TY 2010 Form 990

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(C) Position (check all that apply)
(1) MANFRED ALTSTADT TREASURER	2.00	X	0	0
(2) JOHN P BERTSCH SECRETARY	2.00	X	0	0
(3) JOHN A DECINA DIRECTOR	2.00	X	0	0
(4) THOMAS J FAHEY JR MD CHAIRMAN OF BOARD	2.00	X	0	0
(5) THOMAS G FERRARA DIRECTOR	2.00	X	0	0
(6) TERENCE GALLAGHER-EMERITUS DIRECTOR	2.00	X	0	0
(7) STEVEN J GOLUB DIRECTOR	2.00	X	0	0
(8) EDWARD D HEBEN DIRECTOR	2.00	X	0	0
(9) RALPH V JOHNSON DIRECTOR	2.00	X	0	0
(10) MSGR EDWARD H BARRY DIRECTOR	2.00	X	0	0
(11) JAMES E INTRONE DIRECTOR	2.00	X	795,861	8,935
(12) RENA M MURTHA RN DIRECTOR	2.00	X	0	0
(13) AMIT SIKDAR DIRECTOR	2.00	X	0	0
(14) MINTO L SOARES DIRECTOR	2.00	X	0	0
(15) JOSEPH A TARANTINO DIRECTOR	2.00	X	0	0
(16) ANNE COTE TAYLOR DIRECTOR	2.00	X	0	0
(17) RICHARD E MEYER VICE CHAIRMAN	2.00	X	0	0

(A) Name and Title	(B) Average hours per week (describe hours for related organizations in Schedule O)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(18) MICHAEL J BRESCIA MD EXECUTIVE MEDICAL DIRECTOR	36.00	X			464,817	23,897
(19) FRANK A CALAMARI PRESIDENT/ EXECUTIVE DIREC	36.00	X			868,487	35,503
(20) CHRISTOPHER COMFORT MD MED DIRECTOR	36.00	X			410,970	50,883
(21) RICHARD KUTILEK CHIEF OPERATIONS OFFICER	36.00	X			330,651	48,723
(22) FRANK J LOCAPARRA CHIEF FINANCIAL OFFICER	36.00	X			130,673	40,573
(23) ANDREW V GRECO CHIEF FINANCIAL OFFICER	36.00	X			252,861	23,438
(24) SALLY UMBRO RN VP FOR PATIENT CARE SERVIC	26.00		X		214,115	40,025
(25) ANTHONY TARANTO ASST. ADMIN. ENVIRONMENT C	36.00		X		170,168	28,497
(26) NANCY D'AGOSTINO RN DIRECTOR HOME CARE/HOSPICE	36.00		X		191,495	46,523
(27) ROBERT BRESCIA MD DIRECTOR PAL CR	36.00			X	337,386	33,502
(28) DEVMANI JAITLY MD ATTENDING PHYSICIAN	36.00			X	463,217	48,883
(29) GAIL CHRZANOWSKI MD ATTENDING PHYSICIAN	36.00			X	264,405	41,369
(30) OSCAR ALVAREZ PHD ADMINISTRATOR/DIR. OF RESE	36.00			X	241,693	48,676
(31) SREENIVASA PATIBANDLA MD STAFF PHYSICIAN	36.00			X	335,486	25,670

(A) Name and business address	(B) Description of services	(C) Compensation
AMERISOURCEBERGEN CORP PO BOX 5188 NEW YORK,NY100875188	PHARMACEUTICAL VENDOR	1,983,173
MMS PO BOX 643925 CINCINNATI,OH45264	MEDICAL SUPPLIES	1,033,524
FARRELL MEDIA GROUP 887 KINDERKAMACK RD 1ST FL RIVER EDGE,NJ07661	ADVERTISING	988,778
US FOOD SERVICE INC PO BOX 642554 PITTSBURGH,PA152642554	FOOD VENDOR	575,161
EXTENDED CARE CONCEPTS 125 NEWTOWN RD SUITE 300 PLAINVIEW,NY11803	HOME HEALTH AIDE AGENCY	489,011
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 in compensation from the organization 52

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to governments and organizations in the U.S. See Part IV, line 21
2	Grants and other assistance to individuals in the U.S. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the U.S. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	3,066,439	2,762,831	303,608
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	52,361,361	47,177,063	5,184,298
8	Pension plan contributions (include section 401(k) and section 403(b) employer contributions) ....	6,397,697	5,764,325	633,372
9	Other employee benefits .......	10,975,600	9,888,906	1,086,694
10	Payroll taxes ...........	3,876,900	3,493,048	383,852
11	Fees for services (non-employees):
a	Management ......	962,000		962,000
b	Legal .........	391,600		391,600
c	Accounting ...........	316,000		316,000
d	Lobbying ...........
e	Professional fundraising. See Part IV, line 17..
f	Investment management fees ......
g	Other ..........	5,528,800	5,528,800
12	Advertising and promotion ....	1,293,800	1,165,701	128,099
13	Office expenses .......	2,657,400	2,394,291	263,109
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	2,429,200	2,188,685	240,515
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......
19	Conferences, conventions, and meetings ....
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization .....	3,847,100	3,466,199	380,901
23	Insurance ..............	558,800	503,473	55,327
24	Other expenses. Itemize expenses not covered above. (Expenses grouped together and labeled miscellaneous may not exceed 5% of total expenses shown on line 25 below.)
a	OTHER ANCILLARY MED EXP	5,751,300	5,751,300
b	PROVISION FOR BAD DEBT	2,160,800	2,160,800
c	MISCELLANEOUS	2,092,100	1,924,577	167,523
d	MAINTENANCE AND REPAIRS	1,255,800	1,131,463	124,337
e	FOOD EXPENSE	962,200	962,200
f	All other expenses	390,706	390,706
25	Total functional expenses. Add lines 1 through 24f	107,275,603	96,654,368	10,621,235	0
26	Joint costs. Check here if following SOP 98-2 (ASC 958-720). Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation

Part X Balance Sheet
	1	Cashnon-interest-bearing ..........	-821,062	1	-1,791,088
2	Savings and temporary cash investments .......	4,699,285	2	2,900,297
3	Pledges and grants receivable, net .........		3
4	Accounts receivable, net .........	18,641,313	4	19,021,098
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........		5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........		6
7	Notes and loans receivable, net .............		7
8	Inventories for sale or use ..............	30,699	8	192,799
9	Prepaid expenses and deferred charges ............	412,047	9	399,297
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	77,551,200
b	Less: accumulated depreciation. .....	10b	61,177,300	16,980,700	10c	16,373,900
11	Investments—publicly traded securities ..........	21,390,483	11	24,099,496
12	Investments—other securities. See Part IV, line 11 ......		12
13	Investments—program-related. See Part IV, line 11 ..	17,200,200	13	19,899,515
14	Intangible assets .........		14
15	Other assets. See Part IV, line 11 ...........	20,200,577	15	21,807,787
16	Total assets. Add lines 1 through 15 (must equal line 34)...	98,734,242	16	102,903,101
	17	Accounts payable and accrued expenses .	15,085,633	17	15,111,098
18	Grants payable ..........		18
19	Deferred revenue ..........		19
20	Tax-exempt bond liabilities ..........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..		21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ....		24
25	Other liabilities. Complete Part X of Schedule D.....	26,602,383	25	26,355,603
26	Total liabilities. Add lines 17 through 25.....	41,688,016	26	41,466,701
		Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....	34,129,640	27	35,702,000
28	Temporarily restricted net assets .....	21,122,386	28	23,901,500
29	Permanently restricted net assets .....	1,794,200	29	1,832,900
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances .....	57,046,226	33	61,436,400
34	Total liabilities and net assets/fund balances .....	98,734,242	34	102,903,101

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.

Attach to Form 990 or Form 990-EZ. right arrow

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

CALVARY HOSPITAL INC

Employer identification number

13-1740274

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches. section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in

section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. Seesection 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box that describes the type of supporting organization and complete lines 11e through 11h.

Type I

Type II

Type III - Functionally integrated

Type III - Other

By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).

If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box ..................................................

Since August 17, 2006, has the organization accepted any gift or contribution from any of the
following persons?

(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)

Yes

and (iii) below, the governing body of the the supported organization? ................

11g(i)

(ii) a family member of a person described in (i) above? ......................

11g(ii)

(iii) a 35% controlled entity of a person described in (i) or (ii) above? ................

11g(iii)

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization in col. (i) listed in your governing document?		(v) Did you notify the organization in col. (i) of your support?		(vi) Is the organization in col. (i) organized in the U.S.?		(vii) Amount of support?
(i) Name of supported organization	(ii) EIN	Yes	No	Yes	No	Yes	No	(vii) Amount of support?


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2010

Page 2

Part II

Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3..
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public Support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets..
11	Total support (Add lines 7 through 10).

Gross receipts from related activities, etc. (See instructions.) ..................

First Five Years If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.......................................... right arrow

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f)) .........

Public Support Percentage for 2009 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2010. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ...................... right arrow

33 1/3% support test—2009. If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2010. If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization .................................................. right arrow

10%-facts-and-circumstances test—2009. If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly
supported organization .............................................. right arrow

Private Foundation If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions ................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 3

Part III

Support Schedule for Organizations Described in IRC 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year(or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......
3	Gross receipts from activities that are not an unrelated trade or business under section 513..
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public Support (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2006	(b) 2007	(c) 2008	(d) 2009	(e) 2010	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.)
13	Total support (Add lines 9, 10c, 11 and 12.).

Section C. Computation of Public Support Percentage

Public Support Percentage for 2010 (line 8 column (f) divided by line 13 column (f)) .........

Public support percentage from 2009 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2010 (line 10c column (f) divided by line 13 column (f)) ......

Investment income percentage from 2009 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests—2010. If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .......... right arrow

33 1/3% support tests—2009. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private Foundation If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions ..... right arrow

Schedule A (Form 990 or 990-EZ) 2010

Page 4

Part IV

Supplemental Information. Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Explanation

Schedule A (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

OMB No. 1545-0047

2010

Name of organization

CALVARY HOSPITAL INC

Employer identification number

13-1740274

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II.

Special Rules

For a section 501(c)(3) organization filing Form 990 or 990-EZ, that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), and received from any one contributor, during the year, a contribution of the
greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, aggregate contributions of more than $1,000 for use exclusively for religious, charitable,
scientific, literary, or educational purposes, or the prevention of cruelty to children or animals. Complete Parts I, II, and
III.

For a section 501(c)(7), (8), or (10) organization filing Form 990, or 990-EZ, that received from any one contributor,
during the year, contributions for use exclusively for religious, charitable, etc., purposes, but these contributions did
not aggregate to more than $1,000. If this box is checked, enter here the total contributions that were received during
the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule
applies to this organization because it received nonexclusively religious, charitable, etc., contributions of $5,000 or more
during the year. ......................... Arrow Bullet

Caution. An Organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2 of its Form 990, or check the box in the heading of its
Form 990-EZ, or on line 2 of its Form 990-PF, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization CALVARY HOSPITAL INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part I
Part I	Contributors (see Instructions)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
RESTRICTED	RESTRICTED RESTRICTED RESTRICTED RESTRICTED, RESTRICTED RESTRICTED	$RESTRICTED	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Aggregate contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II if there is a noncash contribution.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Name of organization CALVARY HOSPITAL INC
Schedule B (Form 990, 990-EZ, or 990-PF) (2010) Page 1 of 1 of Part II
Part II	Noncash Property (see Instructions)
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Page 1 of 1 of Part III

Name of organization
CALVARY HOSPITAL INC

Employer identification number

13-1740274

Part III

Exclusively religious, charitable, etc., individual contributions to section 501(c)(7), (8), or (10) organizations
aggregating more than $1,000 for the year. (Complete columns (a) through (e) and the following line entry.)
For organizations completing Part III, enter the total of exclusively religious, charitable, etc.,
contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b)
Purpose of gift

(d)
Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2010)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below.
SchCMd Bullet

Attach to Form 990 or Form 990-EZ. SchCMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public
Inspection

If the organization answered “Yes,” to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered “Yes,” to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)) Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered “Yes,” to Form 990, Part IV, Line 5 (Proxy Tax) or Form 990-EZ, Part V, line 35a (Proxy Tax), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

CALVARY HOSPITAL INC

Employer identification number

13-1740274

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization's direct and indirect political campaign activities on behalf of or in opposition to candidates for public office in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c) except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt funtion activities .................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Privacy Act and Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2010

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check if the filing organization belongs to an affiliated group.
B Check if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated Group Totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the instructions for lines 2a through 2f on page 4.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2007	(b) 2008	(c) 2009	(d) 2010	(e) Total

2a	Lobbying non-taxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots non-taxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2010

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? If "Yes," describe in Part IV ..........................

Yes

23,232

Total. lines 1c through 1i ...................................

23,232

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carryover lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) if BOTH Part III-A, lines 1 and 2 are answered “No” OR if Part III-A, line 3 is answered “Yes”.

Dues, assessments and similar amounts from members .....................

Section 162(e) non-deductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ...........................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Complete this part to provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; and Part ll-B, line 1i.
Also, complete this part for any additional information.

Identifier	Return Reference	Explanation
EXPLANATION OF OTHER LOBBYING ACTIVITIES:	PART II-B, LINE 1I:	CALVARY HOSPITAL, INC. DOES NOT ENGAGE IN ANY DIRECT LOBBYING ACTIVITIES; HOWEVER, IT DOES BEAR INDIRECT COSTS THAT HAVE LOBBYING IMPLICATIONS. THE $23,232 REPORTED ON PART II-B, LINE 1(I) REPRESENTS THAT PORTION OF ITS MEMBERSHIP DUES THE HOSPITAL PAYS TO THE HOSPITAL ASSOCIATION OF NEW YORK STATE (HANYS) AND THE GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA) THAT RELATES TO LOBBYING EXPENSES. THIS AMOUNT HAS BEEN DETERMINED IN ACCORDANCE WITH MEDICARE PROVIDER REIMBURSEMENT MANUAL, PART I, SECTION 2139.

Schedule C (Form 990 or 990EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11, or 12.
SchDMd Bullet

Attach to Form 990. SchDMd Bullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

CALVARY HOSPITAL INC

Employer identification number

13-1740274

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .......
2	Aggregate contributions to (during year) ...
3	Aggregate grants from (during year) ...
4	Aggregate value at end of year .......

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds may be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit. ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or pleasure) Preservation of an historically importantly land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a–2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06 ........	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the taxable year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting and enforcing conservation easements during the year SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section
170(h)(4)(B)(i) and 170(h)(4)(B)(ii)? ....................................

Yes No

In Part XIV, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116, not to report in its revenue statement and balance sheet works of
art, historical treasures, or other similar assets held for public exhibition, education or research in furtherance of public service,
provide, in Part XIV, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116, to report in its revenue statement and balance sheet works of art,
historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service,
provide the following amounts relating to these items:

(i)

Revenues included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 relating to these items:

Revenues included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 52283D

Schedule D (Form 990) 2010

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s accession and other records, check any of the following that are a significant use of its collection
items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIV.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIV and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21? .....................

Yes No

If “Yes,” explain the arrangement in Part XIV.

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current Year	(b)Prior Year
1a	Beginning of year balance ....	22,916,700	20,492,500
b	Contributions ........	1,901,600	1,747,600
c	Investment earnings or losses ...	2,815,700	2,610,800
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........	1,899,600	1,934,200
f	Administrative expenses ....
g	End of year balance ......	25,734,400	22,916,700

Provide the estimated percentage of the year end balance held as:

Board designated or quasi-endowment: SchDMd Bullet

0 %

Permanent endowment: SchDMd Bullet

7.120 %

Term endowment: SchDMd Bullet

92.880 %

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIV the intended uses of the organization's endowment funds.

Part VI

InvestmentsLand, Buildings, and Equipment. See Form 990, Part X, line 10.

Description of investment		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	538,000		538,000
b	Buildings ................	27,751,100	19,948,800	7,802,300
c	Leasehold improvements ............	3,552,800	2,440,600	1,112,200
d	Equipment ................	45,669,000	38,787,900	6,881,100
e	Other .................	40,300		40,300
Total. Add lines 1a-1e. (Column (d) should equal Form 990, Part X, column (B), line 10(c).)........				16,373,900

Schedule D (Form 990) 2010

Page 3

Part VII

InvestmentsOther Securities. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) should equal Form 990, Part X, col.(B) line 12.)

Part VIII

InvestmentsProgram Related. See Form 990, Part X, line 13.

(a) Description of investment type	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND	19,899,515	F








Total. (Column (b) should equal Form 990, Part X, col.(B) line 13.)	19,899,515

Part IX

Other Assets. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1) DUE FROM THIRD PARTIES				620,000
(2) CAPITAL IMPROVEMENTS				5,072,700
(3) SELF INSURANCE FUND ASSETS				2,060,500
(4) EQUIPMENT ESCROW FUND				7,540,100
(5) DONOR RESTRICTED ASSETS				4,837,100
(6) DEFERRED COMPENSATION ASSET				1,481,900
(7) OTHER ASSETS				10,487
(8) DUE FROM AFFILIATES				185,000

Total. (Column (b) should equal Form 990, Part X, col.(B) line 15.)...........				21,807,787

Part X

Other Liabilities. See Form 990, Part X, line 25.

1.(a) Description of Liability		(b) Amount
Federal Income Taxes
ACCRUED PENSION LIABILITY		20,507,500
DUE TO THIRD PARTIES		4,731,303
MALPRACTICE LIABILITY		1,116,800






Total. (Column (b) should equal Form 990, Part X, col.(B) line 25.)		26,355,603
2. Fin 48 (ASC 740) Footnote. In Part XIV, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC740).

Schedule D (Form 990) 2010

Page 4

Part XI Reconciliation of Change in Net Assets from Form 990 to Financial Statements
1	Total revenue (Form 990, Part VIII, column (A), line 12) ....................	1	106,088,993
2	Total expenses (Form 990, Part IX, column (A), line 25) .....................	2	107,275,603
3	Excess or (deficit) for the year. Subtract line 2 from line 1 .............	3	-1,186,610
4	Net unrealized gains (losses) on investments ..........................	4	525,900
5	Donated services and use of facilities .............................	5
6	Investment expenses ...................................	6
7	Prior period adjustments ..................................	7
8	Other (Describe in Part XIV) .................................	8	5,050,884
9	Total adjustments (net). Add lines 4 - 8 .............................	9	5,576,784
10	Excess or (deficit) for the year per financial statements. Combine lines 3 and 9 .........	10	4,390,174

Part XII Reconciliation of Revenue per Audited Financial Statements With Revenue per Return
1	Total revenue, gains, and other support per audited financial statements .......			1	106,614,900
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains on investments ..........	2a	525,900
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIV): ............	2d	7
e	Add lines 2a through 2d .....................			2e	525,907
3	Subtract line 2e from line 1.....................			3	106,088,993
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIV): ...........	4b
c	Add lines 4a and 4b.......................			4c	0
5	Total Revenue. Add lines 3 and 4c. (This should equal Form 990, Part I, line 12.) ......			5	106,088,993

Part XIII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return
1	Total expenses and losses per audited financial statements .............			1	107,275,600
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIV): ............	2d
e	Add lines 2a through 2d......................			2e	0
3	Subtract line 2e from line 1.....................			3	107,275,600
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIV): ............	4b	3
c	Add lines 4a and 4b.......................			4c	3
5	Total expenses. Add lines 3 and 4c. (This should equal Form 990, Part I, line 18.) ......			5	107,275,603

Part XIV

Supplemental Information

Complete this part to provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X; Part XI, line 8; Part XII, lines 2d and 4b; and Part XIII, lines 2d and 4b. Also complete this part to provide any additional information.

Identifier	Return Reference	Explanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:	PART V, LINE 4:	AT DECEMBER 31, 2010, TEMPORARILY RESTRICTED NET ASSETS WERE AS FOLLOWS: BUILDING FUNDS $ 7,425,800 SPECIFIC PURPOSE FUNDS 7,379,000 HOSPITAL PROGRAMS 9,096,700 TOTAL $ 23,901,500 NET ASSETS DESIGNATED AS A BUILDING FUNDS ARE RESTRICTED FOR THE PURPOSE OF CAPITAL ADDITIONS. NET ASSETS DESIGNATED AS SPECIFIC-PURPOSE FUNDS ARE DESIGNATED FOR THE OPERATIONAL SUPPORT OF HOSPITAL-SPONSORED PROGRAMS, INCLUDING COMMUNITY OUTREACH, BEREAVEMENT, AND PALLIATIVE EDUCATION. DURING 2010, NET ASSETS WERE RELEASED FROM DONOR RESTRICTIONS BY INCURRING EXPENSES SATISFYING THE FOLLOWING: MEDIA ADVERTISING $ 1,217,400 PALLIATIVE CARE INSITUTE PROGRAMS 41,300 HOME HEALTH AND HOSPICE PROGRAMS 120,000 WOUND CLINIC 200,000 PASTORAL CARE 80,000 MISCELLANEOUS PROGRAM EXPENSES 240,900 TOTAL $ 1,899,600 PERMANENTLY RESTRICTED NET ASSETS AT DECEMBER 31, 2010, ARE RESTRICTED TO THE FOLLOWING: INVESTMENTS HELD IN PERPETUITY - THE INCOME TO WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES $ 850,000 BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND, INC. 982,900 TOTAL $ 1,832,900 PERMANENTLY RESTRICTED NET ASSETS ARE ENDOWMENT INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME OF WHICH IS EXPENDABLE TO SUPPORT HEALTH SERVICES AS IS REPORTED AS NONOPERATING GAINS IN THE STATEMENT OF OPERATIONS. THE BOARD OF DIRECTORS HAS DETERMINED THAT DONOR-RESTRICTED ENDOWMENT FUNDS WILL BE GOVERNED BY SPECIFIC POLICIES WITH THE OBJECTIVE THAT THE ORIGINAL GIFT SHALL BE PROTECTED IN PERPETUITY AS THE ENDOWED CORPUS AND DISTRIBUTIONS WILL NOT BE MADE IF THEY WILL BRING THE VALUE BELOW THAT THRESHOLD. POLICIES HAVE BEEN DEVELOPED REGARDING THE EXPENDITURE OF FUNDS IN ACCORDANCE WITH DONOR-IMPOSED RESTRICTIONS.

Schedule D (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" to Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

CALVARY HOSPITAL INC

Employer identification number

13-1740274

Part I

Charity Care and Certain Other Community Benefits at Cost

Yes

Does the organization have a charity care policy? If "No," skip to question 6a...........

Yes

If "Yes," is it a written policy? .......................

If the organization has multiple hospitals, indicate which of the following best describes application of the charity care policy to the various hospitals.

Applied uniformly to all hospitals Applied uniformly to most hospitals Generally tailored to individual hospitals

Answer the following based on the charity care eligibility criteria that applies to the largest number of the organization's patients.

Does the organization use Federal Poverty Guidelines (FPG) to determine eligibility for providing free care to low

income individuals? If "Yes," indicate which of the following is the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other

Does the organization use FPG to determine eligibility for providing discounted care to low income individuals? If

"Yes," indicate which of the following is the family income limit for eligibility for discounted care: .....

Yes

200% 250% 300% 350% 400% Other

If the organization does not use FPG to determine eligibility, describe in Part VI the income based criteria for determining eligibility for free or discounted care. Include in the description whether the organization uses an asset test or other threshold, regardless of income, to determine eligibility for free or discounted care.

Does the organization's policy provide free or discounted care to the "medically indigent"? ......

Yes

Does the organization budget amounts for free or discounted care provided under its charity care policy? ...

Yes

If "Yes," did the organization's charity care expenses exceed the budgeted amount?.........

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discounted
care to a patient who was eligibile for free or discounted care?...............

Does the organization prepare an annual community benefit report?.............

Yes

If "Yes," does the organization make it available to the public? ..............

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Charity Care and Certain Other Community Benefits at Cost

	(c) Total community benefit expense	(e) Net community benefit expense	(f) Percent of total expense
a Charity care at cost (from Worksheets 1 and 2) ..	117,100	117,100	0.110 %
b Unreimbursed Medicaid (from Worksheet 3, column a) .	821,526	821,526	0.780 %
c Unreimbursed costs—other means-tested government programs (from Worksheet 3, column b) ....
dTotal Charity Care and Means-Tested Government Programs .....	938,626	938,626	0.890 %
Other Benefits e Community health improvement services and community benefit operations (from (Worksheet 4) ....
f Health professions education (from Worksheet 5) ..
g Subsidized health services (from Worksheet 6) ..
h Research (from Worksheet 7)
i Cash and in-kind contributions to community groups (from Worksheet 8) ..
jTotal Other Benefits ...
kTotal. Add lines 7d and 7j. ..	938,626	938,626	0.890 %

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2010

Schedule H (Form 990) 2010

Page 2

Part II

Community Building Activities Complete this table if the organization conducted any community building activities.

		(a) Number of activities or programs (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support	16	228,979	0	228,979	0.220 %
4	Environmental improvements
5	Leadership development and training for community members	1	2,000		2,000	0 %
6	Coalition building
7	Community health improvement advocacy	1	5,000		5,000	0 %
8	Workforce development
9	Other	3	65,628		65,628	0.060 %
10	Total	21	301,607		301,607	0.280 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Does the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense (at cost).....

2,160,800

Enter the estimated amount of the organization's bad debt expense (at cost) attributable to patients eligible under the organization's charity care policy ..

Provide in Part VI the text of the footnote to the organization's financial statements that describes bad debt expense. In addition, describe the costing methodology used in determining the amounts reported on lines 2 and 3, and rationale for including a portion of bad debt amounts as community benefit.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

41,650,838

Enter Medicare allowable costs of care relating to payments on line 5.....

43,843,844

Subtract line 6 from line 5. This is the surplus or (shortfall)........

-2,193,006

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.
Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.
Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Does the organization have a written debt collection policy? ...............

Yes

If "Yes," does the organization's collection policy contain provisions on the collection practices to be followed for patients who are known to qualify for charity care or financial assistance? Describe in Part VI......

Yes

Part IV

Management Companies and Joint Ventures

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership%	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2010

Page 3

Part VFacility Information

Section A. Hospital Facilities (list in order of size, measured by total revenue per facility, from largest to smallest) How many hospital facilities did the organization operate during the tax year?2 Name and address		Other (Describe)
1	CALVARY HOSPITAL INC 1740 EASTCHESTER ROAD BRONX,NY10461	X	X	X
2	CALVARY HOSPITAL INC (BROOKLYN CAMPUS) 150 55TH STREET BROOKLYN,NY11220	X	X	X

Schedule H (Form 990) 2010

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices.

(Complete a separate Section B for each of the hospital facilities listed in Part V, Section A)

Name of Hospital Facility:NA

Line Number of Hospital Facility (from Schedule H, Part V, Section A):1

				Yes	No
Community Health Needs Assessment (Lines 1 through 7 are optional for 2010)
1	During the tax year or any prior tax year, did the hospital facility conduct a community health needs assessment (“Needs Assessment”)? If “No,” skip to question 8. .....................		1
	If “Yes,” indicate what the Needs Assessment describes (check all that apply):
	a	A definition of the community served by the hospital facility
	b	Demographics of the community
	c	Existing health care facilities and resources within the community that are available to respond to the health needs of the community
	d	How data was obtained
	e	The health needs of the community
	f	Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups
	g	The process for identifying and prioritizing community health needs and services to meet those needs
	h	The process for consulting with persons representing the community’s interests
	i	Information gaps that limit the hospital facility’s ability to assess all of the community’s health needs
	j	Other (describe in Part VI)
2	Indicate the tax year the hospital facility last conducted a Needs Assessment: 20
3	In conducting its most recent Needs Assessment, did the hospital facility take into account input from persons who represent the community served by the hospital facility? If “Yes,” describe in Part VI how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted.		3
4	Was the hospital facility’s Needs Assessment conducted with one or more other hospital facilities? If “Yes,” list the other hospital facilities in Part VI............................		4
5	Did the hospital facility make its Needs Assessment widely available to the public? ...........		5
	If “Yes,” indicate how the Needs Assessment was made widely available (check all that apply):
	a	Hospital facility’s website
	b	Available upon request from the hospital facility
	c	Other (describe in Part VI)
6	If the hospital facility addressed needs identified in its most recently conducted Needs Assessment, indicate how (check all that apply):
	a	Adoption of an implementation strategy to address the health needs of the hospital facility’s community
	b	Execution of the implementation strategy
	c	Development of a community benefit plan for the facility
	d	Participation in community-wide community benefit plan
	e	Inclusion of a community benefit section in operational plans
	f	Adoption of a budget for provision of services that address the needs identified in the CHNA
	g	Prioritization of health needs in the community
	h	Prioritization of services that the hospital facility will undertake to meet health needs in its community
	i	Other (describe in Part VI)
7	Did the hospital facility address all of the needs identified in its most recently conducted Needs Assessment? If “No,” explain in Part VI which needs it has not addressed together with the reasons why it has not addressed such needs.		7
Financial Assistance Policy
	Did the hospital facility have in place during the tax year a written financial assistance policy that:
8	Explains eligibility criteria for financial assistance, and whether such assistance includes free or discounted care?		8		No
9	Used federal poverty guidelines (FPG) to determine eligibility for providing free care to low incomeindividuals?..		9		No
	If “Yes,” indicate the FPG family income limit for eligibility for free care: %

Schedule H (Form 990) 2010

Page 5

Part VFacility Information (continued)

				Yes	No
10	Used FPG to determine eligibility for providing discounted care to low income individuals?.........		10		No
	If “Yes,” indicate the FPG family income limit for eligibility for discounted care: %
11	Explained the basis for calculating amounts charged to patients?.................		11		No
	If “Yes,” indicate the factors used in determining such amounts (check all that apply):
	a	Income level
	b	Asset level
	c	Medical indigency
	d	Insurance status
	e	Uninsured discount
	f	Medicaid/Medicare
	g	State regulation
	h	Other (describe in Part VI)
12	Explained the method for applying for financial assistance?...................		12		No
13	Included measures to publicize the policy within the community served by the hospital facility?.......		13		No
	If “Yes,” indicate how the hospital facility publicized the policy (check all that apply):
	a	The policy was posted at all times on the hospital facility’s web site
	b	The policy was attached to all billing invoices
	c	The policy was posted in the hospital facility’s emergency rooms or waiting rooms
	d	The policy was posted in the hospital facility’s admissions offices
	e	The policy was provided, in writing, to patients upon admission to the hospital facility
	f	The policy was available upon request
	g	Other (describe in Part VI)
Billing and Collections
14	Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy that explained actions the hospital facility may take upon non-payment?........		14		No
15	Check all of the following collection actions against a patient that were permitted under the hospital facility's policies at any time during the tax year:
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments or arrests
	e	Other (describe in Part VI)
16	Did the hospital facility engage in or authorize a third party to engage in any of the following collection actions during the tax year?...................................		16		No
	If “Yes,” check all collection actions in which the hospital facility or a third party engaged (check all that apply):
	a	Reporting to credit agency
	b	Lawsuits
	c	Liens on residences
	d	Body attachments
	e	Other (describe in Part VI)
17	Indicate which actions the hospital facility took before initiating any of the collection actions checked in question 16 (check all that apply):
	a	Notified patients of the financial assistance policy upon admission
	b	Notified patients of the financial assistance policy prior to discharge
	c	Notified patients of the financial assistance policy in communications with the patients regarding the patients’ bills
	d	Documented its determination of whether a patient who applied for financial assistance under the financial assistance policy qualified for financial assistance
	e	Other (describe in Part VI)

Schedule H (Form 990) 2010

Page 6

Part VFacility Information (continued)

Policy Relating to Emergency Medical Care
				Yes	No
18	Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that requires the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..........		18		No
	If “No,” indicate the reasons why (check all that apply):
	a	The hospital facility did not provide care for any emergency medical conditions
	b	The hospital facility did not have a policy relating to emergency medical care
	c	The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Part VI)
	d	Other (describe in Part VI)
Charges for Medical Care
19	Indicate how the hospital facility determined the amounts generally billed to individuals who had insurance covering emergency or other medically necessary care (check all that apply):
	a	The hospital facility used the lowest negotiated commercial insurance rate for those services at the hospital facility
	b	The hospital facility used the average of the three lowest negotiated commercial insurance rates for those services at the hospital facility
	c	The hospital facility used the Medicare rate for those services
	d	Other (describe in Part VI)
20	Did the hospital facility charge any of its patients who were eligible for assistance under the hospital facility’s financial assistance policy, and to whom the hospital facility provided emergency or other medically necessary services, more than the amounts generally billed to individuals who had insurance covering such care?.........		20		No
	If “Yes,” explain in Part VI.
21	Did the hospital facility charge any of its patients an amount equal to the gross charge for services provided to that patient?...................................		21		No
	If “Yes,” explain in Part VI.

Schedule H (Form 990) 2010

Page 7

Part VFacility Information (continued)

Section C. Other Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, measured by total revenue per facility, from largest to smallest) How many non-hospital facilities did the organization operate during the tax year?
Name and address		Type of Facility (Describe)
1
2
3
4
5
6
7
8
9
10

Schedule H (Form 990) 2010

Page 8

Part VI

Supplemental Information

Complete this part to provide the following information.

1	Required descriptions. Provide the description required for Part I, lines 3c, 6a, and 7; Part II; Part III, lines 4, 8, and 9b; and Part V, Section B, lines 1j, 2, 4c, 6i, 7, 11i, 13i, 17l, 18l, 19e, 21d, 25, and 26.
2	Community health needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any community health needs assessments reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Identifier	ReturnReference	Explanation
		PART I, LINE 3C: CALVARY HOSPITAL, INC. USES THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE TO LOW-INCOME PATIENTS.
		PART I, LINE 6A: CALVARY HOSPITAL, INC. IS REQUIRED TO PREPARE AN ANNUAL COMMUNITY SERVICE PLAN (CSP) A.K.A., THE COMPREHENSIVE COMMUNITY SERVICE PLAN FOR THE NYS DEPARTMENT OF HEALTH. THIS REPORT IS FILED WITH THE NYS DOH. THE COMMUNITY SERVICE PLAN IS AVAILABLE ON THE ORGANIZATION'S WEB SITE (WWW.CALVARYHOSPITAL.ORG). ADDITIONALLY, CALVARY POSTS INFORMATION REGARDING FINANCIAL ASSISTANCE PROGRAMS AND HAS A CALENDAR ON PROGRAMMATIC INFORMATION AS IT BECOMES AVAILABLE REGARDING BEREAVEMENT GROUPS AND SUPPORT NETWORKS ON THE ORGANIZATION'S WEB SITE.
		PART I, LINE 7: CALVARY HOSPITAL, INC. HAS UTILIZED NET REALIZABLE VALUE OF THE SERVICES RENDERED FOR THE CHARITY CARE AMOUNT LISTED ON PART I LINE 7. CALVARY UTILIZED THE AMOUNT REPORTED IN ITS COST REPORT PREPARED FOR THE NYS DOH.
		PART I, LINE 7G: CALVARY HOSPITAL, INC. HAS INCLUDED CHARITY CARE SERVICES IN THE AMOUNT OF $117,100 ON THE FORM 990, PART VIII, LINE 2G. THIS AMOUNT IS EXCLUDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN SCHEDULE H, PART I, LINE 7(F) AS PER THE INSTRUCTIONS.CALVARY HOSPITAL, INC. IS A NOT-FOR PROFIT SPECIALTY HOSPITAL THAT PROVIDES SERVICES FOR THE CARE OF TERMINALLY ILL CANCER PATIENTS. CALVARY HOSPITAL, INC. IS OPERATED IN CONNECTION WITH THE ROMAN CATHOLIC ARCHDIOCESE OF NEW YORK.THE MISSION OF CALVARY HOSPITAL, INC. IS AS FOLLOWS:FROM ITS INCEPTION IN 1899, CALVARY HOSPITAL HAS BEEN FAITHFULLY DEVOTED TO PROVIDING PALLIATIVE CARE TO ADULT PATIENTS IN THE ADVANCED STAGES OF CANCER, ADDRESSING THE SYMPTOMS OF THE DISEASE, NOT ITS CURE. A VOLUNTARY, NOT-FOR-PROFIT HOSPITAL, OPERATED IN CONNECTION WITH THE ARCHDIOCESE OF NEW YORK, CALVARY CONTINUES TO EMBODY THIS TRADITION OF CARING THROUGH THE SERVICES AND PROGRAMS OFFERED BY AND THROUGH THE DEDICATION AND CONCERN SHOWN BY ITS STAFF MEMBERS.THE HOSPITAL WILL CONTINUE TO BE FAITHFUL TO THIS TRADITION THROUGH A TWOFOLD COMMITMENT. CALVARY WILL STRIVE PRIMARILY TO EXPAND ITS PROGRAMS AND SERVICES TO MEET THE EMERGING PHYSICAL, PSYCHOSOCIAL, AND SPIRITUAL NEEDS OF BOTH PATIENTS AND FAMILIES THROUGH THE PROVISION OF ACUTE INPATIENT, OUTPATIENT, HOME CARE, HOSPICE, AND SATELLITE SERVICES. IN ADDITION, THROUGH THE THE PALLIATIVE CARE INSTITUTE, THE HOSPITAL ENDEAVORS TO TRANSMIT TO OTHER HEALTH CARE PROFESSIONALS, THROUGH RESEARCH AND EDUCATION, THE KNOWLEDGE AND COMPETENCE WHICH IT HAS DEVELOPED IN THE CARE OF THE ADVANCED CANCER PATIENT.THROUGH THIS TWOFOLD COMMITMENT, CALVARY HOSPITAL WILL DEEPEN AND STRENGTHEN THE PHILOSOPY OF COMPASSIONATE CARE WHICH HAS BEEN THE CORNERSTONE OF ITS PROGRAM OF SERVICE, AND WILL OFFER TO THOSE IN OUR EXPANDED COMMUNITY AND OTHERS, A TRADITION OF SUCCESSFUL EXPEDRIENCE IN THE CARE OF THE ADVANCED CANCER PATIENT.CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. WITH 225 BEDS IN THE BRONX AND BROOKLYN AND MORE THAN 1029 EMPLOYEES, CALVARY SERVES MORE THAN 5,500 PATIENTS ANNUALLY. CALVARY PROVIDES PALLIATIVE CARE, WHICH IS THE ACTIVE TREATMENT OF THE SYMPTOMS, NOT THE CURE OF THE DISEASE, IN ORDER TO MAKE OUR PATIENTS AS COMFORTABLE AS POSSIBLE. CALVARY'S PROGRAMS INCLUDE INPATIENT CARE, CASE MANAGEMENT, OUTPATIENT CARE, HOSPICE, HOME CARE AND SUPPORT PROGRAMS FOR FAMILIES AND FRIENDS.AS CALVARY APPROACHES THE FUTURE WITH A SENSE OF HOPE AND PROMISE, CALVARY IS EVER MINDFUL OF THE LEGACY OF OUR FOUNDERS, THE WOMEN OF CALVARY, TO PROVIDE COMPREHENSIVE CARE WHILE RECOGNIZING THE INDIVIDUALITY AND DIGNITY OF EVERY PATIENT. AT THE SAME TIME, CALVARY WILL CONTINUE TO DEVELOP NEW PROGRAMS AND SERVICES TO MEET THE NEEDS OF TODAY'S WORLD.
		PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2160800.
		PART II: CALVARY HOSPITAL MAKES A NUMBER OF DIFFERENT SUPPORT GROUPS AVAILABLE TO THE COMMUNITY. THESE SUPPORT GROUPS ARE ADVERTISED ON CALVARY HOSPITAL'S WEBSITE, WWW.CALVARYHOSPITAL.ORG, ON ITS CALENDAR OF EVENTS. ALL GROUPS ARE FREE AND ARE OPEN TO THE COMMUNITY.CALVARY HOSPITAL PROVIDES BEREAVEMENT SUPPORT FOR ADULTS WHO HAVE LOST LOVED ONES AT CALVARY HOSPITAL OR CALVARY@HOME, AND THOSE FROM THE COMMUNITY AT LARGE WHO HAVE LOST SOMEONE BECAUSE OF ILLNESS, ACCIDENTS, VIOLENCE, OR ANY OTHER CAUSE. GROUPS ARE OFFERED IN THE BRONX AND BROOKLYN.THE HOSPITAL OFFERS AGE-APPROPRIATE SUPPORT GROUPS FOR CHILDREN, AGES 6 THROUGH 11, AND FOR ADOLESCENTS, AGES 12 TO 18.CALVARY IN TOUCH, A BI-MONTHLY NEWSLETTER ABOUT BEREAVEMENT ISSUES IS AVAILABLE THROUGH THE HOSPITAL'S WELBSITE.THESE COMMUNITY SUPPORT GROUPS INCLUDE BUT ARE NOT LIMITED TO:- SUPPORT GROUPS FOR BEREAVED PARENTS- PRECIOUS MOMENTS SUPPORT GROUP FOR CHILDREN AGES 6 TO 11- TEEN BEREAVEMENT GROUP- DEATH OF A SPOUSE BEREAVEMENT GROUP- DEATH OF A PARENT BEREAVEMENT GROUP- CAMP COURAGEOUS DAY CAMP FOR BEREAVED CHILDRENGROUPS ARE OPEN TO ALL, ARE FREE OF CHARGE, AND ARE LED BY CALVARY HOSPITAL STAFF. REGISTRATION IN ADVANCE OF PARTICIPATION IS REQUIRED.CALVARY HOSPITAL ALSO MAKES AVAILABLE A NUMBER OF DIFFERENT WELLNESS ACTIVITIES TO THE COMMUNITY. THESE WELLNESS ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO YOGA CLASSES AND RECREATIONAL THERAPY.CALVARY HOSPITAL'S THERAPEUTIC RECREATION AND MUSIC THERAPY PROGRAMS WERE CREATED TO GIVE PATIENTS A SENSE OF ACCOMPLISMENT AND TO RELIEVE THE SUFFERING OF OUR OUR PATIENTS AND THEIR FAMILIES. THERAPEUTIC RECREATION ACTIVITIES INCLUDE DRAWING, SCULPTURE, AND CERAMICS PROJECTS; HORTICULTURE; A GAMES AND DISCUSSION HOUR; AND HOLIDAY PARTIES. MUSIC THERAPY OFTEN HELPS SOOTHE PATIENTS AND HELPS THEM FOCUS ON LIFE.OUR BOARD CERTIFIED MUSIC THERAPISTS USE MUSIC THERAPY INTERVENTIONS TO SOOTHE PATIENTS, RELIEVE ANXIETY, REMINISCE, AND EASE PAIN AND SUFFERING. MUSIC THERAPY INTERVENTIONS MAY ALSO PROVIDE RELEASE IN THE LAST HOURS OR MOMENTS OF LIFE. PATIENTS RECEIVING MUSIC THERAPY SOMETIMES WRITE SONGS ASSISTED BY THE MUSIC THERAPISTS TO LEAVE FOR LOVED ONES, OR FIND OTHER WAYS TO OPEN THEIR HEARTS THROUGH MUSIC. OUR CLINICIANS REPORT THAT IN SOME CASES, THE ONLY TIME A PATIENT LAUGHS OR SMILES IS DURING A MUSIC THERAPY SESSION. WE ALSO FIND THAT MUSIC THERAPY IS AVAILABLE AT BOTH INPATIENT LOCATIONS AND IS ALSO ONE OF THE SERVICES WE OFFER THROUGH CALVARY@HOME.IN KEEPING WITH OUR MISSION TO SHARE OUR KNOWLEDGE AND EXPERIENCE WITH OTHERS, CALVARY OFFERS INTERNSHIP PROGRAMS IN THE FOLLOWING AREAS: PALLIATIVE CARE AND MUSIC THERAPY, WHICH IS RECOGNIZED AS A NATIONAL CLINICAL TRAINING SITE BY THE AMERICAN MUSIC THERAPY ASSOCIATION.THROUGH ITS EDDIE HIGGINS SCHOLARSHIP PROGRAM, CALVARY HOSPITAL PROVIDES LEADERSHIP DEVELOPMENT AND TRAINING. THE EDDIE HIGGINS SCHOLARSHIP IS NAMED AFTER A CHERISHED MEMBER OF THE CALVARY FAMILY WHO CAME TO THE HOSPITAL AS A YOUNG BOY. EDDIE WAS HOSPITALIZED INTERMITTENTLY FOR 15 YEARS AT CALVARY UNTIL HIS DEATH IN 1982 AT THE AGE OF 29. EDDIE IS REMEMBERED FOR HIS LOVE OF GOD AND HIS REMARKABLE COURAGE DESPITE HIS ILLNESS. CALVARY HAS GIVEN THE ANNUAL SCHOLARSHIP SINCE 1985.CALVARY HOSPITAL IS VERY ACTIVE IN THE COMMUNITY AND PARTICIPATES IN ANNUAL EVENTS SUCH AS THE COMMUNITY COLUMBUS DAY PARADE AND THE ANNUAL ORCHARD BEACH BREAST CANCER WALK.
		PART III, LINE 4: THE CALVARY HOSPITAL, INC. AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE REGARDING BAD DEBT.COSTING METHODOLOGY USED FOR BAD DEBT:THE METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED IN LINE 2 IS BASED ON THE HOSPITAL'S COLLECTION/BAD DEBT WRITE-OFF POLICY WHICH STATES THAT ALL REASONABLE EFFORTS WILL BE MADE TO OBTAIN PAYMENTS AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. COLLECTION EFFORTS ARE MADE ON THE NET REALIZABLE AMOUNT.
		PART III, LINE 8: CALVARY HOSPITAL, INC. HAS REPORTED A SHORTFALL IN PART III SECTION B LINE 7. THE EXPENSES, REVENUES AND SHORTFALL REPORTED IN PART III LINES 5-7 WERE DEVELOPED FROM THE 2010 CALVARY HOSPITAL, INC. COST REPORTS FILED WITH THE NYS DOH AND NATIONAL GOVERNMENT SERVICES (MEDICARE INTERMEDIARY).
		PART III, LINE 9B: CALVARY HOSPITAL, INC.'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE.CALVARY HOSPITAL'S COLLECTION: BAD DEBT WRITE-OFFS POLICY INDICATES THAT ALL REASONABLE EFFORTS WILL BE MADE BY PATIENT ACCOUNTS REPRESENTATIVES TO OBTAIN PAYMENT AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. THE PATIENT ACCOUNTING SYSTEM WILL BEAR ENTRIES OF SUCH ATTEMPTS, INCLUDING THE DATE AND THE REPRESENTATIVE'S INITIALS. ACCOUNTS RESISTING SETTLEMENT MAY BE REFERRED TO A COLLECTION AGENCY.
		PART V, SECTION A: CALVARY HOSPITAL, INC. IS A NOT-FOR-PROFIT SPECIALTY HOSPITAL THAT PROVIDES SERVICES FOR THE CARE OF TERMINALLY ILL CANCER PATIENTS. ARCHCARE, A NOT-FOR-PROFIT CORPORATION, IS THE SOLE CORPORATE MEMBER OF THE HOSPITAL.THE HOSPITAL HAS TWO LOCATIONS, THE MAIN LOCATION IN THE BRONX, NEW YORK, AND THE BRANCH LOCATION IN BROOKLYN, NEW YORK. THE AUDITED FINANCIAL STATEMENTS FOR CALVARY HOSPITAL, INC. CONTAIN THE OPERATIONS OF BOTH LOCATIONS AND ONE TAX RETURN IS FILED.CALVARY HOSPITAL, INC. IS AFILIATED WITH CALVARY HOLDING COMPANY, INC., A NOT-FOR-PROFIT CORPORATION ORGANIZED UNDER SECTION 402 OF THE NOT-FOR-PROFIT CORPORATION LAW OF THE STATE OF NEW YORK. THE COMPANY IS RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE IRC AND ENGAGES IN CHARITABLE, SCIENTIFIC, AND MEDICAL ACTIVITIES TO SUPPORT CALVARY HOSPITAL AND ITS AFFILIATED ORGANIZATIONS. THIS ENTITY RECEIVES A SEPARATE FINANCIAL STATEMENT AND FILES A SEPARATE TAX RETURN.THE CALVARY FUND, INC. WAS INCORPORATED ON JANUARY 7, 1985, AS A NOT-FOR PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW YORK. THE FUND'S PURPOSE IS TO SOLICIT, ACCEPT AND RECEIVE REAL AND PERSONAL PROPERTY AND TO COLLECT INCOME THEREFROM TO BE APPLIED EXCLUSIVELY FOR ANY HEALTH-RELATED CHARITABLE ORGANIZATION OR CORPORATION AFFILIATED WITH THE ROMAN CATHOLIC ARCHDIOCESE OF NEW YORK. HOWEVER, THE CURRENT AND HISTORIC INTENT HAS BEEN TO PROVIDE EXCLUSIVE SUPPORT TO CALVARY HOSPITAL, INC. THIS ENTITY RECEIVES A SEPARATE FINANCIAL STATEMENT AND FILES A SEPARATE TAX RETURN.
		PART VI, LINE 2: CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED ACCUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADULT ADVANCED CANCER PATIENTS IN THE UNITED STATES, LOCATED IN THE BRONX AND BROOKLYN.CALVARY HOSPITAL USES A VARIETY OF METHODS AND SERVICES TO GATHER COMMUNITY INPUT, ASSESS THE NEEDS OF THE COMMUNITY, AND TO ASSURE INPUT IN THE COMMUNITY SERVICE PLAN. SOME OF THESE METHODS ARE:A. COMMUNITY OUTREACH SERVICES -COMMUNITY OUTREACH SERVICES FUNCTIONS AS A LIAISON WITH THE COMMUNITY, REFERRERS, PHYSICIANS, PATIENTS, AND FAMILIES AND FACILITATES ADMISSION TO CALVARY HOSPITAL. THE DEPARTMENT OUTREACHES THROUGH THE TRI-STATE REGION AND EDUCATES THE HEALTH CARE AND PATIENT COMMUNITIES AS TO THE CONTINUUM OF SERVICES CALVARY PROVIDES (INPATIENT, OUTPATIENT, HOME CARE, HOSPICE, NURSING HOME HOSPICE, AND WOUND CARE). THROUGH ON-SITE VISITS, PUBLIC PRESENTATIONS AND PARTICIPATION IN COMMUNITY AND PROVIDER ACTIVITIES, THE OUTREACH STAFF CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY.B. PROFESSIONAL ADVISORY BOARD -THE PROFESSIONAL ADVISORY BOARD WAS ESTABLISHED IN 1992 TO OBTAIN INPUT FROM THE COMMUNITY. THE ADVISORY BOARD MEETS AT LEAST ANNUALLY AND IS COMPRISED OF PHYSICIANS, NURSES, AND SOCIAL WORKERS, REPRESENTING HOSPITALS, AND HOME CARE AGENCIES, AS WELL AS THE COMMUNITY. THIS GROUP HAS CONTRIBUTED A VARIETY OF IDEAS FOR ENHANCING SERVICES TO THE COMMUNITY.C. COMMUNITY PLANNING BOARD -EACH YEAR THE HOSPITAL INVITES THE HEALTH COMMITTEE OF COMMUNITY PLANNING BOARD #11 AND #10 TO VISIT THE HOSPITAL AND MEET WITH SENIOR STAFF.D. OUTREACH REPRESENTATION (OPEN HOUSE) FOR HEALTH CARE PROFESSIONALS -COMMUNITY OUTREACH HOSTS OPEN HOUSES AT BOTH THE BRONX AND BROOKLYN LOCATIONS TO PROVIDE INFORMATION TO AND RECEIVE INFORMATION FROM ITS REFERRERS.CALVARY HOSPITAL, INC. ALSO HAS PUBLIC PARTICIPATION IN THE EXTENDED COMMUNITY THROUGH PARTICIPATION IN:- GREATER NEW YORK HOSPITAL ASSOCIATION- HOSPITAL ASSOCIATION OF NEW YORK STATE- AMERICAN HOSPITAL ASSOCIATION- NEW YORK CITY DEPARTMENT OF HEALTH- NEW YORK STATE DEPARTMENT OF HEALTH- CATHOLIC HEALTHCARE ASSOCIATION- CMSTHROUGH ONGOING PARTICIPATION IN THE GROUPS ABOVE, CALVARY HOSPITAL CONTINUALLY MONITORS THE TRENDS IN THE HEALTHCARE NEEDS OF THE LARGER COMMUNITY. ALTHOUGH THE NATURE OF ITS SERVICES IS LIMITED BY ITS SPECIALIZED MISSION, CALVARY HAS IDENTIFIED A VARIETY OF ACTIVITIES TO PARTICIPATE IN IMPROVING THE HEALTH OF ITS EXTENDED COMMUNITY.
		PART VI, LINE 3: EACH PERSON REQUESTING CALVARY'S SERVICES MUST BE MADE AWARE OF CALVARY'S UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES PROGRAM AS FOLLOWS:1. DISTRIBUTE AN INDIVIDUAL NOTICE TO EACH PERSON WHO IS SEEKING SERVICES ON BEHALF OF HIMSELF OR ANOTHER. THIS NOTICE IS PASSED TO THE INDIVIDUAL USUALLY AT THE POINT OF ADMISSION OR REGISTRATION WHEN FINANCIAL ARRANGEMENTS ARE BEING DISCUSSED. THE "NOTICE OF AVAILABILITY OF UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES" IS UPDATED ANNUALLY.2. POST SIGNS PROVIDED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES CONSPICUOUSLY IN THE ADMITTING OFFICE, BUSINESS OFFICE, CLINICS, HOME HEALTH AGENCY, AND HOSPICE AREAS. THE SIGNS ARE TO BE IN ENGLISH AND SPANISH. ADDITIONALLY, CALVARY HAS ACCESS TO A LANGUAGE TELEPHONE SERVICE THAT ADDS 58 ADDITIONAL LANGUAGES TO ENGLISH AND SPANISH.3. PUBLISH NOTICE OF HILL-BURTON UNCOMPENSATED SERVICES OBLIGATION ANNUALLY IN LOCAL NEWSPAPER IN SERVICE AREA (NEW YORK TIMES LEGAL).
		PART VI, LINE 4: CALVARY HOSPITAL'S MAIN CAMPUS IS LOCATED IN THE BRONX, NY. THE BRONX IS CONSIDERED THE PRIMARY COMMUNITY FOR THE PURPOSES OF PUBLIC HEALTH PLANNING, AND 59% OF ITS EMPLOYEES RESIDE IN THE PRIMARY SERVICE AREA. IN ADDITION, AS A TERTIARY REFERRAL CENTER FOR ADVANCED DISEASE, CALVARY HOSPITAL SERVES THE ENTIRE TRI-STATE REGION. THE SECONDARY SERVICE IS DETERMINED BASED ON CURRENT REFERRAL PATTERNS.THE PRIMARY REFERRAL SOURCES FOR ADMISSIONS CONTINUE TO BE THE ACUTE CARE HOSPITALS. CURRENTLY 76% OF ADMISSIONS ARE REFERRED BY HOSPITALS LOCATED WITHIN THE BOROUGHS OF NEW YORK CITY, ROCKLAND, AND WESTCHESTER COUNTIES, LONG ISLAND, AND THE STATES OF NEW JERSEY AND CONNECTICUT. OTHER REFERRAL SOURCES ARE CALVARY HOSPITAL HOME CARE, HOSPICE, AND OTHER HOME CARE AND HOSPICE AGENCIES. CALVARY OUTPATIENT SERVICES, FAMILIES, PHYSICIANS, NURSING HOMES, AND COMMUNITY AGENCIES.IN 2001, CALVARY EXPANDED ITS SERVICES WITH THE OPENING OF CALVARY HOSPITAL - THE BROOKLYN CAMPUS, AT LUTHERAN MEDICAL CENTER.
REPORTS FILED WITH STATES	PART VI, LINE 7	NY

Schedule H (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990,
Part IV, question 23.
SchJMediumBullet

Attach to Form 990. SchJMediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

CALVARY HOSPITAL INC

Employer identification number

13-1740274

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement orprovision of all the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
officers, directors, trustees, and the CEO/Executive Director, regarding the items checked in line 1a? ....

Yes

Indicate which, if any, of the following the organization uses to establish the compensation of the
organization's CEO/Executive Director. Check all that apply.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ...............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? ........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? ........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3) and 501(c)(4) organizations only must complete lines 5-9.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regs. section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Privacy Act and Paperwork Reduction Act Notice, see the Intructions for Form 990

Cat. No. 50053T

Schedule J (Form 990) 2010

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use Schedule J-1 if additional space needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.

Note. The sum of columns (B)(i)-(iii) must equal the applicable column (D) or column (E) amounts on Form 990, Part VII, line 1a.

(A) Name		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation reported in prior Form 990 or Form 990-EZ
(A) Name		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
(1) JAMES E INTRONE	(i) (ii)	0 651,968	0 30,000	0 113,893	0 0	0 8,935	0 804,796	0 0
(2) MICHAEL J BRESCIA MD	(i) (ii)	388,563 0	20,000 0	56,254 0	16,170 0	7,727 0	488,714 0	0 0
(3) FRANK A CALAMARI	(i) (ii)	435,335 0	30,000 0	403,152 0	25,670 0	9,833 0	903,990 0	0 0
(4) CHRISTOPHER COMFORT MD	(i) (ii)	329,230 0	17,500 0	64,240 0	25,670 0	25,213 0	461,853 0	0 0
(5) RICHARD KUTILEK	(i) (ii)	251,994 0	17,500 0	61,157 0	25,670 0	23,053 0	379,374 0	0 0
(6) FRANK J LOCAPARRA	(i) (ii)	24,876 0	0 0	105,797 0	25,670 0	14,903 0	171,246 0	0 0
(7) ANDREW V GRECO	(i) (ii)	239,600 0	0 0	13,261 0	0 0	23,438 0	276,299 0	0 0
(8) SALLY UMBRO RN	(i) (ii)	210,024 0	0 0	4,091 0	23,677 0	16,348 0	254,140 0	0 0
(9) ANTHONY TARANTO	(i) (ii)	161,542 0	0 0	8,626 0	20,771 0	7,726 0	198,665 0	0 0
(10) NANCY D'AGOSTINO RN	(i) (ii)	187,830 0	0 0	3,665 0	22,270 0	24,253 0	238,018 0	0 0
(11) ROBERT BRESCIA MD	(i) (ii)	301,957 0	17,500 0	17,929 0	25,670 0	7,832 0	370,888 0	0 0
(12) DEVMANI JAITLY MD	(i) (ii)	457,276 0	0 0	5,941 0	25,670 0	23,213 0	512,100 0	0 0
(13) GAIL CHRZANOWSKI MD	(i) (ii)	260,172 0	0 0	4,233 0	25,670 0	15,699 0	305,774 0	0 0
(14) OSCAR ALVAREZ PHD	(i) (ii)	237,187 0	0 0	4,506 0	25,463 0	23,213 0	290,369 0	0 0
(15) SREENIVASA PATIBANDLA MD	(i) (ii)	332,428 0	0 0	3,058 0	25,670 0	0 0	361,156 0	0 0

Schedule J (Form 990) 2010

Page 3

Part III

Supplemental Information

Complete this part to provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 4c, 5a, 5b, 6a, 6b, 7, and 8. Also complete this part for any additional information.

Identifier	Return Reference	Explanation
	PART I, LINE 1A	EFFECTIVE JUNE 1, 1998, THE HOSPITAL ESTABLISHED THE CALVARY HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO PROVIDE PENSION BENEFITS FOR WAGES EARNED BY CERTAIN PHYSICIANS AND SENIOR EXECUTIVE STAFF WITH COMPENSATION IN EXCESS OF THE IRS LIMITS AND ALSO ESTABLISHED THE CALVARY HOSPITAL KEY EMPLOYEE SHARE OPTION PLAN (KEYSOP) TO PROVIDE ADDITIONAL AND ALTERNATIVE FORMS OF COMPENSATION TO KEY EMPLOYEES. PRIOR TO 2002, THE HOSPITAL UTILIZED THE KEYSOP TO FUND THE SERP. AS A RESULT OF THE IRS 457 REGULATIONS WHICH WERE ISSUED DURING 2002, THE UTILIZATION OF THE KEYSOP TO FUND THE SERP BECAME UNFEASIBLE. AFTER CONSIDERATION OF VARIOUS REPLACEMENT OPTIONS, IN 2003, CALVARY HOSPITAL CHOSE THE TAX GROSS-UP OPTION, WHEREBY, INDIVIDUAL PARTICIPANTS' DEFERRALS WOULD BE GROSSED-UP TO DUPLICATE THE BENEFITS HE WOULD RECEIVE IN A TAX-DEFERRED ARRANGEMENT AND PAID THEM OUT DIRECTLY TO THE PARTICIPANTS. THE FOLLOWING EXECUTIVES RECEIVED TAX GROSS-UP PAYMENTS IN 2010 IN ORDER TO DUPLICATE A TAX DEFERRED VEHICLE: (THE AMOUNTS WERE CALCULATED BY DELOITTE CONSULTING LLP UTILIZING EXPECTED TAX RATES TO CALCULATE THE NET AMOUNTS.) THE FOLLOWING TAX EXECUTIVES ALSO RECEIVED KEYSOP DIVIDENDS AS TAX GROSS-UP PAYMENTS IN 2010: - FRANK A. CALAMARI - RICHARD KUTILEK THE ORGANIZATION PROVIDED SOCIAL CLUB DUES IN 2010 FOR FRANK CALAMARI AND THE DUES WERE INCLUDED AS TAXABLE COMPENSATION.
	PART I, LINE 4B	THE FOLLOWING CALVARY HOSPITAL OFFICERS PARTICPATE IN A NOW-DEFUNCT SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: FRANK CALAMARI, MICHAEL BRESCIA, FRANK LOCAPARRA, AND RICHARD KUTILEK.

Schedule J (Form 990) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.

OMB No. 1545-0047

2010

Open to Public
Inspection

Name of the organization

CALVARY HOSPITAL INC

Employer identification number

13-1740274

Identifier	Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6		.THE SOLE MEMBER OF CALVARY HOSPITAL IS ARCHCARE
FORM 990, PART VI, SECTION A, LINE 7A		THE CALVARY HOSPITAL BYLAWS RESERVE CERTAIN RIGHTS TO ARCHCARE AS THE SOLE MEMBER OF THE HOSPITAL. THESE RIGHTS ARE ENUMERATED IN ARTICLE IV AND INCLUDE THE RIGHT TO AMEND THE HOSPITAL'S BYLAWS AND ORGANIZING DOCUMENTS, APPOINT AND REMOVE BOARD MEMBERS AND APPROVE CERTAIN DECISIONS OF THE HOSPITAL'S BOARD OF DIRECTORS, INCLUDING BUT NOT LIMITED TO, THE ADOPTION OF A STRATEGIC PLAN, ACQUISITION OF ANOTHER ORGANIZATION, REAL ESTATE TRANSACTIONS EXCEEDING A CERTAIN DOLLAR THRESHOLD, ADOPTION OF CRITERIA FOR MANAGED CARE CONTRACTING, AND ADOPTION OF SYSTEM-WIDE MEASURES.
FORM 990, PART VI, SECTION B, LINE 11		THE FORM 990 WAS PRESENTED AND DRAFTS WERE MADE AVAILABLE TO THE BOARD OF DIRECTORS ON 10/05/2011. A COPY OF THE FORM 990 WAS PROVIDED TO EACH MEMBER OF THE CALVARY HOSPITAL BOARD OF DIRECTORS PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE IN ELECTRONIC FORMAT.
	FORM 990, PART VI, SECTION B, LINE 12C	EACH OFFICER, DIRECTOR, TRUSTEE AND KEY EMPLOYEE IS REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THAT ARISE BY VIRTUE OF THEIR EMPLOYMENT AND POSITION WITH CALVARY HOSPITAL OR CALVARY FUND. CALVARY MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL QUESTIONNAIRE SUBMITTED TO THESE INDIVIDUALS. POTENTIAL CONFLICTS ARE INVESTIGATED IMMEDIATELY AND, IF ANY ARE UNCOVERED, THERE ARE POLICIES IN PLACE TO ENSURE THAT THOSE INDIVIDUALS RECUSE THEMSELVES FROM PARTICIPATING IN ANY DECISIONMAKING RELATED TO SUCH CONFLICT.
	FORM 990, PART VI, SECTION B, LINE 15	CALVARY HOSPITAL, INC UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS TO ITS TOP MANAGEMENT OFFICIALS AND ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS REASONABLE. IN RELEVANT PART, THE BOARD OF DIRECTORS HAS ESTABLISHED A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN THE PROPOSED COMPENSATION ARRANGEMENT. THE BOARD OF DIRECTORS USES AN INDEPENDENT COMPENSATION CONSULTANT TO HELP ADVISE ON THE APPROPRIATE COMPENSATION LEVELS FOR THE AFOREMENTIONED INDIVIDUALS. THAT COMPENSATION CONSULTANT WILL USE COMPARABILITY OR BENCHMARKLNG DATA (BASED ON INDUSTRY SURVEYS) THAT DOCUMENTS THE COMPENSATION OF PERSONS HOLDING SIMILAR PERSONS IN SIMILAR ORGANIZATIONS. ONCE THE COMPENSATION CONSULTANT HAS MADE ITS RECOMMENDATIONS, THE CALVARY COMPENSATION COMMITTEE MUST APPROVE THE COMPENSATION, WITHOUT INPUT OR VOTING PARTICIPATION BY THE PERSON WHOSE COMPENSATION IS BEING APPROVED OR BY ANY OTHER INDIVIDUAL WITH A CONFLICT OF INTEREST THE FINAL DETERMINATION IS THEN DOCUMENTED IN COMMITTEE MINUTES THOSE MINUTES WILL CONTAIN THE TERMS OF THE PROPOSED COMPENSATION, THE DECISIONS OF THOSE INDIVIDUALS WHO VOTED ON THE COMPENSATION, AND THE COMPARABILITY DATA THAT WAS RELIED UPON.
	FORM 990, PART VI, SECTION C, LINE 19	CALVARY HOSPITAL MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC BY RETAINING A COPY AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION.
CHANGES IN NET ASSETS OR FUND BALANCES:	FORM 990, PART XI, LINE 5:	NET UNREALIZED GAINS ON INVESTMENTS: 525,900. PENSION-RELATED ADJUSTMENTS 2,352,000. INTEREST IN NET ASSETS OF CALVARY FUND, INC. 2,699,300. ROUNDING -416. TOTAL TO FORM 990, PART XI, LINE 5: 5,576,784.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2010

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" to Form 990, Part IV, line 33, 34, 35, 36, or 37.
MediumBullet

Attach to Form 990. MediumBullet

See separate instructions.

OMB No. 1545-0047

2010

Open to Public Inspection

Name of the organization

CALVARY HOSPITAL INC

Employer identification number

13-1740274

Part I

Identification of Disregarded Entities (Complete if the organization answered "Yes" on Form 990, Part IV, line 33.)

(a) Name, address, and EIN of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity
(1) CALVARY PALLIATIVE CARE NETWORK LLC 1740 EASTCHESTER ROAD BRONX,NY10461	HEALTHCARE	NY	0	0	N/A
(2) NETWORK INDEPENDENT PRACTICE ASSOCIATION 1740 EASTCHESTER ROAD BRONX,NY10461	HEALTHCARE	NY	0	0	N/A
(3) CALVARY NETWORK MANAGEMENT SERVICES LLC 1740 EASTCHESTER ROAD BRONX,NY10461	MGMT SERVICES	NY	0	0	N/A

Part II

Identification of Related Tax-Exempt Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled organization
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1) CALVARY FUND INC 1740 EASTCHESTER ROAD BRONX,NY10461 13-3259649	FUNDRAISING	NY	501(C)(3)	LINE 11A, I	N/A		No
(2) CALVARY HOLDING COMPANY 1740 EASTCHESTER ROAD BRONX,NY10461 06-1531426	HOLDING CO	NY	501(C)(3)	LINE 9	N/A		No
(3) ARCHCARE 155 EAST 56TH STREET FLOOR 2 NEW YORK,NY10022 13-3896624	HEALTHCARE	NY	501(C)(3)	LINE 9	N/A		No

For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2010

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust (Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.)

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership

Schedule R (Form 990) 2010

Page 3

Part V

Transactions With Related Organizations (Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35, 35A, or 36.)

Note. Complete line 1 if any entity is listed in Parts II, III or IV.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest (ii) annuities (iii) royalties (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .

b Gift, grant, or capital contribution to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

c Gift, grant, or capital contribution from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

d Loans or loan guarantees to or for other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

e Loans or loan guarantees by other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

f Sale of assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

g Purchase of assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

h Exchange of assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

i Lease of facilities, equipment, or other assets to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .

j Lease of facilities, equipment, or other assets from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .

k Performance of services or membership or fundraising solicitations for other organization(s) . . . . . . . . . . . . . . . . . . . . . .

l Performance of services or membership or fundraising solicitations by other organization(s) . . . . . . . . . . . . . . . . . . . . . .

Yes

m Sharing of facilities, equipment, mailing lists, or other assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

n Sharing of paid employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

o Reimbursement paid to other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

p Reimbursement paid by other organization for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

q Other transfer of cash or property to other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

r Other transfer of cash or property from other organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of other organization	(b) Transaction type(a-r)	(c) Amount involved	(d) Method of determining amount involved
(1)
(2)
(3)
(4)
(5)
(6)

Schedule R (Form 990) 2010

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership (Complete if the organization answered "Yes" on Form 990, Part IV, line 37.)

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Are all partners section 501(c)(3) organizations?		(e) Share of end-of-year assets	(f) Disproprtionate allocations?		(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	(h) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(e) Share of end-of-year assets	Yes	No	(g) Code VUBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2010

Page 5

Part VII

Supplemental Information

Complete this part to provide additional information for responses to questions on Schedule R (see instructions).

Identifier	Return Reference	Explanation

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: CALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL EXCLUSIVELY PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ....	3	16
4	Number of independent voting members of the governing body (Part VI, line 1b) ....	4	15
5	Total number of individuals employed in calendar year 2010 (Part V, line 2a) ...	5	1,029
6	Total number of volunteers (estimate if necessary) ....	6	170
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ..	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 ..	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	6,352,838	3,916,697
9	Program service revenue (Part VIII, line 2g) .........	93,606,436	96,290,400
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	993,253	4,983,798
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	814,008	898,098
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	101,766,535	106,088,993
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4) ....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	74,039,100	76,677,997
16a	Professional fundraising fees (Part IX, column (A), line 11e)....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24f)....	30,246,900	30,597,606
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	104,286,000	107,275,603
19	Revenue less expenses. Subtract line 18 from line 12......	-2,519,465	-1,186,610
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16)............	98,734,242	102,903,101
21	Total liabilities (Part X, line 26)............	41,688,016	41,466,701
22	Net assets or fund balances. Subtract line 21 from line 20 .....	57,046,226	61,436,400

Sign Here

	Signature of officer	Date

	Type or print name and title.

Paid Preparer's Use Only	Preparer's signature	Date	Check if self- employed	Preparer’s taxpayer identification number (see instructions)
	Firm’s name (or yours if self-employed), address, and ZIP + 4			EIN
				Phone no.


4a	(Code: ) (Expenses $ 78,053,461 including grants of $ ) (Revenue $ 78,340,100 )
	ADVANCED CANCER CARE INPATIENT - CALVARY SERVES ABOUT 12% OF ALL INDIVIDUALS WHO DIE OF CANCER IN THE NEW YORK METROPOLITAN AREA EACH YEAR. PATIENTS ARE REFERRED TO CALVARY FROM EVERY MAJOR HOSPITAL AND MEDICAL CENTER IN NEW YORK CITY. IN 2010, CALVARY CARED FOR MORE THAN 5,300 PATIENTS AND FAMILIES AS INPATIENTS IN OUR 200-BED BRONX CAMPUS AND OUR 25-BED SATELLITE AT LUTHERAN MEDICAL CENTER IN BROOKLYN, AS OUTPATIENTS, THROUGH OUR CENTER FOR CURATIVE AND PALLIATIVE WOUND CARE; AND THROUGH HOSPICE AND HOME CARE. THE AVERAGE LENGTH OF INPATIENT STAY IS 23 DAYS.OUR PATIENTS CAME FROM ACROSS THE NEW YORK TRI-STATE AREA: THE BRONX, QUEENS, MANHATTAN WESTCHESTER, BROOKLYN, AND LONG ISLAND AS WELL AS FROM OTHER LOCATIONS. THEY RANGED IN AGE FROM 20 TO 108, WITH A MAJORITY (82%) OVER AGE THE AGE OF 55. MINORITIES (INCLUDING ASIAN, AFRICAN AMERICAN, AND HISPANIC) MADE UP 46% OF ALL INPATIENTS.

4b	(Code: ) (Expenses $ 13,445,725 including grants of $ ) (Revenue $ 15,654,200 )
	CALVARY HOSPITAL HOSPICE IS A MEDICARE-CERTIFIED HOSPICE PROGRAM, WHICH PROVIDES AN INTERDISCIPLINARY CARE TEAM FOR PATIENTS WITH A TERMINAL PROGNOSIS FOR ALL END-STAGE DISEASES. CALVARY HOSPITAL HOSPICE EMBRACES AND IMPLEMENTS THE BASIC ASSUMPTIONS OF THE HOSPICE CONCEPT, INCLUDING THE FOLLOWING:- HOSPICE PROVIDES PALLIATIVE MEDICAL CARE, TREATING THE PHYSICAL, EMOTIONAL AND SPIRITUAL PAIN OF THE PATIENT AND FAMILY.- HOSPICE TREATS THE PATIENT AND LOVED ONES TOGETHER AS A WHOLE UNIT OF CARE AND OFFERS BEREAVEMENT COUNSELING FOR SURVIVING CAREGIVERS AFTER THE PATIENT'S DEATH.- HOSPICE PATIENTS REMAIN IN THE FAMILIAR, COMFORTING SURROUNDINGS OF HOME, WHETHER IT'S A PRIVATE RESIDENCE, NURSING HOME, HOSPITAL OR AN ASSISTED LIVING FACILITY.- HOSPICE CARE PROVIDES THE FOLLOWING FOUR LEVELS OF CARE: ROUTINE CARE, GENERAL INPATIENT CARE (IF NEEDED), CONTINUOUS CARE (DURING A CRISIS), AND RESPITE CARE.HOSPICE SERVICES- NURSING CARE, AS NECESSARY TO MAINTAIN THE PATIENT AT HOME- 24 HOURS A DAY, 7 DAYS A WEEK ON-CALL NURSE- PHYSICIAN SERVICES- MEDICAL SOCIAL SERVICES- PASTORAL CARE- COUNSELING SERVICES- NUTRITIONAL COUNSELING- SHORT-TERM INPATIENT AND RESPITE CARE- MEDICAL SUPPLIES RELATED TO TERMINALLY ILL- PERSONAL CARE PROVIDED BY CERTIFIED HOME HEALTH AIDES- THERAPIES (E.G., PHYSICAL, OCCUPATIONAL AND SPEECH)- MEDICATIONS FOR SYMPTOM MANAGEMENT AND PAIN CONTROL RELATED TO THETERMINALLY ILL- BEREAVEMENT COUNSELING FOR FAMILY MEMBERS- VOLUNTEER SERVICES

4c	(Code: ) (Expenses $ 2,863,603 including grants of $ ) (Revenue $ 1,539,500 )
	CALVARY'S HOME HEALTH AGENCY SERVES PATIENTS IN THE BRONX, QUEENS, NORTHERN MANHATTAN, AND SOUTHERN WESTCHESTER COUNTY. CALVARY OFFERS HOME CARE TO PATIENTS WITH ALL DIAGNOSES. MOST PATIENTS RETURN TO PRE-ILLNESS FUNCTION AND ARE DISCHARGED TO SELF-CARE WITHIN SIX TO EIGHT WEEKS. ALL OF OUR PATIENTS WHO WE CARE FOR AT HOME GET THE SAME LEVEL OF HIGH-QUALITY AND UNIQUE "CALVARY CARE" AS ALL OF OUR INPATIENTS.THE FOLLOWING SERVICES ARE AVAILABLE TO PATIENTS AND THEIR FAMILIES THROUGH CALVARY'S CERTIFIED HOME HEALTH AGENCY:NURSING SERVICES- OUR COMMUNITY HEALTH NURSES PROVIDE NURSING VISITS TO PATIENTS IN THEIR HOMES.- SPECIALIZED NURSING IS AVAILABLE SUCH AS ENTEROSTOMAL THERAPY.- 24-HOUR TELEPHONE ACCESS TO RN (REGISTERED NURSE) ON-CALL.HOME HEALTH AIDE- PROVIDES ASSISTANCE WITH PERSONAL CARE AND OTHER ACTIVITIES RELATED TO HEALTH CARE.NUTRITIONAL SERVICES- CALVARY'S DIETITIANS ARE AVAILABLE BY PHONE TO HELP IN PLANNINGTHERAPEUTIC NUTRITIONAL MANAGEMENT.THERAPY SERVICES- PHYSICAL THERAPY- OCCUPATIONAL THERAPY- SPEECH THERAPYMEDICAL CARE- CALVARY HOME CARE STAFF WILL WORK CLOSELY WITH THE PATIENT'S OWN PHYSICIAN TO MEET HOME HEALTH NEEDS.- OUR STAFF HAS EXTENSIVE KNOWLEDGE OF PAIN MANAGEMENT.MEDICAL SOCIAL WORKA FULL RANGE OF SOCIAL WORK SERVICES ARE AVAILABLE TO HELP PATIENTS AND FAMILIES COPE WITH THE PROBLEMS OF ILLNESS.- ASSISTANCE IN MEDICAID APPLICATION- ASSISTANCE IN LONG-TERM PLANNINGREFERRING PATIENTS- REFERRALS MAY BE MADE BY PATIENTS, FAMILY MEMBERS, FRIENDS, HOSPITALS, CLINICS, PHYSICIANS, OTHER HEALTH CARE PROFESSIONALS AND COMMUNITY AGENCIES.- TO MAKE A REFERRAL OR TO LEARN MORE ABOUT OUR SERVICES, PLEASE CALL (718) 430-9540.PART OF THE CALVARY CONTINUUM- FACILITATE ADMISSION TO INPATIENT CARE FOR SYMPTOM MANAGEMENT- REFERRAL TO OUTPATIENT AND WOUND CARE CLINICS- PROVIDE INFORMATION ON CALVARY PROGRAMS INCLUDING BEREAVEMENT SUPPORT

	(Code: ) (Expenses $ 2,291,579 including grants of $ ) (Revenue $ 906,403 )
	ADVANCED CANCER CARE OUTPATIENT/OTHER PROGRAMSTHE OUTPATIENT CLINIC PROVIDES CARE THROUGH A MULTIDISCIPLINARY APPROACH, WHICH ENCOMPASSES THE PHYSICAL, EMOTIONAL AND SPIRITUAL NEEDS OF THE PATIENT AND THEIR FAMILY. THE AIM OF THE CLINIC IS TO PROVIDE COMPREHENSIVE HEALTH CARE FOR THE ADVANCED CANCER PATIENT.OUTPATIENT SERVICES1. THE OUTPATIENT CLINIC SPECIALIZES IN PAIN CONTROL, WOUND CARE AND OTHER SERVICES SPECIFIC TO THE ADVANCED CANCER PATIENT.2. EACH PATIENT IS ASSIGNED A PRIMARY PHYSICIAN, REGISTERED NURSE, SOCIAL WORKER AND DIETITIAN.3. THE SERVICES OF PASTORAL CARE, THERAPEUTIC RECREATION, RADIOLOGY, LABORATORY, ENTEROSTOMAL THERAPY AND OTHER SERVICES ARE AVAILABLE IF NEEDED.4. THE OUTPATIENT NURSES PROVIDE ADDITIONAL SUPPORT TO PATIENTS AND FAMILIES THROUGH FREQUENT TELEPHONE CALLS.5. ASSISTANCE WITH TRANSPORTATION ARRANGEMENTS WILL BE PROVIDED IF NEEDED.6. TWENTY-FOUR HOUR TELEPHONE COVERAGE WITH A NURSE AND PHYSICIAN FOR ADVICE OR REASSURANCE IS AVAILABLE.7. CONSULTATION WITH MEDICAL SPECIALISTS CAN BE ARRANGED AND COORDINATED.8. COORDINATION OF SERVICES IS PROVIDED AMONG THE PATIENT'S PHYSICIAN, HOME CARE AGENCY AND OTHER PROVIDERS TO ASSURE APPROPRIATE AND CONTINUAL CARE.

4d	Other program services. (Describe in Schedule O.)
	(Expenses $ 2,291,579 including grants of $ ) (Revenue $ 906,403 )
4e	Total program service expenses$ 96,654,368

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	4,676,424	795,861	545,097

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512, 513, or 514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d		1,370,003
e	Government grants (contributions)1e

f	All other contributions, gifts, grants, and similar amounts not included above1f		2,546,694
g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			3,916,697
			Business Code
2a	MEDICARE REVENUE		900,099	66,725,637	66,725,637
b	MEDICAID REVENUE		900,099	16,792,314	16,792,314
c	PATIENT SERVICE REVENU		900,099	12,772,449	12,772,449
d
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			96,290,400
3	Investment income (including dividends, interest
	and other similar amounts).....			1,040,098			1,040,098
4	Income from investment of tax-exempt bond proceeds..
5	Royalties............
		(i) Real	(ii) Personal
6a	Gross Rents	42,000
b	Less: rental expenses
c	Rental income or (loss)	42,000
d	Net rental income or (loss).......			42,000			42,000
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	13,588,500
b	Less: cost or other basis and sales expenses	9,621,500	23,300
c	Gain or (loss)	3,967,000	-23,300
d	Net gain or (loss)..........			3,943,700			3,943,700
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Miscellaneous Revenue			Business Code
11a	PARKING LOT REVENUE		900,099	249,095			249,095
b	CAFETERIA		900,099	231,497			231,497
c	MISCELLANEOUS INCOME		900,099	225,703			225,703
d	All other revenue ....			149,803	149,803
e	Total. Add lines 11a–11d ......			856,098
12	Total revenue. See Instructions....			106,088,993	96,440,203	0	5,732,093


				(A) Beginning of year		(B) End of year
1	Cashnon-interest-bearing ..........			-821,062	1	-1,791,088
2	Savings and temporary cash investments .......			4,699,285	2	2,900,297
3	Pledges and grants receivable, net .........				3
4	Accounts receivable, net .........			18,641,313	4	19,021,098
5	Receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of
	Schedule L ..........				5
6	Receivables from other disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B). Complete Part II of
	Schedule L ..........				6
7	Notes and loans receivable, net .............				7
8	Inventories for sale or use ..............			30,699	8	192,799
9	Prepaid expenses and deferred charges ............			412,047	9	399,297
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	77,551,200
b	Less: accumulated depreciation. .....	10b	61,177,300	16,980,700	10c	16,373,900
11	Investments—publicly traded securities ..........			21,390,483	11	24,099,496
12	Investments—other securities. See Part IV, line 11 ......				12
13	Investments—program-related. See Part IV, line 11 ..			17,200,200	13	19,899,515
14	Intangible assets .........				14
15	Other assets. See Part IV, line 11 ...........			20,200,577	15	21,807,787
16	Total assets. Add lines 1 through 15 (must equal line 34)...			98,734,242	16	102,903,101
17	Accounts payable and accrued expenses .			15,085,633	17	15,111,098
18	Grants payable ..........				18
19	Deferred revenue ..........				19
20	Tax-exempt bond liabilities ..........				20
21	Escrow or custodial account liability. Complete Part IV of Schedule D..				21
22	Payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........				22
23	Secured mortgages and notes payable to unrelated third parties ..				23
24	Unsecured notes and loans payable to unrelated third parties ....				24
25	Other liabilities. Complete Part X of Schedule D.....			26,602,383	25	26,355,603
26	Total liabilities. Add lines 17 through 25.....			41,688,016	26	41,466,701
	Organizations that follow SFAS 117, check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets .....			34,129,640	27	35,702,000
28	Temporarily restricted net assets .....			21,122,386	28	23,901,500
29	Permanently restricted net assets .....			1,794,200	29	1,832,900
	Organizations that do not follow SFAS 117, check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances .....			57,046,226	33	61,436,400
34	Total liabilities and net assets/fund balances .....			98,734,242	34	102,903,101