STRATEGY STUDIO / PUBLIC DATA EXPLORER

CENTRAL SUFFOLK HOSPITAL FOUNDATION: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
CENTRAL SUFFOLK HOSPITAL FOUNDATION (EIN 20-0714587)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-16
IRS object ID
201513209349309371
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)
Return2015-11-16T14:04:08-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN131517563PreparerFirmEIN

Preparer Firm Name PreparerFirmName

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

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1655 THIRD AVENUE 12TH FLOORAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10017ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN200714587EIN

Business Name BusinessName

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

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonANDREW J MITCHELLPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone6315486064PhoneNum
Signature2015-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAARON SHAPIROPreparerPersonNm
PTINP01333816PTIN
Phone2128674000PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

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

US Address USAddress

FieldValueIRS element (for citing)
Address Line11300 ROANOKE AVENUEAddressLine1Txt
CityRIVERHEADCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11901ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,105,072GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PBMEDICALCENTER.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2004FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTHE FOUNDATION'S MISSION IS TO DEVELOP PHILANTHROPIC AND COLLABRATIVE RELATIONSHIPS FOR CENTRAL SUFFOLK HOSPITAL.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,318,620PYContributionsGrantsAmt
CY Contributions Grants$3,071,944CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$2,241PYInvestmentIncomeAmt
CY Investment Income$5,072CYInvestmentIncomeAmt
PY Other Revenue-$85,225PYOtherRevenueAmt
CY Other Revenue-$94,459CYOtherRevenueAmt
PY Total Revenue$1,235,636PYTotalRevenueAmt
CY Total Revenue$2,982,557CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$178,206PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$151,380CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$1,732,578CYTotalFundraisingExpenseAmt
PY Other Expenses$1,697,529PYOtherExpensesAmt
CY Other Expenses$1,588,831CYOtherExpensesAmt
PY Total Expenses$1,875,735PYTotalExpensesAmt
CY Total Expenses$1,740,211CYTotalExpensesAmt
PY Revenues Less Expenses-$640,099PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,242,346CYRevenuesLessExpensesAmt
Total Assets BOY$2,888,516TotalAssetsBOYAmt
Total Assets EOY$4,239,308TotalAssetsEOYAmt
Total Liabilities BOY$139,654TotalLiabilitiesBOYAmt
Total Liabilities EOY$250,847TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,748,862NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,988,461NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSEE SCHEDULE OTHE FOUNDATION'S MISSION IS TO DEVELOP AND CULTIVATE PHILANTHROPIC AND COLLABRATIVE RELATIONSHIPS THAT FOSTER PROGRAMS AND SERVICES OFFERED THROUGH THE HOSPITAL WHICH IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
DescTHE SUPPORT OF HOSPITAL SERVICES OF CENTRAL SUFFOLK HOSPITAL.Desc
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit CounselingYes (1)CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document3IRPDocumentCnt
IRP Document W2 G1IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
J GORDON HUSZAGH
CHAIRMAN10.0015.00Yes (X)Yes (X)$0$0$0
IRWIN L GARSTEN
VICE CHAIR10.00Yes (X)Yes (X)$0$0$0
EMILIE ROY COREY
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
RICHARD ISRAEL
SECRETARY1.001.00Yes (X)Yes (X)$0$0$0
JOAN LEVAN
TREASURER1.001.00Yes (X)Yes (X)$0$0$0
ANDREW J MITCHELL FACHE
PRESIDENT/CEO15.0022.50Yes (X)Yes (X)$0$760,097$63,126
BRUCE BARNET
BOARD MEMBER1.00Yes (X)$0$0$0
KENNEY BARRA
BOARD MEMBER1.001.00Yes (X)$0$0$0
BARRY BRANDEIS
BOARD MEMBER1.00Yes (X)$0$0$0
CAROLE G HANKIN PHD
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD RUBENSTEIN MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
JOSEPH VAN DE WETERING
BOARD MEMBER1.001.00Yes (X)$0$0$0
RICHARD WINSLOW PHD
BOARD MEMBER1.001.00Yes (X)$0$0$0
STANLEY ZINBERG MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$760,097TotReportableCompRltdOrgAmt
Total Other Compensation$63,126TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CENTRAL SUFFOLK HOSPITAL
1300 ROANOKE AVENUERIVERHEADNY11901ADMINISTRATIVE SERVICES$1,194,674
THE GOBEL GROUP
2 STATE STREET SUITE 1150ROCHESTERNY14614FUNDRAISING COUNSEL$100,630
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Fundraising$462,812FundraisingAmt
All Other Contributions$2,609,132AllOtherContributionsAmt
Noncash Contributions$199,980NoncashContributionsAmt
Total Contributions$3,071,944TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,311TotalRevenueColumnAmt
Exclusion$4,311ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$4,793SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$4,032SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$761SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$761TotalRevenueColumnAmt
Exclusion$761ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$24,024FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$462,812ContriRptFundraisingEventAmt
Fundraising Direct Expenses$118,483FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$94,459TotalRevenueColumnAmt
Exclusion-$94,459ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,982,557TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$89,387ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$6,000TotalAmt
Fundraising$6,000FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$151,380TotalAmt
Fundraising$151,380FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$2,633TotalAmt
Management And General$2,633ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,320,441TotalAmt
Fundraising$1,320,441FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,895TotalAmt
Fundraising$1,895FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$198,186TotalAmt
Fundraising$198,186FundraisingAmt

Occupancy OccupancyGrp

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

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$11,661TotalAmt
Fundraising$11,661FundraisingAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtFundraisingFundraisingAmtManagement And GeneralManagementAndGeneralAmt
COMMUNITY OUTREACH$17,191$17,191
BAD DEBT EXPENSE$5,000$5,000

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$18,324TotalAmt
Fundraising$18,324FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,740,211TotalAmt
Program Services$0ProgramServicesAmt
Management And General$7,633ManagementAndGeneralAmt
Fundraising$1,732,578FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$90,555BOYAmt
EOY$105,853EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,053,320BOYAmt
EOY$1,207,231EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,446,142BOYAmt
EOY$2,624,374EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$5,625EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$12,460BOYAmt
EOY$12,154EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$286,039BOYAmt
EOY$284,071EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,888,516BOYAmt
EOY$4,239,308EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$27,088BOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$90,697BOYAmt
EOY$105,994EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$21,869BOYAmt
EOY$144,853EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$139,654BOYAmt
EOY$250,847EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,427,502BOYAmt
EOY$1,653,129EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,321,360BOYAmt
EOY$2,335,332EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,748,862BOYAmt
EOY$3,988,461EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,888,516BOYAmt
EOY$4,239,308EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,242,346ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$2,747NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,419,214CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,988,253CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,247,758CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,318,620CurrentTaxYearMinus1YearAmt
Current Tax Year$3,071,944CurrentTaxYearAmt
Total$11,045,789TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,419,214CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,988,253CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,247,758CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,318,620CurrentTaxYearMinus1YearAmt
Current Tax Year$3,071,944CurrentTaxYearAmt
Total$11,045,789TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$2,974,427SubstantialContributorsTotAmt
Public Support Total170$8,071,362PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,791CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$749CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$408CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,091CurrentTaxYearMinus1YearAmt
Current Tax Year$4,311CurrentTaxYearAmt
Total$10,350TotalAmt
FieldValueIRS element (for citing)
Total Support$11,056,139TotalSupportAmt
Public Support CY1700.73000PublicSupportCY170Pct
Public Support PY1700.67710PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

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

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescCORPORATE BONDSDesc
Book Value$284,071BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$284,071TotalBookValueSecuritiesAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTERDesc
Amt$144,853Amt
FieldValueIRS element (for citing)
Total Liability$144,853TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$2,979,810TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$2,747NetUnrealizedGainsInvstAmt
Revenue Not Reported-$2,747RevenueNotReportedAmt
Revenue Subtotal$2,982,557RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,982,557TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,740,211TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$1,740,211ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,740,211TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, LINE 2B:IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, THE FOUNDATION HAS REFLECTED AS A LIABILITY FOR THOSE CONTRIBUTIONS BEING HELD ON BEHALF OF WOMEN'S HEALTH PARTNERSHIP.
PART X, LINE 2:THE FOUNDATION HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. PERIODS ENDING DECEMBER 31, 2011 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES.

Schedule G IRS990ScheduleG

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

Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdActivityActivityTxtFundraiser Control Of FundsFundraiserControlOfFundsIndGross ReceiptsGrossReceiptsAmtRetained By ContractorRetainedByContractorAmtNet To OrganizationNetToOrganizationAmt
HARRIS CONNECT LLC
1511 ROUTE 22 SUITE 25BREWSTERNY10509FUNDRAISING COUNSEL0$0$50,750$0
THE GOBEL GROUP
2 STATE STREET SUITE 1150ROCHESTERNY14614FUNDRAISING COUNSEL0$0$100,630$0
FieldValueIRS element (for citing)
Total Retained By Contractors$151,380TotalRetainedByContractorsAmt
Licensed StatesNYLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1BLACK AND WHITEEvent1Nm
Gross Receipts Event1$409,086GrossReceiptsEvent1Amt
Charitable Contri Event1$406,418CharitableContriEvent1Amt
Gross Revenue Event1$2,668GrossRevenueEvent1Amt
Cash Prizes Event1$13,125CashPrizesEvent1Amt
Rent Facility Costs Event1$11,706RentFacilityCostsEvent1Amt
Food And Beverage Event1$32,282FoodAndBeverageEvent1Amt
Entertainment Event1$1,750EntertainmentEvent1Amt
Other Direct Expenses Event1$27,356OtherDirectExpensesEvent1Amt
Event2GARDEN FESTIVALEvent2Nm
Gross Receipts Event2$77,750GrossReceiptsEvent2Amt
Charitable Contri Event2$56,394CharitableContriEvent2Amt
Gross Revenue Event2$21,356GrossRevenueEvent2Amt
Rent Facility Costs Event2$6,950RentFacilityCostsEvent2Amt
Food And Beverage Event2$1,587FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$23,727OtherDirectExpensesEvent2Amt
Gross Receipts Total$486,836GrossReceiptsTotalAmt
Charitable Contributions Tot$462,812CharitableContributionsTotAmt
Gross Revenue Total Events$24,024GrossRevenueTotalEventsAmt
Cash Prizes Total Events$13,125CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$18,656RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$33,869FoodAndBeverageTotalEventsAmt
Entertainment Total Events$1,750EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$51,083OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$118,483DirectExpenseSummaryEventsAmt
Net Income Summary-$94,459NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonANDREW J MITCHELL FACHEPersonNm
TitlePRESIDENT/CEOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$573,932CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$167,043BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$19,122OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$33,100DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$30,026NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$823,223TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationCENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER, A RELATED ORGANIZATION, UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2014.ExplanationTxt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$199,980NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

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

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE CEO/PRESIDENT, AND CHIEF FINANCIAL OFFICER OF THE CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER, A RELATED ORGANIZATION, REVIEW THE 990. A COPY OF THE 990 IS ALSO PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW.
FORM 990, PART VI, SECTION B, LINE 12THE FOUNDATION FOLLOWS THE CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER, A RELATED ORGANIZATION'S CONFLICT OF INTEREST POLICY.
FORM 990, PART VI, SECTION B, LINE 15CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER, A RELATED ORGANIZATION, UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS LAST PERFORMED IN 2014.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11GSPECIAL EVENT PHOTOGRAPHY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 1,102. TOTAL EXPENSES 1,102. ADMINISTRATIVE SERVICE FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 1,194,674. TOTAL EXPENSES 1,194,674. CONSULTANTS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 7,510. TOTAL EXPENSES 7,510. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 117,155. TOTAL EXPENSES 117,155.
FORM 990, PART XII, LINE 2C:THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
CENTRAL SUFFOLK HOSPITAL DBA PECONIC BAY MEDICAL CENTER
1300 ROANOKE AVERIVERHEADNY11901111661359HOSPITAL CARENY501(C)(3)3PECONIC HEALTH CORPORATION0
PECONIC BAY HEALTH SYSTEMS
1300 ROANOKE AVERIVERHEADNY11901112761795PARENT COMPANY OF PBMCNY501(C)(3)30N/A
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd