MERCY MEDICAL CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: MERCY MEDICAL CENTER (EIN 11-1635088)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-11-15
IRS object ID: 201103199349303285
Schema version: 2010v3.4
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule I
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2011-11-15T10:12:00-06:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JH COHN LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	4 BECKER FARM ROAD	AddressLine1
City	ROSELAND	City
State	NJ	State
ZIP Code	070681739	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	111635088	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MERCY MEDICAL CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	MERC	NameControl
Phone	5167052525	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1000 NORTH VILLAGE AVENUE	AddressLine1
City	ROCKVILLE CENTRE	City
State	NY	State
ZIP Code	11570	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	ALAN D GUERCI MD	Name
Title	PRES & CEO	Title
Phone	5167052525	Phone
Date Signed	2011-11-14	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	THOMAS LANNING	Name
Phone	9732283500	Phone

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-03-07 17:11:31Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	ALAN D GUERCI MD	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	1000 NORTH VILLAGE AVENUE	AddressLine1
City	ROCKVILLE CENTRE	City
State	NY	State
ZIP Code	11570	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	195796692	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	HTTP://MERCYMEDICALCENTER.CHSLI.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1913	YearFormation
State Legal Domicile	NY	StateLegalDomicile
Activity Or Mission Description	MERCY MEDICAL CENTER, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED. CHS AFFIRMS THE SANCTITY OF LIFE, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. CHS CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION, AND INNOVATION WITH JUSTICE, INTEGRITY, AND RESPECT FOR THE DIGNITY OF EACH PERSON.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	21	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	20	NbrIndependentVotingMembers
Total Nbr Employees	1837	TotalNbrEmployees
Total Nbr Volunteers	1029	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	4878517	ContributionsGrantsPriorYear
Contributions Grants Current Year	6783886	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	188604978	ProgramServiceRevenuePriorYear
Program Service Revenue CY	185289934	ProgramServiceRevenueCY
Investment Income Prior Year	625970	InvestmentIncomePriorYear
Investment Income Current Year	255531	InvestmentIncomeCurrentYear
Other Revenue Prior Year	3231023	OtherRevenuePriorYear
Other Revenue Current Year	3102624	OtherRevenueCurrentYear
Total Revenue Prior Year	197340488	TotalRevenuePriorYear
Total Revenue Current Year	195431975	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	0	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	150520	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	110923771	SalariesEtcPriorYear
Salaries Etc Current Year	109640109	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	94579615	OtherExpensePriorYear
Other Expenses Current Year	77386938	OtherExpensesCurrentYear
Total Expenses Prior Year	205503386	TotalExpensesPriorYear
Total Expenses Current Year	187177567	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-8162898	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	8254408	RevenuesLessExpensesCY
Total Assets BOY	169377823	TotalAssetsBOY
Total Assets EOY	160796058	TotalAssetsEOY
Total Liabilities BOY	151850655	TotalLiabilitiesBOY
Total Liabilities EOY	135381314	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	17527168	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	25414744	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	MERCY MEDICAL CENTER, A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, COMMITTED TO THOSE IN NEED, AFFIRMS THE SANCTITY OF LIFE, AND ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. CHS CONDUCTS ITS HEALTHCARE PRACTICE, BUSINESS, EDUCATION, AND INNOVATION WITH JUSTICE, INTEGRITY, AND RESPECT FOR THE DIGNITY OF EACH PERSON.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	158228574	Expense
Revenue	185289934	Revenue
Description	MERCY MEDICAL CENTER IS A 375 BED, NOT-FOR-PROFIT ACUTE CARE HOSPITAL SERVING THE HEALTHCARE NEEDS OF NASSAU COUNTY AND ITS SURROUNDING AREA. FOUNDED IN 1913 BY THE NURSING SISTERS OF THE CONGREGATION OF THE INFANT JESUS, MERCY MEDICAL CENTER HAS GROWN FROM A THREE FLOOR WOODEN STRUCTURE TO AN EXTENSIVE INSTITUTION OCCUPYING A 42-ACRE CAMPUS THAT HOUSES SOME OF THE MOST ADVANCED MEDICAL TECHNOLOGIES. ACCORDING TO INTERNAL DATA, OVER 30% OF MMC'S TOTAL INPATIENT DISCHARGES IN 2010 CAME FROM HEMPSTEAD, UNIONDALE, FREEPORT, AND ROOSEVELT. THESE FOUR COMMUNITIES HAVE BEEN REFERRED TO AS "COMMUNITIES AT RISK", MANY OF THE RESIDENTS LIVING IN POVERTY AND HAVING POOR HEALTH OUTCOMES. OF THE 30,633 ED TREATED & RELEASED VISITS MMC HAD IN 2010, 14,892 OR NEARLY 49% CAME FROM THESE SAME FOUR ZIP CODES.	Description
Total Program Service Expense	157661867	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	1	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	1	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	0	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	116	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1837	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	1	QuidProQuoContributions
Quid Pro Quo Disclosure	0	QuidProQuoDisclosure
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	21	NbrVotingGoverningBodyMembers
Number Independent Voting Members	20	NumberIndependentVotingMembers
Family Or Business Relationship	0	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	CHS SERVICES INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	5167051926	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	992 NORTH VILLAGE AVENUE	AddressLine1
City	ROCKVILLE CENTRE	City
State	NY	State
ZIP Code	11570	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
PETER QUICK
CHAIRMAN	2.00	X	X	0	0	0
DANIEL J DENIHAN
VICE CHAIRMAN	2.00	X	X	0	0	0
C JUSTIN MCCARTHY
TREASURER	2.00	X	X	0	0	0
REV MSGR FRANCIS J CALDWELL
SECRETARY	2.00	X	X	0	0	0
JAMES DADDARIO
TRUSTEE	2.00	X		0	0	0
SR DOLORES WISNIEWSKI CIJ
TRUSTEE	2.00	X		0	0	0
DELORES C KERSHAW
TRUSTEE	2.00	X		0	0	0
DAVID J MILLER DDS
TRUSTEE	2.00	X		0	0	0
RABBI BARRY DOV SCHWARTZ PHD
TRUSTEE	2.00	X		0	0	0
SUSAN POWERS SCHOTT
TRUSTEE	2.00	X		0	0	0
THOMAS E CHRISTMAN
TRUSTEE	2.00	X		0	0	0
KEVIN J CONWAY
TRUSTEE	2.00	X		0	0	0
EDWARD J COOK PHD
TRUSTEE	2.00	X		0	0	0
THOMAS J FANNING
TRUSTEE	2.00	X		0	0	0
JOSEPH A GRIMALDI
TRUSTEE	2.00	X		0	0	0
EUGENE F MURPHY
TRUSTEE	2.00	X		0	0	0
CHRISTOPHER S PASCUCCI
TRUSTEE	2.00	X		0	0	0
ROBERT P QUINN
TRUSTEE	2.00	X		0	0	0
MATTHEW D SERRA
TRUSTEE	2.00	X		0	0	0
EUGENE P SOUTHER ESQ
TRUSTEE	2.00	X		0	0	0
ALAN D GUERCI MD
PRESIDENT & CEO	50.00	X	X	0	3599437	46979
WILLIAM C ARMSTRONG
VP & CHIEF FINANCIAL OFFICER	50.00		X	0	653102	245315
NANCY SIMMONS
EXECUTIVE VICE PRESIDENT	50.00		X	487128	0	121201
JOHN REILLY
CMO	50.00			381684	0	37798	X
RONALD STEIMEL
CHIEF OPERATING OFFICER	50.00			347804	0	95401		X
STEPHEN TRAPANI
VICE PRESIDENT OF FINANCE	50.00			371517	0	133572		X
SWARNA DEVARAJAN MD
DIRECTOR OF PEDIATRICS	38.00			321440	0	40456		X
RENEE MAURIELLO
CNO	50.00			289992	0	37720		X
KHALID CHAUDRY
PSYCHIATRIST	38.00			281425	0	22710		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	2480990	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	4252539	TotalReportableCompFrmRltdOrgs
Total Other Compensation	781152	TotalOtherCompensation
Number Individuals GT100 K	130	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
S&D MEDICAL LLP
52 MAIN STREET	BEFORD HILLS	NY	10507	RADIOLOGY SERVICES	3249996
LONG ISLAND EMERGENCY SERVICES PC
1000 NORTH VILLAGE AVENUE	ROCKVILLE CENTRE	NY	11570	EMERGENCY MEDICINE SERVICES	1960000
MADONNA PHYSICIANS SERVICES PC
200 OLD COUNTRY ROAD	MINEOLA	NY	11501	NEONATOLOGY SERVICES	333476
LI THORACIC SURGERY PC
444 MERRICK ROAD	LYNBROOK	NY	11563	SURGICAL SERVICES	226330
KPMG LLP
PO BOX 120001	DALLAS	TX	75312	AUDITING SERVICES	214100

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	11	NumberOfContractorsGT100K
Fundraising Events	134460	FundraisingEvents
Related Organizations	5423000	RelatedOrganizations
Government Grants	551061	GovernmentGrants
All Other Contributions	675365	AllOtherContributions
Total Contributions	6783886	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	PATIENT SERVICES	Description
Business Code	621300	BusinessCode
Total Revenue Column	185289934	TotalRevenueColumn
Related Or Exempt Function Income	185289934	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	185289934	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	255531	TotalRevenueColumn
Exclusion	$255,531	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	1773156	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	177860	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	1595296	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	1595296	TotalRevenueColumn
Exclusion	$1,595,296	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	247126	GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events	134460	CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses	186857	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	60269	TotalRevenueColumn
Exclusion	$60,269	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount
CAFETERIA/COFFEE SHOP	561000	590159	$590,159
REBATES	446110	193068	$193,068

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	663832	TotalRevenueColumn
Exclusion	$663,832	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	1447059	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	195431975	TotalRevenueColumn
Related Or Exempt Function Income	185289934	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$3,358,155	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	150520	Total
Program Services	150520	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	1344133	Total
Management And General	1344133	ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	82234751	Total
Program Services	75896155	ProgramServices
Management And General	6338596	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	4726697	Total
Program Services	4292210	ProgramServices
Management And General	434487	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	15401986	Total
Program Services	14136226	ProgramServices
Management And General	1265760	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	5932542	Total
Program Services	5387212	ProgramServices
Management And General	545330	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	646208	Total
Management And General	646208	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	93489	Total
Management And General	93489	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	183508	Total
Management And General	183508	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	6018410	Total
Program Services	6018410	ProgramServices

Advertising Advertising

Field	Value	IRS element (for citing)
Total	1013412	Total
Management And General	1013412	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	26035910	Total
Program Services	25139783	ProgramServices
Management And General	896127	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	4304695	Total
Program Services	4304695	ProgramServices

Travel Travel

Field	Value	IRS element (for citing)
Total	69283	Total
Program Services	67211	ProgramServices
Management And General	2072	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	1585948	Total
Program Services	1585948	ProgramServices

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	2860160	Total
Program Services	1458449	ProgramServices
Management And General	1401711	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	9005720	Total
Program Services	9005720	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	-3170382	Total
Program Services	-3170382	ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral	Program ServicesProgramServices
FINANCE AND TECHNOLOGY	12186024	12186024
PROVISION FOR BAD DEBT	4136000		4136000
EQUIPMENT SERVICE CONTR	2901844	5788	2896056
HOME OFFICE	1963053	1963053
EQUIPMENT RENTAL	1715366	58992	1656374

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	5838290	Total
Program Services	4701280	ProgramServices
Management And General	1137010	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	187177567	Total
Program Services	157661867	ProgramServices
Management And General	29515700	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	7014177	BOY
EOY	4887614	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	113530	BOY
EOY	218299	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	1140517	BOY
EOY	784765	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	17261029	BOY
EOY	18948749	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	2537910	BOY
EOY	2818601	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2740567	BOY
EOY	2606067	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	263703103	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	155109555	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	113303861	BOY
EOY	108593548	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	18053620	BOY
EOY	19843404	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	7212612	BOY
EOY	2095011	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	169377823	BOY
EOY	160796058	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	19323019	BOY
EOY	19092917	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	62619486	BOY
EOY	56182848	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	69908150	BOY
EOY	60105549	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	151850655	BOY
EOY	135381314	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	16054669	BOY
EOY	23259876	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1472499	BOY
EOY	2154868	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	17527168	BOY
EOY	25414744	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	169377823	BOY
EOY	160796058	EOY

Field	Value	IRS element (for citing)
Reconcilation Revenue Expenses	8254408	ReconcilationRevenueExpenses
Reconcilation Other Changes	-366832	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	0	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$64,040	OtherActivitiesAmount
Total Lobbying Expenditures IIB	64040	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF OTHER LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1I:	ReturnReference
Explanation	AMOUNT REFLECTS PORTION OF TRADE ASSOCIATION DUES WHICH WERE USED FOR LEGISLATIVE LOBBYING ON BEHALF OF THE HEALTHCARE INDUSTRY THOSE TRADE ORGANIZATIONS REPRESENT.	Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	341486	BeginningOfYearBalance
Contributions	2030	Contributions
Grants Or Scholarships	2000	GrantsOrScholarships
Other Expenditures	12045	OtherExpenditures
End Of Year Balance	329471	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	350792	BeginningOfYearBalance
Contributions	1860	Contributions
Grants Or Scholarships	2000	GrantsOrScholarships
Other Expenditures	9166	OtherExpenditures
End Of Year Balance	341486	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	360363	BeginningOfYearBalance
Contributions	7910	Contributions
Grants Or Scholarships	2000	GrantsOrScholarships
Other Expenditures	15481	OtherExpenditures
End Of Year Balance	350792	EndOfYearBalance

Field	Value	IRS element (for citing)
Board Designated EOY Balance	1.00000	BoardDesignatedEOYBalance
Endowments Held By Unrelated Orgs	0	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	0	EndowmentsHeldByRelatedOrgs

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	8529460	OtherCostOrOtherBasis
Book Value	8529460	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	160028095	OtherCostOrOtherBasis
Depreciation	75733915	Depreciation
Book Value	84294180	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	407946	OtherCostOrOtherBasis
Depreciation	291290	Depreciation
Book Value	116656	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	89404074	OtherCostOrOtherBasis
Depreciation	74994445	Depreciation
Book Value	14409629	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5333528	OtherCostOrOtherBasis
Depreciation	4089905	Depreciation
Book Value	1243623	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	108593548	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (6 entries)

DescriptionDescription	AmountAmount
ESTIMATED THIRD PARTY PAYOR LIABILITIES	$13,475,819
AMOUNTS DUE TO RELATED PARTIES	$23,330,918
ESTIMATED MALPRACTICE LIABILITY	$7,443,657
OTHER SELF INSURANCE/WC LIABILITY	$11,995,273
OTHER NON-CURRENT LIABILITES	$2,006,632
ACCRUED-MEDICAL	$1,853,250

Field	Value	IRS element (for citing)
Total Of Amounts	60105549	TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	PART V, LINE 4: MERCY MEDCIAL CENTER'S MAGOVERN FUND IS RESTRICTED FOR THE PURPOSE OF FUNDING EXPENDITURES RELATING TO THE HOSPITAL'S RADIOLOGY TRAINING PROGRAM.
		PART X - LINE 2 MERCY MEDICAL CENTER IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES PURSUANT TO SECTION 501 (A) OF THE CODE. THERE ARE NO TRANSACTIONS WHICH MANAGEMENT HAS DEEMED TO BE "UNRELATED BUSINESS INCOME" AND THEREFORE NO TAX LIABILITY HAS BEEN RECOGNIZED IN THE ACCOMPANYING FINANCIAL STATEMENTS. MANAGEMENT REVIEWS TRANSACTIONS TO ESTIMATE POTENTIAL TAX LIABILITIES USING A THRESHOLD OF MORE LIKELY THAN NOT.

Schedule G IRS990ScheduleG

Events Information EventsInformation

Field	Value	IRS element (for citing)
Name Of Event1	BALL	NameOfEvent1
Gross Receipts Event1	192350	GrossReceiptsEvent1
Charitable Contributions Event1	77400	CharitableContributionsEvent1
Gross Revenue Event1	114950	GrossRevenueEvent1
Non Cash Prizes Event1	7593	NonCashPrizesEvent1
Rent Facility Costs Event1	55989	RentFacilityCostsEvent1
Other Direct Expenses Event1	35670	OtherDirectExpensesEvent1
Name Of Event2	GOLF	NameOfEvent2
Gross Receipts Event2	120286	GrossReceiptsEvent2
Charitable Contributions Event2	27800	CharitableContributionsEvent2
Gross Revenue Event2	92486	GrossRevenueEvent2
Non Cash Prizes Event2	7302	NonCashPrizesEvent2
Rent Facility Costs Event2	42760	RentFacilityCostsEvent2
Other Direct Expenses Event2	3081	OtherDirectExpensesEvent2
Total Number Of Other Events	1	TotalNumberOfOtherEvents
Gross Receipts Other Events	68950	GrossReceiptsOtherEvents
Charitable Contrib Other Events	29260	CharitableContribOtherEvents
Gross Revenue Other Events	39690	GrossRevenueOtherEvents
Cash Prizes Other Events	3250	CashPrizesOtherEvents
Rent Facility Costs Other Events	22434	RentFacilityCostsOtherEvents
Other Direct Expenses Other Events	8778	OtherDirectExpensesOtherEvents
Gross Receipts Total	381586	GrossReceiptsTotal
Charitable Contributions Total	134460	CharitableContributionsTotal
Gross Revenue Total Events	247126	GrossRevenueTotalEvents
Cash Prizes Total Events	3250	CashPrizesTotalEvents
Non Cash Prizes Total Events	14895	NonCashPrizesTotalEvents
Rent Facility Costs Total Events	121183	RentFacilityCostsTotalEvents
Other Direct Expenses Total Events	47529	OtherDirectExpensesTotalEvents
Direct Expense Summary Events	186857	DirectExpenseSummaryEvents
Net Income Summary	60269	NetIncomeSummary

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
FPG Reference Free Care	1	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	300.000000000000	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent400	X	Pcent400
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	4883360	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3743263	DirectOffsettingRevenue
Net Community Benefit Expense	1140097	NetCommunityBenefitExpense
Percent Of Total Expense	0.00620	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	24929703	TotalCommunityBenefitExpense
Direct Offsetting Revenue	16909638	DirectOffsettingRevenue
Net Community Benefit Expense	8020065	NetCommunityBenefitExpense
Percent Of Total Expense	0.04380	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	330276	TotalCommunityBenefitExpense
Direct Offsetting Revenue	277452	DirectOffsettingRevenue
Net Community Benefit Expense	52824	NetCommunityBenefitExpense
Percent Of Total Expense	0.00030	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	30143339	TotalCommunityBenefitExpense
Direct Offsetting Revenue	20930353	DirectOffsettingRevenue
Net Community Benefit Expense	9212986	NetCommunityBenefitExpense
Percent Of Total Expense	0.05030	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	722717	TotalCommunityBenefitExpense
Direct Offsetting Revenue	4900	DirectOffsettingRevenue
Net Community Benefit Expense	717817	NetCommunityBenefitExpense
Percent Of Total Expense	0.00390	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	711315	TotalCommunityBenefitExpense
Direct Offsetting Revenue	219624	DirectOffsettingRevenue
Net Community Benefit Expense	491691	NetCommunityBenefitExpense
Percent Of Total Expense	0.00270	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	235094	TotalCommunityBenefitExpense
Direct Offsetting Revenue	207538	DirectOffsettingRevenue
Net Community Benefit Expense	27556	NetCommunityBenefitExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6812	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	6812	NetCommunityBenefitExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	23689	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	23689	NetCommunityBenefitExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1699627	TotalCommunityBenefitExpense
Direct Offsetting Revenue	432062	DirectOffsettingRevenue
Net Community Benefit Expense	1267565	NetCommunityBenefitExpense
Percent Of Total Expense	0.00690	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	31842966	TotalCommunityBenefitExpense
Direct Offsetting Revenue	21362415	DirectOffsettingRevenue
Net Community Benefit Expense	10480551	NetCommunityBenefitExpense
Percent Of Total Expense	0.05720	PercentOfTotalExpense

Community Support CommunitySupport

Field	Value	IRS element (for citing)
Total Community Building Expense	57603	TotalCommunityBuildingExpense
Direct Offsetting Revenue	28580	DirectOffsettingRevenue
Net Community Building Expense	29023	NetCommunityBuildingExpense
Percent Of Total Expense	0.00020	PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

Field	Value	IRS element (for citing)
Total Community Building Expense	9351	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	9351	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Leadership Development LeadershipDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	97	TotalCommunityBuildingExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Building Expense	97	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Coalition Building CoalitionBuilding

Field	Value	IRS element (for citing)
Total Community Building Expense	16757	TotalCommunityBuildingExpense
Net Community Building Expense	16757	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

Field	Value	IRS element (for citing)
Total Community Building Expense	8752	TotalCommunityBuildingExpense
Net Community Building Expense	8752	NetCommunityBuildingExpense
Percent Of Total Expense	0.00000	PercentOfTotalExpense

Workforce Development WorkforceDevelopment

Field	Value	IRS element (for citing)
Total Community Building Expense	10825	TotalCommunityBuildingExpense
Net Community Building Expense	10825	NetCommunityBuildingExpense
Percent Of Total Expense	0.00010	PercentOfTotalExpense

Total Total

Field	Value	IRS element (for citing)
Total Community Building Expense	103385	TotalCommunityBuildingExpense
Direct Offsetting Revenue	28580	DirectOffsettingRevenue
Net Community Building Expense	74805	NetCommunityBuildingExpense
Percent Of Total Expense	0.00050	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$1,079,496	BadDebtExpenseAmount
Amount Attributable To	0	AmountAttributableTo
Amount Reimbursed By Medicare	57307715	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	61009984	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-3702269	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	MERCY MEDICAL CENTER	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	1000 NORTH VILLAGE AVENUE	AddressLine1
City	ROCKVILLE CENTRE	City
State	NY	State
ZIP Code	11570	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	MERCY MEDICAL CENTER	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 7: RATIO OF PATIENT CARE COST TO CHARGES WORKSHEET (WORKSHEET 2) AS PRESCRIBED BY THE IRS INSTRUCTIONS TO SCHEDULE H FORM 990 WAS THE METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED IN PART 1, LINE 7 CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST LINES 7A,7B AND 7C AND 7D. ALL OTHER LINES INCLUDE COSTS THAT WERE DERIVED BASED ON THE RCC METHODOLOGY OR ACTUAL COSTS FOR THE SERVICES AS TRACKED BY HOSPITAL PERSONNEL UTILIZING DIRECT HOURLY LABOR COSTS, FRINGES AND SUPPLY COSTS.PART I, LINE 7A, COLUMN D DIRECT OFFSETTING REVENUES REPRESENT DISTRIBUTIONS FROM THE NEW YORK STATE (NYS) INDIGENT CARE POOL (ICP) WHICH IS SHOWN NET OF HOSPITAL CONTRIBUTIONS TO THE STATEWIDE POOL. THE FORMULA EMPLOYED BY NYS TO DETERMINE DISTRIBUTIONS TO HOSPITALS FROM THE ICP IS COMPLEX AND IS DERIVED FROM A HOSPITAL'S "NEED" CALCULATION. THIS CALCULATION CONSIDERS 90% OF A HOSPITAL'S "NEED" IS BASED ON BAD DEBTS AND CHARITY CARE WRITE OFFS, AND 10% IS BASED ON A "UNITS OF SERVICE" METHODOLOGY FOR UNINSURED PATIENTS. THE HOSPITAL HAS APPOINTED THE ICP REVENUE BETWEEN BAD DEBT AND CHARITY CARE FOR REPORTING ON LINE 7A BASED ON THE PROPORTION OF EACH TO THE TOTAL OF ACTUAL BAD DEBT AND CHARITY CARE FOR 2010.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 4136000.
PART II:MMC'S COMMUNITY BUILDING ACTIVITIES PROMOTE THE COMMUNITY'S HEALTH IN MANY WAYS. FOR EXAMPLE, ASSISTING PATIENTS TO ENROLL IN PUBLIC PROGRAMS EXPANDS THEIR ACCESS TO CARE. DISASTER READINESS DRILLS BEYOND MINIMUM MANDATES ENSURES AVAILABILITY OF HOSPITAL SERVICES DURING TIMES OF HIGHEST NEED. COLLECTION AND DISPOSAL OF SYRINGES FOR THE COMMUNITY ELIMINATES A HEALTH HAZARD. ADVOCACY FOR BEHAVIORAL HEALTH CLIENTS PROMOTES THE INTERESTS OF A VULNERABLE POPULATION. DEFENSIVE DRIVING CLASSES PREVENT INJURY FROM CAR ACCIDENTSPART III, LINE 4 - COSTING METHODOLOGY:BAD DEBT AT COST WAS CALCULATED BY APPLYING THE COST TO CHARGE RATIO FROM WORKSHEET 2 TO BAD DEBT EXPENSE, WHICH IS REPORTED AT CHARGES. PART III, LINE 4 -TEXT OF FOOTNOTE DISCUSSING BAD DEBT:THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED NET COLLECTIONS CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTH CARE COVERAGE AND OTHER COLLECTION INDICATORS. MANAGEMENT PERIODICALLY ASSESSES THE ADEQUACY OF THIS ALLOWANCE BASED UPON HISTORICAL WRITE OFF EXPERIENCE BY PAYOR CATEGORY. THE RESULTS OF THESE REVIEWS ARE USED TO MODIFY, AS NECESSARY, THE PROVISION FOR BAD DEBTS AND TO ESTABLISH APPROPRIATE ALLOWANCES FOR UNCOLLECTIBLE NET PATIENT ACCOUNTS RECEIVABLE. AFTER SATISFACTION OF AMOUNTS DUE FROM INSURANCE, THE MEDICAL CENTER FOLLOWS ESTABLISHED GUIDELINES FOR PLACING CERTAIN PATIENT BALANCES WITH COLLECTION AGENCIES, SUBJECT TO CERTAIN RESTRICTIONS ON COLLECTION EFFORTS AS DETERMINED BY EACH FACILITY. ACCOUNT BALANCES ARE CHARGED OFF AGAINST THE ALLOWANCE AFTER ALL MEANS OF COLLECTION HAVE BEEN EXHAUSTED AND THE POTENTIAL FOR RECOVERY IS CONSIDERED REMOTE.PART III, LINE 4 - BAD DEBT AS COMMUNITY BENEFIT:AS PART OF ITS TAX EXEMPT PURPOSE MERCY MEDICAL CENTER PROVIDES ACCESS TO MEDICALLY NECESSARY CARE FOR EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF AGE, GENDER, GEOGRAPHIC LOCATION, OR CULTURAL BACKGROUND. MERCY TREATS EMERGENCY AND NON-ELECTIVE PATIENTS REGARDLESS OF WHETHER THEY HAVE THIRD-PARTY COVERAGE OR THE ABILITY TO PAY. BY PROVIDING HEALTH CARE TO ALL WHO REQUIRE EMERGENCY OR NON ELECTIVE CARE IN A NON-DISCRIMINATORY MANNER, MERCY IS PROVIDING HEALTH CARE TO THE BROAD COMMUNITY IT SERVES. A PATIENT'S PORTION OF A BILL THAT REMAINS UNPAID FOR A CERTAIN STIPULATED TIME PERIOD IS WHOLLY OR PARTIALLY CLASSIFIED AS BAD DEBT. BAD DEBTS ASSOCIATED WITH PATIENTS WHO HAVE RECEIVED CARE FROM THE HOSPITAL SHOULD BE CONSIDERED TO BE COMMUNITY BENEFIT SINCE CHARITABLE HOSPITALS EXIST TO PROVIDE SUCH CARE IN PURSUIT OF THEIR TAX EXEMPT PURPOSE, WHICH IS MEETING THE NEED FOR EMERGENCY AND NON-ELECTIVE MEDICAL CARE SERVICES IN THE COMMUNITY. PART III, LINE 8 - COSTING METHODOLOGY:THE MEDICARE REVENUE AND ALLOWABLE COSTS SHOWN ON PART III SECTION B LINE 5 WERE DERIVED FROM THE AS FILED 2010 CMS-2552 (MEDICARE COST REPORT). MEDICARE REVENUE IS BASED ON THE MEDICARE PROVIDER STATISTICAL AND REIMBURSEMENT REPORT AND MEDICARE COSTS ARE DEVELOPED UTILIZING A RATIO OF MEDICARE ALLOWABLE COSTS TO CHARGES METHODOLOGY.PART III, LINE 8 -MEDICARE SHORTFALL AS COMMUNITY BENEFIT:LOSSES ON TREATING MEDICARE BENEFICIARIES SHOULD BE INCLUDED AS A COMMUNITY BENEFIT IN THEIR ENTIRETY.MERCY INCURRED A LOSS OF APPROXIMATELY $3.7 MILLION TO DELIVER CARE TO MEDICARE PATIENTS. THIS REPRESENTS THE AMOUNT BY WHICH COSTS TO DELIVER CARE TO MEDICARE RECIPIENTS EXCEEDS THE LEVEL OF PAYMENT. MERCY BEARS THE BURDEN OF NOT ONLY PROVIDING THE BEST AND MOST ADVANCED MEDICAL CARE POSSIBLE TO THE COMMUNITY, BUT ALSO DOING SO WITH NO RECOURSE TO OBTAIN PAYMENT FOR THE COST OF PROVIDING CARE IN EXCESS OF THE MEDICARE PAYMENT. AS MEDICARE REVENUE DECLINES AND THE COST TO PROVIDE CUTTING EDGE CARE TO THE COMMUNITY INCREASES, THE HOSPITAL WILL CARRY THE BURDEN. AS A PARTICIPATING PROVIDER AND A CHARITABLE ORGANIZATION, MEDICARE PATIENTS, THE MAJORITY OF WHOM ARE ELDERLY AND DISABLED, ARE NOT TURNED AWAY, SO MERCY WILL CONTINUE TO BEAR THE LOSS IN PROVIDING THE BEST CARE POSSIBLE TO THE LOCAL COMMUNITY.PART III, LINE 9BTHE HOSPITAL'S CHARITY CARE POLICY DESCRIBES THE POLICIES AND PROCEDURES RELATING TO THE PROVISION OF CHARITY CARE TO PERSONS WHO ARE UNABLE TO PAY FOR ALL OR A PORTION OF THEIR BILL. NO INDIVIDUAL WILL BE DENIED MEDICALLY NECESSARY HOSPITAL SERVICES BASED ON A DEMONSTRATED INABILITY TO PAY FOR THOSE SERVICES. IN ADDITION, UPON APPLYING FOR CHARITY CARE, EACH PATIENT AND PATIENT GUARANTOR'S ABILITY TO PAY WILL BE ASSESSED.ELIGIBILITY FOR ASSISTANCE: A REASONABLE REVIEW SHALL BE PERFORMED PRIORTO TURNING AN ACCOUNT OVER TO A THIRD-PARTY COLLECTION AGENT AND PRIOR TOINSTITUTING ANY LEGAL ACTION FOR NON-PAYMENT, TO ASSURE THAT THE PATIENTAND PATIENT GUARANTOR ARE NOT ELIGIBLE FOR ANY ASSISTANCE PROGRAM (I.E.MEDICAID) AND DO NOT QUALIFY FOR COVERAGE THROUGH THE CHS CHARITY CAREPOLICY. AFTER HAVING BEEN TURNED OVER TO A THIRD-PARTY COLLECTION AGENT,ANY ACCOUNT THAT SUBSEQUENTLY IS DETERMINED TO MEET THE CHARITY CARECRITERIA SHALL BE RETURNED IMMEDIATELY BY THE THIRD-PARTY COLLECTION AGENTFOR APPROPRIATE FOLLOW-UP.THE THIRD-PARTY COLLECTION AGENT SHALL ADVISE THE PATIENT/GUARANTOR OF THEHOSPITAL'S CHARITY CARE POLICY AND RETURN THE ACCOUNT IMMEDIATELY IF IT IS DETERMINED THAT THE QUALIFICATIONS ARE MET.
PART VI, LINE 2: NEEDS ASSESSMENT:MERCY MEDICAL CENTER WORKS WITH MANY OUTSIDE PARTICIPANTS IN THE COMMUNITY IN ONGOING IDENTIFICATION OF COMMUNITY HEALTH NEEDS, INCLUDING NEIGHBORING SCHOOLS, PARISHES, BUSINESSES, COMMUNITY CENTERS, AND LOCAL CHAPTERS OF ORGANIZATIONS. MERCY STRIVES TO REACH INDIVIDUALS OF ALL AGES IN PROVIDING QUALITY CARE AND HEALTH EDUCATION. THE HEALTHY SUNDAYS PROGRAM, WHICH PROVIDES FREE MEDICAL SCREENINGS ANDEDUCATION TO THE UNDERSERVED FOLLOWING WORSHIP SERVICES ON A BIMONTHLYBASIS, WAS THE RESULT OF A JOINT COMMUNITY NEEDS ASSESSMENT BY CHSHOSPITALS. IT WILL ALSO BECOME A PRIMARY SOURCE OF PUBLIC PARTICIPATION.BY DISTRIBUTING COMMUNITY NEEDS SURVEYS (AVAILABLE IN ENGLISH AND SPANISH)TO PARTICIPANTS AT SCREENING SITES, EVERY POINT OF CONTACT DOUBLES AS ANOPPORTUNITY TO REQUEST FEEDBACK ON HOW THE HOSPITAL CAN BETTER MEET THENEEDS OF THE COMMUNITY. THESE EVENTS ARE PROMOTED VIA CALENDAR LISTINGSIN PARISH BULLETINS AND FLYERS POSTED IN PLACES OF BUSINESS AND WORSHIP INTHE COMMUNITY SURROUNDING THE OUTREACH SITE.OVER THE YEAR, MERCY HAS WORKED WITH MANY ORGANIZATIONS TO DEVELOP HEALTH CARE PROGRAMS FOR RESIDENTS IN THE AREA: AMERICAN CANCER ASSOCIATION, AMERICAN HEART ASSOCIATION, CATHOLIC CHARITIES; COALITION FOR COMMUNITY WELL BEING (HEMPSTEAD); DOWNSTATE NEW YORK HEALTHY START PROGRAM; ECONOMIC OPPORTUNITY CENTER (HEMPSTEAD AND ROCKVILLE CENTRE); NASSAU COUNTY DEPARTMENT OF HEALTH IMMUNIZATION PROGRAMS; NASSAU COUNTY DEPARTMENT OF DRUG & ALCOHOL; NASSAU COUNTY DEPARTMENT OF MENTAL HEALTH; ROCKVILLE CENTRE CHAMBER OF COMMERCE, AND ROCKVILLE CENTRE YOUTH COUNCIL.IN SELECTING THE PREVENTION AGENDA PRIORITIES, MERCY MET WITH OTHER HEALTHCARE PROVIDERS TO SELECT 1-2 PRIORITIES TO WORK ON TOGETHER FOR A JOINT COUNTY WIDE EFFORT. THESE OTHER PROVIDERS INCLUDED THE NASSAU COUNTY DEPARTMENT OF HEALTH, AND MANY NASSAU COUNTY HOSPITALS (LONG BEACH MEDICAL CENTER, ST. JOSEPH HOSPITAL, NORTH SHORE LONG ISLAND JEWISH HEALTH CENTER, SOUTH NASSAU COMMUNITIES HOSPITAL, ST. FRANCIS HOSPITAL AND WINTHROP UNIVERSITY HOSPITAL). THE PRIORITIES SELECTED WERE PREVENTION OF FALLS BY HOSPITALIZED PATIENTS AND SMOKING CESSATION. MERCY THEN WORKED WITH THE CENTER FOR TOBACCO CONTROL AND THE TOBACCO ACTION COALITION OF LONG ISLAND ON THE SMOKING CESSATION INITIATIVE, AND THE TOWN OF HEMPSTEAD DEPARTMENT OF SENIOR ENRICHMENT AND THE NASSAU COUNTY DEPARTMENT OF SENIOR AFFAIRS ON THE FALLS INITIATIVE. THESE COMMUNITY PARTNERS HAVE NOT CHANGED AND CONTINUE TO MEET SEVERAL TIMES A YEAR. IN SUPPORT OF THIS SMOKING CESSATION INITIATIVE, THE MEDICAL CENTER BECAME A SMOKE FREE CAMPUS EFFECTIVE MAY 1, 2011.COMMUNITY HEALTH NEEDS ARE DISCUSSED AND ASSESSED ON A CONTINUAL BASIS AMONG THE HOSPITAL BOARD OF TRUSTEES, THE MISSION AND MINISTRY COMMITTEE AND THE PLANNING COMMITTEE OF THE BOARD, MERCY SENIOR LEADERSHIP, AND VARIOUS COMMITTEES WITHIN THE HOSPITAL SUCH AS THE COMMUNITY OUTREACH COMMITTEE WHICH HAS MULTI DISCIPLINARY REPRESENTATION OF STAFF AT THE HOSPITAL. OVER THE YEAR, MERCY CONTINUALLY SOLICITED INPUT FROM OUR AUXILIARY ORGANIZATIONS AT THE HOSPITAL - THE FRIENDS OF MERCY MEDICAL CENTER AND THE COUNCIL OF LEAGUES, REPRESENTING OVER 2000 VOICES. COMMUNITY HEALTH NEEDS ARE ALSO ASSESSED BY THE ADMINISTRATIVE STAFF AND BOARD OF TRUSTEES OF OUR PARENT CORPORATION, CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS). MERCY DISTRIBUTES A COMMUNITY NEEDS SURVEY AT ALL OF ITS OUTREACH PROGRAMS. THROUGH PATIENT SATISFACTION SURVEYS, INPATIENTS AND EMERGENCY DEPARTMENT PATIENTS HAVE THE OPPORTUNITY TO MAKE COMMENTS ABOUT THEIR ONGOING AND FUTURE HEALTH CARE NEEDS. THROUGH A JOINT COMMUNITY NEEDS ASSESSMENT BY MERCY ADMINISTRATION, THE PASTORAL CARE DEPARTMENT, CHS OUTREACH COORDINATOR AND THE PARISH COMMUNITY, MERCY IS ABLE TO IDENTIFY THOSE POPULATIONS AT GREATEST RISK AND PROVIDE APPROPRIATE SERVICES.
PART VI, LINE 3: COMMUNICATION OF FINANCIAL ASSISTANCE POLICY:ALL EMPLOYEES IN THE SCHEDULING, PATIENT ACCESS,PATIENT FINANCIAL SERVICES AND EMERGENCY DEPARTMENTS ARE FULLY VERSED IN THE CHARITY CARE POLICY, HAVE ACCESS TO THE CHARITY CARE APPLICATION FORMS, AND ARE ABLE TO DIRECT QUESTIONS TO THE APPROPRIATE HOSPITAL REPRESENTATIVES.THE HOSPITAL POSTS MULTILINGUAL NOTICES AS TO ANY POLICIES ON CHARITY CAREIN SEVERAL PROMINENT LOCATIONS WITHIN THE HOSPITAL INCLUDING, BUT NOTLIMITED TO, THE EMERGENCY DEPARTMENT, BILLING OFFICE, WAITING ROOMS FORPURPOSES OF ADMISSIONS, AND THE INPATIENT AND OUTPATIENT REGISTRATIONAREA. SAID NOTICES ARE PUBLISHED IN AT LEAST ENGLISH AND SPANISH, AND ARECLEARLY VISIBLE TO THE PUBLIC FROM THE LOCATION AT WHICH THEY ARE POSTED.THE HOSPITAL PROVIDES PATIENTS, IN A TIMELY MANNER, A SUMMARY OF ITSCHARITY CARE POLICY UPON REQUEST. THE SUMMARY, AT A MINIMUM PROVIDESSPECIFIC INFORMATION AS TO INCOME LEVELS USED TO DETERMINE ELIGIBILITY ANDTHE MEANS OF APPLYING FOR ASSISTANCE. THIS SUMMARY IS WRITTEN AT OR BELOWA SIXTH GRADE READING LEVEL.THE HOSPITAL POSTS ITS CHARITY CARE POLICY SUMMARY ON ITS INTERNETWEBSITE.THE HOSPITAL PROVIDES ALL PATIENTS INTERPRETERS TO ASSIST THEM INUNDERSTANDING ITS CHARITY CARE PROGRAM IN THE LANGUAGE SPOKEN BY THEPATIENT DURING ANY PRE-ADMISSION, ADMISSION, AND DISCHARGE PROCESS.ON ALL BILLS AND STATEMENTS SENT TO PATIENTS, A STATEMENT IS INCLUDEDREGARDING THE AVAILABILITY OF VARIOUS FINANCIAL ASSISTANCE PROGRAMS,INCLUDING CHARITY CARE, AND A CONTACT NUMBER TO CALL TO OBTAIN FURTHERINFORMATION. THIS INFORMATION IS AVAILABLE AT OR BELOW A SIXTH GRADEREADING LEVEL.
PART VI, LINE 4: COMMUNITY INFORMATION:MMC'S PRIMARY SERVICE AREA CONTINUES TO INCLUDE HEMPSTEAD, ROCKVILLE CENTRE, WEST HEMPSTEAD, LYNBROOK, FREEPORT, BELLMORE/NORTH BELLMORE, MERRICK/NORTH MERRICK, VALLEY STREAM, ELMONT, UNIONDALE, ROOSEVELT, BALDWIN AND EAST MEADOW, A TOTAL POPULATION OF APPROXIMATELY 345,000. ACCORDING TO INTERNAL DATA, OVER 30% OF MMC'S TOTAL INPATIENT DISCHARGES IN 2010 CAME FROM HEMPSTEAD, UNIONDALE, FREEPORT, AND ROOSEVELT. THE NASSAU COUNTY DEPARTMENT OF HEALTH HAS REFERRED TO THESE TOWNS AS "COMMUNITIES AT RISK", WITH MANY RESIDENTS LIVING IN POVERTY AND HAVING POOR HEALTH OUTCOMES. OF THE 30,633 EMERGENCY TREATED & RELEASED VISITS IN 2010, 14,892 OR NEARLY 49% CAME FROM THESE SAME FOUR TOWNS.
PART VI, LINE 6: PROMOTION OF COMMUNITY HEALTH:MERCY, IN CONJUNCTION WITH OTHER CATHOLIC HEALTH SERVICES OF LONG ISLAND HOSPITALS, PARTICIPATES IN THE HEALTHY SUNDAYS PROGRAM, A COMMUNITY OUTREACH PROGRAM HELD IN PARISHES DESIGNED TO PROMOTE EDUCATION ON MANY IMPORTANT HEALTH SUBJECTS SUCH AS CANCER AWARENESS, DIABETES, BLOOD PRESSURE, HEALTHY EATING, SMOKING CESSATION AND CHOLESTEROL.MANAGING WEIGHT AND ASSOCIATED HEALTH ISSUES HAS BECOME A FACT OF LIFE AND CHALLENGE FOR MANY AMERICANS. AS A BARIATRIC CENTER OF EXCELLENCE, MERCY MEDICAL CENTER DEVELOPED THREE WEIGHT MANAGEMENT PROGRAMS THAT BEGAN IN 2009. MERCY PROVIDES A FACILITATED SUPPORT GROUP FOR POST BARIATRIC SURGERY PATIENTS, AS WELL AS CONDUCTING TWO FACILITATED WEIGHT MANAGEMENT GROUPS, ONE FOR ADULTS AND THE OTHER FOR ADOLESCENTS.
PART VI, LINE 7: AFFILIATED HEALTHCARE SYSTEM:MERCY MEDICAL CENTER IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL WHICH IS LOCATED ON A SINGLE CAMPUS IN ROCKVILLE CENTRE, NEW YORK. ALONG WITH THE AFOREMENTIONED COMMUNITY PROGRAMS MERCY, THROUGH ITS DAILY OPERATION, PROVIDES TO THE AREA ACUTE, PSYCHIATRIC, REHABILITATIVE, EMERGENT AND OUTPATIENT CARE. MERCY IS A MEMBER OF CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS) WHICH IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE.AS OF DECEMBER 31, 2010 CHS WAS COMPRISED OF SIX HOSPITALS (MERCY MEDICAL CENTER AND ST. FRANCIS HOSPITAL IN NASSAU COUNTY; GOOD SAMARITAN HOSPITAL MEDICAL CENTER, ST. CHARLES HOSPITAL AND ST. CATHERINE OF SIENA MEDICAL CENTER IN SUFFOLK COUNTY; AND AS PASSIVE PARENT TO ST. JOSEPH HOSPITAL IN NASSAU COUNTY); THREE NURSING HOMES (ST. CATHERINE OF SIENA NURSING HOME; GOOD SAMARITAN NURSING HOME AND OUR LADY OF CONSOLATION RESIDENCE, ALL IN SUFFOLK COUNTY); A REGIONAL HOME CARE AND HOSPICE NETWORK AND A COMMUNITY BASED AGENCY FOR PERSONS WITH SPECIAL NEEDS. WITH MORE THAN 17,000 STAFF AND 3,800 MEDICAL STAFF WORKING THROUGHOUT THE SYSTEM, CHS PROVIDES THE REGION'S FINEST HEALTH AND HUMAN SERVICES.MEMBER ORGANIZATIONS OF CHS OFFER VIRTUALLY EVERY MEDICAL SPECIALTY AND CLINICAL SERVICE, AND SHARE A DEDICATION TO CONTINUOUSLY UPGRADE THE SCOPE, QUALITY AND ACCESSIBILITY OF CARE. EACH OF CHS' MEMBER ORGANIZATIONS HAVE RETAINED THEIR INDIVIDUAL LINKS TO HISTORY, A DISTINCTIVE PERSONALITY, AS WELL AS THE SERVICE SPECIALTIES WHICH THEY ARE KNOWN FOR, THUS EMBEDDING THE ORGANIZATION IN THE COMMUNITY AND SERVING IT EFFECTIVELY.THE CHS SYSTEM PROVIDES AN ABUNDANCE OF EDUCATION AND SUPPORT GROUPS, FREE HEALTH SCREENINGS THROUGH THE HEALTHY SUNDAYS PROGRAM, HEALTH FAIRS AND OTHER PROGRAMS WHICH HELP THE COMMUNITIES SERVED BY CHS ACCESS CARE. SINCE 1907 CATHOLIC HEALTH CARE ON LONG ISLAND HAS BUILT A DISTINGUISHED TRADITION OF OPERATING COMMUNITY-BASED HOSPITALS AND HUMAN SERVICE ORGANIZATIONS, WITH THE PRIMARY OBJECTIVE OF SERVING THE COMMUNITY.TO FURTHER THE MISSION OF BRINGING CARE TO THE COMMUNITY, CHS AND ITS MEMBER HOSPITALS, TOGETHER WITH A NUMBER OF OTHER HEALTHCARE PROVIDERS ON LONG ISLAND ENTERED INTO A PARTNERSHIP AGREEMENT WHICH OPERATES AS THE LONG ISLAND HEALTH NETWORK (LIHN). LIHN WAS CREATED TO ESTABLISH A COMPREHENSIVE AND EFFICIENT HOSPITAL NETWORK IN NASSAU AND SUFFOLK COUNTIES WORKING TO, AMONG OTHER THINGS, IMPROVE QUALITY OF CARE, FACILITATE CLINICAL INTEGRATION, BENCHMARK BEST PRACTICES, AND REDUCE LENGTH OF STAY AND COSTS.
NY	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	0	RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	DIOCESE OF ROCKVILLE CENTRE - CATHOLIC MINISTRIES APPEAL	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	50 NORTH PARK AVE	AddressLine1
City	ROCKVILLE CENTRE	City
State	NY	State
ZIP Code	11571	ZIPCode

Field	Value	IRS element (for citing)
EIN Of Recipient	111837437	EINOfRecipient
Amount Of Cash Grant	150520	AmountOfCashGrant
Purpose Of Grant	TO FURTHER THE MISSION OF THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE.	PurposeOfGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	OTHER INFORMATION:	Identifier
Return Reference	PART IV:	ReturnReference
Explanation	PART I, LINE 2: THE DIOCESE OF ROCKVILLE CENTRE PROVIDES ANNUAL UPDATES TO ALL CONTRIBUTORS TO THE CATHOLIC MINISTRIES APPEAL, WHETHER PARISHIONERS OR CORPORATE CONTRIBUTORS LIKE CHSLI.	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
ALAN D GUERCI MD
0	748115	0	334000	0	2517322	0	17175	0	29804	0	3646416	0	1529431
WILLIAM C ARMSTRONG
0	481076	0	160000	0	12026	0	220926	0	24389	0	898417	0	0
NANCY SIMMONS
382125	0	90000	0	15003	0	104123	0	17078	0	608329	0	0	0
JOHN REILLY
342311	0	35000	0	4373	0	14896	0	22902	0	419482	0	0	0
RONALD STEIMEL
300863	0	35000	0	11941	0	72636	0	22765	0	443205	0	0	0
STEPHEN TRAPANI
298437	0	60000	0	13080	0	109085	0	24487	0	505089	0	0	0
SWARNA DEVARAJAN MD
320637	0	0	0	803	0	14896	0	25560	0	361896	0	0	0
RENEE MAURIELLO
247376	0	30000	0	12616	0	14896	0	22824	0	327712	0	0	0
KHALID CHAUDRY
281266	0	0	0	159	0	14896	0	7814	0	304135	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
SUPPLEMENTAL INFORMATION	PART III	NANCY SIMMONS, RONALD STEIMEL, AND STEPHEN TRAPANI PARTICIPATE IN A SUPPLEMENTAL EMPLOYEE RETIREMENT PLAN. THE AMOUNTS INCLUDED ARE AS FOLLOWS: NANCY SIMMONS = $89,227 RONALD SITEIMEL = $57,740 STEPHEN TRAPANI = $94,189
SUPPLEMENTAL INFORMATION	PART III	SCHEDULE J PART II B(III), OTHER REPORTABLE COMPENSATION INCLUDES SERP DISTRIBUTION OF $2,493,740 FOR ALAN GUERCI, M.D., OF WHICH $726,349 IS CURRENT YEAR AMOUNT.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (13 entries)

IdentifierIdentifier	ExplanationExplanation	Return ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 6	THE SOLE MEMBER OF MERCY MEDICAL CENTER IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS). CHS IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER (DIOCESE).
FORM 990, PART VI, SECTION A, LINE 7A	CHS IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF MERCY MEDICAL CENTER AND AS SUCH, HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF MERCY MEDICAL CENTER.
FORM 990, PART VI, SECTION A, LINE 7B	CHS AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF MERCY MEDICAL CENTER IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY MERCY'S GOVERNING BODY.
FORM 990, PART VI, SECTION B, LINE 11	THE FORM 990 AND APPROPRIATE SCHEDULES, AS REQUIRED (FORM 990), IS COMPLETED BY THE ACCOUNTING AND FINANCE STAFF OF THE ORGANIZATION AND REVIEWED INTERNALLY BY MANAGEMENT. IT IS THEN REVIEWED BY OUTSIDE TAX ADVISORS AND ANY NECESSARY ADJUSTMENTS ARE MADE, AFTER WHICH TIME IT IS CONSIDERED AN INITIAL DRAFT. THE INITIAL DRAFT IS THEN PRESENTED TO EXECUTIVE MANAGEMENT OF THE ORGANIZATION BY TAX ADVISORS AND STAFF TO PROVIDE DETAIL AND GIVE LEADERSHIP AN OPPORTUNITY TO GIVE FEEDBACK RELATIVE TO THE INFORMATION INCLUDED IN THE FORM 990. ANY NECESSARY CHANGES ARE MADE AND A COMPLETE FORM 990 IS SENT TO EXECUTIVES FOR FINAL REVIEW. ATTESTATIONS ARE THEN PROVIDED BY EXECUTIVES INDICATING THEIR REVIEW AND SATISFACTION WITH THE CONTENT OF THE FORM 990. THE DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF TRUSTEES (THE BOARD), WHICH HAS BEEN DELEGATED THE DETAILED REVIEW FUNCTION BY THE BOARD. ONCE THE COMMITTEE'S REVIEW IS COMPLETE, THE COMMITTEE RECOMMENDS THE APPROVAL OF THE FORM 990 TO THE BOARD (OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE). THE FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD. UPON APPROVAL BY THE BOARD (OR THE EXECUTIVE COMMITTEE OF THE BOARD, AS APPROPRIATE), THE ORGANIZATION'S BOARD CHAIR AND CHIEF EXECUTIVE OFFICER COMMUNICATES, IN WRITING TO THE CHS COMPLIANCE AND AUDIT COMMITTEE AND CHS BOARD CHAIR, SUCH APPROVAL, RECOMMENDS APPROVAL TO THE CHS BOARD, AND CERTIFIES THAT THE CHS BOARD APPROVED FORM 990 REVIEW PROCESS HAS BEEN FOLLOWED. THE CHS COMPLIANCE AND AUDIT COMMITTEE REVIEWS THE ORGANIZATION'S CORRESPONDENCE REGARDING THE FORM 990 RECOMMENDED APPROVAL AND REVIEW PROCESS. THE CHS COMPLIANCE AND AUDIT COMMITTEE IS PROVIDED WITH THE ORGANIZATION'S FORM 990 AND REVIEWS THE FORM TO THE EXTENT IT DEEMS APPROPRIATE IN THE LIGHT OF THE ORGANIZATIONAL CERTIFICATIONS AND OTHER FACTORS AS DETERMINED BY THE COMMITTEE. UPON THE CHS COMPLIANCE AND AUDIT COMMITTEE'S REVIEW OF THE ORGANIZATION'S RECOMMENDED APPROVAL AND SATISFACTION OF THE FORM 990 REVIEW PROCESS, IT SHALL RECOMMEND THE APPROVAL OF THE FORM 990 TO THE CHS BOARD OF DIRECTORS (OR THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, AS APPROPRIATE). THE CHS BOARD OF DIRECTORS (OR THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, AS APPROPRIATE) REVIEWS THE CHS COMPLIANCE AND AUDIT COMMITTEE'S RECOMMENDATION AND PROVIDES THE FINAL APPROVAL OF THE FORM 990. THE FORM 990 IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE.
	DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE BY THE ORGANIZATION'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFFERED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. IF A CONFLICT OF INTEREST IS IDENTIFIED AND IF A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORTH WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CHS SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT.	FORM 990, PART VI, SECTION B, LINE 12C
	THE EXECUTIVE COMPENSATION POLICY (THE "POLICY") APPLIES TO THOSE WHO ARE DEFINED AS "DISQUALIFIED PERSONS." THE POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CHS OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER, AND CHIEF OPERATING OFFICERS OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS; D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITES OF CHS OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CHS OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMNE A SUBSTANTIAL PORTION OF CHS OR AN OPERATING ENTITY'S CAPITAL EXPENDITURES, OPERATING BUDGET, OR COMPENSATION FOR OTHER EMPLOYEES; F) THE PERSON MANAGES A DEPARTMENT OR ACTIVITY OF CHS OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CHS OR AN OPERATING ENTITY, COMPARED TO THE ORGANIZATION AS A WHOLE; OR G) FAMILY MEMBERS OF ANY OF THOSE DESCRIBED IN THE PRECEDING D, E, OR F. THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APROVAL TO THE CORPORATE CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE POLICY. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW, AND THE COMMITTEE MAKES RECOMMENDATION TO THE BOARD OF TRUSTEES WITH RESPECT TO THE PROPOSED EXECUTIVE COMPENSATION. THE BOARD HAS RETAINED AN INDEPENDENT COMPENSATION CONSULTANT TO APPLY ITS STANDARD METHODOLOGY FOR DETERMINATION OF APPROPRIATE EXECUTIVE COMPENSATION AND BENEFIT LEVELS FOR "DISQUALIFIED PERSONS." IT IS POLICY TO TARGET THE TOTAL COMPENSATION (BASE SALARY, INCENTIVE COMPENTSATION AND BENEFITS) OF "DISQUALIFIED PERSONS" AT THE MEDIAN OF THE DEFINED MARKETPLACE FOR SIMILARLY SITUATED EXECUTIVES IN CONSULTATION WITH AN INDEPENDENT COMPENSATION CONSULTANT IN A MANNER THAT COMPLIES WITH THE INTERMEDIATE SANCTION REGULATIONS AND OTHER FEDERAL AND STATE LAWS AND REGULATIONS. THE BOARD REVIEWS BASE SALARIES FOR "DISQUALIFIED PERSONS" BASED UPON THE MEDIAN AMOUNTS (50TH PERCENTILE) PAID TO SIMILARLY SITUATED EXECUTIVES WITHIN THE RELEVANT MARKETPLACE, WITH POSSIBLE ADJUSTMENTS MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. INCENTIVE COMPENSATION IS BASED ON A PERCENTAGE OF THE BASE SALARY AND AWARDED ONLY IF A "DISQUALIFIED PERSON" MEETS OBJECTIVE PERFORMANCE CRITERIA. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASURABLE AND RELATED TO INDICATORS OF PERFORMANCE, WHICH SHALL INCLUDE BOTH THE PERFORMANCE OF THE OPERATING ENTITY THAT EMPLOYS THE "DISQUALIFIED PERSON" AND THE PERFORMANCE OF THE CHS SYSTEM AS A WHOLE. USING SUCH CRITERIA, THE CHS CEO SHALL RECOMMEND TO THE CHS EXECUTIVE COMPENSATION COMMITTEE INCENTIVE COMPENSATION FOR SYSTEM-LEVEL EXECUTIVES WHO ARE "DISQUALIFIED PERSONS," AND THE CEO OF EACH OPERATING ENTITY SHALL RECOMMEND TO THE OPERATING ENTITY EXECUTIVE COMPENSATION COMMITTEE INCENTIVE COMPENSATION FOR OPERATING ENTITY EXECUTIVES WHO ARE "DISQUALIFIED PERSONS," IF APPROVED BY THE CHS CEO. EXECUTIVES PARTICIPATE IN THE DIOCESAN PENSION PLAN AND OTHER BENEFIT PLANS AS APPROVED BY THE CHS CORPORATE BOARD OR CHS OPERATING ENTITY BOARD, AS THE CASE MAY BE.	FORM 990, PART VI, SECTION B, LINE 15
	FORM 990, PART VI, SECTION C, LINE 19: GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILIED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND.	FORM 990, PART VI, SECTION C, LINE 19
	REFLECTED IN PART VII, SECTION A, LINE 1A ARE THE ESTIMATED WEEKLY HOURS (2.0). TRUSTEES CONTRIBUTE TO THIS AND ALL OTHER RELATED ORGANIZATIONS, NOT NECESSARILY EQUALLY BUT IN THE PROPORTION NECESSARY, FOR WHICH THEY RECEIVE NO COMPENSATION.	PART VII, SECTION A, LINE 1A:
	ALAN GUERCI, M.D. PRESIDENT AND CEO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. FRANCIS HOSPITAL (11-2050523); ST. FRANCIS HOSPITAL FOUNDATION (11-2916033); ST. FRANCIS RESEARCH AND EDUCATIONAL CORPORATION INC. (11-3090867); MERCY MEDICAL CENTER (11-1635088). WILLIAM ARMSTRONG, SENIOR VICE PRESIDENT AND CFO - THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: ST. FRANCIS HOSPITAL (11-2050523); ST. FRANCIS HOSPITAL FOUNDATION (11-2916033); ST. FRANCIS RESEARCH AND EDUCATIONAL CORPORATION INC. (11-3090867); MERCY MEDICAL CENTER (11-1635088)	PART VII, SECTION A, LINE 1A:
ELECTION TO ALLOCATE BUSINESS ASSET EXPENSE	THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS, AS DEFINED IN SECTION 179(D)(7), HEREBY CONSENT TO THE APPORTIONMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2010 ELECTION TO ALLOCATE $40,000 ALTERNATIVE MINIMUM TAX EXEMPTION THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS(WITHIN THE MEANING OF SECTION 1563(A)), HEREBY CONSENT UNDER REGULATION 1.58-1(C)(3) TO THE APPORTIONMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2010. ELECTION TO ALLOCATE $150,000 ALTERNATIVE MINIMUM TAX PHASE-OUT THE UNDERSIGNED CORPORATIONS, COMPONENT MEMBERS OF A CONTROLLED GROUP OF CORPORATIONS (WITHIN THE MEANING OF SECTION 1563(A)), HEREBY CONSENT UNDER REGULATION 1.58-1(C(3) TO THE APPOINTMENT PLAN LISTED BELOW WITH RESPECT TO THE TAXABLE YEAR OF EACH CORPORATION WHICH INCLUDES DECEMBER 31, 2010. EMPLOYER ID NO. $128,00 $40,000 $150,000 11-3403968 NONE NONE NONE 14-1801961 NONE NONE NONE 11-3594561 NONE NONE NONE 11-3555766 NONE NONE NONE 11-1888924 NONE NONE NONE 77-0611240 NONE NONE NONE 11-2537396 NONE NONE NONE 11-2958438 NONE NONE NONE 11-3434776 NONE NONE NONE 11-2861698 NONE NONE NONE 11-2861690 NONE NONE NONE 11-3638367 NONE NONE NONE 11-1635088 NONE NONE NONE 11-2126736 NONE NONE NONE 11-3284066 NONE NONE NONE 20-8067039 NONE NONE NONE 11-2499790 NONE NONE NONE 06-1569129 NONE NONE NONE 06-1562701 NONE NONE NONE 11-1871039 NONE NONE NONE 41-2076312 NONE NONE NONE 11-3613997 NONE NONE NONE 11-2050523 NONE NONE NONE 11-2916033 NONE NONE NONE 11-3090867 NONE NONE NONE 11-2110488 NONE NONE NONE 11-2983148 NONE NONE NONE 11-2716640 NONE NONE NONE 11-3559713 NONE NONE NONE 11-1635088 NONE NONE NONE 55-0813603 NONE NONE NONE 27-1459941 NONE NONE NONE IN PROCESS NONE NONE NONE 26-3169427 NONE NONE NONE 45-0517566 NONE NONE NONE 27-1531084 NONE NONE NONE 11-2798383 NONE NONE NONE 11-2801136 NONE NONE NONE 11-2838185 $128,000 $40,000 $150,000 11-3319259 NONE NONE NONE 06-1568934 NONE NONE NONE 11-3307977 NONE NONE NONE 11-2126736 NONE NONE NONE	CONTROLLED GROUP ELECTION STATEMENT
CONTROLLED GROUP ELECTION - CONTINUED	EMPLOYER NAME, ADDRESS & TAX YEAR-END ID NO. 11-3403968 CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 14-1801961 CHS AMBULANCE SERVICES 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-3594561 CHS HOME SUPPORT SERVICES, INC. 15 POWER DRIVE HAUPPAUGUE, NY 11788 TAX YEAR END: 12/31/10 11-3555761 CHS SERVICES, INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-1888924 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 77-0611240 GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2537396 GOOD SAMARITAN HOSPITAL SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2958438 GOOD SHEPHERD HOSPICE 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 11-3434776 MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAX YEAR END: 12/31/10 11-2861698 MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-2861690 MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-3638367 THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAXABLE YEAR: 12/31/10 11-1635088 MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2126736 CATHOLIC HOME CARE 1150 PORTION BLVD. SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 11-3284066 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 20-8067039 RVC INSURANCE COMPANY, INC. 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2499790 RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 06-1569129 SIENA VILLAGE 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 06-1562701 ST. CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 11-1871039 ST. CHARLES HOSPITAL AND REHABILITATION CENTER 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 41-2076312 ST. CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-3613997 ST. FRANCIS CARDIOVASCULAR PHYSICIANS PC 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2050523 ST. FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2916033 ST. FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-3090867 ST. FRANCIS RESEARCH & EDUCATIONAL CORPORATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2110488 SUFFOLK HEARING & SPEECH 369 EAST MAIN STREET EAST ISLIP, NY 11730 TAX YEAR END: 12/31/10 11-2983148 THE ST. CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-2716640 THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 11-3559713 WISDOM GARDENS HOUSING DEVELOPMENT CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-1635088 ST. FRANCIS-MERCY CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 55-0813603 MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 27-1459941 ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 IN PROCESS CATHOLIC HOME CARE FOUNDATION 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 26-3169427 CATHOLIC HOME CARE FOUNDATION 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 45-0517566 OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 27-1531084 OUR LADY OF CONSOLATION FOUNDATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2798383 FAIRVIEW HILL MANAGEMENT CORP 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2801136 HEALTHCARE TEMP SERVICES 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2838185 SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-3319259 SAMARITAN HOME CARE AMERICA, INC. 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 06-1568934 SIENA MEDICAL REALTY 50 ROUTE 25A SMITHTOWN, NY 11787 TAXABLE YEAR: 12/31/10 11-3307977 SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-2126736 NURSING SISTERS HOME CARE, INC 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAXABLE YEAR: 12/31/10
STATEMENT OF TAX BRACKET ALLOCATION	THE AMOUNTS IN EACH TAXABLE INCOME BRACKET IN THE TAX TABLE IN SECTION 11(B) HAVE BEEN ALLOCATED TO THE CORPORATIONS LISTED BELOW PURSUANT TO REGULATION 1.1561-3(A). THE ORIGINAL COPY OF THIS STATEMENT IS FILED WITH THE INTERNAL REVENUE SERVICE CENTER IN OGDEN, UTAH. AUTHORIZATION CONSENT FOR ALLOCATION ON BEHALF OF MEMBER COMPANIES ____________________________________________ EMPLOYER ID NO. $50,000 $25,000 $9,925,000 BRACKET BRACKET BRACKET 11-3403968 NONE NONE NONE 14-1801961 NONE NONE NONE 11-3594561 NONE NONE NONE 11-3555766 NONE NONE NONE 11-1888924 NONE NONE NONE 77-0611240 NONE NONE NONE 11-2537396 NONE NONE NONE 11-2958438 NONE NONE NONE 11-3434776 NONE NONE NONE 11-2861698 NONE NONE NONE 11-2861690 NONE NONE NONE 11-3638367 NONE NONE NONE 11-1635088 NONE NONE NONE 11-2126736 NONE NONE NONE 11-3284066 NONE NONE NONE 20-8067039 NONE NONE NONE 11-2499790 NONE NONE NONE 06-1569129 NONE NONE NONE 06-1562701 NONE NONE NONE 11-1871039 NONE NONE NONE 41-2076312 NONE NONE NONE 11-3613997 NONE NONE NONE 11-2050523 NONE NONE NONE 11-2916033 NONE NONE NONE 11-3090867 NONE NONE NONE 11-2110488 NONE NONE NONE 11-2983148 NONE NONE NONE 11-2716640 NONE NONE NONE 11-3559713 NONE NONE NONE 11-1635088 NONE NONE NONE 55-0813603 NONE NONE NONE 27-1459941 NONE NONE NONE IN PROCESS NONE NONE NONE 26-3169427 NONE NONE NONE 45-0517566 NONE NONE NONE 27-1531084 NONE NONE NONE 11-2798383 NONE NONE NONE 11-2801136 NONE NONE NONE 11-2838185 $50,000 $25,000 $9,925,000 11-3319259 NONE NONE NONE 06-1568934 NONE NONE NONE 11-3307977 NONE NONE NONE 11-2126736 NONE NONE NONE
STATEMENT OF TAX BRACKET ALLOCATION - CONTINUED	EMPLOYER NAME, ADDRESS & TAX YEAR-END ID NO. 11-3403968 CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 14-1801961 CHS AMBULANCE SERVICES 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-3594561 CHS HOME SUPPORT SERVICES, INC. 15 POWER DRIVE HAUPPAUGUE, NY 11788 TAX YEAR END: 12/31/10 11-3555761 CHS SERVICES, INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-1888924 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 77-0611240 GOOD SAMARITAN HOSPITAL FOUNDATION 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2537396 GOOD SAMARITAN HOSPITAL SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 11-2958438 GOOD SHEPHERD HOSPICE 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 11-3434776 MARYHAVEN TRANSPORTATION SERVICES 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAX YEAR END: 12/31/10 11-2861698 MARYHAVEN CENTER OF HOPE 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-2861690 MARYHAVEN SCHOOL CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-3638367 THE CENTER OF HOPE FOUNDATION 51 TERRYVILLE ROAD PORT JEFFERSON, NY 11776 TAXABLE YEAR: 12/31/10 11-1635088 MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2126736 CATHOLIC HOME CARE 1150 PORTION BLVD. SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 11-3284066 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 20-8067039 RVC INSURANCE COMPANY, INC. 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2499790 RIVERHEAD HOSTEL HOLDING CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 06-1569129 SIENA VILLAGE 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 06-1562701 ST. CATHERINE OF SIENA MEDICAL CENTER 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 11-1871039 ST. CHARLES HOSPITAL AND REHABILITATION CENTER 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 41-2076312 ST. CHARLES HOSPITAL FOUNDATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-3613997 ST. FRANCIS CARDIOVASCULAR PHYSICIANS PC 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2050523 ST. FRANCIS HOSPITAL 100 PORT WASHINGTON BLVD. ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2916033 ST. FRANCIS HOSPITAL FOUNDATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-3090867 ST. FRANCIS RESEARCH & EDUCATIONAL CORPORATION 100 PORT WASHINGTON BOULEVARD ROSLYN, NY 11576 TAX YEAR END: 12/31/10 11-2110488 SUFFOLK HEARING & SPEECH 369 EAST MAIN STREET EAST ISLIP, NY 11730 TAX YEAR END: 12/31/10 11-2983148 THE ST. CHARLES CORPORATION 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAX YEAR END: 12/31/10 11-2716640 THE SAMARITAN CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 11-3559713 WISDOM GARDENS HOUSING DEVELOPMENT CORPORATION 51 TERRYVILLE ROAD PORT JEFFERSON STATION, NY 11776 TAX YEAR END: 12/31/10 11-1635088 ST. FRANCIS-MERCY CORPORATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 55-0813603 MERCY MEDICAL CENTER FOUNDATION 1000 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11795 TAX YEAR END: 12/31/10 27-1459941 ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION 50 ROUTE 25A SMITHTOWN, NY 11787 TAX YEAR END: 12/31/10 IN PROCESS CATHOLIC HOME CARE FOUNDATION 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAX YEAR END: 12/31/10 26-3169427 CATHOLIC HOME CARE FOUNDATION 245 OLD COUNTRY ROAD MELVILLE, NY 11747 TAX YEAR END: 12/31/10 45-0517566 OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP, NY 11795 TAX YEAR END: 12/31/10 27-1531084 OUR LADY OF CONSOLATION FOUNDATION 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE, NY 11570 TAX YEAR END: 12/31/10 11-2798383 FAIRVIEW HILL MANAGEMENT CORP 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2801136 HEALTHCARE TEMP SERVICES 200 BELLE TERRE ROAD PORT JEFFERSON, NY 11777 TAXABLE YEAR: 12/31/10 11-2838185 SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-3319259 SAMARITAN HOME CARE AMERICA, INC. 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 06-1568934 SIENA MEDICAL REALTY 50 ROUTE 25A SMITHTOWN, NY 11787 TAXABLE YEAR: 12/31/10 11-3307977 SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP, NY 11795 TAXABLE YEAR: 12/31/10 11-2126736 NURSING SISTERS HOME CARE, INC 1150 PORTION ROAD, SUITE 1 HOLTSVILLE, NY 11742 TAXABLE YEAR: 12/31/10

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (36 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
CATHOLIC HEALTH SYSTEM OF LONG ISLAND
992 NORTH VILLAGE AVENUE	ROCKVILLE CENTRE	NY	11570	113403968	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I	N/A	0
CHS SERVICES INC
992 NORTH VILLAGE AVENUE	ROCKVILLE CENTRE	NY	11570	113555766	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
CHS AMBULANCE SERVICES INC
992 NORTH VILLAGE AVENUE	ROCKVILLE CENTRE	NY	11570	141801961	DORMANT	NY	501(C)(3)	LINE 3		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
GOOD SAMARITAN HOSPITAL MEDICAL CENTER
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	111888924	HOSPITAL	NY	501(C)(3)	LINE 3		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	112537396	SELF INSURANCE	NY	501(C)(3)	LINE 11A, I		0	GOOD SAMARITAN HOSPITAL
MARYHAVEN TRANSPORTATION SERVICES
51 TERRYVILLE ROAD	PORT JEFFERSON STATION	NY	11776	113434776	TRANSPORTATION SERVICES	NY	501(C)(3)	LINE 9		0	MARYHAVEN CENTER OF HOPE
MARYHAVEN CENTER OF HOPE
51 TERRYVILLE ROAD	PORT JEFFERSON STATION	NY	11776	112861698	PROGRAMS/HOUSING FOR THE DEVELOPMENTALLY DISABLED	NY	501(C)(3)	LINE 3		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
MARYHAVEN SCHOOL CORPORATION
51 TERRYVILLE ROAD	PORT JEFFERSON STATION	NY	11776	112861690	SCHOOL FOR DEVELOPMENTALLY DISABLED	NY	501(C)(3)	LINE 9		0	MARYHAVEN CENTER OF HOPE
THE CENTER OF HOPE FOUNDATION
51 TERRYVILLE ROAD	PORT JEFFERSON STATION	NY	11776	113638367	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	MARYHAVEN CENTER OF HOPE
CATHOLIC HOME CARE
1150 PORTION ROAD SUITE 1	HOLTSVILLE	NY	11742	112126736	HOME CARE	NY	501(C)(3)	LINE 9		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
OUR LADY OF CONSOLATION GERIATRIC CARE CENTER
111 BEACH DRIVE	WEST ISLIP	NY	11795	113284066	LT NURSING CARE	NY	501(C)(3)	LINE 3		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
RIVERHEAD HOSTEL HOLDING CORPORATION
51 TERRYVILLE ROAD	PORT JEFFERSON STATION	NY	11776	112499790	RENTING	NY	501(C)(3)	LINE 9		0	MARYHAVEN CENTER OF HOPE
SIENA VILLAGE INC
50 ROUTE 25A	SMITHTOWN	NY	11787	061569129	SENIOR HOUSING	NY	501(C)(3)	LINE 9		0	ST CATHERINE OF SIENA MEDICAL CENTER
ST CATHERINE OF SIENA MEDICAL CENTER
50 ROUTE 25A	SMITHTOWN	NY	11787	061562701	HOSPITAL	NY	501(C)(3)	LINE 3		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
ST CHARLES HOSPITAL
200 BELLE TERRE ROAD	PORT JEFFERSON STATION	NY	11777	111871039	HOSPITAL	NY	501(C)(3)	LINE 3		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
CHS HOME SUPPORT SERVICES INC
15 POWER DRIVE	HAUPPAUGE	NY	11788	113594561	RESPIRATORY THERAPY SVC/MED. EQUIP.	NY	501(C)(3)	LINE 9		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
ST FRANCIS HOSPITAL
100 PORT WASHINGTON BLVD	ROSLYN	NY	11576	112050523	HOSPITAL	NY	501(C)(3)	LINE 3		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
ST FRANCIS HOSPITAL FOUNDATION
100 PORT WASHINGTON BLVD	ROSLYN	NY	11576	112916033	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	ST FRANCIS HOSPITAL
ST FRANCIS HOSPITAL RESEARCH & EDUCATIONAL CORP
100 PORT WASHINGTON BLVD	ROSLYN	NY	11576	113090867	RESEARCH ORGANIZATION	NY	501(C)(3)	LINE 9		0	ST FRANCIS HOSPITAL
WSNCHS NORTH INC
4295 HEMPSTEAD TURNPIKE	BETHPAGE	NY	11714	113438973	HOSPITAL	NY	501(C)(3)	LINE 3		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
SUFFOLK HEARING & SPEECH CENTER INC
369 EAST MAIN STREET	EAST ISLIP	NY	11730	112110488	DIAGNOSTIC TESTING	NY	501(C)(3)	LINE 3		0	GOOD SAMARITAN HOSPITAL
THE ST CHARLES CORPORATION
200 BELLE TERRE ROAD	PORT JEFFERSON	NY	11777	112983148	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
THE SAMARITAN CORPORATION
992 NORTH VILLAGE AVENUE	ROCKVILLE CENTRE	NY	11570	112716640	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
WISDOM GARDENS HOUSING DEVELOPMENT FUND INC
51 TERRYVILLE ROAD	PORT JEFFERSON STATION	NY	11776	113559713	SENIOR HOUSING	NY	501(C)(3)	LINE 9		0	MARYHAVEN CENTER OF HOPE
GOOD SHEPHERD HOSPICE
245 OLD COUNTRY ROAD	MELVILLE	NY	11747	112958438	HOSPICE SERVICES	NY	501(C)(3)	LINE 9		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
ST CHARLES HOSPITAL FOUNDATION
200 BELLE TERRE ROAD	PORT JEFFERSON	NY	11777	412076312	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	ST CHARLES HOSPITAL
GOOD SAMARITAN HOSPITAL FOUNDATION
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	770611240	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	GOOD SAMARITAN HOSPITAL
ST FRANCIS-MERCY CORPORATION
992 NORTH VILLAGE AVENUE	ROCKVILLE CENTRE	NY	11570	111635088	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
MERCY MEDICAL CENTER FOUNDATION
1000 NORTH VILLAGE AVENUE	ROCKVILLE CENTRE	NY	11570	550813603	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	MERCY MEDICAL CENTER
ST CATHERINE OF SIENA MEDICAL CENTER FOUNDATION
50 ROUTE 25A	SMITHTOWN	NY	11787	271459941	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	ST CATHERINE OF SIENA MEDICAL CENTER
CATHOLIC HOME CARE FOUNDATION
1150 PORTION ROAD SUITE 1	HOLTSVILLE	NY	11742		SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	CATHOLIC HOME CARE
GOOD SHEPHERD HOSPICE FOUNDATION
245 OLD COUNTRY ROAD	MELVILLE	NY	11747	263169427	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	GOOD SHEPHERD HOSPICE
OUR LADY OF CONSOLATION FOUNDATION
111 BEACH DRIVE	WEST ISLIP	NY	11795	450517566	SUPPORT ORG	NY	501(C)(3)	LINE 11A, I		0	OUR LADY OF CONSOLATION
RVC SUPPORT
992 NORTH VILLAGE AVENUE	ROCKVILLE CENTRE	NY	11570	271531084	REAL ESTATE	NY	501(C)(3)	LINE 11A, I		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND
ST FRANCIS CARDIOVASCULAR PHYSICIANS PC
100 PORT WASHINGTON BLVD	ROSLYN	NY	11576	113613997	HEALTHCARE SERVICES	NY	501(C)(3)	LINE 3		0	ST FRANCIS HOSPITAL
RVC INSURANCE COMPANYINC
992 NORTH VILLAGE AVENUE	ROCKVILLE CENTRE	NY	11570	208067039	CAPTIVE INSURANCE COMPANY	NY	501(C)(3)	LINE 11A, I		0	CATHOLIC HEALTH SYSTEM OF LONG ISLAND

Form990 Schedule R Part IV Form990ScheduleRPartIV (12 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Type Of EntityTypeOfEntity
RADIOLOGY CONSULTING OF LONG ISLAND PLLC
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	421646134	HEALTHCARE SERVICES	NY	GOOD SAMARITAN HOSPITAL	C
SAMARITAN EMERGENCY MEDICAL SERVICES PC
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	208243412	DIAGNOSTIC TESTING	NY	GOOD SAMARITAN HOSPITAL	C
SAMARITAN PEDIATRIC SERVICES PC
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	208180263	HEALTHCARE SERVICES	NY	GOOD SAMARITAN HOSPITAL	C
SAMARITAN MEDICAL SERVICES PC
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	208088453	DIAGNOSTIC TESTING	NY	GOOD SAMARITAN HOSPITAL	C
SOUTHWEST SUFFOLK MEDICAL PC
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	061603195	HEALTHCARE SERVICES	NY	GOOD SAMARITAN HOSPITAL	C
CARDIAC EKG INTERPRETATION PC
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	112924518	HEALTHCARE SERVICES	NY	GOOD SAMARITAN HOSPITAL	C
LI REGIONAL ARTHRITIS & OSTEOPOROSIS CARE PC
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	208964140	HEALTHCARE SERVICES	NY	GOOD SAMARITAN HOSPITAL	C
SAMARITAN MANAGEMENT SERVICES INC
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	112838185	HEALTHCARE SERVICES	NY	CATHOLIC HEALTH SYSTEM OF LONG ISLAND	C
FAIRVIEW HILL MANAGEMENT CO INC
200 BELLE TERRE ROAD	PORT JEFFERSON	NY	11777	112798383	SERVICES	NY	ST CHARLES CORPORATION	C
ADVANCED REHABILIATION MEDICINE PLLC
200 BELLE TERRE ROAD	PORT JEFFERSON	NY	11777	113640709	HEALTHCARE SERVICES	NY	ST CHARLES HOSPITAL	C
ST FRANCIS CARDIAC PREVENTION SERVICES PC
100 PORT WASHINGTON BLVD	ROSLYN	NY	11576	113224885	HEALTHCARE SERVICES	NY	ST FRANCIS HOSPITAL	C
SOUTH SHORE PRACTICE MANAGEMENT
1000 MONTAUK HIGHWAY	WEST ISLIP	NY	11795	113307977	HEALTHCARE SERVICES	NY	GOOD SAMARITAN HOSPITAL	C

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	0	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	0	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	1	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	0	OtherTransferToOtherOrg
Other Transfer From Other Org	0	OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
CATHOLIC HEALTH SERVICES OF LONG ISLAND
L	1315940	COST
CHS SERVICES INC
P	-1271311	COST
MARYHAVEN CENTER OF HOPE
P	-538850	COST
ST FRANCIS HOSPITAL
C	-5169916	COST
RVC INSURANCE CO
L	460105	COST

Form990 Schedule R Part VII Form990ScheduleRPartVII

Field	Value	IRS element (for citing)
Return Reference	PART V, TRANSACTIONS WITH RELATED PARTIES	ReturnReference
Explanation	MERCY MEDICAL CENTER HAS DISCLOSED IN SCHEDULE R THE PREDOMINANT TRANSACTION TYPE WITH EACH FACILITY WITH WHICH IT HAS CONDUCTED TRANSACTIONS. HOWEVER, THERE ARE ADDITIONAL TRANSACTION TYPES TO DESCRIBE THE ACTIVITIES CHS HAS ENGAGED IN WITH ITS RELATED PARTY ORGANIZATIONS. THE FOLLOWING IS A LIST OF ADDITIONAL TRANSACTION TYPES BY FACILITY. NAME OF ADDITIONAL ORGANIZATION EIN TRANSACTION TYPES CATHOLOIC HEALTH SYSTEM OF LI 11-3403968 P CHS SERVICES, INC. 11-3555766 L,J,N,O ST. FRANCIS HOSPITAL 11-2050523 N,O,P MARYHAVEN CENTER OF HOPE 11-2861698 N,O RVC INSURANCE COMPANY 20-8067039 O	Explanation