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GLEN COVE HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
GLEN COVE HOSPITAL (EIN 11-1633487)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-12-13
IRS object ID
201243489349300729
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)
EIN111633487EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GLEN COVE HOSPITALBusinessNameLine1
Business Name Line2C/O NORTH SHORE-LIJ HEALTH SYSTEMBusinessNameLine2
FieldValueIRS element (for citing)
In Care Of Name% NORTH SHORE-LIJ HEALTH SYSTEInCareOfName
Name ControlGLENNameControl
Phone5168766061Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1972 BRUSH HOLLOW ROAD 5TH FLAddressLine1
CityWESTBURYCity
StateNYState
ZIP Code11590ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT S SHAPIROName
TitleEXEC VP & CFOTitle
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 PersonMICHAEL J DOWLINGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1145 COMMUNITY DRIVEAddressLine1
CityGREAT NECKCity
StateNYState
ZIP Code11021ZIPCode
FieldValueIRS element (for citing)
Gross Receipts213198097GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.NSLIJ.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1956YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionGlen Cove strives to improve the health of the communities it serves and is committed to providing the highest quality clinical care and caring for the entire community regardless of the ability to pay.ActivityOrMissionDescription
Nbr Voting Members Governing Body152NbrVotingMembersGoverningBody
Nbr Independent Voting Members144NbrIndependentVotingMembers
Total Nbr Employees1492TotalNbrEmployees
Total Nbr Volunteers150TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year762433ContributionsGrantsPriorYear
Contributions Grants Current Year456534ContributionsGrantsCurrentYear
Program Service Revenue Prior Year179614501ProgramServiceRevenuePriorYear
Program Service Revenue CY188414490ProgramServiceRevenueCY
Investment Income Prior Year2093774InvestmentIncomePriorYear
Investment Income Current Year2100043InvestmentIncomeCurrentYear
Other Revenue Prior Year2217862OtherRevenuePriorYear
Other Revenue Current Year6591976OtherRevenueCurrentYear
Total Revenue Prior Year184688570TotalRevenuePriorYear
Total Revenue Current Year197563043TotalRevenueCurrentYear
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 Year115131294SalariesEtcPriorYear
Salaries Etc Current Year124705836SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year7630TotalFundrsngExpCurrentYear
Other Expense Prior Year62257414OtherExpensePriorYear
Other Expenses Current Year70108490OtherExpensesCurrentYear
Total Expenses Prior Year177388708TotalExpensesPriorYear
Total Expenses Current Year194814326TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7299862RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2748717RevenuesLessExpensesCY
Total Assets BOY171373789TotalAssetsBOY
Total Assets EOY184893946TotalAssetsEOY
Total Liabilities BOY81833920TotalLiabilitiesBOY
Total Liabilities EOY93962822TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY89539869NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY90931124NetAssetsOrFundBalancesEOY
Mission DescriptionGLEN COVE HOSPITAL IS PART OF THE NORTH SHORE-LIJ HEALTH SYSTEM ("THE SYSTEM"), WHICH STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES AND IS COMMITTED TO PROVIDING THE HIGHEST QUALITY CLINICAL CARE; EDUCATING THE CURRENT AND FUTURE GENERATIONS OF HEALTHCARE PROFESSIONALS; SEARCHING FOR NEW ADVANCES IN MEDICINE THROUGH THE CONDUCT OF BIOMEDICAL RESEARCH; PROMOTING HEALTH EDUCATION; AND CARING FOR THE ENTIRE COMMUNITY REGARDLESS OF THE ABILITY TO PAY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense152972762Expense
Revenue169616158Revenue
DescriptionGlen Cove Hospital (GCH) is a 265-bed community hospital that offers inpatient medical/surgical, intensive and cardiac care, orthopedics, gynecology, pediatrics, and psychiatry. GCH offers state of the art inpatient and outpatient orthopedic rehabilitation services, including total join replacement, spinal procedures and sports medicine. GCH has established itself as a national and international center for orthopedic surgery and joint replacement. GCH is also a NYS DOH - designated Stroke Center. In 2011, the hospital had 9,501 inpatient discharges, provided 21,565 emergency department visits and performed 3,861 ambulatory surgeries, including endoscopies.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense21920654Expense
Revenue18798332Revenue
DescriptionThe Physician and Ambulatory Network Services (formerly Faculty Practice Plan) strive to make a measurable difference in the health status of communities it serves by providing a complete and comprehensive practice management infrastructure that enable enterprise to achieve the financial status necessary to meet patient, physician and Health System needs.Description
FieldValueIRS element (for citing)
Total Program Service Expense174893416TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiestrueForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family 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 With109621NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees1492NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
Name Of Foreign CountryEINameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members152NbrVotingGoverningBodyMembers
Number Independent Voting Members144NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonNORTH SHORE-LIJ HEALTH SYSTENamePerson
Telephone Number5168766061TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1972 BRUSH HOLLOW ROAD 5TH FLAddressLine1
CityWESTBURYCity
StateNYState
ZIP Code11590ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MICHAEL J DOWLING
PRESIDENT & CEO50.0XX02521221742813
RICHARD D GOLDSTEIN
CHAIRMAN3.0XX000
WILLIAM L MACK
VICE CHAIRMAN2.0XX000
BARRY RUBENSTEIN
VICE CHAIRMAN2.0XX000
ALAN I GREENE
TREASURER2.0XX000
DONALD ZUCKER
SECRETARY2.0XX000
MARK CLASTER
VICE CHAIRMAN2.0XX000
RALPH NAPPI
TRUSTEE & PRES FOUNDATION50.0X0774818534580
NON-COMPENSATED TRUSTEES
SEE SCHEDULE OX
ANTHONY C FERRERI
TRUSTEE AND PRES/CEO SIUH50.0X01041142291142
KEVIN F LAWLOR
TRUSTEE AND PRES/CEO HUNT HOSP50.0X0744807313444
HOWARD GOLD
SR VP, REVENUE & BUSINESS DEV50.0X01039768351634
MARK J SOLAZZO
EVP, CHIEF OPERATING OFFICER50.0X01312802138838
ROBERT S SHAPIRO
SR VP, CHIEF FINANCIAL OFFICER50.0X01047340262780
LAWRENCE G SMITH MD
EVP/PHYSICIAN-IN-CHIEF50.0X077472343937
KEITH THOMPSON
SR VP & GENERAL COUNSEL50.0X0856803356015
JEFFREY KRAUT
SR VP STRATEGIC PLANNING50.0X0767349221731
KATHLEEN GALLO RN PHD
CHF LEARNING OFFICER50.0X0712494347598
EUGENE TANGNEY
REGIONAL EXECUTIVE DIRECTOR50.0X070515193957
HARRY GINDI
VP, LEGAL AFFAIRS50.0X030433942050
DENNIS CONNORS
EXECUTIVE DIRECTOR50.06195810255586X
EUGENE KRAUSS
DIRECTOR, ORTHOPEDICS50.0985488034700X
AYAL SEGAL
PHYSICIAN50.0709180034700X
VINCENT LEONE
PHYSICIAN50.0723841034700X
BRIAN PINARD
CHAIRPERSON50.0485648042050X
JAY SIMONCIC
PHYSICIAN50.0656744034700X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4180482TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs12602757TotalReportableCompFrmRltdOrgs
Total Other Compensation4176955TotalOtherCompensation
Number Individuals GT100 K200NumberIndividualsGT100K
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
MICHAEL ANTHONY CONTRACTING CORP
161 RAILROAD AVENUEGARDEN CITYNY11040GENERAL CONTRACTOR585284
OCEANSIDE INSTITUTIONAL INDUSTRIES
2525 LONG BEACH ROADOCEANSIDENY11572LAUNDRY SERVICE584345
GE HEALTHCARE
80 E SEAVIEW BLVDPORT WASHINGTONNY11050EQUIP SVC CONTRACTOR349156
AG LANDSCAPING
3 ST JAMES PALCEGLEN COVENY11542LANDSCAPE CONTRACTOR228012
SILENT TYPE INC
196 SOUTH BRUNT STENGLEWOODNJ07631TRANSCRIPTION SVC225737
FieldValueIRS element (for citing)
Number Of Contractors GT100 K14NumberOfContractorsGT100K
Related Organizations38865RelatedOrganizations
Government Grants417669GovernmentGrants
Total Contributions456534TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE621300108928446108928446
PHYSICIAN PRACTICE REVENUE6213001890876118908761
MEDICARE/MEDICAID PAYMENTS6213006057728360577283
FieldValueIRS element (for citing)
Total Program Service Revenue188414490TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1368996TotalRevenueColumn
Exclusion$1,368,996ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column76171TotalRevenueColumn
Exclusion$76,171ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real178300Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real178300Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column178300TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities16289930Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities15635054Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities654876Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column654876TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmountRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
TELEPHONE INCOME900099170702$170,702
OH RECOVERY90009912069831206983
CAFETERIA SALES900099644614$644,614

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column4391377TotalRevenueColumn
Related Or Exempt Function Income4171740RelatedOrExemptFunctionIncome
Exclusion$219,637ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue6413676TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column197563043TotalRevenueColumn
Related Or Exempt Function Income193793213RelatedOrExemptFunctionIncome
Exclusion$2,480,120ExclusionAmount

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)
Total619581Total
Program Services619581ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total93956727Total
Program Services88360924ProgramServices
Management And General5591326ManagementAndGeneral
Fundraising4477Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total8515605Total
Program Services8008439ProgramServices
Management And General506760ManagementAndGeneral
Fundraising406Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total15591242Total
Program Services14662671ProgramServices
Management And General927828ManagementAndGeneral
Fundraising743Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6022681Total
Program Services5663987ProgramServices
Management And General358407ManagementAndGeneral
Fundraising287Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total10075Total
Management And General10075ManagementAndGeneral

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)
Total1106206Total
Program Services1040323ProgramServices
Management And General65830ManagementAndGeneral
Fundraising53Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total5659Total
Program Services5322ProgramServices
Management And General337ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total31403087Total
Program Services29532806ProgramServices
Management And General1868785ManagementAndGeneral
Fundraising1496Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2906309Total
Program Services2733218ProgramServices
Management And General172953ManagementAndGeneral
Fundraising138Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total131158Total
Program Services131158ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total173122Total
Program Services173122ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total848904Total
Management And General848904ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5472438Total
Program Services5146515ProgramServices
Management And General325923ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total5356729Total
Program Services5356729ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL & OTHER PURCHASED SERV32575773257577
BAD DEBT83995048399504
CENTRALIZED ADMIN EXP91982509198250
DUES & SUBSCRIPTIONS2241362107871333811

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1615336Total
Program Services1590753ProgramServices
Management And General24564ManagementAndGeneral
Fundraising19Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total194814326Total
Program Services174893416ProgramServices
Management And General19913280ManagementAndGeneral
Fundraising7630Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY60396BOY
EOY66009EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY57196204BOY
EOY56842831EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY264738BOY
EOY50002EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY10564059BOY
EOY13778569EOY

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)
BOY2655921BOY
EOY2522088EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY47497BOY
EOY54451EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis92116518LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec41117988LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY50079678BOY
EOY50998530EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY5012093BOY
EOY3427397EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
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)
BOY45493203BOY
EOY57154069EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY171373789BOY
EOY184893946EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY24716035BOY
EOY24903753EOY

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)
BOY15149071BOY
EOY10106872EOY

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)
BOY41968814BOY
EOY58952197EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY81833920BOY
EOY93962822EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY78755024BOY
EOY82629477EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY8125047BOY
EOY5603236EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY2659798BOY
EOY2698411EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY89539869BOY
EOY90931124EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY171373789BOY
EOY184893946EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses2748717ReconcilationRevenueExpenses
Reconcilation Other Changes-1357462ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationstrueRalliesDemonstrations
Rallies Demonstrations$22,380RalliesDemonstrationsAmount
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB22380TotalLobbyingExpendituresIIB
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 Balance2562388BeginningOfYearBalance
Contributions238613Contributions
Investment Earnings Or Losses-49307InvestmentEarningsOrLosses
Other Expenditures38613OtherExpenditures
End Of Year Balance2713081EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2282024BeginningOfYearBalance
Contributions27451Contributions
Investment Earnings Or Losses278282InvestmentEarningsOrLosses
Other Expenditures25369OtherExpenditures
End Of Year Balance2562388EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance1816559BeginningOfYearBalance
Contributions40965Contributions
Investment Earnings Or Losses464366InvestmentEarningsOrLosses
Other Expenditures39866OtherExpenditures
End Of Year Balance2282024EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2300116BeginningOfYearBalance
Contributions563641Contributions
Investment Earnings Or Losses-986465InvestmentEarningsOrLosses
Other Expenditures60733OtherExpenditures
End Of Year Balance1816559EndOfYearBalance
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 Basis174043OtherCostOrOtherBasis
Book Value174043BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis70159178OtherCostOrOtherBasis
Depreciation31472433Depreciation
Book Value38686745BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis19279035OtherCostOrOtherBasis
Depreciation9404967Depreciation
Book Value9874068BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2504262OtherCostOrOtherBasis
Depreciation240588Depreciation
Book Value2263674BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings50998530TotalOfBookValueLandBuildings

Other Assets OtherAssets (8 entries)

DescriptionDescriptionBook ValueBookValue
DUE FROM AFFILIATE35313214
INTEREST IN FOUNDATION,UNREST.2243746
BOND FINANCING217375
DEPOSITS ON EQUIPMENT13792
MALPRACTICE SELF INSURANCE1464165
OTHER ASSETS271596
AUXILIARY49095
INSURANCE CLAIMS RECEIVABLE17581086
FieldValueIRS element (for citing)
Total Book Value Other Assets57154069TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescriptionAmountAmount
ESTIMATED PAYABLE TO 3RD PARTY$6,400,383
OTHER LIABILITIES$9,909,763
MALPRACTICE INSURANCE$12,210,000
PENSION$12,793,052
BOND PREM/DISC$57,913
INSURANCE CLAIMS LIABILITY$17,581,086
FieldValueIRS element (for citing)
Total Of Amounts58952197TotalOfAmounts
Total Revenue197563043TotalRevenue
Total Expenses194814326TotalExpenses
Excess Or Deficit For Year2748717ExcessOrDeficitForYear
Net Unrealized GL On Investments-2401063NetUnrealizedGLOnInvestments
Other$1,043,601OtherAmount
Total Adjustments-1357462TotalAdjustments
Excess Or Deficit Per FS1391255ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt194931808TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-2257417NetUnrealizedGainsInvestments
Other Revenues-238783OtherRevenues
Revenue Not Rptd F990-2496200RevenueNotRptdF990
Revenue Subtotal197428008RevenueSubtotal
Other Revenues Not Included135035OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt135035RevenueNotRptdOnFinStmt
Total Revenue Per Form990197563043TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt191972586TotExpensesEtcAuditedFinclStmt
Expenses Subtotal191972586ExpensesSubtotal
Other Expenses Not Included2841740OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt2841740ExpensesNotRptdOnFinStmt
Total Expenses Per Form990194814326TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FIN 48PART X, LINE 2Certain 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.
OTHER CHANGE IN NET ASSETSPART XI, LINE 8CHANGE IN EQUITY UNDER FAS 136 1,141,691 DEFEASANCE OF OF LT DEBT (238,783) NET ASSETS RELEASED FROM RESTRICTIONS 134,309 INC/DEC IN AUXILIARY ASSETS 6,384 TOTAL OTHER CHANGES IN NET ASSETS 1,043,601
REVENUE ON RETURN BUT NOT ON BOOKSPART XII, LINE 4BRESTRICTED CONTRIBUTIONS 38,613 RESTRICTED INVESTMENT INCOME 96,422 TOTAL 135,035
INTENDED USE OF ENDOWMENTSPART V, LINE 4There are various components that encompass the Endowment Fund. In general, their intended use is for teaching, research and training, major modernization, and purchases of equipment.
REVENUE ON BOOKS NOT ON RETURNPART XII, LINE 1DDEFEASANCE OF LONG TERM DEBT (238,783)
EXPENSE ON RETURN BUT NOT ON BOOKSPART XIII, LINE 4BADDITIONAL MINIMUM LIABILITY ON PENSION 2,841,740

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable (2 entries)

RegionRegionType Of Activities ConductedTypeOfActivitiesConductedTotal ExpendituresTotalExpenditures
Central America and the CaribbeanInvestments4800432
Europe (Including Iceland and Greenland)Investments4686024
FieldValueIRS element (for citing)
Subtotal Amount Spent9486456SubtotalAmountSpent
Total Amount Spent9486456TotalAmountSpent
Transfer To Foreign CorpfalseTransferToForeignCorp
Interest In Foreign TrustfalseInterestInForeignTrust
Own Foreign CorpfalseOwnForeignCorp
Passive Foreign Invest CofalsePassiveForeignInvestCo
Foreign PartnershipfalseForeignPartnership
Boycott CountriesfalseBoycottCountries

Schedule H IRS990ScheduleH

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

Discounted Other DiscountedOther

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

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served5158PersonsServed
Total Community Benefit Expense5371000TotalCommunityBenefitExpense
Direct Offsetting Revenue1978000DirectOffsettingRevenue
Net Community Benefit Expense3393000NetCommunityBenefitExpense
Percent Of Total Expense0.01800PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served16139PersonsServed
Total Community Benefit Expense13780466TotalCommunityBenefitExpense
Direct Offsetting Revenue8819932DirectOffsettingRevenue
Net Community Benefit Expense4960534NetCommunityBenefitExpense
Percent Of Total Expense0.02630PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served21297PersonsServed
Total Community Benefit Expense19151466TotalCommunityBenefitExpense
Direct Offsetting Revenue10797932DirectOffsettingRevenue
Net Community Benefit Expense8353534NetCommunityBenefitExpense
Percent Of Total Expense0.04430PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs109NumberOfActivitiesOrPrograms
Persons Served46609PersonsServed
Total Community Benefit Expense2550498TotalCommunityBenefitExpense
Direct Offsetting Revenue1146261DirectOffsettingRevenue
Net Community Benefit Expense1404237NetCommunityBenefitExpense
Percent Of Total Expense0.00740PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs22NumberOfActivitiesOrPrograms
Persons Served230PersonsServed
Total Community Benefit Expense3564405TotalCommunityBenefitExpense
Direct Offsetting Revenue1762824DirectOffsettingRevenue
Net Community Benefit Expense1801581NetCommunityBenefitExpense
Percent Of Total Expense0.00950PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served76PersonsServed
Total Community Benefit Expense48623TotalCommunityBenefitExpense
Net Community Benefit Expense48623NetCommunityBenefitExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs140NumberOfActivitiesOrPrograms
Persons Served46915PersonsServed
Total Community Benefit Expense6163526TotalCommunityBenefitExpense
Direct Offsetting Revenue2909085DirectOffsettingRevenue
Net Community Benefit Expense3254441NetCommunityBenefitExpense
Percent Of Total Expense0.01720PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs142NumberOfActivitiesOrPrograms
Persons Served68212PersonsServed
Total Community Benefit Expense25314992TotalCommunityBenefitExpense
Direct Offsetting Revenue13707017DirectOffsettingRevenue
Net Community Benefit Expense11607975NetCommunityBenefitExpense
Percent Of Total Expense0.06150PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs2NumberOfActivitiesOrPrograms
Persons Served79PersonsServed
Total Community Building Expense54957TotalCommunityBuildingExpense
Net Community Building Expense54957NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs5NumberOfActivitiesOrPrograms
Persons Served119PersonsServed
Total Community Building Expense54957TotalCommunityBuildingExpense
Net Community Building Expense54957NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$2,883,000BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare67267328AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare73096844CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5829516MedicareSurplusOrShortfall

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 Line1GLEN COVE HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1101 ST ANDREWS LANEAddressLine1
CityGLEN COVECity
StateNYState
ZIP Code11542ZIPCode
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 Line1GLEN COVE 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 Facilities5NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
NORTH SHORE-LIJ ORTHOPEDICS
833 NORTHERN BLVDGREAT NECKNY11021OUTPATIENT PHYSICIAN CLINIC
SCHOOL STREET FAMILY PRACTICE
1 SCHOOL STREETGLEN COVENY11542FAMILY HEALTH CENTER
OYSTER BAY FAMILY PRACTICE
70 WEST MAIN STREETOYSTER BAYNY11771FAMILY HEALTH CENTER
NORTH SHORE-LIJ IMAGING AT GLEN COVE
10 MEDICAL PLAZAGLEN COVENY11542DIAGNOSTIC CENTER
NORTH COAST INTERNAL MEDICINE PC
207 GLEN COVE AVENUESEA CLIFFNY11579OUTPATIENT PHYSICIAN CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
IdentifierPART VI - SUPPLEMENTAL INFORMATIONIdentifier
ExplanationPart 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 ofExplanation

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 OrgtrueCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (19 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
MICHAEL J DOWLING
011730960132800002012507216380211750326403400
HOWARD GOLD
0870612014052002863603336050180290139140200
MARK J SOLAZZO
0975957030000003684501204130184250145164000
ROBERT S SHAPIRO
0869950015552002187002445600182200131012000
LAWRENCE G SMITH MD
0675150075780023793026950016987081866000
KEITH THOMPSON
0697420013000002938303404180155970121281800
JEFFREY KRAUT
062281701205200240120203691018040098908000
KATHLEEN GALLO RN PHD
0574034010978002868003324980151000106009200
EUGENE TANGNEY
0589571010578009800074095019862079910800
HARRY GINDI
027236502859103383026950015100034638900
DENNIS CONNORS
49358901167800921202361080194780875167000
EUGENE KRAUSS
764398020078002031001960001510001020188000
AYAL SEGAL
70795000012300196000151000743880000
VINCENT LEONE
7230610007800196000151000758541000
BRIAN PINARD
4036950207800611730269500151000527698000
JAY SIMONCIC
574806000819380196000151000691444000
RALPH NAPPI
0649111010000002570705156550189250130939800
ANTHONY C FERRERI
0880730014066001975202733350178070133228400
KEVIN F LAWLOR
0597817011900002799002961930172510105825100

Form990 Schedule J Part III Form990ScheduleJPartIII (3 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 Michael J Dowling ($694,688), Ralph Nappi ($488,705), Mark Solazzo($93,463), Robert S Shapiro ($217,610), Howard Gold ($306,655), Keith Thompson ($313,468), Jeffrey Kraut ($176,741), Kathleen Gallo ($305,548), Eugene Tangney ($47,145), Dennis Connors ($209,158), Anthony C Ferreri ($235,564) and Kevin F Lawlor ($273,978).
COMPENSATION CONTINGENT ON REVENUESPART I, LINE 5APursuant to the persons listed in Form 990, Part VII, section A, line 1A, there is no contractual obligation to pay or accrue any compensation to officers of the North Shore LIJ Health System based on the revenue of the organization. A listed person(s) that may qualify under this condition could be one or more of the physicians listed as a highly compensated employee.
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 (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
DORMITORY AUTHORITY OF THE STATE OF NEW YORK
14600029364983Q4R72006-10-1819738362005 Bonds - CAPITAL IMPROVEMEfalsefalsefalse
DORMITORY AUTHORITY OF THE STATE OF NEW YORK
146000293649903LC32007-05-3146044342007 A&B Bonds-CAP IMPROV & REFUNDtruefalsefalse
DORMITORY AUTHORITY OF THE STATE OF NEW YORK
146000293649905QL32009-09-1714126482009 A&E Bonds-CAP IMPROV & REFI 2falsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Amount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
2181890204615514058500179410069761181786802010truefalsetruetrue
1135396043345302929468538913542124325100102624510006980truetruefalsetrue
001409450154053109238022900006226962314370truefalsefalsetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalse0true
falsefalsefalsefalse0true
falsefalsefalsefalse0true

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebateTerm Of HedgeTermOfHedgeSuperintegrated HedgeSuperintegratedHedgeHedge TerminatedHedgeTerminatedTerm Of GICTermOfGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied
0
falsefalsefalsefalse0falsetrue
CITIBANK NA
falsefalsetruetrueMBIAfalsetrue25.9falsefalse18.1true
0
falsefalsefalsefalse0falsetrue
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 K IRS990ScheduleK

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (29 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
BOARD MEMBER RELATIONSPART VI, SECTION A - GOVERNING BODY, 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. William Achenbaum has a business relationship with Eric and Roger Blumencranz. John Alexander has a business relationship with John Shall and Stanley Applebaum. Philip Altheim has a business relationship with Eric Blumencranz. Stanley Applebaum has a business relationship with John Alexander and John Shall. Michael Ashner has a business relationship with William Mack. Morton Bass has a family relationship with Sandra Atlas Bass. Eric Blumencranz has as a family relationship with Roger Blumencranz. He has a business relationship with Roger Blumencranz, William Achenbaum, Philip Altheim, Richard D. Goldstein, Lloyd Goldman, Alan Greene, James Greene, Richard Guarasci, Richard Horowitz, Jeffrey Jurick, Lyn Jurick, Seth Kupferberg, Arthur Levine, Stuart Levine, David Mack, Bradley Marsh, Charles Merinoff, Ralph Nappi, Dennis Riese. Roger Blumencranz has a family relationship with Eric Blumencranz. He has a business relationship with Eric Blumencranz, William Achenbaum, Alan Greene, James Greene, Stanley Grey, Richard D. Goldstein, Richard Horowitz, Jeffrey Jurick, Lyn Jurick, Stuart Levine, David Mack, Bradley Marsh, Charles Merinoff, Ralph Nappi, Mark Solazzo, Donald Zucker, Barbara Zucker. David Blumenfeld has a family relationship with Edward Blumenfeld. Edward Blumenfeld has a family relationship with David Blumenfeld. He has a business relationship with William Mack. Steve Braun has a family relationship with Richard Sims. Alan Chopp has a business relationship with Patrick McDermott. Mark Claster has a business relationship with Robert Rosenthal, Richard Goldstein, Saul Katz. Philippe Dauman has a business relationship with Michael Hoffman. Daniel deRoulet has a family relationship with Lorinda deRoulet. Lorinda deRoulet has a family relationship with Daniel deRoulet. Leonard Feinstein has a business relationship with William Mack. Anthony Ferreri has a family and business relationship with John Shall. Lloyd Goldman has a business relationship with Eric Blumencranz, Richard Goldstein and William Mack. Richard D. Goldstein has a business relationship with Roger Blumencranz, Eric Blumencranz, Mark Claster, Lloyd Goldman, William Mack, and Barry Rubenstein. Joaquin Gonzalez has a business relationship with John Shall. Alan I. Greene has a family relationship with James R. Greene. He has a business relationship with Eric and Roger Blumencranz. James R. Greene has a family relationship with Alan I. Green. He has a business relationship with Eric and Roger Blumencranz. Stanley Grey has a business relationship with Roger Blumencranz. Richard Guarasci has a business relationship with Eric Blumencranz. Paul Guenther has a business relationship with Michael Hoffman. William Hiltz has a business relationship with Michael Hoffman and Jeff Maurer. Michael Hoffman has a business relationship with Phillipe Dauman, Paul Guenther, Marlene Hess, William Hiltz and Richard Nye. Richard Horowitz has a business relationship with Eric and Roger Blumencranz. Jeffrey Jurick has a family relationship with Lynn Jurick. He has a business relationship with Eric and Roger Blumencranz. Lynn Jurick has a family relationship with Jeffrey Jurick. She has a business relationship with Eric and Roger Blumencranz. David Katz has a family relationship with Saul Katz and Michael Katz. Michael Katz has a family relationship with Saul Katz and David Katz. He has a business relationship with Saul Katz, Curt Launer and Michael Slade. Saul Katz has a family relationship with Michael Katz and David Katz. He has a business relationship with Mark Claster, Michael Katz, Curt Launer and Michael Slade. Seth Kupferberg has a business relationship with Eric Blumencranz. Jeffrey Lane has a business relationship with William Mack. Curt Launer has a business relationship with Michael Katz. David Lehr has a business relationship with Ronald Mazzucco. Arthur Levine has a business relationship with Eric Blumencranz. Stuart Levine has a business relationship with Eric and Roger Blumencranz. David Mack has a family relationship with William Mack. He has a business relationship with William Mack, Eric Blumencranz, and Roger Blumencranz. William Mack has a family relationship with David Mack. He has business relationships with David Mack, Michael Ashner, Edward Blumenfeld, Leonard Feinstein, Lloyd Goldman, Jeffrey Lane, Barry Rubenstein, Scott Rudolph, Richard Goldstein and Roy Zuckerberg. Bradley Marsh has a family relationship with Jack Ross. He has a business relationship with Eric and Roger Blumencranz. Ronald Mazzucco has a business relationship with David Lehr. F.J. McCarthy has a business relationship with Robert Rosenthal. Patrick McDermott has a business relationship with Alan Chopp and John Shall. Charles Merinoff has a business relationship with Eric Blumencranz. Richard Murcott has a business relationship with Barry Rubenstein. Ralph Nappi has a business relationship with Eric Blumencranz. Dennis Riese has a business relationship with Eric Blumencranz. Robert Rosenthal has a business relationship with Mark Claster and F.J. McCarthy. Dr Bernard Rosof has a business relationship with Huntington Hospital Trustees. Jack Ross has a family relationship with Bradley Marsh. Barry Rubenstein has a business relationship with Richard Goldstein, William Mack and Mark Claster. Scott Rudolph has a business relationship with William Mack. John Shall has a family relationship with Anthony Ferreri. He has a business relationship with Anthony Ferreri, Patrick McDermott, John Alexander, Stanley Applebaum, and Joaquin Gonzalez. Richard Sims has a family relationship with Steve Braun. Michael Slade has a business relationship with Eric Blumencranz, Saul Katz and Michael Katz. Barbara Hrbek Zucker has a family relationship with Donald Zucker. She has a business relationship with Roger Blumencranz. Donald Zucker has a family relationship with Barbara Hrbek Zucker. He has a business relationship with Roger Blumencranz. Roy Zuckerberg has a business relationship with William Mack.
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 12CThe North Shore-Long Island Jewish Health System ("Health System") has several control mechanisms to mitigate conflicts of interest. The Health System's Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, our Code of Ethical Conduct requires individuals to conduct Health System business in a manner that places the interests of the Health System ahead of their personal interests. In addition, the Health System has a Conflicts of Interest Policy Statement further elaborating upon individuals' disclosure and recusal obligations. Individuals that are in a position to influence the business or other decisions of the Health System are required to filled out a conflicts of interest disclosure form on a regular basis. The Corporate Compliance Office reviews all disclosures of possible conflicts, including matters disclosed in any conflicts of interest disclosure report and takes any actions deemed required or appropriate to manage or resolve any actual or potential conflicts of interest. In appropriate cases these disclosures and responsive actions will be reported to the Health System's Audit and Corporate Compliance Committee and other applicable committees. In addition, the Health System provides training to individuals on an annual basis regarding conflicts of interest and other compliance related topics. If an individual violates the Code of Ethical Conduct or any related policy such as the Conflicts of Interest Policy Statement, appropriate disciplinary action is taken based upon the facts and circumstances of the situation.
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 others 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 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 MAKES IT GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
NON-COMPENSATED TRUSTEESPART VII, SECTION A - LINE 1ARichard S. Abramson Albert L. Granger,DDS Katherine McEnroe William Achenbaum Alan I. Greene James McMullen John W. Alexander James R. Greene Charles Merinoff Ira I. Altfeder Stanley Grey Aimee Merszei Philip S. Altheim Richard Guarasci,PhD Richard D. Monti Stanley A. Applebaum Paul B. Guenther Tomas D. Morales, PhD Michael L. Ashner Henry L. Hackmann Richard Murcott Beverly VP. Banker Amy M. Hagedorn Ralph A. Nappi Ralph M. Baruch Stephen L. Hammerman Richard B. Nye Morton M. Bass Ira Hazan Clyde I. Payne, Ed.D. Frank J. Besignano Linda W. Heaney Arnold S. Penner Elise M. Bloom Marlene Hess John J. Raggio Eric S. Blumencranz William O. Hiltz Lewis S. Ranieri Roger A. Blumencranz Michael Hoffman Jay R. Raubvogel David Blumenfeld Gedale B. Horowitz Corey Ribotsky Edward Blumenfeld Richard A. Horowitz Dennis Riese E. Steve Braun M. Allan Hyman Terry P. Rifkin, M.D. Dayton T. Brown, Jr Mark Jacobson Robert A. Rosen Allen E. Busching Jeffrey Jurick Marcie Rosenberg Jonathan S. Canno Lyn Jurick Robert D. Rosenthal Michael Caridi Arthur Kalish Bernard M. Rosof, M.D. Rev.Carolina Sr,Ed.D Steven L. Kantor Jack J. Ross Rudolph C. Carryl David M. Katz Barry Rubenstein Robert W. Chasanoff Michael Katz Herbert Rubin Alan Chopp Saul B. Katz Scott Rudolph Mark Claster Lisa A. Kaufman Michael H. Sahn Diana F. Colgate Robert Kaufman Frank W. Scarangello, Sr. Daniel M. Crown Cary Kravet Norman Schlanger Philippe P. Dauman Stanley Kreitman Lois C. Schlissel Daniel C. de Roulet Seth Kupferberg John M. Shall Lorinda de Roulet Jeffrey B. Lane Robert F. Shapiro Thomas E. Dewey, Jr. Curt N. Launer Marc V. Shaw Thomas E. Dooley Laura Lauria Sean G. Simon Michael J. Dowling Kevin F. Lawlor Richard Sims Robert N. Downey Michale S. Leeds Michael C. Slade Melvin Dubin David W. Lehr Phyllis Hill Slater Patrick R. Edwards Jonathan W. Leigh Howard D. Stave Toni J. Elliott Sylvia Lester Russell Stern Michael A. Epstein Arthur S. Levine Maganlal Sutaria, M.D. Leonard Feinstein Stuart R. Levine John B. Thomson, Jr. Michael E. Feldman Seth Lipsay Peter Tilles Anthony C. Ferreri David S. Mack Sandra Tytel Arlene Lane Fisher William L. Mack Nancy Waldbaum Catherine C. Foster Howard S. Maier Gary Walter William H. Frazier Linda Manfredi Howard Weingrow Eugene B. Friedman, M.D. James S. Marcus Lewis M. Weston Sy Garfinkel Bradley Marsh, D.P.M. Jon A. Wurtzburger Lloyd Michael Goldman Jeffrey S. Maurer Barbara Hrbek Zucker Richard D. Goldstein Ronald J. Mazzucco Donald Zucker J. Joaquin Gonzalez F.J. McCarthy Roy J. Zuckerberg Michael Gould Patrick F. McDermott
AVERAGE HOURS PER WEEKPART 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 5CHANGE IN NET UNREALIZED GAINS/LOSSES (2,401,063) CHANGE IN EQUITY UNDER FAS 136 1,141,691 DEFEASANCE OF LONG TERM DEBT (238,783) INCREASE IN AUXILIARY ASSETS 6,384 TOTAL (1,357,462)
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MICHAEL J DOWLING TITLE:PRESIDENT & CEO HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:RICHARD D GOLDSTEIN TITLE:CHAIRMAN HOURS:3
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:WILLIAM L MACK TITLE:VICE CHAIRMAN HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:BARRY RUBENSTEIN TITLE:VICE CHAIRMAN HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ALAN I GREENE TITLE:TREASURER HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DONALD ZUCKER TITLE:SECRETARY HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MARK CLASTER TITLE:VICE CHAIRMAN HOURS:2
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:RALPH NAPPI TITLE:TRUSTEE & PRES FOUNDATION HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ANTHONY C FERRERI TITLE:TRUSTEE AND PRES/CEO SIUH HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:KEVIN F LAWLOR TITLE:TRUSTEE AND PRES/CEO HUNT HOSP HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:HOWARD GOLD TITLE:SR VP, REVENUE & BUSINESS DEV HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:MARK J SOLAZZO TITLE:EVP, CHIEF OPERATING OFFICER HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:ROBERT S SHAPIRO TITLE:SR VP, CHIEF FINANCIAL OFFICER HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:LAWRENCE G SMITH MD TITLE:EVP/PHYSICIAN-IN-CHIEF HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:KEITH THOMPSON TITLE:SR VP & GENERAL COUNSEL HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:JEFFREY KRAUT TITLE:SR VP STRATEGIC PLANNING HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:KATHLEEN GALLO RN PHD TITLE:CHF LEARNING OFFICER HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:EUGENE TANGNEY TITLE:REGIONAL EXECUTIVE DIRECTOR HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:HARRY GINDI TITLE:VP, LEGAL AFFAIRS HOURS:50
HOURS DEVOTED FOR RELATED ORGANIZATIONFORM 990 PART VIINAME:DENNIS CONNORS TITLE:EXECUTIVE DIRECTOR HOURS:50

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (34 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 RDWESTBURYNY11590113418133SUPPORT ORGNY501(C)(3)11, TYPE 1NAfalse
NORTH SHORE-LIJ HEALTH CARE INC
972 BRUSH HOLLOW RDWESTBURYNY11590112965586SUPPORT ORGNY501(C)(3)11, TYPE 1NS-LIJHSfalse
NORTH SHORE UNIVERSITY HOSPITAL
972 BRUSH HOLLOW RDWESTBURYNY11590111562701HEALTH CARENY501(C)(3)3NS-LIJ HCfalse
LONG ISLAND JEWISH MEDICAL CENTER
972 BRUSH HOLLOW RDWESTBURYNY11590112241326HEALTH CARENY501(C)(3)3NS-LIJ HCfalse
FOREST HILLS HOSPITAL
972 BRUSH HOLLOW RDWESTBURYNY11590112163522HEALTH CARENY501(C)(3)3NS-LIJ HCfalse
PLAINVIEW HOSPITAL
972 BRUSH HOLLOW RDWESTBURYNY11590113241243HEALTH CARENY501(C)(3)3NS-LIJ HCfalse
FRANKLIN HOSPITAL
972 BRUSH HOLLOW RDWESTBURYNY11590112296824HEALTH CARENY501(C)(3)3NS-LIJ HCfalse
SOUTHSIDE HOSPITAL
972 BRUSH HOLLOW RDWESTBURYNY11590111667761HEALTH CARENY501(C)(3)3NS-LIJ HCfalse
NORTH SHORE-LIJ HEALTH SYSTEM LABS
972 BRUSH HOLLOW RDWESTBURYNY11590113412370SUPPORT ORGNY501(C)(3)11, TYPE 1NS-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
NSUH STERN FAMILY CECR
972 BRUSH HOLLOW RDWESTBURYNY11590237007485NURSING HOMENY501(C)(3)9NS-LIJ HCfalse
LIJ MEDICAL CENTER AT HOME PHARMACY
972 BRUSH HOLLOW RDWESTBURYNY11590113251128SUPPORTNY501(C)(3)11, TYPE 1NS-LIJHSfalse
LIJ FOUNDATION
972 BRUSH HOLLOW RDWESTBURYNY11590112661239SUPPORT ORGNY501(C)(3)11, TYPE 1NS-LIJHSfalse
NORTH SHORE-LIJ MEDICAL CARE CENTERS
972 BRUSH HOLLOW RDWESTBURYNY11590113473923SUPPORT ORGNY501(C)(3)11, TYPE 1NS-LIJHSfalse
SSH INC
972 BRUSH HOLLOW RDWESTBURYNY11590112774102SUPPORT ORGNY501(C)(3)11, TYPE 1SOUTHSIDEfalse
NORTH SHORE COMMUNITY SERVICES INC
972 BRUSH HOLLOW RDWESTBURYNY11590237273200HOUSING COMPNY501(C)(2)N/ANS-LIJHSfalse
NORTH SHORE UNIVERSITY HOSPITAL HOUSING
972 BRUSH HOLLOW RDWESTBURYNY11590112171903HOUSING COMPNY501(C)(2)N/ANS-LIJHSfalse
NSUH AT GLEN COVE HOUSING
972 BRUSH HOLLOW RDWESTBURYNY11590237010468HOUSING COMPNY501(C)(2)N/ANS-LIJHSfalse
HILLSIDE HOSPITAL HOUSES INC
972 BRUSH HOLLOW RDWESTBURYNY11590112113949HOUSINGNY501(C)(2)N/ANS-LIJHSfalse
SIUH SYSTEMS INC
475 SEAVIEW AVESTATEN ISLANDNY10305061074604FUNDRAISINGNY501(C)(3)7NS-LIJ HCfalse
STATEN ISLAND UNIVERSITY HOSPITAL
475 SEAVIEW AVESTATEN ISLANDNY10305112868878HEALTH CARENY501(C)(3)3NS-LIJ HCfalse
STATEN ISLAND UNIVERSITY HOSPITAL FDN
360 SEAVIEW AVESTATEN ISLANDNY10305870765787FUNDRAISINGNY501(C)(3)7SIUHfalse
THE HEART INSTITUTE
475 SEAVIEW AVESTATEN ISLANDNY10305311757254SUPPORT ORGNY501(C)(3)11, TYPE 1NAfalse
CHAPS COMMUNITY HEALTH CENTER
1 EDGEWATER PLAZASTATEN ISLANDNY10305113345477INACTIVENY501(C)(3)9SIUHfalse
HOSPICE CARE NETWORK
99 SUNNYSIDE BLVDWOODBURYNY11797112925757HOSPICENY501(C)(3)9NS-LIJHSfalse
HUNTINGTON HOSPITAL
270 PARK AVENUEHUNTINGTONNY11743111630914HEALTH CARENY501(C)(3)3NS-LIJ HCfalse
HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH
284 PULASKI RDGREENLAWNNY11740113368503HEALTH CARENY501(C)(3)3HUNTINGTONfalse
PHYSICIANS OF UNIVERSITY HOSPITAL PC
1 EDGEWATER PLAZA 6TH FLSTATEN ISLANDNY10305200096809HEALTH CARENY501(C)(3)11, TYPE 1SIUHfalse
LENOX HILL HOSPITAL
100 EAST 77TH STNEW YORKNY10021131624070HEALTH CARENY501(C)(3)3NS-LIJ HCfalse
LHH CORPORATION
100 EAST 77TH STNEW YORKNY10021133272016SUPPORTNY501(C)(3)11, TYPE 1NS-LIJHSfalse
THE ELMEZZI GRADUATE SCHOOL OF MOLECULAR
972 BRUSH HOLLOW ROADWESTBURYNY11590113284934GRADUATE SCHONY501(C)(3)2NS-LIJHSfalse
SPORTS PHYSICAL THERAPY AND REHAB SVCS O
972 BRUSH HOLLOW ROADWESTBURYNY11590061655704HEALTH CARENY501(C)(3)9LIJfalse
NORTH SHORE-LIJ ALLIANCE
972 BRUSH HOLLOW ROADWESTBURYNY11590263727582HEALTH 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 LLC
972 BRUSH HOLLOW RDWESTBURYNY11590262838027CONSULTINGNYCARE MGMT GRP
POPULATION HEALTH MANAGEMENT LLC
972 BRUSH HOLLOW ROADWESTBURYNY11590452409051ACONYNS-LIJ HC
LONG ISLAND BEHAVIORAL HEALTH LLC
972 BRUSH HOLLOW ROADWESTBURYNY11590453572263STATISTICSNYNS-LIJ HC

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/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
NORTH SHORE HEALTH SYSTEM ENTERPRISES
972 BRUSH HOLLOW RDWESTBURYNY11590113316922HOLDING COMPANYNS-LIJHSC
REGIONCARE INC
972 BRUSH HOLLOW RDWESTBURYNY11590113052191HOMECARENYNSHS ENTERPRISEC
NORTH SHORE HEALTH ENTERPRISES
972 BRUSH HOLLOW RDWESTBURYNY11590061605319HOLDING COMPANYNSHS ENTERPRISEC
CARE MANAGEMENT GROUP OF GREATER NY
972 BRUSH HOLLOW RDWESTBURYNY11590113336381BUSINESS SERVNYNSH ENTERPRISESC
REGIONAL INSURANCE COMPANY LTD
000000000INSURANCENS-LIJ HCCC/O CEDAR HOUSE 41 CEDAR AVEHAMILTONBERMUDABDHM 12BD
ALETTA CORPORATION
972 BRUSH HOLLOW RDWESTBURYNY11590112622371PHYSICIAN SERNYSOUTHSIDEC
NS-LIJ PHYSICIAN INSURANCE COMPANY RRG
100 BANK STBURLINGTONVT05401261487515INSURANCEVTNS-LIJ HCPC
NORTH SHORE-LIJ SERVICE ALLIANCE
972 BRUSH HOLLOW RDWESTBURYNY11590263651575SUPPORT SERVINYNAC
NORTH SHORE-LIJ HEALTH SYSTEM IPA #1
972 BRUSH HOLLOW RDWESTBURYNY11590113533659HEALTH CARENYLIJC
NORTH SHORE-LIJ HEALTH SYSTEM IPA #2
972 BRUSH HOLLOW RDWESTBURYNY11590113533670HEALTH CARENYLIJC
NORTH SHORE-LIJ HEALTH SYSTEM IPA #3
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ACTIVITY WORKS LLC
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VIVOHEALTH INC
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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
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg