2024-11-15T14:26:04-06:00 2023-12-31 PwC US Tax LLP 2001 MARKET STREET SUITE 1800 PHILADELPHIA PA 19103 990 2023-01-01 112958438 GOOD SHEPHERD HOSPICE % CHS SERVICES INC GOOD 6314656300 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 KIM KRANZ PRESIDENT 6318287411 2024-11-11 true true ERIC M MCNEIL P00460263 2673303000 2023 2024-10-15 13:58:12Z KIM KRANZ 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 47992194 false 0928 X HTTP//GOODSHEPHERDHOSPICE.CHSLI.ORG/ X 1989 NY WE, AT CH, HUMBLY JOIN TOGETHER TO BRING CHRIST'S HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES. 5 5 331 100 0 0 879338 2713249 43731491 44634928 20488 67924 359275 549125 44990592 47965226 9092 10434 0 0 29801996 29123597 0 0 0 13245944 12208046 43057032 41342077 1933560 6623149 44086084 49251614 19634026 17972496 24452058 31279118 X SEE SCHEDULE O false false 25523749 10434 29159842 HOSPICE CARE-FOCUSED ON PATIENT COMFORT IN AN ENVIRONMENT THAT AFFIRMS LIFE AND DIGNITY. INCLUDING A NETWORK OF PROFESSIONAL CAREGIVERS WORKING IN CONJUNCTION WITH THE PATIENT'S PRIMARY CARE PHYSICIAN. THE MULTIDISCIPLINARY APPROACH ENSURES THE DELIVERY OF HIGH QUALITY PHYSICAL, PSYCHOLOGICAL AND SPIRITUAL CARE THROUGHOUT THE PROCESS. HOSPICE SERVED A TOTAL OF 3,484 PATIENTS IN 2023 AND OUR DAILY CENSUS WAS 432. 9511785 0 15974107 INPATIENT UNIT SERVICES. 35035534 true true false true false false false false false true true false false true true true false true false false false false false false true false false true false true false false false false false false false false false false false false false true true true false false true 38 0 true 331 true false false false false false true true false false false false false false X 5 5 false false false false true true true true true false false true true true true true true false false false X CHS SERVICES INC 5167053700 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 X KIM KRANZ PRESIDENT 50.0 0.0 X 0 532346 75574 JEFFREY BERGMAN PHYSICIAN 50.0 0.0 X 288925 0 71345 DANIELLE STEIN VP FINANCE 50.0 0.0 X 0 291455 68565 PEDRO CALVES SR ASSOC MED DIRECTOR 50.0 0.0 X 290909 14058 50274 GENINE FRANCIS MEDICAL DIRECTOR 37.5 0.0 X 298880 0 54777 EMILY COPEL PHYSICIAN 37.5 0.0 X 278370 0 19437 JACQUELINE SPENCER PHYSICIAN 37.5 0.0 X 256853 0 24250 THOMAS CHRISTMAN CHAIRPERSON 2.0 0.0 X X 0 0 0 PETER DAGHER VICE CHAIRPERSON 2.0 0.0 X X 0 0 0 MICHAEL LAMBERT SECRETARY 2.0 0.0 X X 0 0 0 JOHN O'BRIEN TREASURER 2.0 0.0 X X 0 0 0 REV STEPHEN PIETROWSKI TRUSTEE 2.0 0.0 X 0 0 0 1413937 837859 364222 78 false true false GURWIN JEWISH GERIATRIC CTR 68 HAUPPAUGE RD COMMACK NY 11725 NURSING HOME FEES 1648097 LI STATE VETERANS HOME 100 PATRIOT RD STONYBROOK NY 11790 NURSING HOME FEES 437626 AMERICAN MEDICAL RESPONSE OF NEW PO BOX 843047 DALLAS TX 752843047 HOME HEALTH AID SVCS 377666 GURWIN HOME CARE AGENCY INC 330 CONKLIN STREET FARMINGDALE NY 11735 HOME HEALTH AID SVCS 270776 AIDES AT HOME 29 WEST MARIE STREET HICKSVILLE NY 11801 HOME HEALTH AID SVCS 131399 7 1551093 1162156 2713249 NET OUTPATIENT SERVICES 621610 35180263 35180263 NET INPATIENT SERVICES 623000 9454665 9454665 44634928 67924 67924 0 0 0 0 0 0 76853 26968 49885 49885 0 0 0 0 0 0 PALLIATIVE CARE STIPEND - RELATED PARTY 900099 499021 499021 MEDICAL RECORD COPIES 900099 219 219 499240 47965226 45133949 118028 10434 10434 0 0 0 0 0 0 21910800 18228677 3682123 1422577 1183512 239065 4199495 3493767 705728 1590725 1323403 267322 0 0 0 676 676 0 0 973776 920720 53056 2880 2880 419394 300609 118785 0 0 0 1306341 878447 427894 608611 605432 3179 0 0 0 342585 342585 772115 772115 319292 319292 PATIENT DME & MEDICAL SUPPLIES 3352670 3352670 NURSING HOME FEES 2987828 2987828 CHS SERVICES 809883 379944 429939 HOME OFFICE 292636 292636 19359 -66781 86140 41342077 35035534 6306543 0 1000 1000 2093707 1799716 0 68872 4830790 7384822 0 0 0 0 0 0 0 0 122172 119855 13060644 7828182 5849072 5232462 0 0 0 0 0 0 0 0 31189343 34644887 44086084 49251614 8204792 6876674 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11429234 11095822 19634026 17972496 X 24214354 30868954 237704 410164 24452058 31279118 44086084 49251614 X 6623149 203911 X false true X true true true X 631382 2793571 1110356 879338 2713249 8127896 35104431 42688338 44934035 43731491 44634928 211093223 0 0 0 35735813 45481909 46044391 44610829 47348177 219221119 117034 107453 201407 100000 150000 675894 0 117034 107453 201407 100000 150000 675894 218545225 30616 11075 1359 20488 67924 131462 0 30616 11075 1359 20488 67924 131462 0 267650 337919 394169 336569 499240 1835547 36034079 45830903 46439919 44967886 47915341 221188128 0.98805 0.98862 0.00059 0.00052 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 676 676 false PART II-B, LINE 1 - OTHER LOBBYING ACTIVITIES GOOD SHEPHERD HOSPICE PAID MEMBERSHIP DUES TO THE NATIONAL HOSPICE AND PALLIATIVE CARE ORGANIZATION & THE CENTER TO ADVANCE PALLIATIVE CARE, OF WHICH 2.18% WAS USED FOR LOBBYING. THE TOTAL DUES PAYMENT FOR 2023 WAS $31,005 AMOUNTING TO THE EXPENSE OF $676. 38000 369 369 38000 38000 369 369 38000 38000 369 369 38000 28000 369 369 28000 18000 10000 369 369 28000 0.00000 1.00000 0.00000 false false 9567685 4939281 4628404 3492801 2888888 603913 158 13 145 5232462 DUE FROM RELATED PARTIES 27061065 RIGHT OF USE ASSETS 5651112 INSURANCE CLAIMS RECEIVABLE 1488731 RESTRICTED USE FUNDS 341292 TRUSSTEE HELD AND OTHER AGREEM 99087 OTHER ASSETS 3600 34644887 0 OPERATING LEASE LIABILITY 5492278 DUE TO RELATED PARTIES 3424951 ESTIMATED MALPRACTICE LIABILITY 1488731 CURRENT PORTION OF OPERATIING LEASE 590774 OTHER NON CURRENT - PENSION 99088 11095822 X PART V, ENDOWMENT FUNDS - LINE 4, ORGANIZATION'S INTENDED USE ENDOWMENT IS TO BE HELD IN PERPETUITY, WITH INCOME TO BE USED FOR THE OPERATIONS OF THE INPATIENT UNIT. PART X, OTHER LIABILITIES - LINE 2, FIN 48 FOOTNOTE CH AND MOST OF ITS SUBSIDIARIES ARE 501(C)(3) ORGANIZATIONS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE. THESE ENTITIES ARE ALSO EXEMPT FROM NEW YORK STATE INCOME TAXES. THERE ARE VARIOUS SUBSIDIARIES OF CH THAT ARE FOR-PROFIT ENTITIES. TAXABLE OPERATIONS AND THE POTENTIAL FOR INCOME TAXES FROM THESE ENTITIES AND FROM UNRELATED BUSINESS ACTIVITIES OF THE TAX EXEMPT ENTITIES ARE NOT SIGNIFICANT TO THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. LIGHTS OF LOVE 9562 9562 3279 BRUNCH 67291 67291 2616 21073 0 0 0 0 0 0 0 0 0 0 76853 0 76853 0 0 0 0 2616 24352 26968 49885 true CATHOLIC HEALTH SERVICES OF LONG ISLAND 992 N VILLAGE AVE ROCKVILLE CENTRE NY 11570 113403968 501(C)(3) 10434 NONE NONE MISSION SUPPORT, OUTPATIENT CENTERS, GRANTS TO UNDERSERVED COMMUNITY, AND CAPITAL SUPPORT 1 0 PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE CHS SERVICES, A RELATED ENTITY, MAINTAINS THE BOOKS AND RECORDS FOR GOOD SHEPHERD HOSPICE AND CATHOLIC HEALTH AND IS THEREFORE ABLE TO MONITOR THAT CATHOLIC HEALTH USES THE GRANT FUNDS FOR MISSION SUPPORT, OUTPATIENT CENTERS AND GRANTS FOR THE UNDERSERVED COMMUNITIES AND CAPITAL SUPPORT. PART II, LINE 1, COLUMN (H) NAME OF ORGANIZATION OR GOVERNMENT: CATHOLIC HEALTH SYSTEM OF LONG ISLAND (H) PURPOSE OF GRANT: 1) SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND AS A PASS THROUGH TO PROVIDE GENERAL SUPPORT TO 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; 2) PROVIDE SUPPORT TO CATHOLIC HEALTH SYSTEM OF LONG ISLAND TO FUND OUTPATIENT CENTERS THAT PROVIDE CHARITY CARE TO THOSE CENTERS' COMMUNITIES; AND 3) TO FUND SUPPORT PROVIDED THROUGH THE CATHOLIC HEALTH CAREGIVERS FUND. THE CATHOLIC HEALTH CAREGIVERS FUND WAS FORMED WITH THE MISSION TO ASSIST OUR FELLOW CAREGIVERS ON THE FRONT LINES, HERE AND ABROAD, WHO STRUGGLE JUST TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. false false false false false false false false false DANIELLE STEIN VP FINANCE 0 257954 0 32000 0 1501 0 20672 0 47893 0 360020 0 0 KIM KRANZ PRESIDENT 0 396326 0 117000 0 19020 0 25410 0 50164 0 607920 0 0 PEDRO CALVES SR ASSOC MED DIRECTOR 259001 -222 30241 14280 1667 0 20532 0 28217 1525 339658 15583 0 0 JEFFREY BERGMAN PHYSICIAN 275018 0 13069 0 838 0 22272 0 49073 0 360270 0 0 0 GENINE FRANCIS MEDICAL DIRECTOR 290780 0 6860 0 1240 0 23188 0 31589 0 353657 0 0 0 EMILY COPEL PHYSICIAN 234386 0 41697 0 2287 0 18282 0 1155 0 297807 0 0 0 JACQUELINE SPENCER PHYSICIAN 255483 0 0 0 1370 0 20166 0 4084 0 281103 0 0 0 KERRIANNE PAGE CHIEF MEDICAL OFF (THRU 3/23) 103652 0 32000 0 423 0 25740 0 4845 0 166660 0 0 0 PART I, LINE 3 - METHODS TO ESTABLISH COMPENSATION BY RELATED ORGANIZATION THE FOLLOWING METHODS ARE USED BY A RELATED ORGANIZATION TO ESTABLISH COMPENSATION OF THE CEO/EXECUTIVE DIRECTOR: A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION THE SOLE MEMBER OF GOOD SHEPHERD HOSPICE IS CATHOLIC HEALTH SYSTEM OF LONG ISLAND (D/B/A/ CATHOLIC HEALTH) (CH). CH IS A NEW YORK NOT-FOR PROFIT CORPORATION ORGANIZED TO SERVE AS THE COORDINATING BODY OF AN INTEGRATED NETWORK OF HEALTHCARE PROVIDERS. CH IS SPONSORED BY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTER (DIOCESE). FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODY CH IS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF GOOD SHEPHERD HOSPICE AND AS SUCH HAS THE RIGHT TO APPOINT THE GOVERNING BODY OF GOOD SHEPHERD HOSPICE. FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY CH AS THE SOLE MEMBER AND ESTABLISHED CO-OPERATOR OF GOOD SHEPHERD HOSPICE, IS REQUIRED TO APPROVE CERTAIN DECISIONS MADE BY THE GOVERNING BODY OF GOOD SHEPHERD HOSPICE. FORM 990, PART VI, LINE 11B - REVIEW PROCESS OF FORM 990 THE FORM 990 AND APPROPRIATE SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. 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 REVIEW FUNCTION BY THE BOARD. UPON APPROVAL OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO ALL VOTING MEMBERS OF THE BOARD. ONCE APPROVED 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 CH BOARD CHAIR. AFTER REVIEW OF ANY APPLICABLE COMMENTS FROM THE BOARD, THE COMPLIANCE AND AUDIT COMMITTEE WILL THEN RECOMMEND THE APPROVAL OF THE FORM 990 TO THE CH BOARD OF DIRECTORS WHO WILL THEN REVIEW THE RECOMMENDATIONS AND PROVIDE THE FINAL APPROVAL OF THE FORM 990. THE FORM 990 IS THEN SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, LINE 12C - 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 CH 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 CH AND WISHES TO GO FORWARD WITH IT, THE CHAIR OF THE ORGANIZATION'S BOARD OF TRUSTEES SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF CH 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 CH, CERTIFIES THAT CH CANNOT SECURE SIMILAR SERVICES FROM AN ORGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIMSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. UPON RECEIPT OF THE WRITTEN REQUEST AND ANY SUPPORTING DOCUMENTS, THE CHS COMPLIANCE AND AUDIT COMMITTEE SHALL MAKE THE FINAL DECISION AS TO WHETHER CH SHALL ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, LINE 15 - COMPENSATION POLICY OF CH, A RELATED ORG THE CHIEF ADMINISTRATIVE OFFICER SUBMITS FOR APPROVAL TO THE SYSTEM CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE POLICY. THE POLICY DEFINES A "DISQUALIFIED PERSON" AS A PERSON IN A POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER THE AFFAIRS OF CH OR AN OPERATING ENTITY, AND IS EITHER A) A VOTING MEMBER OF THE BOARD OF DIRECTORS OR BOARD OF TRUSTEES; B) THE ENTITY'S PRESIDENT, CHIEF EXECUTIVE OFFICER, AND CHIEF OPERATING OFFICERS OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS; D) THE PERSON'S COMPENSATION IS PRIMARILY BASED ON REVENUES DERIVED FROM ACTIVITIES OF CH OR AN OPERATING ENTITY, OR OF A PARTICULAR DEPARTMENT OR FUNCTION OF CH OR AN OPERATING ENTITY, THAT THE PERSON CONTROLS; E) THE PERSON HAS OR SHARES AUTHORITY TO CONTROL OR DETERMINE 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 CH OR AN OPERATING ENTITY THAT REPRESENTS A SUBSTANTIAL PORTION OF THE ACTIVITIES, ASSETS, INCOME, OR EXPENSES OF CH 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. ONCE APPROVED BY THE CORPORATE CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE FOR REVIEW. THE EXECUTIVE COMPENSATION COMMITTEE, WITH AN INDEPENDENT COMPENSATION CONSULTANT ENGAGED BY THE BOARD, WILL REVIEW PROPOSED SALARY ADJUSTMENTS AND INCENTIVE AWARDS TO ENSURE REASONABLENESS BY REVIEWING COMPARABLE TOTAL COMPENSATION DATA(INCLUDING INCENTIVES) PAID TO SIMILARLY SITUATED EXECUTIVES AT THE MEDIAN OF THE DEFINED MARKETPLACE WITH POSSIBLE ADJUSTMENT MADE FOR SPECIAL SKILL, EXPERIENCE, COMPETENCE AND PERFORMANCE, INCLUDING CONTRIBUTION TO THE SYSTEM AS A WHOLE. REVIEWS ARE DONE BY AN INDEPENDENT CONSULTANT ANNUALLY. THE COMPENSATION COMMITTEE SETS STANDARDS TO ENSURE THAT THE CRITERIA USED TO DETERMINE INCENTIVE COMPENSATION ARE SPECIFIC, OBJECTIVE, MEASUREABLE AND RELATED TO INDICATORS OF PERFORMANCE. BASED ON THE INFORMATION, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE BOARD OF TRUSTEES. FORM 990, PART VI, LINE 19 - DOCUMENTS AVAILABLE FOR PUBLIC INSPECTION GOVERNING DOCUMENTS - CERTIFICATE OF INCORPORATION FILED WITH THE NYS DEPARTMENT OF STATE; CONFLICT OF INTEREST POLICY IS NOT PUBLICLY AVAILABLE; CH CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE AT DAC BOND. FORM 990, PART VII, SECTION A - LINE 1A HOURS FOR TRUSTEES 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. DANIELLE STEIN, VP FINANCE - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SHEPHERD HOSPICE (11-2958438); GOOD SHEPHERD HOSPICE FOUNDATION (26-3169427) AND CATHOLIC HEALTH HOME CARE (11-2126736). KIM KRANZ, PRESIDENT - THE TOTAL HOURS WORKED REPORTED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: GOOD SHEPHERD HOSPICE (11-2958438); GOOD SHEPHERD HOSPICE FOUNDATION (26-3169427) AND CATHOLIC HEALTH HOME CARE (11-2126736). FORM 990,PART XI,LINE 9 - OTHER CHANGES IN NET ASSETS EQUITY TRANSFER TO FOUNDATION $203,,911 FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION GOOD SHEPHERD HOSPICE IS A MEMBER OF CATHOLIC HEALTH. WE, AT CATHOLIC HEALTH , HUMBLY JOIN TOGETHER TO BRING CHRIST'S HEALING MISSION AND THE MISSION OF MERCY OF THE CATHOLIC CHURCH EXPRESSED IN CATHOLIC HEALTH CARE TO OUR COMMUNITIES. I-CARE VALUES INTEGRITY: WE ARE WHO WE SAY WE ARE AND ACT IN ACCORDANCE WITH THE SPLENDOR OF TRUTH OF OUR CATHOLIC MORAL TEACHING AND OUR CATHOLIC VALUES. COMPASSION: WE HAVE COMPASSION FOR OUR PATIENTS, SEE THE SUFFERING CHRIST IN THEM, STRIVE TO ALLEVIATE SUFFERING AND SERVE THE SPIRITUAL, PHYSICAL AND EMOTIONAL NEEDS OF OUR PATIENTS. ACCOUNTABILITY: WE TAKE RESPONSIBILITY FOR OUR ACTIONS AND THEIR CONSEQUENCES. RESPECT: WE HONOR THE SANCTITY OF LIFE AT EVERY STAGE OF LIFE AND THE DIGNITY OF EVERY PERSON, AND INCORPORATE ALL THE PRINCIPLES OF CATHOLIC SOCIAL TEACHING IN OUR RELATIONSHIPS AND ADVOCACY. EXCELLENCE: WE SEEK THE GLORY OF GOD IN THE COMPASSIONATE SERVICE OF OUR PATIENTS, AND WE STRIVE TO DO THE BEST THAT CAN BE DONE, WHATEVER OUR ROLE. 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CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP NY 11795 450517566 SUPPORT ORG NY 501(C)(3) 12A- I OURLADYOFC false RVC SUPPORT 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 271531084 REAL ESTATE NY 501(C)(3) 12A- I CHSLI false CHS PHYSICIAN PARTNERS PC 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113613997 HEALTHCARESVC NY 501(C)(3) 12A- I ST FRANCIS false RVC INSURANCE COMPANYINC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 208067039 CAPTIVE INS NY 501(C)(3) 12B- II CHSLI false SAMARITAN EMERGENCY MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208243412 HEALTHCARESVC NY 501(C)(4) GOOD SAMARTN false ST JOSEPH HOSPITAL FOUNDATION 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 472353387 SUPPORT ORG NY 501(C)(3) 12A- I WSNCHS NORTH false RVC II INSURANCE COMPANY INC 992 N VILLAGE AVE ROCKVILLE CENTRE ROCKVILLE CENTRE NY 11570 921136144 CAPTIVE INS NY 501(C)(3) 12B-II CHSLI false BIPO HOLDINGS LLC 992 N VILLAGE AVE ROCKVILLE CENTRE ROCKVILLE CENTRE NY 11570 464763720 PHYSICIAN ASSN NY NA N/A IDHC LLC 2500 YORK RD JAMISONPA 18929 JAMISON PA 18929 452411095 HEALTH SERVICES PA NA N/A BEACON HEALTH PTNRS 992 N VILLAGE AVE ROCKVILLE CENTRE ROCKVILLE CENTRE NY 11570 454229842 HEALTHCARE NY NA N/A WISDOM GARDENS LP 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 113567947 SR HOUSING NY NA N/A CHS PHYSICIAN PARTNERS ACO LLC 992 N Village Ave Rockville Centre ROCKVILLE CENTRE NY 11570 999999999 HEALTHCARE NY NA N/A LONG ISLAND HEALTHCARE NETWORK 992 N VILLAGE AVE ROCKVILLE CENTRE ROCKVILLE CENTRE NY 11570 113465837 CONTRACTING NY NA N/A RADIOLOGY CONSULTING OF LONG ISLANDPLLC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 421646134 HEALTHCARE SV NY GOOD SAMARITAN C-CORP false SAMARITAN PEDIATRIC SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208180263 HEALTHCARE SV NY GOOD SAMARITAN C-CORP false SAMARITAN MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208088453 HEALTHCARE SV NY GOOD SAMARITAN C-CORP false SOUTHWEST SUFFOLK MEDICAL PC 580 UNION BOULEVARD WEST ISLIP NY 11795 061603195 HEALTHCARE SV NY GOOD SAMARITAN C-CORP false CARDIAC EKG INTERPRETATION PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 112924518 HEALTHCARE SV NY GOOD SAMARITAN C-CORP false LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208964140 HEALTHCARE SV NY GOOD SAMARITAN C-CORP false SAMARITAN MANAGEMENT SERVICES 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112838185 HEALTHCARE SV NY CHSLI C-CORP false ADVANCED REHABILIATION MEDICINE PLLC 200 BELLE TERRE ROAD PORT JEFFERSON NY 11777 113640709 HEALTHCARE SV NY STCHARLES HOSP C-CORP false ST FRANCIS CARDIAC PREVENTION SERVICES 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113224885 HEALTHCARE SV NY STFRANCIS HOSP C-CORP false SOUTH SHORE PRACTICE MANAGEMENT 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113307977 HEALTHCARE SV NY SAMARITAN MGMT C-CORP false SAMARITAN HOME CARE AMERICA 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 113319259 HEALTHCARE SV NY SAMARITAN MGMT C-CORP false MERCY INTERNAL MEDICINE PC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 510639649 HEALTHCARE SV NY MERCY MED CTR C-CORP false LONG ISLAND EMERGENCY CARE PC 1000 N VILLAGE AVE ROCKVILLE NY 11571 113633515 PHYSICIAN SVC NY MERCY MED CTR S-CORP false MY CHS RX INC 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 842359236 PHARMACY NY CHSLI C-CORP false false true false false false false false false false false true false false true true true true true false SCHEDULE R, PART IV FOR ALL PROFESSIONAL CORPORATIONS REPORTED ON SCHEDULE R, PART IV, THE PHYSICIAN IS THE SOLE SHAREHOLDER OF THE ENTITY AND THE DIRECT CONTROLLING ENTITY REPORTED IN COLUMN (D) IS THE BENEFICIAL OWNER. THIS STRUCTURE IS CONSISTENT WITH THE NEW YORK CORPORATE PRACTICE OF MEDICINE.