HUDSON VISTA PHYSICIAN SERVICES PC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- HUDSON VISTA PHYSICIAN SERVICES PC (EIN 27-2020746)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201433189349306553
- 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 | 2014-11-14T13:37:49-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 141604297 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VANACOREDEBENEDICTUSDIGOVANNI&WEDDELL | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 RACQUET RD | AddressLine1 |
| City | NEWBURGH | City |
| State | NY | State |
| ZIP Code | 12550 | 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 | 272020746 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUDSON VISTA PHYSICIAN SERVICESPC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HUDS | BusinessNameControlTxt |
| Phone | 8454584025 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 DUBOIS STREET C/O JM CASSIDY | AddressLine1 |
| City | NEWBURGH | City |
| State | NY | State |
| ZIP Code | 12550 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR SCOT BLACKSTONE HILL | PersonNm |
| Person Title | MEDICAL DIRECTOR | PersonTitleTxt |
| Phone | 8454584025 | PhoneNum |
| Signature | 2014-11-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVIDE DIGENOVA CPA | PreparerPersonNm |
| PTIN | P00955704 | PTIN |
| Phone | 8455679000 | PhoneNum |
| Preparation | 2014-11-06 | PreparationDt |
| 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 | DR SCOT BLACKSTONE HILL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 DUBOIS STREET | AddressLine1 |
| City | NEWBURGH | City |
| State | NY | State |
| ZIP Code | 12550 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,684,284 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE EMERGENCY PHYSICIAN SERVICES AND OTHER LICENSED HEALTH CARE PROFESSIONALS TO ST. LUKE'S CORNWALL HOSPITAL PATIENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 1 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 43 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,004,981 | PYContributionsGrantsAmt |
| CY Contributions Grants | $791,199 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,290,041 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,893,085 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,295,022 | PYTotalRevenueAmt |
| CY Total Revenue | $11,684,284 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,310,107 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,411,102 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $984,915 | PYOtherExpensesAmt |
| CY Other Expenses | $5,273,182 | CYOtherExpensesAmt |
| PY Total Expenses | $7,295,022 | PYTotalExpensesAmt |
| CY Total Expenses | $11,684,284 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $0 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $791,610 | TotalAssetsBOYAmt |
| Total Assets EOY | $853,445 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $791,610 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $853,445 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE EMERGENCY PHYSICIAN SERVICES AND OTHER LICENSED HEALTH CARE PROFESSIONALS TO ST. LUKE'S CORNWALL HOSPITAL PATIENTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $9,351,149 | ExpenseAmt |
| Revenue | $10,893,085 | RevenueAmt |
| Desc | EMERGENCY PHYSICIAN SERVICES. | Desc |
| Total Program Service Expenses | $9,351,149 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | 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 | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 43 | 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 1 | 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 | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEAN MARIE CASSIDY | PersonNm |
| Phone | 8454584025 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 DUBOIS STREET | AddressLine1 |
| Address Line2 | 70 DUBOIS STREET | AddressLine2 |
| City | NEWBURGH | City |
| State | NY | State |
| ZIP Code | 12550 | ZIPCode |
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 |
|---|---|---|---|---|---|---|---|---|
| ROBERT S ROSS | ||||||||
| ASSISTANT SE | 40.00 | 1.00 | Yes (X) | Yes (X) | $0 | $368,331 | $46,399 | |
| SCOT BLACKSTONE HILL | ||||||||
| MEDICAL DIRE | 40.00 | Yes (X) | $349,806 | $0 | $22,355 | |||
| MARY ELIZABETH DUFFY | ||||||||
| SECRETARY | 1.00 | 40.00 | Yes (X) | $0 | $347,479 | $41,200 | ||
| JARRETT LEFBERG | ||||||||
| ER PHYSICIAN | 40.00 | $374,414 | $0 | $23,749 | Yes (X) | |||
| ALAN MADELL | ||||||||
| ER PHYSICIAN | 40.00 | $351,884 | $0 | $34,559 | Yes (X) | |||
| JOEL CHAISE | ||||||||
| ER PHYSICIAN | 40.00 | $337,734 | $0 | $32,973 | Yes (X) | |||
| MICHELLE GRACIA-RYBKIN | ||||||||
| ER PHYSICIAN | 40.00 | $337,048 | $0 | $16,575 | Yes (X) | |||
| SAMUEL JONES | ||||||||
| ER PHYSICIAN | 40.00 | $309,918 | $0 | $17,481 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,060,804 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $715,810 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $235,291 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 23 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Business Name Line2ContractorName/BusinessName/BusinessNameLine2 | Address Line1ContractorAddress/USAddress/AddressLine1 | Address Line2ContractorAddress/USAddress/AddressLine2 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|---|---|
| WEATHERBY LOCUMS INC | |||||||
| WEATHERBY LOCUMS INC | PO BOX 972633 | PO BOX 972633 | DALLAS | TX | 75397 | PHYSICIAN STAFF | $501,333 |
| PST SERVICES INC DBA PER SE TECH | |||||||
| BANK OF AMERICA LOCKBOX SERVICES | BOX 403421 | 6000 FELDWOOD RD | COLLEGE PARK | GA | 30349 | BILLING | $359,279 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $791,199 | RelatedOrganizationsAmt |
| Total Contributions | $791,199 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $10,893,085 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,893,085 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,893,085 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,684,284 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,893,085 | RelatedOrExemptFuncIncomeAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $372,161 | TotalAmt |
| Program Services | $301,450 | ProgramServicesAmt |
| Management And General | $70,711 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,389,442 | TotalAmt |
| Program Services | $4,311,554 | ProgramServicesAmt |
| Management And General | $1,077,888 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $110,481 | TotalAmt |
| Program Services | $88,385 | ProgramServicesAmt |
| Management And General | $22,096 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $539,018 | TotalAmt |
| Program Services | $431,214 | ProgramServicesAmt |
| Management And General | $107,804 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,315 | TotalAmt |
| Program Services | $19,452 | ProgramServicesAmt |
| Management And General | $4,863 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,400 | TotalAmt |
| Program Services | $6,720 | ProgramServicesAmt |
| Management And General | $1,680 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,029 | TotalAmt |
| Program Services | $55,223 | ProgramServicesAmt |
| Management And General | $13,806 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,310 | TotalAmt |
| Program Services | $5,048 | ProgramServicesAmt |
| Management And General | $1,262 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $369,853 | TotalAmt |
| Program Services | $295,882 | ProgramServicesAmt |
| Management And General | $73,971 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $4,246,507 | $3,397,206 | $849,301 |
| CONTRACTED SERVICES | $424,612 | $339,690 | $84,922 |
| COLLECTION FEES | $74,699 | $59,759 | $14,940 |
| RECRUITING | $26,000 | $20,800 | $5,200 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,457 | TotalAmt |
| Program Services | $18,766 | ProgramServicesAmt |
| Management And General | $4,691 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,684,284 | TotalAmt |
| Program Services | $9,351,149 | ProgramServicesAmt |
| Management And General | $2,333,135 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $169,254 | BOYAmt |
| EOY | $105,507 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $622,356 | BOYAmt |
| EOY | $747,938 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $791,610 | BOYAmt |
| EOY | $853,445 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $719,791 | BOYAmt |
| EOY | $853,445 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,819 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $791,610 | BOYAmt |
| EOY | $853,445 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $791,610 | BOYAmt |
| EOY | $853,445 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $0 | ReconcilationRevenueExpnssAmt |
| 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 | ST LUKE'S CORNWALL HOSPITALL | BusinessNameLine1 |
| Business Name Line2 | ST LUKE'S CORNWALL HOSPITALL | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 141340054 | EIN |
| Organization Type | 3 | OrganizationTypeDesc |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Supported Org Notified | false | SupportedOrgNotifiedInd |
| US Organized | false | USOrganizedInd |
| Support | $0 | SupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
Form990 Schedule A Part IV Form990ScheduleAPartIVGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SUPPLEMENTAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | PART I, LINE 11(H)(VII) PROVIDE EMERGENCY PHYSICIAN SERVICES AND OTHER LICENSED HEALTH CARE PROFESSIONALS TO ST. LUKE'S CORNWALL HOSPITAL PATIENTS. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT S ROSS | ||||||||||||
| ASSISTANT SECRETARY | $329,167 | $39,164 | $34,075 | $12,324 | $414,730 | |||||||
| SCOT BLACKSTONE HILL | ||||||||||||
| MEDICAL DIRECTOR | $325,000 | $24,806 | $16,575 | $5,780 | $372,161 | |||||||
| MARY ELIZABETH DUFFY | ||||||||||||
| SECRETARY | $290,063 | $32,416 | $34,075 | $7,125 | $388,679 | $25,000 | ||||||
| JARRETT LEFBERG | ||||||||||||
| ER PHYSICIAN | $270,669 | $17,878 | $5,765 | $17,984 | $398,163 | $85,867 | ||||||
| ALAN MADELL | ||||||||||||
| ER PHYSICIAN | $263,387 | $25,772 | $17,984 | $16,575 | $386,443 | $62,725 | ||||||
| JOEL CHAISE | ||||||||||||
| ER PHYSICIAN | $260,453 | $25,735 | $16,575 | $16,398 | $370,707 | $51,546 | ||||||
| MICHELLE GRACIA-RYBKIN | ||||||||||||
| ER PHYSICIAN | $275,038 | $18,130 | $16,575 | $353,623 | $43,880 | |||||||
| SAMUEL JONES | ||||||||||||
| ER PHYSICIAN | $262,278 | $8,895 | $16,575 | $906 | $327,399 | $38,745 | ||||||
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 6 | THE ORGANIZATION HAS ONE SOLE STOCKHOLDER. |
| FORM 990, PAGE 6, PART VI, LINE 7A | EACH SHAREHOLDER OF THE CORPORATION (A "SHAREHOLDER") SHALL, AT THE TIME OF ISSUANCE OF THE SHARES AND AT ALL TIMES WHILE OWNING OR HOLDING THE SHARES, BE EMPLOYED BY, OR OTHERWISE SUBJECT TO THE CONTROL AND DIRECTION OF, ST. LUKE'S CORNWALL HOSPITAL BYLAWS. AS REQUIRED BY SECTION 703 OF THE BCL, ALL DIRECTORS OF THE CORPORATION SHALL BE ELECTED BY THE SHAREHOLDER(S). |
| FORM 990, PAGE 6, PART VI, LINE 7B | EACH SHAREHOLDER OF THE CORPORATION (A "SHAREHOLDER") SHALL, AT THE TIME OF ISSUANCE OF THE SHARES AND AT ALL TIMES WHILE OWNING OR HOLDING THE SHARES, BE EMPLOYED BY, OR OTHERWISE SUBJECT TO THE CONTROL AND DIRECTION OF, ST. LUKE'S CORNWALL HOSPITAL BYLAWS. AS REQUIRED BY SECTION 703 OF THE BCL, ALL DIRECTORS OF THE CORPORATION SHALL BE ELECTED BY THE SHAREHOLDER(S). |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WAS SENT TO THE GOVERNING BODY BEFORE IT WAS FILED FOR THEIR REVIEW. NO ISSUES WERE RAISED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION ENFORCES THEIR CONFLICT OF INTEREST POLICY BY ISSUING AN ANNUAL CONFLICT OF INTEREST DISCLOSURE STATEMENT WHICH MUST BE FILLED OUT, SIGNED AND DATED BY ALL BOARD MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 15A | ST. LUKE'S CORNWALL HOSPITAL'S HUMAN RESOURCES DEPARTMENT EVALUATES ALL COMPENSATION PACKAGES FOR TOP MANAGEMENT OFFICIALS. THE HUMAN RESOURCES DEPARTMENT REVIEWS EACH POSITION USING PUBLISHED EXTERNAL SALARY SURVEYS TO DETERMINE FAIR AND EQUITABLE SALARIES. POSITIONS ARE EVALUATED AGAINST HOSPITALS OF SIMILAR BED, FULL-TIME EMPLOYEES, AND REVENUE SIZE IN THE NORTHEAST AND GREATER NY REGION. ALL RESULTS ARE SHARED AND REVIEWED WITH THE APPLICABLE VICE PRESIDENT. |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Business Name Line2DisregardedEntityName/BusinessNameLine2 | Address Line1USAddress/AddressLine1 | Address Line2USAddress/AddressLine2 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Business Name Line2DirectControllingEntityName/BusinessNameLine2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ST LUKE'S CORNWALL HOSPITAL | ||||||||||||||
| ST LUKE'S CORNWALL HOSPITAL | 70 DUBOIS STREET | 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 141340054 | HOSPITAL | NY | 501C3 | 3 | N/A | false | ||
| ST LUKE'S CORNWALL HEALTH SYSTEM | ||||||||||||||
| ST LUKE'S CORNWALL HEALTH SYSTEM | 70 DUBOIS STREET | 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 223026261 | SUPPORT | NY | 501C3 | 7 | N/A | false | ||
| AMOS F & SARAH L HOLDEN HOME | ||||||||||||||
| AMOS F & SARAH L HOLDEN HOME | 73 GRAND STREET | 73 GRAND STREET | NEWBURGH | NY | 12550 | 141365995 | ELDER CARE | NY | 501C3 | 9 | N/A | false | ||
| GOLDSMITH D & MARY B JOHNES HOME | ||||||||||||||
| GOLDSMITH D & MARY B JOHNES HOME | 70 DUBOIS STREET | 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 141364666 | ELDER CARE | NY | 501C3 | 9 | N/A | false | ||
| ST LUKE'S CORNWALL HEALTH SYS FND | ||||||||||||||
| ST LUKE'S CORNWALL HEALTH SYS FND | 70 DUBOIS STREET | 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 223026263 | SUPPORT | NY | 501C3 | 7 | false | SLCH | SLCH | |
| HUDSON VISTA MEDICAL PC | ||||||||||||||
| HUDSON VISTA MEDICAL PC | 70 DUBOIS STREET | 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 272020746 | MED SERV | NY | 501C3 | 3 | false | SLCH | SLCH | |
| HUDSON VISTA CORPORATION | ||||||||||||||
| HUDSON VISTA CORPORATION | 70 DUBOIS STREET | 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 222286782 | GOVERNANCE | NY | 501C3 | 7 | N/A | false | ||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Business Name Line2RelatedOrganizationName/BusinessNameLine2 | Address Line1ForeignAddress/AddressLine1 | Address Line2ForeignAddress/AddressLine2 | CityForeignAddress/City | Province Or StateForeignAddress/ProvinceOrState | CountryForeignAddress/Country | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Address Line1USAddress/AddressLine1 | Address Line2USAddress/AddressLine2 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SLCH INSURANCE CAPTIVE LTD | ||||||||||||||||
| SLCH INSURANCE CAPTIVE LTD | PO BOX HM 2274 | PO BOX HM 2274 | HAMILTON | HAMILTON HM JX | BD | INSURANCE | BD | N/A | false | |||||||
| SLCH CORP | ||||||||||||||||
| SLCH CORP | DORMANT | N/A | false | 70 DUBOIS STREET | 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 141765661 | NY | ||||||
| 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 | Yes (true) | 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 | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | 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 |