2015-11-12T19:12:10-06:00 2014-12-31 PricewaterhouseCoopers LLP 300 Madison Avenue New York NY 10017 990 2014-01-01 113555766 CHS SERVICES INC % CHS SERVICES INC CHSS 5167053700 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 ALAN D GUERCI PRESIDENT, CEO 6464713000 2015-11-11 true LAURA J PARELLO P01080295 6464713000 2014 2016-04-25 22:37:26Z ALAN D GUERCI MD 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 147176095 false 0928 X N/A X 2000 NY CHSLI 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. 23 22 972 0 385010 15673 420 0 163308626 147103315 1555 1693 0 71087 163310601 147176095 10000000 26713457 0 0 88794084 92742598 0 0 0 48017507 47684539 146811591 167140594 16499010 -19964499 205879679 174356745 123353723 111795288 82525956 62561457 X CHS SERVICES,INC, 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. false false 167140594 26713457 146495741 CHS SERVICES INC. PROVIDES ADMINISTRATIVE SUPPORT TO THE CHS ENTITIES INCLUDING, BUT NOT LIMITED TO ACCOUNTING, REVENUE CYCLE, SUPPLY CHAIN AND INFORMATION TECHNOLOGY. CHS SERVICES PROMOTES EFFICIENT MANAGEMENT, COOPERATIVE PLANNING AND EFFICIENT USE OF RESOURCES BY ALL SUPPORTED ORGANIZATIONS. 167140594 true false false false false false false false false false true false true true true true false true false false false false false false false false false true false true false false false false false false false false false false false false false true true true false false true 56 0 true 972 true true true false false false false false false false false false X 23 22 false false false false true true true true true false false true true true true true true true true false X CHS SERVICES INC 5167053700 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 X RICHARD JJ SULLIVAN JR CHAIR 2.0 0.0 X X 0 0 0 SISTER ELAINE CALLAHAN OP VICE CHAIR THRU APRIL 2014 2.0 0.0 X X 0 0 0 THOMAS E CHRISTMAN TREASURER THRU APRIL 2014 2.0 0.0 X X 0 0 0 EUGENE MURPHY SECRETARY THRU APRIL 2014 2.0 0.0 X X 0 0 0 VIRGINIA EWEN TRUSTEE 2.0 0.0 X 0 0 0 BARBARA ELLEN BLACK TRUSTEE 2.0 0.0 X 0 0 0 THOMAS DOWLING JR MD TRUSTEE 2.0 0.0 X 0 0 0 SISTER AUDREY HARSEN TRUSTEE 2.0 0.0 X 0 0 0 SISTER MARGARET JOHN KELLY DC TRUSTEE THRU APRIL 2014 2.0 0.0 X 0 0 0 REV MSGR ROBERT MORRISSEY TRUSTEE 2.0 0.0 X 0 0 0 PATRICIA NAZEMETZ TRUSTEE 2.0 0.0 X 0 0 0 JOSEPH TANTILLO SECRETARY AS OF APRIL 2014 2.0 0.0 X X 0 0 0 REV MSGR JAMES VLAUN TRUSTEE 2.0 0.0 X 0 0 0 JOHN J WAGNER TRUSTEE 2.0 0.0 X 0 0 0 BRIAN MCGUIRE VICE CHAIR AS OF APRIL 2014 2.0 0.0 X X 0 0 0 FRANK L KURRE TRUSTEE 2.0 0.0 X 0 0 0 CHRIS PASCUCCI TREASURER AS OF APRIL 2014 2.0 0.0 X X 0 0 0 DANIEL T ROWE TRUSTEE 2.0 0.0 X 0 0 0 ALAN GUERCI MD PRESIDENT & CEO 50.0 0.0 X X 0 1230209 247778 KEVIN J CONWAY TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 PETER D'ANGELO TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 REV PETER DUGANDZIC TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 BRIAN P HEHIR TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 HON ANTHONY MARANO TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 STEPHEN F MCLOUGHLIN TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 JEROME POLLER TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 SALVATORE SODANO TRUSTEE AS OF APRIL 2014 2.0 0.0 X 0 0 0 COLLEEN BLYE EXECUTIVE VP & CFO 50.0 0.0 X 0 797602 303419 MARCY DUNN SVP & CIO 50.0 0.0 X 418604 0 127995 ALAN KATZ MD VP MEDICAL INFORMATICS 50.0 0.0 X 453943 0 50748 WILLIAM MEAD SVP PHYSICIAN STRATEGY 50.0 0.0 X 602657 0 251268 WILLIAM ARMSTRONG SR VP FINANCE 50.0 0.0 X 510193 157612 135888 LAWRENCE MAGRAS MD VP CLINICAL EFFECTIVENESS 50.0 0.0 X 375045 0 9824 LAWRENCE MCMANUS FORMER PRESIDENT/CEO 0.0 0.0 X 0 740573 13627 DAN MACKSOOD FORMER SVP FINANCE/CFO E. DIV. 0.0 X 516717 0 18450 2877159 2925996 1158997 220 true true false HARVEST 245 OLD COUNTRY ROAD 131 JERICHO TPKE JERICHO NY 11753 RENT 3611410 MILLER MILONE PC 100 QUENTIN ROOSEVELT BLVD GARDEN CITY NY 11530 LEGAL SERVICES 1547657 ALLSCRIPTS LLC 24630 NETWORK PLACE CHICAGO IL 60673 CONSULTING SERVICES 1576468 DELLA FEMINA ROTHSCHILD 129 WEST 129TH STREET NEW YORK NY 10001 ADVERTISING 985783 WEISERMAZARS LLP 600 CROSSWAYS PARK DRIVE WEST WOODBURY NY 11797 CONSULTING SERVICES 582030 16 0 ASSESSMENT REVENUE 900099 146495741 146495741 MANAGEMENT SERV REV 900099 385010 385010 PHYSICIAN AFFILIATE SUBSIDY 900099 222564 222564 147103315 1693 1693 0 0 0 0 0 0 0 0 0 CREDENTIALLING FEE REIMBURSEMENT 900099 58625 58625 OTHER 900099 12462 12462 71087 147176095 146495741 385010 295344 26713457 26713457 0 0 0 0 0 71132956 71132956 5455046 5455046 0 0 11228012 11228012 4926584 4926584 834257 834257 0 3611 3611 0 0 0 2986759 2986759 2282350 2282350 14618859 14618859 0 0 5989102 5989102 322758 322758 0 0 1279258 1279258 0 17962234 17962234 165229 165229 ALL OTHER EXPENSES 1003347 1003347 EQUIPMENT SERVICE CONTRACTS 236775 236775 167140594 167140594 0 0 27161703 20372620 1062903 1457811 0 0 241780 261439 0 0 0 0 0 0 0 0 3584579 3207122 136288988 63925549 78848048 72363439 0 0 0 0 25516019 9394213 0 0 69464647 67300101 205879679 174356745 27268481 29488325 0 0 381275 318732 0 0 0 0 0 0 74729725 60342135 4224744 1173540 16749498 20472556 123353723 111795288 X 82525956 62561457 0 0 0 0 82525956 62561457 205879679 174356745 -19964499 X false true X true true true X X 13 MERCY MEDICAL CENTER 111635088 03 false 0 0 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 111888924 03 false 0 0 ST FRANCIS HOSPITAL 112050523 03 false 0 0 ST CATHERINE OF SIENA MEDICAL CENTER 061562701 03 false 0 0 ST CHARLES HOSPITAL 111871039 03 false 0 0 WSNCHS NORTH INC 113438973 03 false 1479895 0 SIENA VILLAGE INC 061569129 04 false 0 0 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 113284066 09 false 0 0 CATHOLIC HOME CARE 112126736 09 false 0 0 GOOD SHEPHERD HOSPICE 112958438 09 false 0 0 CHS HOME SUPPORT SERVICES INC 113594561 09 false 0 0 MARYHAVEN CENTER OF HOPE 112861698 09 false 0 0 MARYHAVEN SCHOOL CORPORATION 112861690 02 false 0 0 13 1479895 false false false false false false false false false false false false false false false false PART IV, SECTION A, LINE 1 CHS SERVICES IS ORGANIZED AND SHALL BE OPERATED EXCLUSIVELY FOR THE PART IV, SECTION C, LINE 1 CHS SERVICES SUPPORTS THOSE ENTITIES FOR WHICH CHSLI IS THE SOLE MEMBER. 18208157 6217190 11990967 118080831 57708359 60372472 72363439 TRUSTEE HELD FUNDS RESTRICTED 9394213 F 9394213 DUE FROM RELATED ORGANIZATIONS 67300101 67300101 0 DUE TO RELATED ORGANIZATIONS 15981000 DEFERRED RENT 3081356 SELF INSURED LIABILIIES 1308888 DUE TO AFFILIATES 101312 20472556 X PART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTE CHS 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. true CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113403968 501(c)(3) 25233562 NONE NONE WORKING CAP. SUBSIDY WSNCHS NORTH INC 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 113438973 501(c)(3) 1479895 NONE NONE ELECTRONIC MEDICAL RECORD EQUIPMENT 2 0 PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE CHS SERVICES INC. MAINTAINS THE BOOKS AND RECORDS FOR CHS SERVICES INC. AND CATHOLIC HEALTH SERVICES OF LONG ISLAND AND IS THEREFORE ABLE TO MONITOR THAT CATHOLIC HEALTH SERVICES OF LONG ISLAND USES THE GRANT AS A WORKING CAPITAL SUBSIDY. CHS SERVICES INC. MAINTAINS THE BOOKS AND RECORDS FOR CHS SERVICES INC. AND WSNCHS NORTH, INC. AND IS THEREFORE ABLE TO MONITOR THAT WSNCHS NORTH, INC. USES THE GRANT TO PURCHASE ELECTRONIC MEDICAL RECORD EQUIPMENT. X true true X X X X X X true true false false false false false false false LAWRENCE MCMANUS FORMER PRESIDENT/CEO 0 0 0 0 0 740573 0 0 0 13627 0 754200 0 742817 MARCY DUNN SVP & CIO 395350 0 0 0 23254 0 99396 0 28599 0 546599 0 0 0 ALAN KATZ MD VP MEDICAL INFORMATICS 451827 0 0 0 2116 0 19396 0 31352 0 504691 0 0 0 WILLIAM MEAD SVP PHYSICIAN STRATEGY 216120 0 0 0 386537 0 19396 0 31352 0 653405 0 251416 0 ALAN GUERCI MD PRESIDENT & CEO 0 1199882 0 0 0 30327 0 216396 0 31382 0 1477987 0 0 COLLEEN BLYE EXECUTIVE VP & CFO 0 768651 0 0 0 28951 0 274396 0 29023 0 1101021 0 0 DAN MACKSOOD FORMER SVP FINANCE/CFO E. DIV. 0 0 0 0 516717 0 0 0 18450 535167 0 520005 0 WILLIAM ARMSTRONG SR VP FINANCE 493519 89172 0 0 16674 68440 105163 2938 23252 4535 638608 165085 0 0 LAWRENCE MAGRAS MD VP CLINICAL EFFECTIVENESS 87057 0 0 287988 0 6538 0 3286 0 384869 0 0 0 PART I, LINE 4A - SEVERANCE PAYMENT LAWRENCE MC MANUS, FORMER PRESIDENT & CEO RECEIVED PAYMENT OF SEVERANCE OF $580,065. MEDICAL BENEFITS WERE ALSO PROVIDED DURING 2014. DAN MACKSOOD, FORMER SVP FINANCE/CFO EASTERN DIV RECEIVED PAYMENT OF SEVERANCE OF $516,717. MEDICAL BENEFITS WERE ALSO PROVIDED DURING 2014. WILLIAM MEAD, SVP PHYSICIAN STRATEGY RECEIVED PAYMENT OF SEVERANCE OF $98,547 AND IS ENTITLED TO ADDITIONAL SEVERANCE OF $156,726. LAWRENCE MAGRAS, MD, VP CLINICAL EFFECTIVENESS RECEIVED PAYMENT OF SEVERANCE OF $275,625. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN THE 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. COLLEEN BLYE $255,000 PARTICIPATION IN THE PLAN. WILLIAM ARMSTRONG $89,000 PARTICIPATION IN PLAN. MARCY DUNN $80,000 PARTICIPATION IN PLAN. WILLIAM MEAD $50,000 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). THERE IS A TAX GROSS-UP INCLUDED IN THESE AMOUNTS. WILLIAM MEAD 251,416 VESTED IN PLAN. LAWRENCE MCMANUS $160,508 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. FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION THE SOLE MEMBER OF CHS SERVICES, INC. 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 CENTRE (DIOCESE). FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODY CHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF CHS SERVICES, INC. AND AS SUCH, HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF CHS SERVICES, INC. FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY CHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF CHS SERVICES, INC., IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERING BODY OF CHS SERVICES, INC. FORM 990, PART VI, LINE 11B - REVIEW PROCESS OF FORM 990 THE 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 POLICY DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE CHS COMPLIANCE AND AUDIT COMMITTEE BY CHS' COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE IS GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE CHS BOARD OF DIRECTORS. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED AND A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE BOARD OF DIRECTORS SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. THE PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIM/HERSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. FORM 990, PART VI, LINE 15 - COMPENSATION POLICY THE CHIEF EXECUTIVE 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 INSPECTION GOVERNING 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 1A HOURS 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. COLLEEN BLYE, EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY, INC. (20-8067039) AND CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968) ALAN D. GUERCI, PRESIDENT & CEO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY,INC. (20-8067039); CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968); ST FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL (11-1871039); SIENA VILLAGE, INC. (06-1569129) AND GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396). 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). CATHOLIC HEALTH SYSTEM OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113403968 SUPPORT ORG NY 501(C)(3) 11A- I NA false CHS AMBULANCE SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 141801961 DORMANT NY 501(C)(3) 3 CHSLI false GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 111888924 HOSPITAL NY 501(C)(3) 3 CHSLI true GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112537396 SELF INSURANC NY 501(C)(3) 11A- I GOOD SAMARTN true MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113434776 TRANSPORTATIO NY 501(C)(3) 11A- I MARYHAVENCTR false MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861698 Prgm-disabled NY 501(C)(3) 9 CHSLI false MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112861690 Schl-disabled NY 501(C)(3) 2 MARYHAVENCTR false THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113638367 SUPPORT ORG NY 501(C)(3) 11A- I MARYHAVENCTR false MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CTR NY 11570 111635088 HOSPITAL NY 501(C)(3) 3 CHSLI true CATHOLIC HOME CARE 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 112126736 HOME CARE NY 501(C)(3) 9 CHSLI false OUR LADY OF CONSOLATION GERIATRIC CARE 111 BEACH DRIVE WEST ISLIP NY 11795 113284066 LT NURSE CARE NY 501(C)(3) 9 CHSLI false RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 112499790 RENTING NY 501(C)(2) MARYHAVENCTR false SIENA VILLAGE INC 2000 BISHOPS ROAD SMITHTOWN NY 11787 061569129 SR HOUSING NY 501(C)(3) 9 STCATHERINE true ST CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN NY 11787 061562701 HOSPITAL NY 501(C)(3) 3 CHSLI true ST CHARLES HOSPITAL 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 111871039 HOSPITAL NY 501(C)(3) 3 CHSLI true CHS HOME SUPPORT SERVICES INC 15 POWER DRIVE HAUPPAUGE NY 11788 113594561 RESP THERAPY NY 501(C)(3) 9 CATHHOMECARE false ST FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112050523 HOSPITAL NY 501(C)(3) 3 CHSLI true ST FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BLVD ROSLYN NY 11576 112916033 SUPPORT ORG NY 501(C)(3) 11A- I ST FRANCIS false ST FRANCIS HOSPITAL RESEARCH & EDUCATIO 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113090867 RESEARCH ORG NY 501(C)(3) 11A- I ST FRANCIS true WSNCHS NORTH INC 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 113438973 HOSPITAL NY 501(C)(3) 3 CHSLI true THE ST CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSN ST NY 11777 112983148 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI false THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112716640 SUPPORT ORG NY 501(C)(3) 11A- I CHSLI false WISDOM GARDENS HOUSING DEVELOPMENT FUND 51 TERRYVILLE ROAD PORT JEFFERSN ST NY 11776 113559713 SR HOUSING NY 501(C)(3) 9 MARYHAVENCTR false GOOD SHEPHERD HOSPICE 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 112958438 HOSPICE SVC NY 501(C)(3) 9 CHSLI false ST CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 412076312 SUPPORT ORG NY 501(C)(3) 11A- I ST CHARLES false GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 770611240 SUPPORT ORG NY 501(C)(3) 11A- I GOOD SAMARTN false MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 550813603 SUPPORT ORG NY 501(C)(3) 11A- I MERCY MEDCTR false ST CATHERINE OF SIENA MEDICAL CTR FDN 50 ROUTE 25A SMITHTOWN NY 11787 271459941 SUPPORT ORG NY 501(C)(3) 11A- I STCATHERINE false CHS HOME CARE AND HOSPICE FOUNDATION 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 452907761 SUPPORT ORG NY 501(C)(3) 11A- I CATHHOMECARE false GOOD SHEPHERD HOSPICE FOUNDATION 110 Bi-County Blvd Suite 114 FARMINGDALE NY 11735 263169427 SUPPORT ORG NY 501(C)(3) 11A- I GOODSHEPHERD false OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP NY 11795 450517566 SUPPORT ORG NY 501(C)(3) 11A- I OURLADYOFC false RVC SUPPORT 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 271531084 REAL ESTATE NY 501(C)(3) 11A- I CHSLI false ST FRANCIS CARDIOVASCULAR PHYSICIANS P 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113613997 HEALTHCARESVC NY 501(C)(3) 11A- I ST FRANCIS false RVC INSURANCE COMPANYINC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 208067039 CAPTIVE INS NY 501(C)(3) 11A- II CHSLI false SAMARITAN EMERGENCY MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208243412 HEALTHCARESVC NY 501(C)(4) GOOD SAMARTN false ST JOSEPH HOSPITAL FOUNDATION 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 472353387 support org NY 501(C)(3) 11A- I WSNCHS NORTH false RADIOLOGY CONSULTING OF LONG ISLANDPLLC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 421646134 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN PEDIATRIC SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208180263 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208088453 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SOUTHWEST SUFFOLK MEDICAL PC 580 UNION BOULEVARD WEST ISLIP NY 11795 061603195 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false CARDIAC EKG INTERPRETATION PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112924518 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208964140 HEALTHCARE SVC NY GOOD SAMARITAN C-CORP false SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112838185 HEALTHCARE SVC NY CHSLI C-CORP false FAIRVIEW HILL MANAGEMENT CO INC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 112798383 HOLDING CO NY CHSLI C-CORP false ADVANCED REHABILIATION MEDICINE PLLC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 113640709 HEALTHCARE SVC NY STCHARLES HOSP C-CORP false ST FRANCIS CARDIAC PREVENTION SERVICES 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113224885 HEALTHCARE SVC NY STFRANCIS HOSP C-CORP false SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113307977 HEALTHCARE SVC NY SAMARITAN MGMT C-CORP false SAMARITAN HOME CARE AMERICA 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113319259 HEALTHCARE SVC NY SAMARITAN MGMT C-CORP false HEALTH CARE TEMP SERVICES INC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 112801136 EMPLOYMENT AGENCY NY FAIRVIEW HILL C-CORP false MERCY INTERNAL MEDICINE PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 510639649 HEALTHCARE SVC NY MERCY MED CTR C-CORP false LONG ISLAND EMERGENCY CARE PC 1000 N VILLAGE AVE ROCKVILLE NY 11571 113633515 PHYSICIAN SVC NY MERCY MED CTR S-CORP false false true false false true false false false false false true true true true true true true true true GOOD SAMARITAN HOSPITAL MEDICAL CENTER LMQS 3009381 COST MERCY MEDICAL CENTER KLMQS 530857 COST ST FRANCIS HOSPITAL KLMQS 2763945 COST ST CHARLES HOSPITAL LMQS 1827976 COST ST CATHERINE OF SIENA MEDICAL CENTER LMQS 1430749 COST WSNCHS NORTH INC LMQS 148209 COST WSNCHS NORTH INC B 1479895 COST SCHEDULE R, PART IV FOR 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.