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CHS SERVICES INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CHS SERVICES INC (EIN 11-3555766)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-13
IRS object ID
201343179349304199
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)
Timestamp2013-11-13T13:59:28-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhouseCoopers LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1300 Madison AvenueAddressLine1
CityNew YorkCity
StateNYState
ZIP Code10017ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN113555766EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1CHS SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% CHS SERVICES INCInCareOfName
Name ControlCHSSNameControl
Phone5167053700Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1992 NORTH VILLAGE AVENUEAddressLine1
Address Line2SuiteAddressLine2
CityROCKVILLE CENTERCity
StateNYState
ZIP Code11570ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameALAN D GUERCIName
TitlePRESIDENT, CEOTitle
Phone5167053700Phone
Date Signed2013-11-05DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone6464713000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRICHARD J J SULLIVAN JRNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1992 NORTH VILLAGE AVENUEAddressLine1
CityROCKVILLE CENTERCity
StateNYState
ZIP Code11570ZIPCode
FieldValueIRS element (for citing)
Gross Receipts103415278GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2000YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionCATHOLIC HEALTH SERVICES OF LONG ISLAND AND ITS MEMBERS, AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUE CHRIST'S HEALING MISSION, BY PROMOTING EXCELLENCE IN CARE AND COMMITTING ITSELF TO THOSE IN NEED.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees958TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI343650TotalGrossUBI
Net Unrelated Business Txbl Income-23115NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year251000ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year77812915ProgramServiceRevenuePriorYear
Program Service Revenue CY103414762ProgramServiceRevenueCY
Investment Income Prior Year489InvestmentIncomePriorYear
Investment Income Current Year516InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year78064404TotalRevenuePriorYear
Total Revenue Current Year103415278TotalRevenueCurrentYear
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 Year56553463SalariesEtcPriorYear
Salaries Etc Current Year74734624SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year26078174OtherExpensePriorYear
Other Expenses Current Year38741385OtherExpensesCurrentYear
Total Expenses Prior Year82631637TotalExpensesPriorYear
Total Expenses Current Year113476009TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4567233RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-10060731RevenuesLessExpensesCY
Total Assets BOY188750967TotalAssetsBOY
Total Assets EOY202209719TotalAssetsEOY
Total Liabilities BOY130461020TotalLiabilitiesBOY
Total Liabilities EOY136182773TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY58289947NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY66026946NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionCHS SERVICES,INC, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED. CHS AFFIRMS THE SANCTITY OF LIFE, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. IT CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION AND INNOVATION WITH JUSTICE, INTEGRITY AND RESPECT FOR THE DIGNITY OF EACH PERSON.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense113476009Expense
Grants0Grants
Revenue103071112Revenue
DescriptionCHS SERVICES INC. PROVIDES ADMINISTRATIVE SUPPORT TO THE CHS ENTITIES INCLUDING, BUT NOT LIMITED TO ACCOUNTING, REVENUE CYCLE, SUPPLY CHAIN AND INFORMATION TECHNOLOGY. CHS SERVICES PROMOTES EFFICIENT MANAGEMENT, COOPERATIVE PLANNING AND EFFICIENT USE OF RESOURCES BY ALL SUPPORTED ORGANIZATIONS.Description
Total Program Service Expense113476009TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
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 ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109647NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees958NumberOfEmployees
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 Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
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
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCHS SERVICES INCNamePerson
Telephone Number5167053700TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1992 NORTH VILLAGE AVENUEAddressLine1
CityROCKVILLE CENTERCity
StateNYState
ZIP Code11570ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormerAverage Hours Per Week RelatedAverageHoursPerWeekRelated
Richard JJ Sullivan Jr
CHAIR/INTERIM CEO2.0XX000
Sister Elaine Callahan OP
Vice Chair2.0XX000
Thomas E Christman
Treasurer2.0XX000
Eugene Murphy
Secretary2.0XX000
VIRGINIA EWEN
Trustee2.0X000
Barbara Ellen Black
Trustee2.0X000
Thomas Dowling Jr MD
Trustee2.0X000
Sister Audrey Harsen
Trustee2.0X000
Sister Margaret John Kelly DC
Trustee2.0X000
Rev Msgr Robert Morrissey
Trustee2.0X000
Patricia Nazemetz
Trustee2.0X000
Joseph Tantillo
Trustee2.0X000
Rev Msgr James Vlaun
Trustee2.0X000
John J Wagner
Trustee2.0X000
Brian McGuire
Trustee2.0X000
LAWRENCE MCMANUS
PRESIDENT/CEO2.0X08239902290953
COLLEEN BLYE
EXECUTIVE VP & CEO50.0X01148296394104
Marcy Dunn
VP & CIO50.05632470214560X
Lynn Jennings Taylor
Sr VP Risk Mgt50.03138500250461X
Alan Katz MD
VP Medical Informatics50.0454280049249X
William Mead
SR VP & CFO Physician Strategy50.03675250121538X
Pegeen McGowan
VP Corp Compliance/Int AUDIT50.03415720119274X
Richard Sarli
Former VP Finance0.04635550261425X
JAMES HARDEN
FORMER PRESIDENT & CEO0152926222864X1.0
FieldValueIRS element (for citing)
Total Reportable Comp From Org2504029TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs3501548TotalReportableCompFrmRltdOrgs
Total Other Compensation3724428TotalOtherCompensation
Number Individuals GT100 K163NumberIndividualsGT100K
Formers ListedtrueFormersListed
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
HARVEST 245 OLD COUNTRY ROAD
131 JERICHO TPKE SUITE PH-1JERICHONY11753RENT3172607
PORTER CURTIS LLC
225 STATE RDMEDIAPA19063INSURANCE BROKER1907708
MILLER MILONE PC
100 QUENTIN ROOSEVELT BLVDGARDEN CITYNY11530LEGAL SERVICES716076
TERRENCE OBRIEN
199 JOHNSON RDSCARSDALENY10583CONSULTING SERVICES585860
DBI STAFFING
12 E 44TH STREET 7TH FLOORNEW YORKNY10017CONSULTING SERVICES518139
FieldValueIRS element (for citing)
Number Of Contractors GT100 K11NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
ASSESSMENT REVENUE900099103071112103071112
MANAGEMENT SERV REV900099343650343650
FieldValueIRS element (for citing)
Total Program Service Revenue103414762TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column516TotalRevenueColumn
Exclusion$516ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column103415278TotalRevenueColumn
Related Or Exempt Function Income103071112RelatedOrExemptFunctionIncome
Unrelated Business Revenue343650UnrelatedBusinessRevenue
Exclusion$516ExclusionAmount

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)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total57861209Total
Program Services57861209ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total5365125Total
Program Services5365125ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7369629Total
Program Services7369629ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total4138661Total
Program Services4138661ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1684571Total
Program Services1684571ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

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)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total112507Total
Program Services112507ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total293082Total
Program Services293082ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total11471580Total
Program Services11471580ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4851432Total
Program Services4851432ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total152076Total
Program Services152076ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total243769Total
Program Services243769ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total584192Total
Program Services584192ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total10060731Total
Program Services10060731ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total23575Total
Program Services23575ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
COLLECTION SERVICES75793275793200
OTHER8505938850593800

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total113476009Total
Program Services113476009ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2995721BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY781285BOY
EOY660365EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY444017BOY
EOY182611EOY

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)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2849483BOY
EOY3580601EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis106798305LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec29758381LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY59034136BOY
EOY77039924EOY

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)
BOY77336332BOY
EOY55917639EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY45309993BOY
EOY64828579EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY188750967BOY
EOY202209719EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY20077715BOY
EOY24906548EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY74681BOY
EOY314161EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

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)
BOY88848520BOY
EOY74729725EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY9857736BOY
EOY21160035EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY11602368BOY
EOY15072304EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY130461020BOY
EOY136182773EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY58289947BOY
EOY66026946EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY58289947BOY
EOY66026946EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY188750967BOY
EOY202209719EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-10060731ReconcilationRevenueExpenses
Reconcilation Other Changes17797730ReconcilationOtherChanges
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 RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (16 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
MERCY MEDICAL CENTER
11163508803falsetruetrue$0
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
11188892403falsetruetrue$0
ST FRANCIS HOSPITAL
11205052303falsetruetrue$0
ST CATHERINE OF SIENA MEDICAL CENTER
06156270103falsetruetrue$0
ST CHARLES HOSPITAL
11187103903falsetruetrue$0
WSNCHS NORTH LLC
11343897303falsetruetrue$0
SIENA VILLAGE INC
06156912909falsetruetrue$0
SUFFOLK HEARING & SPEECH CENTER INC
11211048809falsetruetrue$0
OUR LADY OF CONSOLATION GERIATRIC CARE CENTER
11328406609falsetruetrue$0
CATHOLIC HOME CARE
11212673609falsetruetrue$0
GOOD SHEPHERD HOSPICE
11295843809falsetruetrue$0
CHS HOME SUPPORT SERVICES INC
11359456109falsetruetrue$0
MARYHAVEN CENTER OF HOPE
11286169809falsetruetrue$0
MARYHAVEN TRANSPORTATION SERVICES
11343477609falsetruetrue$0
MARYHAVEN SCHOOL CORPORATION
11286169009falsetruetrue$0
THE CENTER OF HOPE FOUNDATION
11363836709falsetruetrue$0
FieldValueIRS element (for citing)
Total Number Of Supported Orgs16TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years
Current Year Minus4 YearsCurrentYearMinus4Years
LandLand
BuildingsBuildings

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis15244978OtherCostOrOtherBasis
Depreciation3029972Depreciation
Book Value12215007BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis91553327OtherCostOrOtherBasis
Depreciation26728409Depreciation
Book Value64824917BookValue
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildings
Total Of Book Value Land Buildings77039924TotalOfBookValueLandBuildings

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
DescriptionTRUSTEE HELD FUNDS RESTRICTEDDescription
Book Value55917639BookValue
Method Of ValuationCMethodOfValuation
FieldValueIRS element (for citing)
Total Of Book Value Program Related55917639TotalOfBookValueProgramRelated

Other Assets OtherAssets

FieldValueIRS element (for citing)
DescriptionDUE FROM RELATED ORGANIZATIONSDescription
Book Value64828579BookValue
FieldValueIRS element (for citing)
Total Book Value Other Assets64828579TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
DUE TO RELATED ORGANIZATIONS$11,267,251
DEFERRED RENT$2,542,329
SELF INSURED LIABILIIES$1,144,522
DUE TO AFFILIATES$118,202
FieldValueIRS element (for citing)
Total Of Amounts15072304TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierPART X, OTHER LIABILITIESIdentifier
Return ReferenceLINE 2, FIN 48 FOOTNOTEReturnReference
ExplanationCHS SERVICES, INC. IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CHS SERVICES,INC. ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE INCOME TAX TOPIC OF THE CODIFICATION. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CATHOLIC HEALTH SERVICES OF LONG ISLAND CONSOLIDATED FINANCIAL STATEMENTS.Explanation

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (9 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
LAWRENCE MCMANUS
PRESIDENT/CEO0757700000662900481523018094300311494300
Marcy Dunn
VP & CIO4034670110000049780018765102690907778070317550
Lynn Jennings Taylor
Sr VP Risk Mgt2966040001724602244830259780564311000
Alan Katz MD
VP Medical Informatics45216600021140200250292240503529000
William Mead
SR VP & CFO Physician Strategy3108920450000116330967660247720489063000
Pegeen McGowan
VP Corp Compliance/Int AUDIT2543840765000106880916370276370460846000
Richard Sarli
Former VP Finance979290800000285626013692501245000724980000
COLLEEN BLYE
EXECUTIVE VP & CEO0815640031600001665603671710269330154240000
JAMES HARDEN
FORMER PRESIDENT & CEO00030657901222683000228640155212601529626

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SCHEDULE J, PART I, LINE 4ASEVERANCERICHARD SARLI FORMER VP FINANCE RECEIVED PAYMENT OF SEVERANCE OF $370,000. JAMES HARDEN FORMER PRESIDENT & CEO RECEIVED PAYMENT OF SEVERANCE OF $1,015,098. LAWRENCE MCMANUS PRESIDENT/CEO RECEIVED $1,809,430 OF SEVERANCE.
SCHEDULE J, PART I, LINE 4BSUPPLEMENTAL NON-QUALIFIED RETIREMENT PLANCOLLEEN BLYE $344,596 PARTICIPATION IN THE PLAN MARCY DUNN $167,626 PARTICIPATION IN THE PLAN; $31,755 PAYMENT FROM PLAN LYNN JENNINGS TAYLOR $204,458 PARTICIPATION IN PLAN WILLIAM MEAD $76,741 PARTICIPATION IN PLAN PEGEEN MCGOWAN $71,612 PARTICIPATION IN PLAN RICHARD SARLI $131,919 PARTICIPATION IN PLAN
SCHEDULE J, PART IICOMPENSATIONTHE AMOUNTS REFLECTED IN COLUMN B(III) AND COLUMN C FOR THE INDIVIDUALS INCLUDES PARTICIPATION IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("SERP"). THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2012 FORM W-2 BOX, 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NONQUALIFIED RETIREMENT PLANS.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, LINE 6MEMBERS OF THE ORGANIZATIONTHE SOLE MEMBER OF CHS SERVICES, INC. IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND, (D/B/A CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS). CHS IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE (DIOCESE).
FORM 990, PART VI, LINE 7AELECTION OF THE GOVERNING BODYCHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF CHS SERVICES, INC. AND AS SUCH, HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF CHS SERVICES, INC.
FORM 990, PART VI, LINE 7BDECISIONS OF THE GOVERNING BODYCHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF CHS SERVICES, INC., IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERING BODY OF CHS SERVICES, INC.
FORM 990, PART VI, LINE 11AREVIEW PROCESS OF FORM 990THE FORM 990 AND APPROPRIATE SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF TRUSTEES (THE BOARD), WHICH HAS BEEN DELEGATED THE DETAILED REVIEW FUNCTION BY THE BOARD. UPON APPROVAL OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO ALL VOTING MEMBERS OF THE BOARD. ONCE APPROVED BY THE BOARD (OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE), THE ORGANIZATION'S BOARD CHAIR AND CHIEF EXECUTIVE OFFICER COMMUNICATES, IN WRITING TO THE CHS COMPLIANCE AND AUDIT COMMITTEE AND CHS BOARD CHAIR. AFTER REVIEW OF ANY APPLICABLE COMMENTS FROM THE BOARD, THE COMPLIANCE AND AUDIT COMMITTEE WILL THEN RECOMMEND THE APPROVAL OF THE FORM 990 TO THE CHS BOARD OF DIRECTORS WHO WILL THEN REVIEW THE RECOMMENDATIONS AND PROVIDE THE FINAL APPROVAL OF THE FORM 990. THE FORM 990 IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, LINE 12CCONFLICT OF INTEREST POLICYCONFLICT OF INTEREST POLICY DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE BY THE ORGANIZATION'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURES SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFERRED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. IF A CONFLICT OF INTEREST IS IDENTIFIED AND IF A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORTH WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANZIATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIMSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT.
FORM 990, PART VI, LINE 15COMPENSATION POLICYTHE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE CORPORATE CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE POLICY. THE POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER, AND CHIEF OPERATING OFFICERS OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS; D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AN OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA(INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE DONE BY AN INDEPENDENT CONSULTANT ANNUALLY. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE BOARD OF TRUSTEES.
FORM 990, PART VI, LINE 19DOCUMENTS AVAILABLE FOR PUBLIC INSPECTIONGOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND.
FORM 990, PART VIISECTION A, LINE 1A - COMPENSATION OF OFFICERSHOURS FOR TRUSTEES ARE THE ESTIMATED WEEKLY HOURS (2.0) TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION. COLLEEN BLYE, EXECUTIVE VICE PRESIDENT AND CHIEF FINANCIAL OFFICER - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766);RVC INSURANCE COMPANY, INC. (20-8067039) AND CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968) LAWRENCE MCMANUS, PRESIDENT & CEO - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY, INC. (20-8067039) AND CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968)
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETSEQUITY TRANSFER FROM RELATED PARTIES 17,797,730

Schedule R IRS990ScheduleR

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
CATHOLIC HEALTH SYSTEM OF LONG ISLAND
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570113403968SUPPORT ORGNY501(C)(3)11A- INAfalse
CHS AMBULANCE SERVICES INC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570141801961DORMANTNY501(C)(3)3CHSLIfalse
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
1000 MONTAUK HIGHWAYWEST ISLIPNY11795111888924HOSPITALNY501(C)(3)3CHSLIfalse
GOOD SAMARITAN SELF INSURANCE AGAINST
MALPRACTICE 1000 MONTAUK HIGHWAYWEST ISLIPNY11795112537396SELF INSURANCNY501(C)(3)11A- IGOOD SAMARTNfalse
MARYHAVEN TRANSPORTATION SERVICES
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113434776TRANSPORTATIONY501(C)(3)9MARYHAVENCTRfalse
MARYHAVEN CENTER OF HOPE
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112861698Prgm-disabledNY501(C)(3)9CHSLIfalse
MARYHAVEN SCHOOL CORPORATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112861690Schl-disabledNY501(C)(3)2MARYHAVENCTRfalse
THE CENTER OF HOPE FOUNDATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113638367SUPPORT ORGNY501(C)(3)9MARYHAVENCTRfalse
MERCY MEDICAL CENTER
1000 NORTH VILLAGE AVENUEROCKVILLE CTRNY11570111635088HOSPITALNY501(C)(3)3CHSLIfalse
CATHOLIC HOME CARE
110 Bi-County Blvd Suite 114FARMINGDALENY11735112126736HOME CARENY501(C)(3)9CHSLIfalse
OUR LADY OF CONSOLATION GERIATRIC CARE
111 BEACH DRIVEWEST ISLIPNY11795113284066LT NURSE CARENY501(C)(3)9CHSLIfalse
RIVERHEAD HOSTEL HOLDING CORPORATION
51 TERRYVILLE ROADPORT JEFFERSN STNY11776112499790RENTINGNY501(C)(2)MARYHAVENCTRfalse
SIENA VILLAGE INC
2000 BISHOPS ROADSMITHTOWNNY11787061569129SR HOUSINGNY501(C)(3)9STCATHERINEfalse
ST CATHERINE OF SIENA MEDICAL CENTER
50 ROUTE 25ASMITHTOWNNY11787061562701HOSPITALNY501(C)(3)3CHSLIfalse
ST CHARLES HOSPITAL
200 BELLE TERRE ROADPORT JEFFERSN STNY11777111871039HOSPITALNY501(C)(3)3CHSLIfalse
CHS HOME SUPPORT SERVICES INC
110 Bi-County Blvd Suite 114FARMINGDALENY11735113594561RESP THERAPYNY501(C)(3)9CATHHOMECAREfalse
ST FRANCIS HOSPITAL
100 PORT WASHINGTON BLVDROSLYNNY11576112050523HOSPITALNY501(C)(3)3CHSLIfalse
ST FRANCIS HOSPITAL FOUNDATION
100 PORT WASHINGTON BLVDROSLYNNY11576112916033SUPPORT ORGNY501(C)(3)11A- IST FRANCISfalse
ST FRANCIS HOSPITAL RESEARCH & EDUCATIO
100 PORT WASHINGTON BLVDROSLYNNY11576113090867RESEARCH ORGNY501(C)(3)11A- IST FRANCISfalse
WSNCHS NORTH INC
4295 HEMPSTEAD TURNPIKEBETHPAGENY11714113438973HOSPITALNY501(C)(3)3CHSLIfalse
SUFFOLK HEARING & SPEECH CENTER INC
369 EAST MAIN STREETEAST ISLIPNY11730112110488DIAGN TESTINGNY501(C)(3)9GOOD SAMARTNfalse
THE ST CHARLES CORPORATION
200 BELLE TERRE ROADPORT JEFFERSN STNY11777112983148SUPPORT ORGNY501(C)(3)11A- ICHSLIfalse
THE SAMARITAN CORPORATION
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570112716640SUPPORT ORGNY501(C)(3)11A- ICHSLIfalse
WISDOM GARDENS HOUSING DEVELOPMENT FUND
51 TERRYVILLE ROADPORT JEFFERSN STNY11776113559713SR HOUSINGNY501(C)(3)9MARYHAVENCTRfalse
GOOD SHEPHERD HOSPICE
110 Bi-County Blvd Suite 114FARMINGDALENY11735112958438HOSPICE SVCNY501(C)(3)9CHSLIfalse
ST CHARLES HOSPITAL FOUNDATION
200 BELLE TERRE ROADPORT JEFFERSONNY11777412076312SUPPORT ORGNY501(C)(3)11A- IIST CHARLESfalse
GOOD SAMARITAN HOSPITAL FOUNDATION
1000 MONTAUK HIGHWAYWEST ISLIPNY11795770611240SUPPORT ORGNY501(C)(3)11A- IGOOD SAMARTNfalse
ST FRANCIS-MERCY CORPORATION
100 PORT WASHINGTON BLVDROSLYNNY11576111635088SUPPORT ORGNY501(C)(3)11A- ICHSLIfalse
MERCY MEDICAL CENTER FOUNDATION
1000 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570550813603SUPPORT ORGNY501(C)(3)11A- IMERCY MEDCTRfalse
ST CATHERINE OF SIENA MEDICAL CTR FDN
50 ROUTE 25ASMITHTOWNNY11787271459941SUPPORT ORGNY501(C)(3)11A- ISTCATHERINEfalse
CATHOLIC HOME CARE FOUNDATION
110 Bi-County Blvd Suite 114FARMINGDALENY11735452907761SUPPORT ORGNY501(C)(3)11A- ICATHHOMECAREfalse
GOOD SHEPHERD HOSPICE FOUNDATION
110 Bi-County Blvd Suite 114FARMINGDALENY11735263169427SUPPORT ORGNY501(C)(3)11A- IGOODSHEPHERDfalse
OUR LADY OF CONSOLATION FOUNDATION
111 BEACH DRIVEWEST ISLIPNY11795450517566SUPPORT ORGNY501(C)(3)11A- IIOURLADYOFCfalse
RVC SUPPORT
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570271531084REAL ESTATENY501(C)(3)11A- ICHSLIfalse
ST FRANCIS CARDIOVASCULAR PHYSICIANS P
100 PORT WASHINGTON BLVDROSLYNNY11576113613997HEALTHCARESVCNY501(C)(3)11A- IST FRANCISfalse
RVC INSURANCE COMPANYINC
992 NORTH VILLAGE AVENUEROCKVILLE CENTRENY11570208067039CAPTIVE INSNY501(C)(3)11A- IICHSLIfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (16 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrg
RADIOLOGY CONSULTING OF LONG ISLANDPLLC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795421646134HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN EMERGENCY MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208243412HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN PEDIATRIC SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208180263HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN MEDICAL SERVICES PC
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208088453HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SOUTHWEST SUFFOLK MEDICAL PC
580 UNION BOULEVARDWEST ISLIPNY11795061603195HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
CARDIAC EKG INTERPRETATION PC
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570112924518HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR
1000 MONTAUK HIGHWAYWEST ISLIPNY11795208964140HEALTHCARE SVCNYGOOD SAMARITANC-CORPfalse
SAMARITAN MANAGEMENT SERVICES
1000 MONTAUK HIGHWAYWEST ISLIPNY11795112838185HEALTHCARE SVCNYCHSLIC-CORPfalse
FAIRVIEW HILL MANAGEMENT CO INC
200 BELLE TERRE ROADPORT JEFFERSONNY11777112798383HOLDING CONYCHSLIC-CORPfalse
ADVANCED REHABILIATION MEDICINE PLLC
200 BELLE TERRE ROADPORT JEFFERSONNY11777113640709HEALTHCARE SVCNYSTCHARLES HOSPC-CORPfalse
ST FRANCIS CARDIAC PREVENTION SERVICES
100 PORT WASHINGTON BLVDROSLYNNY11576113224885HEALTHCARE SVCNYSTFRANCIS HOSPC-CORPfalse
SOUTH SHORE PRACTICE MANAGEMENT
1000 MONTAUK HIGHWAYWEST ISLIPNY11795113307977HEALTHCARE SVCNYSAMARITAN MGMTC-CORPfalse
SAMARITAN HOME CARE AMERICA
1000 MONTAUK HIGHWAYWEST ISLIPNY11795113319259HEALTHCARE SVCNYSAMARITAN MGMTC-CORPfalse
HEALTH CARE TEMP SERVICES INC
200 BELLE TERRE ROADPORT JEFFERSONNY11777112801136EMPLOYMENT AGENCYNYFAIRVIEW HILLC-CORPfalse
MERCY INTERNAL MEDICINE PC
992 N VILLAGE AVENUEROCKVILLE CENTRENY11570510639649HEALTHCARE SVCNYMERCY MED CTRC-CORPfalse
LONG ISLAND EMERGENCY CARE PC
1000 N VILLAGE AVEROCKVILLE CENTRENY115719024113633515PHYSICIAN SVCNYMERCY MED CTRS-CORPfalse
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 OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
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 OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg