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STATEN ISLAND UNIVERSITY HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
STATEN ISLAND UNIVERSITY HOSPITAL (EIN 11-2868878)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201333199349302963
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-11-15T09:22:04-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WithumSmithBrown PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1465 South St Ste 200AddressLine1
CityMorristownCity
StateNJState
ZIP Code079606497ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN112868878EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1STATEN ISLAND UNIVERSITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% THOMAS RECAInCareOfName
Name ControlSTATNameControl
Phone7182261148Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1475 SEAVIEW AVENUEAddressLine1
Address Line2SuiteAddressLine2
CitySTATEN ISLANDCity
StateNYState
ZIP Code10305ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTHOMAS RECAName
TitleCFOTitle
Phone9738989494Phone
Date Signed2013-11-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAnthony J PanicoName
Phone9738989494Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonANTHONY C FERRERINameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1475 SEAVIEW AVENUEAddressLine1
CitySTATEN ISLANDCity
StateNYState
ZIP Code10305ZIPCode
FieldValueIRS element (for citing)
Gross Receipts838881263GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.siuh.eduWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1869YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionStaten Island University Hospital is part of the North Shore-LIJ Health System, WHICH STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITies IT SERVES. SEE PART III.ActivityOrMissionDescription
Nbr Voting Members Governing Body136NbrVotingMembersGoverningBody
Nbr Independent Voting Members128NbrIndependentVotingMembers
Total Nbr Employees6679TotalNbrEmployees
Total Nbr Volunteers918TotalNbrVolunteers
Total Gross UBI8987748TotalGrossUBI
Net Unrelated Business Txbl Income-105387NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3676168ContributionsGrantsPriorYear
Contributions Grants Current Year3971783ContributionsGrantsCurrentYear
Program Service Revenue Prior Year783155014ProgramServiceRevenuePriorYear
Program Service Revenue CY825262856ProgramServiceRevenueCY
Investment Income Prior Year1987289InvestmentIncomePriorYear
Investment Income Current Year4083113InvestmentIncomeCurrentYear
Other Revenue Prior Year5267929OtherRevenuePriorYear
Other Revenue Current Year5563511OtherRevenueCurrentYear
Total Revenue Prior Year794086400TotalRevenuePriorYear
Total Revenue Current Year838881263TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year502034828SalariesEtcPriorYear
Salaries Etc Current Year525486600SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year265494006OtherExpensePriorYear
Other Expenses Current Year270285594OtherExpensesCurrentYear
Total Expenses Prior Year767528834TotalExpensesPriorYear
Total Expenses Current Year795772194TotalExpensesCurrentYear
Revenues Less Expenses Prior Year26557566RevenuesLessExpensesPriorYear
Revenues Less Expenses CY43109069RevenuesLessExpensesCY
Total Assets BOY676230590TotalAssetsBOY
Total Assets EOY744558374TotalAssetsEOY
Total Liabilities BOY487447058TotalLiabilitiesBOY
Total Liabilities EOY498952883TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY188783532NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY245605491NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSTATEN ISLAND UNIVERSITY HOSPITAL IS PART OF THE NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM ("THE SYSTEM"), WHICH STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES AND IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CLINICAL CARE; EDUCATING THE CURRENT AND FUTURE GENERATIONS OF HEALTHCARE PROFESSIONALS; SEARCHING FOR NEW ADVANCES IN MEDICINE THROUGH THE CONDUCT OF BIOMEDICAL RESEARCH; PROMOTING HEALTH EDUCATION; AND CARING FOR THE ENTIRE COMMUNITY REGARDLESS OF THE ABILITY TO PAY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense537900232Expense
Grants0Grants
Revenue669319043Revenue
DescriptionSTATEN ISLAND UNIVERSITY HOSPITAL PROVIDES ACUTE CARE HOSPITAL SERVICES AT TWO FACILITIES IN RICHMOND COUNTY. NORTH AND SOUTH SITE CAMPUSES PROVIDE SERVICES IN CARDIOLOGY, BURN CARE, TRAUMA, ORTHOPEDICS, ONCOLOGY, GERIATRICS, OBSTETRICS, PEDIATRICS, REHABILITATION, PRIMARY CARE, COMMUNITY OUTREACH, HOSPICE, AND HOME CARE REGARDLESS OF ABILITY TO PAY. IN 2012 THE COMBINED CAMPUSES OF THE HOSPITAL HAD 42,172 DISCHARGES, (EXCLUDING NORMAL NEWBORN DISCHARGES); 2,904 DELIVERIES; 124,552 EMERGENCY DEPARTMENT VISITS (includes 31,632 admits); AND 15,392 AMBULATORY SURGERY CASES.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense65715923Expense
Grants0Grants
Revenue58227826Revenue
DescriptionEXPENSES INCURRED IN PROVIDING EMERGENCY DEPARTMENT SERVICES TO ALL INDIVIDUALS, 24 HOURS A DAY, 7 DAYS A WEEK, 365 DAYS A YEAR, IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense45591133Expense
Grants0Grants
Revenue42262541Revenue
DescriptionEXPENSES INCURRED IN PROVIDING AMBULATORY SURGERY SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp33928086TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev55453446TotalOfOtherProgramServiceRev
Total Program Service Expense683135374TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvesttrueReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096402NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees6679NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members136NbrVotingGoverningBodyMembers
Number Independent Voting Members128NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTHOMAS RECANamePerson
Telephone Number7182261148TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE EDGEWATER PLAZAAddressLine1
CitySTATEN ISLANDCity
StateNYState
ZIP Code10305ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (149 entries)

TitleTitleAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationAverage Hours Per WeekAverageHoursPerWeekKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
RICHARD D GOLDSTEIN
CHAIRMAN - TRUSTEE3.0XX000
JOHN W ALEXANDER
TREASURER - TRUSTEE2.0XX000
RICHARD S ABRAMSON
TRUSTEE2.0X000
WILLIAM ACHENBAUM
TRUSTEE2.0X000
PHILIP S ALTHEIM
TRUSTEE2.0X000
STANLEY A APPLEBAUM
TRUSTEE2.0X000
MICHAEL L ASHNER
TRUSTEE2.0X000
BEVERLY BANKER
TRUSTEE2.0X000
RALPH M BARUCH
TRUSTEE2.0X000
FRANK J BESIGNANO
TRUSTEE2.0X000
ELISE M BLOOM
TRUSTEE2.0X000
ERIC S BLUMENCRANZ
TRUSTEE2.0X000
ROGER A BLUMENCRANZ
TRUSTEE2.0X000
DAVID BLUMENFELD
TRUSTEE2.0X000
EDWARD BLUMENFELD
TRUSTEE2.0X000
E STEVE BRAUN
TRUSTEE2.0X000
DAYTON T BROWN JR
TRUSTEE2.0X000
ALLEN E BUSCHING
TRUSTEE2.0X000
JONATHAN S CANNO
TRUSTEE2.0X000
MICHAEL CARIDI
TRUSTEE2.0X000
REV DEMETRIUS CAROLINA SR EDD
TRUSTEE2.0X000
RUDOLPH C CARRYL
TRUSTEE2.0X000
ROBERT W CHASANOFF
TRUSTEE2.0X000
ALAN CHOPP
TRUSTEE2.0X000
MARK CLASTER
TRUSTEE2.0X000
DIANA F COLGATE
TRUSTEE2.0X000
DANIEL M CROWN
TRUSTEE2.0X000
PHILIPPE P DAUMAN
TRUSTEE2.0X000
DANIEL C DE ROULET
TRUSTEE2.0X000
LORINDA DE ROULET
TRUSTEE2.0X000
THOMAS E DEWEY JR
TRUSTEE2.0X000
THOMAS E DOOLEY
TRUSTEE2.0X000
MICHAEL J DOWLING
TRUSTEE50.0X028233501128235
ROBERT N DOWNEY
TRUSTEE2.0X000
MELVIN DUBIN
TRUSTEE2.0X000
PATRICK R EDWARDS
TRUSTEE2.0X000
MICHAEL A EPSTEIN
TRUSTEE2.0X000
LEONARD FEINSTEIN
TRUSTEE2.0X000
MICHAEL E FELDMAN
TRUSTEE2.0X000
ANTHONY C FERRERI
PRESIDENT/CEO - TRUSTEE50.0XX01049046387210
ARLENE LANE FISHER
TRUSTEE2.0X000
CATHERINE C FOSTER
TRUSTEE2.0X000
WILLIAM H FRAZIER
TRUSTEE2.0X000
EUGENE B FRIEDMAN MD
TRUSTEE2.0X000
WILLIAM J FRITZ PHD
TRUSTEE2.0X000
SY GARFINKEL
TRUSTEE2.0X000
LLOYD MICHAEL GOLDMAN
TRUSTEE2.0X000
J JOAQUIN GONZALEZ
TRUSTEE2.0X000
MICHAEL GOULD
TRUSTEE2.0X000
ALBERT L GRANGER DDS
TRUSTEE2.0X000
ALAN I GREENE
TRUSTEE2.0X000
JAMES R GREENE
TRUSTEE2.0X000
STANLEY GREY
TRUSTEE2.0X000
RICHARD GUARASCI PHD
TRUSTEE2.0X000
PAUL B GUENTHER
TRUSTEE2.0X000
AMY M HAGEDORN
TRUSTEE2.0X000
IRA HAZAN
TRUSTEE2.0X000
LINDA W HEANEY
TRUSTEE2.0X000
MARLENE HESS
TRUSTEE2.0X000
WILLIAM O HILTZ
TRUSTEE2.0X000
GEDALE B HOROWITZ
TRUSTEE2.0X000
RICHARD A HOROWITZ
TRUSTEE2.0X000
M ALLAN HYMAN
TRUSTEE2.0X000
MARK JACOBSON
TRUSTEE2.0X000
JEFFREY JURICK
TRUSTEE2.0X000
DAVID M KATZ
TRUSTEE2.0X000
MICHAEL KATZ
TRUSTEE2.0X000
SAUL B KATZ
TRUSTEE2.0X000
LISA A KAUFMAN
TRUSTEE2.0X000
ROBERT KAUFMAN
TRUSTEE2.0X000
CARY KRAVET
TRUSTEE2.0X000
STANLEY KREITMAN
TRUSTEE2.0X000
SETH KUPFERBERG
TRUSTEE2.0X000
JEFFREY B LANE
TRUSTEE2.0X000
CURT N LAUNER
TRUSTEE2.0X000
LAURA LAURIA
TRUSTEE2.0X000
KEVIN F LAWLOR
TRUSTEE50.0X0799176280574
DAVID W LEHR
TRUSTEE2.0X000
JONATHAN W LEIGH
TRUSTEE2.0X000
SYLVIA LESTER
TRUSTEE2.0X000
ARTHUR S LEVINE
TRUSTEE2.0X000
STUART R LEVINE
TRUSTEE2.0X000
SETH LIPSAY
TRUSTEE2.0X000
DAVID S MACK
TRUSTEE2.0X000
WILLIAM L MACK
TRUSTEE2.0X000
LINDA MANFREDI
TRUSTEE2.0X000
JAMES S MARCUS
TRUSTEE2.0X000
BRADLEY MARSH DPM
TRUSTEE2.0X000
JEFFREY S MAURER
TRUSTEE2.0X000
RONALD J MAZZUCCO
TRUSTEE2.0X000
F J MCCARTHY
TRUSTEE2.0X000
PATRICK F MCDERMOTT
TRUSTEE2.0X000
JAMES MCMULLEN
TRUSTEE2.0X000
CHARLES MERINOFF
TRUSTEE2.0X000
RICHARD D MONTI
TRUSTEE2.0X000
RICHARD MURCOTT
TRUSTEE2.0X000
RALPH A NAPPI
TRUSTEE50.0X0227654660770
RICHARD B NYE
TRUSTEE2.0X000
CLYDE I PAYNE ED D
TRUSTEE2.0X000
ARNOLD S PENNER
TRUSTEE2.0X000
JOHN J RAGGIO
TRUSTEE2.0X000
LEWIS S RANIERI
TRUSTEE2.0X000
JAY R RAUBVOGEL
TRUSTEE2.0X000
DENNIS RIESE
TRUSTEE2.0X000
TERRY P RIFKIN MD
TRUSTEE2.0X000
ROBERT F ROSE
TRUSTEE2.0X000
ROBERT A ROSEN
TRUSTEE2.0X000
MARCIE ROSENBERG
TRUSTEE2.0X000
ROBERT D ROSENTHAL
TRUSTEE2.0X000
BERNARD M ROSOF MD
TRUSTEE2.0X000
JACK J ROSS
TRUSTEE2.0X000
BARRY RUBENSTEIN
TRUSTEE2.0X000
HERBERT RUBIN
TRUSTEE2.0X000
SCOTT RUDOLPH
TRUSTEE2.0X000
MICHAEL H SAHN
TRUSTEE2.0X000
FRANK W SCARANGELLO SR
TRUSTEE2.0X000
LOIS C SCHLISSEL
TRUSTEE2.0X000
JOHN M SHALL
TRUSTEE2.0X000
MARC V SHAW
TRUSTEE2.0X000
SEAN G SIMON
TRUSTEE2.0X000
RICHARD SIMS
TRUSTEE2.0X000
MICHAEL C SLADE
TRUSTEE2.0X000
PHYLLIS HILL SLATER
TRUSTEE2.0X000
HOWARD D STAVE
TRUSTEE2.0X000
RUSSELL STERN
TRUSTEE2.0X000
JOHN B THOMSON JR
TRUSTEE2.0X000
PETER TILLES
TRUSTEE2.0X000
SANDRA TYTEL
TRUSTEE2.0X000
FREDERICK A VOLK
TRUSTEE2.0X000
NANCY WALDBAUM
TRUSTEE2.0X000
EMMETT F WALKER JR
TRUSTEE2.0X000
GARY WALTER
TRUSTEE2.0X000
LEWIS M WESTON
TRUSTEE2.0X000
BARBARA HRBEK ZUCKER
TRUSTEE2.0X000
DONALD ZUCKER
TRUSTEE2.0X000
ROY J ZUCKERBERG
TRUSTEE2.0X000
ARTHUR KLEIN
EXECUTIVE DIRECTOR50.0X01075608288200
KEITH C THOMPSON
ASSISTANT SECRETARY50.0X02868822533031
HARRY E GINDI
ASSISTANT TREASURER50.0X028455842600
MARK P JARRETT MD
CMO/VP CHIEF QUALITY OFFICER42.0X68884596396471598.0
ROBERT S SHAPIRO
SVP/CFO NS-LIJ HEALTH SYSTEM50.001139453231819X
THOMAS RECA
CHIEF FINANCIAL OFFICER5300461000004077650.0X
DONNA PROSKE
EVP - CHIEF NURSING EXECUTIVE56450803457850.0X
GREGORY RADINSKY
CHIEF COMPLIANCE OFFICER50.0030959042200X
JOSEPH T MCGINN MD
PHYSICIAN149599303568250.0X
JONATHON DEITCH MD
PHYSICIAN99884902138650.0X
MICHAEL L COOPER MD
PHYSICIAN93652403542250.0X
PHILIP M VIGNERI MD
PHYSICIAN91996803749450.0X
CHRISTOPHER DEMAS MD
PHYSICIAN91595903089950.0X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6430731TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs13322545TotalReportableCompFrmRltdOrgs
Total Other Compensation3278035TotalOtherCompensation
Number Individuals GT100 K798NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MORRISON MANAGEMENT SPECIALISTS
12975 COLLECTIONS CENTER DRIVECHICAGOIL60693FOOD6902713
ADVANTEDGE HEALTHCARE SOLUTIONS INC
30 TECHNOLOGY DRIVEWARRENNJ07059BILLING3459800
UNIVERSITY PHYSICIANS GROUP PC
ONE EDGEWATER PLAZASTATEN ISLANDNY10305MEDICAL3349940
MCKESSON INFORMATION SOLUTIONS INC
5995 WINDWARD PARKWAYALPHARETTAGA30005IT CONSULTANTS3246002
QUEST DIAGNOSTICS INC
1 MALCOLM AVENUETETERBORONJ07608LABORATORY2279351
FieldValueIRS element (for citing)
Number Of Contractors GT100 K86NumberOfContractorsGT100K
Info In Schedule O Part VIIIXInfoInScheduleOPartVIII
Related Organizations74514RelatedOrganizations
Government Grants3711795GovernmentGrants
All Other Contributions185474AllOtherContributions
Total Contributions3971783TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
NET PATIENT SERVICE REVENUE6215007812786307722908828987748
PROFESSIONAL SERVICES REVENUE62111020047212004721
OTHER HEALTHCARE RELATED REVENUE6219904197950541979505
FieldValueIRS element (for citing)
Total Program Service Revenue825262856TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4082763TotalRevenueColumn
Exclusion$4,082,763ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1813032Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1813032Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1813032TotalRevenueColumn
Exclusion$1,813,032ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other350Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other350Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column350TotalRevenueColumn
Exclusion$350ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA AND DIETARY7225142422977$2,422,977
PARKING REVENUE812930533405$533,405
REBATES812900344602$344,602

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column449495TotalRevenueColumn
Exclusion$449,495ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue3750479TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column838881263TotalRevenueColumn
Related Or Exempt Function Income816275108RelatedOrExemptFunctionIncome
Unrelated Business Revenue8987748UnrelatedBusinessRevenue
Exclusion$9,646,624ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1243351Total
Management And General1243351ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total200620Total
Program Services0ProgramServices
Management And General200620ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total400463510Total
Program Services359907302ProgramServices
Management And General40556208ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total25391566Total
Program Services23540562ProgramServices
Management And General1851004ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total69104313Total
Program Services64058341ProgramServices
Management And General5045972ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total29083240Total
Program Services26959239ProgramServices
Management And General2124001ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total776287Total
Management And General776287ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total986781Total
Management And General986781ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total99071Total
Management And General99071ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total13295739Total
Program Services13295739ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total944158Total
Program Services944158ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total14750934Total
Program Services10699935ProgramServices
Management And General4050999ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total2536806Total
Program Services1840132ProgramServices
Management And General696674ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total9335128Total
Program Services3408463ProgramServices
Management And General5926665ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total335984Total
Program Services243714ProgramServices
Management And General92270ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total705780Total
Program Services511954ProgramServices
Management And General193826ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total7796775Total
Program Services5655573ProgramServices
Management And General2141202ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total32616205Total
Program Services23658927ProgramServices
Management And General8957278ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total30035466Total
Program Services29206933ProgramServices
Management And General828533ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL EXPENSES831982346034978522848449
CONTRACTED SERVICES4525282644944458308368
UTILITIES87910632500008541063
CENTRALIZED ADMIN. SVCS.17716410128510124865398

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1111947Total
Program Services809147ProgramServices
Management And General302800ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total795772194Total
Program Services683135374ProgramServices
Management And General112636820ManagementAndGeneral
Fundraising0Fundraising
FieldValueIRS element (for citing)
Info In Schedule O Part XXInfoInScheduleOPartX

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY60201BOY
EOY60984EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY108844454BOY
EOY35565305EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1906377BOY
EOY1522765EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY88732941BOY
EOY83763758EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY7975381BOY
EOY9156502EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1378627BOY
EOY1053041EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis685542830LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec451415489LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY226591836BOY
EOY234127341EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY122727420BOY
EOY267590947EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY27870431BOY
EOY22195105EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY90142922BOY
EOY89522626EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY676230590BOY
EOY744558374EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY94261683BOY
EOY99378036EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY62626865BOY
EOY61359786EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY52396935BOY
EOY54861388EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY25902787BOY
EOY18300000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY252258788BOY
EOY265053673EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY487447058BOY
EOY498952883EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY178518820BOY
EOY232262508EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY8780523BOY
EOY11858794EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1484189BOY
EOY1484189EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY188783532BOY
EOY245605491EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY676230590BOY
EOY744558374EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses43109069ReconcilationRevenueExpenses
Reconciliation Unrealized Invest5496809ReconciliationUnrealizedInvest
Reconcilation Other Changes8216081ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationstrueRalliesDemonstrations
Rallies Demonstrations$99,071RalliesDemonstrationsAmount
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB99071TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYING ACTIVITIESIdentifier
Return ReferenceSCHEDULE C, PART II-B; LINES 1G AND 1HReturnReference
ExplanationTHE ORGANIZATION IS A MEMBER OF THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. IS A MEMBER OF THE GREATER NEW YORK HOSPITAL ASSOCIATION ("GNYHA"), THE HEALTH CARE ASSOCIATION OF NEW YORK STATE and THE AMERICAN HOSPITAL ASSOCIATION WHICH ALL ENGAGE IN LOBBYING EFFORTS ON BEHALF OF THEIR MEMBER HOSPITALS. THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. PAYS DUES TO THESE ASSOCIATIONS ON BEHALF OF THIS ORGANIZATION. ADDITIONALLY, THROUGH GNYHA, THE ORGANIZATION PAYS DUES TO THE 1199 JOB SECURITY FUND. A PORTION OF THE DUES PAID TO THESE ORGANIZATIONS HAS BEEN ALLOCATED TO LOBBYING ACTIVITES PERFORMED ON BEHALF OF THE ORGANIZATION. THIS ALLOCATION AMOUNTED TO $99,071.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1484189BeginningOfYearBalance
End Of Year Balance1484189EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1484189BeginningOfYearBalance
End Of Year Balance1484189EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1484189BeginningOfYearBalance
End Of Year Balance1484189EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1484189BeginningOfYearBalance
End Of Year Balance1484189EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1484189BeginningOfYearBalance
End Of Year Balance1484189EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis4107673OtherCostOrOtherBasis
Book Value4107673BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis351657008OtherCostOrOtherBasis
Depreciation197417675Depreciation
Book Value154239333BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis247563OtherCostOrOtherBasis
Depreciation18654Depreciation
Book Value228909BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis289743765OtherCostOrOtherBasis
Depreciation241714168Depreciation
Book Value48029597BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis39786821OtherCostOrOtherBasis
Depreciation12264992Depreciation
Book Value27521829BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings234127341TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated (12 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
INVESTMENT IN HEALTHFIRST10467815F
INVESTMENT IN VERIZON - AT&T10143F
U.S. GOVERNMENT OBLIGATIONS17403000F
CORPORATE BONDS3371000F
ACCRUED INTEREST RECEIVABLE430000F
FIXED INCOME MUTUAL FUNDS7442000F
COMMINGLED FIXED INCOME FUNDS2870000F
EQUITY SECURITIES12103000F
EQUITY MUTUAL FUNDS3419000F
FUNDS OF HEDGE FUNDS3341000F
LIMITED USE27502000F
CASH AND CASH EQUIVALENTS179231989F
FieldValueIRS element (for citing)
Total Of Book Value Program Related267590947TotalOfBookValueProgramRelated

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM RELATED PARTIES0
OTHER ASSETS232794
OTHER RECEIVABLES935224
DEPOSITS139417
ASU 2010-0488215191
FieldValueIRS element (for citing)
Total Book Value Other Assets89522626TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (9 entries)

DescriptionDescriptionAmountAmount
PARTY PAYERS; CURRENT$22,476,845
LIABILITIES; CURRENT$6,839,142
INTEREST PAYABLE$921,276
OTHER LONG TERM LIABILITIES$45,233,378
LIABILITIES; NON-CURRENT$67,187,666
LIABILITIES; CURRENT$5,438,260
LIABILITIES; NON-CURRENT$23,951,091
INSURANCE PAYABLE$88,215,191
DUE TO RELATED PARTIES; NET$4,790,824
FieldValueIRS element (for citing)
Total Of Amounts265053673TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt836050171TotRevenueEtcAuditedFinclStmt
Other Revenues924051OtherRevenues
Revenue Not Rptd F990924051RevenueNotRptdF990
Revenue Subtotal835126120RevenueSubtotal
Other Revenues Not Included3755143OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt3755143RevenueNotRptdOnFinStmt
Total Revenue Per Form990838881263TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt790227194TotExpensesEtcAuditedFinclStmt
Expenses Subtotal790227194ExpensesSubtotal
Other Expenses Not Included5545000OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt5545000ExpensesNotRptdOnFinStmt
Total Expenses Per Form990795772194TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ENDOWMENT FUNDSSCHEDULE D, PART V, QUESTION 4ENDOWMENT FUNDS INCLUDED IN PERMANENTLY RESTRICTED NET ASSETS ARE USED TO SUPPORT THE CHARITABLE ACTIVITIES AND PROGRAMS OF THE ORGANIZATION AND ITS AFFILIATES.
TEXT OF FIN 48 AUDITED FINANCIAL STATEMENT FOOTNOTESCHEDULE D, PART XCertain entities included in the System's consolidated financial statements are taxable entities under Federal or state laws. U.S. generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in income in the period of enactment. At December 31, 2012 and 2011, the System has a deferred income tax asset which has been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion, or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to the allowance for doubtful accounts receivable and net operating loss carry forwards. Certain entities have net operating loss carry forwards aggregating approximately $149,000,000, which expire in varying amounts through 2032, and are available to offset future taxable income.
RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTSSCHEDULE D, PART XI; LINE 2DOTHER RECONCILIATION ITEMS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART VIII, LINE 12 INCLUDE: - NET ASSETS RELEASED FROM RESTRICTION USED FOR OPERATIONS - $924,051.
RECONCILIATION OF REVENUE PER AUDITED FINANCIAL STATEMENTSSCHEDULE D, PART XI; LINE 4BOTHER RECONCILIATION ITEMS INCLUDED ON FORM 990, PART VIII, LINE 12 BUT NOT ON LINE 1 INCLUDE: - INVESTMENT INCOME - $3,755,143.
RECONCILIATION OF EXPENSES PER AUDITED FINANCIAL STATEMENTSSCHEDULE D, PART XII; LINE 4BOTHER RECONCILIATION ITEMS INCLUDED ON FORM 990, PART IX, LINE 25 BUT NOT ON LINE 1 INCLUDE: - AMORTIZATION OF INTANGIBLE ASSET - $5,545,000.

Schedule F IRS990ScheduleF

FieldValueIRS element (for citing)
Grant Records MaintainedtrueGrantRecordsMaintained

Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)

RegionRegionNumber Of EmployeesNumberOfEmployeesType Of Activities ConductedTypeOfActivitiesConductedTotal ExpendituresTotalExpenditures
Central America and the Caribbean1Investments3364982
Central America and the Caribbean1Investments12043338
FieldValueIRS element (for citing)
Subtotal Number Of Employees2SubtotalNumberOfEmployees
Total Number Of Employees2TotalNumberOfEmployees
Subtotal Amount Spent15408320SubtotalAmountSpent
Total Amount Spent15408320TotalAmountSpent
Transfer To Foreign CorpfalseTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorpfalseOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage500.DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served7468PersonsServed
Total Community Benefit Expense12862000TotalCommunityBenefitExpense
Direct Offsetting Revenue5282000DirectOffsettingRevenue
Net Community Benefit Expense7580000NetCommunityBenefitExpense
Percent Of Total Expense0.00950PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served367918PersonsServed
Total Community Benefit Expense153393427TotalCommunityBenefitExpense
Direct Offsetting Revenue128810613DirectOffsettingRevenue
Net Community Benefit Expense24582814NetCommunityBenefitExpense
Percent Of Total Expense0.03130PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served375386PersonsServed
Total Community Benefit Expense166255427TotalCommunityBenefitExpense
Direct Offsetting Revenue134092613DirectOffsettingRevenue
Net Community Benefit Expense32162814NetCommunityBenefitExpense
Percent Of Total Expense0.04080PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs140NumberOfActivitiesOrPrograms
Persons Served128604PersonsServed
Total Community Benefit Expense6393259TotalCommunityBenefitExpense
Net Community Benefit Expense6393259NetCommunityBenefitExpense
Percent Of Total Expense0.00810PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs10NumberOfActivitiesOrPrograms
Persons Served1845PersonsServed
Total Community Benefit Expense52010974TotalCommunityBenefitExpense
Direct Offsetting Revenue15635155DirectOffsettingRevenue
Net Community Benefit Expense36375819NetCommunityBenefitExpense
Percent Of Total Expense0.04630PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served14220PersonsServed
Total Community Benefit Expense5203000TotalCommunityBenefitExpense
Direct Offsetting Revenue3330000DirectOffsettingRevenue
Net Community Benefit Expense1873000NetCommunityBenefitExpense
Percent Of Total Expense0.00240PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs11NumberOfActivitiesOrPrograms
Persons Served228PersonsServed
Total Community Benefit Expense234332TotalCommunityBenefitExpense
Net Community Benefit Expense234332NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs162NumberOfActivitiesOrPrograms
Persons Served144897PersonsServed
Total Community Benefit Expense63841565TotalCommunityBenefitExpense
Direct Offsetting Revenue18965155DirectOffsettingRevenue
Net Community Benefit Expense44876410NetCommunityBenefitExpense
Percent Of Total Expense0.05710PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs164NumberOfActivitiesOrPrograms
Persons Served520283PersonsServed
Total Community Benefit Expense230096992TotalCommunityBenefitExpense
Direct Offsetting Revenue153057768DirectOffsettingRevenue
Net Community Benefit Expense77039224NetCommunityBenefitExpense
Percent Of Total Expense0.09790PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served53PersonsServed
Total Community Building Expense8224TotalCommunityBuildingExpense
Net Community Building Expense8224NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs3NumberOfActivitiesOrPrograms
Persons Served1050PersonsServed
Total Community Building Expense2443TotalCommunityBuildingExpense
Net Community Building Expense2443NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs6NumberOfActivitiesOrPrograms
Persons Served1366PersonsServed
Total Community Building Expense10667TotalCommunityBuildingExpense
Net Community Building Expense10667NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$7,774,000BadDebtExpenseAmount
Amount Reimbursed By Medicare188724591AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare171133423CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall17591168MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeWebsite AddressWebsiteAddressLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalEr24 HoursEr24HoursFacility Reporting GroupFacilityReportingGroup
STATEN ISLAND UNIV HOSPITAL - NORTH
1475 SEAVIEW AVENUESTATEN ISLANDNY10305WWW.SIUH.EDUXXXX1
STATEN ISLAND UNIV HOSPITAL - SOUTH
2375 SEGUINE AVENUESTATEN ISLANDNY10309WWW.SIUH.EDUXXXX1

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1STATEN ISLAND UNIV HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent500.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Other FactorsXOtherFactors
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Other Actions TakenXOtherActionsTaken
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargestrueGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities10NumberOfOtherFacilities

Other Facilities OtherFacilities (10 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
SOUTH BEACH PSYCHIATRIC CENTER
777 SEAVIEW AVENUESTATEN ISLANDNY10305CLINIC
NEW DORP HIGH SCHOOL
465 NEW DORP LANESTATEN ISLANDNY10306CLINIC
AUDIOSPEECH PATHOLOGY CENTER
500 SEAVIEW AVENUESTATEN ISLANDNY10305CLINIC
CHEMICAL DEPENDENCE TREATMENT PROGRAM
111 WATER STREETSTATEN ISLANDNY10304CLINIC
THE BAY STREET HEALTH CENTER
57 BAY STREETSTATEN ISLANDNY10301CLINIC
PSYCHALCOHOLISM TREATMENT PROGRAM
450 SEAVIEW AVENUESTATEN ISLANDNY10305CLINIC
CANARSIE MULTI SERVICE CENTER
567 E 10TH STREETBROOKLYNNY11218CLINIC
SANFORD R NALITT INSTITUTUE FOR CANCER
256 MASON AVENUESTATEN ISLANDNY10305CLINIC
CONEY ISLAND MULTIPLE SERVICE CENTER
425-427 CONEY ISLAND AVENUEBROOKYLNNY11218CLINIC
CENTER FOR WOMENS HEALTH
440 SEAVIEW AVENUESTATEN ISLANDNY10305CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (27 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ELIGIBILITY FOR DISCOUNTED CAREPART I, LINE 3CThis hospital is an affiliated entity of the North Shore-LIJ Health System ("North Shore-LIJ" or "the System"). North Shore-LIJ uses FPG to determine eligibility and utilizes the New York State Department of Health (NYSDOH) guidelines regarding the consideration of assets. Asset tests cannot be used to deny financial assistance, but only to "upgrade" a patient's level of obligation, up to the legal maximum permitted under the financial assistance law.
COMMUNITY BENEFIT REPORTSCHEDULE H, PART I; QUESTION 6AThe Community Benefit report is prepared by the hospital, in conjunction with an affiliated entity (North Shore-Long Island Jewish Health System) of the hospital. The Community Benefit Report is accessible to the public and can be accessed on the North Shore-LIJ website: http://www.northshorelij.com.
SUBSIDIZED HEALTH SERVICESSCHEDULE H, PART I; QUESTION 7Row (a) The cost of charity care was determined by utilizing the ratio of cost to charges (RCC) calculated on Worksheet 2 applied to gross charges written off for patients qualifying for charity under the hospital's financial assistance policy. Bad Debt was not reported in any row of Part I, Line 7. Row (b) The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. A RCC is developed from these costs, and that RCC is applied to total Medicaid gross ancillary services charges to determine the cost of services provided to Medicaid patients. Row (e) Costs associated with Community Health Improvement Services were determined by adding indirect or overhead costs to the direct costs of the activity. Indirect costs were calculated as a percentage of direct costs. Direct costs for staff expenses were calculated using average hospital facility hourly rates, and were adjusted to account for fringe benefits, using a blended rate based on the ratio of total employee benefit expenses to total salary and wages. Row (f) The Bad Debt Expense that appears on Form 990, Part IX, Line 25 column (A), but not included for purposes of calculating the percentage in this column is equal to the amount reported on Form 990, Part X. The costs related to health professions education were determined by utilizing the step down method of cost finding. Row (h) Costs associated with research activities were determined by adding indirect, or overhead, costs to the direct costs of the activity. Indirect costs were calculated as a percentage of costs. Row (i) The cost of in-kind contributions to community groups is comprised of the direct costs of personnel whose compensated time was donated to various charities and community groups. The salaries and wages were adjusted to include benefits using a rate based on the ratio of total employee benefit expenses to total salary and wages. Indirect costs were calculated as a percentage of direct costs. Column (a) The number of activities or programs was determined by counting unique community benefit activities or programs conducted throughout the year. Each activity or program may include multiple occurrences. In Part I line 7a-k, column (a) represents the total number of unique community benefit activities and programs; not the number of occurrences for each activity and program. Column (b) Persons served were determined by the unique number of community members that encountered a specific community benefit activity or program. Persons were reported multiple times when engaged in services in different categories of activity or program. Column (f) for Rows (a)-(k) The percentage of Net Community Benefit Expense divided by Total Expense for the hospital (to calculate the percent of total expense). Note: For the entire North Shore-LIJ Health System, Part I, Line 7(Row K, Column F) is approximately 10.9% as a percentage of expenses.
COMMUNITY BUILDING ACTIVITIESSCHEDULE H, PART IIAll community building activities improve access to health services and address federal, state, or local public health priorities, as well as leverage public health department activities, and in doing so, they provide relief of government burden. These activities broadly serve low-income, underserved patients, and include: collaboration with various community coalitions, system-wide recycling initiative, organizational response to worldly disasters, and bioterrorism efforts. The System's bioterrorism & disaster preparedness includes Center for Emergency Medical Services, which is a state and federal planning resource on weapons of mass destruction, and a designated a Bioterrorism Resource Center. The System has conducted staff training for more than 100 hospitals and area first responders and invested heavily in the infrastructure needed for large-scale emergencies. During catastrophes, (i.e. Super storm Sandy), North Shore-LIJ provides a safe haven for thousands of patients, outside nursing home residents, and community members seeking shelter. North Shore-LIJ ambulances assists with the transport of patients throughout the metropolitan area and stand ready to contribute food, medicine and blankets to numerous individuals who may lose power in their homes, and assist both affiliated and non-affiliated hospital patients. Investment in a field hospital has furthered the public health infrastructure needed for mass casualties that could result from a terrorist attack, natural attack, or large-scale emergency.
BAD DEBT EXPENSESCHEDULE H, PART III, SECTION A; QUESTION 4For patients who were determined by the System to have the ability to pay but did not, the uncollected amounts are recorded as bad debt expense. Bad debt expenses are determined by applying the ratio of cost to charges from Worksheet 2 to gross patient charges written off to bad debt.
COMMUNITY BENEFITSCHEDULE H, PART III, SECTION B; QUESTION 8Medicare costs are determined utilizing a combination of the step down method of cost findings and a cost per unit of service. Cost per unit of service is used to calculate the routine cost of services provided to Medicare patients. The Ratio of Cost to Charges method (or RCC) is used to determine the cost of ancillary services. An RCC is developed from these costs, and that RCC is applied to total Medicare gross ancillary services charges to determine the cost of services provided to Medicare patients.
COLLECTION POLICYSCHEDULE H, PART III, SECTION B; QUESTION 9BThe organization's collection policy is standard to all accounts regardless of insurance status (e.g. insured, underinsured, and uninsured). The hospital's collection policy states that they will not send patient accounts to collection if a decision on a financial assistance application is pending, or if a patient is determined to be eligible for Medicaid at the time services were rendered and for which services Medicaid payment is available.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTIONS 1J, 3, 4, 5C, 6I & 7NOT APPLICABLE.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTION 9The organization's financial assistance policy will review a patient's assets if they fall within the family size and income levels approved by the New York State to provide free or discounted care. Asset test cannot be used to deny financial assistance, but only to "upgrade" a patient's level of obligation, up to the legal maximum permitted under the financial assistance law.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTION 10NOT APPLICABLE.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTION 11NOT APPLICABLE.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTION 12HThe hospital also uses household size.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTIONS 14GThe policy is included in the hospital's Community Service Plan and provided at health fairs and presentations open to the community at no cost, in addition to mailing financial policy summary brochures.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTION 16ENOT APPLICABLE.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTION 17ENOT APPLICABLE.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTION 18EBefore initiating any of the actions, the hospital facility sends letters, makes telephone calls and utilizes presumptive eligibility.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTIONS 19C & 19DNOT APPLICABLE.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTION 20DThe hospital used a blended Medicaid rate as a criterion during the tax year to determine the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care. Under NYS Health Law Section 2807-k (9a) indigent care pool requires a sliding fee scale from qualifying patients. A reduction from gross charges must result in an expected payment that does not exceed the amount paid for the same services by the hospital's highest volume payer (i.e. Medicare or Medicaid).
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTION 21NOT APPLICABLE.
FACILITY INFORMATIONSCHEDULE H, PART V, SECTION B, QUESTION 22In general, the hospital facility does not charge its FAP-eligible patients an amount equal to the gross charge for any service provided. The hospital may charge an amount equal to the gross charge when it is less than the Medicaid rate.
NEEDS ASSESSMENTSCHEDULE H, PART VI; QUESTION 2The Community Health Needs Assessment (CHNA) is performed on an ongoing basis. North Shore-LIJ conducts and participates in population, demographic, and health status evaluations of our respective hospitals' service areas based on county regions and the communities we serve. There is a special effort to include individuals with health disparities and organizations who serve these communities in the CHNA process. The CHNA includes the analysis of primary and secondary data. Multi-year analyses, trends and projections are developed, which identify areas of need for the continuum of health care services. Primary data is obtained through a combination of qualitative analysis of community-based organization (CBO), informant interviews and surveys, individual community member surveys, and participation in collaborative partner meetings. These meetings include representatives from the Departments of Health, CBOs, academic institutions, government agencies, and hospitals. Ongoing input concerning our communities' needs is also obtained through: our Board of Trustees/Directors who are all area residents and leaders in their respective communities; facility based advisory boards and councils, and; the feedback received by our facility administrators and clinicians that serve on local community agency boards. Secondary data analysis includes: internal hospital data, including Prevention Quality Indicators (PQI); Department of Health Community Health Assessments; local regional NYS Prevention Agenda data sources; E-BRFSS; 2010 US Census data and Statewide Planning and Research System (SPARCS) data. The Committee on Community Health, a committee of the Board of Trustees, provides recommendations that concern North Shore-LIJ's community health priorities and interventions based on the CHNA. Committee discussions focus on New York State (NYS) Prevention Agenda Priority Areas, including strategies and intervention outcomes related to chronic disease prevention, women and children's health, healthy safe environments, health access, mental health and substance abuse, HIV/AIDS/STDs and community immunizations. Regional departments of health (I.E. Nassau County Department of Health, Suffolk County Department of Health Services, and NYC Department of Health and Mental Hygiene) perform additional community health assessments (CHA) with the input of hospital and community stakeholders. These regional partners use strategies such as community member surveys, CBO surveys, and public listening sessions to solicit information on community needs. Together with other healthcare organizations and CBOs, North Shore-LIJ participates in meetings organized by these regional departments of health academic organizations to discuss the shared responsibility of public health planning within the NYS Prevention Agenda. These meetings provide an opportunity for general discussion regarding the public health goals of the NYS Prevention Agenda and the selection of shared priorities for collaborative regional planning. The partnership among local health departments, hospitals and CBOs, enables region wide leveraging of resources, consensus on health priorities and collaboration on health promotion strategies.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCESCHEDULE H, PART VI; QUESTION 3North Shore-LIJ is a regional leader in the development of financial assistance programs for the uninsured. The System's financial assistance policy provides a uniformly-administered system of reduced fees for the uninsured residents of our service area. The current fee schedule includes patients with household incomes up to 500% of the FPL. While the fee schedule serves as a guide, all hardship cases are evaluated on a case-by-case basis, taking into account the individual's financial and personal circumstances. All medically necessary services are covered under the financial assistance program and the public is notified of the availability of the program through: multilingual signage and educational brochures; centralized program administration accessible via phone ; staff outreach, and all bills include a notice about the financial assistance program. Soft credit scoring software is used to facilitate the application process, but is not used to deny an applicant. The Healthcare Access Center (HAC), staffed by bilingual employees, assists community residents' with referrals for enrollment into government-subsidized insurance programs such as Medicaid, Child Health Plus and Family Health Plus. In addition, the HAC staff refers patients to the Medicaid Prenatal Care Program and to the Senior Navigator Program within North Shore-LIJ for assistance with Medicaid for pregnant women and Medicare enrollment for seniors.
COMMUNITY INFORMATIONSCHEDULE H, PART VI; QUESTION 4The North Shore-LIJ has a service area of more than approximately 7.2 million people covering Long Island (Nassau and Suffolk counties) and the Metropolitan area covering the boroughs of Manhattan, Queens, and Staten Island. The demographics of the community show a broad range of cultural and ethnic diversity, particularly in Queens, the most multi-ethnic county in the country. Overall the area has shown an increase in the number of uninsured and underinsured. The other counties in the service area continue to show trends of increasing diversity, as well. By 2018, our service area population 65 and older will grow by 14.5%, while residents under 65 will decline less than 1% (Thomson Reuters, Market Planner Plus). The service area has also shown high rates of obesity, diabetes, asthma and heart/cerebrovascular disease mortality.
PROMOTION OF COMMUNITY HEALTHSCHEDULE H, PART VI; QUESTION 5North Shore-LIJ works to promote community health through education, community advocacy, partnerships, and programs that result in improved access to care and health outcomes. The activities and strategies for achieving this goal include: establishing collaborative partnerships with local CBOs, health-related organizations, business, and government to identify and address community health needs; advocating for policies that benefit the broader community at state and local levels; providing community health programs and services based on identified community health needs/priorities; delivering preventive care services and education; conducting community outreach and engagement activities and expanding community member representation and involvement on committees/boards for programming and educational events. North Shore-LIJ provides community residents with a broad array of community health programs, such as: access to healthcare services and caring for the medically underserved; screenings and immunizations; health forums and health fairs; community education and outreach programs; support groups and counseling and emergency medical services. A comprehensive list of programs can be found in the Community Service Plans located on the North Shore-LIJ public website. North Shore-LIJ recognizes that, to have an impact on community health status, it must collaborate, to the extent possible, with multiple partners who can address different components of program design, including: providing trust and "reach" into a community; access to capital and funding; policy guidance and best practices for program development. With thousands of community programs, our partners are many and varied; some of our partners include: government, national/professional associations, area businesses, other area health care providers, philanthropies, civic organizations and CBOs.
AFFILIATED HEALTHCARE SYSTEMSCHEDULE H, PART VI; QUESTION 6The organization is an affiliate of the North Shore-LIJ Health System Inc., an integrated health care delivery system which includes 16 hospitals, 3 skilled nursing facilities, a world renowned children's hospital, post-acute services, ambulatory network, rehabilitation network and a freestanding research institute, which is chartered to confer doctoral (PhD) degrees through its Elmezzi Graduate School of Molecular Medicine. All North Shore-LIJ entities are considered to be under common control for antitrust and other legal purposes. Each hospital facility shares a common board and management in the North Shore-LIJ Health System and as such is referred to as being commonly managed. Also, in a joint venture, the Hofstra North Shore-LIJ School of Medicine at Hofstra University provides an allopathic medical school for the benefit of the community. In keeping with its mission to improve the health and caring for the communities it serves, regardless of the ability to pay, North Shore-LIJ established the Office of Community and Public Health (OCPH) to promote health and wellness. The OCPH plays a key role in leading many of the mission-critical initiatives of the System and operates in alignment with the National Prevention Strategy and NYS Prevention Agenda. The OCPH is guided by the Committee on Community Health, a committee composed of the Board of Trustees, which is charged with identifying the overall health needs of the community and making recommendations for the population the System serves. The objectives of the Committee include: promoting a dialogue about the obligations of a large health system in addressing critical health issues of the public; reviewing information which assesses the health status of the communities served; promoting activities which have been shown to positively impact health; proposing policy recommendations to guide current programs or develop new ones; identifying opportunities to meet health care needs through improved delivery of health care; and recommending community health interventions to be provided by the System. North Shore-LIJ has established comprehensive and coordinated clinical programs that span across the enterprise. These programs not only provide a full continuum of services and seamless delivery of care, but offer community health activities, outreach and education as well; they include: Behavioral Health, Cancer, Cardiovascular Services, Dental Medicine, Emergency Medicine, Family Medicine, Hospice Care, Imaging/Radiology, Laboratory Medicine and Pathology, Medicine, Neurology, Neurosurgery, Obstetrics/Gynecology, Ophthalmology, Orthopedic Surgery, Otolaryngology, Pediatrics, Physical Medicine & Rehabilitation, Population Health, Senior Services, Surgery, Urology, and Women's Health. The System's hospitals, programs and services support one of the largest resident and fellowship training programs in the United States. It directly sponsors approximately 120 accredited graduate medical education (GME) programs and trains more than 1,500 medical residents and fellows annually. Our hospitals and facilities collectively serve as teaching sites for more than 1,200 rotations for medical students from five medical schools.
STATE FILING OF COMMUNITY BENEFIT REPORTSCHEDULE H, PART VI; QUESTION 7New York
FACILITY REPORTING GROUP(S)SCHEDULE H, PART VI; QUESTION 8For any facility reported in Section B, the answers provided in Question 1 are identical.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgtrueCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
MICHAEL J DOWLING
TRUSTEE0117290201628000022448011071100211250395158500
ANTHONY C FERRERI
PRESIDENT/CEO - TRUSTEE0873896015500002015003721100151000143625600
KEVIN F LAWLOR
TRUSTEE0665596010440002918002633810171930107975000
RALPH A NAPPI
TRUSTEE06720870150000014544590419950187750233731601389266
ARTHUR KLEIN
EXECUTIVE DIRECTOR0871740016900003486802731000151000136380800
KEITH C THOMPSON
ASSISTANT SECRETARY07248520113000020309700511950021081034018530313468
HARRY E GINDI
ASSISTANT TREASURER02800270004531027500015100032715800
ROBERT S SHAPIRO
SVP/CFO NS-LIJ HEALTH SYSTEM0921947019000002750602095190223000137127200
THOMAS RECA
CHIEF FINANCIAL OFFICER46831704244301928610000027000013776057082210000000
MARK P JARRETT MD
CMO/VP CHIEF QUALITY OFFICER6748554455200139951844365427500905151007344363899600
DONNA PROSKE
EVP - CHIEF NURSING EXECUTIVE496339044443023726027000075780599086000
GREGORY RADINSKY
CHIEF COMPLIANCE OFFICER0269330021756018504027500014700035179000
JOSEPH T MCGINN MD
PHYSICIAN149521900077401500002068201531675000
JONATHON DEITCH MD
PHYSICIAN8988490100000000150000638601020235000
MICHAEL L COOPER MD
PHYSICIAN93652400000150000204220971946000
PHILIP M VIGNERI MD
PHYSICIAN72801601750000169520250000124940957462000
CHRISTOPHER DEMAS MD
PHYSICIAN7959590120000000110770198220946858000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COMPENSATION INFORMATIONCORE FORM, PART VII and SCHEDULE J, PART II; QUESTION 4BTWO individuals' participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. THE AMOUNTS REFLECTED IN COLUMN B(III) FOR THE FOLLOWING INDIVIDUALS INCLUDES PARTICIPATION IN A SERP FOR WHICH AMOUNTS ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THE AMOUNT OUTLINED HEREIN WAS INCLUDED IN EACH INDIVIDUAL'S 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: RALPH A. NAPPI, $1,389,266 AND KEITH C. THOMPSON, $313,468. SEVEN individuals' participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. Accordingly, the individualS may never actually receive the unvested benefit amount and the amounts outlined herein were properly not reported in each individual's Form W-2, Box 5, AS TAXABLE MEDICARE WAGES. These amounts are included in Schedule J-II, Column C for Michael J. DowlinG, $1,079,610; ANTHONY C. FERRERI, $344,610; KEVIN F. LAWLOR, $233,853; Ralph A. Nappi, $14,495; ARTHUR KLEIN, $245,600; KEITH C. THOMPSON, $484,450 AND ROBERT S. SHAPIRO, $182,019.
COMPENSATION INFORMATIONSCHEDULE J, PART I; QUESTION 5APURSUANT TO THE PERSONS LISTED IN FORM 990, PART VII, SECTION A, LINE 1A, THERE IS NO CONTRACTUAL OBLIGATION TO PAY OR ACCRUE ANY COMPENSATION TO OFFICERS OF THE NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM BASED ON THE REVENUE OF THE ORGANIZATION. A LISTED PERSON(S) THAT MAY QUALIFY UNDER THIS CONDITION COULD BE ONE OR MORE OF THE PHYSICIANS LISTED AS A HIGHLY COMPENSATED EMPLOYEE.
COMPENSATION INFORMATIONSCHEDULE J, PART I; QUESTION 7ON FORM 990, PART VII, SECTION A, LINE 1A, THE ORGANIZATION MAY PROVIDE NON-FIXED PAYMENTS, NOT DESCRIBED ON LINES 5 AND 6, TO CERTAIN LISTED PERSONS. THE ORGANIZATION BASES SUCH PAYMENTS ON MANY PERFORMANCE BASED FACTORS. PAYMENTS OF THIS TYPE APPEAR ON SCHEDULE J-1, PART I, B (II).
COMPENSATION INFORMATIONSCHEDULE J, PART II, COLUMN FTHE AMOUNTS REPORTED IN SCHEDULE J, PART II, COLUMN F FOR THE FOLLOWING INDIVIDUALS INCLUDE VESTED BENEFITS IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP") WHICH AMOUNTS ARE NO LONGER SUBJECT TO A SUBSTANTIAL RISK OF COMPLETE FORFEITURE. THESE AMOUNTS WERE REPORTED IN SCHEDULE J, PART II, COLUMN C AS RETIREMENT AND OTHER DEFERRED COMPENSATION ON PRIOR YEAR'S FORMS 990. THE AMOUNTS WERE TREATED AS TAXABLE INCOME AND REPORTED ON EACH INDIVIDUAL'S 2012 FORM W-2, BOX 5, AS TAXABLE MEDICARE WAGES: RALPH A. NAPPI, $1,389,266 AND KEITH C. THOMPSON, $313,468.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
DORMITORY AUTHORITY - STATE OF NEW YORK
A146000293649906JT22011-10-0662381682CAPITAL IMPROVEMENTfalsefalsefalse
DORMITORY AUTHORITY - STATE OF NEW YORK
B1460002932009-08-194744692LEASE OF EQUIPMENTfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindYear Of Subst CompletionYearOfSubstCompletion
A9099840624395905021231517772011048710010277334360534830truetruefalsetrue
B770782047446920008325000466144200falsefalsetruetrue2010

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
Afalsefalsefalsefalse0falsefalsefalsetrue
Bfalsefalsefalsefalse0falsefalsefalsetrue

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
0
Afalsetruetruefalsefalsefalsefalse0falsetrue
0
Bfalsetruetruefalsefalsefalsefalse0falsetrue

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Atrue
Btrue

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
TONI A SPINELLA
DAUGHTER OF OFFICER34131EMPLOYEEfalse
TARA MAZZUCCO
DAUGHTER OF TRUSTEE39942EMPLOYEEfalse
SCARAN OIL
COMPANY/FAMILY OF TRUSTEE333874OIL/UTILITY PRODUCTfalse
DONNA FERRERI
FAMILY MEMBER of officer20976EMPLOYEEfalse
JAMES R WELLER
SON OF OFFICER79088EMPLOYEEfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierBUSINESS TRANSACTIONS INVOLVING INTERESTED PERSONSIdentifier
Return ReferenceSCHEDULE L, PART IVReturnReference
ExplanationFRANK W. SCARANGELLO, SR. IS A TRUSTEE OF THE ORGANIZATION. THE ORGANIZATION UTILIZED THE SERVICES OF HIS COMPANY, SCARAN OIL, DURING 2012. TOTAL FEES PAID TO SCARAN OIL WERE $333,874. SERVICES WERE RENDERED AT FAIR MARKET VALUE RATES PURSUANT TO ARM'S LENGTH NEGOTIATIONS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTSCORE FORM, PART III; LINE 4DEXPENSES INCURRED IN PROVIDING VARIOUS OTHER MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY.
BUSINESS AND FAMILY RELATIONSHIPSCORE FORM, PART VI, SECTION A; QUESTION 2FORM 990 SCHEDULE A, PART III STATEMENT ABOUT ACTIVITY ====================================================== ALL TRANSACTIONS WITH NORTH SHORE-LIJ HEALTH SYSTEM ENTITIES ARE AS FOLLOWS: (1) NEGOTIATED AT ARM'S LENGTH; (2) ALL PURCHASES ARE AT FAIR MARKET VALUE; AND (3) ALL PRODUCTS OR SERVICES ARE RENDERED ON AN "AS NEEDED" BASIS. William Achenbaum ----------------- has a business relationship with Eric Blumencranz and Roger Blumencranz. John Alexander -------------- has a business relationship with John Shall. Philip Altheim -------------- has a business relationship with Eric Blumencranz. Stanley Applebaum ----------------- has a business relationship with John Shall. Michael Ashner -------------- has a business relationship with William Mack and Scott Rudolph. Eric Blumencranz ---------------- has as a family relationship with Roger Blumencranz. He has a business relationship with Roger Blumencranz, William Achenbaum, Philip Altheim, Arlene Lane Fisher, Richard Goldstein, Lloyd Goldman, Alan Greene, James Greene, Stanley Grey, Richard Guarasci, Richard Horowitz, M. Allen Hyman, Jeffrey Jurick, Arthur Levine, Stuart Levine, David Mack, Bradley Marsh, Charles Merinoff, Ralph Nappi, Dennis Riese and Michael Slade. Roger Blumencranz ----------------- has a family relationship with Eric Blumencranz. He has a business relationship with Eric Blumencranz, William Achenbaum, mark claster, Alan Greene, James Greene, Stanley Grey, Richard Goldstein, Richard Horowitz, Jeffrey Jurick, Stuart Levine, David Mack, Ralph Nappi, Donald Zucker, Barbara Zucker. David Blumenfeld ---------------- has a family relationship with Edward Blumenfeld. Edward Blumenfeld ----------------- has a family relationship with David Blumenfeld. He has a business relationship with William Mack. Steve Braun ----------- has a family relationship with Richard Sims. he has a business relationship with cary kravet. Robert w. Chasanoff ------------------- has a business relationship with Michael h. Sahn. Alan Chopp ---------- has a business relationship with Patrick Mc Dermott. Mark Claster ------------ has a business relationship with Roger A. Blumencranz, Richard Goldstein, Saul Katz, robert d. rosenthal and Barry Rubenstein. Philippe Dauman --------------- has a business relationship with thomas dooley. Daniel de Roulet ---------------- has a family relationship with Lorinda de Roulet. Lorinda de Roulet ---------------- has a family relationship with Daniel de Roulet. thomas dooley ------------- has a business relationship with philippe dauman. Leonard Feinstein ----------------- has a business relationship with William Mack. Anthony Ferreri --------------- has a family and business relationship with John Shall. Arlene Lane Fisher ------------------ has a business relationship with eric blumencranz. Lloyd Goldman ---------------- has a business relationship with Eric Blumencranz, Richard Goldstein and William Mack. RICHARD GOLDSTEIN ----------------- has a business relationship with Roger Blumencranz, Eric Blumencranz, Mark Claster, Lloyd Goldman, William Mack, and Barry Rubenstein. Joaquin Gonzalez ---------------- has a business relationship with John Shall. Alan I. Greene -------------- has a family relationship with James R. Greene. He has a business relationship with Eric blumencranz and Roger Blumencranz. James R. Greene --------------- has a family relationship with Alan I. Green. He has a business relationship with Eric blumencranz and Roger Blumencranz. Stanley Grey ------------ has a business relationship with eric blumencranz and Roger Blumencranz. Richard Guarasci ---------------- has a business relationship with Eric Blumencranz. William Hiltz ------------- has a business relationship with jeff maurer. Richard Horowitz ---------------- has a business relationship with Eric blumencranz, Roger Blumencranz and m. allen hyman. m. allen hyman -------------- has a business relationship with eric blumencranz, richard horowitz, saul katz and donald zucker. Jeffrey Jurick -------------- has a business relationship with Eric blumencranz and Roger Blumencranz. David Katz ---------- has a family relationship with Saul Katz and Michael Katz. He has a business relationship with saul katz and seth lipsay. Michael Katz ------------ has a family relationship with Saul Katz and David Katz. He has a business relationship with Saul Katz, Curt Launer and Michael Slade. Saul Katz --------- has a family relationship with Michael Katz and David Katz. He has a business relationship with Mark Claster, Michael Katz, Curt Launer, Michael Slade, m. allen hyman and david katz. cary kravet ----------- has a business relationship with steve braun. Jeffrey Lane ------------ has a business relationship with William Mack. Curt Launer ----------- has a business relationship with Michael Katz and Saul Katz. David Lehr ---------- has a business relationship with Ronald Mazzucco. Arthur Levine ------------- has a business relationship with Eric Blumencranz. Stuart Levine ------------- has a business relationship with Eric blumencranz and Roger blumencranz. David MACK ---------- has a family relationship with William Mack. He has a business relationship with William Mack, Eric Blumencranz, and Roger Blumencranz. William Mack ------------ has a family relationship with David Mack. He has business relationships with David Mack, Michael Ashner, Edward Blumenfeld, Leonard Feinstein, Lloyd Goldman, Jeffrey Lane, Barry Rubenstein, Richard Goldstein and Roy Zuckerberg. Bradley Marsh ------------- has a family relationship with Jack Ross. He has a business relationship with Eric Blumencranz. jeffrey maurer -------------- has a business relationship with william hiltz. Ronald Mazzucco --------------- has a business relationship with David Lehr. F.J. McCarthy ------------- has a business relationship with Robert Rosenthal. Patrick McDermott ----------------- has a business relationship with Alan Chopp and John Shall. Charles Merinoff ---------------- has a business relationship with Eric Blumencranz. richard murcott --------------- has a business relationship with barry rubenstein. Ralph Nappi ----------- has a business relationship with Eric Blumencranz and roger blumencranz. Dennis Riese ------------ has a business relationship with Eric Blumencranz. Robert Rosenthal ---------------- has a business relationship with Mark Claster, F.J. McCarthy and nancy waldenbaum. Jack Ross --------- has a family relationship with Bradley Marsh. Barry Rubenstein ---------------- has a business relationship with mark claster, richard goldstein, william mack and Saul Katz. Scott Rudolph ------------- has a business relationship with michael ashner. John Shall ---------- has a family relationship with Anthony Ferreri. He has a business relationship with Anthony Ferreri, Patrick McDermott, John Alexander, Stanley Applebaum, and Joaquin Gonzalez. Richard Sims ------------ has a family relationship with Steve Braun. Michael Slade ------------- has a business relationship with Eric Blumencranz, Saul Katz and Michael Katz. nancy waldenbaum ---------------- has a business relationship with robert rosenthal. Barbara Hrbek Zucker -------------------- has a family relationship with Donald Zucker. She has a business relationship with Roger Blumencranz. Donald Zucker ------------- has a family relationship with Barbara Hrbek Zucker. He has a business relationship with Roger Blumencranz and m. allen hyman. Roy Zuckerberg -------------- has a business relationship with William Mack.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION A; QUESTION 7North Shore-Long Island Jewish Health Care, Inc. ("Health Care") is the sole corporate member of the organization. Health Care has the right to elect or appoint members of the organization's governing body and has the right to approve or ratify certain corporate decisions. This organization and Health Care are part of the North Shore - long Island Jewish Health System, an integrated healthcare delivery system.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION b; QUESTION 11bAll North Shore-LONG ISLAND JEWISH Health System Inc. and affiliated entities prepare the annual Return of Organization Exempt Form Income Tax (Form 990) with input from various departments including Corporate Compliance, Finance, Human Resources, and Legal). Before filing the returns, the documents are electronically made available for review to members of the Executive Committee. The Executive Committee, which is a committee made up of members from the Board of Trustees, may exercise all of the authority of the Board of Trustees except as such authority is limited by applicable law and except to the extent, if any, that such authority would be inconsistent with any provision of these By-laws or is limited by any resolution to such effect adopted by the Board of Trustees.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION B; QUESTION 12The North Shore-Long Island Jewish Health System ("Health System") has several control mechanisms to mitigate conflicts of interest. The Health System's Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, our Code of Ethical Conduct requires individuals to conduct Health System business in a manner that places the interests of the Health System ahead of their personal interests. In addition, the Health System has a Conflicts of Interest Policy Statement further elaborating upon individuals' disclosure and recusal obligations. Individuals that are in a position to influence the business or other decisions of the Health System are required to filed out a conflicts of interest disclosure form on a regular basis. The Corporate Compliance Office reviews all disclosures of possible conflicts, including matters disclosed in any conflicts of interest disclosure report and takes any actions deemed required or appropriate to manage or resolve any actual or potential conflicts of interest. In appropriate cases these disclosures and responsive actions will be reported to the Health System's Audit and Corporate Compliance Committee and other applicable committees. In addition, the Health System provides training to individuals on an annual basis regarding conflicts of interest and other compliance related topics. If an individual violates the Code of Ethical Conduct or any related policy such as the Conflicts of Interest Policy Statement, appropriate disciplinary action is taken based upon the facts and circumstances of the situation.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION B; QUESTION 15THE BY-LAWS OF THE HEALTH SYSTEM CREATE A COMMITTEE OF THE BOARD WITH FULL POWERS OF THE BOARD TO REVIEW AND APPROVE THE COMPENSATION OF OFFICERS AND OTHER KEY EMPLOYEES. THE COMMITTEE CONSISTS OF APPROXIMATELY 6 TRUSTEES WHO HAVE NO CONNECTION TO THE SYSTEM EXCEPT AS TRUSTEES AND THEY HAVE NO CONFLICTS AS TO MATTERS THEY CONSIDER. THE COMMITTEE MEETS SEVERAL TIMES A YEAR AS NEEDED BUT ALWAYS MEETS IN NOVEMBER/DECEMBER TO REVIEW AND DETERMINE OFFICER AND KEY EMPLOYEE COMPENSATION FOR THE FOLLOWING YEAR. FOR PURPOSES OF THEIR REVIEW THE COMMITTEE CONSIDERS THE RECOMMENDATIONS OF THE CEO FOR ALL PERSONS OTHER THAN THE CEO. FOR PURPOSES OF THE REVIEW EACH YEAR THE COMMITTEE RECEIVES INFORMATION FROM AN OUTSIDE INDEPENDENT COMPENSATION CONSULTANT AS TO COMPENSATION FOR COMPARABLE POSITIONS IN COMPARABLE ORGANIZATIONS AND MAKES ITS DECISIONS ON THIS BASIS, WITH THE OVERALL OBJECTIVE OF PAYING BASE SALARY AT THE 50TH PERCENTILE. ANY CONTRACTS OR OTHER COMPENSATION FOR OFFICERS OR KEY EMPLOYEES ARE SEPARATELY CONSIDERED AND NORMALLY ONLY APPROVED AFTER RECEIPT OF A "FAIRNESS OPINION" FROM THE INDEPENDENT CONSULTANT. ALL THE WORK AND PROCESS OF THE COMMITTEE IS STRUCTURED TO FALL WITHIN THE APPLICABLE SAFE HARBOR REGULATIONS.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION C; QUESTION 19CURRENTLY THE ORGANIZATION PROVIDES GOVERNANCE DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST.
RELATED HOURS INFORMATIONCORE FORM, PART VII, SECTION AThis organization is affiliated with the North Shore - Long Island Jewish Health System (the "Health System"). The Officers, Directors and Trustees listed on Schedule J hold similar positions with both this organization and other affiliates of the Health System, and they do not separately allocate their time to this organization and such other affiliates. The hours shown for all such persons reflect time devoted to the entire Health System and its affiliates, including this organization. For Directors and Trustees, the hours shown reflect the estimated average weekly time. For officers, Key Employees and Highest Compensated Employees, the hours shown reflect the weekly hours used when determining compensation payments for services rendered and are, generally, less than the actual weekly hours devoted to the Health System and its affiliates.
OFFICER DISCLOSURECORE FORM, PART VII AND SCHEDULE JMARK P. JARRETT, M.D., WAS EMPLOYEED AS THE CHIEF MEDICAL OFFICER OF THIS ORGANIZATION FROM JANUARY 1, 2012 THROUGH FEBRUARY 28, 2012. AS OF MARCH 1, 2013 MARK P. JARRETT, M.D. BECAME THE VICE PRESIDENT CHIEF QUALITY OFFICER AT NORTH SHORE - LONG ISLAND JEWISH. THEREFORE THIS RETURN SHOWS COMPENSATION FROM THIS ORGANIZATION AS WELL AS A TAX-EXEMPT RELATED CODE SECTION 501(C)(3) ORGANIZATION.
RECONCILIATION OF NET ASSETSCORE FORM, PART XI; QUESTION 9OTHER CHANGES IN FUND BALANCE INCLUDE: - NET ASSETS RELEASED FROM RESTRICTIONS USED FOR OPERATIONS - $924,051; - CHANGE IN VALUE ON EQUITY METHOD INVESTMENTS - $3,171,541; - CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENTS DESIGNATED AS DERIVATIVE INSTRUMENTS - $172,273; - NET ASSETS RELEASED FROM RESTRICTION FOR CAPITAL ASSET ACQUISITIONS - $2,087,532; - PENSION AND OTHER POSTRETIREMENT LIABILITY ADJUSTMENTS - ($1,217,587); and - NET CHANGE IN TEMPORARILY RESTRICTED NET ASSETS - $3,078,271.
AUDITED FINANCIAL STATEMENTSCORE FORM, PART XII; QUESTION 2THE ORGANIZATION IS AN AFFILIATE WITHIN THE NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. ("SYSTEM"), A TAX-EXEMPT INTEGRATED HEALTHCARE DELIVERY SYSTEM WHICH INCLUDES STATEN ISLAND UNIVERSITY HOSPITAL. THE SYSTEM'S PARENT ENTITY IS NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. AN INDEPENDENT CPA FIRM AUDITED THE CONSOLIDATED FINANCIAL STATEMENTS OF NORTH SHORE - LONG ISLAND JEWISH HEALTH SYSTEM, INC. AND ITS AFFILIATES FOR THE YEARS ENDED DECEMBER 31, 2012 AND DECEMBER 31, 2011; RESPECTIVELY. THESE CONSOLIDATED AUDITED FINANCIAL STATEMENTS INCLUDE CONSOLIDATING SCHEDULES ON AN ENTITY BY ENTITY BASIS. THE INDEPENDENT CPA FIRM ISSUED AN UNQUALIFIED OPINION WITH RESPECT TO THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS. THE NORTH SHORE - LONG ISLAND JEWISH HEALTHCARE SYSTEM, INC. EXECUTIVE COMMITTEE HAS ASSUMED RESPONSIBILITY FOR THE OVERSIGHT OF THE AUDIT OF THE CONSOLIDATED FINANCIAL STATEMENTS, WHICH INCLUDES THIS ORGANIZATION, AND THE SELECTION OF AN INDEPENDENT AUDITOR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1CASTLETON AVENUE ASSOCIATES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1475 SEAVIEW AVENUEAddressLine1
CitySTATEN ISLANDCity
StateNYState
ZIP Code10305ZIPCode
FieldValueIRS element (for citing)
EIN133943199EIN
Primary ActivitiesINACTIVEPrimaryActivities
Legal Domicile StateNYLegalDomicileState
Total Income0TotalIncome
EOY Assets0EOYAssets

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SIUHBusinessNameLine1

Form990 Schedule R Part II Form990ScheduleRPartII (36 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CHAPS Community Health Center Inc
1 Edgewater Plaza 6th FloorStaten IslandNY10305113345477InactiveNY501(C)(3)9SIUHtrue
Feinstein Institute for Medical Research
972 Brush Hollow RdWestburyNY11590112673595ResearchNY501(C)(3)4NS-LIJ HSfalse
Forest Hills Hospital
972 Brush Hollow RdWestburyNY11590112163522HealthCareNY501(C)(3)3NS-LIJ HCfalse
Franklin Hospital
972 Brush Hollow RdWestburyNY11590112296824HealthCareNY501(C)(3)3NS-LIJ HCfalse
Glen Cove Hospital
972 Brush Hollow RdWestburyNY11590111633487HealthCareNY501(C)(3)3NS-LIJ HCfalse
Hillside Hospital Houses Inc
972 Brush Hollow RdWestburyNY11590112113949Housing CompNY501(C)(2)N/ANS-LIJ HSfalse
Hospice Care Network
99 Sunnyside BlvdWoodburyNY11797112925757HospiceNY501(C)(3)9NS-LIJ HSfalse
Huntington Hospital
270 Park AvenueHuntingtonNY11743111630914HealthCareNY501(C)(3)3NS-LIJ HCfalse
Huntington Hosp Dolan Family Health Ctr
284 Pulaski RdGreenlawnNY11740113368503HealthCareNY501(C)(3)3Huntingtonfalse
LIJ Foundation
972 Brush Hollow RdWestburyNY11590112661239support orgNY501(C)(3)11, TYPE INS-LIJ HSfalse
Long Island Jewish Medical Center
972 Brush Hollow RdWestburyNY11590112241326HealthCareNY501(C)(3)3NS-LIJ HCfalse
LIJ Medical Center at Home Pharmacy
972 Brush Hollow RdWestburyNY11590113251128support orgNY501(C)(3)11, TYPE INS-LIJ HSfalse
North Shore Community Services Inc
972 Brush Hollow RdWestburyNY11590237273200Housing CompNY501(C)(2)N/ANS-LIJ HSfalse
North Shore University Hospital
972 Brush Hollow RdWestburyNY11590111562701HealthCareNY501(C)(3)3NS-LIJ HCfalse
NS Univ Hospital at Glen Cove Housing
972 Brush Hollow RdWestburyNY11590237010468Housing CompNY501(C)(2)N/ANS-LIJ HSfalse
North Shore University Hospital Housing
972 Brush Hollow RdWestburyNY11590112171903Housing CompNY501(C)(2)N/ANS-LIJ HSfalse
NSLIJ STERN FAMILY CENTER FOR REHAB
972 Brush Hollow RdWestburyNY11590237007485Nursing HomeNY501(C)(3)9NS-LIJ HCfalse
North Shore-LIJ Health Care Inc
972 Brush Hollow RdWestburyNY11590112965586support orgNY501(C)(3)11, TYPE INS-LIJ HSfalse
North Shore-LIJ Health System
972 Brush Hollow RdWestburyNY11590113418133support orgNY501(C)(3)11, TYPE INAfalse
North Shore-LIJ Health System Foundation
972 Brush Hollow RdWestburyNY11590112965575FundraisingNY501(C)(3)7NS-LIJ HSfalse
North Shore-LIJ Health Sys Laboratories
972 Brush Hollow RdWestburyNY11590113412370Support OrgNY501(C)(3)11, TYPE INS-LIJ HSfalse
North Shore-LIJ Medical Care Centers
972 Brush Hollow RdWestburyNY11590113473923support orgNY501(C)(3)11, TYPE INS-LIJ HSfalse
Plainview Hospital
972 Brush Hollow RdWestburyNY11590113241243HealthCareNY501(C)(3)3NS-LIJ HCfalse
SIUH Systems Inc
475 Seaview AvenueStaten IslandNY10305061074604FundraisingNY501(C)(3)7NS-LIJ HCfalse
Southside Hospital
972 Brush Hollow RdWestburyNY11590111667761HealthCareNY501(C)(3)3NS-LIJ HCfalse
SSH Inc
972 Brush Hollow RdWestburyNY11590112774102support orgNY501(C)(3)11, TYPE ISOUTHSIDEfalse
Staten Island Univ Hospital Foundation
360 Seaview AvenueStaten IslandNY10305870765787FundraisingNY501(C)(3)7SIUHtrue
THE HEART INSTITUTE
475 SEAVIEW AVENUESTATEN ISLANDNY10305311757254inactiveNY501(C)(3)11, TYPE INAfalse
PHYSICIANS OF UNIVERSITY HOSPITAL PC
1 EDGEWATER PLAZA 6th floorSTATEN ISLANDNY10305200096809HEALTHCARENY501(C)(3)11, TYPE ISIUHtrue
LENOX HILL HOSPITAL
100 EAST 77 STREETNEW YORKNY10021131624070HEALTHCARENY501(C)(3)3NS-LIJ HCfalse
LHH CORPORATION
100 EAST 77TH STREETNEW YORKNY10021133272016SUPPORT ORGNY501(C)(3)11, TYPE INS-LIJ HSfalse
THE ELMEZZI GRAD SCHOOL OF MOLECULAR MED
972 BRUSH HOLLOW RDWESTBURYNY11590113284934GRADUATE SCHNY501(C)(3)2NS-LIJ HSfalse
SPORTS PHYSICAL THERAPY AND REHAB SVCS
972 BRUSH HOLLOW RDWESTBURYNY11590061655704HEALTHCARENY501(C)(3)9LIJfalse
NORTH SHORE - LIJ ALLIANCE
972 BRUSH HOLLOW RDWESTBURYNY11590263727582HEALTHCARENY501(C)(3)3NAfalse
THE LONG ISLAND HOME
400 SUNRISE HIGHWAYAMITYVILLENY11701112837244HEALTHCARENY501(c)(3)3LHH CORPfalse
THE LONG ISLAND HOME FOUNDATION
400 SUNRISE HIGHWAYAMITYVILLENY11701112049038SUPPORTNY501(C)(3)11, TYPE 1LHH CORPfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocations
KRASNOFF CONS SVCS
972 Brush Hollow ROADWESTBURYNY11590262838027CONSULTINGNYCARE MGT GROUPN/Afalse
LONG ISL BEHAV HLTH
972 BRUSH HOLLOW RDWESTBURYNY11590453572263STATISTICSNYNS-LIJ HCRELATEDfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (64 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrgShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
Adv Heart Phys & Surgeons Network PC
130 East 77th St 4th FloorNew YorkNY10021133853125Medical ServicesNYLENOX HILLC CORPORATIONfalse
Adv Imag & Rad of Lenox Hill Hosp PC
100 East 77th StNew YorkNY10021200719612Medical ServiCESNYLENOX HILLC CORPORATIONfalse
Aletta Corporation
972 Brush Hollow RdWestburyNY11590112622371Physician svcs.NYSOUTHSIDEC CORPORATIONfalse
Autoimmune Research Therapeutics
972 Brush Hollow RdWestburyNY11590270701489InactiveNYRESEARCHC CORPORATIONfalse
Care Management Group of Greater NY
972 Brush Hollow RdWestburyNY11590113336381Business ServicesNYNSH ENTERPRISESC CORPORATIONfalse
Emergency Med Svcs of Staten Island PC
1 Edgewater Plaza 6th floorStaten IslandNY10305134200899Medical ServiCESNYSIUHC CORPORATIONtrue7668987991.00000
Goethals Radiology PC
500 Seaview AveStaten IslandNY10305200010287Radiology SVCs.NYSIUHC CORPORATIONtrue8425102641.00000
Lenox Hill Cardiology Associates PC
100 East 77th StNew YorkNY10021133385163Medical ServiCESNYLENOX HILLC CORPORATIONfalse
Lenox Hill Int Card & Vasc Svcs PC
130 East 77th St 9th floorNew YorkNY10021201435770Medical ServiCESNYLENOX HILLC CORPORATIONfalse
Lenox Hill Pathology PC
100 East 77th StNew YorkNY10021133644370Medical ServiCESNYLENOX HILLC CORPORATIONfalse
Lenox Hill Phy Hospital Org Inc
122 East 76th St suite 3-aNew YorkNY100212834133775996Managed CareNYLENOX HILLC CORPORATIONfalse
Lenox otolaryngology head & neck surgery
186 East 76th St 2nd floorNew YorkNY10021208784395Medical ServicesNYLENOX HILLC CORPORATIONfalse
Manhattan Min Inv and Bar Surgery PC
186 East 76th St 1st FloorNew YorkNY10021200250107Medical ServicesNYLENOX HILLC CORPORATIONfalse
North Shore Health Enterprises
972 Brush Hollow RdWestburyNY11590061605319Holding CompNYNSHS ENTERPRISEC CORPORATIONfalse
NS Health System Enterprises
972 Brush Hollow RdWestburyNY11590113316922Holding CompNYNS-LIJ HSC CORPORATIONfalse
North Shore IPA 5 Inc
972 Brush Hollow RdWestburyNY11590113383468Business ServicesNYNS-LIJ HCC CORPORATIONfalse
NS Radiology at Glen Cove PC
972 Brush Hollow RdWestburyNY11590113301179Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ Health System IPA #1
972 Brush Hollow RdWestburyNY11590113533659Health CareNYLIJC CORPORATIONfalse
NS-LIJ Health System IPA #2
972 Brush Hollow RdWestburyNY11590113533670Health CareNYLIJC CORPORATIONfalse
NS-LIJ Health System IPA #3
972 Brush Hollow RdWestburyNY11590113533678Health CareNYLIJC CORPORATIONfalse
NS-LIJ Health System IPA #4
972 Brush Hollow RdWestburyNY11590113533677Health CareNYLIJC CORPORATIONfalse
NS-LIJ Health System IPA #5
972 Brush Hollow RdWestburyNY11590113533675Health CareNYLIJC CORPORATIONfalse
NS-LIJ Medical Gr at Huntington PC
972 Brush Hollow RdWestburyNY11590274384049Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ Medical Gr at North Nassau PC
972 Brush Hollow RdWestburyNY11590274384146Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ Medical Group at Syosset PC
972 Brush Hollow RdWestburyNY11590273957752Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ Medical Group PC
972 Brush Hollow RdWestburyNY11590274384249Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ Network Inc
972 Brush Hollow RdWestburyNY11590320257193Support ServicesNYNS-LIJ HSC CORPORATIONfalse
NS-LIJ Phys Insurance Co Risk Ret Group
100 Bank StBurlingtonVT05401261487515INSURANCEVTNS-LIJ HCC CORPORATIONfalse
North Shore-LIJ Physicians Group PC
972 Brush Hollow RdWestburyNY11590274384326Medical ServicesNYNSUHC CORPORATIONfalse
North Shore-LIJ Radiology Services PC
972 Brush Hollow RdWestburyNY11590223970667Medical ServicesNYNSUHC CORPORATIONfalse
North Shore-LIJ Service Alliance Inc
972 Brush Hollow RdWestburyNY11590263651575Support ServicesNYNAC CORPORATIONfalse
Ocean Breeze Home Care Agency
1 Edgewater Plaza 6th FloorStaten IslandNY10305133773601InactiveNYOVMC CORPORATIONfalse
Ocean View Management inc
1 Edgewater Plaza 6th FloorStaten IslandNY10305133138888Management Svcs.NYSIUHC CORPORATIONtrue21136511060611.00000
Palliative Care Medical Services PC
99 Sunnyside BlvdWoodburyNY11797273957835Medical ServicesNYHOSPICEC CORPORATIONfalse
Park Lenox Emergency Medicine PC
100 East 77th StNew YorkNY10021262661082Medical ServicesNYLENOX HILLC CORPORATIONfalse
Park Lenox Medical PC
100 East 77th StNew YorkNY10021133575380Medical ServicesNYLENOX HILLC CORPORATIONfalse
Park Lenox OBGYN PC
130 East 77th St 2nd FloorNew YorkNY10021133596988Medical ServicesNYLENOX HILLC CORPORATIONfalse
Park Lenox Orthopedics PC
100 East 77th StNew YorkNY10021264634966Medical ServicesNYLENOX HILLC CORPORATIONfalse
Park Lenox Pediatrics PC
100 East 77th StNew YorkNY10021133755683Medical ServicesNYLENOX HILLC CORPORATIONfalse
Park Lenox Surgical PC
130 East 77th St 13th FloorNew YorkNY10021133397814Medical ServicesNYLENOX HILLC CORPORATIONfalse
Regency Alliance Services Inc
1 Edgewater Plaza 6th FloorStaten IslandNY10305133277698inactiveNYOVMC CORPORATIONfalse
Regional Insurance Company LTD
insuranceNS-LIJ HCC CORPORATIONfalse41 Cedar AveHamiltonBERMUDABDHM 12BD
Regioncare Inc
972 Brush Hollow RdWestburyNY11590113052191HomecareNYNSHS ENTERPRISEC CORPORATIONfalse
Staten Island Hospitalists PC
475 Seaview AveStaten IslandNY10305331010283Medical ServicesNYSIUHC CORPORATIONtrue95991641091.00000
Staten Island Imaging Corp
1 Edgewater Plaza 6th FloorStaten IslandNY10305133615474InactiveNYOVMC CORPORATIONfalse
Staten Island Medical Intensivist PC
501 Seaview Ave Suite 102Staten IslandNY10305043716494Medical ServicesNYSIUHC CORPORATIONtrue27839121101.00000
Staten Island Neonatology PC
500 Seaview AveStaten IslandNY10305133375474Medical ServicesNYSIUHC CORPORATIONtrue2943851001.00000
SIUH Perinatology PC
475 Seaview AveStaten IslandNY10305134107082Medical ServicesNYSIUHC CORPORATIONtrue1.00000
United Medical Surgical PC
256 Mason Ave BLDG B 2nd FLStaten IslandNY10305134038780Surgical ServicesNYSIUHC CORPORATIONfalse100398715488481.00000
Univ Ph OncHematology Gp PC
500 Seaview AveStaten IslandNY10305133642729Medical ServicesNYSIUHs CORPORATIONtrue808160511.00000
Verrazano Radiology Associates PC
500 Seaview Ave Suite 200Staten IslandNY10305200011201Radiology Svcs.NYSIUHC CORPORATIONtrue911474220102801.00000
Vivohealth Inc
972 Brush Hollow RdWestburyNY11590264118016InactiveNYNSH ENTERPRISEC CORPORATIONfalse
PARK LENOX PSYCHIATRY PC
130 EAST 77TH STREETNEW YORKNY10021133424466Medical ServicesNYLENOX HILLC CORPorationfalse
NS-LIJ CARDIOVASCULAR MEDICINE PC
972 BRUSH HOLLOW RDWESTBURYNY11590275078717Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ CARDIOLOGY PC
972 BRUSH HOLLOW RDWESTBURYNY11590275078531Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ HEART SURGERY PC
972 BRUSH HOLLOW RDWESTBURYNY11590275078838Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ INTERNAL MEDICINE PC
972 BRUSH HOLLOW RDWESTBURYNY11590275078361Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ MEDICAL GROUP URGENT MED CARE PC
972 BRUSH HOLLOW RDWESTBURYNY11590275078426Medical ServicesNYNSUHC CORPORATIONfalse
LENOX HILL HOSPITAL MEDICAL PC
972 BRUSH HOLLOW RDWESTBURYNY11590452661543Medical ServicesNYlenoxC CORPORATIONfalse
NS-LIJ MEDICAL PC
972 BRUSH HOLLOW RDWESTBURYNY11590453023019Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ OCCUPATIONAL MEDICINE PC
972 BRUSH HOLLOW RDWESTBURYNY11590451004103Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ OB-GYN PC
972 Brush Hollow RdWestburyNY11590461382916Medical ServicesNYnsuhc corporationfalse
NS-LIJ ANESTHESIOLOGY PC
972 BRUSH HOLLOW RDWESTBURYNY11590461617561Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ HEALTH PLANS INC
972 Brush Hollow RdWestburyNY11590461617516Medical ServicesNYNS-LIJ HCc corporationfalse
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierTRANSACTIONS WITH RELATED ORGANIZATIONSIdentifier
Return ReferenceSCHEDULE R, PART VReturnReference
ExplanationTHIS ORGANIZATION IS AN AFFILIATE OF North Shore - long Island Jewish Health System ("sYSTEM"). ORGANIZATIONS WITHIN THE SYSTEM ROUTINELY PAY EXPENSES FOR VARIOUS AFFILIATES IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED.Explanation