CHS SERVICES INC: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- CHS SERVICES INC (EIN 11-3555766)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-15
- IRS object ID
- 201143199349302894
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-15T10:19:33-06:00 | 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 | 113555766 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHS SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHSS | NameControl |
| Phone | 5167051931 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 992 NORTH VILLAGE AVENUE | AddressLine1 |
| City | ROCKVILLE CENTRE | City |
| State | NY | State |
| ZIP Code | 11570 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RICHARD JJ SULLIVAN JR | Name |
| Title | EXECUTIVE CHAIRMAN | Title |
| Phone | 5167051931 | 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 | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RICHARD JJ SULLIVAN JR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| 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) |
|---|---|---|
| Gross Receipts | 69908736 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2000 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | CHS SERVICES, INC., A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION. PROMOTES EXCELLENCE IN CARE,AND COMMITS ITSELF TO THOSE IN NEED. CHS AFFIRMS THE SANCTITY OF LIFE, 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 | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 718 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 325000 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -104703 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 62990737 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 69906839 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 59163 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1897 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 76999 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 63126899 | TotalRevenuePriorYear |
| Total Revenue Current Year | 69908736 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 45324837 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 50857443 | 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 | 20539461 | OtherExpensePriorYear |
| Other Expenses Current Year | 22526500 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 65864298 | TotalExpensesPriorYear |
| Total Expenses Current Year | 73383943 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -2737399 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3475207 | RevenuesLessExpensesCY |
| Total Assets BOY | 59182172 | TotalAssetsBOY |
| Total Assets EOY | 81507121 | TotalAssetsEOY |
| Total Liabilities BOY | 27881782 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 38479793 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 31300390 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 43027328 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | CHS SERVICES,INC., A MEMBER OF CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHS), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, COMMITTED TO THOSE IN NEED, 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 73383943 | Expense |
| Revenue | 69581839 | Revenue |
| Description | CHS SERVICES INC. PROVIDES ADMINISTRATIVE SUPPORT TO THE CHS ENTITIES INCLUDING, BUT NOT LIMITED TO ACCOUNTING, SUPPLY CHAIN AND INFORMATION TECHNOLOGY. CHS SERVICES PROMOTES EFFICIENT MANAGEMENT, COOPERATIVE PLANNING AND EFFICIENT USE OF RESOURCES BY ALL SUPPORTED ORGANIZATIONS. | Description |
| Total Program Service Expense | 73383943 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | 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 | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | 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 | 47 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 718 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 | 0 | QuidProQuoContributions |
| 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 | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | 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 | 5167051931 | 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 (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| RICHARD JJ SULLIVAN JR | ||||||||
| CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | ||
| SISTER ELAINE CALLAHAN | ||||||||
| TRUSTEE | 2.00 | X | X | 0 | 0 | 0 | ||
| THOMAS CHRISTMAN | ||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | ||
| EUGENE MURPHY | ||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | ||
| JAMES HARDEN | ||||||||
| PRESIDENT AND CEO | 50.00 | X | X | 0 | 1167467 | 48164 | ||
| LIONEL BARRAU MD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| REV MSGR ROBERT BRENNAN | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| THOMAS DOWLING MD | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| REV JAMES VLAUN | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| SR AUDREY HARSEN | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| SISTER MARGARET JOHN KELLY | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| RICHARD MEYER | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| PATRICIA NAZEMETZ | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| JOSEPH TANTILLO | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| RICHARD SARLI | ||||||||
| VP-FINANCE | 50.00 | X | 427716 | 0 | 152595 | |||
| CATHY O'BRIEN | ||||||||
| VP-SUPPLY CHAIN | 50.00 | 359269 | 0 | 99310 | X | |||
| MARCY DUNN | ||||||||
| VP AND CIO | 50.00 | 455697 | 0 | 173333 | X | |||
| DEBORAH WALSH | ||||||||
| VP- PATIENT FIN SVCS | 50.00 | 308887 | 0 | 72778 | X | |||
| PEGEEN MCGOWAN | ||||||||
| VP CORP COMPLIANCE INTERNAL AUDIT | 50.00 | 311036 | 0 | 111819 | X | |||
| EDWARD GRUNWALD | ||||||||
| DIRECTOR TECHNOLOGY SVC | 50.00 | 280214 | 0 | 43177 | X | |||
| ESTATE OF TERENCE G DALY | ||||||||
| FORMER SR VP FINANCE & CFO | 0.00 | 0 | 680964 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2142819 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1848431 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 701176 | TotalOtherCompensation |
| Number Individuals GT100 K | 86 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| MILLER AND MILONE PC | |||||
| 100 QUENTIN ROOSEVELT BLVD | GARDEN CITY | NY | 11530 | CREDIT AND COLLECTION SERVICES | 1227031 |
| NCO FINANCIAL SYSTEMS | |||||
| PO BOX 945541 | ATLANTA | GA | 30394 | CREDIT AND COLLECTION SERVICES | 886323 |
| DELOITTE & TOUCHE | |||||
| 4152 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | CONSULTING SERVICES | 785271 |
| PROFESSIONAL CLAIMS BUREAU | |||||
| 274 DUFFY AVENUE | HICKSVILLE | NY | 11801 | COLLECTION SERVICES | 387947 |
| RUBIN AND ROTHMAN | |||||
| 1787 VETS MEM HWY | ISLANDIA | NY | 11722 | COLLECTION SERVICES | 376371 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 10 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| ASSESSMENT REVENUE | 900099 | 68600520 | 68275520 | 325000 |
| MANAGEMENT SERVICES | 900099 | 1306319 | 1306319 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 69906839 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1897 | TotalRevenueColumn |
| Exclusion | $1,897 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 69908736 | TotalRevenueColumn |
| Related Or Exempt Function Income | 69581839 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 325000 | UnrelatedBusinessRevenue |
| Exclusion | $1,897 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 427716 | Total |
| Program Services | 427716 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38038727 | Total |
| Program Services | 38038727 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2968091 | Total |
| Program Services | 2968091 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6717562 | Total |
| Program Services | 6717562 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2705347 | Total |
| Program Services | 2705347 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23027 | Total |
| Program Services | 23027 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49871 | Total |
| Program Services | 49871 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 186450 | Total |
| Program Services | 186450 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7415819 | Total |
| Program Services | 7415819 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4924590 | Total |
| Program Services | 4924590 | ProgramServices |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 66774 | Total |
| Program Services | 66774 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 100803 | Total |
| Program Services | 100803 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4032407 | Total |
| Program Services | 4032407 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24487 | Total |
| Program Services | 24487 | ProgramServices |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| COLLECTION SERVICES | 3072366 | 3072366 |
| MISCELLANEOUS | 2629906 | 2629906 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73383943 | Total |
| Program Services | 73383943 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5223789 | BOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 318268 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 85229 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1224191 | BOY |
| EOY | 2282533 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 108484410 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 72115105 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15278408 | BOY |
| EOY | 36369305 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37455784 | BOY |
| EOY | 42451786 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59182172 | BOY |
| EOY | 81507121 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15299810 | BOY |
| EOY | 14316392 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 12674232 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12581972 | BOY |
| EOY | 11489169 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27881782 | BOY |
| EOY | 38479793 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31300390 | BOY |
| EOY | 43027328 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31300390 | BOY |
| EOY | 43027328 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 59182172 | BOY |
| EOY | 81507121 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -3475207 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 15202145 | 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) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (57 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| GOOD SAMARITAN HOSPITAL MEDICAL CENTER | |||||
| 111888924 | 3 | 0 | 1 | 1 | $0 |
| MERCY MEDICAL CENTER | |||||
| 111635088 | 3 | 0 | 1 | 1 | $0 |
| ST CHARLES HOSPITAL AND REHABILITATION CENTER | |||||
| 111871039 | 3 | 0 | 1 | 1 | $0 |
| ST FRANCIS HOSPITAL | |||||
| 112050523 | 3 | 0 | 1 | 1 | $0 |
| CHS AMBULANCE SERVICES INC | |||||
| 141081961 | 9 | 0 | 1 | 1 | $0 |
| ST CATHERINE OF SIENA HOSPITAL | |||||
| 061562701 | 3 | 0 | 1 | 1 | $0 |
| OUR LADY OF CONSOLATION NURSING HOME | |||||
| 113284066 | 3 | 0 | 1 | 1 | $0 |
| MARYHAVEN CENTER OF HOPE | |||||
| 112861698 | 9 | 0 | 1 | 1 | $0 |
| MARYHAVEN TRANSPORTATION SERVICES | |||||
| 113434776 | 9 | 0 | 1 | 1 | $0 |
| RIVERHEAD HOSTEL HOLDINGS CORP | |||||
| 112499790 | 9 | 0 | 1 | 1 | $0 |
| MARYHAVEN SCHOOL CORPORATION | |||||
| 112861690 | 9 | 0 | 1 | 1 | $0 |
| RIVERHEAD HOSTEL HOLDINGS CORP | |||||
| 112499790 | 9 | 0 | 1 | 1 | $0 |
| SIENA MEDICAL REALTY LLC | |||||
| 061568934 | 9 | 0 | 1 | 1 | $0 |
| SIENA RETIREMENT REALTY LLC | |||||
| 061569102 | 9 | 0 | 1 | 1 | $0 |
| SIENA VILLAGE | |||||
| 061569129 | 9 | 0 | 1 | 1 | $0 |
| ST FRANCIS HOSPITAL RESEARCH CORP | |||||
| 113090867 | 9 | 0 | 1 | 1 | $0 |
| SUFFOLK HEARING & SPEECH | |||||
| 112110488 | 9 | 0 | 1 | 1 | $0 |
| ST CHARLES HOSPITAL CORPORATION | |||||
| 112983148 | 7 | 0 | 1 | 1 | $0 |
| THE SAMARITAN CORP | |||||
| 112716640 | 9 | 0 | 1 | 1 | $0 |
| WISDOM GARDENS HOUSING CORP | |||||
| 113559713 | 9 | 0 | 1 | 1 | $0 |
| GOOD SHEPHERD HOSPICE | |||||
| 112958438 | 9 | 0 | 1 | 1 | $0 |
| GOOD SAMARITAN NURSING HOME | |||||
| 111888924 | 3 | 0 | 1 | 1 | $0 |
| ST CATHERINE OF SIENA NURSING HOME | |||||
| 061562701 | 3 | 0 | 1 | 1 | $0 |
| THE CENTER OF HOPE FOUNDATION | |||||
| 113638367 | 9 | 0 | 1 | 1 | $0 |
| GOOD SAMARITAN HOSPITAL FOUNDATION | |||||
| 770611240 | 9 | 0 | 1 | 1 | $0 |
| ST CHARLES HOSPITAL FOUNDATION | |||||
| 412076312 | 9 | 0 | 1 | 1 | $0 |
| ST FRANCIS HOSP FOUNDATION | |||||
| 112916033 | 9 | 0 | 1 | 1 | $0 |
| CATHOLIC HOME CARE | |||||
| 112126736 | 9 | 0 | 1 | 1 | $0 |
| CHS HOME SUPPORT SERVICES | |||||
| 113594561 | 9 | 0 | 1 | 1 | $0 |
| CATHOLIC HEALTH SYSTEM OF LI | |||||
| 113403968 | 9 | 0 | 1 | 1 | $0 |
| SAMARITAN MANAGEMENT SERVICES INC | |||||
| 112838185 | 9 | 0 | 1 | 1 | $0 |
| SOUTH SHORE PRACTICE MANAGEMENT SERVICES | |||||
| 113307977 | 9 | 0 | 1 | 1 | $0 |
| GOOD SAMARITAN SELF INSURANCE | |||||
| 112537396 | 9 | 0 | 1 | 1 | $0 |
| RVC INSURANCE | |||||
| 208067039 | 3 | 0 | 1 | 1 | $0 |
| ADVANCED REHABILITATION MEDICINE PLLC | |||||
| 113640709 | 3 | 0 | 1 | 1 | $0 |
| CARDIAC EKG INTRPRETATION PC | |||||
| 112924518 | 3 | 0 | 1 | 1 | $0 |
| LONG ISLAND REGIONAL ARTHRITIS AND OSTEOPOROSIS CARE | |||||
| 208964140 | 3 | 0 | 1 | 1 | $0 |
| RADIOLOGY CONSULTANTS | |||||
| 421646134 | 9 | 0 | 1 | 1 | $0 |
| SAMARITAN MEDICAL EMERGENCY SERVICES | |||||
| 208243412 | 9 | 0 | 1 | 1 | $0 |
| SAMARITAN MEDICAL SERVICES | |||||
| 208088453 | 9 | 0 | 1 | 1 | $0 |
| SAMARITAN PEDIATRIC SERVICES | |||||
| 208180263 | 3 | 0 | 1 | 1 | $0 |
| SOUTHWEST SUFFOLK MEDICAL | |||||
| 061603195 | 3 | 0 | 1 | 1 | $0 |
| ST FRANCIS CARDIAC PREVENTION | |||||
| 113224885 | 3 | 0 | 1 | 1 | $0 |
| ST FRANCIS CARDIOVASCULAR | |||||
| 113613997 | 3 | 0 | 1 | 1 | $0 |
| FAIRVIEW MANAGEMENT | |||||
| 112798383 | 9 | 0 | 1 | 1 | $0 |
| GOOD SHEPHERD HOSPICE FOUNDATION | |||||
| 263169427 | 3 | 0 | 1 | 1 | $0 |
| HEALTHCARE TEMP SERVICES | |||||
| 112801136 | 9 | 0 | 1 | 1 | $0 |
| MERCY MEDICAL CENTER FOUNDATION | |||||
| 550813603 | 9 | 0 | 1 | 1 | $0 |
| RVC SUPPORT | |||||
| 271531084 | 9 | 0 | 1 | 1 | $0 |
| SAMARITAN AT HOME SERVICES | |||||
| 112829946 | 9 | 0 | 1 | 1 | $0 |
| SAMARITAN HOME CARE AMERICA | |||||
| 113319259 | 9 | 0 | 1 | 1 | $0 |
| ST CATHERINE OF SIENA | |||||
| 271459941 | 3 | 0 | 1 | 1 | $0 |
| WSNCHSNORTHLLC | |||||
| 113438973 | 3 | 0 | 1 | 1 | $0 |
| ST FRANCIS MERCY CORP | |||||
| 111635088 | 9 | 0 | 1 | 1 | $0 |
| OUR LADY OF CONSOLATION | |||||
| 450517566 | 9 | 0 | 1 | 1 | $0 |
| ST CHARLES HOSPITAL FOUNDATION | |||||
| 412076312 | 9 | 0 | 1 | 1 | $0 |
| MERCY INTERNAL MEDICINE | |||||
| 510639649 | 9 | 0 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 57 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 7025415 | InvestmentCostOrOtherBasis |
| Depreciation | 1493572 | Depreciation |
| Book Value | 5531843 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 101458995 | InvestmentCostOrOtherBasis |
| Depreciation | 70621533 | Depreciation |
| Book Value | 30837462 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 36369305 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM RELATED ORGANIZATIONS | 42232711 |
| DUE FROM AFFILIATES (NET) | 219075 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 42451786 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO RELATED ORGANIZATIONS | $8,340,971 |
| ACCRUED EMPLOYEE BENEFITS | $641,434 |
| DEFERRED RENT | $1,595,325 |
| SELF INSURED LIABILIIES | $911,439 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 11489169 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | CHS SERVICES, INC. IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501 (C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED. CHS SERVICES, INC. ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE INCOME TAX TOPIC OF THE CODIFICATION. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED CATHOLIC HEALTH SYSTEMS OF LONG ISLAND FINANCIAL STATEMENTS. | 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 | 1 | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES HARDEN | |||||||||||||
| 0 | 1146762 | 0 | 20705 | 0 | 0 | 0 | 17847 | 0 | 30317 | 0 | 1215631 | 0 | 0 |
| RICHARD SARLI | |||||||||||||
| 333948 | 0 | 83000 | 0 | 10768 | 0 | 142843 | 0 | 9752 | 0 | 580311 | 0 | 0 | 0 |
| CATHY O'BRIEN | |||||||||||||
| 247671 | 0 | 100000 | 0 | 11598 | 0 | 81732 | 0 | 17578 | 0 | 458579 | 0 | 0 | 0 |
| MARCY DUNN | |||||||||||||
| 342770 | 0 | 100000 | 0 | 12927 | 0 | 149509 | 0 | 23824 | 0 | 629030 | 0 | 0 | 0 |
| DEBORAH WALSH | |||||||||||||
| 246496 | 0 | 50000 | 0 | 12391 | 0 | 63437 | 0 | 9341 | 0 | 381665 | 0 | 0 | 0 |
| PEGEEN MCGOWAN | |||||||||||||
| 236575 | 0 | 64000 | 0 | 10461 | 0 | 85927 | 0 | 25892 | 0 | 422855 | 0 | 0 | 0 |
| EDWARD GRUNWALD | |||||||||||||
| 239674 | 0 | 40000 | 0 | 540 | 0 | 18474 | 0 | 24703 | 0 | 323391 | 0 | 0 | 0 |
| ESTATE OF TERENCE G DALY | |||||||||||||
| 0 | 680964 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 680964 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINES 4A-B | ReturnReference |
| Explanation | SCHEDULE J PART I, LINE 4A CHANGE OF CONTROL, ESTATE OF TERENCE G. DALY $680,964 PART I, LINE 4B SERP ADJUSTMENTS WERE MADE AS FOLLOWS: MARCY DUNN $131,011 CATHY O'BRIEN $ 63,234 RICHARD SARLI $124,345 DEBORAH WALSH $ 44,939 PEGEEN MCGOWAN $ 67,582 | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF CHS SERVICES, INC. IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND, (D/B/A CATHOLIC HEALTH SERVICES OF LONG ISLAND) (CHS). CHS IS A NEW YORK NOT-FOR-PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF PROVIDERS SERVING NASSAU AND SUFFOLK COUNTIES. CHS IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE.(DIOCESE) | |
| FORM 990, PART VI, SECTION A, LINE 7A | CHS IS THE SOLE MEMBER OF CHS SERVICES, INC. AND AS SUCH, HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF CHS SERVICES, INC. | |
| FORM 990, PART VI, SECTION A, LINE 7B | CHS, AS THE SOLE MEMBER OF CHS SERVICES, INC., IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE CHS SERVICES' 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 FINAL DRAFT OF THE FORM 990 IS THEN PRESENTED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF TRUSTEES (THE BOARD), WHICH HAS BEEN DELEGATED THE DETAILED REVIEW FUNCTION BY THE BOARD. ONCE THE COMMITTEE'S REVIEW IS COMPLETE, THE COMMITTEE RECOMMENDS APPROVAL OF THE FORM 990 TO THE BOARD (OF 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 APPROPORIATE 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. | |
| CONFLICT OF INTEREST POLICY DISCLOSURE IN ACCORDANCE WITH THE CONFLICT OF INTEREST POLICY (THE POLICY) BY BOARD AND BOARD COMMITTEE MEMBERS, EMPLOYEES AND OTHERS THAT SATISFY THE CRITERIA TO BE CONSIDERED AN INTERESTED PERSON IS SUBMITTED UPON HIRE OR APPOINTMENT AND ANNUALLY THEREAFTER. SUCH INDIVIDUALS HAVE A CONTINUING OBLIGATION TO UPDATE THE INFORMATION PROVIDED DURING THE COURSE OF THE YEAR. A SUMMARY OF DISCLOSURES IS PROVIDED TO THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE BY THE ORGANIZATION'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURES SHALL BE GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE ORGANIZATION'S COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE BOARD OF TRUSTEES FOR REVIEW. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF THE BOARD OR BOARD COMMITTEE DETERMINES THAT NO CONFLICT EXISTS, THE MATTER SHALL BE REFERRED FOR REVIEW BY THE CHS COMPLIANCE AND AUDIT COMMITTEE BEFORE THE DETERMINATION BECOMES FINAL. IF A CONFLICT OF INTEREST IS IDENTIFIED AND IF A MAJORITY OF THE BOARD OR BOARD COMMITTEE AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS AND WISHES TO GO FORTH WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF CHS COMPLIANCE AND AUDIT COMMITTEE, DELINEATING THE TRANSACTION AND CONFLICT AND PROVIDING REASONS WHY THE BOARD AGREES THAT THE TRANSACTION OR ARRANGEMENT IS IN THE BEST INTEREST OF CHS, CERTIFIES THAT CHS CANNOT SECURE SIMILAR SERVICES FROM AN ORGANZIATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT,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 | |
| EXECUTIVE COMPENSATION POLICY 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 OFFICER AND/OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURER AND/OR CHIEF FINANCIAL OFFICER; 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 COMPENSATION 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 | |
| GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CHS CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND.COM | FORM 990, PART VI, SECTION C, LINE 19 | |
| TRUSTEE HOURS | 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. JAMES HARDEN PRESIDENT AND CEO-THE TOTAL HOURS WORKED REPORTED (50.0) REFLECTS TIME WORKED AS OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY, INC. (20-8067039) AND CATHOLIC HEALTH SYSTEM OF LONG ISLAND (11-3403968) | PART VII, SECTION A, LINE 1A |
| CHANGES IN NET ASSETS OR FUND BALANCES: | EQUITY TRANSFER 15,202,145. TOTAL TO FORM 990, PART XI, LINE 5: 15,202,145. | FORM 990, PART XI, LINE 5: |
| 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 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 | |
| MERCY MEDICAL CENTER | |||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 111635088 | HOSPITAL | NY | 501(C)(3) | LINE 3 | 0 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | |
| 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 (13 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 |
| MERCY INTERNAL MEDICINE PC | ||||||||
| 992 N VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11710 | 510639649 | HEALTHCARE SERVICES | NY | MERCY MEDICAL CENTER | 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 | 0 | 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 | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | 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 (11 entries)
| Method Of Amt DeterminationMethodOfAmtDetermination | Transaction TypeTransactionType | Amount InvolvedAmountInvolved |
|---|---|---|
| (no name) | ||
| COST | ||
| GOOD SAMARITAN HOSPITAL MEDICAL CENTER 11-1888924 | ||
| COST | P | 215401 |
| MERCY MEDICAL CENTER 11-1635088 | ||
| COST | K | 1271311 |
| ST FRANCIS HOSPITAL 11-2050523 | ||
| COST | K | 2602713 |
| ST JOSEPH HOSPITAL 11-3438973 | ||
| COST | K | 2707335 |
| OUR LADY OF CONSOLATION GERIATRIC CARE 11-3284066 | ||
| COST | K | 647617 |
| (no name) | ||
| COST | ||
| GOOD SHEPHERD HOSPICE 11-2958438 | ||
| COST | K | 144038 |
| CATHOLIC HOME CARE 11-2126736 | ||
| COST | K | 640587 |
| CHS HOME SUPPORT SERVICE INC 11-3594561 | ||
| COST | K | 152527 |
| ST CHARLES HOSPITAL AND REHABILITATION 11-1871059 | ||
| COST | P | -131246 |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | TRANSACTIONS WITH RELATED ORGANIZATIONS | Identifier |
| Return Reference | SCHEDULE R PART V LINE 2 | ReturnReference |
| Explanation | CHS SERVICES, INC., 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 SERVICES, INC. HAS ENGAGED IN WITH ITS RELATED PARTY ORGANIZATIONS. THE FOLLOWING IS A LIST OF ADDITIONAL TRANSACTION TYPES BY FACILITY. CATHOLIC HEALTH SERVICES OF LONG ISLAND P,I GOOD SAMARITAN HOSPITAL MEDICAL CENTER C,K,L MERCY MEDICAL CENTER C,P,I,L ST. FRANCIS HOSPITAL C,P,I,L ST. CATHERINE OF SIENA MEDICAL CENTER C,P,L ST. JOSEPH HOSPITAL P MARYHAVEN CENTER OF HOPE C,I,L OUR LADY OF CONSOLATION GERIATRIC CARE C,L RVC INSURANCE COMPANY, INC. K SIENA VILLAGE K SIENA MEDICAL REALTY K GOOD SHEPHERD HOSPICE C,L CATHOLIC HOME CARE C,I,L CHS HOME SUPPORT C,L ST. CHARLES HOSPITAL AND REHABILITATION C,K,L | Explanation |