NURSING SISTERS HOME CARE: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- NURSING SISTERS HOME CARE (EIN 11-3403968)
- Tax period
- 2010-01-01 to 2010-12-31
- Filed
- 2011-11-15
- IRS object ID
- 201143199349303294
- 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 | 2011-11-15T10:21:13-06:00 | 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 | 113403968 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CATH | NameControl |
| Phone | 5167053700 | 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 | 5167053700 | 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
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CATHOLIC HEALTH SERVICES OF LI | BusinessNameLine1 |
| 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 | 16375437 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | HTTP://WWW.CHSLI.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1997 | YearFormation |
| State Legal Domicile | NY | StateLegalDomicile |
| Activity Or Mission Description | CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHSLI), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED. CHSLI AFFIRMS THE SANCTITY OF LIFE, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. CHSLI 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 | 9 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 950000 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 14128048 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 15207527 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 231095 | InvestmentIncomePriorYear |
| Investment Income Current Year | 217910 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 14359143 | TotalRevenuePriorYear |
| Total Revenue Current Year | 16375437 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 950000 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7346543 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8295008 | 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 | 6145547 | OtherExpensePriorYear |
| Other Expenses Current Year | 6973181 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 13492090 | TotalExpensesPriorYear |
| Total Expenses Current Year | 16218189 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 867053 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 157248 | RevenuesLessExpensesCY |
| Total Assets BOY | 58888363 | TotalAssetsBOY |
| Total Assets EOY | 59488382 | TotalAssetsEOY |
| Total Liabilities BOY | 61561100 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 60928370 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -2672737 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -1439988 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHSLI), AS A MINISTRY OF THE CATHOLIC CHURCH, CONTINUES CHRIST'S HEALING MISSION, PROMOTES EXCELLENCE IN CARE, AND COMMITS ITSELF TO THOSE IN NEED. CHSLI AFFIRMS THE SANCTITY OF LIFE, ADVOCATES FOR THE POOR AND UNDERSERVED, AND SERVES THE COMMON GOOD. CHSLI 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 | 13011006 | Expense |
| Description | CATHOLIC HEALTH SERVICES OF LONG ISLAND PROMOTES THE EFFICIENT GOVERNANCE AND MANAGEMENT OF THE SUPPORTED ORGANIZATIONS. IN ADDITION, CHSLI'S COOPERATIVE PLANNING AND EFFICIENT USE OF RESOURCES ASSISTS THE SUPPORTED ORGANIZATION TO ACHIEVE THEIR RESPECTIVE AND COLLABORATIVE GOALS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1191959 | Expense |
| Description | SUPPORTING AND STRENGTHENING THE MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE AND OTHER MINISTRIES SPONSORED BY THE ROMAN CATHOLIC CHURCH. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 14202965 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| 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 | 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 | 44 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 9 | 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 | 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 | CATHOLIC HEALTH SERVICES OF LONG IS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6314654102 | 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 (22 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 J J SULLIVAN JR | ||||||||
| CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| SISTER ELAINE CALLAHAN OP | ||||||||
| VICE CHAIR | 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 | ||
| 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 | |||
| SISTER AUDREY HARSEN | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| SISTER MARGARET JOHN KELLY DC | ||||||||
| 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 | |||
| REV MSGR JAMES VLAUN | ||||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |||
| JAMES HARDEN | ||||||||
| PRESIDENT & CEO | 50.00 | X | X | 1167467 | 0 | 48164 | ||
| COLLEEN BLYE | ||||||||
| SR VP FINANCE & CFO | 50.00 | X | 273168 | 0 | 245136 | |||
| JAMES CALDAS | ||||||||
| EVP ADMINISTRATION | 50.00 | 689240 | 0 | 147153 | X | |||
| JOEL YOHAI MD | ||||||||
| SR VP MEDICAL AFFAIRS & CM | 50.00 | 885524 | 0 | 41611 | X | |||
| JOSEPH CONTE | ||||||||
| EXEC VP CORPORATE SERVICES | 50.00 | 581231 | 0 | 200541 | X | |||
| DAVID DECERBO | ||||||||
| SVP & GENERAL COUNSEL | 50.00 | 142600 | 0 | 163591 | X | |||
| JOSEPH LOIACONO | ||||||||
| VP PROGRAM DEVELOPMENT | 50.00 | 286127 | 0 | 109987 | X | |||
| PATRICIA GAROFALO | ||||||||
| FORMER SR VP & GENERAL COUNSEL | 50.00 | 974230 | 0 | 434819 | X | |||
| ESTATE OF TERENCE G DALY | ||||||||
| FORMER SR VP FINANCE & CFO | 0.00 | 680964 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 5680551 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1391002 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | 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 |
|---|---|---|---|---|---|
| ISEMAN CUNNINGHAM RIESTER H | |||||
| 9 THURLOW TERRACE | ALBANY | NY | 12203 | LEGAL | 1216163 |
| PROSKAUER ROSE LLP | |||||
| 1585 BROADWAY | NEW YORK | NY | 10036 | LEGAL | 990869 |
| TOWERS WATSON PENNSYLVANIA | |||||
| PO BOX 8500 S-6110 | PHILADELPHIA | PA | 19178 | CONSULTING | 329305 |
| QUICK LEONARD KIEFFER | |||||
| 233 SOUTH WACKER DRIVE SUITE 6820 | CHICAGO | IL | 60606 | CONSULTING | 280201 |
| PARK STRATEGIES LLC | |||||
| 101 PARK AVENUE SUITE 2506 | NEW YORK | NY | 10178 | CONSULTING | 240000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 12 | NumberOfContractorsGT100K |
| Related Organizations | 950000 | RelatedOrganizations |
| Total Contributions | 950000 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MANAGEMMENT SERVICE RE | 900099 | 15168956 | 15168956 |
| OTHER REVENUE | 900099 | 38571 | 38571 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 15207527 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 217910 | TotalRevenueColumn |
| Exclusion | $217,910 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16375437 | TotalRevenueColumn |
| Related Or Exempt Function Income | 15207527 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $217,910 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 950000 | Total |
| Program Services | 950000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4762079 | Total |
| Program Services | 4762079 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1578383 | Total |
| Program Services | 1578383 | ProgramServices |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1342325 | Total |
| Program Services | 1342325 | ProgramServices |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 331978 | Total |
| Program Services | 331978 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 280243 | Total |
| Program Services | 280243 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1680016 | Total |
| Management And General | 1680016 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115000 | Total |
| Management And General | 115000 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1023215 | Total |
| Program Services | 1023215 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 276914 | Total |
| Program Services | 276914 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10847 | Total |
| Program Services | 10847 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 121793 | Total |
| Management And General | 121793 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34640 | Total |
| Program Services | 34640 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 286249 | Total |
| Program Services | 286249 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 221714 | Total |
| Program Services | 221714 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 64698 | Total |
| Management And General | 64698 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| MEMBERSHIP DUES | 2229129 | 2229129 |
| CONTRIBUTIONS | 241959 | 241959 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 667007 | Total |
| Program Services | 633290 | ProgramServices |
| Management And General | 33717 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16218189 | Total |
| Program Services | 14202965 | ProgramServices |
| Management And General | 2015224 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6439828 | BOY |
| EOY | 7677381 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 419001 | BOY |
| EOY | 505629 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2388195 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2047452 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 503343 | BOY |
| EOY | 340743 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 51526191 | BOY |
| EOY | 50964629 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58888363 | BOY |
| EOY | 59488382 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4943654 | BOY |
| EOY | 5323031 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39409742 | BOY |
| EOY | 41647462 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17207704 | BOY |
| EOY | 13957877 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61561100 | BOY |
| EOY | 60928370 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -2826734 | BOY |
| EOY | -1648341 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 153997 | BOY |
| EOY | 208353 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -2672737 | BOY |
| EOY | -1439988 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 58888363 | BOY |
| EOY | 59488382 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 157248 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 1075501 | 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 Type1 | X | SupportingOrg509a3Type1 |
| 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 (35 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 | |||||
| 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 MEDICAL CENTER | |||||
| 061562701 | 3 | 0 | 1 | 1 | $0 |
| OUR LADY OF CONSOLATION GERIATRIC CARE CENTER | |||||
| 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 |
| MARYHAVEN SCHOOL CORPORATION | |||||
| 112861690 | 9 | 0 | 1 | 1 | $0 |
| RIVERHEAD HOSTEL HOLDINGS CORPORATION | |||||
| 112499790 | 9 | 0 | 1 | 1 | $0 |
| SIENA VILLAGE | |||||
| 061569129 | 9 | 0 | 1 | 1 | $0 |
| ST FRANCIS RESEARCH & EDUCATIONAL CORPORATION | |||||
| 113090867 | 9 | 0 | 1 | 1 | $0 |
| ST CHARLES CORPORATION | |||||
| 112983148 | 9 | 0 | 1 | 1 | $0 |
| THE SAMARITAN CORPORATION | |||||
| 112716640 | 9 | 0 | 1 | 1 | $0 |
| WISDOM GARDENS HOUSING DEVELOPMENT FUND INC | |||||
| 113559713 | 9 | 0 | 1 | 1 | $0 |
| GOOD SHEPHERD HOSPICE | |||||
| 112958438 | 9 | 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 HOSPITAL 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 |
| CHS SERVICESINC | |||||
| 113555766 | 9 | 0 | 1 | 1 | $0 |
| GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE | |||||
| 112537396 | 9 | 0 | 1 | 1 | $0 |
| RVC INSURANCE COMPANYINC | |||||
| 208067039 | 9 | 0 | 1 | 1 | $0 |
| ST FRANCIS CARDIOVASCULAR PHYSICIANS PC | |||||
| 113613997 | 3 | 0 | 1 | 1 | $0 |
| GOOD SHEPHERD HOSPICE FOUNDATION | |||||
| 263169427 | 9 | 0 | 1 | 1 | $0 |
| MERCY MEDICAL CENTER FOUNDATION | |||||
| 550813603 | 9 | 0 | 1 | 1 | $0 |
| RVC SUPPORT | |||||
| 271531084 | 9 | 0 | 1 | 1 | $0 |
| ST CATHERINE OF SIENA MEDICAL CENTER FOUNDATION | |||||
| 271459941 | 9 | 0 | 1 | 1 | $0 |
| ST FRANCIS-MERCY CORPORATION | |||||
| 111635088 | 9 | 0 | 1 | 1 | $0 |
| OUR LADY OF CONSOLATION FOUNDATION | |||||
| 450517566 | 9 | 0 | 1 | 1 | $0 |
| WSNCHS NORTH LLC | |||||
| 113438973 | 3 | 0 | 1 | 1 | $0 |
| SUFFOLK HEARING & SPEECH CENTER INC | |||||
| 112110488 | 9 | 0 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 35 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 0 | SumOfAmounts |
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 D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 140524 | OtherCostOrOtherBasis |
| Depreciation | 139244 | Depreciation |
| Book Value | 1280 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2151817 | OtherCostOrOtherBasis |
| Depreciation | 1837228 | Depreciation |
| Book Value | 314589 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 95854 | OtherCostOrOtherBasis |
| Depreciation | 70980 | Depreciation |
| Book Value | 24874 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 340743 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM RELATED ORGANIZATIONS | 31068765 |
| INVESTMENT IN RVC INSURANCE COMPANY | 2250000 |
| LIMITED USE ASSETS | 4945023 |
| EXECUTIVE RETIREMENT ASSETS | 12700841 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 50964629 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO RELATED ORGANIZATIONS AND AFFILIATES | $850,566 |
| EXECUTIVE RETIREMENT LIABILITY | $13,107,311 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 13957877 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | CHSLI AND MOST OF ITS SUBSIDIARIES ARE EXEMPT FROM FEDERAL INCOME TAXES UNDER 501(C)(3)OF THE INTERNAL REVENUE CODE OF 1986,AS AMENDED. CHSLI ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE INCOME TAX TOPIC OF THE CODIFICATION. INCOME TAXES OF CHSLI FOR-PROFIT SUBSIDIARIES ARE NOT MATERIAL TO THE CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT ANNUALLY REVIEWS ITS TAX POSITIONS AND HAS DETERMINED THAT THERE ARE NO MATERIAL UNCERTAIN TAX POSITIONS THAT REQUIRE RECOGNITION IN THE CONSOLIDATED FINANCIAL STATEMENTS. | Explanation |
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 AVENUE | AddressLine1 |
| City | ROCKVILLE CENTRE | City |
| State | NY | State |
| ZIP Code | 11570 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 111837437 | EINOfRecipient |
| Amount Of Cash Grant | 950000 | AmountOfCashGrant |
| Purpose Of Grant | TO PROVIDE GENERAL SUPPORT OF THE CATHOLIC MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE IN CONNECTION WITH THE FORMATION OF YOUTH AND ADULTS IN THE FAITH, PROMOTION OF THE DIGNITY OF LIFE, PROMOTION OF QUALITY EDUCATION FOR YOUNG PEOPLE, AND FOSTERING OF VOCATIONS FOR THE PRIESTHOOD. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
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 | 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 (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES HARDEN | |||||||||||||
| 1146762 | 0 | 0 | 0 | 20705 | 0 | 17847 | 0 | 30317 | 0 | 1215631 | 0 | 0 | 0 |
| COLLEEN BLYE | |||||||||||||
| 265385 | 0 | 0 | 0 | 7783 | 0 | 244684 | 0 | 452 | 0 | 518304 | 0 | 0 | 0 |
| JAMES CALDAS | |||||||||||||
| 633260 | 0 | 0 | 0 | 55980 | 0 | 129759 | 0 | 17394 | 0 | 836393 | 0 | 0 | 0 |
| JOEL YOHAI MD | |||||||||||||
| 537911 | 0 | 186000 | 0 | 161613 | 0 | 24395 | 0 | 17216 | 0 | 927135 | 0 | 0 | 0 |
| JOSEPH CONTE | |||||||||||||
| 452102 | 0 | 113000 | 0 | 16129 | 0 | 174081 | 0 | 26460 | 0 | 781772 | 0 | 0 | 0 |
| DAVID DECERBO | |||||||||||||
| 137562 | 0 | 0 | 0 | 5038 | 0 | 158117 | 0 | 5474 | 0 | 306191 | 0 | 0 | 0 |
| JOSEPH LOIACONO | |||||||||||||
| 175751 | 0 | 100000 | 0 | 10376 | 0 | 108074 | 0 | 1913 | 0 | 396114 | 0 | 0 | 0 |
| PATRICIA GAROFALO | |||||||||||||
| 188766 | 0 | 67419 | 0 | 718045 | 0 | 426993 | 0 | 7826 | 0 | 1409049 | 0 | 391111 | 0 |
| ESTATE OF TERENCE G DALY | |||||||||||||
| 680964 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 680964 | 0 | 680964 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUPPLEMENTAL INFORMATION | PART III | PART I, LINE 4A: ESTATE OF TERENCE G. DALY $680,963 CHANGE OF CONTROL PAYMENT PATRICIA GAROFALO $224,700 SEVERANCE PAYMENT |
| SUPPLEMENTAL INFORMATION | PART III | PART I, LINE 4B: JAMES HARDEN $214,189 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPATION COLLEEN BLYE $103,991 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPATION JAMES CALDAS $132,354 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPATION JOSEPH CONTE $163,809 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPATION JOEL YOHAI, MD $201,403 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPATION DAVID DECERBO $40,320 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPATION JOSEPH LOIACONO $97,596 SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PARTICIPATION |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | CATHOLIC HEALTH SERVICES OF LONG ISLAND (CHSLI)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. CHSLI IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE. | |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE,AS THE SPONSOR OF CATHOLIC HEALTH SERVICES OF LONG ISLAND HAS THE ABILITY TO NOMINATE MEMBERS OF THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION A, LINE 7B | AS OUTLINED IN THE BY-LAWS OF CATHOLIC HEALTH SERVICES OF LONG ISLAND, CERTAIN BOARD DECISIONS ALSO REQUIRE THE APPROVAL OF THE ORGANIZATION'S MEMBERS. | |
| 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. | FORM 990, PART VI, SECTION C, LINE 19 | |
| REFLECTED IN PART VII, SECTION A, LINE 1A ARE THE ESTIMATED WEEKLY HOURS (2.0). DIRECTORS 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 REFLECTS TIME WORKED AS OFFICER FOR ALL THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766), RVC INSURANCE COMPANY, INC. (20-8067039) AND CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968) COLLEEN BLYE, SVP AND CHIEF FINANCIAL OFFICER - THE TOTAL HOURS WORKED REPORTED 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 SYSTEMS OF LONG ISLAND (11-3403968) | FORM 990, PART VII, SECTION A, LINE 1A | |
| CHANGES IN NET ASSETS OR FUND BALANCES: | TRANSFERS FROM RELATED PARTIES 1,050,000. TRANSFER OF FIXED ASSETS TO ST. JOSEPH HOSPITAL -28,855. RESTRICTED CONTRIBUTIONS 75,421. RELEASED FROM RESTRICTION -21,065. TOTAL TO FORM 990, PART XI, LINE 5: 1,075,501. | FORM 990, PART XI, LINE 5: |
| ELECTION TO ALLOCATE 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 |
| 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 | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|---|
| CHS SERVICES INC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 113555766 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| CHS AMBULANCE SERVICES INC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 141801961 | DORMANT | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| GOOD SAMARITAN HOSPITAL MEDICAL CENTER | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 111888924 | HOSPITAL | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 112537396 | SELF INSURANCE | NY | 501(C)(3) | LINE 11A, I | GOOD SAMARITAN HOSPITAL | 0 |
| MARYHAVEN TRANSPORTATION SERVICES | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 113434776 | TRANSPORTATION SERVICES | NY | 501(C)(3) | LINE 9 | MARYHAVEN CENTER OF HOPE | 0 |
| 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 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| MARYHAVEN SCHOOL CORPORATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 112861690 | SCHOOL FOR DEVELOPMENTALLY DISABLED | NY | 501(C)(3) | LINE 9 | MARYHAVEN CENTER OF HOPE | 0 |
| THE CENTER OF HOPE FOUNDATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 113638367 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | MARYHAVEN CENTER OF HOPE | 0 |
| MERCY MEDICAL CENTER | ||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 111635088 | HOSPITAL | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| CATHOLIC HOME CARE | ||||||||||
| 1150 PORTION ROAD SUITE 1 | HOLTSVILLE | NY | 11742 | 112126736 | HOME CARE | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| OUR LADY OF CONSOLATION GERIATRIC CARE CENTER | ||||||||||
| 111 BEACH DRIVE | WEST ISLIP | NY | 11795 | 113284066 | LT NURSING CARE | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| RIVERHEAD HOSTEL HOLDING CORPORATION | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 112499790 | RENTING | NY | 501(C)(3) | LINE 9 | MARYHAVEN CENTER OF HOPE | 0 |
| SIENA VILLAGE INC | ||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 061569129 | SENIOR HOUSING | NY | 501(C)(3) | LINE 9 | ST CATHERINE OF SIENA MEDICAL CENTER | 0 |
| ST CATHERINE OF SIENA MEDICAL CENTER | ||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 061562701 | HOSPITAL | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| ST CHARLES HOSPITAL | ||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON STATION | NY | 11777 | 111871039 | HOSPITAL | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| CHS HOME SUPPORT SERVICES INC | ||||||||||
| 15 POWER DRIVE | HAUPPAUGE | NY | 11788 | 113594561 | RESPIRATORY THERAPY SVC/MED. EQUIP. | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| ST FRANCIS HOSPITAL | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 112050523 | HOSPITAL | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| ST FRANCIS HOSPITAL FOUNDATION | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 112916033 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | ST FRANCIS HOSPITAL | 0 |
| ST FRANCIS HOSPITAL RESEARCH & EDUCATIONAL CORP | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113090867 | RESEARCH ORGANIZATION | NY | 501(C)(3) | LINE 9 | ST FRANCIS HOSPITAL | 0 |
| WSNCHS NORTH INC | ||||||||||
| 4295 HEMPSTEAD TURNPIKE | BETHPAGE | NY | 11714 | 113438973 | HOSPITAL | NY | 501(C)(3) | LINE 3 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| SUFFOLK HEARING & SPEECH CENTER INC | ||||||||||
| 369 EAST MAIN STREET | EAST ISLIP | NY | 11730 | 112110488 | DIAGNOSTIC TESTING | NY | 501(C)(3) | LINE 3 | GOOD SAMARITAN HOSPITAL | 0 |
| THE ST CHARLES CORPORATION | ||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 112983148 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| THE SAMARITAN CORPORATION | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 112716640 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| WISDOM GARDENS HOUSING DEVELOPMENT FUND INC | ||||||||||
| 51 TERRYVILLE ROAD | PORT JEFFERSON STATION | NY | 11776 | 113559713 | SENIOR HOUSING | NY | 501(C)(3) | LINE 9 | MARYHAVEN CENTER OF HOPE | 0 |
| GOOD SHEPHERD HOSPICE | ||||||||||
| 245 OLD COUNTRY ROAD | MELVILLE | NY | 11747 | 112958438 | HOSPICE SERVICES | NY | 501(C)(3) | LINE 9 | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| ST CHARLES HOSPITAL FOUNDATION | ||||||||||
| 200 BELLE TERRE ROAD | PORT JEFFERSON | NY | 11777 | 412076312 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | ST CHARLES HOSPITAL | 0 |
| GOOD SAMARITAN HOSPITAL FOUNDATION | ||||||||||
| 1000 MONTAUK HIGHWAY | WEST ISLIP | NY | 11795 | 770611240 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | GOOD SAMARITAN HOSPITAL | 0 |
| ST FRANCIS-MERCY CORPORATION | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 111635088 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| MERCY MEDICAL CENTER FOUNDATION | ||||||||||
| 1000 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 550813603 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | MERCY MEDICAL CENTER | 0 |
| ST CATHERINE OF SIENA MEDICAL CENTER FOUNDATION | ||||||||||
| 50 ROUTE 25A | SMITHTOWN | NY | 11787 | 271459941 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | ST CATHERINE OF SIENA MEDICAL CENTER | 0 |
| CATHOLIC HOME CARE FOUNDATION | ||||||||||
| 1150 PORTION ROAD SUITE 1 | HOLTSVILLE | NY | 11742 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | CATHOLIC HOME CARE | 0 | |
| GOOD SHEPHERD HOSPICE FOUNDATION | ||||||||||
| 245 OLD COUNTRY ROAD | MELVILLE | NY | 11747 | 263169427 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | GOOD SHEPHERD HOSPICE | 0 |
| OUR LADY OF CONSOLATION FOUNDATION | ||||||||||
| 111 BEACH DRIVE | WEST ISLIP | NY | 11795 | 450517566 | SUPPORT ORG | NY | 501(C)(3) | LINE 11A, I | OUR LADY OF CONSOLATION | 0 |
| RVC SUPPORT | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 271531084 | REAL ESTATE | NY | 501(C)(3) | LINE 11A, I | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
| ST FRANCIS CARDIOVASCULAR PHYSICIANS PC | ||||||||||
| 100 PORT WASHINGTON BLVD | ROSLYN | NY | 11576 | 113613997 | HEALTHCARE SERVICES | NY | 501(C)(3) | LINE 3 | ST FRANCIS HOSPITAL | 0 |
| RVC INSURANCE COMPANYINC | ||||||||||
| 992 NORTH VILLAGE AVENUE | ROCKVILLE CENTRE | NY | 11570 | 208067039 | CAPTIVE INSURANCE COMPANY | NY | 501(C)(3) | LINE 11A, I | CATHOLIC HEALTH SYSTEM OF LONG ISLAND | 0 |
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 | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (10 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| GOOD SAMARITAN HOSPITAL MEDICAL CENTER | ||
| K | 343203 | COST |
| OUR LADY OF CONSOLATION | ||
| K | -548074 | COST |
| MERCY MEDICAL CENTER | ||
| K | -1315940 | COST |
| MARYHAVEN CENTER OF HOPE | ||
| K | 84782 | COST |
| SAMARITAN HOME INFUSION SERVCHS HOME SUPPORT | ||
| K | 100535 | COST |
| CATHOLIC HOME CARE AND HOSPICE | ||
| K | 253645 | COST |
| ST CHARLES HOSPITAL | ||
| K | -2249088 | COST |
| ST CATHERINE OF SIENA MEDICAL CENTER | ||
| K | -170068 | COST |
| ST FRANCIS HOSPITAL | ||
| K | -867149 | COST |
| ST JOSEPH HOSPITAL | ||
| K | 61708 | COST |
Form990 Schedule R Part VII Form990ScheduleRPartVII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | TRANSACTIONS WITH RELATED ORGANIZATIONS | Identifier |
| Return Reference | SCHEDULE R PART V 2 | ReturnReference |
| Explanation | CATHOLIC HEALTH SYSTEM OF LONG ISLAND 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 CATHOLIC HEALTH SYSTEM OF LONG ISLAND HAS ENGAGED IN WITH ITS RELATED PARTY ORGANIZATIONS. THE FOLLOWING IS A LIST OF ADDITIONAL TRANSACTION TYPES BY FACILITY. GOOD SAMARITAN HOSPITAL MEDICAL CENTER P,L OUR LADY OF CONSOLATION P,R MERCY MEDICAL CENTER P,R MARYHAVEN CENTER OF HOPE P,R SAMARITAN HOME INFUSION SERV/CHS HOME SUPPORT P CATHOLIC HOME CARE P,R ST. CHARLES HOSPITAL P,R ST. CATHERINE OF SIENA MEDICAL CENTER P,R ST. FRANCIS HOSPITAL P,L,R ST. JOSEPH HOSPITAL P | Explanation |