2014-11-14T15:01:18-06:00 2013-12-31 131517563 LOEB & TROPER LLP 655 THIRD AVENUE 12TH FLOOR NEW YORK NY 10017 990 2013-01-01 200714587 CENTRAL SUFFOLK HOSPITAL FOUNDATION CENT 6315486064 1300 ROANOKE AVENUE RIVERHEAD NY 11901 ANDREW MITCHELL PRESIDENT/CEO 6315486064 2014-11-14 1 ISRAEL TANNENBAUM P01589203 2128674000 2013 2015-11-30 17:44:51Z SEE SCHEDULE O FOR DBA PECONIC BAY MEDICAL CENTER FOUNDATION ANDREW MITCHELL 1300 ROANOKE AVENUE RIVERHEAD NY 11901 1378542 0 X WWW.PBMEDICALCENTER.ORG X 2004 NY THE 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. 15 14 0 14 0 0 2247758 1318620 0 0 408 2241 -70127 -85225 2178039 1235636 0 0 0 0 0 0 393159 178206 1874982 1365154 1697529 1758313 1875735 419726 -640099 3910802 2888516 522458 139654 3388344 2748862 X SEE 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. 0 0 THE SUPPORT OF HOSPITAL SERVICES OF CENTRAL SUFFOLK HOSPITAL 1 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 2 0 0 0 0 0 0 0 1 1 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 0 1 1 1 1 0 NY X MICHAEL F O'DONNELL 6315486074 1300 ROANOKE AVENUE RIVERHEAD NY 11901 J GORDON HUSZAGH CHAIRMAN 10.00 15.00 X X 0 0 0 IRWIN L GARSTEN VICE CHAIR 10.00 X X 0 0 0 EMILIE ROY COREY VICE CHAIR 1.00 X X 0 0 0 RICHARD ISRAEL SECRETARY 1.00 1.00 X X 0 0 0 JOAN LEVAN TREASURER 1.00 1.00 X X 0 0 0 ANDREW J MITCHELL FACHE PRESIDENT/CEO 15.00 22.50 X X 0 574386 54252 BRUCE BARNET BOARD MEMBER 1.00 X 0 0 0 KENN BARRA BOARD MEMBER 1.00 1.00 X 0 0 0 BARRY BRANDEIS BOARD MEMBER 1.00 X 0 0 0 CAROLE G HANKIN PHD BOARD MEMBER 1.00 X 0 0 0 DAVID J MCCANN BOARD MEMBER 1.00 X 0 0 0 RICHARD RUBENSTEIN MD BOARD MEMBER 1.00 1.00 X 0 0 0 JOSEPH VAN DE WETERING BOARD MEMBER 1.00 1.00 X 0 0 0 RICHARD WINSLOW PHD BOARD MEMBER 1.00 1.00 X 0 0 0 STANLEY ZINBERG MD BOARD MEMBER 1.00 1.00 X 0 0 0 0 574386 54252 0 0 1 0 CENTRAL SUFFOLK HOSPITAL 1300 ROANOKE AVENUE RIVERHEAD NY 11901 ADMINISTRATIVE SERVICES 1332520 1 359272 200000 759348 32919 1318620 2091 2091 1807 1657 150 150 150 56024 359272 141249 -85225 -85225 1235636 0 0 -82984 X 6000 6000 178206 178206 753 753 1333595 1333595 3586 3586 227305 227305 7500 7500 13673 13673 105117 105117 1875735 0 753 1874982 67299 90555 1806050 1053320 2037453 1446142 12460 286039 3910802 2888516 2351 27088 67441 90697 452666 21869 522458 139654 X 1484331 1427502 1904013 1321360 3388344 2748862 3910802 2888516 -640099 617 0 X X 0 1 X 1 0 X 967777 1419214 2988253 2247758 1318620 8941622 967777 1419214 2988253 2247758 1318620 8941622 2869698 6071924 1634 2791 749 408 2091 7673 17936 17936 8967231 0.67710 0.73460 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 67441 23256 90697 1 X 0 CORPORATE BONDS 286039 C 286039 DUE TO CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER 21869 21869 X 1236253 617 617 1235636 0 1235636 1875735 0 1875735 0 1875735 PART IV, LINE 2B: IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES, THE FOUNDATION HAS REFLECTED AS A LIABILITY 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, 2010 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. X X X X X 1 HARRIS CONNECT LLC 1511 ROUTE 22 SUITE 25 BREWSTER NY 10509 CONSULTING 0 0 178206 0 178206 NY BLACK AND WHITE 341977 285953 56024 17500 14588 26146 1650 63651 GARDEN FESTIVAL 73319 73319 4904 12810 415296 359272 56024 17500 19492 26146 1650 76461 141249 -85225 0 0 0 0 0 0 0 1 0 ANDREW J MITCHELL FACHE PRESIDENT/CEO 0 567112 0 6500 0 774 0 23000 0 31252 0 628638 0 0 PART I, LINE 3 CENTRAL 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 MARCH 2014. PART I, LINE 7 PERFORMANCE BASED ON BOARD DISCRETION. AN EMPLOYMENT AGREEMENT IS IN PLACE WITH THE HOSPITAL WITH THE CEO. X 4 32919 SELLING PRICE 0 0 0 PART I, COLUMN (B): NUMBER OF CONTRIBUTORS FORM 990, PART VI, SECTION B, LINE 11 THE CEO/PRESIDENT, AND CHIEF FINANCIAL OFFICER OF THE CENTRAL SUFFOLK HOSPITAL D/B/A PECONIC BAY MEDICAL CENTER, A RELATED ORGANIZATION, REVIEWS THE 990. A COPY OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12 THE 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 15 CENTRAL 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 MARCH 2014. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G SPECIAL EVENT PHOTOGRAPHY: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 1,075. TOTAL EXPENSES 1,075. ADMINISTRATIVE SERVICE FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 1,332,520. TOTAL EXPENSES 1,332,520. FORM 990, PART XII, LINE 2C: THIS PROCESS DID NOT CHANGE FROM THE PRIOR YEAR. CENTRAL SUFFOLK HOSPITAL DBA PECONIC BAY MEDICAL CENTER 1300 ROANOKE AVE RIVERHEAD NY 11901 111661359 HOSPITAL CARE NY 501(C)(3) 3 N/A 0 PECONIC BAY HEALTH SYSTEMS 1300 ROANOKE AVE RIVERHEAD NY 11901 112761795 PARENT COMPANY OF PBMC NY 501(C)(3) 3 N/A 0 0 0 1 1 1 0 0 0 0 0 1 1 0 1 1 0 0 0 0