PENINSULA HOSPITAL CENTER: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PENINSULA HOSPITAL CENTER (EIN 11-6037195)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-15
- IRS object ID
- 201313199349308361
- Schema version
- 2012v2.0
- 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 D
- Schedule H
- Schedule J
- Schedule N
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-11-15T15:05:43-07:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 116037195 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENINSULA HOSPITAL CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PENI | NameControl |
| Phone | 5164664110 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 CUTTER MILL ROAD | AddressLine1 |
| Address Line2 | SUITE 201N | AddressLine2 |
| City | GREAT NECK | City |
| State | NY | State |
| ZIP Code | 11021 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Lori Lapin Jones | Name |
| Title | Chapter 11 Trustee | Title |
| Phone | 5164664110 | Phone |
| Date Signed | 2013-11-14 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | Lori Lapin Jones Chapter 11 Trustee | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 Cutter Mill Road | AddressLine1 |
| Address Line2 | Suite 201N | AddressLine2 |
| City | Great Neck | City |
| State | NY | State |
| ZIP Code | 11021 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 15919244 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1957 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | THE HOSPITAL MISSION WAS TO PROVIDE THE HIGHEST QUALITY CARE TO PATIENTS OF ALL AGES, BACKGROUNDS, AND BELIEFS. WE WERE DEDICATED TO DELIVERING COMPETENT, COLLABORATIVE AND PROFESSIONAL SERVICES TO ALL OF OUR PATIENTS AND RESIDENTS OF THE ROCKAWAYS AND NEIGHBORING COMMUNITIES. THE HOSPITAL CEASED OPERATIONS ON APRIL 6, 2012. | ActivityOrMissionDescription |
| Termination Or Contraction | X | TerminationOrContraction |
| Nbr Voting Members Governing Body | 1 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 1 | NbrIndependentVotingMembers |
| Total Nbr Employees | 743 | TotalNbrEmployees |
| Total Nbr Volunteers | 2 | TotalNbrVolunteers |
| Total Gross UBI | 59247 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -145000 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 244537 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 82288 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 73246467 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 11468762 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | -5586899 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 6916663 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3054127 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 80407667 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9018278 | 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 | 55613181 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 14987201 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 31065581 | OtherExpensePriorYear |
| Other Expenses Current Year | 9786224 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 86678762 | TotalExpensesPriorYear |
| Total Expenses Current Year | 24773425 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -6271095 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -15755147 | RevenuesLessExpensesCY |
| Total Assets BOY | 26226692 | TotalAssetsBOY |
| Total Assets EOY | 13076963 | TotalAssetsEOY |
| Total Liabilities BOY | 60009144 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 62658693 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -33782452 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -49581730 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE HOSPITAL MISSION WAS TO PROVIDE THE HIGHEST QUALITY CARE TO PATIENTS OF ALL AGES, BACKGROUNDS, AND BELIEFS. WE WERE DEDICATED TO DELIVERING COMPETENT, COLLABORATIVE & PROFESSIONAL SERVICES TO ALL OF OUR PATIENTS AND RESIDENTS OF THE ROCKAWAYS AND NEIGHBORING COMMUNITIES. THE HOSPITAL CEASED OPERATIONS ON APRIL 6, 2012 | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 1 | SignificantChange |
| Expense | 16646604 | Expense |
| Revenue | 12848788 | Revenue |
| Description | PROVISION OF ACUTE HOSPITAL CARE SERVICES UP UNTIL THE HOSPITAL CLOSURE DATE OF APRIL 6, 2012. | Description |
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 16646604 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | 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 | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | 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 | 0 | 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 | 0 | TaxExemptBonds |
| 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 | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 1 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 169 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 743 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 1 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 1 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 1 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 1 | 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 | 1 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Lori Lapin Jones Chapter 11 Trustee | NamePerson |
| Telephone Number | 5164664110 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 98 Cutter Mill Road | AddressLine1 |
| Address Line2 | Suite 201 North | AddressLine2 |
| City | Great Neck | City |
| State | NY | State |
| ZIP Code | 11021 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (37 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | FormerFormer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| David Ribet | ||||||||
| Vice Chair of Board | 1 | 0 | X | X | 0 | 0 | 0 | |
| Louis Caucig | ||||||||
| Asstistant Treasurer | 1 | 0 | X | X | 0 | 0 | 0 | |
| Marvin Eisenstadt | ||||||||
| Sr. Vice Chairman | 1 | 0 | X | X | 0 | 0 | 0 | |
| Lori Lapin Jones | ||||||||
| Chapter 11 Trustee | 0.00 | 0 | 216431 | 0 | 0 | X | ||
| Monica Terrano | ||||||||
| Director of Finance | 38 | 0 | 161997 | 0 | 535 | X | ||
| Justin Baum | ||||||||
| Director Strategic Planning | 38 | 0 | 134715 | 0 | 25710 | X | ||
| Darryl Greene | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Elliot Shapiro | ||||||||
| Secretary | 1 | 0 | X | 0 | 0 | 0 | ||
| Francis Rudolph | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Frank Russo | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| George Greco | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| George Murphy | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Joel Miele Sr | ||||||||
| Chairman | 1 | 0 | X | 0 | 0 | 0 | ||
| Leonard Tanzer | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Lucy Salpeter | ||||||||
| Assistant Secretary | 1 | 0 | X | 0 | 0 | 0 | ||
| Martin Oliner | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Steven Greenberg | ||||||||
| Treasurer | 1 | 0 | X | 0 | 0 | 0 | ||
| Morton Schwartz | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Nancy Vardakis | ||||||||
| Vice Chairperson | 1 | 0 | X | 0 | 0 | 0 | ||
| Noel Schwartz | ||||||||
| Honorary Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Patte Bogen Roberts | ||||||||
| Vice Chairperson | 1 | 0 | X | 0 | 0 | 0 | ||
| Reverend Evan D Gray | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Richard Hoffman | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Steven Eisentadt | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Robert Levine | ||||||||
| Former President/CEO | 38 | 0 | X | 0 | 0 | 0 | ||
| Mark Skulnick | ||||||||
| CFO & VP of Finance | 38 | 0 | X | 0 | 0 | 0 | ||
| Robert Aglialoro | ||||||||
| Director of MIS | 38 | 0 | X | 0 | 0 | 0 | ||
| Todd Miller | ||||||||
| President/CEO | 38 | 0 | X | 129514 | 0 | 21264 | ||
| Thomas Egan | ||||||||
| Chief Financial Officer | 38 | 0 | X | 54519 | 0 | 180 | ||
| David Masini | ||||||||
| Chief Operating Officer | 38 | 0 | X | 98673 | 0 | 326 | ||
| Robin Blackwell | ||||||||
| VP Nursing | 38 | 0 | X | 20588 | 0 | 6014 | ||
| Allen Corby | ||||||||
| VP Operations | 38 | 0 | X | 6469 | 0 | 21 | ||
| Peter Galvin | ||||||||
| Chief Medical Officer | 38 | 0 | X | 55812 | 0 | 0 | ||
| Martin Grossman | ||||||||
| Director of Medicine | 38 | 0 | X | 18000 | 0 | 14923 | ||
| Howard Sussman | ||||||||
| Director of Surgery | 38 | 0 | X | 41758 | 0 | 20974 | ||
| Joel Miele Jr | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| David Gruber | ||||||||
| Board Member | 1 | 0 | X | 0 | 0 | 0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 938476 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 89947 | TotalOtherCompensation |
| Number Individuals GT100 K | 3 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 | Address Line2AddressOfContractor/AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|
| Garfunkel Wild PC | ||||||
| 111 Great Neck Road 6th Floor | Great Neck | NY | 11021 | Legal services | 644715 | |
| Sodexo | ||||||
| 500 Ross Street | Pittsburgh | PA | 15262 | Dietary Services | 358056 | |
| Abrams Fensterman et al | ||||||
| 630 Third Avenue 5th Floor | New York | NY | 10017 | Legal services | 248172 | |
| Citistorage LLC | ||||||
| 5 North 11th Street | Brooklyn | NY | 11249 | Record Storage | 247817 | |
| The Garden City Group | ||||||
| 1985 Marcus Avenue | Lake Success | NY | 11042 | Claims Processing | 246222 | Suite 200 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 11 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 0 | RelatedOrganizations |
| Government Grants | 0 | GovernmentGrants |
| All Other Contributions | 82288 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 82288 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Patient Service Revenue | 622000 | 11409515 | 11409515 | 0 | $0 |
| Medical Laboratory | 621511 | 59247 | 0 | 59247 | $0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 11468762 | TotalProgramServiceRevenue |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 1314067 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 6900966 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | -5586899 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -5586899 | TotalRevenueColumn |
| Related Or Exempt Function Income | -5586899 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Intern Resident Program | 900099 | 358500 | 358500 | 0 | $0 |
| Skilled Nursing Home | 623000 | 1021527 | 1021527 | 0 | $0 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1674100 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1674100 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3054127 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9018278 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8876743 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 59247 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 811990 | Total |
| Program Services | 178068 | ProgramServices |
| Management And General | 633922 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8288803 | Total |
| Program Services | 6846551 | ProgramServices |
| Management And General | 1442252 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5121202 | Total |
| Program Services | 4457120 | ProgramServices |
| Management And General | 664082 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 765206 | Total |
| Program Services | 631690 | ProgramServices |
| Management And General | 133516 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28327 | Total |
| Management And General | 28327 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7000 | Total |
| Management And General | 7000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2869152 | Total |
| Program Services | 556347 | ProgramServices |
| Management And General | 2312805 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22098 | Total |
| Program Services | 22098 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 361473 | Total |
| Program Services | 361473 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 102566 | Total |
| Program Services | 102566 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 656460 | Total |
| Program Services | 656460 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5581 | Total |
| Management And General | 5581 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14486 | Total |
| Management And General | 14486 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 159315 | Total |
| Program Services | 159315 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 904409 | Total |
| Program Services | 904409 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 622121 | Total |
| Program Services | 622121 | ProgramServices |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Bankruptcy Expenses | 2375402 | 0 | 2375402 | 0 |
| Supplies | 1388620 | 1148386 | 240234 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 269214 | Total |
| Management And General | 269214 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24773425 | Total |
| Program Services | 16646604 | ProgramServices |
| Management And General | 8126821 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 484662 | BOY |
| EOY | 2258683 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 308629 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9739200 | BOY |
| EOY | 2798823 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 463517 | BOY |
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 724235 | BOY |
| EOY | 375673 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 14802487 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 12172055 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9531400 | BOY |
| EOY | 2630432 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4975049 | BOY |
| EOY | 5013352 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26226692 | BOY |
| EOY | 13076963 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30979181 | BOY |
| EOY | 32526848 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 525000 | BOY |
| EOY | 174805 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 621000 | BOY |
| EOY | 2521000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27883963 | BOY |
| EOY | 27436040 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 60009144 | BOY |
| EOY | 62658693 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -34121029 | BOY |
| EOY | -49876176 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 338577 | BOY |
| EOY | 294446 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -33782452 | BOY |
| EOY | -49581730 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26226692 | BOY |
| EOY | 13076963 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -15755147 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 0 | ReconciliationUnrealizedInvest |
| Reconcilation Donated Services | 0 | ReconcilationDonatedServices |
| Reconcilation Invest Expenses | 0 | ReconcilationInvestExpenses |
| Reconcilation Prior Adjustment | 0 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | -44131 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 0 | FSAudited |
| 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 D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 268383 | OtherCostOrOtherBasis |
| Book Value | 268383 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 13799513 | OtherCostOrOtherBasis |
| Depreciation | 11475356 | Depreciation |
| Book Value | 2324157 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 734591 | OtherCostOrOtherBasis |
| Depreciation | 696699 | Depreciation |
| Book Value | 37892 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2630432 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Due from Affiliates | 1080285 |
| Due from third party payors | 3886163 |
| Deposit for Sale of Hospital and Clinic | -725000 |
| Deferred financing fees | 57901 |
| Other Assets | 713332 |
| Assets with restricted use | 671 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 5013352 | TotalBookValueOtherAssets |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (5 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Due to Affiliates | $6,836,983 |
| Due to Third Party Payors | $11,027,505 |
| Estimated Malpractice Liability | $7,901,109 |
| Capitalized Lease Obligations | $189,329 |
| Other Liabilities | $1,481,114 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 27436040 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 0 | AmountsBudgetedForCharityCare |
| Annual Community Benefit Report | 0 | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 343462 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 180761 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 162701 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0066 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6792870 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3542183 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3250687 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.1312 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 7136332 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 3722944 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3413388 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.1378 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2114322 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1934875 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 179447 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0072 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1415271 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 468973 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 946298 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0382 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 0 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 3529593 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2403848 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1125745 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.0454 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 10665925 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 6126792 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4539133 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.1832 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $452,756 | BadDebtExpenseAmount |
| Amount Attributable To | 95572 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 4558582 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 4408365 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 150217 | 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 | Peninsula Hospital Center | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 51-15 Beach Channel Drive | AddressLine1 |
| City | Far Rockaway | City |
| State | NY | State |
| ZIP Code | 11691 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.peninsulahospital.org | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
| Other | Rehabilitation, pediatric and hospice units | Other |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Peninsula Hospital Center | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 100 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 300 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| 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 Body Attachment | X | PermitBodyAttachment |
| Collection Activities | 1 | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Lawsuit | X | Lawsuit |
| 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 | 1 | AmountsGenerallyBilled |
| Gross Charges | 1 | 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 | Peninsula Center for Extended Care and Rehabilitation | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50-15 Beach Channel Drive | AddressLine1 |
| City | Far Rockaway | City |
| State | NY | State |
| ZIP Code | 11691 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | Skilled Nursing Facility | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SchH_P01_S00_L03c | Schedule H, Part I, Line 3c | Peninsula Hospital Center uses Federal poverty guideline to determine financial assistance eligibility. |
| SchH_P01_S00_L07 | Schedule H, Part I, Line 7 | Cost-to-charge ratio calculated using Worksheet 2 of the instruction was used in the calculation of costs. |
| SchH_P03_S0A_L04 | Schedule H, Part III, Section A, Line 4 | The process for estimating the ultimate collection of receivables involves significant assumptions and judgments. Accounts balances are written off against the allowance when management determines it is probable the receivable will not be recovered. The use of historical collection and payor reimbursement experience is an integral part of the estimation of reserves for uncollectible accounts. Revisions in reserves for uncollectible accounts estimates are recorded as an adjustment to the provision for bad debts. |
| SchH_P03_S0B_L08 | Schedule H, Part III, Section B, Line 8 | There is no Medicare shortfall. The Medicare cost was obtained from Worksheets D and D-1 of the Medicare Cost Report. Medicare cost report calculates ancillary and outpatient costs using cost to charge methodology. The inpatient routine cost was calculated using average cost per diem methodology. |
| SchH_P03_S0C_L09b | Schedule H, Part III, Section C, Line 9b | The Hospital's bad debt collection policy applies uniformly. It specifically requires that collection agencies follow the financial assistance policies of the Hospital. |
| SchH_P05_S0B_L20 | Schedule H, Part V, Section B, Line 20 | Peninsula Hospital Center uses the greater of Medicare or Medicaid rates when calculating the maximum amount that can be charged. |
| SchH_P05_S0B_L21 | Schedule H, Part V, Section B, Line 21 | Peninsula Hospital Center uses the greater of Medicare or Medicaid rates when calculating the maximum amount that can be charged. It is possible that in some situations, the Medicare or Medicaid rate could be higher than the rate under a commercial insurance plan. |
| SchH_P05_S0B_L22 | Schedule H, Part V, Section B, Line 22 | Peninsula Hospital Center set the maximum amount that can be charged to the lower of gross charge or Medicare/Medicaid rate. If Medicare or Medicaid rate is higher than gross charge, then gross charge is used. |
| SchH_P06_S00_L02 | Schedule H, Part VI, Line 2 | New York State requires an annual Community Service Plan and needs assessment. The diversity in the Rockaway population is a factor in determining its health care needs. The Hospital Center utilizes the series of publications entitled, "Community Health Profiles" published by the New York City Department of Health and Mental Hygiene in addition to other data available through City, State and Federal agencies and both public and private agencies. Many members of the hospital administration staff are actively involved in community-based organizations. In 2007, The Hospital Center commissioned Charney Research to assist it in determining the needs of the community and continues to solicit feedback from its Community Advisory Council, Board of Directors and Support Groups. |
| SchH_P06_S00_L03 | Schedule H, Part VI, Line 3 | The Hospital Center implemented its Financial Aid Program entitled "PHC Choices" to ensure that all uninsured patients who are interested in financial aid can obtain the same, with minimal eligibility barriers. The Hospital Center has posted information on "PHC Choices" throughout the hospital and on its website, made brochures available in all patient registration areas, intake areas and in its Hospital Patient Guide. The Hospital Center continually attempts to integrate the full range of financial options for uninsured patients into a process whereby patients are evaluated for eligibility into Medicaid, Family Health Plus/Child Health Plus and all financial assistance plans. |
| SchH_P06_S00_L04 | Schedule H, Part VI, Line 4 | The Hospital Center is located in Far Rockaway, Queens. Our primary service area was the Rockaway Peninsula, including zip codes 11691 through 11697. It also served parts of mainland Queens and Brooklyn as well as the Five Towns area of Nassau County. It had a diverse population of 106,000, and the population is rapidly growing. Approximately 28% of the population is living at and below the Federal poverty level. Due to its isolated geographic location and the limited public transportation available. |
| SchH_P06_S00_L05 | Schedule H, Part VI, Line 5 | The Hospital Center participated in various community health fairs and support groups. The Hospital Center participated in a community outreach program which brought a mobile health van weekly to various locations in the Rockaway community. Basic health screenings were provided. This forum provides opportunities for members of the community to talk about their health and for Hospital Center staff to solicit comments and opinions about how they would like health care delivered. The Hospital Center provided free angio-screenings weekly to the community. This is a screening tool to help determine risk for heart attack and stroke. Statistics have shown that this screening has saved lives and many who didn't realize they had some significant health issues are now being treated successfully. The Hospital Center was actively involved in various emergency preparedness activities. It was the goal of the Hospital Center, in collaboration with other local, City and State agencies and organizations, to ensure that the community was knowledgeable, prepared and aware of all means of personal protection including evacuation and last resort shelters. |
| SchH_P06_S00_L06 | Schedule H, Part VI, Line 6 | The Hospital Center is affiliated with the Joseph P. Addabbo Family Health Center, providing emergency, ancillary, specialist and inpatient services as needed. The Joseph P. Addabbo Family Health Center is a Federally Qualified Health Center (FQHC) serving a medically under served population. The Hospital Center has affiliations and collaborations with various hospital and medical facilities to assist in the training of interns and residents as well as a growing Family Practice Residency Program the focus of which is to "train and retain" physicians in this under served area. |
| SchH_P06_S00_L07 | Schedule H, Part VI, Line 7 | New York |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | 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 | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Monica Terrano | ||||||||||||||
| Director of Finance | 161997 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 535 | 0 | 162532 | 0 | 0 | 0 |
| Justin Baum | ||||||||||||||
| Director Strategic Planning | 134715 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 25710 | 0 | 160425 | 0 | 0 | 0 |
| Todd Miller | ||||||||||||||
| President/CEO | 129514 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 21264 | 0 | 150778 | 0 | 0 | 0 |
| Lori Lapin Jones | ||||||||||||||
| Chapter 11 Trustee | 216431 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 216431 | 0 | 0 | 0 |
Schedule N IRS990ScheduleN
Disposition Table DispositionTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Asset | On June 27, 2012 Peninsula Hospital Center conducted an auction sale of substantially all of the facility's equipment, furniture and supplies. The auction was conducted by The Great American Group. On May 2, 2013 a sale of the Peninsula Hospital Center real estate was completed. | DescriptionOfAsset |
| Date Of Distribution | 2013-06-30 | DateOfDistribution |
| FMV Of Asset | 1040953 | FMVOfAsset |
| Method Of FMV Determination | Great American Group conducted a public auction in which the assets were sold to highest bidder. | MethodOfFMVDetermination |
| Name Person | Public Auction | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor2 | 0 | DirectorOfSuccessor2 |
| Employee Of Successor2 | 0 | EmployeeOfSuccessor2 |
| Owner Of Successor2 | 0 | OwnerOfSuccessor2 |
| Receive Compensation2 | 0 | ReceiveCompensation2 |
Form990 Schedule N Part III Form990ScheduleNPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchN_P01_S00_L01 | Identifier |
| Return Reference | Schedule N, Part I, Line 1 | ReturnReference |
| Explanation | On May 2, 2013 the Chapter 11 Trustee consummated a sale of the Peninsula Hospital Center real estate. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P00_S00_L0A | Form 990, Header, Line A | This tax return is for the calendar year ending December 31, 2012. It includes the period January 1, 2012 to March 8, 2012, which was the period prior to the appointment of the Chapter 11 Trustee. The financial information for the period prior to the appointment of the Chapter 11 Trustee is based on the books and records of Peninsula Hospital Center which were inherited by the Trustee. While the Trustee believes the books and records are accurate, she does not assume responsibility for such information. |
| F990_P03_S00_L03 | Form 990, Part III, Line 3 | Under the direction of the court appointed Chapter 11 Trustee, Lori Lapin Jones, Peninsula Hospital Center ceased operating as a Hospital on April 6, 2012. |
| F990_P04_S00_L20a | Form 990, Part IV, Line 20a | The Hospital ceased operations on April 6, 2012. Inpatient and Outpatient services were closed |
| F990_P06_S0A_L02 | Form 990, Part VI, Section A, Line 2 | The following family members are board members: Joel A. Miele Sr. (Chairman) and Joel Miele Jr. (Director); Marvin E. Eisenstadt (Sr. Vice Chairman) and Steven Eisenstadt (Director). |
| F990_P06_S0A_L03 | Form 990, Part VI, Section A, Line 3 | By Order dated March 9, 2012, the Court approved the appointment of Lori Lapin Jones as the Chapter 11 Trustee of the Debtors' estates. |
| F990_P06_S0A_L04 | Form 990, Part VI, Section A, Line 4 | On August 16, 2011, an involuntary petition for relief under chapter 11 of the Bankruptcy Code was filed against PHC. On September 19, 2011, PHC consented to entry of the order for relief under chapter 11 of the Bankruptcy Code. On September 21, 2011, the Court entered an order for relief under chapter 11 of the Bankruptcy Code. In February 2012, the NYS DOH issued summary orders closing the laboratory and directing suspension of hospital services dependent on the laboratory. By Order dated March 9, 2012, the Court approved the appointment of Lori Lapin Jones as the Chapter 11 Trustee of the Debtors' estates, for the chapter 11 cases. In April, 2012 the NYS DOH approved a plan of closure for Peninsula Hospital Center. |
| F990_P06_S0A_L09 | Form 990, Part VI, Section A, Line 9 | Lori Lapin Jones, the court appointed Chapter 11 Trustee, can be reached at her office located at: Lori Lapin Jones PLLC 98 Cutter Mill Road - Suite 201N Great Neck, New York 11021 |
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | The document was prepared by Monica Terrano and Justin Baum and reviewed by Lori Lapin Jones, Chapter 11 Trustee. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | Upon information and belief, prior to the Trustee's appointment, disclosure in accordance with the Conflict of Interest Policy by employees that satisfy the criteria to be considered an "interested person" was submitted upon hiring and annually thereafter. The Audit and Compliance committee reviewed the submissions for conflicts and the Department of Internal Audit monitors compliance. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | The Chapter 11 Trustee was appointed and reviewed executive compensation. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | Governing documents: Certificate of Inc. filed with the NYS Department of State; Conflict of Interest Policy is not publicly available. Monthly Operating Reports are filed with the Bankruptcy Court and are available upon request. |
| F990_P07_S0A_L01a | Form 990, Part VII, Section A, Line 1a | Compensation for Lori Lapin Jones, Chapter 11 Trustee, consists of commissions and expenses approved by order of the Bankruptcy Court. |
| F990_P11_S00_L09 | Form 990, Part XI, Line 9 | Change in unrestricted and temporarily restricted net assets |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Peninsula General Nursing Home Corp | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50-51 Beach Channel Drive | AddressLine1 |
| City | Far Rockaway | City |
| State | NY | State |
| ZIP Code | 11691 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237086890 | EIN |
| Primary Activities | Nursing Home and Rehabilitation Center | PrimaryActivities |
| Legal Domicile State | NY | LegalDomicileState |
| Exempt Code Section | 501 (c) 3 | ExemptCodeSection |
| Public Charity Status | 3 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| 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 | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | 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 | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | 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 | Peninsula General Nursing Home Corp | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | q | TransactionType |
| Amount Involved | 2196856 | AmountInvolved |