HUDSON VISTA PHYSICIAN SERVICES PC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- HUDSON VISTA PHYSICIAN SERVICES PC (EIN 27-2020746)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201313189349306121
- Schema version
- 2012v2.3
- 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) |
|---|---|---|
| Timestamp | 2013-11-14T15:12:18-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VANACOREDEBENEDICTUSDIGOVANNI&WEDDELL | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| 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 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 272020746 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUDSON VISTA PHYSICIAN SERVICESPC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HUDS | NameControl |
| Phone | 8455682580 | Phone |
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 |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DR SCOT BLACKSTONE HILL | Name |
| Title | MEDICAL DIRECTOR | Title |
| Phone | 8455682580 | Phone |
| Date Signed | 2013-11-12 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVIDE DIGENOVA CPA | Name |
| Phone | 8455679000 | Phone |
| Date Prepared | 2013-11-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DR SCOT BLACKSTONE HILL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| 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 | 7295022 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2010 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE EMERGENCY PHYSICIAN SERVICES AND OTHER LICENSED HEALTH CARE PROFESSIONALS TO ST. LUKE'S CORNWALL HOSPITAL PATIENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 1 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 39 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1790709 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1004981 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5575830 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6290041 | ProgramServiceRevenueCY |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7366539 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7295022 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 6160493 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6310107 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1206046 | OtherExpensePriorYear |
| Other Expenses Current Year | 984915 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7366539 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7295022 | TotalExpensesCurrentYear |
| Revenues Less Expenses CY | 0 | RevenuesLessExpensesCY |
| Total Assets BOY | 888335 | TotalAssetsBOY |
| Total Assets EOY | 791610 | TotalAssetsEOY |
| Total Liabilities BOY | 888335 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 791610 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances EOY | 0 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDE EMERGENCY PHYSICIAN SERVICES AND OTHER LICENSED HEALTH CARE PROFESSIONALS TO ST. LUKE'S CORNWALL HOSPITAL PATIENTS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 5908967 | Expense |
| Revenue | 6290041 | Revenue |
| Description | EMERGENCY PHYSICIAN SERVICES. | Description |
| Total Program Service Expense | 5908967 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 5 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 39 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 1 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARY ELIZABETH DUFFY | NamePerson |
| Telephone Number | 8455682026 | TelephoneNumber |
Address US AddressUS
| 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 Form990PartVIISectionA (8 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| MARY ELIZABETH DUFFY | |||||||
| SECRETARY | 1.00 | 40.00 | X | 0 | 356264 | 42443 | |
| ROBERT S ROSS | |||||||
| ASSISTANT SE | 1.00 | 40.00 | X | 0 | 347098 | 48804 | |
| SCOT BLACKSTONE HILL | |||||||
| MEDICAL DIRE | 40.00 | X | 325774 | 0 | 7928 | ||
| ALAN MADELL | |||||||
| ER PHYSICIAN | 40.00 | 347051 | 0 | 13466 | X | ||
| JOEL CHAISE | |||||||
| ER PHYSICIAN | 40.00 | 304751 | 0 | 22198 | X | ||
| SAMUEL JONES | |||||||
| ER PHYSICIAN | 40.00 | 291898 | 0 | 0 | X | ||
| DANIEL SINGER | |||||||
| ER PHYSICIAN | 40.00 | 261103 | 0 | 7928 | X | ||
| BERNADETTE BRANDON | |||||||
| ER PHYSICIAN | 40.00 | 217275 | 0 | 7928 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1747852 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 703362 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 150695 | TotalOtherCompensation |
| Number Individuals GT100 K | 19 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Business Name Line2NameOfContractor/NameBusiness/BusinessNameLine2 | Address Line1AddressOfContractor/AddressUS/AddressLine1 | Address Line2AddressOfContractor/AddressUS/AddressLine2 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|---|---|
| WEATHERBY LOCUMS INC | |||||||
| WEATHERBY LOCUMS INC | PO BOX 972633 | PO BOX 972633 | DALLAS | TX | 75397 | PHYSICIAN STAFF | 1124230 |
| PST SERVICES INC DBA PER SE TECH | |||||||
| BANK OF AMERICA LOCKBOX SERVICES | BOX 403421 | 6000 FELDWOOD RD | COLLEGE PARK | GA | 30349 | BILLING | 376670 |
| MOUNT SINAI SCHOOL OF MEDICINE | |||||||
| DEPARTMENT OF EMERGENCY MEDICINE | 1 GUSTAVE LEVY PLACE | BOX 1620 | NEW YORK | NY | 10029 | OVERSIGHT CONTR | 175000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Related Organizations | 1004981 | RelatedOrganizations |
| Total Contributions | 1004981 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NET PATIENT REVENUE | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 6290041 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6290041 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6290041 | TotalProgramServiceRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7295022 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6290041 | RelatedOrExemptFunctionIncome |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 333702 | Total |
| Program Services | 270299 | ProgramServices |
| Management And General | 63403 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5336489 | Total |
| Program Services | 4322556 | ProgramServices |
| Management And General | 1013933 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 639916 | Total |
| Program Services | 518332 | ProgramServices |
| Management And General | 121584 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27568 | Total |
| Program Services | 22330 | ProgramServices |
| Management And General | 5238 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2697 | Total |
| Program Services | 2185 | ProgramServices |
| Management And General | 512 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41124 | Total |
| Program Services | 33310 | ProgramServices |
| Management And General | 7814 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1527 | Total |
| Program Services | 1237 | ProgramServices |
| Management And General | 290 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3167 | Total |
| Program Services | 2565 | ProgramServices |
| Management And General | 602 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 361773 | Total |
| Program Services | 293036 | ProgramServices |
| Management And General | 68737 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CONTRACTED SERVICES | 456562 | 369815 | 86747 |
| FINANCIAL COLLECTION SERV | 73715 | 59709 | 14006 |
| TRAINING AND EDUCATION | 16782 | 13593 | 3189 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7295022 | Total |
| Program Services | 5908967 | ProgramServices |
| Management And General | 1386055 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88392 | BOY |
| EOY | 169254 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 799943 | BOY |
| EOY | 622356 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 888335 | BOY |
| EOY | 791610 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 732580 | BOY |
| EOY | 719791 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155755 | BOY |
| EOY | 71819 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 888335 | BOY |
| EOY | 791610 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 888335 | BOY |
| EOY | 791610 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 0 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation
Name Name
| 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 |
| Type Of Organization | 3 | TypeOfOrganization |
| Listed In Governing Doc | true | ListedInGoverningDoc |
| Supported Organization Notified | false | SupportedOrganizationNotified |
| Organized In US | false | OrganizedInUS |
| Amount | $0 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 1 | TotalNumberOfSupportedOrgs |
| General Explanation | PROVIDE EMERGENCY PHYSICIAN SERVICES AND OTHER LICENSED HEALTH CARE PROFESSIONALS TO ST. LUKE'S CORNWALL HOSPITAL PATIENTS. | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO ST. LUKE'S HOSPITAL | Description |
| Amount | $71,819 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 71819 | TotalOfAmounts |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)
| TitleTitle | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARY ELIZABETH DUFFY | ||||||||||||
| SECRETARY | 294013 | 30000 | 32251 | 35375 | 7068 | 398707 | ||||||
| ROBERT S ROSS | ||||||||||||
| ASSISTANT SECRETARY | 285557 | 30000 | 31541 | 35375 | 13429 | 395902 | ||||||
| SCOT BLACKSTONE HILL | ||||||||||||
| MEDICAL DIRECTOR | 286468 | 15000 | 24306 | 7928 | 333702 | |||||||
| ALAN MADELL | ||||||||||||
| ER PHYSICIAN | 260322 | 61457 | 25272 | 6543 | 360517 | 6923 | ||||||
| JOEL CHAISE | ||||||||||||
| ER PHYSICIAN | 252300 | 28145 | 24306 | 22198 | 326949 | |||||||
| SAMUEL JONES | ||||||||||||
| ER PHYSICIAN | 282317 | 9581 | 291898 | |||||||||
| DANIEL SINGER | ||||||||||||
| ER PHYSICIAN | 202183 | 58765 | 155 | 7928 | 269031 | |||||||
| BERNADETTE BRANDON | ||||||||||||
| ER PHYSICIAN | 164063 | 34590 | 18622 | 7928 | 225203 | |||||||
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | THE ORGANIZATION HAS ONE SOLE STOCKHOLDER. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | 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. |
| ENFORCEMENT OF CONFLICTS POLICY | 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. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | 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. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)
| Business Name Line2NameOfDisregardedEntity/BusinessNameLine2 | Address Line1AddressUS/AddressLine1 | Address Line2AddressUS/AddressLine2 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 | PF | 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 | N/A | false |
| HUDSON VISTA MEDICAL PC | ||||||||||||
| HUDSON VISTA MEDICAL PC | 70 DUBOIS STREET | 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 272020746 | MED SERV | NY | 501C3 | 3 | N/A | false |
| HUDSON VISTA CORPORATION | ||||||||||||
| HUDSON VISTA CORPORATION | 70 DUBOIS STREET | 70 DUBOIS STREET | NEWBURGH | NY | 12550 | 222286782 | GOVERNANCE | NY | 501C3 | 7 | N/A | false |
Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)
| Business Name Line2NameOfRelatedOrg/BusinessNameLine2 | Address Line1AddressForeign/AddressLine1 | Address Line2AddressForeign/AddressLine2 | Province Or StateAddressForeign/ProvinceOrState | CountryAddressForeign/Country | Primary ActivityPrimaryActivity | Legal Domicile Foreign CountryLegalDomicileForeignCountry | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Address Line1AddressUS/AddressLine1 | Address Line2AddressUS/AddressLine2 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Legal Domicile StateLegalDomicileState |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SLCH INSURANCE CAPTIVE LTD | |||||||||||||||
| SLCH INSURANCE CAPTIVE LTD | PO BOX HM 2274 | PO BOX HM 2274 | 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 Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |