HEALTH-RELATED ISSUES AND KEEPING THEM INFORMED OF UPCOMING EVENTS AND HOSPITAL SERVICES. EMERGENCY RESPONSE APPRECIATION DINNERS: EMERGENCY RESPONSE PERSONNEL ARE AT THE FOREFRONT OF THE MEDICAL PROCESS. THEY PROVIDE IMMEDIATE MEDICAL SERVICE AND WORK COLLABORATIVELY TO OFFER TIMELY CARE. ST. CATHERINE'S OFFERS A QUARTERLY EMERGENCY RESPONSE APPRECIATION AND CONTINUING MEDICAL EDUCATION (CME) DINNER FOR LOCAL EMERGENCY RESPONSE PERSONNEL. THE APPRECIATION DINNERS WERE IMPLEMENTED IN 2008, AND HAVE BECOME A HIGHLIGHT FOR ST. CATHERINE'S AND LOCAL EMERGENCY RESPONSE TEAMS. THE DINNERS ACT AS REMINDERS OF HOW GRATEFUL THE HOSPITAL IS FOR PROMPTNESS AND EFFICIENCY IN THE FIELD. THEY ALSO OFFER A FORUM FOR SPECIAL EDUCATIONAL PROGRAMS AND AN OPPORTUNITY FOR EMERGENCY RESPONSE PERSONNEL TO GAIN CME CREDITS. HEALTHY SUNDAYS: THE HEALTHY SUNDAYS PROGRAM REFLECTS THE COMMITMENT OF CATHOLIC HEALTH SERVICES OF LONG ISLAND BY PROACTIVELY HELPING UNDERSERVED COMMUNITIES WITH EDUCATIONAL SEMINARS AND PREVENTIVE SCREENINGS THAT MAY BE OTHERWISE UNAVAILABLE. THE PROGRAM REACHES OUT INTO COMMUNITIES OF NEED THROUGH LOCAL PARISHES AND COMMUNITY CENTERS TO HELP BRIDGE THE GAP BETWEEN THE INDIVIDUAL AND THE HEALTH PROVIDER TO PROVIDE QUALITY, ACCESSIBLE SERVICES, ULTIMATELY CREATING A LINK FOR THE COORDINATION OF CARE. ST. CATHERINE PARTICIPATES IN SEVERAL HEALTHY SUNDAYS EVENTS EACH YEAR, OFFERING FREE HEALTH SCREENINGS AND IMMUNIZATIONS TO THOSE IN NEED. MATERNITY EDUCATION: "YOU AND YOUR BABY" EDUCATION SERIES-THE MATERNITY DEPARTMENT OFFERS A VARIETY OF SUPPORT GROUPS AND WORKSHOPS FOR NEW MOTHERS AND FAMILY MEMBERS AS FOLLOWS: BREAST-FEEDING SUPPORT GROUPS, CHILDBIRTH EDUCATION, EARLY PREGNANCY CLASSES, FAMILY AND FRIENDS CPR: INFANT ONLY, GRANDPARENTS CLASSES, INFANT CARE CLASSES, PRENATAL BREAST-FEEDING CLASSES, SIBLING CLASSES AND MOTHER'S CIRCLE OF HOPE, A POST- PARTUM SUPPORT GROUP. MEDICAL COMMUNITY EDUCATION: ST. CATHERINE'S IS DEDICATED TO EDUCATING THE COMMUNITY AND PROUDLY OFFERS FREE LECTURES AND PRESENTATIONS ON A VARIETY OF HEALTH AND WELLNESS TOPICS TO HELP PROVIDE INFORMATION AND RAISE AWARENESS. THROUGH A COMBINATION OF LECTURES AND PRESENTATIONS, ST. CATHERINE'S HOPES TO IMPROVE THE QUALITY OF LIFE, PROMOTE WELLNESS AND HEALTHY LIVING FOR ALL THOSE WHO LIVE AND WORK IN THE COMMUNITY. HEALTH CARE CAREER EXPLORATION AND INTERNSHIP PROGRAM (HCEIP): ST. CATHERINE, IN COLLABORATION WITH SMITHTOWN AND COMMACK HIGH SCHOOLS, CONDUCTS A 16-WEEK SEMINAR AND HANDS-ON WORKSHOP FOR STUDENTS INTERESTED IN CAREERS IN HEALTH CARE. PROFESSIONALS FROM VARIOUS CLINICAL DEPARTMENTS LECTURE/TEACH AND PROVIDE SKILL-BASED TRAINING, ALONG WITH INFORMATION REGARDING COLLEGE CHOICES AND DEGREE REQUIREMENTS, SO STUDENTS CAN MAKE INFORMED CHOICES ABOUT A CAREER CHOICE. UPON COMPLETION OF THE PROGRAM AND 30 HOURS OF VOLUNTEER SERVICE IN EITHER THE HOSPITAL OR NURSING AND REHABILITATION CARE CENTER, STUDENTS ARE ELIGIBLE TO RECEIVE HALF A HEALTH CREDIT. PASTORAL CARE: PASTORAL CARE SERVICE IS AVAILABLE FOR PATIENTS OF ALL DENOMINATIONS DURING THEIR HOSPITAL STAY. THE DEPARTMENT PROVIDES SPIRITUAL RESOURCES, COUNSEL AND PRAYER, AND ASSISTS PATIENTS WITH INTEGRATING THEIR SPIRITUAL BELIEFS INTO THEIR HEALING PROCESS. PASTORAL CARE IS OFTEN CALLED UPON FOR ETHICAL ADVICE WITH ADVANCE DIRECTIVES IN COLLABORATION WITH THE PATIENT ADVOCATE. OTHER SUPPORT GROUPS OFFERED TO THE COMMUNITY: BARIATRIC DIABETES STROKE PARKINSON'S DISEASE BEREAVEMENT CAREGIVERS OF PEOPLE WITH DEMENTIA
PART VI, LINE 6 - AFFILIATED HEALTHCARE SYSTEMST. CATHERINE OF SIENA MEDICAL CENTER (ST. CATHERINE OR THE HOSPITAL OR THE MEDICAL CENTER) AND ST. CATHERINE OF SIENA NURSING AND REHABILITATION CARE CENTER ARE LOCATED ON A SINGLE CAMPUS IN SMITHTOWN, NEW YORK. ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS, ST. CATHERINE, THROUGH ITS DAILY OPERATION, PROVIDES TO THE AREA ACUTE, EMERGENT AND OUTPATIENT CARE, AS WELL AS LONG-TERM CARE AND HOUSING. ST. CATHERINE IS A MEMBER OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS) WHICH IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE. AS OF DECEMBER 31, 2014, CHS COMPRISED SIX HOSPITALS (MERCY MEDICAL CENTER, ST. FRANCIS HOSPITAL AND ST. JOSEPH HOSPITAL IN NASSAU COUNTY, AND GOOD SAMARITAN HOSPITAL MEDICAL CENTER, ST. CHARLES HOSPITAL AND REHABILITATION CENTER AND ST. CATHERINE OF SIENA MEDICAL CENTER IN SUFFOLK COUNTY), AS WELL AS THREE NURSING HOMES (ST. CATHERINE OF SIENA NURSING AND REHABILITATION CARE CENTER, GOOD SAMARITAN NURSING HOME AND OUR LADY OF CONSOLATION NURSING AND REHABILITATIVE CARE CENTER, ALL IN SUFFOLK COUNTY), A REGIONAL HOME CARE AND HOSPICE NETWORK, AND A COMMUNITY-BASED AGENCY FOR PERSONS WITH SPECIAL NEEDS. WITH APPROXIMATELY 17,000 STAFF AND 4,600 MEDICAL STAFF WORKING THROUGHOUT THE SYSTEM, CHS PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES. OUR MISSION STATES: CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE AND COMMITS ITSELF TO THOSE IN NEED. CHS AFFIRMS THE SANCTITY OF LIFE, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTH CARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON. MEMBER ORGANIZATIONS OF CHS OFFER VIRTUALLY EVERY MEDICAL SPECIALTY AND CLINICAL SERVICES, AND SHARE A DEDICATION TO CONTINUOUSLY UPGRADE THE SCOPE, QUALITY AND ACCESSIBILITY OF CARE. ALL OF CHS'S MEMBER ORGANIZATIONS HAVE RETAINED THEIR INDIVIDUAL LINKS TO THEIR HISTORY AND THEIR DISTINCTIVE PERSONALITIES, AS WELL AS THE SERVICE SPECIALTIES WHICH THEY ARE KNOWN FOR, THUS EMBEDDING THE ORGANIZATION IN THE COMMUNITY AND SERVING IT EFFECTIVELY. THE CHS SYSTEM PROVIDES AN ABUNDANCE OF EDUCATION AND SUPPORT GROUPS, FREE HEALTH SCREENINGS THROUGH THE HEALTHY SUNDAYS PROGRAM, HEALTH FAIRS AND OTHER PROGRAMS, WHICH HELP THE COMMUNITIES SERVED BY CHS ACCESS CARE. SINCE 1907, CATHOLIC HEALTH CARE ON LONG ISLAND HAS BUILT A DISTINGUISHED TRADITION OF OPERATING COMMUNITY-BASED HOSPITALS AND HUMAN SERVICE ORGANIZATIONS WITH THE PRIMARY OBJECTIVE OF SERVING THE COMMUNITY. TO FURTHER THE MISSION OF BRINGING CARE TO THE COMMUNITY, CHS AND ITS MEMBER HOSPITALS, TOGETHER WITH A NUMBER OF OTHER HEALTH CARE PROVIDERS ON LONG ISLAND, ENTERED INTO A PARTNERSHIP AGREEMENT WHICH OPERATES AS THE LONG ISLAND HEALTH NETWORK (LIHN). LIHN WAS CREATED TO ESTABLISH A COMPREHENSIVE AND EFFICIENT HOSPITAL NETWORK IN NASSAU AND SUFFOLK COUNTIES BY WORKING TO, AMONG OTHER THINGS, IMPROVE QUALITY OF CARE, FACILITATE CLINICAL INTEGRATION, BENCHMARK BEST PRACTICES, AND REDUCE LENGTH OF STAY AND COSTS.

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1CATHOLIC HEALTH SERVICES OF LONG ISLANDBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1992 N VILLAGE AVEAddressLine1Txt
CityROCKVILLE CENTRECityNm
State AbbreviationNYStateAbbreviationCd
ZIP11570ZIPCd
FieldValueIRS element (for citing)
Recipient EIN113403968RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$311,197CashGrantAmt
Valuation Method UsedNONEValuationMethodUsedDesc
Non Cash AssistanceNONENonCashAssistanceDesc
Purpose Of GrantOUTPATIENT CENTERSPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USECHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR ST. CATHERINE OF SIENA MEDICAL CENTER AND CATHOLIC HEALTH SERVICES OF LONG ISLAND AND IS THEREFORE ABLE TO MONITOR THAT CATHOLIC HEALTH SERVICES OF LONG ISLAND USES THE GRANT FUNDS FOR OUTPATIENT CENTERS AND GRANTS FOR THE UNDERSERVED COMMUNITIES.
PART II, LINE 1, COLUMN (H)NAME OF ORGANIZATION OR GOVERNMENT: CATHOLIC HEALTH SYSTEM OF LONG ISLAND (H) PURPOSE OF GRANT: 1) SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND AS A PASS THROUGH TO PROVIDE GENERAL SUPPORT TO THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD; 2) PROVIDE SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND TO FUND OUTPATIENT CENTERS THAT PROVIDE CHARITY CARE TO THOSE CENTERS COMMUNITIES; AND 3) TO FUND SUPPORT PROVIDED THROUGH THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CAREGIVERS FUND. THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CAREGIVERS FUND WAS FORMED WITH THE MISSION TO ASSIST OUR FELLOW CAREGIVERS ON THE FRONT LINES, HERE AND ABROAD, WHO STRUGGLE JUST TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
PAUL ROWLAND
EXC VP & CAO$365,416$0$0$0$22,935$0$50,070$0$3,168$0$441,589$0$0$0
JASON GOLBIN
CMO$339,912$0$0$0$679$0$18,070$0$18,920$0$377,581$0$0$0
BRUCE MAYERSEN MD
PHYSICIAN$650,960$0$0$0$954$0$18,070$0$32,444$0$702,428$0$0$0
GARA EDELSTEIN
SR VP ADMIN & CNO$354,591$0$0$0$129,297$0$79,070$0$21,801$0$584,759$0$116,731$0
MICHAEL WEBER MD
PHYSICIAN$393,106$0$30,000$0$966$0$18,070$0$30,157$0$472,299$0$0$0
SCHENLEY QUE MD
PHYSICIAN$616,861$0$0$0$1,458$0$18,070$0$19,856$0$656,245$0$0$0
DENNIS O'BRIEN
PHYSICIAN$370,300$0$68,465$0$4,907$0$18,070$0$0$0$461,742$0$0$0
JAMES CALDAS
FORMER PRESIDENT & CEO$0$0$0$0$0$1,939,643$0$188,000$0$10,703$0$2,138,346$0$1,738,371
DAN MACKSOOD
FORMER SVP FIN/CFO EASTERN DIV$0$0$0$0$0$516,717$0$0$0$18,450$0$535,167$0$520,005
ALAN D GUERCI MD
PRESIDENT & CEO$0$1,199,882$0$0$0$30,327$0$216,396$0$31,382$0$1,477,987$0$0
DENNIS VERZI
FORMER EXEC VP & CAO$0$839,064$0$0$0$254,125$0$89,396$0$12,260$0$1,194,845$0$120,899
PATRICK O'SHAUGHNESSY
FORMER CMO$0$681,525$0$0$0$17,520$0$290,396$0$27,738$0$1,017,179$0$0
WILLIAM C ARMSTRONG
SVP FINANCE$0$582,691$0$0$0$85,114$0$108,101$0$27,787$0$803,693$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4A - SEVERANCE PAYMENTJames Caldas, Former President & CEO received payment of Severence of $880,019. MEDICAL BENEFITS WERE ALSO PROVIDED DURING 2014. Dan Macksood, Former SVP Finance/CFO Eastern Div received payment of Severence of $516,717. MEDICAL BENEFITS WERE ALSO PROVIDED DURING 2014.
PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANTHE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN C. ALAN GUERCI $197,000 PARTICIPATION IN PLAN JAMES CALDAS $188,000 PARTICIPATION IN PLAN GARA EDELSTEIN $61,000 PARTICIPATION IN PLAN PAUL ROWLAND $32,000 PARTICIPATION IN PLAN DENNIS VERZI $ 70,000 PARTICIPATION IN PLAN PATRICK O'SHAUGHNESSY $271,000 PARTICIPATION IN PLAN WILLIAM ARMSTRONG $89,000 PARTICIPATION IN PLAN THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THESE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NON-QUALIFIED RETIREMENT PLANS. THE FOLLOWING INDIVIDUALS VESTED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B(III). THESE AMOUNTS INCLUDE A TAX GROSS UP. JAMES CALDAS $984,725 VESTED IN PLAN GARA EDELSTEIN $116,731 VESTED IN PLAN DENNIS VERZI $230,389 VESTED IN PLAN THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2014 FORM W-2, BOX 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. EFFECTIVE 7/1/2013, DENNIS VERZI WAS TRANSFERRED TO CATHOLIC HEALTH SERVICES OF LONG ISLAND, A RELATED ENTITY, TO SERVE AS THE COO. EFFECTIVE 6/1/2013, PATRICK O'SHAUGHNESSY WAS TRANSFERRED TO CATHOLIC HEALTH SERVICES OF LONG ISLAND, A RELATED ENTITY, TO SERVE AS THE CMO.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
ALTHOUGH ON DECEMBER 17, 2013, THE CORPORATE MEMBERS OF CATHOLIC HEALTHSERVICES OF LONG ISLAND ADOPTED A RESOLUTION RESTRUCTURING THE GOVERNANCE OF CHS SO THAT A SINGLE MIRROR BOARD GOVERNS CHS AND THE SIX ACUTE CARE OPERATING ENTITIES, THE REFERENCED CHANGE WAS EFFECTUATED BY ENACTMENT OF A RESOLUTION AND DID NOT ENTAIL A CHANGE TO THE ORGANIZING DOCUMENT OR BYLAWS.
FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATIONTHE SOLE MEMBER OF ST. CATHERINE OF SIENA MEDICAL CENTER IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS). CHS IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER.
FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODYCHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF ST CATHERINE OF SIENA MEDICAL CENTER, AND HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF ST. CATHERINE.
FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODYAS THE SOLE MEMBER OF ST. CATHERINE OF SIENA MEDICAL CENTER, CHS IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERING BODY OF ST. CATHERINE OF SIENA MEDICAL CENTER. THE GOVERNING BODY OF ST. CATHERINE MEDICAL CENTER IS THE SAME AS THAT OF CHS.
FORM 990, PART VI, LINE 11B - REVIEW PROCESS FOR FORM 990THE FORM 990 AND RELATED SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD, AND PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS OF CHS, WHICH HAS BEEN DELEGATED THE FORM 990 REVIEW FUNCTION BY THE BOARD. UPON REVIEW AND RECOMMENDATION OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO THE BOARD FOR APPROVAL. UPON BOARD APPROVAL, THE FORM 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST POLICYDISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE CHS COMPLIANCE AND AUDIT COMMITTEE BY CHS' COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE IS GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE CHS BOARD OF DIRECTORS. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE BOARD OF DIRECTORS SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. THE PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIM/HERSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT.
FORM 990, PART VI, LINE 15 - COMPENSATION POLICYTHE CHIEF ADMINISTRATIVE OFFICER SUBMITS FOR APPROVAL TO THE SYSTEM CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE CHS EXECUTIVE COMPENSATION POLICY (COMPENSATION POLICY). THE COMPENSATION POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER (CEO), AND CHIEF OPERATING OFFICERS (COO) OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS (CFO); D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AN OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. ONCE APPROVED BY THE CHS CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE OF THE CHS BOARD OF DIRECTORS FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA (INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE PERFORMED ANNUALLY BY AN INDEPENDENT CONSULTANT. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION PROVIDED, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE CHS BOARD OF DIRECTORS.
FORM 990, PART VI, LINE 19 - DOCUMENTS AVAILABLE FOR PUBLIC INSPECTIONGOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND.
FORM 990, PART VII, SECTION A - LINE 1AHOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. ALAN GUERCI, M.D. PRESIDENT AND CEO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); RVC INSURANCE COMPANY (20-8067039); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); SIENNA VILLAGE (06-1569129) AND ST. CHARLES HOSPITAL (11-1871039). PAUL ROWLAND, EXECUTIVE VP AND CAO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); SIENA VILLAGE (06-1569129). WILLIAM ARMSTRONG, SR VP FINANCE - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER OR HIGHEST PAID EMPLOYEE FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); SIENA VILLAGE, INC. (06-1569129); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396) AND GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240).
FORM 990, PART X, LINE 20 - TAX-EXEMPT BOND LIABILITIESTHE TAX-EXEMPT BOND ISSUANCES REFLECTED ON PART X, LINE 20 ARE ISSUED ON BEHALF OF THE CATHOLIC HEALTH SERVICES OF LONG ISLAND OBLIGATED GROUP PROJECT WHICH INCLUDES THE FILING ENTITY AND RELATED ENTITIES. THREE BONDS WERE ISSUED TO THE OBLIGATED GROUP, SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION (SERIES 2011 SUFFOLK BONDS), NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE AND FINANCING CORPORATION (SERIES 2011 NASSAU BOND) AND SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION (SERIES 2014c SUFFOLK BONDS). THE BONDS ARE REPORTED ON SCHEDULE K OF THE PARENT ORGANIZATION, CATHOLIC HEALTH SERVICES OF LONG ISLAND.
FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETSCHANGES IN POST RETIREMENT BENEFITS: ($125,000)

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
SIENA RETIREMENT REALTY CCRC
50 ROUTE 25ASMITHTOWNNY11787061569102RETIRE COMMUNNY$0$3,479,779STCATHERINE
SIENA MEDICAL REALTY
50 ROUTE 25ASMITHTOWNNY11787061568934MED BUILDINGNY$1,323,296$7,631,674STCATHERINE

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (36 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
CATHOLIC HEALTH SYSTEM OF LONG ISLAND
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113403968SUPPORT ORGNY501(C)(3)11A- INAfalse
CHS SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113555766SUPPORT ORGNY501(C)(3)11A- IICHSLIYes (true)
CHS AMBULANCE SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570141801961DORMANTNY501(C)(3)3CHSLIfalse
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
1000 MONTAUK HIGHWAYWEST ISLIPNY11795111888924HOSPITALNY501(C)(3)3CHSLIYes (true)
GOOD SAMARITAN SELF INSURANCE AGAINST
MALPRACTICE 1000 MONTAUK HIGHWAYWEST ISLIPNY11795112537396SELF INSURANCNY501(C)(3)11A- IGOOD SAMARTNYes (true)
MARYHAVEN TRANSPORTATION SERVICES
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113434776TRANSPORTATIONY501(C)(3)11A- IMARYHAVENCTRfalse
MARYHAVEN CENTER OF HOPE
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112861698Prgm-disabledNY501(C)(3)9CHSLIfalse
MARYHAVEN SCHOOL CORPORATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112861690Schl-disabledNY501(C)(3)2MARYHAVENCTRfalse
THE CENTER OF HOPE FOUNDATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113638367SUPPORT ORGNY501(C)(3)11A- IMARYHAVENCTRfalse
MERCY MEDICAL CENTER
1000 NORTH VILLAGE AVENUEROCKVILLE CTRNY11570111635088HOSPITALNY501(C)(3)3CHSLIYes (true)
CATHOLIC HOME CARE
110 BI-COUNTY BLVD SUITE 114FARMINGDALENY11735112126736HOME CARENY501(C)(3)9CHSLIfalse
OUR LADY OF CONSOLATION GERIATRIC CARE
111 BEACH DRIVEWEST ISLIPNY11795113284066LT NURSE CARENY501(C)(3)9CHSLIfalse
RIVERHEAD HOSTEL HOLDING CORPORATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112499790RENTINGNY501(C)(2)MARYHAVENCTRfalse
SIENA VILLAGE INC
2000 BISHOPS ROADSMITHTOWNNY11787061569129SR HOUSINGNY501(C)(3)9STCATHERINEYes (true)
ST CHARLES HOSPITAL
200 BELLE TERRE ROADPORT JEFFERSN STNY11777111871039HOSPITALNY501(C)(3)3CHSLIYes (true)
CHS HOME SUPPORT SERVICES INC
15 POWER DRIVEHAUPPAUGENY11788113594561RESP THERAPYNY501(C)(3)9CATHHOMECAREfalse
ST FRANCIS HOSPITAL
100 PORT WASHINGTON BLVDROSLYNNY11576112050523HOSPITALNY501(C)(3)3CHSLIYes (true)
ST FRANCIS HOSPITAL FOUNDATION
100 PORT WASHINGTON BLVDROSLYNNY11576112916033SUPPORT ORGNY501(C)(3)11A- IST FRANCISfalse
ST FRANCIS HOSPITAL RESEARCH & EDUCATIO
100 PORT WASHINGTON BLVDROSLYNNY11576113090867RESEARCH ORGNY501(C)(3)11A- IST FRANCISYes (true)
WSNCHS NORTH INC
4295 HEMPSTEAD TURNPIKEBETHPAGENY11714113438973HOSPITALNY501(C)(3)3CHSLIYes (true)
THE ST CHARLES CORPORATION
200 BELLE TERRE ROADPORT JEFFERSN STNY11777112983148SUPPORT ORGNY501(C)(3)11A- ICHSLIfalse
THE SAMARITAN CORPORATION
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570112716640SUPPORT ORGNY501(C)(3)11A- ICHSLIfalse
WISDOM GARDENS HOUSING DEVELOPMENT FUND
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113559713SR HOUSINGNY501(C)(3)9MARYHAVENCTRfalse
GOOD SHEPHERD HOSPICE
110 BI-COUNTY BLVD SUITE 114FARMINGDALENY11735112958438HOSPICE SVCNY501(C)(3)9CHSLIfalse
ST CHARLES HOSPITAL FOUNDATION
200 BELLE TERRE ROADPORT JEFFERSONNY11777412076312SUPPORT ORGNY501(C)(3)11A- IST CHARLESfalse
GOOD SAMARITAN HOSPITAL FOUNDATION
1000 MONTAUK HIGHWAYWEST ISLIPNY11795770611240SUPPORT ORGNY501(C)(3)11A- IGOOD SAMARTNfalse
MERCY MEDICAL CENTER FOUNDATION
1000 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570550813603SUPPORT ORGNY501(C)(3)11A- IMERCY MEDCTRfalse
ST CATHERINE OF SIENA MEDICAL CTR FDN
50 ROUTE 25ASMITHTOWNNY11787271459941SUPPORT ORGNY501(C)(3)11A- ISTCATHERINEYes (true)
CATHOLIC HOME CARE FOUNDATION
110 BI-COUNTY BLVD SUITE 114FARMINGDALENY11735452907761SUPPORT ORGNY501(C)(3)11A- ICATHHOMECAREfalse
GOOD SHEPHERD HOSPICE FOUNDATION
110 BI-COUNTY BLVD SUITE 114FARMINGDALENY11735263169427SUPPORT ORGNY501(C)(3)11A- IGOODSHEPHERDfalse
OUR LADY OF CONSOLATION FOUNDATION
111 BEACH DRIVEWEST ISLIPNY11795450517566SUPPORT ORGNY501(C)(3)11A- IOURLADYOFCfalse
RVC SUPPORT
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570271531084REAL ESTATENY501(C)(3)11A- ICHSLIfalse
ST FRANCIS CARDIOVASCULAR PHYSICIANS P
100 PORT WASHINGTON BLVDROSLYNNY11576113613997HEALTHCARESVCNY501(C)(3)11A- IST FRANCISfalse
RVC INSURANCE COMPANYINC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570208067039CAPTIVE INSNY501(C)(3)11A- IICHSLIfalse
SAMARITAN EMERGENCY MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208243412HEALTHCARESVCNY501(C)(4)GOOD SAMARTNfalse
ST JOSEPH HOSPITAL FOUNDATION
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570472353387SUPPORT ORGNY501(C)(3)11A- IWSNCHS NORTHfalse

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (15 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
RADIOLOGY CONSULTING OF LONG ISLANDPLLC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795421646134HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN PEDIATRIC SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208180263HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208088453HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SOUTHWEST SUFFOLK MEDICAL PC
580 UNION BOULEVARDWEST ISLIPNY11795061603195HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
CARDIAC EKG INTERPRETATION PC
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570112924518HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208964140HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN MANAGEMENT SERVICES
1000 MONTAUK HIGHWAYWEST ISLIPNY11795112838185HEALTHCARE SVCNYCHSLIC-CORPfalse
FAIRVIEW HILL MANAGEMENT CO INC
200 BELLE TERRE ROADPORT JEFFERSONNY11777112798383HOLDING CONYCHSLIC-CORPfalse
ADVANCED REHABILIATION MEDICINE PLLC
200 BELLE TERRE ROADPORT JEFFERSONNY11777113640709HEALTHCARE SVCNYSTCHARLES HOSPC-CORPfalse
ST FRANCIS CARDIAC PREVENTION SERVICES
100 PORT WASHINGTON BLVDROSLYNNY11576113224885HEALTHCARE SVCNYSTFRANCIS HOSPC-CORPfalse
SOUTH SHORE PRACTICE MANAGEMENT
1000 MONTAUK HIGHWAYWEST ISLIPNY11795113307977HEALTHCARE SVCNYSAMARITAN MGMTC-CORPfalse
SAMARITAN HOME CARE AMERICA
1000 MONTAUK HIGHWAYWEST ISLIPNY11795113319259HEALTHCARE SVCNYSAMARITAN MGMTC-CORPfalse
HEALTH CARE TEMP SERVICES INC
200 BELLE TERRE ROADPORT JEFFERSONNY11777112801136EMPLOYMENT AGENCYNYFAIRVIEW HILLC-CORPfalse
MERCY INTERNAL MEDICINE PC
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570510639649HEALTHCARE SVCNYMERCY MED CTRC-CORPfalse
LONG ISLAND EMERGENCY CARE PC
1000 N VILLAGE AVEROCKVILLENY11571113633515PHYSICIAN SVCNYMERCY MED CTRS-CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (true)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (true)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
CHS SERVICES INC
LMPS$1,430,749COST
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
LMS$390,243COST
ST FRANCIS HOSPITAL
LMS$307,597COST
ST CHARLES HOSPITAL
LMS$114,999COST
SIENA VILLAGE
LQ$280,314COST

Supplemental Information Detail SupplementalInformationDetail

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