2014-11-13T21:16:12-06:00 2013-12-31 PricewaterhouseCoopers LLP 300 Madison Avenue New York NY 10017 990 2013-01-01 061562701 ST CATHERINE OF SIENA MEDICAL CENTER % CHS SERVICES INC STCA 6318623000 50 ROUTE 25A Suite SMITHTOWN NY 11787 PAUL ROWLAND EXECUTIVE VP, CAO 6318623000 2014-11-07 2013 2015-11-30 17:44:51Z ALAN D GUERCI MD 50 ROUTE 25A SMITHTOWN NY 11787 258656097 false 0928 X HTTP://STCATHERINES.CHSLI.ORG 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. 12 12 2268 238 82513 19116 3708616 21950810 242914264 224856949 282437 415611 3068524 9923443 249973841 257146813 212578 314580 0 0 156238660 157936736 0 0 0 96843703 97335400 253294941 255586716 -3321100 1560097 168818914 162634433 222480293 215035376 -53661379 -52400943 X ST. 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. false false 205062852 299232 198341793 ST. CATHERINE OF SIENA MEDICAL CENTER IS A 318 BED ACUTE CARE HOSPITAL DEVOTED TO PROVIDING ADVANCED HEALTHCARE IN AN ENVIRONMENT OF COMPASSION. IN 2013, THE MEDICAL CENTER HAD 12,894 DISCHARGES AND PROVIDED CARE FOR 29,908 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 UNCOMPENSATED CARE REPORTED, AT COST, $3,131,000 IN CHARITY CARE. COMMUNITY SERVICE AND OTHER CHARITABLE ACTIVITIES PROVIDED FOR THE COMMUNITY TOTALED, AT COST, $6,931,000 AND REPORTED, AT COST, $812,000 IN UNCOMPENSATED CARE AS BAD DEBTS IN 2013. 28248116 15348 33068369 ST. 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 83,553 DAYS OF CARE IN 2013. THE NURSING HOME PROVIDED $345,000 IN UNCOMPENSATED CARE AS BAD DEBT IN 2013. 233310968 true true false true false false false false false false true false false true true true false true false false false false false false true false true true true false true false false false false false false false false false false false false true true true true false false true 144 0 true 2268 true true true false false false false true true false false false false X 12 12 false false false false true true true true true false false true true true true true true true true false X CHS SERVICES INC 5167051937 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 X JEROME POLLER CHAIRMAN 2.0 X X 0 0 0 RAYMOND BORSELLA TREASURER 2.0 X X 0 0 0 MICHAEL LAMBERT ESQ SECRETARY 2.0 X X 0 0 0 ROBERT CARLIN MD TRUSTEE 2.0 X 0 0 0 JAMES DILTS TRUSTEE 2.0 X 0 0 0 HON JEANNE GARANT TRUSTEE 2.0 X 0 0 0 SISTER ANN GRAY DW TRUSTEE 2.0 X 0 0 0 J ROBERT GROSS DC TRUSTEE 2.0 X 0 0 0 JOHN HALLERON III ESQ TRUSTEE 2.0 X 0 0 0 REV MSGR JAMES MCNAMARA TRUSTEE 2.0 X 0 0 0 JERRY NINIA MD TRUSTEE 2.0 X 0 0 0 RICHARD SCHMIDT TRUSTEE 2.0 X 0 0 0 JAMES CALDAS PRESIDENT&CEO THRU JULY 2013 50.0 X X 0 905395 1824265 ALAN D GUERCI MD PRESIDENT&CEO AS OF JULY 2013 50.0 X X 0 1320796 53241 PAUL ROWLAND EXEC VP & CAO 50.0 X 104997 0 405 DAN MACKSOOD SVP FINANCE/CFO EASTERN DIV 50.0 X 0 551900 668066 DENNIS VERZI EXEC V/P & CAO THRU JUNE 2013 50.0 X 529708 739433 132701 JASON GOLBIN CMO 50.0 X 104623 0 4906 PATRICK O'SHAUGHNESSY CHIEF MED OFFICER THRU 5/2013 50.0 X 261151 407759 49497 PAUL SAVOCA MD MEDICAL DIRECTOR 50.0 X 446003 0 49440 GARA EDELSTEIN SENIOR VP ADMIN & CNO 50.0 X 419765 0 133421 MICHAEL WEBER MD PHYSICIAN 40.0 X 438483 0 42631 SULTAN MOHIUDDIN MD PHYSICIAN 40.0 X 468814 0 23388 JUNE LEE PHYSICIAN 40.0 X 367546 0 30925 3141090 3925283 3012886 223 false true false CHEM RX PHARMACY SVCS LLC 750 PARK PLACE LONG BEACH NY 11561 PHARMACY 602242 ISLAND NEONATOLOGY PLLC PO BOX 272 EAST ISLIP NY 11730 PHYSICIAN SERVICES 504610 HORIZON HEALTHCARE STAFFING 20 JERUSALEM AVE 3RD FL HICKSVILLE NY 11801 NURSING AGENCY FEES 243864 PIONEER GROUP HARDSCAPE DESIGN 168 TOWNLINE ROAD KINGS PARK NY 11754 ENGINEERING SERVICES 208360 DARR CONSTRUCTION 870 SLYVAN BAYPORT NY 11705 CONSTRUCTION 204399 13 749 210720 21500000 69617 169724 21950810 NET PATIENT REV-HOSP 621990 191788580 191706067 82513 NET PATIENT REV-NH 623000 33068369 33068369 224856949 415611 415611 0 0 1565385 1432904 132481 0 132481 132481 0 102300 210720 76380 25920 25920 0 0 CONTRACTED SVCS-SWSM 900099 6503245 6503245 TELEPHONE 900099 97089 97089 CAFETERIA 721210 57577 57577 3107131 3107131 9765042 257146813 231410162 82513 3703328 314580 314580 0 0 0 1187987 434327 753660 0 114127451 109516664 4610787 8127325 7735656 391669 25760282 24516166 1244116 8733691 8311354 422337 1203983 126862 1077121 312523 312523 112944 112944 50657 50657 0 0 9735404 8128897 1606507 372550 10086 362464 4535391 3438800 1096591 0 0 0 4068928 3944214 124714 38978 17068 21910 0 53523 53523 3401239 3401239 6727856 441765 6286091 8648299 8648299 5362177 4694731 667446 MEDICAL SUPPLIES 32924123 32924123 SERVICE/MAINTENANCE CONTRACTS 2982565 2870861 111704 HOME OFFICE ALLOCATION 2192283 200310 1991973 CHS SERVICES 14424392 13552661 871731 187585 28782 158803 255586716 233310968 22275748 0 X 5047230 3704335 1126739 1417829 86961 93479 30630587 29853937 0 0 0 0 0 0 3264914 3458729 2171243 1707026 166903244 76650730 90844484 90252514 7122775 7126187 0 0 0 0 0 0 28523981 25020397 168818914 162634433 26906800 25048806 0 0 0 0 68801692 68730791 0 0 0 0 0 0 0 0 126771801 121255779 222480293 215035376 X -54412391 -53464275 751012 1063332 0 0 -53661379 -52400943 168818914 162634433 X 1560097 -212562 -87099 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 50657 50657 false PART II-B, LINE 1 - LOBBYING ACTIVITIES AMOUNT REFLECTS PORTION OF TRADE ASSOCIATION DUES WHICH WERE USED FOR LEGISLATIVE LOBBYING ON BEHALF OF THE HEALTHCARE INDUSTRY THOSE TRADE ASSOCIATIONS REPRESENT. 10126496 10126496 94899086 37308814 57590272 59429650 38694869 20734781 2448012 647047 1800965 90252514 INSURANCE CLAIMS RECEIVABLE 22942534 OTHER ASSETS 782381 DUE FROM RELATED PARTIES, NET 144149 DEFERRED FINANCING COSTS, NET 1151333 25020397 0 RESIDENT FUNDS AND SECURITY DEPOSITS 354297 THIRD PARTY PAYOR LIABILITIES 24625520 RETIREMENT LIABILITY - PENSION 579138 RETIREMENT LIABILITY - 457B FUNDS 152396 RETIREMENT LIABILITY - POST RETIREMENT 2077000 ESTIMATED MALPRACTICE LIABILITY 24277461 SELF INSURED LIABILITY 24805507 DUE TO RELATED PARTIES 44384460 121255779 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. 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VOLUNTEERS REPRESENTING 10 COMMUNITIES IN WESTERN SUFFOLK AND SIENA VILLAGE RESIDENTS WERE ALSO GIVEN THE PAPER SURVEY TO FILL OUT. 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 4 GOOD 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 5B - OTHER WEBSITE NSHC.ORG/LONG-ISLAND-HEALTH-COLLABORATIVE/ PART V, SECTION B, LINE 7 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. 1 ST CATHERINE OF SIENA NURSING HOME 25 ROUTE 25A SMITHTOWN NY NY 11787 SKILLED NURSING FACILITY PART I, LINE 4 WHEN ESTABLISHED, THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY'S FACTOR IN DETERMINING ELIGIBILITY FOR FREE OR DISCOUNTED CARE WAS SPECIFICALLY SET HIGHER THAN FEDERALLY REQUIRED GUIDELINES IN ORDER TO CAPTURE POTENTIALLY MEDICALLY INDIGENT PATIENTS WHO MAY PRESENT THEMSELVES AT THE HOSPITAL FOR CARE. THE POLICY OF THE HOSPITAL WAS REVISED IN 2014 TO SPECIFICALLY DISCUSS CARE TO THE MEDICALLY INDIGENT. PART I, LINE 7 RATIO 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 2013. PART I, LINE 7 REFLECTS HOSPITAL INFORMATION ONLY. PART III, LINES 2 AND 4 - TEXT OF FOOTNOTE DISCUSSING BAD DEBT THE 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 EACH FACILITY. 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 4 - BAD DEBT AS COMMUNITY BENEFIT AS 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 PATIENTS 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, LINE 8 THE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 2013 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. ST. CATHERINE INCURRED A LOSS OF APPROXIMATELY $14.9 MILLION TO DELIVER CARE TO MEDICARE PATIENTS. 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 9B THE 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 CENTERS 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 GOALS ST. 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. PART VI, LINE 3 - COMMUNICATION OF FINANCIAL ASSISTANCE POLICY 1. 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 INFORMATION ST. 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, ST. JAMES, HAUPPAUGE, KINGS PARK, COMMACK, NESCONSET, NORTHPORT AND EAST NORTHPORT. THROUGH 2015, THERE IS A PROJECTED INCREASE OF RESIDENTS THAT ARE 65 YEARS OF AGE OR OLDER. PART VI, LINE 5 - PROMOTION OF COMMUNITY HEALTH ST. 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 900 COMMUNITY MEMBERS IN 2013. THE HEALTH FAIR OFFERS FREE HEALTH CARE EDUCATION AND SCREENINGS, WHICH INCLUDED SKIN CANCER AND PROSTATE SCREENINGS. ALSO, FREE FLU SHOTS WERE ADMINISTERED, AND SERVICES ON CAMPUS WERE HIGHLIGHTED. 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. MAILED THROUGHOUT THE SERVICE AREA, TO MORE THAN 100,000 HOUSEHOLDS, THE VOICE IS A PRIMARY COMPONENT 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. EACH DINNER ACTS AS A REMINDER OF HOW GRATEFUL THE HOSPITAL IS FOR PROMPTNESS AND EFFICIENCY IN THE FIELD. THE DINNERS OFFER A FORUM FOR SPECIAL EDUCATIONAL PROGRAMS AND AN OPPORTUNITY FOR EMERGENCY RESPONSE PERSONNEL TO GAIN EDUCATION CREDITS. HEALTHY SUNDAYS: THE HEALTHY SUNDAYS PROGRAM MANIFESTS THE COMMITMENT OF CATHOLIC HEALTH SERVICES OF LONG ISLAND BY PROACTIVELY HELPING UNDERSERVED COMMUNITIES BY PROVIDING 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 BUILDING A LINK FOR THE COORDINATION OF CARE. HEALTHY SUNDAYS PROVIDES A SAFE AVENUE TO IMPROVE ACCESS TO VITAL PRIMARY CARE SERVICES. 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 EDUCATE AND RAISE AWARENESS. WITH THE COMBINATION OF LECTURES AND PRESENTATIONS OFFERED, 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 THAT 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 FOR 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 IN 2013, TO BETTER IDENTIFY AND ADDRESS THE REGION'S PREVALENT HEALTH NEEDS, ST. CATHERINE OF SIENA MEDICAL CENTER JOINED FORCES WITH OTHER HOSPITALS, LOCAL HEALTH DEPARTMENTS, HEALTH CARE PROVIDERS, PUBLIC HEALTH SPECIALISTS FROM ACADEMIC INSTITUTIONS AND COMMUNITY-BASED ORGANIZATIONS TO FORM 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 IV, LINE 6 ST. 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, 2013, 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. 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. true CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 113403968 501(C)(3) 314580 NONE NONE OUTPATIENT CENTERS 1 PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE CHS 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. 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; AND 2) PROVIDE SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND TO FUND OUTPATIENT CENTERS THAT PROVIDE CHARITY CARE TO THOSE CENTERS COMMUNITIES. X X X X X X true true false false false false false false false PAUL SAVOCA MD MEDICAL DIRECTOR 444053 0 0 0 1950 0 22772 0 26668 0 495443 0 0 0 GARA EDELSTEIN SENIOR VP ADMIN & CNO 329309 0 62000 0 28456 0 108772 0 24649 0 553186 0 16204 0 MICHAEL WEBER MD PHYSICIAN 397515 0 40000 0 968 0 22772 0 19859 0 481114 0 0 0 DAN MACKSOOD SVP FINANCE/CFO EASTERN DIV 0 370182 0 120000 0 61718 0 649321 0 18745 0 1219966 0 0 DENNIS VERZI EXEC V/P & CAO THRU JUNE 2013 231688 419676 150000 0 148020 319757 109386 11513 5860 5942 644954 756888 199289 0 PATRICK O'SHAUGHNESSY CHIEF MED OFFICER THRU 5/2013 178969 398694 82000 0 182 9065 9488 13432 11223 15354 281862 436545 0 0 SULTAN MOHIUDDIN MD PHYSICIAN 463417 0 0 0 5397 0 0 0 23388 0 492202 0 0 0 JAMES CALDAS PRESIDENT&CEO THRU JULY 2013 0 724676 0 159000 0 21719 0 1803934 0 20331 0 2729660 0 0 JUNE LEE PHYSICIAN 329483 0 33000 0 5063 0 22772 0 8153 0 398471 0 0 0 ALAN D GUERCI MD PRESIDENT&CEO AS OF JULY 2013 0 1002487 0 170000 0 148309 0 23027 0 30214 0 1374037 0 0 PART I, LINE 4A - SEVERANCE PAYMENT JAMES CALDAS, PRESIDENT & CEO IS ENTITLED TO SEVERANCE OF $1,531,826. DAN MACKSOOD, SVP FINANCE/CFO EASTERN DIV IS ENTITLED TO SEVERANCE OF $643,568. PART I, LINE 4B - SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN JAMES CALDAS $251,000 PARTICIPATION IN PLAN DENNIS VERZI $98,000 PARTICIPATION IN PLAN, $303,670 VESTED IN PLAN GARA EDELSTEIN $86,000 PARTICIPATION IN PLAN, $16,204 VESTED IN PLAN ALAN D. GUERCI, MD $105,347 VESTED IN PLAN THE AMOUNTS REFLECTED IN COLUMN B(III) AND COLUMN C FOR THE INDIVIDUALS INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP"). THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2013 FORM W-2 BOX, 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NONQUALIFIED RETIREMENT PLANS. PART II, COLUMN (F) - COMPENSATION REPORTED AS DEFERRED ON PRIOR FORM 990 ALAN D. GUERCI, MD BECAME AN OFFICER OF ST. CATHERINE OF SIENA MEDICAL CENTER AS OF JULY 2013. HIS SERP PAYMENT OF $105,347 WAS PREVIOUSLY REPORTED AS DEFERRED COMPENSATION ON THE PRIOR YEAR 990 OF ST. FRANCIS HOSPITAL, A RELATED ORGANIZATION. FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION THE 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 PROVIDERS. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER. FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODY CHS 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 BODY CHS AS THE SOLE MEMBER AND CO-OPERATOR OF ST. CATHERINE IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY ST. CATHERINE'S GOVERNING BODY. FORM 990, PART VI, LINE 11B - REVIEW PROCESS FOR FORM 990 THE FORM 990 AND APPROPRIATE SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS (THE BOARD) OF CHS, WHICH HAS BEEN DELEGATED THE REVIEW FUNCTION BY THE BOARD. UPON APPROVAL OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO ALL VOTING MEMBERS OF THE BOARD OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE. THE FORM 990 IS THEN 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 ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE BY THE ORGANIZATION'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFERRED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. 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 ORGANIZATION'S BOARD OF TRUSTEES 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. PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIMSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT. 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 POLICY. THE 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, AND CHIEF OPERATING OFFICERS OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS; 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 CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE 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 DONE BY AN INDEPENDANT CONSULTANT ANNUALLY. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASURABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE BOARD OF TRUSTEES. 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. JAMES CALDAS, PRESIDENT AND CEO THRU JULY 2013 - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); ST CHARLES CORPORATION (11-2983148); SIENA VILLAGE (06-1569129); THE SAMARITAN CORPORATION (11-2716640). ALAN D. GUERCI, PRESIDENT & CEO SINCE JULY 2013 - 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 CARDIOVASCULAR PHYSICIANS PC (11-3613997); 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)AND ST. CHARLES HOSPITAL (11-1871039). DAN MACKSOOD, SVP FINANCE AND CFO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11-1888924); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL (11-1871039); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); ST CHARLES CORPORATION (11-2983148); SIENA VILLAGE (06-1569129); THE SAMARITAN CORPORATION (11-2716640). DENNIS VERZI, 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). 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). FORM 990, PART X, LINE 20 - TAX-EXEMPT BOND LIABILITIES THE 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. TWO BONDS WERE ISSUED TO THE OBLIGATED GROUP, SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORPORATION (SERIES 2011 SUFFOLK BONDS) AND NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE AND FINANCING CORPORATION (SERIES 2011 NASSAU BONDS). THE BONDS ARE REPORTED ON SCHEDULE K OF THE PARENT ORGANIZATION, CATHOLIC HEALTH SERVICES OF LONG ISLAND. FORM 990, PART XI, LINE 9 - CHANGES IN NET ASSETS POST-RETIREMENT BENEFIT: (87,099) TOTAL TO FORM 990, PART XI, LINE 9: (87,099) SIENA RETIREMENT REALTY CCRC 50 ROUTE 25A SMITHTOWN NY 11787 061569102 RETIRE COMMUN NY 0 3481000 STCATHERINE SIENA MEDICAL REALTY 50 ROUTE 25A SMITHTOWN NY 11787 061568934 MED BUILDING NY 1334000 7622000 STCATHERINE 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 SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113555766 SUPPORT ORG NY 501(C)(3) 11A- II CHSLI 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 false 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 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 false 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 false WSNCHS NORTH INC 4295 HEMPSTEAD TURNPIKE BETHPAGE NY 11714 113438973 HOSPITAL NY 501(C)(3) 3 CHSLI false 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 true CATHOLIC HOME CARE 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 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 true true true false false false false false false true true false true true true true false GOOD SAMARITAN HOSPITAL C 17000000 COST SIENA VILLAGE C 4500000 COST ST CHARLES HOSPITAL M 10605 COST GOOD SAMARITAN HOSPITAL M, P 270282 COST SIENA VILLAGE L, Q 201379 COST