TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) MARGARET PASTUSZKO ST 621...................................................................... DIRECTOR, PRES, SYS COO & CSO	1.00 ................. 0.00	X		0	2,064,641	62,296
(2) RICHARD MURPHY...................................................................... PRESIDENT & CEO	35.50 ................. 2.00	X	X	1,897,519	0	75,674
(3) STEPHEN HARVEY START 121...................................................................... TRUSTEE, EVP SYS CHF FIN&CORP SRV	1.00 ................. 0.00	X		0	1,403,564	75,202
(4) ARTHUR KLEIN TERMED 0621...................................................................... DIRECTOR, EVP, PRES HEALTH NETWORK	1.00 ................. 1.00	X		1,889,801	0	39,104
(5) ANTHONY CANCELLIERI...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(6) ANTHONY PONTE...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(7) BUTCH YAMALI...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(8) DAVID BONAGURA...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(9) EDWARD SCOTT...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(10) GEORGE SCHIEREN...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(11) JEFFREY FRISCH...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(12) JOEL SCHNEIDER...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(13) JOSPEPH J FENNESSY...................................................................... CHAIRMAN	1.00 ................. 1.00	X		0	0	0
(14) LOWELL FREY...................................................................... ASSISTANT SECRETARY	1.00 ................. 1.00	X		0	0	0
(15) MARILYN COHEN...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(16) MICHAEL SAPRAICONE...................................................................... DIRECTOR	1.00 ................. 1.00	X		0	0	0
(17) MICHAEL SCHAMROTH...................................................................... PAST CHAIRMAN	1.00 ................. 1.00	X		0	0	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(18) MIHAI DIMANCESCU MD........................................................................ DIRECTOR	1.00 .......................1.00	X			0	0	0
(19) NANCY KOOPERSMITH........................................................................ DIRECTOR	1.00 .......................1.00	X			0	0	0
(20) PETER C BREITSTONE........................................................................ TREASURER	1.00 .......................1.00	X			0	0	0
(21) SALLY VALENTI........................................................................ DIRECTOR	1.00 .......................1.00	X			0	0	0
(22) STEVEN GOLD........................................................................ DIRECTOR	1.00 .......................1.00	X			0	0	0
(23) WAYNE LIPTON........................................................................ DIRECTOR	1.00 .......................1.00	X			0	0	0
(24) ALAN GARELY........................................................................ CLINICAL CHAIR OB/GYN	22.00 .......................15.50		X		1,153,453	0	78,925
(25) MATTHEW RIFKIN........................................................................ PRESIDENT	18.75 .......................18.75		X		0	794,918	67,906
(26) ADHI SHARMA........................................................................ PRESIDENT & CEO	36.50 .......................1.00		X		756,421	0	49,326
(27) WILLIAM ALLISON........................................................................ CHIEF OPERATING OFFICER	36.50 .......................1.00		X		697,860	0	50,685
(28) DINA EL KADY........................................................................ PRESIDENT/DIRECTOR	17.90 .......................19.60		X		0	667,811	45,721
(29) JOHN POHLMAN........................................................................ CHIEF FINANCIAL OFFICER	36.50 .......................1.00		X		586,831	0	69,878
(30) DANIEL MCCALLY........................................................................ VICE PRESIDENT/DIRECTOR	19.60 .......................17.90		X		0	391,030	34,736
(31) SAMUEL SANDOWSKI........................................................................ VP/DIRECTOR	26.60 .......................10.90		X		0	331,394	46,242
(32) STANLEY REDDY........................................................................ DIRECTOR	34.00 .......................1.00		X		0	300,000	0
(33) WILLIAM ULRICH TERMED 0621........................................................................ VP FACILITIES MANAGEMENT	36.50 .......................1.00		X		239,924	0	50,610
(34) JASON FREEMAN........................................................................ DIR OF INTER CARDIO	37.50 .......................0.00			X	1,003,807	0	72,129
(35) LAWRENCE KANNER........................................................................ DIR OF ELECTROPHYSIOLOGY	36.50 .......................1.00			X	966,488	0	72,214
(36) ASIF REHMAN TERMED 6121........................................................................ ASSOC DIR INTER CARDIO	37.50 .......................0.00			X	506,742	0	32,517
(37) JOSEPH CALDERONE........................................................................ VP CORP COMMUNICATIONS	37.50 .......................0.00			X	397,345	0	48,906
(38) MATTHEW RUNYAN........................................................................ VP, CIO	37.50 .......................0.00			X	345,924	0	51,429

(A) Name and business address	(B) Description of services	(C) Compensation
EW HOWELL CO LLC 245 NEWTOWN ROAD PLAINVIEW,NY11803	CONSTRUCTION SERVICES	32,880,740
HUNTER ROBERTS CONSTRUCTION GROUP 55 WATER STREET 51ST FLOOR NEW YORK,NY10041	CONSTRUCTION SERVICES	13,570,013
WHITING-TURNER CONTRACTING COMPANY 300 E JOPPA ROAD BALTIMORE,MD212863048	CONSTRUCTION SERVICES	11,406,970
HELLMUTHOBATA & KASSABAUMPC PO BOX 205182 DALLAS,TX753205182	CONSTRUCTION SERVICES	6,947,087
AXIS CONSTRUCTION CORP 125 LASER COURT HAUPPAUGE,NY11788	CONSTRUCTION SERVICES	5,151,820
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 89

- TIN:

SCHEDULE A
(Form 990)

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.
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Attach to Form 990 or Form 990-EZ.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

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 12, check only one box.)

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

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% 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 33 1/3% 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. See section 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 on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

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

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2021

Page 2

Part II

Support Schedule for Organizations Described in Sections 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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

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

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. 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—2020. If the organization did not check a 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—2021. 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 VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. 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 VI 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) 2021

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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 VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. 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—2020. 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) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2021 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

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, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) 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), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions 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 an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled 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. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't 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 on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't 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) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization SOUTH NASSAU COMMUNITIES HOSPITAL INC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization SOUTH NASSAU COMMUNITIES HOSPITAL INC		Employer identification number 11-1352310

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(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) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization SOUTH NASSAU COMMUNITIES HOSPITAL INC			Employer identification number 11-1352310
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. 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.) $ Use duplicate copies of Part III if additional space is needed.

(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) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

If the organization answered "Yes" on 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" on 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" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

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

Name of the organization

SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

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 in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... SchCMd Bullet

Volunteer hours for political campaign activities. See instructions ..................................................................

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 function 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-.
1
2
3
4
5
6

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

Cat. No. 50084S

Schedule C (Form 990) 2021

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 SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

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 separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2018	(b) 2019	(c) 2020	(d) 2021	(e) Total

2a	Lobbying nontaxable amount

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

c	Total lobbying expenditures

d	Grassroots nontaxable amount

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

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2021

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)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(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? ...................................................................................................................

Yes

231,698

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

231,698

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 carry over 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) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

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

Section 162(e) nondeductible 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

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
PART II-B, LINE 1:	THE HOSPITAL IS A MEMBER OF MULTIPLE HEALTHCARE ASSOCIATIONS WHICH INCLUDE THE AMERICAN HOSPITAL ASSOCIATION, HEALTHCARE ASSOCIATION OF NEW YORK, THE NASSAU SUFFOLK HOSPITAL COUNCIL, AND THE HOME CARE ASSOCIATION OF NEW YORK STATE. THESE ORGANIZATIONS LOBBY ON BEHALF OF THE HEALTHCARE INDUSTRY. THE HOSPITAL ALSO CONTRACTS WITH VARIOUS LOBBYING CONSULTING FIRMS ON HOSPITAL SPECIFIC ISSUES.

Schedule C (Form 990) 2021

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," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

Part I

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

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of 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 can 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" on 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 education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 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 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax 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, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, 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 section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, 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" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, 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 XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, 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)

Revenue included on 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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

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

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

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

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

Using the organization’s acquisition, 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 XIII.

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" on 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


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
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, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

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

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	12,080,544	9,819,471	7,264,102	6,118,501	3,815,354
b	Contributions ...	48,924,107	8,737,658	8,705,608	16,346,591	6,282,696
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	50,206,764	6,476,585	6,150,239	15,200,990	3,979,549
f	Administrative expenses ....
g	End of year balance ......	10,797,887	12,080,544	9,819,471	9,819,471	6,118,501

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

9.500 %

Term endowment SchDMd Bullet

90.500 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

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

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

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	29,635,981		29,635,981
b	Buildings ....	393,241,222	223,882,361	169,358,861
c	Leasehold improvements	10,229,804	9,953,746	276,058
d	Equipment ....	263,876,221	208,291,286	55,584,935
e	Other .....	191,667,173	3,999,024	187,668,149
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				442,523,984

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. 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........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)DUE FROM SUBSIDIARIES				34,220,056
(2)ASSETS WHOSE USE IS LIMITED				151,240,139
(3)INSURANCE CLAIMS RECEIVABLE				4,685,000
(4)OPERATING LEASES				66,823,881
(5)OTHER ASSETS				3,780,548
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				260,749,624

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	106,808,751
2. Liability for uncertain tax positions. In Part XIII, 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 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
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 XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
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 XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
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 XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

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, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

PART V, LINE 4:

TWO FUNDS EXIST AT THE HOSPITAL, THE ANNUAL IMPROVEMENT FUND AND THE SPECIAL PURPOSE FUND. THESE FUNDS ARE RESTRICTED AS TO THEIR PURPOSE OR TIME AS IS STIPULATED BY THE DONOR'S REQUEST. THE MONEY IS KEPT IN SEPARATE INVESTMENT VEHICLES FOR EACH FUND. UNRESTRICTED DONATIONS ARE KEPT IN THESE TEMPORARY FUNDS ALSO. PERMANENTLY RESTRICTED NET ASSETS HAVE BEEN RESTRICTED BY DONORS AND ARE TO BE MAINTAINED BY THE HOSPITAL IN PERPETUITY. THESE ASSETS CONSIST OF INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH MAY BE RESTRICTED FOR SPECIFIC HOSPITAL ACTIVITIES OR MAY BE UNRESTRICTED AS TO USE. IF A DONATION IS MADE FOR A SPECIAL PROGRAM, IT IS PLACED INTO A TEMPORARILY RESTRICTED CATEGORY. WHEN THE EXPENDITURE IS INCURRED TO FULFILL THE REQUIREMENTS OF THIS PROGRAM/DONATION, THE FUNDS ARE TRANSFERRED FROM TEMPORARILY RESTRICTED STATUS AND ARE EXPENDED.

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

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

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization
SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990) 2021

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 GOLF OUTING (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	615,000	615,000
2	Less: Contributions . . . .	441,200	441,200
3	Gross income (line 1 minus line 2) . . . . . .	173,800	173,800

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	134,645	134,645
7	Food and beverages . . .
8	Entertainment . . . .
9	Other direct expenses . . .	221,417	221,417
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		356,062
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		-182,262

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2021

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2021

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" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

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

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

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

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

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

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did 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.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	1	985	1,884,151	523,545	1,360,606	0.240 %
b	Medicaid (from Worksheet 3, column a) . . . . .	1	75,189	100,892,897	66,616,915	34,275,982	5.980 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	2	76,174	102,777,048	67,140,460	35,636,588	6.220 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	190	29,027	2,095,847		2,095,847	0.370 %
f	Health professions education (from Worksheet 5) . . .	3	121	9,149,668	8,237,509	912,159	0.160 %
g	Subsidized health services (from Worksheet 6) . . . .	3	18,597	26,300,762	13,164,933	13,135,829	2.290 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .
j	Total. Other Benefits . .	196	47,745	37,546,277	21,402,442	16,143,835	2.820 %
k	Total. Add lines 7d and 7j .	198	123,919	140,323,325	88,542,902	51,780,423	9.040 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2021

Schedule H (Form 990) 2021

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	243,671	243,671	0.040 %
8	Workforce development
9	Other
10	Total	243,671	243,671	0.040 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

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

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

19,553,451

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

761,858

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

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

171,340,952

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

166,264,298

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

5,076,654

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

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 NEW YORK MEDICAL PARTNERS ACO LLC	ACCOUNTABLE CARE ORGANIZATION	50.000 %	50.000 %
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2021

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	SOUTH NASSAU COMMUNITIES HOSPITAL ONE HEALTHY WAY OCEANSIDE,NY115721551 HTTPS://WWW.SOUTHNASSAU.ORG 2950001H	X	X	X

Schedule H (Form 990) 2021

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

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

	SOUTH NASSAU COMMUNITIES HOSPITAL
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 19

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Yes

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): HTTS://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 19

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): HTTS://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2021

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	SOUTH NASSAU COMMUNITIES HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 100.000000000000%
and FPG family income limit for eligibility for discounted care of 300.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/FINANCIAL-ASSISTANCE-PROGRAM.ASPX

The FAP application form was widely available on a website (list url):

HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/FINANCIAL-ASSISTANCE-PROGRAM.ASPX

A plain language summary of the FAP was widely available on a website (list url):
HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/FINANCIAL-ASSISTANCE-PROGRAM.ASPX

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2021

Page 6

Part VFacility Information (continued)

Billing and Collections

	SOUTH NASSAU COMMUNITIES HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required 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?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2021

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Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	SOUTH NASSAU COMMUNITIES HOSPITAL
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual 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? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2021

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Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
SOUTH NASSAU COMMUNITIES HOSPITAL	PART V, SECTION B, LINE 5: THE HOSPITAL PARTICIPATED IN A SERIES OF COLLARBORATIVE CHNA PLANNING AND IMPLEMENTATION MEETINGS WITH REPRESENTATION AND INPUT FROM PUBLIC HEALTH EXPERTS, FROM LOCAL ACADEMIC PARTNERS, THE NASSAU COUNTY DEPARTMENT OF HEALTH, THE SUFFOLK COUNTY DEPARTMENT OF HEALTH AND HOSPITALS AND MULTIPLE COMMUNITY-BASED ORGANIZATIONS LOCATED THROUGHOUT NASSAU AND SUFFOLK COUNTIES. THE LONG ISLAND HEALTH COLLABORATIVE, CONSISTING OF OVER ONE HUNDRED ENTITIES, DEVELOPED THE HEALTH NEEDS ASSESSMENT AND THEN DISTRIBUTED IT TO THE PUBLIC VIA THE INTERNET, LOCAL COMMUNITY BASED ORGANIZATIONS, THE PARTICIPATING HOSPITALS AND COMMUNITY MAILINGS. THE LONG ISLAND POPULATION HEALTH IMPROVEMENT PROGRAM (LIPHIP) IS A NEW YORK STATE DEPARTMENT OF HEALTH GRANT-FUNDED INITIATIVE; THE LONG ISLAND HEALTH COLLABORATIVE (LIHC) IS A WORKGROUP OF THE LIPHIP. TO CAPTURE THE VALUABLE PERSPECTIVES OF REPRESENTATIVES FROM COMMUNITY-BASED ORGANIZATIONS (CBOS) AND SOCIAL SERVICE AGENCIES ON LONG ISLAND, THE PHIP HELD TWO SUMMIT EVENTS DURING WHICH QUALITATIVE DATA WAS COLLECTED. REPRESENTATIVES FROM A COMPREHENSIVE NETWORK OF ORGANIZATIONS WHO POSSESS UNPARALLELED EXPERIENCE WORKING WITH COMMUNITY MEMBERS THROUGHOUT LONG ISLAND PARTICIPATED DURING THESE EVENTS. SOME EXAMPLES OF PARTICIPATING CBOS ARE LI CARES, MOMMAS HOUSE, CATHOLIC HOME CARE, COORDINATING AGENCY FOR SPANISH AMERICANS, FAMILY & CHILDREN'S ASSOCIATION, LGBT NETWORK, SOCIETY OF ST. VINCENT DE PAUL, AND THE HISPANIC COUNSELING CENTER. A TOTAL OF 45 ORGANIZATIONS FROM NASSAU COUNTY PARTICIPATED IN THE SUMMIT WHICH CONTRIBUTED TO THE DIVERSITY AND BREADTH OF QUALITATIVE DATA COLLECTED AND ANALYZED. A SCRIPT FOR FACILITATORS WAS DEVELOPED AND USED AS THE PRIMARY DATA COLLECTION TOOL, ADAPTED FROM THE NASSAU COUNTY DEPARTMENT OF HEALTH'S KEY INFORMANT SCRIPT. QUESTIONS PERTAINED TO HEALTH PROBLEMS AND CONCERNS, HEALTH DISPARITIES, BARRIERS TO CARE, SERVICES AVAILABLE AND OPPORTUNITIES FOR IMPROVEMENT.FOR A COMPLETE LIST OF GREATER THAN 100 MEMBERS OF THE LONG ISLAND HEALTH COLLABORATIVE PLEASE SEE APPENDIX C OF THE CHNA REPORT, AVAILABLE AT HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX.
SOUTH NASSAU COMMUNITIES HOSPITAL	PART V, SECTION B, LINE 6A: FOR A COMPLETE LIST OF GREATER THAN 100 MEMBERS OF THE LONG ISLAND HEALTH COLLABORATIVE PLEASE SEE APPENDIX C OF THE CHNA REPORT, AVAILABLE AT HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX.
SOUTH NASSAU COMMUNITIES HOSPITAL	PART V, SECTION B, LINE 6B: FOR A COMPLETE LIST OF GREATER THAN 100 MEMBERS OF THE LONG ISLAND HEALTH COLLABORATIVE PLEASE SEE APPENDIX C OF THE CHNA REPORT, AVAILABLE AT HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX.
SOUTH NASSAU COMMUNITIES HOSPITAL	PART V, SECTION B, LINE 7D: MOUNT SINAI SOUTH NASSAU POSTS THE COMMUNITY SERVICE PLAN (CSP)/COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) ON ITS WEBSITE (WWW.SOUTHNASSAU.ORG) AND OFFERS PAPER COPIES TO THE PUBLIC WHEN REQUESTED. OUR COMMUNITY NEWSLETTER, WHICH REACHES OVER 280,000 RESIDENTS, PROVIDES INFORMATION ON HOW TO OBTAIN THE CSP/CHNA, AS DOES THE EMPLOYEE NEWSLETTER. ADDITIONALLY, THE DEPARTMENT OF COMMUNITY EDUCATION BRINGS THE DOCUMENT TO VARIOUS COMMUNITY EVENTS.
SOUTH NASSAU COMMUNITIES HOSPITAL	PART V, SECTION B, LINE 11: DETAILS ON HOW SOUTH NASSAU COMMUNITIES HOSPITAL, INC. IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA ARE IDENTIFIED IN THE HOSPITAL'S COMPREHENSIVE 2019-2021 COMMUNITY SERVICE PLAN (CSP), AVAILABLE ON OUR WEBSITE AT HTTPS://WWW.SOUTHNASSAU.ORG/MAIN/COMMUNITY-SERVICE-PLAN.ASPX. THIS 3-YEAR PLAN EXPLAINS IN DETAIL THE MANY WAYS WE ARE COMMITTED TO THE HEALTH OF THE COMMUNITIES WE SERVE BY OFFERING COMMUNITY PROGRAMS (I.E. 5-WEEK SMOKING CESSATION PROGRAM), LECTURES (I.E. DIABETES PREVENTION, CARDIOVASCULAR HEALTH, FALL PREVENTION) AND FREE HEALTH SCREENINGS (I.E. CHOLESTEROL, BLOOD PRESSURE, PSA).THE CRITERIA UTILIZED TO DETERMINE THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITIES WE SERVE INCLUDED ANALYSIS OF THE LONG ISLAND COMMUNITY HEALTH ASSESSMENT SURVEY, REVIEW OF THE INFORMATION GLEANED FROM THE NASSAU COUNTY CBO SUMMIT, AND REVIEW OF PUBLICLY-AVAILABLE DATA SETS INCLUDING STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS), NEW YORK STATE PREVENTION AGENDA DASHBOARD, COUNTY HEALTH RANKINGS, BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS) AND NEW YORK STATE VITAL STATISTICS. DATA ANALYSIS EFFORTS WERE COORDINATED THROUGH THE POPULATION HEALTH IMPROVEMENT PROGRAM. THE HEALTH CONCERNS WHICH SURFACED AS TOP PRIORITIES WERE: 1) PREVENT CHRONIC DISEASE, AND 2) PROMOTE WELL-BEING AND PREVENT MENTAL AND SUBSTANCE USE DISORDERS.

Schedule H (Form 990) 2021

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Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?11
Name and address		Type of Facility (describe)
1	1 - SNCH - OUTPATIENT BEHAVIORAL HEALTH 2277 GRAND AVE BALDWIN,NY11510	OUTPATIENT
2	2 - SNCH - FAMILY PRACTICE CENTER 196 MERRICK ROAD OCEANSIDE,NY11572	OUTPATIENT
3	3 - SNCH - RADIATION ONCOLOGY THERAPY CNTR ONE SOUTH CENTERAL AVE VALLEY STREAM,NY11580	OUTPATIENT
4	4 - SNCH - OUTPATIENT DIALYSIS CENTER 3618 OCEANSIDE ROAD OCEANSIDE,NY11572	OUTPATIENT
5	5 - SNCH - OUTPATIENT ANNEX 440 MERRICK ROAD OCEANSIDE,NY11572	OUTPATIENT
6	6 - SNCH - SLEEP CENTER 1420 BROADWAY HEWLETT,NY11557	OUTPATIENT
7	7 - SNCH - HOMECARE AGENCY 1000 SOUTH OYSTER BAY RD HICKSVILLE,NY11801	OUTPATIENT
8	8 - SNCH - FAMILY MEDICINE AT LONG BEACH 761 FRANKLIN BLVD LONG BEACH,NY11561	OUTPATIENT
9	9 - SNCH - OFF CAMPUS EMERGENCY DEPARTMENT 325 EAST BAY DRIVE LONG BEACH,NY11561	OUTPATIENT
10	10 - SNCH - MENTAL HEALTH AT HEMPSTEAD 250 FULTON AVE HEMPTEAD,NY11550	OUTPATIENT
11	11 - SNCH - DIABETES EDUCATION CENTER 2277 GRAND AVENUE BALDWIN,NY11510	OUTPATIENT

Schedule H (Form 990) 2021

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs 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.

Form and Line Reference	Explanation
PART I, LINE 6A:	THE HOSPITAL FILED A 2019-2021 COMMUNITY SERVICE PLAN ("CSP"), WHICH INCLUDED A COMMUNITY BENEFIT REPORT, WITH THE NYS DEPARTMENT OF HEALTH ("DOH") ON DECEMBER 19, 2019.
PART I, LINE 7:	THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS FOR LINE 2 AND LINE 3 USES TOTAL GROSS BAD DEBT CHARGES MULTIPLIED BY THE AMOUNT OF THE HOSPITAL'S OVERALL RATIO OF COSTS TO CHARGES (CALCULATED USING THE INSTITUTIONAL COST REPORT).
PART I, LINE 7G:	INCLUDED IN THE TOTAL COMMUNITY BENEFIT EXPENSE ARE LOSSES RELATED TO THE SNCH FAMILY HEALTH CENTER, INPATIENT AND OUTPATIENT RENAL DIALYSIS, AND THE INPATIENT PEDIATRIC PROGRAMS.PART I, LN 7 COL (F):DISTINGUISHING BAD DEBT EXPENSE FROM CHARITY CARE REQUIRES JUDGMENT; TOGETHER, THEY REPRESENT UNCOMPENSATED CARE. THE HOSPITAL'S POLICY REGARDING CHARITY CARE IS TO PROVIDE A SIGNIFICANT AMOUNT OF CARE WITHOUT REGARD TO THE PATIENTS' ABILITY TO PAY FOR SERVICES RENDERED; THIS INCLUDES FREE CARE AND A SLIDING FEE SCALE, BASED ON THE PATIENTS' ABILITY TO PAY WHICH IS DEFINED AS UP TO 300% OF THE POVERTY LEVEL.THE HOSPITAL UTILIZES A CREDIT VERIFICATION FIRM TO ASSIST IN DETERMINING IF UNINSURED PATIENTS MEET THE HOSPITAL'S CHARITY CRITERIA. THIS PROCESS IDENTIFIES UNINSURED PATIENTS THAT WERE UNDER THE POVERTY LEVEL BUT DID NOT APPLY FOR CHARITY CARE.
PART III, LINE 2:	THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS FOR LINE 2 ANDLINE 3 USES TOTAL GROSS BAD DEBT CHARGES MULTIPLIED BY THE AMOUNT OF THE HOSPITAL'S OVERALL RATIO OF COSTS TO CHARGES (CALCULATED USING THE INSTITUTIONAL COST REPORT).
PART III, LINE 3:	THE AMOUNT REPORTED IN PART III LINE 3 WAS RELATED TO THE EMERGENCY ROOM'S BAD DEBT AT COST. THE FIGURE WAS DERIVED USING THE EMERGENCY ROOM'S BAD DEBT GROSS CHARGES AND MULTIPLYING THIS AMOUNT BY THE EMERGENCY'S ROOMS SPECIFIC RCC TO COME UP WITH THE BAD DEBT EXPENSE AT COST FOR THE EMERGENCY ROOM. WE DID NOT INCLUDE ANY AMOUNTS OF BAD DEBT IN PART I LINE 7. WE BELIEVE THE ENTIRE AMOUNT SHOULD BE CONSIDERED CHARITY CARE. EMTALA AND OTHER REGULATIONS REQUIRE THAT THE HOSPITAL PROVIDE EMERGENCY SERVICES TO INDIVIDUALS BEFORE DISCUSSING FINANCIAL INFORMATION.CHARITY CARE IS USUALLY RELATED TO PATIENTS WHO WE DEFINE AS LACKING THEABILITY TO PAY. A HOSPITAL'S INABILITY TO COLLECT FROM A PATIENT WHO HAS THE MEANS TO PAY IS BAD DEBT EXPENSE.OUR REGISTRATION DEPARTMENT DOES NOT HAVE THE ABILITY TO DETERMINE THEEMERGENCY ROOM PATIENT FINANCIAL STATUS BEFORE CARE IS DELIVERED AND IN MANY CASES, THE INFORMATION PROVIDED BY THE PATIENTS IS INACCURATE. SINCE WE RENDERED CARE WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY WE BELIEVE THAT THESE PATIENTS ARE SIMILAR TO CHARITY CARE AND NOT BAD DEBT.
PART III, LINE 4:	BAD DEBT EXPENSE IS DESCRIBED IN PAGE 18 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8:	SOUTH NASSAU COMMUNITIES HOSPITAL CONSIDERS THE MEDICARE SHORTFALL AS A BENEFIT PROVIDED TO THE COMMUNITY. IF IT WAS ALLOWED TO BE INCLUDED IN THE SHORTFALL, THE COMMUNITY BENEFIT PERCENTAGE WOULD BE 9.55%. THE AMOUNT REPORTED IN PART III, LINE 6 WAS RELATED TO MEDICARE'S ALLOWABLE COSTS. THE FIGURE WAS DERIVED USING THE MEDICARE CHARGES AS REPORTED ON THE ANNUAL INSTITUTIONAL COST REPORT AND MULTIPLYING THAT AMOUNT BY THE RATIO SOUTH NASSAU COMMUNITIES HOSPITAL, INC. 11-1352310 OF COST TO CHARGE (RCC).
PART III, LINE 9B:	UPON APPLYING FOR CHARITY CARE, THE PATIENT IS ADVISED TO DISREGARD ALL BILLS SENT BY THE HOSPITAL UNTIL A FINAL DECISION HAS BEEN MADE. A PATIENT THAT RECEIVES PARTIAL CHARITY CARE IS SUBJECT TO THE HOSPITAL COLLECTION POLICY EXCEPT THAT:1) THE PATIENT WILL BE PROVIDED WITH A WRITTEN NOTICE 30 DAYS PRIOR TO THE ACCOUNT GOING TO COLLECTION.2) THE HOSPITAL WILL NOT PLACE A LIEN ON THE PATIENT'S ASSETS.
PART VI, LINE 2:	IN AN EFFORT TO IDENTIFY THE NEEDS OF PATIENTS AND COMMUNITIES, SOUTH NASSAU UTILIZES TOOLS AND COLLABORATES WITH LOCAL AND STATE GOVERNMENTS, CIVIC ASSOCIATIONS AND OTHER COMMUNITY GROUPS TO ESTABLISH THE NEEDS OF THE COMMUNITY THE HOSPITAL SERVICES. NASSAU COUNTY DEPARTMENT OF HEALTH CONDUCTED A COMPARISON BETWEEN A SELECTED GROUP OF COMMUNITIES AND THE REST OF THE COUNTY POPULATION. THE ANALYSIS HELPED TO LOCATE MANY OF THE HEALTH DISPARITIES THAT EXIST WITHIN THE COUNTY. THE SELECTED COMMUNITIES WERE CHOSEN WITH THE ASSISTANCE OF AN INDEX COMPRISED OF MULTIPLE SOCIOECONOMIC AND HEALTH RELATED FACTORS. OF THE IDENTIFIED AT-RISK COMMUNITIES, TWO FALL WITHIN OUR PRIMARY SERVICE AREA (FREEPORT AND ROOSEVELT) AND FOUR WITHIN OUR SECONDARY SERVICE AREA (ELMONT, HEMPSTEAD, UNIONDALE, AND INWOOD. SO, WHILE NASSAU COUNTY AS A WHOLE APPEARS TO BE QUITE WELL OFF, THERE IS AN UNEQUAL DISTRIBUTION OF WEALTH AND WELLBEING AMONG COMMUNITIES.THE HOSPITAL PARTICIPATES IN THE CENTER FOR MEDICARE AND MEDICAID SERVICES PATIENT SATISFACTION SURVEY (KNOWN AS HCAHPS) BY USING PRESS GANEY, WHICH CONDUCTS A PHONE SURVEY, CONTACTING A STATISTICALLY VALID SAMPLE OF INPATIENTS AFTER DISCHARGE. SURVEY QUESTIONS INQUIRE ABOUT PATIENTS' SATISFACTION WITH THE DOCTORS, NURSES, TRANSITIONS OF CARE PLANNING, MEDICATIONS AND HOSPITAL SERVICES. QUARTERLY SURVEY RESULTS ARE BENCHMARKED AGAINST NATIONAL, STATE AND COMPARABLE HOPSITALS. THE QUARTERLY RESULTS ARE REVIEWED BY THE ADMINISTRATIVE TEAM, MANAGERIAL STAFF AND HOSPITAL STAFF. QUARTERLY ACTION PLANS TO IMPROVE THE SCORES NOT MEETING ESTABLIHSED GOALS ARE DEVELOPED BY THE VARIOUS NURSING UNITS AND DEPARTMENTS. SOUTH NASSAU'S BOARD, WHICH IS COMPOSED OF LOCAL INDIVIDUALS WHO RESIDE IN THE COMMUNITIES SERVED BY THE HOSPITAL AND INCLUDES A CROSS-SECTION OF REPRESENTATIVES SUCH AS CLERGY, BUSINESS PEOPLE AND PHYSICIANS, MEETS REGULARLY. WHILE THE MEMBERS OF SOUTH NASSAU COMMUNITIES HOSPITAL'S BOARD OF DIRECTORS ACCEPT RESPONSIBILITY FOR GOVERNANCE OF THE HOSPITAL, THEY ARE ALSO COMMUNITY ADVOCATES. AS SUCH, THEY ARE ABLE TO SPEAK ON BEHALF OF THE COMMUNITY AND RAISE ISSUES WITH THE HOSPITAL OR CONSIDER ACTIONS THAT AFFECT HOSPITALS PLANS AND OPERATIONS. THE BOARD HAS ESTABLISHED A NUMBER OF COMMITTEES THAT ARE RESPONSIBLE FOR OVERSIGHT AND COORDINATION OF HOSPITAL ACTIVITIES IN REGARDS TO COMMUNITY ADVOCACY.SOUTH NASSAU SOLICITS THE COMMUNITY'S FEEDBACK FOLLOWING FREE PUBLIC CONFERENCES IT SPONSORS EACH YEAR. SURVEYS YIELD VALUABLE INFORMATION SUCH AS COMMUNITY PREFERENCE FOR SEMINAR CONTENT AND FORMAT AND REQUESTS FOR EXPANDED PROGRAMS AND SERVICES.DEPARTMENTS HOSPITAL-WIDE HAVE RELATIONSHIPS WITH INDIVIDUALS AND GROUPS WHO HAVE SPECIAL NEEDS, SUCH AS PHYSICAL HANDICAPS, LANGUAGE BARRIERS AND CULTURAL ISSUES. THESE DEPARTMENTS ENCOURAGE COMMENTS AND SUGGESTIONS FROM THESE POPULATIONS. THEIR FEEDBACK IS USED TO ASSESS THE EFFECTIVENESS OF EXISTING PROCEDURES AND PROGRAMS.SOUTH NASSAU'S ADMINISTRATION MAINTAINS AN OPEN-DOOR POLICY AND ANY MEMBER OF THE COMMUNITY IS WELCOME TO COMMENT. ANY REASONABLE ISSUE RAISED IS ADDRESSED AND CARE IS TAKEN TO RESPOND IN A TIMELY AND SATISFACTORY FASHION.SOUTH NASSAU MAINTAINS AN EXTENSIVE WEBSITE, WWW.SOUTHNASSAU.ORG, ACOMPREHENSIVE SOURCE OF INFORMATION ON THE HOSPITAL'S SERVICES, SPECIALTY CENTERS, PHYSICIANS, NEW DEVELOPMENTS AND EMPLOYMENT OPPORTUNITIES. ITINCORPORATES MICROSITES FOR CARDIOLOGY, CANCER AND CANCER TREATMENT OPTIONS, ORTHPEDICS, WEIGHT LOSS SURGERY, UROLOGY AND MORE. CONTACT INFORMATION FOR USERS TO SUBMIT QUESTIONS AND REQUESTS FOR INFORMATION IS CLEARLY PROVIDED, AS IS LOCATION AND PHONE INFORMATION FOR THE HOSPITAL'S SATELLITE PRACTICES.SOUTH NASSAU'S ADMINISTRATION IS IN CONSTANT COMMUNICATION WITH LOCAL AND GOVERNMENT LEADERS IN DETERMINING THE NEEDS OF THE COMMUNITIES. THE ADMINISTRATIVE TEAMS ALSO ARE INVOLVED WITH HOSPITAL ASSOCIATIONS AND OTHER HEALTHCARE ASSOCIATES WHICH TARGET THE NEEDS OF THE COMMUNITIES THE HOSPITAL SERVES. NEW YORK STATE'S DEPARTMENT OF HEALTH ALSO WORKS VERY CLOSELY WITH THE HOSPITAL TO HELP ASSESS THE NEEDS OF THE COMMUNITY SERVED.SOUTH NASSAU'S FOUR ACTIVE AUXILIARIES ACT AS LIAISONS BETWEEN THE HOSPITAL AND THE COMMUNITIES THEY REPRESENT.THE HOSPITAL COLLECTS DATA WITH REGARDS TO ECONOMIC, SOCIAL, CULTURAL AND GEOGRAPHIC BARRIERS THAT EXIST.
PART VI, LINE 3:	THE HOSPITAL INFORMS AND EDUCATES PATIENTS ON A VARIETY OF FINANCIAL ASSISTANCE PROGRAMS. IT HAS A FULLY STAFFED FINANCIAL ASSISTANCE SERVICES DEPARTMENT STAFFED WITH TRANSLATION CAPABILITIES THAT HELP EDUCATE AND PROVIDE ASSISTANCE IN APPLYING FOR MEDICAID, CHILD HEALTH PLUS, FAMILY HEALTH PLUS, CHARITY CARE AND DISCOUNTED CARE. LARGE POSTERS ARE DISPLAYED IN PROMINENT LOCATIONS (INCLUDING THE EMERGENCY ROOM, BILLING OFFICE, ADMITTING, FAMILY PRACTICE CENTER, ACCOUNT SERVICES, MENTAL HEALTH CENTER, OUTPATIENT REGISTRATION, DIALYSIS CENTER,HOME CARE, CARDIAC REHABILITATION, PHYSICAL THERAPY, WOUND CARE) AND OTHER REGISTRATION AREAS SHOWING THE AVAILABILITY OF CHARITY CARE IN ENGLISH AND LARGE POSTERS ARE DISPLAYED IN PROMINENT LOCATIONS (INCLUDING THE EMERGENCY ROOM, BILLING OFFICE, ADMITTING, FAMILY PRACTICE CENTER, ACCOUNT SERVICES, MENTAL HEALTH CENTER, OUTPATIENT REGISTRATION, DIALYSIS CENTER, HOME CARE, CARDIAC REHABILITATION, PHYSICAL THERAPY, WOUND CARE) AND OTHER REGISTRATION AREAS SHOWING THE AVAILABILITY OF CHARITY CARE IN ENGLISH AND SPANISH.THE HOSPITAL POSTS THE AVAILABILITY OF FINANCIAL AID INCLUDING CHARITY CARE ON ITS EXTERNAL WEBSITE: SOUTHNASSAU.ORG DIRECTING THEM TO THE FINANCIAL ASSISTANCE DEPARTMENT.THE HOSPITAL EDUCATES ALL EMPLOYEES THAT INTERACT WITH PATIENTS ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE INCLUDING CHARITY CARE AND WHERE TO FIND INFORMATION ON THESE PROGRAMS.FINANCIAL ASSISTANCE AND CHARITY CARE INFORMATION IS INCLUDED IN PATIENT GUIDES AND SERVICE LINE GUIDES THAT ARE PROVIDED TO PATIENTS.PATIENT BILLS SENT OUT INCLUDE A NOTE ABOUT THE EXISTENCE OF THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ON THE BACK OF THE BILL IS A CHARITY CARE APPLICATION. BILLING AND ACCOUNT SERVICES DEPARTMENTS ARE EDUCATED ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND INFORMS PATIENTS OF THIS POLICY. ANY PATIENT CAN REQUEST AN APPLICATION FOR CHARITY CARE FROM THE ABOVE REGISTRATION AREAS, BILLING OFFICE AND ACCOUNT SERVICES DURING REGULAR BUSINESS HOURS AND VIA TELEPHONE.
PART VI, LINE 4:	SOUTH NASSAU IS LOCATED ON THE SOUTH SHORE OF LONG ISLAND IN NASSAU COUNTY, NEW YORK, IN THE TOWN OF OCEANSIDE. NASSAU COUNTY HAS A POPULATION OF 1.39 MILLION (BASED ON JULY 1, 2021 ESTIMATE US CENSUS DATA) WITH APPROXIMATELY 800,000 PEOPLE FALLING INTO THE HOSPITAL'S SERVICE AREA. NASSAU COUNTY'S MEDIAN HOUSEHOLD INCOME IS $120,036(ACCORDING TO 2021 CENSUS DATA) AND $53,363 PER CAPITA (2021). ACCORDING TO THE 2021 CENSUS ESTIMATES, NASSAU COUNTY'S POVERTY LEVEL WAS 5.7%, WITH MORE OF THE POORER AREAS LOCATED ON THE SOUTH SHORE OF NASSAU COUNTY AND FALLING INTO THE HOSPITAL'S SERVICE AREA. HISPANICS, ALONG WITH OTHER MINORITIES, ARE CONCENTRATED IN SOUTH SHORE COMMUNITIES SUCH AS BALDWIN, FREEPORT, HEMPSTEAD, ROOSEVELT, AND INWOOD, WITH MANY OF THESE COMMUNITIES' MEMBERS BEING UNINSURED OR INSURED BY MEDICAID.BASED ON 2021 PATIENTS SERVED AT SOUTH NASSAU, PATIENT DEMOGRAPHICS BASED ON VISITS (OUTPATIENT) ARE MEDICARE 36% MEDICAID 22% SELF PAY 1% AND CHARITY CARE 1%.OTHER HOSPITALS THAT ALSO SERVICE THESE COMMUNITIES ARE FRANKLIN HOSPITAL-NORTHWELL HEALTH AND MERCY MEDICAL CENTER.
PART VI, LINE 5:	THE HOSPITAL HAS ESTABLISHED A COMMUNITY ADVOCACY COMMITTEE THAT IS COMPOSED OF MEMBERS OF A NUMBER OF COMMUNITY ORGANIZATIONS, AND REPRESENTATIVES FROM HOSPITAL ADMINISTRATION, STAFF AND BOARD. THIS GROUP MEETS FOUR TIMES A YEAR TO IDENTIFY NEEDS OF THEIR RESPECTIVE COMMUNITIES AND TO DISCUSS ISSUES OR RECOMMEND ACTIONS IN THE INTEREST OF IMPROVED SERVICE TO THOSE COMMUNITIES. THIS INFORMATION IS THEN PRESENTED TO THE BOARD OF DIRECTORS FOR CONSIDERATION.SOUTH NASSAU'S DEPARTMENT OF COMMUNITY EDUCATION IS A VALUED COMMUNITY RESOURCE. THIS DEPARTMENT PROVIDES HEALTH EDUCATION, COMMUNITY OUTREACH, FREE HEALTH SCREENINGS, AND REFERRAL SERVICES TO THE COMMUNITIES WE SERVE. IN KEEPING WITH POPULATION HEALTH INITIATIVES, THE DEPARTMENT'S GOALS FOCUS ON PROMOTING WELLNESS AND PREVENTING OR MANAGING CHRONIC DISEASE. IN 2021, OUR COMMUNITY-WIDE EFFORTS TOUCHED THE LIVES OF MANY INDIVIDUALS. FEEDBACK FROM PROGRAM PARTICIPANTS AS WELL AS COMMUNITY PARTNERS CONTINUES TO BE OVERWHELMINGLY POSITIVE WHICH HAS BEEN EVIDENT IN POST-PROGRAM EVALUATIONS AND FOLLOW-UP. OUR SCREENINGS FOR THE YEAR TOTALED 190 AND INCLUDED BALANCE, BLOOD PRESSURE, BMI, CHOLESTEROL, COLORECTAL CANCER, HEAD AND NECK CANCER, PROSTATE CANCER, SKIN CANCER, AND SLEEP ASSESSMENT. DURING 2021 MOUNT SINAI SOUTH NASSAU CONTINUED ITS COVID-19 TESTING PROGRAM. THROUGH THE VARIOUS SITES (FIVE TOWNS, LONG BEACH, ETC.) THE HOSPITAL TESTED 17,809 COMMUNITY MEMBERS. IN ADDITION, MOUNT SINAI SOUTH NASSAU PROVIDED 5,969 VACCINES TO THE COMMUNITY. DURING 2021, WE PROVIDED SERVICES TO 29,027 PARTICIPANTS.THE MISSION OF THE DEPARTMENT OF COMMUNITY EDUCATION IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES THROUGH EDUCATION, AWARENESS, OUTREACH, PREVENTION AND SCREENING SERVICES. THROUGH ITS COMMUNITY-BASED INITIATIVES, THE DEPARTMENT STRIVES TO SUPPORT THE HOSPITAL'S PERFORMANCE TARGETS IN THE AREAS OF QUALITY, PATIENT SAFETY, AND SERVICE EXCELLENCE. THE DEPARTMENT PARTNERS WITH COMMUNITY-BASED ORGANIZATIONS SUCH AS LOCAL LIBRARIES AND SCHOOLS, COMMUNITY CENTERS, SENIOR CENTERS AND CHURCHES TO PROVIDE EDUCATIONAL PROGRAMS, PRESENTATIONS AND SCREENINGS TO WHERE PEOPLE LIVE, WORK, AND PLAY. EXAMPLES OF THESE COMMUNITY PARTNERS ARE THE HEWLETT HOUSE 1 IN 9 CANCER SUPPORT CENTER, NEW YORK POISON CONTROL CENTER, THE OCEANSIDE JEWISH COMMUNITY CENTER, THE KNIGHTS OF COLUMBUS, THE TOWN OF HEMPSTEAD, AND THE CITY OF LONG BEACH.ADDITIONALLY, THE DEPARTMENT OF COMMUNITY EDUCATION OFFERS CPR CLASSES TO THE COMMUNITY AND BLS AND ACLS TO THE STAFF. THE DEPARTMENT RECOGNIZES THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES' NATIONAL HEALTH OBSERVANCES WITH INFORMATION AND PRESENTATIONS ON THE MONTH'S CHOSEN TOPICS. COMMUNITY EDUCATION IS ALSO RESPONSIBLE FOR FOURTEEN FREE SUPPORT GROUPS RANGING FROM BARIATRIC SUPPORT TO BREAST CANCER TO BEREAVEMENT. THE ACTIVITIES OF THE DEPARTMENT OF COMMUNITY EDUCATION ARE REPORTED REGULARLY TO THE BOARD OF DIRECTORS.
PART VI, LINE 6:	SOUTH NASSAU COMMUNITIES HOSPITAL IS AFFILIATED WITH MOUNT SINAI HOSPITALS GROUP, INC. (MOUNT SINAI). MOUNT SINAI IS A NOT-FOR-PROFIT CORPORATION RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. EFFECTIVE SEPTEMBER 2019, THE HOSPITAL IS DOING BUSINESS AS MOUNT SINAI SOUTH NASSAU.THE HOSPITAL PARTICIPATES IN THE LONG ISLAND HEALTH COLLABORTIVE (LIHC). A COALITION THAT INCLUDES THE NASSAU AND SUFFOLK COUNTY HEALTH DEPARTMENTS. EVERY HOSPIAL ON LONG ISLAND, HEALTH AND SOCIAL SERVICE COMMUNITY-BASED ORGANIZATIONS, INSURANCE PLANS, ACEDEMIC INSTITUTIONS, LOCAL GOVERNMENTS, AND OTHER GROUPS THAT ARE WORKING TOGETHER TOWARD A HEALTHIER LONG ISLAND COMMUNITY, THE LONG ISLAND HEALTH COLLARBORTIVE WORKS TO IMPROVE CLINICAL QUALITY AND EXPAND ACCESS TO CARE FOR THE 2.8 MILLION RESIDENTS OF NASSAU AND SUFFOLK COUNTIES. LIHC HOSPITALS CONTINUE THEIR FOCUS ON DELIVERING COMMUNITY-BASED CARE AND COLLABORATING WITH INSURER'S EFFORTS TO EXPAND LOCAL ACCESS TO AFFORDABLE HEALTH INSURANCE PRODUCTS.
PART VI, LINE 7, REPORTS FILED WITH STATES	NY

Schedule H (Form 990) 2021

Additional Data

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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" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

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 on 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 on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of 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
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

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 on 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), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on 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," on line 5a or 5b, describe in Part III.

For persons listed on 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," on line 6a or 6b, describe in Part III.

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

Yes

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

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

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

Cat. No. 50053T

Schedule J (Form 990) 2021

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on 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) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(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)
1MARGARET PASTUSZKO ST 621 DIRECTOR, PRES, SYS COO & CSO	(i) (ii)	0 ------------- 1,412,500	0 ------------- 652,141	0 ------------- 0	0 ------------- 29,000	0 ------------- 33,296	0 ------------- 2,126,937	0 ------------- 0
2RICHARD MURPHY PRESIDENT & CEO	(i) (ii)	678,121 ------------- 0	1,214,034 ------------- 0	5,364 ------------- 0	45,500 ------------- 0	30,174 ------------- 0	1,973,193 ------------- 0	0 ------------- 0
3ARTHUR KLEIN TERMED 0621 DIRECTOR, EVP, PRES HEALTH NETWORK	(i) (ii)	1,500,000 ------------- 0	389,801 ------------- 0	0 ------------- 0	29,000 ------------- 0	10,104 ------------- 0	1,928,905 ------------- 0	0 ------------- 0
4STEPHEN HARVEY START 121 TRUSTEE, EVP SYS CHF FIN&CORP SRV	(i) (ii)	0 ------------- 931,666	0 ------------- 471,898	0 ------------- 0	0 ------------- 29,000	0 ------------- 46,202	0 ------------- 1,478,766	0 ------------- 0
5ALAN GARELY CLINICAL CHAIR OB/GYN	(i) (ii)	936,053 ------------- 0	217,400 ------------- 0	0 ------------- 0	45,500 ------------- 0	33,425 ------------- 0	1,232,378 ------------- 0	0 ------------- 0
6JASON FREEMAN DIR OF INTER CARDIO	(i) (ii)	886,407 ------------- 0	117,400 ------------- 0	0 ------------- 0	41,665 ------------- 0	30,464 ------------- 0	1,075,936 ------------- 0	0 ------------- 0
7LAWRENCE KANNER DIR OF ELECTROPHYSIOLOGY	(i) (ii)	847,838 ------------- 0	118,650 ------------- 0	0 ------------- 0	39,000 ------------- 0	33,214 ------------- 0	1,038,702 ------------- 0	0 ------------- 0
8MATTHEW RIFKIN PRESIDENT	(i) (ii)	0 ------------- 681,438	0 ------------- 113,480	0 ------------- 0	0 ------------- 45,500	0 ------------- 22,406	0 ------------- 862,824	0 ------------- 0
9ADHI SHARMA PRESIDENT & CEO	(i) (ii)	580,921 ------------- 0	171,900 ------------- 0	3,600 ------------- 0	19,500 ------------- 0	29,826 ------------- 0	805,747 ------------- 0	0 ------------- 0
10WILLIAM ALLISON CHIEF OPERATING OFFICER	(i) (ii)	515,872 ------------- 0	179,108 ------------- 0	2,880 ------------- 0	45,500 ------------- 0	5,185 ------------- 0	748,545 ------------- 0	0 ------------- 0
11DINA EL KADY PRESIDENT/DIRECTOR	(i) (ii)	0 ------------- 593,311	0 ------------- 74,500	0 ------------- 0	0 ------------- 15,046	0 ------------- 30,675	0 ------------- 713,532	0 ------------- 0
12JOHN POHLMAN CHIEF FINANCIAL OFFICER	(i) (ii)	441,426 ------------- 0	139,645 ------------- 0	5,760 ------------- 0	38,451 ------------- 0	31,427 ------------- 0	656,709 ------------- 0	0 ------------- 0
13ASIF REHMAN TERMED 6121 ASSOC DIR INTER CARDIO	(i) (ii)	489,342 ------------- 0	17,400 ------------- 0	0 ------------- 0	27,437 ------------- 0	5,080 ------------- 0	539,259 ------------- 0	0 ------------- 0
14JOSEPH CALDERONE VP CORP COMMUNICATIONS	(i) (ii)	304,325 ------------- 0	89,180 ------------- 0	3,840 ------------- 0	45,500 ------------- 0	3,406 ------------- 0	446,251 ------------- 0	0 ------------- 0
15DANIEL MCCALLY VICE PRESIDENT/DIRECTOR	(i) (ii)	0 ------------- 383,338	0 ------------- 7,692	0 ------------- 0	0 ------------- 8,200	0 ------------- 26,536	0 ------------- 425,766	0 ------------- 0
16MATTHEW RUNYAN VP, CIO	(i) (ii)	280,424 ------------- 0	65,500 ------------- 0	0 ------------- 0	18,154 ------------- 0	33,275 ------------- 0	397,353 ------------- 0	0 ------------- 0
17SAMUEL SANDOWSKI VP/DIRECTOR	(i) (ii)	0 ------------- 267,061	0 ------------- 64,333	0 ------------- 0	0 ------------- 12,817	0 ------------- 33,425	0 ------------- 377,636	0 ------------- 0
18STANLEY REDDY DIRECTOR	(i) (ii)	0 ------------- 300,000	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 300,000	0 ------------- 0
19WILLIAM ULRICH TERMED 0621 VP FACILITIES MANAGEMENT	(i) (ii)	227,238 ------------- 0	12,686 ------------- 0	0 ------------- 0	45,500 ------------- 0	5,110 ------------- 0	290,534 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
PART I, LINE 4B	SENIOR EXECUTIVE POSITIONS, WHO ARE IMPACTED BY LIMITS UNDER THE HOSPITAL'S TAX-QUALIFIED RETIREMENT PLAN THAT DO NOT LIMIT OTHER EMPLOYEES, ALSO HAVE A SUPPLEMENTAL PLAN. THE SUPPLEMENTAL PLAN IS INTENDED ONLY TO MAKE UP FOR SUCH LIMITS AND CONTAINS VESTING SCHEDULES DESIGNED TO RETAIN THE EXECUTIVE UNTIL RETIREMENT. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THIS PLAN IN 2021, WITH THE SUPPLEMENTAL RETIREMENT INCOME INCLUDED IN DEFERRED COMPENSATION IN SCHEDULE J, PART II, BOX C: JOHN POHLMAN- SUPPLEMENTAL RETIREMENT OF $8,675
PART I, LINE 7	THE HOSPITAL MAINTAINS AN INCENTIVE COMPENSATION PROGRAM THAT PAYS VARIABLE COMPENSATION BASED ON THE SATISFACTION BY THE HOSPITAL AND THE EXECUTIVES OF PRE-ESTABLISHED QUALITY OF CARE, PROGRAM, FINANCIAL AND SIMILAR GOALS ESTABLISHED AT THE BEGINNING OF THE YEAR PRIOR TO PAYMENT. SOME EMPLOYEES RECEIVE ADDITIONAL COMPENSATION BASED ON VARIOUS PRODUCTIVITY MEASURES. AWARDS ARE SET FORTH IN PART II, COLUMN B(II).
ADDITIONAL DISCLOSURE	THE COMPENSATION REPORTED ON BOTH PART VII AND SCHEDULE J OF THE FORM 990 FOR CERTAIN OFFICERS AND KEY PERSONNEL REPRESENTS AMOUNTS PAID FOR SERVICES RENDERED TO SOUTH NASSAU COMMUNITIES HOSPITAL ("SNCH") AND ITS AFFILIATED ORGANIZATIONS. THE FORM 990 REQUIRES COMPENSATION TO BE REPORTED BASED ON THE ORGANIZATION THAT PROVIDES THE OFFICER HIS OR HER W-2, HOWEVER, REPORTING COMPENSATION IN THIS FASHION DOES NOT TAKE INTO ACCOUNT THE INTEGRATED RELATIONSHIPS WITHIN A HEALTH SYSTEM THAT REQUIRE OFFICERS AND EMPLOYEES TO ALLOCATE THEIR TIME AND SERVICES AMONG MANY ORGANIZATIONS.

Schedule J (Form 990) 2021

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number
11-1352310

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE CORP	27-4291221	63166LBT7	10-23-2012	100,932,698	REFUND PRIOR BONDS ISSUED 8/22/01 & 8/7/03-CONSTRUCTION & EQUIP. PURCHASE		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	33,950,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	100,932,698
4 Gross proceeds in reserve funds .............	1,387,275
5 Capitalized interest from proceeds .............	1,667,774
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	1,454,576
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	27,110,685
11 Other spent proceeds .............	70,699,662
12 Other unspent proceeds .............
13 Year of substantial completion .............	2015
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........	X
16 Has the final allocation of proceeds been made? ..........	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	0 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........	0 %
6 Total of lines 4 and 5 .............	0 %
7 Does the bond issue meet the private security or payment test? ...		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X
b Exception to rebate? ........		X
c No rebate due? .........	X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
DATE REBATE COMPUTATION PERFORMED	ISSUER NAME: NASSAU COUNTY LOCAL ECONOMIC ASSISTANCE CORP DATE THE REBATE COMPUTATION WAS PERFORMED: 01/13/2017
PART II, LINE 4	THE AMOUNT SHOWN HERE CONSISTS OF DEPOSITS TO A BONA FIDE DEBT SERVICE FUND.
PART III, LINE 2	CERTAIN PROPERTY FINANCED BY THE BONDS IS LEASED TO AFFILIATED 501(C)(3) ORGANIZATIONS; SUCH LEASES DO NOT GIVE RISE TO PRIVATE BUSINESS USE.
PART IV, LINE 6	THIS QUESTION IS BEING ANSWERED WITHOUT REGARD TO A YIELD RESTRICTED REFUNDING ESCROW FINANCED WITH PROCEEDS OF THE BONDS.

Schedule K (Form 990) 2021

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Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No






Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990) 2021

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	32,880,740	CONSTRUCTION SERVICES		No
(2) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	13,570,013	CONSTRUCTION SERVICES		No
(3) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	11,406,970	CONSTRUCTION SERVICES		No
(4) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	6,947,087	CONSTRUCTION SERVICES		No
(5) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	5,151,820	CONSTRUCTION SERVICES		No
(6) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	5,139,169	CATERING SERVICES		No
(7) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	3,474,733	BILLING SERVICES		No
(8) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	2,076,293	VALET SERVICES		No
(9) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	1,872,443	STAFFING AGENCY		No
(10) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	1,299,200	MEDICAL RECORDS		No
(11) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	1,142,722			No
(12) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	1,130,127	CLEANING SERVICES		No
(13) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	1,128,460	LEGAL SERVICES		No
(14) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	1,111,402	LEGAL SERVICES		No
(15) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	868,088	INSURANCE		No
(16) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	849,838	CONSTRUCTION SERVICES		No
(17) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	771,738	COMPUTER SERVICES		No
(18) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	759,478	CONSTRUCTION SERVICES		No
(19) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	630,804	NEUROLOGICAL SERVICES		No
(20) SUBSTANTIAL CONTRIBUTOR	SUBSTANTIAL CONTRIBUTOR	613,148	FINANCIAL SERVICES		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	4	259,601	COST OR SELLING PRICE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

Yes

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

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

Cat. No. 51227J

Schedule M (Form 990) (2021)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation
PART I, COLUMN (B):	SCHEDULE M, PART I, COLUMN (B): THERE WERE 4 CONTRIBUTORS

Schedule M (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 2	TWO OR MORE OF THE PERSONS LISTED IN THIS FORM 990 PART VII HAVE A BUSINESS RELATIONSHIP WITH EACH OTHER BY VIRTUE OF SITTING ON ONE OR MORE BOARDS OF DIRECTORS OR BY SERVING IN AN EMPLOYMENT RELATIONSHIP WITH ONE OR MORE ENTITIES IN THE SNCH GROUP OF AFFILIATED ENTITIES.
FORM 990, PART VI, SECTION A, LINE 6	MOUNT SINAI HOSPITALS GROUP, INC. IS THE SOLE MEMBER OF SOUTH NASSAU COMMUNITIES HOSPITAL. THE SYSTEM IS ORGANIZED AS A NOT FOR PROFIT CORPORATION UNDER FEDERAL AND NEW YORK STATE LAWS.
FORM 990, PART VI, SECTION A, LINE 7A	MOUNT SINAI HOSPITALS GROUP, INC. IS THE SOLE MEMBER OF SOUTH NASSAU COMMUNITIES HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7B	IN ADDITION TO SUCH AUTHORITY RESERVED TO THE TAXPAYER'S SOLE MEMBER, MOUNT SINAI HOSPITALS GROUP, INC. ("MOUNT SINAI") PURSUANT TO THE NEW YORK NOT-FOR-PROFIT CORPORATION LAW, SUCH AS THE AUTHORITY TO (I) ELECT AND REMOVE MEMBERS OF THE TAXPAYER'S GOVERNING BOARD, (II) APPROVE AMENDMENTS TO THE TAXPAYER'S CERTIFICATE OF INCORPORATION AND BYLAWS, AND (III) APPROVE SIGNIFICANT CORPORATE TRANSACTIONS SUCH AS MERGERS, CONSOLIDATIONS, THE DISSOLUTION OF THE TAXPAYER AND THE SALE, LEASE, MORTGAGE, PLEDGE OR OTHER TRANSFER OF SIGNIFICANT ASSETS OF THE TAXPAYER, THE APPROVAL OF THE FOLLOWING MATTERS HAVE BEEN SPECIFICALLY RESERVED TO MOUNT SINAI, IN ITS CAPACITY AS THE TAXPAYER'S SOLE MEMBER, PURSUANT TO THE TAXPAYER'S CERTIFICATE OF INCORPORATION AND BYLAWS: (A) THE INITIATION BY SNCH OF A VENTURE INVOLVING THE JOINT OWNERSHIP OR OPERATION OF A BUSINESS ACTIVITY WITH ONE OR MORE THIRD PARTIES OR THE AMENDMENT OF AN EXISTING VENTURE IF, IN ANY SUCH CASE, SUCH VENTURE IS MATERIAL TO SNCH OR INVOLVES ONE OR MORE THIRD PARTIES THAT IS A COMPETITOR OF MSHG OR AN AFFILIATE OF MSHG; (B) ESTABLISHMENT OF ANY MATERIAL NEW LINE OF BUSINESS; (C) ANY MERGER, CONSOLIDATION OR DISSOLUTION OF SNCH OR ANY SNCH AFFILIATE; (D) ANY CORPORATE REORGANIZATION OF SNCH AND ANY ESTABLISHMENT OR DISSOLUTION OF ANY SUBSIDIARY ORGANIZATION; (E) ANY ACQUISITION OR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE OR OTHER ALIENATION OF ASSETS OR PROPERTY OF SNCH OR ANY MATERIAL SUBSIDIARY THAT IN ANY CASE HAS A VALUE AT THE TIME OF THE TRANSACTION EQUAL TO OR GREATER THAN $10,000,000; (F) ANY TRANSACTION THAT RESULTS IN SNCH BECOMING THE SOLE MEMBER OR, TO THE EXTENT PERMITTED BY LAW, THE SOLE SHAREHOLDER OF ANY CORPORATION OWNING OR OPERATING A LICENSED HOSPITAL; (G) ANY TRANSACTION THAT RESULTS IN ANY OTHER CORPORATION, ENTITY OR PERSON BECOMING A MEMBER OF SNCH OR A MEMBER OR EQUITY OWNER OF A SNCH AFFILIATE; (H) ANY TRANSACTION THAT RESULTS IN ANY OTHER CORPORATION, ENTITY OR PERSON BECOMING ENTITLED TO APPOINT DESIGNEES TO THE BOARD OF DIRECTORS OF SNCH OR TO THE GOVERNING BOARD OF A SNCH AFFILIATE; (I) INITIATION OF BANKRUPTCY OR INSOLVENCY ACTIONS WITH RESPECT TO SNCH OR AN SNCH AFFILIATE; (J) ANY ACTION THAT RESULTS IN THE COMPLETE CLOSURE OR CONVERSION OF USE FROM A GENERAL ACUTE CARE MEMBER OF SNCH; (K) ANY AMENDMENT TO THE CERTIFICATE OF INCORPORATION OF SNCH OR ANY AMENDMENT TO THE BYLAWS (PROVIDED THAT, DURING THE INITIAL PERIOD, SUCH RIGHT OF APPROVAL SHALL ONLY APPLY TO AMENDMENTS (I) THAT AFFECT THE RIGHTS OF THE MSHG, OR (II) THAT OTHERWISE AMENDS THE BYLAWS AND MSHG OBJECTS IN WRITING WITHIN THIRTY (30) DAYS OF ITS RECEIPT OF NOTICE); (L) ISSUANCE OF LONG TERM DEBT IN EXCESS OF $10,000,000, SUCH APPROVAL NOT TO BE UNREASONABLY WITHHELD; (M) THE SUBMISSION OF AN APPLICATION FOR A CERTIFICATE OF NEED ("CON") TO ANY REGULATORY AUTHORITY IF SUCH APPLICATION WILL BE SUBJECT TO FULL REVIEW BY SUCH REGULATORY AUTHORITY (PROVIDED NOTICE IS PROVIDED TO THE MEMBER OF ANY CON THAT IS NOT SUBJECT TO FULL REVIEW; (N) THE ESTABLISHMENT OF AN ACADEMIC AFFILIATION, OR THE AMENDMENT OF AN EXISTING ACADEMIC AFFILIATION AGREEMENT, WITH ANY EDUCATIONAL INSTITUTION OTHER THAN THE ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI (EXISTING AFFILIATION AGREEMENTS ARE PERMITTED); OR (O) THE EXERCISE BY A MATERIAL SUBSIDIARY OF ANY AUTHORITY THAT PURSUANT TO THE GOVERNING DOCUMENTS OF SUCH MATERIAL SUBSIDIARY REQUIRES THE CONSENT OR APPROVAL OF SNCH OR ANY OTHER MATERIAL SUBSIDIARY.
FORM 990, PART VI, SECTION B, LINE 11B	THE POLICY OF SOUTH NASSAU COMMUNITIES HOSPITAL FOR REVIEWING AND APPROVING THE IRS FORM 990 IS THE FOLLOWING: THE AUDIT COMMITTEE, A SUB COMMITTEE OF THE BOARD OF DIRECTORS, IS ASSIGNED TO REVIEW AND APPROVE THE IRS FORM 990 THAT IS FILED ON BEHALF OF THE ORGANIZATION, BEFORE IT IS FILED WITH THE IRS. THE AUDIT COMMITTEE WILL NOTIFY THE BOARD OF DIRECTORS WHEN THE IRS FORM 990 IS APPROVED BY THE AUDIT COMMITTEE. ONCE THE 990 IS APPROVED, THE BOARD OF DIRECTORS WILL RECEIVE A COPY (ELECTRONICALLY OR HARDCOPY) BEFORE IT IS ULTIMATELY FILED WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12C	SOUTH NASSAU COMMUNITIES HOSPITAL HAS A WRITTEN CONFLICT OF INTEREST POLICY THAT IS UPDATED ON AN ANNUAL BASIS WITH MEMBERS OF THE CORPORATE COMPLIANCE COMMITTEE (A SUB-COMMITTEE OF THE BOARD OF DIRECTORS) AND WITH LEGAL COUNSEL. THE POLICY IS UPDATED FOR ANY NEW/UPDATED LEGAL AND GOVERNANCE ISSUES AND DISTRIBUTED TO BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND MANAGEMENT ON AN ANNUAL BASIS. ALONG WITH THE POLICY, A QUESTIONNAIRE IS PROVIDED TO ALL BOARD MEMBERS, OFFICERS, KEY EMPLOYEES AND MANAGEMENT REQUESTING ACKNOWLEDGEMENT THAT THEY RECEIVED THE FORM, ASKING THEM TO DISCLOSE ALL KNOWN RELATIONSHIPS AND RETURN THE SIGNED FORM TO THE CORPORATE COMPLIANCE DEPARTMENT. THE CORPORATE COMPLIANCE DEPARTMENT FOLLOWS UP WITH ANY BOARD MEMBER, OFFICERS, KEY EMPLOYEES OR MANAGEMENT STAFF WHEN A POTENTIAL CONFLICT EXISTS. THIS INFORMATION IS THEN REPORTED BACK TO THE CORPORATE COMPLIANCE COMMITTEE WHICH THEN REPORTS TO THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 15	15(A) SOUTH NASSAU COMMUNITIES HOSPITAL HAS A COMPENSATION COMMITTEE (A SUB COMMITTEE OF THE BOARD OF DIRECTORS) WHICH DETERMINES THE OFFICERS' COMPENSATION. THE COMPENSATION COMMITTEE, COMPRISED EXCLUSIVELY OF DISINTERESTED DIRECTORS, UTILIZES A VARIETY OF SOURCES IN DETERMINING THE OFFICERS OVERALL COMPENSATION. THESE SOURCES INCLUDE A COMPENSATION STUDY PERFORMED BY AN INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEYS AND THE OFFICERS' HISTORICAL SALARIES. THE COMPENSATION CONSULTANT PERIODICALLY RENDERS AN OPINION THAT THE TOTAL PROPOSED COMPENSATION FOR THE OFFICERS ARE "REASONABLE" WITH RESPECT TO THE INTERNAL REVENUE SERVICE (IRS) INTERMEDIATE SANCTIONS REGULATIONS AND THAT THE SAFE-HARBOR DESCRIBED THEREIN IS SATISFIED. THIS INDEPENDENT CONSULTANT UTILIZES PUBLISHED SURVEYS AND RELEVANT MARKET DATA TO DETERMINE RANGES FOR THE OFFICERS' SALARY TO REACH ITS OPINION. 15(B) COMPENSATION FOR THE OTHER OFFICERS (NOT INCLUDED ABOVE) AND KEY EMPLOYEES IS BASED ON A VARIETY OF SOURCES WHICH INCLUDE THIRD PARTY COMPENSATION SURVEYS AND STUDIES, THE ORGANIZATION'S HISTORICAL SALARY RATES, OTHER COMPENSATION WITHIN THE ORGANIZATION FOR SIMILAR TITLES AND POSITIONS, AND THE CURRENT LABOR MARKET. ALL SALARIES FOR EMPLOYEES MUST BE APPROVED BY THE CHIEF EXECUTIVE OFFICER AND/OR THE CHIEF OPERATING OFFICER AND THE SENIOR VICE PRESIDENT OF HUMAN RESOURCES.
FORM 990, PART VI, SECTION C, LINE 19	THE PUBLIC CAN OBTAIN A COPY OF THE 990, 990T, AUDITED FINANCIAL STATEMENTS VIA A WRITTEN OR VERBAL REQUEST THROUGH THE HOSPITAL'S OFFICE OF EXTERNAL AFFAIRS, 2277 GRAND AVE., BALDWIN, NY 11510. THE BYLAWS, ARTICLES OF INCORPORATION AND THE CONFLICT OF INTEREST POLICY OF THE HOSPITAL CAN BE OBTAINED AT MANAGEMENT'S DISCRETION VIA A WRITTEN REQUEST THROUGH THE HOSPITAL'S OFFICE OF EXTERNAL AFFAIRS, 2277 GRAND AVE., BALDWIN, NY 11510. PHONE NUMBER: 1-516-377-5370. THE HOSPITAL'S PREVIOUS YEARS' 990 CAN BE FOUND ON THE WEBSITE, WW.GUIDESTAR.COM.
FORM 990, PART XI, LINE 9:	TRANSFER TO/FROM RELATED PARTIES -9,892,112. EQUITY TRANSFER TO/FROM RELATED PAR 3,545,265. PENSION AND POTRETIREMENT LIABILITY ADJUSTMENTS 29,237,105. INSURANCE RECOVERIES 100,000. PRIOR PERIOD ADJUSTMENT 148,916.

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

Cat. No. 51056K

Schedule O (Form 990) 2021

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" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

SOUTH NASSAU COMMUNITIES HOSPITAL INC

Employer identification number

11-1352310

Part I

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

(a) Name, address, and EIN (if applicable) 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) SOUTH NASSU 195 NORTH VILLAGE RVC LLC ONE HEALT OCEANSIDE,NY115721551 83-1998916	HOLDING COMPANY	NY	-61,188	277,944	SOUTH NASSAU COMMUNITIES HOSPITAL INC

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 entity?
(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)SIBS PLACE INC 1420 BROADWAY HEWLETT,NY11557 81-3485876	SUPPORT PROGRAM	NY	501(C)(3)	7	N/A		No
(2)MOUNT SINAI HOSPITALS GROUP INC ONE GUSTAVE L LEVY PLACE BOX 1099 NEW YORK,NY10029 46-4242915	HOLDING COMPANY	NY	501(C)(3)	12B, II			No
(3)THE MOUNT SINAI MEDICAL CENTER INC ONE GUSTAVE L LEVY PLACE NEW YORK,NY10029 13-6271888	SUPPORT	NY	501(C)(3)	12B, II			No
(4)MITRAL FOUNDATION 1190 FIFTH AVENUE NEW YORK,NY10029 80-0468600	RESEARCH	NY	501(C)(3)	12A, I			No
(5)THE MOUNT SINAI CHILDREN'S CENTER FND ONE GUSTAVE L LEVY PLACE NEW YORK,NY10029 22-3059294	SUPPORT	NY	501(C)(3)	12A, I			No
(6)MSMC REALTY CORPORATION ONE GUSTAVE L LEVY PLACE NEW YORK,NY10029 13-3852596	REAL ESTATE	NY	501(C)(3)	12A, I			No
(7)MSMC RESIDENTIAL REALTY LLC 1425 MADISON AVENUE NEW YORK,NY10029 20-0244426	REAL ESTATE	NY	501(C)(3)	12A, I			No
(8)MSMC RESIDENTIAL REALTY MANAGER INC ONE GUSTAVE L LEVY PLACE NEW YORK,NY10029 20-1289396	MGMT	NY	501(C)(3)	12A, I			No
(9)VALENTIN FUSTER MT SINAI FND SCI HLTH ONE GUSTAVE L LEVY PLACE NEW YORK,NY10029 80-0952088	SUPPORT PROGRAM	NY	501(C)(3)	12A, I			No
(10)MOUNT SINAI HEALTH SYSTEM INC ONE GUSTAVE L LEVY PLACE NEW YORK,NY10029 46-4248304	HOLDING COMPANY	NY	501(C)(3)	12A, I	N/A		No
(11)ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI ONE GUSTAVE L LEVY PLACE NEW YORK,NY10029 13-6171197	SCHOOL	NY	501(C)(3)	2			No
(12)CONTINUUM HEALTH PARTNERS INC 150 EAST 42ND STREET 5TH FL NEW YORK,NY10019 13-3939476	HOLDING COMPANY	NY	501(C)(3)	12A, I	N/A		No
(13)BIMC HOLDING CORPORATION FIRST AVENUE AT 16TH STREET NEW YORK,NY10003 13-3444730	HOLDING COMPANY	NY	501(C)(3)	12A, I			No
(14)MOUNT SINAI AMBULATORY VENTURES INC 150 EAST 42ND STREET 5TH FL NEW YORK,NY10019 13-3838460	SURGICENTER	NY	501(C)(3)	3			No
(15)BI NURSING HOME COMPANY 327 EAST 17TH STREET NEW YORK,NY10003 13-3627753	NURSING HOME	NY	501(C)(3)	3			No
(16)EAST 17TH STREET PROPERTIES INC 150 EAST 42ND STREET 5TH FL NEW YORK,NY10019 13-3547502	REAL ESTATE	NY	501(C)(3)	9			No
(17)THE LONG ISLAND COLLEGE HOSPITAL 150 EAST 42ND STREET 5TH FL NEW YORK,NY10019 11-1018985	HOSPITAL	NY	501(C)(3)	3			No
(18)ST LUKE'S-ROOSEVELT HOSPITAL CENTER 1111 AMSTERDAM AVENUE NEW YORK,NY10025 13-2997301	HOSPITAL	NY	501(C)(3)	3			No
(19)AUGUSTUS & JAMES CORPORATION 150 EAST 42ND STREET5TH FLOOR NEW YORK,NY10019 13-3392851	REAL ESTATE	NY	501(C)(3)	12A, I			No
(20)ST LUKE'S-ROOSEVELT INSTITUTE FOR HEALTH 1111 AMSTERDAM AVENUE NEW YORK,NY10025 13-2914343	RESEARCH	NY	501(C)(3)	4			No
(21)NEW YORK EYE AND EAR INFIRMARY 310 EAST 14TH STREET NEW YORK,NY10003 13-5562304	HOSPITAL	NY	501(C)(3)	3			No
(22)NEW YORK EYE & EAR INFIRMARY FNDN 310 EAST 14TH STREET NEW YORK,NY10003 13-4012469	PRIVATE FDN	NY	501(C)(3)	PF			No
(23)NYEEI HOUSING COMPANY INC 317-327 EAST 13TH STREET NEW YORK,NY10003 31-1696826	REAL ESTATE	NY	501(C)(3)	NA			No
(24)BETH ISRAEL MEDICAL CENTER FDN INC 150 EAST 42ND STREET 5TH FLOO NEW YORK,NY10019 30-0571387	FUNDRAISING	NY	501(C)(3)	7			No
(25)ST LUKE'S-ROOSEVELT HOSPITAL CENTER FDN 150 EAST 42ND STREET 5TH FLOO NEW YORK,NY10019 30-0571390	FUNDRAISING	NY	501(C)(3)	7			No
(26)BETH ISRAEL MEDICAL CENTER FIRST AVENUE AT 16TH STREET NEW YORK,NY10003 13-5564934	HOSPITAL	NY	501(C)(3)	3			No
(27)MOUNT SINAI HEALTH PARTNERS PC 150E 42ND STREET 5TH FLOOR NEW YORK,NY10017 81-2057452	HEALTHCARE	NY	501(C)(3)	10			No
(28)MOUNT SINAI HEALTH SYSYEM SELF INSURANCE 150E 42ND STREET NEW YORK,NY10017 82-3994798	SUPPORT	NY	501(C)(3)	12B, II			No
(29)EAST 98TH STREET COMMUNITY SERVICE INC ONE GUSTAVE L LEVY PLACE NEW YORK,NY10029 82-2536805	AMB SURG CENTER	NY	501(C)(3)	3			No
(30)BACHMAN-STAUSS DYSTONIA FOUNDATION INC 150E 42ND STREET NEW YORK,NY10017 13-3804248	FUNDRAISING	NY	501(C)(3)	7			No
(31)CARE CONTINUUM VENTURESINC ONE GUSTAVE L LEVY PLACE NEW YORK,NY10029 86-3155355	SUPPORT	NY	501(C)(3)	12B, II			No

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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 V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(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 V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

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	(i) Section 512(b)(13) controlled entity?
(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	Yes	No
(1) SN HEALTHCARE SERVICES ONE HEALTHLY WAY OCEANSIDE,NY11572 11-3571538	INACTIVE	NY	SOUTH NASSAU COMMUNITIES HOSPITAL INC	C			100.000 %	Yes
(2) SN HEALTHCARE REGISTRY ONE HEALTHY WAY OCEANSIDE,NY11572 26-0228658	INACTIVE	NY	SOUTH NASSAU COMMUNITIES HOSPITAL INC	C			100.000 %	Yes
(3) GREATER METROPOLITAN IPA V - 13-3977019 150 EAST 42ND ST 5TH FL NEW YORK,NY10019 13-3977019	INACTIVE	NY	BIMCSLR	C					No
(4) GREATER METROPOLITAN IPA V - 13-3977019 150 EAST 42ND ST 5TH FL NEW YORK,NY10019 13-4141695	INACTIVE	NY	BIMCSLR	C					No
(5) MANHATTAN MANAGEMENT SERVICES 1780 BROADWAY 7TH FL NEW YORK,NY10019 13-3618543	MGMT SERVICES	NY	SLR	C					No
(6) SLR MANAGEMENT SERVICES - 13-3977019 150 EAST 42ND ST 5TH FL NEW YORK,NY10019 13-3853145	MGMT SERVICES	NY	SLR	C					No
(7) WEST CARE MEDICAL PC 150 EAST 42ND ST 5TH FL NEW YORK,NY10019 13-3811203	INACTIVE	NY	SLR	C					No
(8) MOUNT SINAI HC VENTURES INC 150 EAST 42ND ST 5TH FL NEW YORK,NY10019 46-0953126	HEALTH CARE M	NY	BIMC HOLDCO	C					No
(9) HIBER-CELL INC 850 NEW BURTON ROAD SUITE 201 DOVER,DE19904 82-0608182	CLINICAL LAB	DE	ISMMS	C					No
(10) AMATHUS THERAPEUTICS INC 1506 BOSTON PROVIDENCE HIGHWAY STE NORWOOD,MA02062 81-4373501	BIOTECH/PHARM	MA	ISMMS	C					No

Schedule R (Form 990) 2021

Page 3

Part V

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

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

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, or (iv) rent from a controlled entity .....................

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

Yes

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

Yes

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

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

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

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

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

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

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

Yes

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 related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI	R	5,726,037	CASH BASIS
(2) THE MOUNT SINAI HOSPITAL	C	20,000,000	CASH BASIS
(3) THE MOUNT SINAI HOSPITAL	Q	3,713,791	CASH BASIS
(4) SOUTH NASSAU FAMILY MEDICINE PC	R	1,733,600	CASH BASIS
(5) SOUTH NASSAU FAMILY MEDICINE PC	N	637,073	CASH BASIS
(6) SOUTH NASSAU FAMILY MEDICINE PC	B	1,417,810	CASH BASIS
(7) SN NEO NATAL PC	S	538,566	CASH BASIS
(8) SN NEO NATAL PC	B	909,489	CASH BASIS
(9) SN MEDICAL GROUP PC	B	6,548,627	CASH BASIS
(10) SN ONOLOGY PRACTICE PC	S	2,580,035	CASH BASIS
(11) SN ONOLOGY PRACTICE PC	B	3,491,538	CASH BASIS
(12) 203 MERRICK ROAD HOLDING CORP	C	136,122	CASH BASIS
(13) SN SERVICES CORPORATION	B	1,686,305	CASH BASIS
(14) SN PHYSICAN PC - DR DATTA	B	382,585	CASH BASIS
(15) SN PHYSICAN PC - DR DATTA	N	64,104	CASH BASIS
(16) SN UROLOGY PC	R	14,000	CASH BASIS
(17) NY MEDICINE PARTNERS ACO	B	96,438	CASH BASIS
(18) SN PHYSICIAN GROUP	C	710,580	CASH BASIS
(19) SN ONOLOGY PC	R	1,418,197	CASH BASIS
(20) SN ONOLOGY PC	N	78,624	CASH BASIS
(21) SN ONOLOGY PC	B	451,777	CASH BASIS
(22) SN PHYSICIANS PRACTICE PC	R	4,130,872	CASH BASIS
(23) SN PHYSICIANS PRACTICE PC	N	448,752	CASH BASIS
(24) SN PHYSICIANS PRACTICE PC	B	28,288	CASH BASIS
(25) SN RADIOLOGY PC	S	897,845	CASH BASIS
(26) SN RADIOLOGY PC	N	24,114	CASH BASIS
(27) SN RADIOLOGY PC	B	594,320	CASH BASIS
(28) RADIOLOGICAL ASSOCIATES OF LONG ISLAND	R	1,605,077	CASH BASIS
(29) RADIOLOGICAL ASSOCIATES OF LONG ISLAND	N	96,329	CASH BASIS
(30) RADIOLOGICAL ASSOCIATES OF LONG ISLAND	B	221,219	CASH BASIS
(31) SOUTH NASSAU PRIMARY MEDICAL PC	S	571,133	CASH BASIS
(32) SOUTH NASSAU PRIMARY MEDICAL PC	N	77,448	CASH BASIS
(33) SOUTH NASSAU PRIMARY MEDICAL PC	B	558,792	CASH BASIS
(34) SN MEDICAL GROUP PC	S	12,711,150	CASH BASIS

Schedule R (Form 990) 2021

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

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation
PART V, LINE 2	VALUE OF THE SERVICES ARE REPORTED ON A CASH BASIS.
PART II, LINE 5, COLUMN F	MSMC RESIDENTIAL REALTY LLC DIRECT CONTROLLING ENTITY ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI, THE MOUNT SINAI HOSPITAL, THE MSMC REALTY CORPORATION AND THE MSMC RESIDENTIAL REALTY MANAGER, INC. ARE ALL MEMBERS OF THIS ENTITY.
PART II, LINE 7, COLUMN F	MSMC RESIDENTIAL REALTY MANAGER, INC DIRECT CONTROLLING ENTITY ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI, THE MOUNT SINAI HOSPITAL, THE MSMC REALTY CORPORATION ARE ALL MEMBERS OF THIS ENTITY.
PART II, LINE 4 COLUMN F	MSMC REALTY CORPORATION DIRECT CONTROLLING ENTITY ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI, THE MOUNT SINAI HOSPITAL, MOUNT SINAI MEDICAL CENTER ARE ALL MEMBERS OF THIS ENTITY.

Schedule R (Form 990) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: COMMITTED TO PROVIDING QUALITY, COMPREHENSIVE AND EASILY ACCESSIBLE HEALTHCARE SERVICES TO ALL RESIDENTS OF THE SOUTH SHORE COMMUNITIES IN A MANNER THAT REFLECTS A CULTURE OF EXCELLENCE, PERSONALIZED, CULTURALLY COMPETENT CARE AND INNOVATION.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	22
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	19
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	4,413
6	Total number of volunteers (estimate if necessary) .............	6	160
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	12,251
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	82,983,030	63,798,045
9	Program service revenue (Part VIII, line 2g) .........	531,653,056	604,362,429
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	2,630,360	4,877,024
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	26,102,947	33,978,439
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	643,369,393	707,015,937
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)	320,940,222	324,825,205
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 741,113
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	226,540,481	248,487,811
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	547,480,703	573,313,016
19	Revenue less expenses. Subtract line 18 from line 12.......	95,888,690	133,702,921
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	1,030,058,493	1,137,075,279
21	Total liabilities (Part X, line 26).............	636,759,982	565,656,114
22	Net assets or fund balances. Subtract line 21 from line 20.....	393,298,511	571,419,165

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 346,347,285 including grants of $ ) (Revenue $ 440,888,292 )
	MEDICAL AND SURGICAL INPATIENT SERVICES:THE HOSPITAL IS CERTIFIED FOR 329 MEDICAL SURGICAL BEDS. THESE BEDS INCLUDE A 36-BED ORTHOPEDIC SPECIALTY UNIT, A 38-BED ONCOLOGY (CANCER) UNIT, A 23-BED STEP-DOWN PROGRESSIVE CARE UNIT INCLUDING AN 8-BED BARIATRIC SURGERY UNIT AND 89 BEDS FOR TELEMETRY OR OTHERS WITH LESS THAN ACUTE CORONARY PROBLEMS. THE HOSPITAL ALSO HAS A 20 BED TRANSITIONAL CARE UNIT. THE HOSPITAL'S OPERATING ROOMS CONSISTS OF 15 SUITES WHICH ARE AVAILABLE FOR BOTH INPATIENT AND OUTPATIENT SURGICAL PROCEDURES. A FULL RANGE OF SURGICAL SPECIALTIES ARE PERFORMED WHICH INCLUDE ORTHOPEDICS, SPINE SURGERY, PLASTIC SURGERY, NEUROSURGERY, GYNECOLOGIC SURGERY, GASTROINTESTINAL SURGERY, LAPAROSCOPIC BARIATRIC SURGERY (MINIMALLY INVASIVE SURGERY FOR WEIGHT LOSS), UROLOGY, OPHTHALMOLOGY, VASCULAR SURGERY, THORACIC SURGERY, PERMANENT PACEMAKERS, IMPLANTABLE DEFIBRILLATORS, PODIATRIC SURGERY, PEDIATRIC SURGERY, EAR, NOSE AND THROAT SURGERY, AND GENERAL SURGERY. THE HOSPITAL ADMITTED 14,986 MEDICAL SURGICAL PATIENTS IN 2021.PEDIATRICS SERVICES:THE HOSPITAL PROVIDES COMPREHENSIVE GENERAL AND SPECIALIZED PEDIATRIC CARE FOR CHILDREN AND TEENAGERS IN NEED OF SURGICAL OR PREVENTIVE SERVICES OR CARE FOR INFECTIOUS DISEASES, SERIOUS ILLNESSES OR COMPLEX MEDICAL CONDITIONS. THIS UNIT FEATURES SPECIALISTS IN PEDIATRIC CARDIOLOGY, ENDOCRINOLOGY, GASTROENTEROLOGY, GENETICS, HEMATOLOGY-ONCOLOGY, NEUROLOGY, PULMONARY MEDICINE AS WELL AS A PEDIATRIC SURGEON, NEONATOLOGIST AND ANESTHESIOLOGIST. A SPECIAL CARE PEDIATRIC UNIT EQUIPPED WITH THE LATEST PEDIATRIC MEDICAL TECHNOLOGY AND MONITORING SYSTEM, CAN EFFECTIVELY MANAGE AND TREAT ALMOST ANY EMERGENCY OR SERIOUS ILLNESS. THE UNIT FEATURES A MULTI-PURPOSE TREATMENT ROOM TO PERFORM MINOR PROCEDURES, WHETHER SURGICAL OR NON-SURGICAL. A TEAM OF SPECIALLY TRAINED NURSING STAFF AND PEDIATRICIANS, INCLUDING NURSING STAFF TRAINED IN PEDIATRIC ADVANCE LIFE SUPPORT (PALS), WITH SPECIALISTS ON-CALL AROUND THE CLOCK. THE HOSPITAL ADMITTED 82 PEDIATRIC PATIENTS IN 2021.MATERNITY AND NURSERY SERVICES:THE HOSPITAL HAS STATE-OF-THE-ART LABOR/DELIVERY ROOMS WHICH CREATE A COMFORTING ENVIRONMENT WHILE PROVIDING ALL THE NECESSARY EQUIPMENT AND CLINICAL SUPPORT FOR MOTHER AND BABY. ALL 26 POSTPARTUM BEDS OFFER PRIVATE ACCOMMODATIONS. THE HOSPITAL PROVIDES SPECIALIZED SERVICES FOR WOMEN WITH HIGH-RISK PREGNANCIES. THE UNIT IS STAFFED BY SOME OF THE AREA'S LEADING SPECIALISTS IN HIGH-RISK PREGNANCIES. SOUTH NASSAU PROVIDES A COMPREHENSIVE PACKAGE OF SERVICES, INCLUDING PERINATOLOGY, FETAL MONITORING, GENETICS COUNSELING, AND DIAGNOSTIC CARE FOR ALL STAGES OF HIGH-RISK PREGNANCIES INCLUDING AMNIOCENTESIS AND ULTRASOUND. THE HOSPITAL ADMITTED 4,763 MATERNITY PATIENTS (INCLUDING NEWBORNS) IN 2021.NEONATAL SERVICES:THE HOSPITAL ALSO HAS A LEVEL II NEONATAL INTENSIVE CARE UNIT FOR PREMATURE BABIES. PREMATURE DELIVERIES AND NEWBORNS WITH DEVELOPMENTAL COMPLICATIONS OR CONDITIONS RECEIVE THE SPECIALIZED CARE THEY NEED IN THE NEONATAL INTENSIVE CARE UNIT. STAFFED BY HIGHLY TRAINED, BOARD-CERTIFIED NEONATOLOGISTS AND NURSES, THE NURSERY PROVIDES INTENSIVE ONE-TO-ONE CARE AND IS EQUIPPED WITH DEDICATED MEDICAL TECHNOLOGY FOR PREMATURE DELIVERIES AND NEWBORNS WITH SPECIAL NEEDS. THE NURSERY ALSO FEATURES A STATE-OF-THE-ART MONITORING SYSTEM. THE HOSPITAL ADMITTED 130 NEONATES IN 2021.IN-PATIENT PSYCHIATRIC SERVICES:IN OUR 36-BED SHORT-TERM INPATIENT BEHAVIORAL HEALTH UNIT, WE PROVIDE RAPID STABILIZATION FOR A WIDE RANGE OF ACUTE PSYCHIATRIC CONDITIONS. PATIENTS RECEIVE PSYCHIATRIC AND PSYCHOLOGICAL CONSULTATION DURING THEIR HOSPITAL STAY TO ALLEVIATE DISTRESS AND PAIN. THE HOSPITAL ADMITTED 851 PSYCHIATRIC PATIENTS IN 2021.TRANSITIONAL CARE UNIT: THIS 20 BED UNIT PROVIDES "TRANSITIONAL" CARE FOR PATIENTS WHO HAVE COMPLETED THEIR ACUTE STAY IN THE HOSPITAL YET STILL REQUIRE SKILLED NURSING AND OTHER SUPPORTIVE CARE BEFORE RETURNING TO HOME OR OTHER LIVING ARRANGEMENTS. THE HOSPITAL ADMITTED 339 PATIENTS IN 2021.SUMMARY:THE HOSPITAL ADMITTED A TOTAL OF 21,137 PATIENTS IN 2021 FOR INPATIENT SERVICES. THESE SERVICES WERE PROVIDED TO THE MEMBERS OF THE COMMUNITY ON AN ELECTIVE BASIS OR EMERGENCY BASIS. THE HOSPITAL PROVIDES CHARITY CARE AND DISCOUNTS TO PATIENTS THAT ARE UNABLE TO PAY FOR THE SERVICES PROVIDED. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $1.0 MILLION (CHARGES) FOR INPATIENTS SERVED IN 2021.

4b	(Code: ) (Expenses $ 72,165,026 including grants of $ ) (Revenue $ 81,999,554 )
	AMBULATORY SURGERY: SOUTH NASSAU AMBULATORY SURGERY SERVICE LINE CONSISTS OF OUTPATIENT SURGICAL, ENDOSCOPY, PAIN MANAGEMENT AND CARDIAC SERVICES. SEE DETAILS OF THE SERVICES THAT COMPRISE AMBULATORY SURGERY BELOW:OUTPATIENT SURGERIES:SOUTH NASSAU'S AMBULATORY SURGERY UNIT (ASU) FEATURES 10 SEMI-PRIVATE PRE-OPERATIVE PATIENT SUITES WHERE THE PATIENT IS ADMITTED PRIOR TO SURGERY AND 16 SEMI-PRIVATE POSTOPERATIVE ROOMS WHERE PATIENTS COMPLETE PHASE TWO OF THEIR RECOVERY, RECEIVE PAIN MEDICATION AND POST-OPERATIVE TEACHING PRIOR TO BEING DISCHARGED FROM THE HOSPITAL. THE ASU POST-OPERATIVE UNIT IS OPEN 24 HOURS A DAY. THE HOSPITAL PERFORMED 5,670 OUTPATIENT SURGICAL PROCEDURES IN 2021.ENDOSCOPY:SOUTH NASSAU COMMUNITIES HOSPITAL'S ENDOSCOPY UNIT PROVIDES STATE-OF-THE-ART PATIENT CARE FOR BOTH INPATIENTS AND OUTPATIENTS REQUIRING UPPER OR LOWER GASTROINTESTINAL STUDIES. THE SERVICE OFFERS E.R.C.P. (ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY) STUDIES OF THE GALL BLADDER, PANCREAS AND BILE DUCTS. ALSO OFFERED ARE ENDOSCOPIC ULTRASOUND, WHICH EXAMINES THE WALLS AND THE SURROUNDING STRUCTURES OF THE GI SYSTEM; GASTROSCOPY AND COLONOSCOPY, A MINIMALLY INVASIVE PROCEDURE TO VIEW THE GASTROINTESTINAL SYSTEM INCLUDING THE ESOPHAGUS, STOMACH AND COLON; AND LIVER BIOPSIES. THE ENDOSCOPY UNIT ALSO PERFORMS PH AND MOTILITY STUDIES USING THE "BRAVO" CAPSULE. THE HOSPITAL PERFORMED 3,971 OUTPATIENT ENDOSCOPY PROCEDURES IN 2021.PAIN MANAGEMENT:SOUTH NASSAU'S PAIN MANAGEMENT UNIT PROVIDES CARE TO BOTH INPATIENTS AND OUTPATIENTS REQUIRING INTERVENTIONAL PAIN MANAGEMENT PROCEDURES. THE PAIN MANAGEMENT ANESTHESIOLOGISTS, WHO ARE ASSISTED BY HIGHLY SKILLED REGISTERED NURSES, ARE TRAINED IN CUTTING-EDGE INTERVENTIONAL PAIN MANAGEMENT MODALITIES. THE HOSPITAL PERFORMED 1,412 OUTPATIENT PAIN MANAGEMENT PROCEDURES IN 2021.CARDIAC SERVICES:CARDIAC CATHETERIZATION LABORATORY: THE HOSPITAL'S CARDIAC CATHETERIZATION LABORATORIES IN THE CENTER FOR CARDIOVASCULAR HEALTH USE STATE-OF-THE-ART DIGITAL IMAGING CAMERAS FOR THE HIGHEST POSSIBLE RESOLUTION AND IMAGE QUALITY. THIS PROVIDES PRECISE RESULTS FOR CARDIAC PROCEDURES WHILE SIGNIFICANTLY REDUCING THE PATIENT'S EXPOSURE TO RADIATION. SOUTH NASSAU WAS APPROVED BY THE DEPARTMENT OF HEALTH TO PERFORM ELECTIVE ANGIOPLASTY. THIS ALLOWS SOUTH NASSAU TO PERFORM DIAGNOSTIC CARDIAC CATHETERIZATIONS AS WELL AS BOTH ELECTIVE AND EMERGENT CORONARY ANGIOPLASTY PROCEDURES. THE CARDIAC CATHETERIZATION LAB AND THE CARDIAC SERVICES ADMITTING/RECOVERY UNIT ARE STAFFED BY SPECIALLY TRAINED REGISTERED NURSES, NURSE PRACTITIONERS, PHYSICIAN'S ASSISTANTS AND EXPERIENCED INTERVENTIONAL CARDIOLOGISTS WHO RANK AMONG THE BEST IN THE STATE. THE HOSPITAL PERFORMED 911 OUTPATIENT CATHETERIZATION PROCEDURES IN 2021.ELECTROPHYSIOLOGY LABORATORY:THE HOSPITAL'S ELECTROPHYSIOLOGY AND ARRHYTHMIAS LAB SPECIALIZES IN THE DIAGNOSIS AND TREATMENT OF LIFE-THREATENING HEART RHYTHM DISORDERS. THE ELECTROPHYSIOLOGY LAB USES STATE-OF-THE-ART 3-D CARDIAC ANATOMIC MAPPING WHICH ALLOWS FOR THE PRECISE LOCATION OF IRREGULAR HEARTBEATS. THE ELECTROPHYSIOLOGY AND ARRHYTHMIAS LAB TEAM IS COMPOSED OF BOARD-CERTIFIED ELECTROPHYSIOLOGISTS TOGETHER WITH SPECIALLY TRAINED PHYSICIAN ASSISTANTS AND REGISTERED NURSES. THE LAB IMPLANTS PERMANENT PACEMAKERS, CARDIAC DEFIBRILLATORS, BIVENTRICULAR DEVICES AND LOOP RECORDERS AND PROVIDES ELECTROPHYSIOLOGY PROCEDURES SUCH AS TABLE TESTING, CARDIAC ABLATIONS, CARDIOVERSIONS, TRANSESOPHAGEAL ECHOCARDIOGRAMS AND DIAGNOSTIC ELECTROPHYSIOLOGY STUDIES. PATIENTS RECEIVING PERMANENT PACEMAKERS OR DEFIBRILLATORS HAVE THE DEVICE INTERROGATIONS PERFORMED IN THE ELECTROPHYSIOLOGY LAB FOLLOWING THE IMPLANTATION AND AT ROUTINE INTERVALS. THE HOSPITAL PERFORMED 317 OUTPATIENT EP STUDIES IN 2021.SUMMARY:AMBULATORY SURGERY SERVICES WERE PROVIDED TO 14,104 MEMBERS OF THE COMMUNITY ON AN ELECTIVE BASIS. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $1.2 MILLION (CHARGES) FOR AMBULATORY PATIENTS SERVED IN 2021.

4c	(Code: ) (Expenses $ 61,902,767 including grants of $ ) (Revenue $ 66,883,659 )
	EMERGENCY SERVICES:OCEANSIDE:THE EMERGENCY ROOM IS OPERATED ON A FULL TIME BASIS (24 HOURS 365 DAYS A WEEK). OUR EMERGENCY ROOM IS ONE OF THE BUSIEST ON THE SOUTH SHORE OF NASSAU COUNTY. THE EMERGENCY ROOM IS THIS AREA'S LEADING CENTER OF SPECIALIZED EMERGENCY CARE, WITH A SOLID REPUTATION FOR DEVELOPING AND IMPLEMENTING INNOVATIONS IN EMERGENCY HEALTH CARE SERVICES. THE EMERGENCY ROOM IS STAFFED BY A TEAM OF DEDICATED PROFESSIONALS, INCLUDING BOARD-CERTIFIED, RESIDENCY-TRAINED EMERGENCY MEDICINE PHYSICIANS (ONE OF FEW HOSPITALS IN NEW YORK WITH SUCH STAFFING), AS WELL AS NURSES, NURSE PRACTITIONERS AND PHYSICIANS' ASSISTANTS WHO HAVE BEEN SPECIALLY-TRAINED IN EMERGENCY MEDICAL CARE. THE EMERGENCY ROOM IS ALSO A LEVEL II TRAUMA CENTER, EQUIPPED WITH THE ADVANCED MEDICAL TECHNOLOGY AND SKILLED SPECIALISTS REQUIRED TO PERFORM EMERGENCY TRAUMA PROCEDURES. IT HAS ALSO BEEN DESIGNATED AS A STROKE CENTER BY THE NEW YORK STATE DEPARTMENT OF HEALTH BECAUSE WE OFFER THE RAPID ASSESSMENT AND ADVANCED THERAPIES AND PROCEDURES THAT CAN MAKE A DIFFERENCE FORSTROKE PATIENT. THE HOSPITAL PROVIDES CHARITY CARE AND DISCOUNTS TO PATIENTS RECEIVING EMERGENCY ROOM SERVICES CONSISTENT WITH OUR POLICY. THE HOSPITAL EXPERIENCED 52,786 EMERGENCY ROOM VISITS IN 2021 OF WHICH 16,499 PATIENTS WERE ADMITTED IN 2021, THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $.5 MILLION (CHARGES) TO INDIVIDUALS WHO RECEIVED EMERGENCY SERVICES.LONG BEACH:THE FREE STANDING EMERGENCY DEPARTMENT, WHICH OPERATES ON A FULL TIME BASIS (24 HOURS A DAY, 365 DAYS A YEAR), IS STAFFED WITH CERTIFIED EMERGENCY NURSES AND PHYSICIANS BOARD CERTIFIED IN EMERGENCY MEDICINE, AND HAS THE SAME FEATURES AND DIAGNOSTIC EQUIPMENT AS A TRADITIONAL EMERGENCY DEPARTMENT WITH THE EXCEPTION BEING THAT IT IS NOT LOCATED ON THE HOSPITAL'S MAIN CAMPUS. ANY PATIENTS REQUIRING CONTINUED HOSPITAL CARE OR ADMISSION ARE TRANSFERRED TO THE MAIN CAMPUS VIA A SOUTH NASSAU AMBULANCE. THESE TRANSFERS ARE PAID FOR BY THE HOSPITAL. IN 2021, THE LONG BEACH EMERGENCY DEPARTMENT EXPERIENCED 10,140 VISITS, OF WHICH 1,105 PATIENTS WERE TRANSFERRED TO THE HOSPITAL'S MAIN CAMPUS RESULTING IN 752 ADMISSIONS. THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $110,000 (CHARGES) TO INDIVIDUALS WHO RECEIVED EMERGENCY SERVICES.

	(Code: ) (Expenses $ 31,828,794 including grants of $ ) (Revenue $ 47,249,710 )
	OTHER PROGRAM SERVICES:ADDITIONAL OUTPATIENT SERVICES OFFERED BY SOUTH NASSAU COMMUNITIES HOSPITAL ARE: WOUND CARE: FAMILY MEDICINE: SPORTS MEDICINE AND REHABILITATION THERAPY; BEHAVIORAL HEALTH SERVICES; OUTPATIENT DIALYSIS; PARENT-CHILD EDUCATION; PRIMARY MEDICAL CARE; CARDIAC REHABILITATION' WEIGHT & LIFE MANAGEMENT; HOME HEALTH CARE; CANCER SERVICES; GAMMA KNIFE SERVICES; BREAST/GYN HEALTH; OTHER CARDIVASCULAR SERVICES; RADIOLOGY SERVICES; WOMEN'S IMAGING; SLEEP MEDICINE; AND FAMILY MEDICINE AT LONG BEACH. THE HOSPITAL PROVIDED 200,000 SERVICES RELATED TO THE OTHER OUTPATIENT SERVICES IN 2021. THESE SERVICES WERE PROVIDED TO THE MEMBERS OF THE COMMUNITY ON AN ELECTIVE. THE HOSPITAL PROVIDES CHARITY CARE AND DISCOUNTS TO PATIENTS THAT ARE UNABLE TO A PAY FOR THESE SERVICES.IN 2020, THE HOSPITAL PROVIDED CHARITY CARE OF APPROXIMATELY $2.8 MILLION (CHARGES) FOR OTHER OUTPATIENT SERVICES.

	(Code: ) (Expenses $ including grants of $ ) (Revenue $ -3,334,616 )
	REFERENCE LAB

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 31,828,794 including grants of $ ) (Revenue $ 43,915,094 )
4e	Total program service expenses512,243,872

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	10,442,115	5,953,358	1,023,500

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	441,200
d	Related organizations		1d
e	Government grants (contributions)		1e	60,971,443

f	All other contributions, gifts, grants, and similar amounts not included above		1f	2,385,402

g	Noncash contributions included in lines 1a - 1f:$		1g	259,601

h Total. Add lines 1a-1f.......		63,798,045

		Business Code
2a	PATIENT REVENUE	622110	599,147,635	599,147,635
b	REFERENCE LAB	621500	3,334,616	3,322,365	12,251
c	RENTAL INCOME	531120	1,880,178	1,880,178
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		604,362,429

3 Investment income (including dividends, interest, and othersimilar amounts) ......			2,628,821			2,628,821
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		12,649,354	7a
b	Less: cost or other basis and sales expenses		10,401,151	7b
c	Gain or (loss)		2,248,203	7c
d	Net gain or (loss).........			2,248,203			2,248,203
8a	Gross income from fundraising events (not including $ 441,200of contributions reported on line 1c). See Part IV, line 18 ....
			8a	173,800
b	Less: direct expenses ...		8b	356,062
c	Net income or (loss) from fundraising events..			-182,262			-182,262
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	SERVICE TO AFFILITIATE		621400	28,416,416	28,416,416
b	REBATES & DISCOUNTS		900099	1,986,512	1,986,512
c	CAFE & CAFETERIA		722514	1,501,915			1,501,915
d	All other revenue ....			2,255,858	2,255,858
e	Total. Add lines 11a–11d ......			34,160,701
12	Total revenue. See instructions.....			707,015,937	637,008,964	12,251	6,196,677

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	11,125,892	9,823,131	1,302,761
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........	258,716,287	228,268,847	30,293,801	153,639
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	12,987,994	11,467,194	1,520,800
9	Other employee benefits .......	17,376,816	15,342,117	2,034,699
10	Payroll taxes ...........	24,618,216	21,735,601	2,882,615
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	467,561	412,813	54,748
c	Accounting ...........	576,026		576,026
d	Lobbying ...........	231,698		231,698
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	399,836		399,836
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	47,008,750	40,740,306	6,268,444
12	Advertising and promotion ....	1,643,519	1,451,075	192,444
13	Office expenses .......	7,556,147	5,819,791	1,148,882	587,474
14	Information technology ......	6,936,024	6,123,866	812,158
15	Royalties ..
16	Occupancy ...........	8,493,924	7,499,425	994,499
17	Travel ............	206,051	181,108	24,943
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	339,810	298,064	41,746
20	Interest ...........	4,307,377	3,803,014	504,363
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	38,527,181	34,017,787	4,509,394
23	Insurance ...	15,476,724	13,664,512	1,812,212
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES	95,809,488	95,809,488
b	DISASTER RESPONSE	6,893,140	6,076,832	816,308
c	EQUIPMENT RENTAL & MAIN	5,985,506	5,265,191	720,315
d	OTHER	4,797,334	4,443,710	353,624
e	All other expenses	2,831,715		2,831,715
25	Total functional expenses. Add lines 1 through 24e	573,313,016	512,243,872	60,328,031	741,113
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			19,177,953	1	16,006,792
2	Savings and temporary cash investments .........			95,080,617	2	115,644,014
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			63,264,172	4	79,085,919
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			8,862,785	8	9,033,349
9	Prepaid expenses and deferred charges ......			4,378,999	9	3,158,486
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	888,650,401
b	Less: accumulated depreciation	10b	446,126,417	379,385,557	10c	442,523,984
11	Investments—publicly traded securities .			172,015,180	11	195,400,139
12	Investments—other securities. See Part IV, line 11 .....			12,219,731	12	15,472,972
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			275,673,499	15	260,749,624
16	Total assets. Add lines 1 through 15 (must equal line 33)...			1,030,058,493	16	1,137,075,279

17	Accounts payable and accrued expenses .....	135,656,200	17	133,573,074
18	Grants payable ...		18
19	Deferred revenue .........	64,610,425	19	45,939,622
20	Tax-exempt bond liabilities .........	158,662,711	20	152,362,827
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	68,903,057	23	78,293,386
24	Unsecured notes and loans payable to unrelated third parties ..	36,900,000	24	48,678,454
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	172,027,589	25	106,808,751
26	Total liabilities. Add lines 17 through 25..	636,759,982	26	565,656,114

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	381,216,689	27	560,621,278
28	Net assets with donor restrictions ...........	12,081,822	28	10,797,887
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	393,298,511	32	571,419,165
33	Total liabilities and net assets/fund balances ........	1,030,058,493	33	1,137,075,279