PHYSICIANS OF UNIVERSITY HOSPITAL PC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- PHYSICIANS OF UNIVERSITY HOSPITAL PC (EIN 20-0096809)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201433189349302463
- Schema version
- 2013v3.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2014-11-14T09:36:04-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WithumSmithBrown PC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 465 South St Ste 200 | AddressLine1 |
| City | Morristown | City |
| State | NJ | State |
| ZIP Code | 079606497 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200096809 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHYSICIANS OF UNIVERSITY HOSPITAL PC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % THOMAS RECA | InCareOfNm |
| Business Name Control | PHYS | BusinessNameControlTxt |
| Phone | 7182264597 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 EDGEWATER PLAZA | AddressLine1 |
| Address Line2 | Suite | AddressLine2 |
| City | STATEN ISLAND | City |
| State | NY | State |
| ZIP Code | 10305 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS RECA | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7182261148 | PhoneNum |
| Signature | 2014-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Anthony J Panico | PreparerPersonNm |
| PTIN | P00365556 | PTIN |
| Phone | 7182261148 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRAHIM ARDOLIC MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 475 SEAVIEW AVENUE | AddressLine1 |
| City | STATEN ISLAND | City |
| State | NY | State |
| ZIP Code | 10305 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $65,285,757 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES IN FURTHERANCE OF THE CHARITABLE PUR- POSES OF SIUH; A RELATED IRC SECTION 501(C)(3) TAX-EXEMPT HOSPITAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 2 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 248 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $65,674,745 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $65,285,757 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $65,674,745 | PYTotalRevenueAmt |
| CY Total Revenue | $65,285,757 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,871,636 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $49,715,483 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $45,681,616 | PYOtherExpensesAmt |
| CY Other Expenses | $13,932,890 | CYOtherExpensesAmt |
| PY Total Expenses | $66,553,252 | PYTotalExpensesAmt |
| CY Total Expenses | $63,648,373 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$878,507 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,637,384 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,420,254 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,840,869 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $174,891 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,653,434 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,245,363 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,187,435 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES IN FURTHERANCE OF THE CHARITABLE PURPOSES OF STATEN ISLAND UNIVERSITY HOSPITAL; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $57,283,537 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $65,285,757 | RevenueAmt |
| Desc | EXPENSES INCURRED ACTING IN FURTHERANCE OF THE CHARITABLE PURPOSES OF STATEN ISLAND UNIVERSITY HOSPITAL; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) tax-exempt hospital WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES to all individuals in a non-discriminatory manner regardless of RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ability to pay. | Desc |
| Total Program Service Expenses | $57,283,537 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 19 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 248 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Excess Business Holdings | false | ExcessBusinessHoldingsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 2 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THOMAS RECA | PersonNm |
| Phone | 7182261148 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 EDGEWATER PLAZA | AddressLine1 |
| City | STATEN ISLAND | City |
| State | NY | State |
| ZIP Code | 10305 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| BRAHIM ARDOLIC MD | |||||||||
| PRESIDENT - TRUSTEE | 3.0 | 47.0 | Yes (X) | Yes (X) | $0 | $516,416 | $56,786 | ||
| FRANK FORTE | |||||||||
| SECRETARY - TRUSTEE | 2.0 | 48.0 | Yes (X) | Yes (X) | $0 | $518,806 | $56,915 | ||
| NICOLE BERWALD MD | |||||||||
| PHYSICIAN | 50.0 | $382,149 | $0 | $28,828 | Yes (X) | ||||
| BORIS KHODORKOVSKY MD | |||||||||
| PHYSICIAN | 50.0 | $376,177 | $0 | $35,380 | Yes (X) | ||||
| CHRISTOPHER GRAZIANO MD | |||||||||
| PHYSICIAN | 50.0 | $350,474 | $0 | $34,582 | Yes (X) | ||||
| HEIDI BAER MD | |||||||||
| PHYSICIAN | 50.0 | $326,155 | $0 | $19,084 | Yes (X) | ||||
| ABBAS HUSAIN MD | |||||||||
| PHYSICIAN | 50.0 | $311,563 | $0 | $27,022 | Yes (X) | ||||
| MARK P JARRETT MD | |||||||||
| FORMER OFFICER | 50.0 | $0 | $672,408 | $42,750 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,746,518 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,707,630 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $301,347 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 70 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| METROPOLITAN OBGYN ASSOCIATES PC | |||||
| 5724 NEW UTRECHT AVENUE | BROOKLYN | NY | 11219 | MEDICAL | $276,644 |
| ISLAND MEDICAL SPECIALISTS LLC | |||||
| 347 EDISON AVENUE | STATEN ISLAND | NY | 10306 | STAFFING | $111,555 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 541900 | $65,230,065 | $65,230,065 |
| OTHER HEALTHCARE RELATED REVENUE | 541900 | $55,692 | $55,692 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $65,285,757 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,285,757 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $65,285,757 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,789,458 | TotalAmt |
| Program Services | $33,110,512 | ProgramServicesAmt |
| Management And General | $3,678,946 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $649,175 | TotalAmt |
| Program Services | $584,258 | ProgramServicesAmt |
| Management And General | $64,917 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,997,282 | TotalAmt |
| Program Services | $9,897,554 | ProgramServicesAmt |
| Management And General | $1,099,728 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,279,568 | TotalAmt |
| Program Services | $1,151,611 | ProgramServicesAmt |
| Management And General | $127,957 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $657,047 | TotalAmt |
| Program Services | $591,343 | ProgramServicesAmt |
| Management And General | $65,704 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,911 | TotalAmt |
| Program Services | $66,520 | ProgramServicesAmt |
| Management And General | $7,391 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,201,932 | TotalAmt |
| Program Services | $11,881,739 | ProgramServicesAmt |
| Management And General | $1,320,193 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,648,373 | TotalAmt |
| Program Services | $57,283,537 | ProgramServicesAmt |
| Management And General | $6,364,836 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,368,242 | BOYAmt |
| EOY | $6,860,602 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $5,962,404 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $6,380 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $157,712 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $18,098 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $139,614 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,012 | BOYAmt |
| EOY | $1,871,869 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,420,254 | BOYAmt |
| EOY | $14,840,869 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $174,891 | BOYAmt |
| EOY | $2,653,434 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $174,891 | BOYAmt |
| EOY | $2,653,434 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,245,363 | BOYAmt |
| EOY | $12,187,435 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,245,363 | BOYAmt |
| EOY | $12,187,435 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,420,254 | BOYAmt |
| EOY | $14,840,869 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,637,384 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $7,304,688 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| Certification | Yes (X) | CertificationInd |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STATEN ISLAND UNIVERSITY HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 112868878 | EIN |
| Organization Type | 03 | OrganizationTypeDesc |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Supported Org Notified | Yes (true) | SupportedOrgNotifiedInd |
| US Organized | Yes (true) | USOrganizedInd |
| Support | $0 | SupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $157,712 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,098 | DepreciationAmt |
| Book Value | $139,614 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $139,614 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE TO AFFILIATES | $1,857,284 |
| OTHER RECEIVABLES | $14,585 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,871,869 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
| Total Liability | $0 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $65,285,757 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $65,285,757 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $65,285,757 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,637,384 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $1,637,384 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $1,637,384 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X | FormAndLineReferenceDesc |
| Explanation | Certain entities included in the System's consolidated financial statements are taxable entities under Federal or state laws. U.S. generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in income in the period of enactment. At December 31, 2013 and 2012, the System has a deferred income tax asset which has been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion, or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to the allowance for doubtful accounts receivable and net operating loss carry forwards. Certain entities have net operating loss carry forwards aggregating approximately $167,000,000, which expire in varying amounts through 2033, and are available to offset future taxable income. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRAHIM ARDOLIC MD | ||||||||||||||
| PRESIDENT - TRUSTEE | $0 | $516,416 | $0 | $0 | $0 | $0 | $0 | $25,500 | $0 | $31,286 | $0 | $573,202 | $0 | $0 |
| FRANK FORTE | ||||||||||||||
| SECRETARY - TRUSTEE | $0 | $518,806 | $0 | $0 | $0 | $0 | $0 | $25,500 | $0 | $31,415 | $0 | $575,721 | $0 | $0 |
| NICOLE BERWALD MD | ||||||||||||||
| PHYSICIAN | $315,776 | $0 | $66,373 | $0 | $0 | $0 | $10,200 | $0 | $18,628 | $0 | $410,977 | $0 | $0 | $0 |
| BORIS KHODORKOVSKY MD | ||||||||||||||
| PHYSICIAN | $309,592 | $0 | $66,585 | $0 | $0 | $0 | $10,252 | $0 | $25,128 | $0 | $411,557 | $0 | $0 | $0 |
| CHRISTOPHER GRAZIANO MD | ||||||||||||||
| PHYSICIAN | $285,641 | $0 | $64,833 | $0 | $0 | $0 | $10,200 | $0 | $24,382 | $0 | $385,056 | $0 | $0 | $0 |
| HEIDI BAER MD | ||||||||||||||
| PHYSICIAN | $291,602 | $0 | $34,553 | $0 | $0 | $0 | $10,005 | $0 | $9,079 | $0 | $345,239 | $0 | $0 | $0 |
| ABBAS HUSAIN MD | ||||||||||||||
| PHYSICIAN | $258,923 | $0 | $52,640 | $0 | $0 | $0 | $10,200 | $0 | $16,822 | $0 | $338,585 | $0 | $0 | $0 |
| MARK P JARRETT MD | ||||||||||||||
| FORMER OFFICER | $0 | $603,093 | $0 | $44,700 | $0 | $24,615 | $0 | $28,050 | $0 | $14,700 | $0 | $715,158 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I; QUESTION 7 | FormAndLineReferenceDesc |
| Explanation | ON FORM 990, PART VII, SECTION A, LINE 1A, THE ORGANIZATION MAY PROVIDE NON-FIXED PAYMENTS, NOT DESCRIBED ON LINES 5 AND 6, TO CERTAIN LISTED PERSONS. THE ORGANIZATION BASES SUCH PAYMENTS ON MANY PERFORMANCE BASED FACTORS. PAYMENTS OF THIS TYPE APPEAR ON SCHEDULE J, PART II, COLUMN B(II). | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7 | STATEN ISLAND UNIVERSITY HOSPITAL IS THE SOLE MEMBER OF THIS ORGANIZATION WHICH EXISTS THROUGH A PHYSICIAN NOMINEE AGREEMENT DUE TO STATE OF NEW YORK corporate practice of medicine RULES AND REGULATIONS. North Shore-Long Island Jewish Health Care, Inc. ("Health Care") IS THE SOLE MEMBER OF STATEN ISLAND UNIVERSITY HOSPITAL. HEALTH CARE HAS THE RIGHT TO ELECT OR APPOINT MEMBERS OF THE ORGANIZATION'S GOVERNING BODY AND HAS THE RIGHT TO APPROVE OR RATIFY CERTAIN CORPORATE DECISIONS. THIS ORGANIZATION AND HEALTHCARE ARE PART OF THE NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM, AN INTEGRATED HEALTHCARE DELIVERY SYSTEM. |
| CORE FORM, PART VI, SECTION B; QUESTION 11b | The annual Return of Organization Exempt From Income Tax (Form 990) for North Shore-LIJ Health System Inc. and Affiliated entities are prepared with input from various departments including Corporate Compliance, Finance, Human Resources, and Legal. Before filing the returns, the documents are electronically made available to all trustees through a secure online portal. Members of the Executive Committee are then informed the returns are ready for review. The Executive Committee, which is a committee made up of members from the Board of Trustees, may exercise all of the authority of the Board of Trustees except as such authority is limited by applicable law and except to the extent, if any, that such authority would be inconsistent with any provision of these By-laws or is limited by any resolution to such effect adopted by the Board of Trustees. |
| CORE FORM, PART VI, SECTION B; QUESTION 12 | The North Shore-Long Island Jewish Health System ("Health System") has several control mechanisms to mitigate conflicts of interest. The Health System's Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, our Code of Ethical Conduct requires individuals to conduct Health System business in a manner that places the interests of the Health System ahead of their personal interests. In addition, the Health System has a Conflict of Interest Policy Statement further elaborating upon individuals' disclosure and recusal obligations. Individuals that are in a position to influence the business or other decisions of the Health System are required to filL out a conflict of interest disclosure form on a regular basis. The Corporate Compliance OfficeR reviews all disclosures of possible conflicts, including matters disclosed in any conflicts of interest disclosure report and takes any actions deemed required or appropriate to manage or resolve any actual or potential conflicts of interest. In appropriate cases these disclosures and responsive actions will be reported to the Health System's Audit and Corporate Compliance Committee and other applicable committees. In addition, the Health System provides training to individuals on an annual basis regarding conflict of interest and other compliance related topics. If an individual violates the Code of Ethical Conduct or any related policy such as the Conflict of Interest Policy Statement, appropriate disciplinary action is taken based upon the facts and circumstances of the situation. |
| CORE FORM, PART VI, SECTION B; QUESTION 15 | THE BY-LAWS OF THE HEALTH SYSTEM CREATE A COMMITTEE OF THE BOARD WITH FULL POWERS OF THE BOARD TO REVIEW AND APPROVE THE COMPENSATION OF OFFICERS AND OTHER KEY EMPLOYEES. THE COMMITTEE CONSISTS OF APPROXIMATELY 6 TRUSTEES WHO HAVE NO CONNECTION TO THE SYSTEM EXCEPT AS TRUSTEES AND THEY HAVE NO CONFLICTS AS TO MATTERS THEY CONSIDER. THE COMMITTEE MEETS SEVERAL TIMES A YEAR AS NEEDED BUT ALWAYS MEETS IN NOVEMBER/DECEMBER TO REVIEW AND DETERMINE OFFICER AND KEY EMPLOYEE COMPENSATION FOR THE FOLLOWING YEAR. FOR PURPOSES OF THEIR REVIEW THE COMMITTEE CONSIDERS THE RECOMMENDATIONS OF THE CEO FOR ALL PERSONS OTHER THAN THE CEO. FOR PURPOSES OF THE REVIEW EACH YEAR THE COMMITTEE RECEIVES INFORMATION FROM AN OUTSIDE INDEPENDENT COMPENSATION CONSULTANT AS TO COMPENSATION FOR COMPARABLE POSITIONS IN COMPARABLE ORGANIZATIONS AND MAKES ITS DECISIONS ON THIS BASIS, WITH THE OVERALL OBJECTIVE OF PAYING BASE SALARY AT THE 50TH PERCENTILE. ANY CONTRACTS OR OTHER COMPENSATION FOR OFFICERS OR KEY EMPLOYEES ARE SEPARATELY CONSIDERED AND NORMALLY ONLY APPROVED AFTER RECEIPT OF A "FAIRNESS OPINION" FROM THE INDEPENDENT CONSULTANT. ALL THE WORK AND PROCESS OF THE COMMITTEE IS STRUCTURED TO FALL WITHIN THE APPLICABLE SAFE HARBOR REGULATIONS. |
| CORE FORM, PART VI, SECTION C; QUESTION 19 | CURRENTLY THE ORGANIZATION PROVIDES GOVERNANCE DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. |
| CORE FORM, PART VII, SECTION A | This organization is affiliated with the North Shore - Long Island Jewish Health System (the "Health System"). The Officers, Directors and Trustees listed on Schedule J hold similar positions with both this organization and other affiliates of the Health System, and they do not separately allocate their time to this organization and such other affiliates. The hours shown for all such persons reflect time devoted to the entire Health System and its affiliates, including this organization. For Directors and Trustees, the hours shown reflect the estimated average weekly time. For officers, Key Employees and Highest Compensated Employees, the hours shown reflect the weekly hours used when determining compensation payments for services rendered and are, generally, less than the actual weekly hours devoted to the Health System and its affiliates. |
| CORE FORM, PART VII, SECTION A | MARK P. JARRETT, M.D.; FORMER PRESIDENT OF THE ORGANIZATION, IS STILL EMPLOYED WITHIN THE NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM AS THE SVP/CHIEF QUALITY OFFICER. |
| CORE FORM, PART XI; QUESTION 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCE INCLUDE: - CASH TO ACCRUAL CONVERSION - $7,304,688. |
| CORE FORM, PART XII; QUESTION 2 | THE ORGANIZATION IS AN AFFILIATE WITHIN THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. ("SYSTEM"), A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH INCLUDES STATEN ISLAND UNIVERSITY HOSPITAL. THE SYSTEM'S TAX-EXEMPT PARENT ENTITY IS NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. AND ITS AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2013 AND DECEMBER 31, 2012; RESPECTIVELY. THESE CONSOLIDATED AUDITED FINANCIAL STATEMENTS INCLUDE CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM, INC. EXECUTIVE COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (43 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CHAPS Community Health Center Inc | ||||||||||
| 1 Edgewater Plaza 6th Floor | Staten Island | NY | 10305 | 113345477 | Inactive | NY | 501(C)(3) | 9 | SIUH | false |
| Feinstein Institute for Medical Research | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112673595 | Research | NY | 501(C)(3) | 4 | NS-LIJ HS | false |
| Forest Hills Hospital | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112163522 | HealthCare | NY | 501(C)(3) | 3 | NS-LIJ HC | false |
| Franklin Hospital | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112296824 | HealthCare | NY | 501(C)(3) | 3 | NS-LIJ HC | false |
| Glen Cove Hospital | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 111633487 | HealthCare | NY | 501(C)(3) | 3 | NS-LIJ HC | false |
| Hillside Hospital Houses Inc | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112113949 | Housing Comp | NY | 501(C)(2) | N/A | NS-LIJ HS | false |
| Hospice Care Network | ||||||||||
| 99 Sunnyside Boulevard | Woodbury | NY | 11797 | 112925757 | Hospice | NY | 501(C)(3) | 9 | NS-LIJ HS | false |
| Huntington Hospital | ||||||||||
| 270 Park Avenue | Huntington | NY | 11743 | 111630914 | HealthCare | NY | 501(C)(3) | 3 | NS-LIJ HC | false |
| Huntington Hosp Dolan Family Health Ctr | ||||||||||
| 284 Pulaski Road | Greenlawn | NY | 11740 | 113368503 | HealthCare | NY | 501(C)(3) | 3 | Huntington | false |
| LIJ Foundation | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112661239 | support org | NY | 501(C)(3) | 11, TYPE I | NS-LIJ HS | false |
| Long Island Jewish Medical Center | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112241326 | HealthCare | NY | 501(C)(3) | 3 | NS-LIJ HC | false |
| LIJ Medical Center at Home Pharmacy | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113251128 | support org | NY | 501(C)(3) | 11, TYPE I | NS-LIJ HS | false |
| North Shore Community Services Inc | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 237273200 | Housing Comp | NY | 501(C)(2) | N/A | NS-LIJ HS | false |
| North Shore University Hospital | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 111562701 | HealthCare | NY | 501(C)(3) | 3 | NS-LIJ HC | false |
| NS Univ Hospital at Glen Cove Housing | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 237010468 | Housing Comp | NY | 501(C)(2) | N/A | NS-LIJ HS | false |
| North Shore University Hospital Housing | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112171903 | Housing Comp | NY | 501(C)(2) | N/A | NS-LIJ HS | false |
| NSLIJ STERN FAMILY CENTER FOR REHAB | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 237007485 | Nursing Home | NY | 501(C)(3) | 9 | NS-LIJ HC | false |
| North Shore-LIJ Health Care Inc | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112965586 | support org | NY | 501(C)(3) | 11, TYPE I | NS-LIJ HS | false |
| North Shore-LIJ Health System | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113418133 | support org | NY | 501(C)(3) | 11, TYPE I | NA | false |
| North Shore-LIJ Health System Foundation | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112965575 | Fundraising | NY | 501(C)(3) | 7 | NS-LIJ HS | false |
| North Shore-LIJ Health Sys Laboratories | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113412370 | support org | NY | 501(C)(3) | 11, TYPE I | NS-LIJ HS | false |
| North Shore-LIJ Medical Care Centers | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113473923 | support org | NY | 501(C)(3) | 11, TYPE I | NS-LIJ HS | false |
| Plainview Hospital | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113241243 | HealthCare | NY | 501(C)(3) | 3 | NS-LIJ HC | false |
| SIUH Systems Inc | ||||||||||
| 475 Seaview Avenue | Staten Island | NY | 10305 | 061074604 | Fundraising | NY | 501(C)(3) | 7 | NS-LIJ HC | false |
| Southside Hospital | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 111667761 | HealthCare | NY | 501(C)(3) | 3 | NS-LIJ HC | false |
| SSH Inc | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112774102 | support org | NY | 501(C)(3) | 11, TYPE I | SOUTHSIDE | false |
| Staten Island Univ Hospital Foundation | ||||||||||
| 360 Seaview Avenue | Staten Island | NY | 10305 | 870765787 | Fundraising | NY | 501(C)(3) | 7 | SIUH | false |
| THE HEART INSTITUTE | ||||||||||
| 475 SEAVIEW AVENUE | STATEN ISLAND | NY | 10305 | 311757254 | SUPPORT ORG | NY | 501(C)(3) | 11, TYPE I | NA | false |
| LENOX HILL HOSPITAL | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 131624070 | HEALTHCARE | NY | 501(C)(3) | 3 | NS-LIJ HC | false |
| LHH CORPORATION | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 133272016 | SUPPORT ORG | NY | 501(C)(3) | 11, TYPE I | NS-LIJ HS | false |
| STATEN ISLAND UNIVERSITY HOSPITAL | ||||||||||
| 475 Seaview Avenue | STATEN ISLAND | NY | 10305 | 112868878 | HEALTHCARE | NY | 501(C)(3) | 3 | NS-LIJ HS | false |
| THE ELMEZZI GRAD SCHOOL OF MOLECULAR MED | ||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 113284934 | GRADUATE SCH | NY | 501(C)(3) | 2 | NS-LIJ HS | false |
| SPORTS PHYSICAL THERAPY AND REHAB SVCS | ||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 061655704 | HEALTHCARE | NY | 501(C)(3) | 9 | LIJ | false |
| NORTH SHORE - LIJ ALLIANCE | ||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 263727582 | HEALTHCARE | NY | 501(C)(3) | 3 | NA | false |
| THE LONG ISLAND HOME | ||||||||||
| 400 SUNRISE HIGHWAY | AMITYVILLE | NY | 11701 | 112837244 | HEALTHCARE | NY | 501(c)(3) | 3 | LHH CORP | false |
| CLNY ALLIANCE INC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 463146870 | LABORATORY | NY | APPLIED FOR | NJ-LIJ LABS | false | |
| NORTH SHORE-LIJ CARDIO MEDICINE PC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 275078717 | MEDICAL SVCS. | NY | 501(C)(3) | 11, TYPE 1 | NSUH | false |
| NORTH SHORE-LIJ CARDIO AT DEER PARK PC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 275078531 | MEDICAL SVCS. | NY | 501(C)(3) | 11, TYPE 1 | NSUH | false |
| NORTH SHORE-LIJ HEART SURGERY PC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 275078838 | MEDICAL SVCS. | NY | 501(c)(3) | 11, TYPE 1 | NSUH | false |
| NORTH SHORE-LIJ INTERNAL MEDICINE PC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 275078631 | MEDICAL SVCS. | NY | 501(c)(3) | 11, TYPE 1 | NSUH | false |
| NORTH SHORE-LIJ MED GROUP URG MED CARE | ||||||||||
| 275078426 | MEDICAL SVCS. | NY | 501(c)(3) | 11, TYPE 1 | NSUH | false | ||||
| NORTH SHORE-LIJ MEDICAL PC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 453023019 | MEDICAL SVCS. | NY | 501(c)(3) | 11, TYPE 1 | NSUH | false |
| NORTH SHORE-LIJ HEALTH PLAN INC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 461617516 | INSURANCE | NY | APPLIED FOR | NJ-LIJ HC | false | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (7 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeTypeTxt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|---|
| KRASNOFF CONS SVCS | ||||||||||
| 972 Brush Hollow ROAD | WESTBURY | NY | 11590 | 262838027 | CONSULTING | NY | CARE MGT GROUP | N/A | ||
| LONG ISL BEHAV HLTH | ||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 453572263 | STATISTICS | NY | NS-LIJ HC | RELATED | false | false |
| ENDOSCOPY CTR OF LI | ||||||||||
| 972 BRUSH HOLLoW ROAD | WESTBURY | NY | 11590 | 260000980 | MEDICAL SVCS. | NY | NS-LIJ VENTURES | N/A | ||
| TRUE NORTH URG CARE | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 464113494 | MEDICAL SVCS. | NY | NS-LIJ URG CARE | N/A | ||
| TRUE NORTH DC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 464601950 | MEDICAL SVCS. | NY | RENAL VENTURES | N/A | ||
| SYN HLTH TRUE NORTH | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 464106483 | MEDICAL SVCS. | NY | CENTRAL STERILE | N/A | ||
| NS-LIJ MED AIR TRAN | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 464858222 | AIR TRANSPORT | NY | NSUH | RELATED | false | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (58 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1 | CityForeignAddress/City | Province Or StateForeignAddress/ProvinceOrState | CountryForeignAddress/Country | Postal CodeForeignAddress/PostalCode | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Adv Imag & Rad of Lenox Hill Hosp PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 200719612 | Medical ServiCES | NY | LENOX HILL | C CORPORATION | false | ||||||
| Aletta Corporation | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112622371 | Physician SVCS. | NY | SOUTHSIDE | C CORPORATION | false | ||||||
| Autoimmune Research Therapeutics | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 270701489 | Inactive | NY | RESEARCH | C CORPORATION | false | ||||||
| Care Management Group of Greater NY | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113336381 | Business ServICES | NY | NSH ENTERPRISES | C CORPORATION | false | ||||||
| Emergency Med Svcs of Staten Island PC | |||||||||||||||
| 1 Edgewater Plaza 6th floor | Staten Island | NY | 10305 | 134200899 | Medical ServiCES | NY | SIUH | C CORPORATION | false | ||||||
| Goethals Radiology PC | |||||||||||||||
| 500 Seaview AveNUE | Staten Island | NY | 10305 | 200010287 | Radiology SVCS. | NY | SIUH | C CORPORATION | false | ||||||
| Lenox Hill Cardiology Associates PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 133385163 | Medical ServiCES | NY | LENOX HILL | C CORPORATION | false | ||||||
| Lenox Hill Int Card & Vasc Svcs PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 201435770 | Medical ServiES | NY | LENOX HILL | C CORPORATION | false | ||||||
| Lenox Hill Pathology PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 133644370 | Medical ServiCES | NY | LENOX HILL | C CORPORATION | false | ||||||
| Lenox Hill Phy Hospital Org Inc | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 133775996 | Managed Care | NY | LENOX HILL | C CORPORATION | false | ||||||
| Lenox otolaryngology head & neck | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 208784395 | Medical ServiES | NY | LENOX HILL | C CORPORATION | false | ||||||
| North Shore Health Enterprises | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 061605319 | Holding Comp | NY | NSHS ENTERPRISE | C CORPORATION | false | ||||||
| NS Health System Enterprises | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113316922 | Holding Comp | NY | NS-LIJ HS | C CORPORATION | false | ||||||
| North Shore IPA 5 Inc | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113383468 | Business ServICES | NY | NS-LIJ HC | C CORPORATION | false | ||||||
| NS Radiology at Glen Cove PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113301179 | Medical Services | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ Health System IPA #1 | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113533659 | HealthCare | NY | LIJ | C CORPORATION | false | ||||||
| NS-LIJ Health System IPA #2 | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113533670 | HealthCare | NY | LIJ | C CORPORATION | false | ||||||
| NS-LIJ Health System IPA #3 | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113533678 | HealthCare | NY | LIJ | C CORPORATION | false | ||||||
| NS-LIJ Health System IPA #4 | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113533677 | HealthCare | NY | LIJ | C CORPORATION | false | ||||||
| NS-LIJ Health System IPA #5 | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113533675 | HealthCare | NY | LIJ | C CORPORATION | false | ||||||
| NS-LIJ Medical Gr at Huntington PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 274384049 | Medical Services | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ Medical Gr at North Nassau PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 274384146 | Medical Services | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ Medical Gr at Syosset PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 273957752 | Medical Services | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ Medical Group PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 274384249 | Medical Services | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ Network Inc | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 320257193 | Support Services | NY | NS-LIJ HS | C CORPORATION | false | ||||||
| NS-LIJ Phys Ins Co Risk Ret Gp | |||||||||||||||
| 100 Bank Street | Burlington | VT | 05401 | 261487515 | INSURANCE | VT | NS-LIJ HC | C CORPORATION | false | ||||||
| North Shore-LIJ Physicians Group PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 274384326 | Medical Services | NY | NSUH | C CORPORATION | false | ||||||
| North Shore-LIJ Radiology Services PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 223970667 | Medical Services | NY | NSUH | C CORPORATION | false | ||||||
| North Shore-LIJ Service Alliance Inc | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 263651575 | Support Services | NY | NA | C CORPORATION | false | ||||||
| Ocean Breeze Home Care Agency | |||||||||||||||
| 1 Edgewater Plaza 6th Floor | Staten Island | NY | 10305 | 133773601 | Inactive | NY | OVM | C CORPORATION | false | ||||||
| Ocean View Management INC | |||||||||||||||
| 1 Edgewater Plaza 6th Floor | Staten Island | NY | 10305 | 133138888 | Management Svcs. | NY | SIUH | C CORPORATION | false | ||||||
| Palliative Care Medical Services PC | |||||||||||||||
| 99 Sunnyside Boulevard | Woodbury | NY | 11797 | 273957835 | Medical Services | NY | HOSPICE | C CORPORATION | false | ||||||
| Park Lenox Emergency Medicine PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 262661082 | Medical Services | NY | LENOX HILL | C CORPORATION | false | ||||||
| Park Lenox Medical PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 133575380 | Medical Services | NY | LENOX HILL | C CORPORATION | false | ||||||
| Park Lenox Pediatrics PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 133755683 | Medical Services | NY | LENOX HILL | C CORPORATION | false | ||||||
| Park Lenox Surgical PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 133397814 | Medical Services | NY | LENOX HILL | C CORPORATION | false | ||||||
| Regency Alliance Services Inc | |||||||||||||||
| 1 Edgewater Plaza 6th Floor | Staten Island | NY | 10305 | 133277698 | inactive | NY | OVM | C CORPORATION | false | ||||||
| Regional Insurance Company LTD | |||||||||||||||
| insurance | NS-LIJ HC | C CORPORATION | false | 41 Cedar Ave | Hamilton | BERMUDA | BD | HM 12 | BD | ||||||
| Regioncare Inc | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113052191 | Homecare | NY | NSHS ENTERPRISE | C CORPORATION | false | ||||||
| Staten Island Hospitalists PC | |||||||||||||||
| 475 Seaview Avenue | Staten Island | NY | 10305 | 331010283 | Medical Services | NY | SIUH | C CORPORATION | false | ||||||
| Staten Island Imaging Corp | |||||||||||||||
| 1 Edgewater Plaza 6th Floor | Staten Island | NY | 10305 | 133615474 | Inactive | NY | OVM | C CORPORATION | false | ||||||
| Staten Island Medical Intensivist PC | |||||||||||||||
| 501 Seaview Avenue Suite 102 | Staten Island | NY | 10305 | 043716494 | Medical Services | NY | SIUH | C CORPORATION | false | ||||||
| Staten Island Neonatology PC | |||||||||||||||
| 500 Seaview Avenue | Staten Island | NY | 10305 | 133375474 | Medical Services | NY | SIUH | C CORPORATION | false | ||||||
| SIUH Perinatology PC | |||||||||||||||
| 475 Seaview Avenue | Staten Island | NY | 10305 | 134107082 | Medical Services | NY | SIUH | C CORPORATION | false | ||||||
| United Medical Surgical PC | |||||||||||||||
| 256 Mason Avenue BLDG B 2nd FL | Staten Island | NY | 10305 | 134038780 | Surgical Services | NY | SIUH | S CORPORATION | false | ||||||
| Univ Ph OncHematology Gp PC | |||||||||||||||
| 500 Seaview Avenue | Staten Island | NY | 10305 | 133642729 | Medical Services | NY | SIUH | C CORPORATION | false | ||||||
| Verrazano Radiology Assoc PC | |||||||||||||||
| 500 Seaview Avenue Suite 200 | Staten Island | NY | 10305 | 200011201 | Radiology Svcs. | NY | SIUH | C CORPORATION | false | ||||||
| Vivohealth Inc | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 264118016 | Inactive | NY | NSH ENTERPRISE | C CORPORATION | false | ||||||
| LENOX HILL HOSPITAL MEDICAL PC | |||||||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 452661543 | Medical Services | NY | lenox | C CORPORATION | false | ||||||
| NS-LIJ OCCUPATIONAL MEDICINE PC | |||||||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 451004103 | Medical Services | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ OB-GYN PC | |||||||||||||||
| 972 Brush Hollow Road | WESTBURY | NY | 11590 | 461382916 | Medical Services | NY | lij | c corporation | false | ||||||
| NS-LIJ ANESTHESIOLOGY PC | |||||||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 461617561 | Medical ServiCES | NY | SOUTHSIDE | C CORPORATION | false | ||||||
| NS-LIJ INTERNAL MEDICINE AT LYNBROOK PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 463475908 | MEDICAL SERVICES | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ INTERNAL MEDICINE NEW HYDE PARK | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 462822879 | MEDICAL SERVICES | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ OB-GYN AT GARDEN CITY PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 462886776 | MEDICAL SERVICES | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ HEALTH PLAN HOLDING INC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 462478147 | INSURANCE | NY | NJ-LIJ HC | C CORPORATION | false | ||||||
| NS-LIJ CARECONNECT INSURANCE COMPANY | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 462270382 | INSURANCE | NY | NJ-LIJ HTH PLAN | C CORPORATION | false | ||||||
| NORTH SHORE MEDICAL ACCELERATOR PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | Westbury | NY | 11590 | 112945979 | MEDICAL SERVICES | NY | nsuh | S CORPORATION | false | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART V | FormAndLineReferenceDesc |
| Explanation | THIS ORGANIZATION IS AN AFFILIATE OF North Shore - long Island Jewish Health System ("sYSTEM"). ORGANIZATIONS WITHIN THE SYSTEM ROUTINELY PAY EXPENSES FOR VARIOUS AFFILIATES IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED. | ExplanationTxt |