2025-11-11T15:04:13-06:00 2024-12-31 PwC US Tax LLP 2001 MARKET STREET SUITE 1800 PHILADELPHIA PA 19103 990 2024-01-01 113403968 CATHOLIC HEALTH SYSTEM OF LONG ISLAND % CHS SERVICES INC CATH 5167053700 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 PATRICK O'SHAUGHNESSY PRESIDENT, CEO 5167051938 2025-11-07 true true ERIC M MCNEIL P00460263 2673303000 2025-11-07 2024 2025-03-06 01:10:19Z CATHOLIC HEALTH PATRICK O'SHAUGHNESSY DO 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 404361742 false 0928 X HTTP://WWW.CHSLI.ORG X 1997 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 20 19 13 0 0 0 79643169 73968230 36376383 50643369 5529079 13717958 -1000 1000 121547631 138330557 1297000 902000 0 0 18885663 16948430 0 0 0 19179417 38987301 39362080 56837731 82185551 81492826 372073783 436821371 331545121 314710498 40528662 122110873 X SEE SCHEDULE O false false 46528238 1468 50644369 CATHOLIC HEALTH PROMOTES THE EFFICIENT GOVERNANCE AND MANAGEMENT OF THE SUPPORTED ORGANIZATIONS. IN ADDITION, CH'S COOPERATIVE PLANNING AND EFFICIENT USE OF RESOURCES ASSISTS THE SUPPORTED ORGANIZATIONS TO ACHIEVE THEIR RESPECTIVE AND COLLABORATIVE GOALS. 750000 750000 0 SUPPORTING AND STRENGTHENING THE MINISTRIES OF THE DIOCESE OF ROCKVILLE CENTRE. 0 0 0 SUPPORTING AND STRENGTHENING THE MINISTRIES OF THE CH HEALTH SYSTEM AND RELATED ORGANIZATIONS. 150532 150532 0 47428770 true true false false false false false false false false true false false true true true false true false false false false false false false false false true false true true false false false false false false false false false false false false false false true true true true false false true 48 0 true 13 true false false false false false false false false false false true false X 20 19 false false false false true true true true true false false true true true true true true true true true true X CHS SERVICES INC 5167053700 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 X PATRICK O'SHAUGHNESSY PRESIDENT & CEO 50.0 0.0 X X 3222318 0 1532793 TRACY MILLER EVP & GNRL. COUNSEL THRU 12/23 0.0 0.0 X 1500364 0 486257 PATRICK MINICUS EVP & COO 50.0 0.0 X 1199960 0 707333 JOSEPH CAROFANO SVP STRATEGY & CMO 50.0 0.0 X 1465661 0 200118 DENNIS VERZI CHIEF OF STAFF 40.0 0.0 X 1071488 0 559482 JOSEPH LAMANTIA EVP CHIEF TRANSFORMATION OFFCR 50.0 0.0 X 1119828 0 423845 JASON GOLBIN DO EVP & CHIEF MED OFFICER 50.0 0.0 X 1035870 0 427265 MICHAEL MAINIERO SVP&CHIEF DIGITAL INFO OFFICER 50.0 0.0 X 1020237 0 432759 ANTHONY PELLICANO SVF CHIEF HR OFFICER 50.0 0.0 X 1166189 0 251732 GARRETT HAVICAN EVP & COO AS OF 02/24 50.0 0.0 X 950634 0 36881 SALVATORE SODANO CHAIR 2.0 0.0 X X 0 0 0 THOMAS CHRISTMAN VICE CHAIR 2.0 0.0 X X 0 0 0 REGINA PISCAZZI SECRETARY 2.0 0.0 X X 0 0 0 ROBERT ZUCCARO TREASURER 2.0 0.0 X X 0 0 0 JERRY BALENTINE DO TRUSTEE 2.0 0.0 X 0 0 0 PETER DAGHER TRUSTEE 2.0 0.0 X 0 0 0 REV LEE DESCOTEAUX TRUSTEE 2.0 0.0 X 0 0 0 HON VITO DESTEFANO TRUSTEE 2.0 0.0 X 0 0 0 REV JASON GRISAFI TRUSTEE 2.0 0.0 X 0 0 0 JOSEPH MATTONE ESQ TRUSTEE 2.0 0.0 X 0 0 0 SUSAN O'HARA RN TRUSTEE 2.0 0.0 X 0 0 0 RONALD SHINDEL TRUSTEE 2.0 0.0 X 0 0 0 PETER QUICK TRUSTEE 2.0 0.0 X 0 0 0 DEBRA DEL VECCHIO TRUSTEE 2.0 0.0 X 0 0 0 JOHN ROMANELLI MD TRUSTEE 2.0 0.0 X 0 0 0 ANDREW ZUCARO TRUSTEE 2.0 0.0 X 0 0 0 REV JOHN MCCARTNEY TRUSTEE 2.0 0.0 X 0 0 0 GEOFFREY DELESSEPS TRUSTEE AS OF 06/24 2.0 0.0 X 0 0 0 JOSEPH F KUEHN JR TRUSTEE AS OF 06/24 2.0 0.0 X 0 0 0 13752549 0 5058465 13 true true false HURON CONSULTING SERVICES LLC 3005 MOMENTUM PLACE CHICAGO IL 606890000 CONSULTING 12340696 KPMG LLP DEPT 0922 PO BOX 120922 DALLAS TX 753120922 CONSULTING 2035050 CONIFER VALUE BASED CARE LLC PO BOX 655025 DALLAS TX 752655025 ADVISORY SERVICES 1456898 NEW YORK ARENA PARTNERS LLC 2400 HEMPSTEAD TURNPIKE ELMONT NY 11003 ADVERTISING 550750 SHEPPARD MULLIN RICHTER HAMPTON L 333 S HOPE ST 43RD FL LOS ANGELES CA 90071 LEGAL SERVICES 543550 19 20902000 52896916 169314 73968230 MANAGEMENT SERVICES REVENUE 900099 50643369 50643369 50643369 1157236 1157236 0 0 0 0 0 278591907 266031185 12560722 12560722 12560722 0 0 0 0 0 0 0 0 0 OTHER REVENUE 900099 1000 1000 1000 138330557 50644369 13717958 902000 902000 0 0 0 9280889 9280889 0 8442801 8442801 241377 241377 -1435979 -1308446 -127533 419342 419342 20619799 20619799 2989565 2989565 1286545 1286545 0 0 0 315677 315677 109 109 1446870 1446870 0 0 197835 197835 41542 41542 0 0 6450223 6450223 0 80862 80862 52017 52017 OUTSIDE SERVICES 1681156 0 1681156 0 FEDERAL EXCISE TAX 1000000 0 1000000 0 OTHER EXPENSES 2825101 495725 2329376 0 56837731 47428770 9408961 0 5336945 212128 0 0 0 0 178641 95257 0 0 0 0 0 0 0 0 40796844 88640845 5777430 5686230 135595 91200 127671250 17264309 0 0 2270667 2138006 9769424 9946314 185914417 318433312 372073783 436821371 16126288 19189895 0 0 0 0 81233013 74104776 0 0 0 0 181219401 165025974 0 0 52966419 56389853 331545121 314710498 X 40172336 121799477 356326 311396 40528662 122110873 372073783 436821371 X 81492826 90595 -1210 X false true X true false X X 9 GOOD SAMARITAN HOSPITAL MEDICAL CENTER 111888924 3 true 0 0 MERCY MEDICAL CENTER 111635088 3 true 0 0 ST CHARLES HOSPITAL CORP 111871039 3 true 0 0 ST FRANCIS HOSPITAL 112050523 3 true 0 0 ST CATHERINE OF SIENA MEDICAL CENTER 061562701 3 true 0 0 WSNCHS NORTH INC 113438973 3 true 0 0 OUR LADY OF CONSOLATION GERIATRIC CARE CENTER 113284066 10 true 0 0 CATHOLIC HOME CARE 112126736 10 true 0 0 GOOD SHEPHERD HOSPICE 112958438 10 true 0 0 9 0 0 false false false false false false false false false false false false false false false true false PART I, LINE 12G, COLUMN IV AND PART IV, SECTION A, LINE 1 THE SUPPORTED ORGANIZATIONS OF CATHOLIC HEALTH ("CH") ARE THOSE ENTITIES FOR WHICH CH IS THE SOLE MEMBER AND CERTAIN OTHER PUBLIC CHARITIES CONTROLLED BY SUCH ORGANIZATIONS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2913658 3026079 -112421 146704 146704 0 2711465 2507844 203621 5603 5603 0 91200 DUE FROM RELATED ORGANIZATIONS 255012794 EXECUTIVE RETIREMENT ASSETS 28751568 BOND INDENTURE AGREEMENT 24676149 RIGHT OF USE ASSET 3376313 INVESTMENT IN SUBSIDIARIES 2825000 457B FUNDS 2436663 EQUITY INVESTMENTS 1043429 DONOR RESTRICTED FUNDS 311396 318433312 0 EXECUTIVE RETIREMENT LIABILITY 37215091 SELF INS/WC LIABILITY 8033263 OPERATING LEASE LIABILITIES 3582318 DUE TO RELATED ORGS & AFFILIATES 850000 CP OF OTHER SELF-INSURED LIABILITIES 737133 OTHER LIABILITIES 5972048 56389853 X 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. true DIOCESE OF ROCKVILLE CENTRE - CATHOLIC MINISTRIES 50 N PARK AVE ROCKVILLE CNTR NY 11570 111837437 501(C)(3) 800000 GENERAL SUPPORT UPLIFT HELP INTL INC 984 N VILLAGE AVE ROCKVILLE CNTR NY 11571 203821339 501(C)(3) 15000 GENERAL SUPPORT LJDR DAVIS FOUNDATION 134-36 246 STREET ROSEDALE NJ 11422 462216693 501(C)(3) 15000 GENERAL SUPPORT URSULINE SISTERS OF TILDONK INC 60 ANCHOR AVE OCEANSIDE NJ 11572 112305323 501(C)(3) 8282 GENERAL SUPPORT 4 0 PART I, LINE 2 - PROCEDURE FOR MONITORING GRANT FUND USE THE DIOCESE OF ROCKVILLE CENTRE PROVIDES ANNUAL UPDATES TO ALL CONTRIBUTORS TO THE CATHOLIC MINISTRIES APPEAL; WHETHER PARISHIONERS OR CORPORATE CONTRIBUTORS LIKE CHSLI. 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. THE CAREGIVERS COMMITTEE, COMPRISED OF STAFF WHO ARE DONATING THEIR SERVICES, MANAGE THE CAREGIVERS FUND. THROUGHOUT THE YEAR, ORGANIZATIONS SUBMIT GRANT APPLICATIONS TO REQUEST FUNDS THAT ARE USED TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. THE CAREGIVERS COMMITTEE REVIEWS THESE APPLICATIONS, AND CHOOSES RECIPIENTS BASED ON THE FOLLOWING CRITERIA: I) CLEAR AND IDENTIFIED NEED, II) ABILITY TO USE THE FUNDS RESPONSIBLY, III) CARE FOR THE CAREGIVERS ON THE FRONT LINE, IV) ABILITY OF THE RECIPIENTS TO USE THE FUNDS FOR THE RECOMMENDED PURPOSES, AND V) CONFIRMATION OF THE LEGAL STATUS OF THE RECIPIENT. FOLLOWING SELECTION, THE COMMITTEE DIRECTS THE GIFTS TO BE MADE TO RECIPIENTS WITH COVER LETTERS INDICATING THE INTENDED PURPOSES. RECIPIENTS ARE ASKED TO PROVIDE FOLLOW-UPS ON THE USE OF THE FUNDS TO THE COMMITTEE WITHIN SIX MONTHS OF THE USE OF FUNDS. PART II, LINE 1 COLUMN (H) NAME OF ORGANIZATION OR GOVERNMENT: DIOCESE OF ROCKVILLE CENTRE - CATHOLIC MINISTRIES APPEAL - (H) - PURPOSE OF GRANT OR ASSISTANCE: 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. IN 2024, A GRANT WAS ALSO DISTRIBUTED FOR HURRICANE RELIEF AS PART OF THE CAREGIVERS FUND. UPLIFT HELP INTL INC - (H) PURPOSE OF GRANT OR ASSISTANCE: HELP TO PURCHASE AND TRANSPORT NEEDED MEDS AND LAB TESTS FOR IJCH IN ISHIAGU, NIGERIA. LJDR DAVIS FOUNDATION - (H) - PURPOSE OF GRANT OR ASSISTANCE: THE PROJECT IS TO PROVIDE FREE MEDICAL HELP TO THE UNDERSERVED POPULATION. THE MEDICAL MISSION IS NOW SEEING PATIENTS COMING FROM ALL OVER JAMAICA ASKING FOR HELP. THEY ARE ADDRESSING PATIENTS WITH HYPERTENSION, DIABETES, WOUNDS, SKIN DISORDERS LIKE ECZEMA AND PSORIASIS. THIS PAST MEDICAL MISSION THEY DETECTED 2 FEMALES WITH BREAST CANCER AND ASSIST THEM FINANCIALLY TO GET MAMMOGRAMS AND BIOPSIES. BOTH NOW REQUIRING SURGERIES. URSULINE SISTERS OF TILDONK INC - (H) PURPOSE OF GRANT OR ASSISTANCE: CONSTRUCTING A HOME FOR THE ELDER SISTERS, TO BE COMPLETED IN SIX MONTHS' TIME. THEY WILL NEED TO EQUIP THE ROOMS WITH MEDICAL BEDS AND CARDIAC TABLES, ETC. THIS WILL HELP AT LEAST 20 ELDERLY SISTERS, AT PRESENT, TO GET A PROPER TREATMENT FACILITY AND OTHER ELDER SISTERS TO GET A PROPER HOME. X true true X X X X X X true true false false false false false false false PATRICK O'SHAUGHNESSY PRESIDENT & CEO 1818384 0 1375000 0 28934 0 1472840 0 59953 0 4755111 0 0 0 TRACY MILLER EVP & GNRL. COUNSEL THRU 12/23 0 0 0 0 1500364 0 221000 0 265257 0 1986621 0 0 0 PATRICK MINICUS EVP & COO 950336 0 220000 0 29624 0 650840 0 56493 0 1907293 0 0 0 JOSEPH CAROFANO SVP STRATEGY & CMO 616679 0 150000 0 698982 0 161840 0 38278 0 1665779 0 398000 0 DENNIS VERZI CHIEF OF STAFF 592548 0 285000 0 193940 0 537840 0 21642 0 1630970 0 0 0 JOSEPH LAMANTIA EVP CHIEF TRANSFORMATION OFFCR 899664 0 200000 0 20164 0 370840 0 53005 0 1543673 0 0 0 JASON GOLBIN DO EVP & CHIEF MED OFFICER 829311 0 185000 0 21559 0 385840 0 41425 0 1463135 0 0 0 ANTHONY PELLICANO SVF CHIEF HR OFFICER 716539 0 175000 0 274650 0 246840 0 4892 0 1417921 0 207000 0 GARRETT HAVICAN EVP & COO AS OF 02/24 814559 0 100000 0 36075 0 0 0 36881 0 987515 0 0 0 MICHAEL MAINIERO SVP&CHIEF DIGITAL INFO OFFICER 849942 0 150000 0 20295 0 422840 0 9919 0 1452996 0 0 0 PART I, LINE 4A - SEVERANCE PAYMENT TRACY MILLER RECEIVED A SEVERANCE PAYMENT OF $1,500,364. THE AMOUNT IS INCLUDED ON SCHEDULE J, PART II, COLUMN B (III). FUTURE SEVERANCE IS $260,156 PART I, LINE 4B - SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J,PART II, COLUMN C. DENNIS VERZI $514,000 PARTICIPATION IN THE PLAN ANTHONY PELLICANO $223,000 PARTICIPATION IN THE PLAN PATRICK O'SHAUGHNESSY $1,449,000 PARTICIPATION IN THE PLAN PATRICK MINICUS $627,000 PARTICIPATION IN PLAN JOSEPH CAROFANO $138,000 PARTICIPATION IN THE PLAN TRACY MILLER $221,000 PARTICIPATION IN THE PLAN JASON GOLBIN $362,000 PARTICIPATION IN THE PLAN JOSEPH LAMANTIA $347,000 PARTICIPATION IN THE PLAN THE DEFERRED COMPENSATION AMOUNT IN COLUMN C FOR THESE INDIVIDUALS INCLUDES BOTH QUALIFIED AND NON-QUALIFIED RETIREMENT PLANS. THE FOLLOWING INDIVIDUALS VESTED IN THE SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN. THE AMOUNTS BELOW ARE INCLUDED ON SCHEDULE J, PART II, COLUMN B(III). THESE AMOUNTS INCLUDE A TAX GROSS UP. JOSEPH CAROFANO $672,694 VESTED IN PLAN. ANTHONY PELLICANO $231,170 VESTED IN PLAN. THE AMOUNTS OUTLINED HEREIN WERE INCLUDED IN EACH INDIVIDUAL'S 2024 FORM W 2, BOX 5 AS TAXABLE WAGES BECAUSE THEY ARE VESTED, BUT ARE NOT DISTRIBUTED UNTIL RETIREMENT. A SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORP 273722095 86476RCU6 2014-09-24 91553113 CAPITAL EXPENDITURES false false false B NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE CORP 274291221 63166LCZ2 2024-05-21 85724031 REFUND 2004 BONDS false false false A 0 0 91553113 0 0 0 1209113 0 0 90344000 0 0 false false true true B 0 0 85724031 0 0 0 1359656 0 0 0 84364375 0 true false true true A false true true true false 0 true B false true true true false 0 false false false true A false false false true false false 0 false 0 false true B false false true false false false 0 false 0 false true A true B true SCHEDULE K, PART I, LINE A SUPPLEMENTAL INFORMATION SECOND ISSUER FOR LINE A IS: NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE CORP, EIN #27-4291221, CUSIP# 63166LDJ7 SCHEDULE K, PART IV FOR THE SUFFOLK COUNTY ECONOMIC DEVELOPMENT CORP 2014 BONDS THE CALCULATION WAS PERFORMED ON MARCH 22, 2019 AND NO REBATE WAS DUE. FORM 990, PART III, LINE 4D - OTHER PROGRAM SERVICES 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. THE CAREGIVERS COMMITTEE, COMPRISED OF STAFF WHO ARE DONATING THEIR SERVICES, MANAGE THE CAREGIVERS FUND. THROUGHOUT THE YEAR, ORGANIZATIONS SUBMIT GRANT APPLICATIONS TO REQUEST FUNDS THAT ARE USED TO OBTAIN BASIC RESOURCES TO PROVIDE CARE TO THOSE DESPERATELY IN NEED. THE CAREGIVERS COMMITTEE REVIEWS THESE APPLICATIONS, AND CHOOSES RECIPIENTS BASED ON THE FOLLOWING CRITERIA: I) CLEAR AND IDENTIFIED NEED, II) ABILITY TO USE THE FUNDS RESPONSIBLY, III) CARE FOR THE CAREGIVERS ON THE FRONT LINE, IV) ABILITY OF THE RECIPIENTS TO USE THE FUNDS FOR THE RECOMMENDED PURPOSES, AND V) CONFIRMATION OF THE LEGAL STATUS OF THE RECIPIENT. FOLLOWING SELECTION, THE COMMITTEE DIRECTS THE GIFTS TO BE MADE TO RECIPIENTS WITH COVER LETTERS INDICATING THE INTENDED PURPOSES. RECIPIENTS ARE ASKED TO PROVIDE FOLLOW-UPS ON THE USE OF THE FUNDS TO THE COMMITTEE WITHIN SIX MONTHS OF THE USE OF FUNDS. FORM 990, PART VI, LINE 6 - MEMBERS OF THE ORGANIZATION CATHOLIC HEALTH SYSTEM OF LONG ISLAND, (D/B/A CATHOLIC HEALTH) (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 CENTRE. FORM 990, PART VI, LINE 7A - ELECTION OF THE GOVERNING BODY THE ROMAN CATHOLIC DIOCESE OF ROCKVILLE CENTRE,AS THE SPONSOR OF CATHOLIC HEALTH HAS THE ABILITY TO NOMINATE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, LINE 7B - DECISIONS OF THE GOVERNING BODY AS OUTLINED IN THE BY-LAWS OF CATHOLIC HEALTH, CERTAIN BOARD DECISIONS ALSO REQUIRE THE APPROVAL OF THE ORGANIZATION'S MEMBERS. FORM 990, PART VI, LINE 11B - REVIEW PROCESS OF FORM 990 THE FORM 990 AND RELATED SCHEDULES ARE COMPLETED BY OUTSIDE TAX ADVISORS AND REVIEWED INTERNALLY BY MANAGEMENT. THE FINAL DRAFT OF THE FORM 990 IS THEN PROVIDED TO ALL VOTING MEMBERS OF THE BOARD, AND PRESENTED TO THE COMPLIANCE AND AUDIT COMMITTEE (THE COMMITTEE) OF THE BOARD OF DIRECTORS OF CH, WHICH HAS BEEN DELEGATED THE FORM 990 REVIEW FUNCTION BY THE BOARD. UPON REVIEW AND RECOMMENDATION OF THE COMMITTEE, THE FORM 990 IS THEN SENT TO THE FOUNDATION AND CH BOARDS FOR APPROVAL. UPON BOARD APPROVAL, THE FORM 990 IS SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, LINE 12C - CONFLICT OF INTEREST POLICY 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 CH COMPLIANCE AND AUDIT COMMITTEE BY CH'S COMPLIANCE OFFICER. ALL DISCLOSURES ARE INVESTIGATED AND INFORMATION RELATED TO THE DISCLOSURE IS GATHERED AND SUMMARIZED AND INCLUDED WITH THE SUMMARY OF DISCLOSURES. UPON REVIEW OF THE SUMMARY OF DISCLOSURES, THE CH COMPLIANCE AND AUDIT COMMITTEE SHALL REPORT ITS FINDINGS TO THE CH BOARD OF DIRECTORS. THE BOARD SHALL DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS BASED ON THE CRITERIA CONTAINED IN THE POLICY. IF A CONFLICT OF INTEREST IS IDENTIFIED AND 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 BOARD OF DIRECTORS SHALL PROVIDE A WRITTEN REQUEST TO THE CHAIR OF THE 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 RGANIZATION WITHOUT A CONFLICT, AND WISHES TO GO FORWARD WITH IT. THE PERSON DETERMINED TO HAVE A CONFLICT OF INTEREST MUST RECUSE HIM/HERSELF FROM ANY DECISION MAKING OR VOTING ON THE INTEREST THAT GAVE RISE TO THE CONFLICT. FORM 990, PART VI, LINE 15 - COMPENSATION POLICY THE CHIEF EXECUTIVE OFFICER SUBMITS FOR APPROVAL TO THE SYSTEM CEO RECOMMENDATIONS FOR BASE SALARY ADJUSTMENTS AND INCENTIVE AWARDS FOR "DISQUALIFIED PERSONS" AS DEFINED IN THE CH EXECUTIVE COMPENSATION POLICY (COMPENSATION POLICY). THE COMPENSATION 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 (CEO), AND CHIEF OPERATING OFFICERS (COO) OR PERSONS HOLDING EQUIVALENT POSITIONS; C) THE ENTITY'S TREASURERS AND CHIEF FINANCIAL OFFICERS (CFO); 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 CH 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 CH CEO, THESE RECOMMENDATIONS ARE SENT TO THE EXECUTIVE COMPENSATION COMMITTEE OF THE CH BOARD OF DIRECTORS 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 PERFORMED ANNUALLY BY AN INDEPENDENT CONSULTANT. 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 PROVIDED, THE COMMITTEE WILL THEN MAKE ITS RECOMMENDATION TO THE CH BOARD OF DIRECTORS. 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. PATRICK O'SHAUGHNESSY, PRESIDENT & CEO - THE TOTAL HOURS WORKED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHs SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY, INC. (20-8067039); CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968); ST. FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11- 1888924); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL CORP (11-1871039), ST. JOSEPH HOSPITAL FOUNDATION (47-2353387); RVC II INSURANCE COMPANY, INC. (92-1136144) AND MERCY MEDICAL CENTER FOUNDATION (51-0813603). PATRICK MINICUS, EVP & CFO - THE TOTAL HOURS WORKED REFLECTS TIME WORKED AS AN OFFICER FOR ALL OF THE FOLLOWING RELATED ENTITIES: CHS SERVICES, INC. (11-3555766); RVC INSURANCE COMPANY, INC. (20-8067039); CATHOLIC HEALTH SYSTEMS OF LONG ISLAND (11-3403968); ST. FRANCIS HOSPITAL (11-2050523); ST FRANCIS HOSPITAL RESEARCH & EDUCATION CORPORATION, INC. (11-3090867); MERCY MEDICAL CENTER (11-1635088); WSNCHS NORTH, INC. (11-3438973); GOOD SAMARITAN HOSPITAL MEDICAL CENTER (11- 1888924); GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE (11-2537396); ST. CATHERINE OF SIENA MEDICAL CENTER (06-1562701); ST. CHARLES HOSPITAL CORP (11-1871039); ST FRANCIS HOSPITAL FOUNDATION (11-2916033); ST. CHARLES HOSPITAL FOUNDATION (41-2076312); GOOD SAMARITAN HOSPITAL FOUNDATION (77-0611240), ST. CATHERINE OF SIENA MEDICAL CENTER FOUNDATION (27-1459941) AND MERCY MEDICAL CENTER FOUNDATION (51-0813603). FORM 990, PART XI, LINE 9 - OTHER CHANGES IN NET ASSETS ROUNDING : (1,210) ---------- TOTAL LINE 9 : (1,210) FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION CATHOLIC HEALTH SYSTEM OF LONG ISLAND IS THE PARENT OF CATHOLIC HEALTH (CH). 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. CHS PHYSICIAN PARTNERS ACO II LLC 992 N VILLAGE AVE ROCKVILLE CENTER NY 11570 833073444 ACCNTBLE CARE NY 0 4604000 CHSLI CHS SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 113555766 SUPPORT ORG NY 501(C)(3) 12B-II CHSLI true CHS AMBULANCE SERVICES INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 141801961 DORMANT NY 501(C)(3) 3 CHSLI true GOOD SAMARITAN HOSPITAL MEDICAL CENTER 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 111888924 HOSPITAL NY 501(C)(3) 3 CHSLI true GOOD SAMARITAN SELF INSURANCE AGAINST MALPRACTICE 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 112537396 SELF INSURANC NY 501(C)(3) 12A-I GOOD SAMARTN true MERCY MEDICAL CENTER 1000 NORTH VILLAGE AVENUE ROCKVILLE CTR NY 11570 111635088 HOSPITAL NY 501(C)(3) 3 CHSLI true CATHOLIC HOME CARE 110 BI-COUNTY BLVD SUITE 114 FARMINGDALE NY 11735 112126736 HOME CARE NY 501(C)(3) 10 CHSLI true OUR LADY OF CONSOLATION GERIATRIC CARE 111 BEACH DRIVE WEST ISLIP NY 11795 113284066 LT NURSE CARE NY 501(C)(3) 10 CHSLI true ST 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SUPPORT ORG NY 501(C)(3) 12A-I GOODSHEPHERD true OUR LADY OF CONSOLATION FOUNDATION 111 BEACH DRIVE WEST ISLIP NY 11795 450517566 SUPPORT ORG NY 501(C)(3) 12A-I OURLADYOFC true RVC SUPPORT 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 271531084 REAL ESTATE NY 501(C)(3) 12A-I CHSLI true CHS PHYSICIAN PARTNERS PC 100 PORT WASHINGTON BLVD ROSLYN NY 11576 113613997 HEALTHCARESVC NY 501(C)(3) 12A-I ST FRANCIS true RVC INSURANCE COMPANYINC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 208067039 CAPTIVE INS NY 501(C)(3) 12B-II CHSLI true SAMARITAN EMERGENCY MEDICAL SERVICES PC 1000 MONTAUK HIGHWAY WEST ISLIP NY 11795 208243412 HEALTHCARESVC NY 501(C)(4) GOOD SAMARTN true ST JOSEPH HOSPITAL FOUNDATION 992 N VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 472353387 SUPPORT ORG NY 501(C)(3) 12A-I WSNCHS NORTH true RVC II INSURANCE COMPANY INC 992 NORTH VILLAGE AVENUE ROCKVILLE CENTRE NY 11570 921136144 CAPTIVE INS NY 501(C)(3) 12B-II CHSLI true BIPO HOLDINGS LLC 992 N VILLAGE AVE ROCKVILLE 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false false true true true true true true true true CHS SERVICES LMNOP 65932051 COST GOOD SAMARITAN HOSPITAL MEDICAL CENTER C 239010 COST GOOD SAMARITAN HOSPITAL MEDICAL CENTER LQS 21588935 COST MERCY MEDICAL CENTER C 110051 COST MERCY MEDICAL CENTER LQS 6244069 COST ST FRANCIS HOSPITAL C 258749 COST ST FRANCIS HOSPITAL LQS 14643679 COST ST CHARLES HOSPITAL C 71461 COST ST CHARLES HOSPITAL DLQS 3889821 COST ST CATHERINE OF SIENA MEDICAL CENTER DLQS 4386062 COST ST CATHERINE OF SIENA MEDICAL CENTER C 77672 COST ST JOSEPH HOSPITAL C 55874 COST ST JOSEPH HOSPITAL LQS 3493247 COST OUR LADY OF CONSOLATION GERIATRIC CARE CENTER LQS 627286 COST RVC INSURANCE COMPANY PQ 2813087 COST RVC INSURANCE COMPANY F 20000000 COST CATHOLIC HOME CARE LQS 1268108 COST MY CHS RX PQ 58424 COST GOOD SHEPHERD HOSPICE LQS 358090 COST CHS PHYSICIAN PARTNERS PC C 49365 COST CHS PHYSICIAN PARTNERS PC LQS 2716046 COST ST FRANCIS FOUNDATION PQ 65170 COST URGENT CARE OF NY PLLC B 52676 COST CATHOLIC HEALTH UC LLC B 693750 COST 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.