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HUNTINGTON HOSPITAL ASSOCIATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
HUNTINGTON HOSPITAL ASSOCIATION (EIN 11-1630914)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-12-13
IRS object ID
201223489349300122
Schema version
2011v1.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-12-13T13:17:13-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN111630914EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Huntington Hospital AssociationBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% MICHAEL FAGANInCareOfName
Name ControlHUNTNameControl
Phone6313512000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1270 Park AvenueAddressLine1
CityHuntingtonCity
StateNYState
ZIP Code11743ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameKEVIN LAWLORName
TitlePRES & CEOTitle
Date Signed2012-12-12DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKevin Lawlor CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1270 PARK AVENUEAddressLine1
CityHuntingtonCity
StateNYState
ZIP Code11743ZIPCode
FieldValueIRS element (for citing)
Gross Receipts289369256GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.HUNTHOSP.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1916YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionThe primary mission of Huntington Hospital Association is to provide a full range of inpatient, outpatient, and specialized healthcare services within an environment nurtured by respect and safety.ActivityOrMissionDescription
Nbr Voting Members Governing Body37NbrVotingMembersGoverningBody
Nbr Independent Voting Members29NbrIndependentVotingMembers
Total Nbr Employees2297TotalNbrEmployees
Total Nbr Volunteers527TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year1550297ContributionsGrantsPriorYear
Contributions Grants Current Year1907708ContributionsGrantsCurrentYear
Program Service Revenue Prior Year273611222ProgramServiceRevenuePriorYear
Program Service Revenue CY283143234ProgramServiceRevenueCY
Investment Income Prior Year7191528InvestmentIncomePriorYear
Investment Income Current Year2065049InvestmentIncomeCurrentYear
Other Revenue Prior Year3002689OtherRevenuePriorYear
Other Revenue Current Year1991176OtherRevenueCurrentYear
Total Revenue Prior Year285355736TotalRevenuePriorYear
Total Revenue Current Year289107167TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year4500GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year161888938SalariesEtcPriorYear
Salaries Etc Current Year214282842SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year512697TotalFundrsngExpCurrentYear
Other Expense Prior Year103762798OtherExpensePriorYear
Other Expenses Current Year103240551OtherExpensesCurrentYear
Total Expenses Prior Year265656236TotalExpensesPriorYear
Total Expenses Current Year317523393TotalExpensesCurrentYear
Revenues Less Expenses Prior Year19699500RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-28416226RevenuesLessExpensesCY
Total Assets BOY288838896TotalAssetsBOY
Total Assets EOY325714051TotalAssetsEOY
Total Liabilities BOY189073931TotalLiabilitiesBOY
Total Liabilities EOY256929924TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY99764965NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY68784127NetAssetsOrFundBalancesEOY
Mission DescriptionTHE HUNTINGTON HOSPITAL ASSOCIATION'S (THE "HOSPITAL") MISSION IS TO PROVIDE A FULL RANGE OF INPATIENT, OUTPATIENT AND SPECIALIZED HEALTHCARE SERVICES, REGARDLESS OF A PATIENT'S ABILITY TO PAY, WITHIN AN ENVIRONMENT NURTURED BY RESPECT AND SAFETY. THE HOSPITAL IS COMMITTED TO GIVING ITS PATIENTS HIGH QUALITY AND TECHNOLOGICALLY ADVANCED CARE BY COMPETENT PROFESSIONALS IN ORDER TO MAINTAIN AND IMPROVE THE HEALTH AND WELL-BEING OF THE COMMUNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense291244409Expense
Grants0Grants
Revenue283143234Revenue
DescriptionA member of the North Shore-LIJ Health System, Huntington Hospital is a 408 bed community hospital, with the following inpatient services; medical/surgical, pediatrics, intensive and critical care, maternity, Level II Perinatal service and psychiatry. The Hospital is a NYS Dept of Health Designated Stroke Center and a recipient of the American Heart Association Get With The Guidelines Stroke Gold Plus Award in 2011 In 2011, the Hospital had 15,920 inpatient discharges, including the delivery of 1,456 babies. Huntington Hospital provided 50,625 Emergency Department visits and performed 8,691 ambulatory surgeries, including endoscopies and outpatient cardiac catheterizations.Description
Total Program Service Expense291244409TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
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 InvestfalseReportProgRelInvest
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 ActivitiestrueFundraisingActivities
GamingtrueGaming
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 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 With1096150NumberFormsTransmittedWith1096
Number W2 G Included1NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2297NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form1098 C FiledtrueForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members37NbrVotingGoverningBodyMembers
Number Independent Voting Members29NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocstrueChangesToOrganizingDocs
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
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMICHAEL FAGANNamePerson
Telephone Number6314254262TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1270 PARK AVENUEAddressLine1
CityHuntingtonCity
StateNYState
ZIP Code11743ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (46 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
KEVIN LAWLOR
PRESIDENT/CEO50.0XX7448070313444
MICHAEL GROSSO MD
SR VP MEDICAL AFFAIRS50.0XX442520048226
MICHAEL ABOFF
BOARD MEMBER1.0X000
CARMELA ANGLIM
BOARD MEMBER1.0X000
MICHAEL ALESANDRO
BOARD MEMBER1.0X000
CHRISTOPHER BARBER
BOARD MEMBER1.0X000
MICHAEL BROWN
BOARD MEMBER1.0X000
FRED BUCKHOLTZ
ASSISTANT TREASURER1.0X000
MICHAEL DOWLING
BOARD MEMBER/CEO NSLIJ50.0X02521221742813
EDNA FETKOWITZ
BOARD MEMBER1.0X000
NICK FITTERMAN MD
Medical Dir - Hosp SVC50.0X438364048226
WILLIAM H FRAZIER
Treasurer1.0X000
LKEITH FRIEDLANDER ESQ
BOARD MEMBER1.0X000
CLIFFORD FRIEDMAN
Board Member1.0X000
J RONALD GAUDREAULT
Board Member1.0X000
ANTHONY GIACCONE
BOARD MEMBER1.0X000
ROSALYN C GORDON
Vice Chairwoman1.0X000
JOHN KEAN
BOARD MEMBER1.0X000
THOMAS G LEDERER
Board Member1.0X000
EUGENE J LEVITT ESQ
BOARD MEMBER1.0X000
SHIRLEY LEVITT
BOARD MEMBER1.0X000
HARRY F MARIANI
Secretary1.0X000
JOHN MCCUSKER
Board Member1.0X000
BRIAN MCNALLY
BOARD MEMBER1.0X000
LEWIS MELTZER ESQ
VICE CHAIRMAN1.0X000
RICHARD MURCOTT
Board Member1.0X000
ROBERT MYERS
BOARD MEMBER1.0X000
MARTHA OSTERHAUS CARLSTROM
BOARD MEMBER1.0X000
PATRICIA PETERSEN
BOARD MEMBER1.0X000
BERNARD M ROSOF MD
Chairman2.0X000
ROBERT W STACKLER
BOARD MEMBER1.0X000
DOLORES THOMPSON
BOARD MEMBER1.0X000
DOUGLAS BYRNES MD
Board Member1.0X000
NOAH FINKEL MD
Board Member1.0X000
CARY KRAVET
BOARD MEMBER1.0X000
JOHN R RICONDA
BOARD MEMBER1.0X000
RICHARD KLEINKNECHT
BOARD MEMBER1.0X000
THOMAS HOEFT
EXECUTIVE VP/COO50.0X1503166039466
MICHAEL FAGAN
VP FINANCE/CFO50.0X385752048226
MICHAEL QUARTIER
VP ADMINISTRATION50.0337800048226X
MYRNA MYERS
VP NURSING50.0295362030868X
PAUL MACCARO MD
MEDICAL DIR OF EP LAB50.0509218048226X
GARY STONE MD
Chief Pathologist50.0382410047771X
MICHAEL BISHAI MD
HOSPITALIST50.0418036047771X
KENT STEPHENSON
Electrophysiologist50.0396620047771X
VIVEKA SAREEN
HOSPITALIST50.0335748047771X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6189803TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2521221TotalReportableCompFrmRltdOrgs
Total Other Compensation1558805TotalOtherCompensation
Number Individuals GT100 K319NumberIndividualsGT100K
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
CROSS COUNTRY STAFFING
PO BOX 404674ATLANTAGA30384NURSING AGENCY883354
HUNTINGTON MEDICAL GROUP
180 E PULASKI RDHUNTINGTON STATIONNY11746MEDICAL SERVICES675199
TRITECH HEALTHCARE MGT LLC
125 NEWTON RDPLAINVIEWNY11803BILLING SERVICES473642
INTENSIVIST CO FKA PHYSICIAN TECH
PO BOX 82638PITTSBURGHPA15218BILLING SERVICES437542
MULLOOLY JEFF ROONEY FLYNN LLP
4 BRIDGE STREETGLEN COVENY11542COLLECTION AGENCY413110
FieldValueIRS element (for citing)
Number Of Contractors GT100 K16NumberOfContractorsGT100K
Fundraising Events399203FundraisingEvents
All Other Contributions1508505AllOtherContributions
Total Contributions1907708TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SVC - HOSPITAL621300269802383269802383
PATIENT SVC-PHYS INC6213001334085113340851
FieldValueIRS element (for citing)
Total Program Service Revenue283143234TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1840479TotalRevenueColumn
Exclusion$1,840,479ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column112587TotalRevenueColumn
Exclusion$112,587ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real433293Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real433293Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column433293TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities105228Securities
Other19343Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other12588Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities105228Securities
Other6755Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column111983TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Fundraising Events236568GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events399203CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses225265FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column11303TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Gaming90425GrossIncomeGaming
Gaming Direct Expenses24236GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column66189TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA INCOME900099886251$886,251
TELEVISION FEES900099159674$159,674
GIFT SHOP900099139019$139,019

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column295447TotalRevenueColumn
Exclusion$295,447ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue1480391TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column289107167TotalRevenueColumn
Related Or Exempt Function Income283143234RelatedOrExemptFunctionIncome
Exclusion$3,433,457ExclusionAmount

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)
Total4147771Total
Program Services4147771ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total125312187Total
Program Services116054407ProgramServices
Management And General8786059ManagementAndGeneral
Fundraising471721Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total55957088Total
Program Services51955554ProgramServices
Management And General3986953ManagementAndGeneral
Fundraising14581Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total19412951Total
Program Services18024717ProgramServices
Management And General1383176ManagementAndGeneral
Fundraising5058Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total9452845Total
Program Services8776865ProgramServices
Management And General673517ManagementAndGeneral
Fundraising2463Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total75236Total
Management And General75236ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total215305Total
Management And General215305ManagementAndGeneral

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)
Total18490396Total
Program Services17168134ProgramServices
Management And General1317444ManagementAndGeneral
Fundraising4818Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total356075Total
Program Services330612ProgramServices
Management And General25370ManagementAndGeneral
Fundraising93Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total46762987Total
Program Services43418930ProgramServices
Management And General3331872ManagementAndGeneral
Fundraising12185Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total4933982Total
Program Services4581149ProgramServices
Management And General351547ManagementAndGeneral
Fundraising1286Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total3525Total
Program Services3525ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total363886Total
Program Services337864ProgramServices
Management And General25927ManagementAndGeneral
Fundraising95Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total2182325Total
Management And General2182325ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total13047195Total
Program Services12114180ProgramServices
Management And General933015ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total7012140Total
Program Services7012140ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBT EXPENSES59041225904122
CENTRALIZED ADMIN EXPENSE23700002370000
DUES & SUBSCRIPTIONS3034412817422162079
ALL OTHER EXPENSES1219936113269786921318

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total317523393Total
Program Services291244409ProgramServices
Management And General25766287ManagementAndGeneral
Fundraising512697Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY15688644BOY
EOY2617068EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY23506516BOY
EOY112063289EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY766565BOY
EOY623083EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY28578285BOY
EOY27659093EOY

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)
BOY3848500BOY
EOY3719985EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4051370BOY
EOY2088563EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis198747942LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec77414626LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY110313386BOY
EOY121333316EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY84134561BOY
EOY24101239EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY9775397BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY8175672BOY
EOY31508415EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY288838896BOY
EOY325714051EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY37103610BOY
EOY41867069EOY

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)
BOY41271815BOY
EOY43410000EOY

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)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY110698506BOY
EOY171652855EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY189073931BOY
EOY256929924EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY95643706BOY
EOY64196127EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2961311BOY
EOY3425000EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1159948BOY
EOY1163000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY99764965BOY
EOY68784127EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY288838896BOY
EOY325714051EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-28416226ReconcilationRevenueExpenses
Reconcilation Other Changes-2564612ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

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$43,030RalliesDemonstrationsAmount
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB43030TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

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 Balance1159948BeginningOfYearBalance
Contributions3427Contributions
Investment Earnings Or Losses22421InvestmentEarningsOrLosses
Other Expenditures22421OtherExpenditures
End Of Year Balance1163375EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance1159948BeginningOfYearBalance
End Of Year Balance1159948EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1159948BeginningOfYearBalance
End Of Year Balance1159948EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1159948BeginningOfYearBalance
End Of Year Balance1159948EndOfYearBalance
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 Basis1255030OtherCostOrOtherBasis
Book Value1255030BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis99521873OtherCostOrOtherBasis
Depreciation37958414Depreciation
Book Value61563459BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis88439112OtherCostOrOtherBasis
Depreciation38874387Depreciation
Book Value49564725BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9531927OtherCostOrOtherBasis
Depreciation581825Depreciation
Book Value8950102BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings121333316TotalOfBookValueLandBuildings

Other Assets OtherAssets (4 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATE8023766
INSURANCE CLAIMS RECEIVABLE21982745
BOND FINANCING1340709
OTHER ASSETS161195
FieldValueIRS element (for citing)
Total Book Value Other Assets31508415TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
ACCRUED PENSION LIABILITY$105,991,974
EST THIRD PARTY PAYOR LIBILITE$27,140,945
ACCRUED MALPRACTICE LIAB$15,172,000
INSURANCE CLAIMS PAYABLE$21,983,285
ACCRUED ASSET RETIREMENT OBLIG$136,530
BOND PREM/DISCOUNT$1,228,121
FieldValueIRS element (for citing)
Total Of Amounts171652855TotalOfAmounts
Total Revenue289107167TotalRevenue
Total Expenses317523393TotalExpenses
Excess Or Deficit For Year-28416226ExcessOrDeficitForYear
Net Unrealized GL On Investments-94804NetUnrealizedGLOnInvestments
Other-$2,469,808OtherAmount
Total Adjustments-2564612TotalAdjustments
Excess Or Deficit Per FS-30980838ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt287354632TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-94804NetUnrealizedGainsInvestments
Other Revenues-240513OtherRevenues
Revenue Not Rptd F990-335317RevenueNotRptdF990
Revenue Subtotal287689949RevenueSubtotal
Other Revenues Not Included1417218OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt1417218RevenueNotRptdOnFinStmt
Total Revenue Per Form990289107167TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt275960515TotExpensesEtcAuditedFinclStmt
Other Expenses Included249501OtherExpensesIncluded
Expenses Not Rptd F990249501ExpensesNotRptdF990
Expenses Subtotal275711014ExpensesSubtotal
Other Expenses Not Included41812379OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt41812379ExpensesNotRptdOnFinStmt
Total Expenses Per Form990317523393TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Schedule D - Supplemental InformationPart V - Line 4The investment income on the permanently restricted endowment funds are unrestricted and used to help support the operations of the Hospital.
RECONCILIATIONSPart XI - LINE 8, PART XII-LINE 2D AND 4B, PART XIII, LINE 2D AND 4BPART XI, LINE 8 TRANSFER FROM AFFILIATES 1,599,333 DEFEASANCE OF LONG TERM DEBT (3,199,443) NONOPERATING CONTRIBUTIONS ( 869,698) TOTAL (2,469,808) PART XII - LINE 2D NET ASSETS RELEASED FROM RESTRICTIONS 379,684 SPECIAL EVENT EXP NET AGAINST REVENUE 225,265 GAMING EVENT EXP NET AGAINST REVENUE 24,236 NONOPERATING CONTRIBUTIONS (869,698) TOTAL (240,513) PART XII - LINE 4B TEMP AND PERM RESTRICTED CONTRIBUTIONS 1,417,218 PART XIII - LINE 2D SPECIAL EVENT EXP NET AGAINST REVENUE 225,265 GAMING EVENT EXP NET AGAINST REVENUE 24,236 TOTAL 249,501 PART XIII - LINE 4B ADDITIONAL MINIMUM PENSION LIABILITY 41,812,379
FIN 48 FOOTNOTEPart X, LINE 2: FIN 48 FOOTNOTECertain organizations included in the System's consolidated financial statements are taxable entities under Federal or state laws. 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, 2011 and 2010, 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. The System has net operating loss carry forwards of approximately $113,555,000, which expire in varying amounts through 2031, and are available to offset future taxable income.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GALA 2011NameOfEvent1
Gross Receipts Event170291GrossReceiptsEvent1
Charitable Contributions Event1210799CharitableContributionsEvent1
Gross Revenue Event1-140508GrossRevenueEvent1
Non Cash Prizes Event15166NonCashPrizesEvent1
Food And Beverage Event160525FoodAndBeverageEvent1
Entertainment Event15500EntertainmentEvent1
Other Direct Expenses Event18140OtherDirectExpensesEvent1
Name Of Event2GOLF CLASSICNameOfEvent2
Gross Receipts Event276838GrossReceiptsEvent2
Charitable Contributions Event2123512CharitableContributionsEvent2
Gross Revenue Event2-46674GrossRevenueEvent2
Cash Prizes Event21790CashPrizesEvent2
Non Cash Prizes Event211092NonCashPrizesEvent2
Rent Facility Costs Event239761RentFacilityCostsEvent2
Food And Beverage Event220574FoodAndBeverageEvent2
Other Direct Expenses Event21706OtherDirectExpensesEvent2
Total Number Of Other Events3TotalNumberOfOtherEvents
Gross Receipts Other Events89439GrossReceiptsOtherEvents
Charitable Contrib Other Events64892CharitableContribOtherEvents
Gross Revenue Other Events24547GrossRevenueOtherEvents
Cash Prizes Other Events6150CashPrizesOtherEvents
Non Cash Prizes Other Events2120NonCashPrizesOtherEvents
Rent Facility Costs Other Events9682RentFacilityCostsOtherEvents
Food And Beverage Other Events35406FoodAndBeverageOtherEvents
Entertainment Other Events3618EntertainmentOtherEvents
Other Direct Expenses Other Events14035OtherDirectExpensesOtherEvents
Gross Receipts Total236568GrossReceiptsTotal
Charitable Contributions Total399203CharitableContributionsTotal
Gross Revenue Total Events-162635GrossRevenueTotalEvents
Cash Prizes Total Events7940CashPrizesTotalEvents
Non Cash Prizes Total Events18378NonCashPrizesTotalEvents
Rent Facility Costs Total Events49443RentFacilityCostsTotalEvents
Food And Beverage Total Events116505FoodAndBeverageTotalEvents
Entertainment Total Events9118EntertainmentTotalEvents
Other Direct Expenses Total Events23881OtherDirectExpensesTotalEvents
Direct Expense Summary Events225265DirectExpenseSummaryEvents
Net Income Summary-387900NetIncomeSummary

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Gross Revenue Other Gaming90425GrossRevenueOtherGaming
Other Direct Expenses Other Gaming24236OtherDirectExpensesOtherGaming
Volunteer Labor Other GamingfalseVolunteerLaborOtherGaming
Gross Revenue Total Gaming90425GrossRevenueTotalGaming
Other Direct Expenses Total Gaming24236OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming24236DirectExpenseSummaryGaming
Net Gaming Income Summary66189NetGamingIncomeSummary
FieldValueIRS element (for citing)
LicensedfalseLicensed
Explanation If NoNYS LICENSE IS PENDINGExplanationIfNo
License Suspended EtcfalseLicenseSuspendedEtc
Gaming With NonmemberstrueGamingWithNonmembers
Member Of Other EntityfalseMemberOfOtherEntity
Percentage Of Gaming Own Facility1.00000PercentageOfGamingOwnFacility
Name Of Gaming Rec Keeper PersonROBERT MOTTOLANameOfGamingRecKeeperPerson

Address Of Gaming Rec Keeper US AddressOfGamingRecKeeperUS

FieldValueIRS element (for citing)
Address Line1270 PARK AVENUEAddressLine1
CityHUNTINGTONCity
StateNYState
ZIP Code11743ZIPCode
FieldValueIRS element (for citing)
Contract With3rd Party For Gam RevfalseContractWith3rdPartyForGamRev
Gaming Manager Name PersonROBERT MOTTOLAGamingManagerNamePerson
Gaming Manager Services ProvidedOVBRALL SUPERVISION OF ANNUAL RAFFLEGamingManagerServicesProvided
Gaming Manager Is EmployeeXGamingManagerIsEmployee
Charitable Distrib RequiredfalseCharitableDistribRequired

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 Served6892PersonsServed
Total Community Benefit Expense5925000TotalCommunityBenefitExpense
Direct Offsetting Revenue1084000DirectOffsettingRevenue
Net Community Benefit Expense4841000NetCommunityBenefitExpense
Percent Of Total Expense0.01790PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served15829PersonsServed
Total Community Benefit Expense28058512TotalCommunityBenefitExpense
Direct Offsetting Revenue18647459DirectOffsettingRevenue
Net Community Benefit Expense9411053NetCommunityBenefitExpense
Percent Of Total Expense0.03480PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served22721PersonsServed
Total Community Benefit Expense33983512TotalCommunityBenefitExpense
Direct Offsetting Revenue19731459DirectOffsettingRevenue
Net Community Benefit Expense14252053NetCommunityBenefitExpense
Percent Of Total Expense0.05270PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs50NumberOfActivitiesOrPrograms
Persons Served73715PersonsServed
Total Community Benefit Expense1048405TotalCommunityBenefitExpense
Direct Offsetting Revenue55003DirectOffsettingRevenue
Net Community Benefit Expense993402NetCommunityBenefitExpense
Percent Of Total Expense0.00370PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs19NumberOfActivitiesOrPrograms
Persons Served468PersonsServed
Total Community Benefit Expense828445TotalCommunityBenefitExpense
Direct Offsetting Revenue386771DirectOffsettingRevenue
Net Community Benefit Expense441674NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served166PersonsServed
Total Community Benefit Expense16198TotalCommunityBenefitExpense
Net Community Benefit Expense16198NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs77NumberOfActivitiesOrPrograms
Persons Served74349PersonsServed
Total Community Benefit Expense1893048TotalCommunityBenefitExpense
Direct Offsetting Revenue441774DirectOffsettingRevenue
Net Community Benefit Expense1451274NetCommunityBenefitExpense
Percent Of Total Expense0.00540PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs79NumberOfActivitiesOrPrograms
Persons Served97070PersonsServed
Total Community Benefit Expense35876560TotalCommunityBenefitExpense
Direct Offsetting Revenue20173233DirectOffsettingRevenue
Net Community Benefit Expense15703327NetCommunityBenefitExpense
Percent Of Total Expense0.05810PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served3PersonsServed
Total Community Building Expense2006TotalCommunityBuildingExpense
Net Community Building Expense2006NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Building Expense50TotalCommunityBuildingExpense
Net Community Building Expense50NetCommunityBuildingExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served3PersonsServed
Total Community Building Expense2056TotalCommunityBuildingExpense
Net Community Building Expense2056NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$5,585,000BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare91856503AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare111679179CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-19822676MedicareSurplusOrShortfall

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 Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Huntington HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1270 Park AvenueAddressLine1
CityHuntingtonCity
StateNYState
ZIP Code11743ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Huntington HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent100FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent500.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Insurance StatusXInsuranceStatus
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 Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1DOLAN FAMILY HEALTH CENTERBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1284 PULASKI ROADAddressLine1
CityGREENLAWNCity
StateNYState
ZIP Code11740ZIPCode
FieldValueIRS element (for citing)
Facility TypeFAMILY HEALTH CENTERFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (2 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
SUPPLEMENTAL INFORMATIONPart I, Line 3c: This hospital is an affiliated entity of the North Shore-LIJ Health System, Inc. ("North Shore-LIJ") or ("the System"). North Shore-LIJ uses Federal Poverty Guidelines ("FPG') to determine eligibility. North Shore-LIJ utilizes the New York State Department of Health (NYSDOH) guidelines regarding the consideration of assets and will only review a patient's assets if they fall within the family size and income levels approved by New York State. 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. In the consideration of assets, the following assets will not be included: primary residence, tax-deferred or comparable retirement accounts, college savings accounts and cars used by the patient or patient's family. Part I, Line 6a: The Community Benefit report is prepared by the hospital, in conjunction with an affiliated entity (North Shore-LIJ Health System, Inc.) 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/NSLIJ/About+Us+Community+Service+Plans Part I, 7: Row (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 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) is not included for purposes of calculating the percent of total expense in column (f). 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 hospital 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 7 (a)-(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 programs. Column (f) for Rows (a)-(k) Theses percentages are calculated using Net Community Benefit Expenses divided by Total Expenses, excluding bad debt, for the hospital. Note: For the entire North Shore-LIJ Health System, Part I, Line 7 Row (k), Column (f) is approximately 10.5% as a percentage of expenses. Part II: All 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 are open to the public. These activities 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 the Center for Emergency Medical Services, which is a state and federal planning resource on weapons of mass destruction, and is a designated 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 North Shore-LIJ provides a safe haven for thousands of patients, outside nursing home residents, and community members seeking shelter. North Shore-LIJ ambulances will assist with the transport of patients throughout the metropolitan area, stand ready to distribute food, medicine, and blankets to numerous individuals who may lose power in their homes. 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. Part III, Line 4: For 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. The bad debt expense is multiplied by the ratio of cost to charges for purposes of inclusion in the total uncompensated care amount identified. 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. The amount of gross charges written off is reduced by any charity care or other discounts provided to the patient, as well as any payments received. As a result of the fulfillment of the exemption under 501(c)(3) of the Internal Revenue Code, a portion of the bad debt is derived from the hospital's obligation not to turn away the community it serves, regardless of ability to pay. Part III, Line 8: Medicare costs are determined utilizing a combination of the step down method of cost findings to arrive at the routine costs of services provided for each patient type, and a 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 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. Part III, Line 9b: The hospital'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. Part V, Section B, line 9: The hospital used the federal poverty guidelines (FPG) limit of 100% to determine eligibility for providing free care although in practice that percentage can be higher based on the facts and circumstances on a case by case basis. Part V, Section B, line 10: The hospital used the FPG limit of 500% to determine eligibility for providing discounted care. The amount of discounted care is based on the facts and circumstances on a case by case basis. Part V, Section B, line 11h: The hospital used the following factors to determine the basis for calculating amounts charged to patients: (a) income level, (b) asset level, (d) insurance status, (e) uninsured discount, (f) Medicaid/Medicare, (g) state regulation, and (h) other - household size. Part V, Section B, line 13g: The hospital used the following measures to publicize the policy within the community served by the hospital facility: (a) the policy is posted on the hospital facility's website, (b) the policy is attached to billing invoices, (c) the policy is posted in the hospital facility's emergency rooms or waiting rooms, (d) the policy is posted in the hospital facility's admissions offices, (e) the policy is provided, in writing, to patients on admission to the hospital facility, (f) the policy is available on request, (g) the policy is included in the hospital's Community Service Plan and (h) other - the policy is provided at health fairs and presentations open to the community at no cost, in addition to the mailing of
STATE FILING OF COMMUNITY BENEFIT REPORTNY,990 SCHEDULE H, PART VI

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
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 PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (13 entries)

Base 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
KEVIN LAWLOR
5978170119000027990029619301725101058251000
MICHAEL GROSSO MD
3787180382120255900222150260110490746000
MICHAEL DOWLING
11730960132800002012507216380211750326403400
NICK FITTERMAN MD
4183190200000450222150260110486590000
THOMAS HOEFT
144355103629202332302221501725101542632000
MICHAEL FAGAN
3307760334110215650222150260110433978000
MICHAEL QUARTIER
2912610287490177900222150260110386026000
MYRNA MYERS
26335402582806180022215086530326230000
PAUL MACCARO MD
494404000148140222150260110557444000
GARY STONE MD
318224000641860222150255560430181000
MICHAEL BISHAI MD
3777590402500270222150255560465807000
KENT STEPHENSON
385190000114300222150255560444391000
VIVEKA SAREEN
3026780330400300222150255560383519000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANPART I, LINE 4BCertain individuals participate in a Supplemental Executive Retirement Plan ("SERP") which is subject to substantial risk of complete forfeiture. Accordingly, the individual 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. These amounts are included in Schedule J, Column C for Kevin Lawlor ($273,978) and Michael Dowling ($694,688).
BONUS AND INCENTIVE COMPENSATIONPART I, LINE 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, Part II, B (ii).

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1DORMITORY AUTHORITY OF THE STATE OF NEW YORKBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN146000293IssuerEIN
CUSIP Number649906JT2CUSIPNumber
Date Issued2011-10-06DateIssued
Issue Price44125573IssuePrice
Description Of Purpose2011 BONDS - CAPITAL IMPROVEMENTSDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer
Pool FinancingfalsePoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired0AmountRetired
Amount Bond Defeased0AmountBondDefeased
Total Proceeds44113386TotalProceeds
Amount In Reserve Fund3548171AmountInReserveFund
Capitalized Interest0CapitalizedInterest
Refunding Escrow8027861RefundingEscrow
Issuance Costs From Proceeds781466IssuanceCostsFromProceeds
Credit Enhancement0CreditEnhancement
Working Capital Expenditures0WorkingCapitalExpenditures
Capital Expenditures3431407CapitalExpenditures
Other Spent Proceeds17469252OtherSpentProceeds
Amount Unspent0AmountUnspent
Current RefundingtrueCurrentRefunding
Advance RefundingtrueAdvanceRefunding
Final Allocation MadefalseFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Prcntge Prvt Business Use By Others0PrcntgePrvtBusinessUseByOthers
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuefalseVariableRateIssue
Hedge Identified In Books And RecdsfalseHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC

Name Of GIC Provider NameOfGICProvider

FieldValueIRS element (for citing)
Business Name Line10BusinessNameLine1
FieldValueIRS element (for citing)
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatetrueExceptionToRebate
FieldValueIRS element (for citing)
Fed Tax Requirements ComplianceXFedTaxRequirementsCompliance

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierPART II, LINE 3 - PROCEEDS, THE TOTAL PROCEEDS DO NOT AGREE TO THE ISSUEIdentifier
Return ReferencePRICE IN PART I, COLUMN (E) DUE TO INVEST EARNINGS & TRANSFERRED PROCEEDSReturnReference

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Contemporary Computer Services
J Riconda, BD Member538481Purchased Computer Servicesfalse
Patrice Piretti
Daughter of BD Member126666Hospital Employeefalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
BOARD MEMBER RELATIONSPART VI, SECTION A - GOVERNING BODY AND MANAGEMENT, LINE 2All 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. Ron Gaudreault has a business relationship with Bernard Rosof, MD. Lewis Meltzer, Esq. has a business relationship with John Riconda and Bernard Rosof, MD John Riconda has a business relationship with Lewis Meltzer, Esq. Bernard Rosof, MD has a business relationship with Ron Gaudreault and Lewis Meltzer, Esq.
EXECUTIVE COMMITTEEPART VI, SECTION B - POLICIES, LINE 11All North Shore-LIJ 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.
CONFLICTS OF INTERESTPART VI, SECTION B - POLICIES, LINE 12CAs a member of the North Shore-Long Island Jewish Health System, the Hospital has several control mechanisms to mitigate conflicts of interest. The Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, the Code of Ethical Conduct requires individuals to conduct Hospital business in a manner that places the interests of the Hospital ahead of personal interests. In Addition, the Hospital 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 Hospital are required to fill out a conflicts of interest disclosure form on a regular basis. The system's 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 Hospital's Audit and Corporate Compliance Committee and other applicable committees. In addition, the Hospital 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.
OFFICERS COMPENSATIONPART VI, SECTION B - POLICIES, LINE 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.
DISCLOSURESPART VI, SECTION C - DISCLOSURES, LINE 19CURRENTLY THE ORGANIZATION PROVIDES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
AVERAGE HOURSPART VII, SECTION A - LINE 1A, COLUMN (B)This 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.
GOVERNING BODYPART VI, LINE 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 health care delivery system.
RECONCILIATION OF NET ASSETSPART XI, LINE 5NET UNREALIZED GAINS/(LOSSES) ( 94,804) TRANSFERS TO/FROM AFFILIATES 1,599,333 DEFEASANCE OF LONG TERM DEBT (3,199,443) NON OPERATING CONTRIBUTIONS ( 477,592) TOTAL CHANGE IN NET ASSETS (2,172,506)
BY LAW CHANGESPART VI, SECTION A - GOVERNING BODY AND MANAGEMENT, LINE 4THE BY-LAW CHANGES MAKES THE CORPORATION A MEMBER OF AN OBLIGATED GROUP FOR FINANCING PURPOSES, WITH OTHER MEMBER-HOSPITALS OF THE NORTH SHORE-LONG ISLAND JEWISH HEALTH SYSTEM.
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:KEVIN LAWLOR TITLE:PRESIDENT/CEO HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MICHAEL GROSSO MD TITLE:SR VP MEDICAL AFFAIRS HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MICHAEL DOWLING TITLE:BOARD MEMBER/CEO NSLIJ HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:NICK FITTERMAN, MD TITLE:Medical Dir - Hosp SVC HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MICHAEL FAGAN TITLE:VP FINANCE/CFO HOURS:50

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (33 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
North Shore LIJ Health System
972 Brush Hollow RdWestburyNY11590113418133SUPPORTNY501(C)(3)11, Type 1NAfalse
North Shore LIJ Health Care Inc
972 Brush Hollow RDWestburyNY11590112965586SUPPORTNY501(C)(3)11, Type 1NS-LIJHSfalse
North Shore LIJ Health Sys Laboratories
972 Brush Hollow RdWestburyNY11590113412370SUPPORTNY501(C)(3)11, Type 1NS-LIJHSfalse
Huntington Hosp Dolan Family HLTH Center
284 Pulaski RoadGreenlawnNY11740113368503Health CareNY501(C)(3)3Huntingtontrue
North Shore University Hospital
972 Brush Hollow RdWestburyNY11590111562701Health CareNY501(C)(3)3NS-LIJ HCIfalse
Long Island Jewish Medical Center
972 Brush Hollow RdWestburyNY11590112241326Health CareNY501(C)(3)3NS-LIJ HCIfalse
Glen Cove Hospital
972 Brush Hollow RdWestburyNY11590111633487Health CareNY501(C)(3)3NS-LIJ HCIfalse
Forest Hills Hospital
972 Brush Hollow RdWestburyNY11590112163522Health CareNY501(C)(3)3NS-LIJ HCIfalse
Plainview Hospital
972 Brush Hollow RdWestburyNY11590113241243Health CareNY501(C)(3)3NS-LIJ HCIfalse
Franklin Hospital
972 Brush Hollow RdWestburyNY11590112296824Health CareNY501(C)(3)3NS-LIJ HCIfalse
Southside Hospital
972 Brush Hollow RdWestburyNY11590111667761Health CareNY501(C)(3)3NS-LIJ HCIfalse
North Shore Univ Hosp Stern Family CECR
972 Brush Hollow RdWestburyNY11590237007485Nursing HomeNY501(C)(3)9NS-LIJ HCIfalse
North Shore Community Services Inc
972 Brush Hollow RdWestburyNY11590237273200Housing CompNY501(C)(3)N/ANS-LIJHSfalse
Feinstein Institute for Medical Research
972 BRUSH HOLLOW RDWestburyNY11590112673595RESEARCHNY501(C)(3)4NS-LIJHSfalse
North Shore-LIJ Health System Foundation
972 BRUSH HOLLOW RDWestburyNY11590112965575FUNDRAISINGNY501(C)(3)7NS-LIJHSfalse
LIJ Medical Center at Home Pharmacy
972 Brush Hollow RoadWestburyNY11590113251128SUPPORTNY501(C)(3)11, TYPE 1NS-LIJHSfalse
LIJ Foundation
972 Brush Hollow RoadWestburyNY11590112661239SUPPORTNY501(C)(3)11, TYPE 1NS-LIJHSfalse
North Shore-LIJ Medical Care Centers
972 Brush Hollow RoadWestburyNY11590113473923SUPPORTNY501(C)(3)11, TYPE 1NS-LIJHSfalse
SSH Inc
972 Brush Hollow RoadWestburyNY11590112774102SUPPORTNY501(C)(3)11, TYPE 1SOUTHSIDEfalse
North Shore University Hospital Housing
972 Brush Hollow RoadWestburyNY11590112171903Housing CompNY501(C)(3)N/ANS-LIJHSfalse
NSUH at Glen Cove Housing
972 Brush Hollow RoadWestburyNY11590237010468Housing CompNY501(C)(3)N/ANS-LIJHSfalse
Hillside Hospital Houses Inc
972 Brush Hollow RoadWestburyNY11590112113949Housing CompNY501(C)(3)N/ANS-LIJHSfalse
SIUH Systems Inc
475 Seaview AvenueStaten IslandNY10305061074604FundraisingNY501(C)(3)7NS-LIJ HCIfalse
Staten Island University Hospital
475 Seaview AvenueStaten IslandNY10305112868878Health CareNY501(C)(3)3NS-LIJ HCIfalse
Staten Island University Hospital Founda
360 Seaview AvenueStaten IslandNY10305870765787FundraisingNY501(C)(3)7SIUHfalse
The Heart Institute
475 Seaview AvenueStaten IslandNY10305311757254SUPPORTNY501(C)(3)11, TYPE 1NA
CHAPS Community Health Center Inc
1 Edgewater Plaza 6th FloorStaten IslandNY10305113345477InactiveNY501(C)(3)9SIUHfalse
Physicians of University Hospital PC
1 Edgewater Plaza 6th FloorStaten IslandNY10305200096809Health CareNY501(C)(3)11, TYPE 1SIUHfalse
Hospice Care Network
99 Sunnyside BlvdWoodburyNY11797112925757HospiceNY501(C)(3)9NS-LIJHSfalse
Lenox Hill Hospital
100 East 77th StreetNew YorkNY10021131624070Health CareNY501(C)(3)3NS-LIJ HCIfalse
LHH Corporation
100 East 77th StreetNew YorkNY10021133272016SUPPORTNY501(C)(3)11, TYPE 1NS-LIJHSfalse
SPORTS PHYSICAL THERAPY AND REHAB SVCS
972 BRUSH HOLLOW RDWESTBURYNY11590061655704HEALTH CARENY501(C)(3)11, TYPE1LIJfalse
NORTH SHORE-LIJ ALLIANCE
972 BRUSH HOLLOW RDWESTBURYNY11590263727582HEALTH CARENY501(C)(3)3NAfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Krasnoff Consultative Services
972 Brush Hollow RoadWestburyNY11590262838027CONSULTINGNYNSH Enterprise
POPULATION HEALTH MANAGEMENT LLC
972 BRUSH HOLLOW RDWESTBURYNY11590452409051ACONYHEALTH CARE INC
LONG ISLAND BEHAVIORAL HEALTH LLC
972 BRUSH HOLLOW RDWESTBURYNY11590453572263STATISTICSNYHEALTH CARE INC

Form990 Schedule R Part IV Form990ScheduleRPartIV (63 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCode
North Shore Health System Enterprises
972 Brush Hollow RoadWestburyNY11590113316922HOLDING COMPNYNS-LIJ HCC
Regioncare Inc
972 Brush Hollow RoadWestburyNY11590113052191HOMECARENYNSHS ENTC
North Shore Health Enterprises
972 Brush Hollow RoadWestburyNY11590061605319HOLDING COMPANYNS-LIJ HCC
Care Management Group of Greater NY
672 Brush Hollow RoadWestburyNY11590113336381BUSINESS SERVNYNSH ENTC
Regional Insurance Company LTD
000000000INSURANCENS-LIJ HCCC/O Cedar House 41 Cedar Ave HM 12HamiltonBermudaBDN/A
Aletta Corporation
972 Brush Hollow RoadWestburyNY11590112622371PHYSICIAN SERNYSOUTHSIDEC
North Shore-LIJ Physician Insurance Comp
100 Bank StreetBurlingtonVT05401261487515INSURANCENYNS-LIJ HCC
North Shore-LIJ Service Alliance Inc
972 Brush Hollow RoadWestburyNY11590263651575SUPPORTNYNS-LIJHSC
North Shore-LIJ Health System IPA #1
972 Brush Hollow RoadWestburyNY11590113533659Health CareNYLIJC
North Shore-LIJ Health System IPA #2
972 Brush Hollow RoadWestburyNY11590113533670Health CareNYLIJC
North Shore-LIJ Health System IPA #3
972 Brush Hollow RoadWestburyNY11590113533678Health CareNYLIJC
North Shore-LIJ Health System IPA #4
972 Brush Hollow RoadWestburyNY11590113533677Health CareNYLIJC
North Shore-LIJ Health System IPA #5
972 Brush Hollow RoadWestburyNY11590113533675Health CareNYLIJC
North Shore IPA 5 Inc
972 Brush Hollow RoadWestburyNY11590113383468BUSINESS SERVNYNS-LIJ HCC
North Shore-LIJ Network Inc
972 Brush Hollow RoadWestburyNY11590320257193SUPPORTNYNS-LIJHSC
Vivohealth Inc
972 Brush Hollow RoadWestburyNY11590264118016InactiveNYNSH ENTERPRISEC
Autoimmune Research Therapeutics
972 Brush Hollow RoadWestburyNY11590270701489InactiveNYNSH ENTERPRISEC
Long Island Medical Care PC
972 Brush Hollow RoadWestburyNY11590113217006MEDICAL SERVINYNSUHC
North Shore Radiology at Glen Cove PC
972 Brush Hollow RoadWestburyNY11590113301179MEDICAL SERVINYNSUHC
North Shore-LIJ Radiology Service PC
972 Brush Hollow RoadWestburyNY11590223970667MEDICAL SERVINYNSUHC
North Shore-LIJ Medical Group at Syosset
972 Brush Hollow RoadWestburyNY11590273957752MEDICAL SERVINYNSUHC
Activity Works LLC
972 Brush Hollow RoadWestburyNY11590264708923MEDICAL SERVINYLIJC
Palliative Care Medical Services PC
99 Sunnyside BlvdWoodburyNY11797273957835MEDICAL SERVINYNAC
North Shore-LIJ Medical Group PC
972 Brush Hollow RoadWestburyNY11590274384249MEDICAL SERVINYNSUHC
NS-LIJ Medical Group at Huntington PC
972 Brush Hollow RoadWestburyNY11590274384049MEDICAL SERVINYNSUHC
NS-LIJ Medical Group at North Nassau PC
972 Brush Hollow RoadWestburyNY11590274384146MEDICAL SERVINYNSUHC
North Shore-LIJ Physicians Group PC
972 Brush Hollow RoadWestburyNY11590274384326MEDICAL SERVINYNSUHC
Staten Island Imaging Corp
1 Edgewater Plaza 6th FloorStaten IslandNY10305133615474InactiveNYOVMC
Ocean View Management
1 Edgewater Plaza 6th FloorStaten IslandNY10305133138888Management SvNYSIUHC
Ocean Breeze Home Care Agency
1 Edgewater Plaza 6th FloorStaten IslandNY10305133773601InactiveNYOVMC
Regency Alliances Services Inc
1 Edgewater Plaza 6th FloorStaten IslandNY10305133277698Management SvNYOVMC
Verrazano Radiology Associates PC
500 Seaview Ave Ste 200Staten IslandNY10305200011201Radiology SerNYSIUHC
Staten Island University Hospital Perina
475 Seaview AvenueStaten IslandNY10305134107082MEDICAL SERVINYSIUHC
United Medical Surgical PC
256 Mason Ave Bldg B 2nd FloorStaten IslandNY10305134038780Surgical ServNYSIUHC
University Physicians OncologyHematolog
500 Seaview AvenueStaten IslandNY10305133642729MEDICAL SERVINYSIUHS
Emergency Medicine Services of Staten Is
1 Edgewater Plaza 6th FloorStaten IslandNY10305134200899MEDICAL SERVINYSIUHC
Goethals Radiology PC
500 Seaview AvenueStaten IslandNY10305200010287Radiology SerNYSIUHC
Staten Island Hospitalists PC
475 Seaview AvenueStaten IslandNY10305331010283MEDICAL SERVINYSIUHC
Staten Island Neonatology PC
500 Seaview AvenueStaten IslandNY10305133375474MEDICAL SERVINYSIUHC
Staten Island Medical Intensivist PC
501 Seaview Avenue Ste 102Staten IslandNY10305043716494MEDICAL SERVINYSIUHC
Lenox Hill Physicians Hospital Organizat
122 East 76th St Suite 3-ANew YorkNY100212834133775996Managed CareNYLENOX HILLC
Lenox Otolaryngology Head & Neck Surgery
186 East 76th Street 2nd FloorNew YorkNY10021208784395MEDICAL SERVINYLENOX HILLC
Park Lenox OBGYN PC
130 East 77th Street 2nd FloorNew YorkNY10021133596988MEDICAL SERVINYLENOX HILLC
Advanced Imaging & Radiology of Lenox Hi
100 East 77th StreetNew YorkNY10021200719612MEDICAL SERVINYLENOX HILLC
Advanced Heart Physicians & Surgeons Net
130 East 77th Street 4th FloorNew YorkNY10021133853125MEDICAL SERVINYLENOX HILLS
Lenox Hill Cardiology Associates PC
100 East 77th StreetNew YorkNY10021133385163MEDICAL SERVINYLENOX HILLC
Lenox Hill Interventional Cardiac & Vasc
130 East 77th Street 9th FloorNew YorkNY10021201435770MEDICAL SERVINYLENOX HILLC
Lenox Hill Pathology PC
100 East 77th StreetNew YorkNY10021133644370MEDICAL SERVINYLENOX HILLC
Park Lenox Emergency Medicine PC
100 East 77th StreetNew YorkNY10021262661082MEDICAL SERVINYLENOX HILLC
Manhattan Minimally Invasive and Bariatr
186 East 76th Street 1st FloorNew YorkNY10021200250107MEDICAL SERVINYLENOX HILLC
Park Lenox Medical PC
100 East 77th StreetNew YorkNY10021133575380MEDICAL SERVINYLENOX HILLC
Park Lenox Orthopedics PC
100 East 77th StreetNew YorkNY10021264634966MEDICAL SERVINYLENOX HILLC
Park Lenox Pediatrics PC
100 East 77th StreetNew YorkNY10021133755683MEDICAL SERVINYLENOX HILLC
Park Lenox Surgical PC
130 East 77th Street 13th FloorNew YorkNY10021133397814MEDICAL SERVINYLENOX HILLC
Park Lenox Psychiatry PC
130 East 77th StreetNew YorkNY10021133424466MEDICAL SERVINYLENOX HILLC
North Shore-LIJ Cardiovascular Medicine
972 Brush Hollow RdWestburyNY11590275078717Medical ServicesNYNSUHC
North Shore-LIJ Cardiology PC
972 Brush Hollow RdWestburyNY11590275078531Medical ServicesNYNSUHC
North Shore-LIJ Heart Surgery PC
972 Brush Hollow RdWestburyNY11590275078838Medical ServicesNYNSUHC
North Shore-LIJ Internal Medicine PC
972 Brush Hollow RdWestburyNY11590275078361Medical ServicesNYNSUHC
NS-LIJ Medical Group Urgent Medical Care
972 Brush Hollow RdWestburyNY11590275078426Medical ServicesNYNSUHC
Lenox Hill Hospital Medical PC
972 Brush Hollow RdWestburyNY11590452661543Medical ServicesNYLENOX HILLC
North Shore-LIJ Medical Care PC
972 Brush Hollow RdWestburyNY11590453023019Medical ServicesNYNSUHC
NS-LIJ Occupational Medicine PC
972 Brush Hollow RdWestburyNY11590451004103Medical ServicesNYNSUHC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
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 OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Huntington Hospital Dolan Family HLTH Center
I286286AT COST
Huntington Hospital Dolan Family HLTH Center
R76238AT COST