CENTRAL SUFFOLK HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL SUFFOLK HOSPITAL (EIN 11-1661359)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-14
- IRS object ID
- 201313189349308281
- Schema version
- 2012v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-14T17:35:20-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 131517563 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOEB & TROPER LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 655 THIRD AVENUE 12TH FLOOR | AddressLine1 |
| City | NEW YORK | City |
| State | NY | State |
| ZIP Code | 10017 | 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 | 111661359 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL SUFFOLK HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CENT | NameControl |
| Phone | 6315486064 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1 |
| City | RIVERHEAD | City |
| State | NY | State |
| ZIP Code | 11901 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANDREW MITCHELL | Name |
| Title | PRESIDENT/CEO | Title |
| Phone | 6315486064 | Phone |
| Date Signed | 2013-11-13 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | FREDERICK H ROTHMAN | Name |
| PTIN | P01275277 | PTIN |
| Phone | 2128674000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PECONIC BAY MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | ANDREW MITCHELL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1 |
| City | RIVERHEAD | City |
| State | NY | State |
| ZIP Code | 11901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 144680100 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PBMEDICALCENTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1951 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | CENTRAL SUFFOLK HOSPITAL (CSH) IS A NOT-FOR-PROFIT HOSPITAL CONSISTING OF 122 ACUTE CARE BEDS, A 60-BED SKILLED NURSING FACILITY AND A CERTIFIED HOME CARE AGENCY. CSH PROVIDES A FULL RANGE OF HEALTH CARE SERVICES TO THE LOCAL COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 24 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 22 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1309 | TotalNbrEmployees |
| Total Nbr Volunteers | 170 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2165400 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 8915623 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 145939986 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 133860699 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 80244 | InvestmentIncomePriorYear |
| Investment Income Current Year | 47893 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1394754 | OtherRevenuePriorYear |
| Other Revenue Current Year | 798951 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 149580384 | TotalRevenuePriorYear |
| Total Revenue Current Year | 143623166 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 70972866 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 77138387 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 77640 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 75956724 | OtherExpensePriorYear |
| Other Expenses Current Year | 61178596 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 146929590 | TotalExpensesPriorYear |
| Total Expenses Current Year | 138316983 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 2650794 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 5306183 | RevenuesLessExpensesCY |
| Total Assets BOY | 106938694 | TotalAssetsBOY |
| Total Assets EOY | 119049801 | TotalAssetsEOY |
| Total Liabilities BOY | 100323749 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 104485885 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6614945 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 14563916 | NetAssetsOrFundBalancesEOY |
| Mission Description | CENTRAL SUFFOLK HOSPITAL (CSH) IS A NOT-FOR-PROFIT HOSPITAL CONSISTING OF 122 ACUTE CARE BEDS, A 60-BED SKILLED NURSING FACILITY AND A CERTIFIED HOME CARE AGENCY. CSH PROVIDES A FULL RANGE OF HEALTH CARE SERVICES TO THE LOCAL COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 106504076 | Expense |
| Revenue | 133860699 | Revenue |
| Description | COMPREHENSIVE HEALTHCARE SERVICES INCLUDING EMERGENCY, SURGICAL, MEDICAL, ICU AND OBSTETRICS/GYNECOLOGICAL. TOTAL PATIENT DAYS FOR ALL INPATIENT SERVICES WERE 50,885. TOTAL OUTPATIENT VISITS WERE 101,758. | Description |
| Total Program Service Expense | 106504076 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 1 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 1 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 82 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 2 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1309 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 24 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 22 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | NY | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAEL F O'DONNELL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6315486074 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1 |
| City | RIVERHEAD | City |
| State | NY | State |
| ZIP Code | 11901 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (36 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| ANDREW MITCHELL | |||||||||
| CHIEF EXECUTIVE OFFICER | 27.50 | 10.00 | X | X | 526998 | 191636 | 53708 | ||
| GERARD ZUNNO | |||||||||
| VP PATIENT CARE SERVICES | 37.50 | X | X | 204964 | 0 | 23891 | |||
| JESSE R GOODALE | |||||||||
| CHAIRMAN | 1.00 | X | X | 0 | 0 | 0 | |||
| SHERRY PATTERSON | |||||||||
| VICE CHAIR | 15.00 | X | X | 0 | 0 | 0 | |||
| J GORDON HUSZAGH | |||||||||
| 2ND VICE CHAIRMAN | 15.00 | X | X | 0 | 0 | 0 | |||
| CHARLES MASSOUD | |||||||||
| TREASURER | 15.00 | X | X | 0 | 0 | 0 | |||
| ANDREW MENDELSON | |||||||||
| SECRETARY | 15.00 | X | X | 0 | 0 | 0 | |||
| MARC ALESSI | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| KENN BARRA | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| JAMES R FARRELL | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| ROBERT GAFFNEY | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| JOSEPH GERGELA | |||||||||
| BOARD MEMBER | 10.00 | X | 0 | 0 | 0 | ||||
| EDWARD HARBES | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| RICHARD ISRAEL | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| JOAN LEVAN | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| MARILYN A MCLAUGHLIN | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| RICHARD V MUSTO | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| RICHARD RUBENSTIEN | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| SCOTT B SHEREN | |||||||||
| BOARD MEMBER | 10.00 | X | 0 | 0 | 0 | ||||
| WILLIAM SIEMERS | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| GEORGE SUMMERS | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| MAUREEN TOBIN | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| RICHARD L WINSLOW | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| JOSEPH VAN DE WETERING | |||||||||
| BOARD MEMBER | 1.00 | X | 0 | 0 | 0 | ||||
| ALAN SCHECHTER | |||||||||
| SENIOR VICE PRESIDENT | 37.50 | X | 291367 | 0 | 26972 | ||||
| MICHAEL O'DONNELL | |||||||||
| CHIEF FINANCIAL OFFICER | 37.50 | X | 257591 | 0 | 33909 | ||||
| DEMETRIOS KADENAS | |||||||||
| CHIEF DEVELOPMENT OFFICER | 37.50 | X | 155062 | 0 | 8162 | ||||
| JAY ZUCKERMAN | |||||||||
| CORPORATE COMPLIANCE OFFICER | 37.50 | X | 142897 | 0 | 4245 | ||||
| RONALD MCMANUS | |||||||||
| VP OPERATIONS | 37.50 | 202861 | 0 | 32710 | X | ||||
| RICHARD KUBIAK | |||||||||
| VP MEDICAL AFFAIRS | 37.50 | 318862 | 0 | 34213 | X | ||||
| CHERYL MAKOSKE | |||||||||
| VP FINANCIAL SERVICES | 37.50 | 171093 | 0 | 21077 | X | ||||
| PETER SULTAN MD | |||||||||
| PHYSICIAN | 37.50 | 829603 | 0 | 34213 | X | ||||
| DAVID PRENTISS | |||||||||
| PHYSICIAN | 37.50 | 261883 | 0 | 6484 | X | ||||
| MAHMOOD AFGHANI | |||||||||
| PHYSICIAN | 37.50 | 212217 | 0 | 28898 | X | ||||
| RICHARD MALESKI | |||||||||
| PHYSICIAN | 37.50 | 186936 | 0 | 14970 | X | ||||
| FAISAL HAMID | |||||||||
| PHYSICIAN | 37.50 | 182426 | 0 | 27325 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3944760 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 191636 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 350777 | TotalOtherCompensation |
| Number Individuals GT100 K | 97 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| SIEMENS | |||||
| PO BOX 7777W3580 | PHILADELPHIA | PA | 19175 | INFORMATION TECHNOLOGY | 1959937 |
| SODEXO | |||||
| PO BOX 81049 | WOBURN | MA | 01813 | CAFETERIA | 1382725 |
| STONY BROOK UNIVERSITY HOSPITAL | |||||
| 31 RESEARCH WAY | EAST SETAUKET | NY | 11733 | EMERGENCY ROOM | 1343454 |
| CROTHALL FACILITIES | |||||
| 955 CHESTERBROOK BLVD | WAYNE | PA | 19087 | HOUSEKEEPING | 494314 |
| EUGENE KRAUSS | |||||
| 833 NORTHERN BLVD | GREAT NECK | NY | 11021 | PROFESSIONAL MEDICAL SERVICES | 414583 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 27 | NumberOfContractorsGT100K |
| Fundraising Events | 259204 | FundraisingEvents |
| Government Grants | 3743669 | GovernmentGrants |
| All Other Contributions | 4912750 | AllOtherContributions |
| Total Contributions | 8915623 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT CARE | 621400 | 133703419 | 133703419 |
| PROVISION OF MEDICAL SERVICES BY | 621110 | 157280 | 157280 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 133860699 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 71956 | TotalRevenueColumn |
| Exclusion | $71,956 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 931823 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 955886 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -24063 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -24063 | TotalRevenueColumn |
| Exclusion | -$24,063 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 41500 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 259204 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 101048 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -59548 | TotalRevenueColumn |
| Exclusion | -$59,548 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| MISCELLANEOUS REVENUE | 900000 | 463879 | $463,879 |
| X-RAY SCHOOL TUITION | 611430 | 202519 | $202,519 |
| CAFETERIA | 624210 | 192101 | $192,101 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 858499 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 143623166 | TotalRevenueColumn |
| Related Or Exempt Function Income | 133860699 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $846,844 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2430663 | Total |
| Management And General | 2430663 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 55258326 | Total |
| Program Services | 42548910 | ProgramServices |
| Management And General | 12709416 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6962787 | Total |
| Program Services | 5361346 | ProgramServices |
| Management And General | 1601441 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8444933 | Total |
| Program Services | 6502598 | ProgramServices |
| Management And General | 1942335 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4041678 | Total |
| Program Services | 3112092 | ProgramServices |
| Management And General | 929586 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 765658 | Total |
| Management And General | 765658 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 189996 | Total |
| Management And General | 189996 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11924 | Total |
| Program Services | 11924 | ProgramServices |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13063755 | Total |
| Program Services | 10059091 | ProgramServices |
| Management And General | 3004664 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 294942 | Total |
| Program Services | 217302 | ProgramServices |
| Fundraising | 77640 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27389199 | Total |
| Program Services | 20556683 | ProgramServices |
| Management And General | 6832516 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 408941 | Total |
| Management And General | 408941 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1615368 | Total |
| Program Services | 1615368 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115267 | Total |
| Program Services | 88756 | ProgramServices |
| Management And General | 26511 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3588437 | Total |
| Program Services | 3588437 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5396402 | Total |
| Program Services | 5396402 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3756216 | Total |
| Program Services | 3756216 | ProgramServices |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | NEW YORK STATE ASSESSME | Description |
| Total | 706282 | Total |
| Program Services | 706282 | ProgramServices |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3876209 | Total |
| Program Services | 2982669 | ProgramServices |
| Management And General | 893540 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 138316983 | Total |
| Program Services | 106504076 | ProgramServices |
| Management And General | 31735267 | ManagementAndGeneral |
| Fundraising | 77640 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11098521 | BOY |
| EOY | 13350611 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6723958 | BOY |
| EOY | 6102830 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 3815070 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15220717 | BOY |
| EOY | 14969476 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3119724 | BOY |
| EOY | 4201170 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2008956 | BOY |
| EOY | 3277580 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 652678 | BOY |
| EOY | 653411 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 132045769 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 72263216 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57524691 | BOY |
| EOY | 59782553 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3824746 | BOY |
| EOY | 4845519 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6764703 | BOY |
| EOY | 8051581 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106938694 | BOY |
| EOY | 119049801 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18849528 | BOY |
| EOY | 19892668 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40180000 | BOY |
| EOY | 38260000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4004118 | BOY |
| EOY | 3493626 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37290103 | BOY |
| EOY | 42839591 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100323749 | BOY |
| EOY | 104485885 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3580911 | BOY |
| EOY | 8057925 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2247126 | BOY |
| EOY | 5719083 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 786908 | BOY |
| EOY | 786908 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6614945 | BOY |
| EOY | 14563916 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106938694 | BOY |
| EOY | 119049801 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 5306183 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 322330 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 2320458 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $11,924 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 11924 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | PORTION OF MEMBERSHIP DUES ASSOCIATED WITH LOBBYING ACTIVITIES | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Collect Used For Public Exhibition | X | CollectUsedForPublicExhibition |
| Solicited Assets For Sale | 0 | SolicitedAssetsForSale |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 786908 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 36084 | InvestmentEarningsOrLosses |
| Other Expenditures | 36084 | OtherExpenditures |
| End Of Year Balance | 786908 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 786908 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1368 | InvestmentEarningsOrLosses |
| Other Expenditures | 1368 | OtherExpenditures |
| End Of Year Balance | 786908 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 786908 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 61625 | InvestmentEarningsOrLosses |
| Other Expenditures | 61625 | OtherExpenditures |
| End Of Year Balance | 786908 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 786908 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 90497 | InvestmentEarningsOrLosses |
| Other Expenditures | 90497 | OtherExpenditures |
| End Of Year Balance | 786908 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 786908 | BeginningOfYearBalance |
| End Of Year Balance | 786908 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 380654 | OtherCostOrOtherBasis |
| Book Value | 380654 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 42545034 | OtherCostOrOtherBasis |
| Depreciation | 31933572 | Depreciation |
| Book Value | 10611462 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 82238672 | OtherCostOrOtherBasis |
| Depreciation | 39468885 | Depreciation |
| Book Value | 42769787 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6881409 | OtherCostOrOtherBasis |
| Depreciation | 860759 | Depreciation |
| Book Value | 6020650 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 59782553 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| EQUITY INTEREST IN THE CENTRAL SUFFOLK HOSPITAL FOUNDATION/ DBA PECONIC BAY | 3388344 |
| DEFERRED EXPENSES | 2454160 |
| ESTIMATED DUE FROM THIRD PARTY PAYORS | 2209077 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 8051581 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED MALPRACTICE COSTS | $9,295,000 |
| ESTIMATED DUE TO THIRD-PARTY PAYORS | $5,692,805 |
| CAPITAL LEASES PAYABLE | $4,057,177 |
| DUE TO AFFILIATE | $9,000,000 |
| SWAP LIABILTY | $9,500,718 |
| ACCRUED PENSION COSTS | $5,293,891 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 42839591 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 146265954 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 322330 | NetUnrealizedGainsInvestments |
| Other Revenues | 2320458 | OtherRevenues |
| Revenue Not Rptd F990 | 2642788 | RevenueNotRptdF990 |
| Revenue Subtotal | 143623166 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 143623166 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 138316983 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 138316983 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 138316983 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| PART III, LINE 4: | THE DONATED ARTWORK PROVIDES A SOOTHING AND CALMING ENVIRONMENT TO THE PATIENTS AND THEIR FAMILIES WHEN THEY ATTEND THE HOSPITAL FOR MEDICAL SERVICES. THE HOSPITAL HOPES THAT WITH A GOOD EXPERIENCE, THEIR PATIENTS CONTINUE TO UTILIZE THE HOSPITAL TO PROVIDE MEDICAL SERVICES. | |
| PART V, LINE 4: | ENDOWMENT FUNDS HAVE BEEN RESTRICED BY DONORS TO BE MAINTAINED BY CSH IN PERPETUITY, THE INCOME FROM WHICH IS AVAILABLE FOR GENERAL PURPOSES. | DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: |
| PART X, LINE 2: | CSH ADOPTED THE PROVISION PERTAINING TO UNCERTAIN TAX POSITIONS, ASC TOPIC 740, AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. TAX RETURNS FOR THE YEARS DECEMBER 31, 2009 AND SUBSEQUENT REMAIN SUBJECT TO EXAMINATION BY APPLICABLE TAXING AUTHORITIES. | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: |
| LOSS ON SWAP AGREEMENT -75,054. PENSION ADJUSTMENTS 1,975,786. CHANGE IN EQUITY INTEREST IN CENTRAL SUFFOLK HOSPITAL FOUNDATION 419,726. | PART XI, LINE 2D - OTHER ADJUSTMENTS: |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | ANNUAL BALL | NameOfEvent1 |
| Gross Receipts Event1 | 300704 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 259204 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 41500 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 20000 | CashPrizesEvent1 |
| Rent Facility Costs Event1 | 5449 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 39823 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 11250 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 24526 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 300704 | GrossReceiptsTotal |
| Charitable Contributions Total | 259204 | CharitableContributionsTotal |
| Gross Revenue Total Events | 41500 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 20000 | CashPrizesTotalEvents |
| Rent Facility Costs Total Events | 5449 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 39823 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 11250 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 24526 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 101048 | DirectExpenseSummaryEvents |
| Net Income Summary | -59548 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 241381 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 273728 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -32347 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17132978 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12385954 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4747024 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03430 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17374359 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 12659682 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4714677 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03430 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 4025670 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1530574 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2495096 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01800 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 9182678 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3263463 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 5919215 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04280 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 13208348 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4794037 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8414311 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06080 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 30582707 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 17453719 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 13128988 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.09510 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $4,422,402 | BadDebtExpenseAmount |
| Amount Attributable To | 17275006 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 42214934 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 50628054 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -8413120 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PECONIC BAY MEDICAL CENTER | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1 |
| City | RIVERHEAD | City |
| State | NY | State |
| ZIP Code | 11901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PECONIC BAY MEDICAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 0 | UsesFPGFree |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300.000000000000 | FPGDiscountPercent |
| Explains Basis | 0 | ExplainsBasis |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Permit Lawsuit | X | PermitLawsuit |
| Permit Lien On Residence | X | PermitLienOnResidence |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| Lien On Residence | X | LienOnResidence |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERHEAD MANAGEMENT CORPORATION | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1 |
| City | REVERHEAD | City |
| State | NY | State |
| ZIP Code | 11901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | MANAGEMENT SERVICE ORGANIZATION | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (5 entries)
| ExplanationExplanation | IdentifierIdentifier |
|---|---|
| PART III, LINE 4: BAD DEBT EXPENSES ON ACCOUNTS RECEIVABLE AND CONTRIBUTIONS RECEIVABLE ARE CHARGED IF THE RECEIVABLE IS DETERMINED TO BE UNCOLLECTIBLE BASED ON PERIODIC REVIEW BY MANAGEMENT. FACTORS USED TO DETERMINE WHETHER AN ALLOWANCE SHOULD BE RECORDED INCLUDE THE AGE OF THE RECEIVABLE AND A REVIEW OF PAYMENTS SUBSEQUENT TO YEAR END. | |
| PART III, LINE 9B: PECONIC BAY MEDICAL CENTER TAKES THE DISCOUNTED AMOUNT AFTER CHARITY (SELF PAY BALANCE) AND FOLLOWS THE SAME GUIDELINES AS SELF PAY. | |
| PART V, SECTION B, LINE 20D: RATES OF THE HIGHEST VOLUME PAYOR. | PECONIC BAY MEDICAL CENTER |
| PART VI, LINE 2: PECONIC BAY MEDICAL CENTER WAS AN ACTIVE PARTICIPANT IN THE COLLABORATIVE PLANNING PROCESS WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH AND COMMUNITY PARTNERS TO ASSESS COMMUNITY HEALTH NEEDS IDENTIFY HEALTH PRIORITIES AND DEVELOP PUBLIC HEALTH PROGRAMS TO MEET THE IDENTIFIED NEEDS. THIS COLLABORATIVE GROUP MET FROM THE FALL OF 2008 THROUGH AUGUST OF 2009, AND SELECTED TOBACCO USE AND UNINTENTIONAL INJURY AS THE TWO HEALTH PRIORITIES IDENTIFIED IN THE NEW YORK STATE PREVENTION AGENDA TOWARD THE HEALTHIEST STATE.SMOKING CESSATION WAS SELECTED BECAUSE THE USE OF TOBACCO IS THE NUMBER ONE UNDERLYING RISK FACTOR FOR MULTIPLE DISEASES. MOREOVER, NASSAU AND SUFFOLK COUNTIES SUFFER FROM SOME OF THE HIGHEST MORTALITY RATES FROM HEART DISEASE IN NEW YORK STATE. UNINTENTIONAL INJURIES WAS SELECTED AS A PRIORITY GIVEN THE FACT THAT SUFFOLK COUNTY HAS A RELATIVELY HIGH MORTALITY RATE FOR UNINTENTIONAL INJURIES WHEN COMPARED TO NEW YORK STATE AND NATIONALLY. THE GROUP ALSO AGREED THAT GIVEN THE SHORTAGE OF RESOURCES AVAILABLE TO ADVANCE PUBLIC HEALTH AGENDAS, IT WAS IMPORTANT TO SELECT PRIORITIES THAT COULD BUILD ON PROGRAMS THAT ARE ALREADY IN PLACE.BOTH SMOKING CESSATION AND PROGRAMS TO REDUCE UNINTENTIONAL INJURIES ACCOMPLISH THIS GOAL. ONE OF THE PRIORITY INITIATIVES FOR THE SUFFOLK COUNTY OFFICE OF HEALTH EDUCATION IS TO DEVELOP AND IMPLEMENT EFFECTIVE ANTI-SMOKING PROGRAMS THAT WILL REDUCE THE RATE OF TOBACCO USE IN SCHOOL-AGED CHILDREN. IN ADDITION, MANY OF THE HOSPITALS IN SUFFOLK COUNTY, INCLUDING PECONIC BAY MEDICAL CENTER HAVE PROGRAMS AND SUPPORT GROUPS IN PLACE TO WORK WITH THEIR EMPLOYEES AND COMMUNITY BASED ORGANIZATIONS TO REDUCE SMOKING. COMMUNITY BASED PROGRAMS AUGMENT COUNTY AND HOSPITAL EFFORTS IN REDUCING TOBACCO USE. THE TOBACCO ACTION COALITION AND HEALTHY MOTHERS/HEALTHY BABY COALITION WILL BE SOUGHT OUT TO ENGAGE IN COLLABORATIVE EFFORTS AS WELL.THERE ARE ALSO A NUMBER OF EXISTING PROGRAMS IN SUFFOLK COUNTY THAT HAVE DEVELOPED STRATEGIES FOR REDUCING THE INCIDENCE OF UNINTENTIONAL INJURIES. THE COUNTY'S BUREAU OF PUBLIC HEALTH NURSING PROVIDES HOME HEALTH CARE SERVICES FOR PATIENTS SUFFERING THE SEQUELAE OF UNINTENTIONAL INJURIES. THE COUNTY ALSO PROVIDES EDUCATION AND SUPPORT TO MOTHERS AND CHILDREN AIMED AT PREVENTING INJURIES FROM BURNS. A PARTNERSHIP BETWEEN ST. JOSEPHS COLLEGE AND THE SUFFOLK COUNTY DEPARTMENT OF HEALTH SERVICES HAS HELP IDENTIFY THE APPROPRIATE TARGET POPULATION FOR EDUCATION AND INTERVENTIONS TO REDUCE THESE INJURIES. FINALLY, ARTICLE 6 FUNDS CAN BE USED BY THE SUFFOLK COUNTY HEALTH DEPARTMENT CONSISTENT WITH NEW YORK STATE'S HEALTH AGENDA TO REDUCE THESE INJURIES.THESE TWO PRIORITIES WILL BE A MAJOR OPERATIONAL COMMITMENT OF PECONIC BAY MEDICAL CENTER OVER THE NEXT THREE YEARS. THE MEDICAL CENTER WILL CONTINUE TO COLLABORATE WITH THE SUFFOLK COUNTY DEPARTMENT OF HEALTH AND COMMUNITY PARTNERS IN ENSURING THAT WE REACH THE GOALS SET FOR THESE TWO PRIORITY AREAS, MEASURE PROGRESS IN ACHIEVING THESE GOALS AND ELIMINATING RACIAL, ETHNIC AND SOCIOECONOMIC HEALTH DISPARITIES WHERE THEY EXIST.ONCE THE PLANNING GROUP ADOPTED THESE PRIORITIES, REPRESENTATIVES FROM THE SUFFOLK COUNTY DEPARTMENT OF HEALTH, SUFFOLK COUNTY HOSPITALS, INCLUDING PECONIC BAY MEDICAL CENTER AND COMMUNITY REPRESENTATIVES DIVIDED INTO TWO WORK GROUPS. EACH WORK GROUP WAS CHARGED WITH DEVELOPING A SET OF RECOMMENDATIONS TO IMPLEMENT EFFECTIVE STRATEGIES TO ADDRESS BOTH HEALTH CARE PRIORITIES. | |
| PART VI, LINE 4: THE MEDICAL CENTER'S PRIMARY SERVICE AREA INCLUDES THE FOLLOWING ZIP CODES: RIVERHEAD (11901); CALVERTON (11933): MANORVILLE (11949). THESE ZIP CODES ACCOUNT FOR FIFTY PERCENT OF THE MEDICAL CENTER'S TOTAL DISCHARGES.THE MEDICAL CENTER'S SECONDARY SERVICE AREA INCLUDES THE FOLLOWING ZIP CODES: HAMPTON BAYS (1946); EAST QUOGUE (11942); MATTITUCK (11952); WESTHAMPTON BEACH (11978); EASTPORT (11941); CENTER MORICHES (11934); EAST MORICHES (11940); WESTHAMPTON (11977); CUTCHOGUE (11935); SHIRLEY (11967); WADING RIVER (11792): SOUTHOLD (11971); RIDGE (11961); MASTIC (11950); GREENPORT (11944); AND LAUREL (11948). THESE ZIP CODES ACCOUNT FOR THIRTY-FIVE PERCENT OF THE MEDICAL CENTER'S TOTAL DISCHARGES.THE SERVICE HAS MORE THAN 191,000 RESIDENTS AND THE POPULATION IS EXPECTED TO GROW BY FIVE PERCENT FROM 2008 TO 2013. AS THE POPULATION OF THIS REGION CONTINUES TO GROW AND IS DRIVING INCREASED DEMAND FOR HEALTH CARE SERVICES, THE MEDICAL CENTER HAS RESPONDED BY MAKING CAPITAL INVESTMENTS IN EMERGENCY ROOM AND SURGICAL SERVICES, AND THE RECRUITMENT OF PHYSICIANS TO BE ABLE TO MEET THESE NEEDS.THE SERVICE AREA HAS A SIGNIFICANTLY HIGHER PERCENTAGE OF ELDERLY THAN SUFFOLK COUNTY, NASSAU COUNTY AND NEW YORK STATE. APPROXIMATELY ONE IN FIVE RESIDENTS OF THE MEDICAL CENTER'S SERVICE AREA ARE OVER THE AGE OF FIFTY-FIVE,THE POPULATION THAT DRIVES HIGHER DEMAND FOR HEALTH CARE SERVICES. MOREOVER, THIS AGE COHORT IS EXPECTED TO INCREASE AS A PERCENTAGE OF THE TOTAL POPULATION OVER THE NEXT FIVE YEARS.THE HOSPITAL HAS DEVELOPED PROGRAMS, ENHANCED ORTHOPEDICS AND NEUROSURGICAL SERVICES, ENHANCED HOME HEALTH CARE AND SKILLED NURSING SERVICES THAT ARE SPECIFICALLY GEARED TOWARDS MEETING THE UNIQUE HEALTH CARE NEEDS OF THIS POPULATION.TO THE EXTENT THAT THERE ARE HEALTH CARE DISPARITIES BASED ON RACE AND ETHNICITY, THE EAST END OF SUFFOLK COUNTY FACES A CHALLENGE WITH A HIGH PROPORTION OF MINORITY RESIDENTS -- AN AVERAGE OF TWENTY PERCENT -- BUT AS HIGH AS THIRTY-THREE PERCENT IN SOME OF THE PRIMARY AND SECONDARY SERVICE AREAS.THERE ARE NO FIRM ESTIMATES OF THE NUMBER OF MIGRANT AGRICULTURAL WORKERS THAT COME INTO THIS AREA. AGRICULTURE IS ONE OF SUFFOLK COUNTY'S LEADING INDUSTRIES. ITS SUCCESS RELIES ON WORKERS WHO MOVE THROUGH THE EASTERN UNITED STATES IN RESPONSE TO THE AVAILABILITY OF SEASONAL WORK. PECONIC BAY MEDICAL CENTER RECOGNIZES THAT THIS POPULATION PRESENTS SERIOUS HEALTH PROBLEMS AND IS COMMITTED TO PROVIDING CARE FOR ITS CULTURALLY DIVERSE PATIENT POPULATION. MANY OF THESE INDIVIDUALS ARE UNINSURED AND UNABLE TO SPEAK ENGLISH. THEY RELY ON THE MEDICAL CENTERS EMERGENCY DEPARTMENT, AS WELL AS THE SUFFOLK COUNTY HEALTH CLINIC, LOCATED IN RIVERHEAD, FOR HEALTH CARE. THE HOSPITAL PROVIDES BI-LINGUAL PUBLICATIONS AND SIGNAGE AND ACTIVELY ASSISTS THE CULTURALLY DIVERSE COMMUNITIES THAT ARE CARED FOR AT THE MEDICAL CENTER.PUBLIC PARTICIPATION:PECONIC BAY MEDICAL CENTER HAS AN EXTENSIVE PROGRAM OF COMMUNITY OUTREACH THAT IS COMPLEMENTED BY THE EFFORTS OF THE EAST END HEALTH ALLIANCE, THE MEDICAL CENTER'S ACTIVE PARENT. INPUT ON THE COMMUNITY SERVICE PLAN IS RECEIVED FROM BOTH INTERNAL AND EXTERNAL SOURCES. NEEDS ARE ASSESSED ON AN ANNUAL BASIS BY THE BOARD OF TRUSTEES, MEDICAL CENTER MANAGEMENT AND STAFF, VOLUNTEERS, AND LEADERS OF LOCAL NOT-FOR-PROFIT ORGANIZATIONS AND GOVERNMENTAL AGENCIES.COMMUNITY PROGRAMS ARE PUBLICIZED IN A VARIETY OF WAYS: DIRECT MAIL, FLYERS, CALENDAR LISTINGS, E-MAIL COMMUNICATIONS, TELEPHONE INFORMATION LINES, NEWSPRINT ADVERTISING, AND LOCAL CABLE TELEVISION. COMMUNITY MEMBERS ARE ENCOURAGED TO OFFER INPUT ON PECONIC BAY MEDICAL CENTER'S COMMUNITY PROGRAMS BY E-MAIL AND VIA SURVEYS COLLECTED AT PUBLIC EVENTS. THE MEDICAL CENTER'S PRESIDENT AND CHIEF EXECUTIVE OFFICER AND OTHER SENIOR STAFF REGULARLY MEET WITH COMMUNITY GROUPS FROM THE EAST END REGION OF LONG ISLAND TO KEEP AREA RESIDENTS INFORMED ABOUT MEDICAL CENTER PROGRAMS AND TO RECEIVE FEEDBACK AND FIELD QUESTIONS FROM THE COMMUNITY.THE MEDICAL CENTER'S WEB SITE WWW.PBMEDICALCENTER.ORG OFFERS A USER-FRIENDLY FORMAT AND EASY ACCESS TO INFORMATION ON MEDICAL CENTER SERVICES AND PROGRAMS. IN ADDITION, THE SITE ALLOWS FOR PHYSICIAN SEARCHES, ON-LINE INQUIRIES AND ON-LINE JOB APPLICATIONS.SERVICES FOR SHORT-TERM AND LONG-TERM CARE FOR CHRONIC AND ACUTE ILLNESS ARE CONTINUALLY EVALUATED THROUGH STATISTICAL DATA THAT INCLUDE QUALITY INDICATORS AND PATIENT OUTCOMES. THIS DATA IS COMPARED NATIONALLY WITH OTHER HEALTH FACILITIES AND INFORMS THE HOSPITAL'S STRATEGIC PLAN AND COMMUNITY SERVICE PLAN. THE MEDICAL CENTER'S STRATEGIC PLANNING COMMITTEE INCLUDES COMMUNITY MEMBERS, MEDICAL CENTER STAFF AND MEDICAL CENTER AND FOUNDATION BOARD MEMBERS WHO WORK COLLABORATIVELY TO ASSESS COMMUNITY NEEDS AND DEVELOP STRATEGIES TO MEET THESE NEEDS. THE EXTERNAL AFFAIRS COMMITTEE WAS ESTABLISHED TO ENHANCE COMMUNICATION BETWEEN THE MEDICAL CENTER AND THE COMMUNITIES IT SERVES. MEMBERS OF THE COMMITTEE INCLUDE A CROSS-SECTION OF PHYSICIANS, NURSES, MEDICAL CENTER MANAGEMENT, MEDICAL CENTER EMPLOYEES AND COMMUNITY VOLUNTEERS.THE MEDICAL CENTER HAS A LONGSTANDING COMMITMENT AND EXPERIENCE IN OUTREACH HAVING ADMINISTERED THE SUFFOLK COUNTY DEPARTMENT OF HEALTH'S WOMEN'S HEALTH PARTNERSHIP FOR THE PAST FIVE YEARS. THIS PROGRAM PROVIDES NO-COST BREAST CANCER SCREENING AND DIAGNOSTIC SERVICES TO WOMEN WHO ARE UNINSURED, AS WELL AS SCREENING FOR PROSTATE, COLORECTAL AND GYNECOLOGIC ONCOLOGY FOR BOTH MEN AND WOMEN. IT ALSO PROVIDES PATIENT NAVIGATION AND COORDINATION OF SERVICES FOR WOMEN DIAGNOSED WITH BREAST AND CERVICAL CANCER THROUGH THE SCREENING PROGRAM. THE MEDICAL CENTER PROVIDES INFORMATION AND SUPPORT SERVICES IN SPANISH TO ACCOMMODATE THOSE WOMEN WHO ARE NOT PROFICIENT IN ENGLISH. THE PARTNERSHIP MODEL WAS CONCEIVED AND IMPLEMENTED BASED ON THE PRINCIPLE THAT COMMUNITY MEMBERS ARE THE BEST PEOPLE TO IDENTIFY THE NEEDS OF THEIR COMMUNITY AND TO CARRY OUT A PLAY OF ACTION THAT ADDRESSES THOSE NEEDS.RESPONDING TO THE NEEDS OF THE COMMUNITY FOR OBSTETRICAL CARE, INCLUDING THOSE WHO ARE UNDER OR UNINSURED, PECONIC BAY MEDICAL CENTER PROVIDES OBSTETRICAL AND GYNECOLOGICAL SERVICES TO THE SUFFOLK COUNTY HEALTH CENTER. IN ADDITION, A SEPARATE GROUP OF PRIMARY CARE PHYSICIANS PROVIDE CARE TO ANY RIVERHEAD HEALTH CENTER PATIENT WHO NEEDS TO BE ADMITTED TO THE MEDICAL CENTER. IN CONJUNCTION WITH SUFFOLK COUNTY, THE MEDICAL CENTER OPERATES A SECURED FORENSIC UNIT FOR INMATES OF THE SUFFOLK COUNTY JAIL WHO REQUIRE HOSPITALIZATION. THE MEDICAL CENTER PROVIDES FREE FLU SHOTS TO RESIDENTS OF THE COMMUNITY WHO ARE AT HIGH RISK FOR INFLUENZA. THE MEDICAL CENTER ALSO HAS RESPONDED TO COMMUNITY NEEDS BY SPONSORING A NUMBER OF COMMUNITY HEALTH FAIRS OFFERING FREE BLOOD PRESSURE, CHOLESTEROL AND GLUCOSE SCREENINGS AS WELL AS PROVIDING IMPORTANT HEALTH AND WELLNESS INFORMATION. THESE HEALTH FAIRS ALSO CREATE THE OPPORTUNITY FOR MEDICAL CENTER STAFF TO OBTAIN IMPORTANT COMMUNITY FEEDBACK, INFORMATION THAT IS SHARED WITH MEDICAL CENTER LEADERSHIP AND CONSIDERED IN FUTURE COMMUNITY OUTREACH.SUPPORTING THIS EDUCATIONAL OUTREACH AND OPPORTUNITY FOR COMMUNITY INPUT, THE MEDICAL CENTER HAS A SPEAKERS BUREAU THAT PROVIDES PROFESSIONAL INPUT RELATED TO HEALTH AND WELLNESS TOPICS, HEALTH HEART DIET, TREATING OVARIAN CANCER, ETC.BASED ON COMMUNITY INPUT, THE MEDICAL CENTER HAS ALSO LAUNCHED PROJECT CARE IN CONJUNCTION WITH STONY BROOK UNIVERSITY'S SCHOOL OF HEALTH MANAGEMENT AND TECHNOLOGY. THIS PROGRAM PROVIDES IN-HOME MONITORING FOR HIGH-RISK PATIENTS THAT WOULD OTHERWISE HAVE DIFFICULTY ACCESSING CARE. THE MEDICAL CENTER HAS ALSO RESPONDED TO COMMUNITY INPUT FROM THE REGIONS AMBULANCE CORPS AND WITH THE SUPPORT OF STONY BROOK PROVIDES THREE FIRST RESPONDER VEHICLES THAT AUGMENT THE LOCAL EMS DURING PEAK HOURS.PBMC WAS SUCCESSFUL IN OBTAINING FUNDING FOR A PATIENT TRANSPORTATION VAN THAT PROVIDES TRANSPORT ROOM OUR SKILLED NURSING FACILITY FOR MEDICAL SERVICES, AS WELL AS PATIENTS FROM OTHER COMMUNITY NURSING HOMES THAT MAY NEED RADIOLOGY OR LABORATORY TESTING.COMMUNITY ORGANIZATION PARTICIPATION: THE HOSPITAL ALSO ROUTINELY SEEKS FEEDBACK FROM COMMUNITY MEMBERS WHO PARTICIPATE IN OUR COMMUNITY OUTREACH PROGRAMS. PECONIC BAY MEDICAL CENTER HAS SIGNIFICANT REPRESENTATION ON A WIDE-RANGE OF COMMUNITY ORGANIZATIONS THAT FACILITATE INPUT FROM RESIDENTS, CORPORATE AND COMMUNITY LEADERS, PATIENTS AND ALLIED HEALTH PROFESSIONS. THIS PARTICIPATION SUPPORTS EFFECTIVE INPUT FROM THE COMMUNITY THROUGH MEDICAL CENTER STAFF AND MEDICAL CENTER TRUSTEE PARTICIPATION COMPLEMENTED BY A CONTINUAL AND OPEN DIALOGUE WITH RESPECTED COMMUNITY LEADERS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANDREW MITCHELL | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | 388548 | 141290 | 125400 | 45600 | 13050 | 4746 | 17967 | 6533 | 21419 | 7789 | 566384 | 205958 | 0 | 0 |
| GERARD ZUNNO | ||||||||||||||
| VP PATIENT CARE SERVICES | 203218 | 0 | 0 | 0 | 1746 | 0 | 6082 | 0 | 17809 | 0 | 228855 | 0 | 0 | 0 |
| ALAN SCHECHTER | ||||||||||||||
| SENIOR VICE PRESIDENT | 283833 | 0 | 0 | 0 | 7534 | 0 | 7500 | 0 | 19472 | 0 | 318339 | 0 | 0 | 0 |
| MICHAEL O'DONNELL | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 256799 | 0 | 0 | 0 | 792 | 0 | 7196 | 0 | 26713 | 0 | 291500 | 0 | 0 | 0 |
| DEMETRIOS KADENAS | ||||||||||||||
| CHIEF DEVELOPMENT OFFICER | 154957 | 0 | 0 | 0 | 105 | 0 | 0 | 0 | 8162 | 0 | 163224 | 0 | 0 | 0 |
| RONALD MCMANUS | ||||||||||||||
| VP OPERATIONS | 201931 | 0 | 0 | 0 | 930 | 0 | 5997 | 0 | 26713 | 0 | 235571 | 0 | 0 | 0 |
| RICHARD KUBIAK | ||||||||||||||
| VP MEDICAL AFFAIRS | 317548 | 0 | 0 | 0 | 1314 | 0 | 7500 | 0 | 26713 | 0 | 353075 | 0 | 0 | 0 |
| CHERYL MAKOSKE | ||||||||||||||
| VP FINANCIAL SERVICES | 170766 | 0 | 0 | 0 | 327 | 0 | 5049 | 0 | 16028 | 0 | 192170 | 0 | 0 | 0 |
| PETER SULTAN MD | ||||||||||||||
| PHYSICIAN | 417569 | 0 | 411129 | 0 | 905 | 0 | 7500 | 0 | 26713 | 0 | 863816 | 0 | 0 | 0 |
| DAVID PRENTISS | ||||||||||||||
| PHYSICIAN | 261530 | 0 | 0 | 0 | 353 | 0 | 6484 | 0 | 0 | 0 | 268367 | 0 | 0 | 0 |
| MAHMOOD AFGHANI | ||||||||||||||
| PHYSICIAN | 212074 | 0 | 0 | 0 | 143 | 0 | 2185 | 0 | 26713 | 0 | 241115 | 0 | 0 | 0 |
| RICHARD MALESKI | ||||||||||||||
| PHYSICIAN | 186713 | 0 | 0 | 0 | 223 | 0 | 5234 | 0 | 9736 | 0 | 201906 | 0 | 0 | 0 |
| FAISAL HAMID | ||||||||||||||
| PHYSICIAN | 182307 | 0 | 0 | 0 | 119 | 0 | 612 | 0 | 26713 | 0 | 209751 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 3 | THE HOSPITAL UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS PERFORMED IN 2012 |
| PART I, LINE 4B | ANDREW MITCHELL - $17,000 |
| PART I, LINE 5 | THE MEDICAL CENTER HAS A CONTRACTUAL ARRANGEMENT FOR A PHYSICIAN ENTITLING THE PHYSICIAN TO ADDITIONAL COMPENSATION BASED UPON CASH COLLECTIONS. |
| PART I, LINE 7 | PERFORMANCE BASED ON BOARD DISCRETION. AN EMPLOYMENT AGREEMENT IS IN PLACE WITH THE HOSPITAL WITH THE CEO |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| TOWN OF RIVERHEAD INDUSTRIAL DEVELOPMENT AGENCY | ||||||||
| A | 112560077 | 768765AB5 | 2006-06-23 | 35000000 | CONSTRUCTION OF FACILITY AND REFUNDING OF PRIOR ISSUE (8/12/1993) | 0 | 0 | 0 |
| TOWN OF RIVERHEAD INDUSTRIAL DEVELOPMENT AGENCY | ||||||||
| B | 112560077 | 768765AE9 | 2007-06-27 | 12000000 | CONSTRUCTION OF FACILITY | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Bond ReferenceBondReferenceCd | Amount RetiredAmountRetired | Total ProceedsTotalProceeds | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 7945000 | 36622284 | 700000 | 359652 | 24392812 | 11169820 | 2008 | 1 | 0 | 1 | 1 | ||
| B | 795000 | 12350712 | 240000 | 307959 | 11752481 | 2009 | 0 | 0 | 1 | 1 | 5009217 | 50272 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Term Of HedgeTermOfHedge | Superintegrated HedgeSuperintegratedHedge | Hedge TerminatedHedgeTerminated | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Business Name Line1NameOfGICProvider/BusinessNameLine1 | Term Of GICTermOfGIC | Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HSBC BANK | |||||||||||||||
| A | 0 | 0 | 1 | 1 | 1 | 1 | 25.000000000000 | 0 | 0 | 1 | MBIA INC | 2.200000000000 | 1 | 0 | 0 |
| HSBC BANK | |||||||||||||||
| B | 0 | 0 | 0 | 1 | 1 | 1 | 25.000000000000 | 0 | 0 | 0 | 0 | 0 | |||
Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | 0 |
| B | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | RICHARD ISRAEL | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | BOARD MEMBER | Relationship |
| Amount Of Transaction | 450416 | AmountOfTransaction |
| Description Of Transaction | RENTAL OF PROPERTY | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE CEO/PRESIDENT, CHIEF OPERATING OFFICER AND CHIEF FINANCIAL OFFICER REVIEW THE 990. A COPY OF THE 990 IS PROVIDED TO THE BOARD OF DIRECTORS FOR REVIEW. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICTS OF INTEREST POLICY APPLIES TO MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, VICE PRESIDENTS, ASSISTANT VICE PRESIDENTS, DEPARTMENT HEADS, CLINICAL DIRECTORS OF DEPARTMENTS, AND OTHER EMPLOYEES (INCLUDING PHYSICIANS) WHO ARE IN A POSITION TO INFLUENCE ANY SUBSTANTIVE BUSINESS DECISION BETWEEN THE MEDICAL CENTER AND A VENDOR. THE DIRECTOR OF CORPORATE COMPLIANCE CONTINUOUSLY MONITORS ALL TRANSACTIONS TO DETERMINE IF ANY POTENTIAL CONFLICT EXISTS. IF IT IS DETERMINED THAT A POTENTIAL CONFLICT EXISTS, THE INDIVIDUAL IS PROHIBITED FROM PARTICIPATING IN THE DECISIONS OF THE TRANSACTION. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HOSPITAL UTILIZES SALARY SURVEYS AND REVIEWS THEM WITH THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE PROCESS WAS PERFORMED IN 2012 | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. | |
| FORM 990, PART XI, LINE 9: | PENSION ADJUSTMENT TO REFLECT FUNDED STATUS 1,975,786. LOSS ON SWAP AGREEMENT -75,054. CHANGE IN EQUITY INTEREST IN CENTRAL SUFFOLK HOSPITAL FOUNDATION 419,726. PENSION ADJUSTMENT TO REFLECT FUNDED STATUS LOSS ON SWAP AGREEMENT CHANGE IN EQUITY INTEREST IN CENTRAL SUFFOLK HOSPITAL FOUNDATION | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XI, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CENTRAL SUFFOLK HOSPITAL DBA PECONIC BAY MEDICAL CENTER FOUNDATION | |||||||||||
| 1300 ROANOKE AVENUE | RIVERHEAD | NY | 11901 | 200714587 | FUNDRAISING/PHILANTHROPIC | NY | 501(C)(3) | 7 | PECONIC BAY HEALTH SYSTEM | 0 | |
| EAST END HEALTH ALLIANCE | |||||||||||
| 201 MANOR PLACE | GREENPORT | NY | 11944 | 113407476 | PARENT COMPANY OF PBMC, SOUTHAMPTON HOSPITAL, EASTERN LONG ISLAND HOSPITAL | NY | 501(C)(3) | 11, TYPE I | 0 | N/A | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERHEAD MANAGEMENT CORPORATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1300 ROANOKE AVENUE | AddressLine1 |
| City | RIVERHEAD | City |
| State | NY | State |
| ZIP Code | 11901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 112800287 | EIN |
| Primary Activity | MANAGEMENT SERVICE ORGANIZATION | PrimaryActivity |
| Legal Domicile State | NY | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Controlled Org | 0 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 1 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RIVERHEAD MANAGEMENT CORPORATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | D | TransactionType |
| Amount Involved | 708701 | AmountInvolved |
| Method Of Amt Determination | COST | MethodOfAmtDetermination |