Form990-PF


Department of the Treasury
Internal Revenue Service

Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
bulletDo not enter social security numbers on this form as it may be made public.
bulletGo to www.irs.gov/Form990PF for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
For calendar year 2021, or tax year beginning 09-01-2021 , and ending 08-31-2022
Name of foundation
BROOKHAVEN MEMORIAL HOSPITAL ASSOC
 
Number and street (or P.O. box number if mail is not delivered to street address)PO BOX 185
  Room/suite
City or town, state or province, country, and ZIP or foreign postal code
PITTSBURGH, PA152300185
A Employer identification number

13-6370889
B Telephone number (see instructions)

(212) 922-8198
C bullet
G Check all that apply:

D 1. Foreign organizations, check here............. bullet
2. Foreign organizations meeting the 85%
test, check here and attach computation ... bullet
E bullet
H Check type of organization:
F bullet
I Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)bullet$3,571,670J Accounting method:
 
(Part I, column (d) must be on cash basis.)
Part I Analysis of Revenue and Expenses (The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).) (a) Revenue and
expenses per
books 		(b) Net investment
income 		(c) Adjusted net
income 		(d) Disbursements
for charitable
purposes
(cash basis only)
Revenue 1 Contributions, gifts, grants, etc., received (attach schedule)  
2 Check bullet.............
3 Interest on savings and temporary cash investments      
4 Dividends and interest from securities... 84,029 84,029  
5a Gross rents............      
b Net rental income or (loss)  
6a Net gain or (loss) from sale of assets not on line 10 268,678
b Gross sales price for all assets on line 6a 1,342,179
7 Capital gain net income (from Part IV, line 2)... 268,678
8 Net short-term capital gain......... 0
9 Income modifications...........  
10a Gross sales less returns and allowances  
b Less: Cost of goods sold....  
c Gross profit or (loss) (attach schedule).....    
11 Other income (attach schedule).......      
12 Total. Add lines 1 through 11........ 352,707 352,707  
Operating and Administrative Expenses 13 Compensation of officers, directors, trustees, etc. 22,118 13,271   8,847
14 Other employee salaries and wages......   0 0 0
15 Pension plans, employee benefits.......   0 0  
16a Legal fees (attach schedule).........       0
b Accounting fees (attach schedule).......        
c Other professional fees (attach schedule)....       0
17 Interest...............       0
18 Taxes (attach schedule) (see instructions)... Click to see attachment 7,243 1,771   0
19 Depreciation (attach schedule) and depletion... 0 0  
20 Occupancy..............        
21 Travel, conferences, and meetings.......   0 0  
22 Printing and publications..........   0 0  
23 Other expenses (attach schedule)....... Click to see attachment 250     250
24 Total operating and administrative expenses.
Add lines 13 through 23.......... 29,611 15,042 0 9,097
25 Contributions, gifts, grants paid....... 198,757 198,757
26 Total expenses and disbursements. Add lines 24 and 25 228,368 15,042 0 207,854
27 Subtract line 26 from line 12:
a Excess of revenue over expenses and disbursements 124,339
b Net investment income (if negative, enter -0-) 337,665
c Adjusted net income (if negative, enter -0-)... 0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X Form 990-PF (2021)
Form 990-PF (2021)
Page 2
Part II Balance Sheets Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.) 		Beginning of year End of year
(a) Book Value (b) Book Value (c) Fair Market Value
Assets 1 Cash—non-interest-bearing.............      
2 Savings and temporary cash investments......... 25,103 46,737 46,737
3 Accounts receivable bullet  
Less: allowance for doubtful accounts bullet     0 0
4 Pledges receivable bullet  
Less: allowance for doubtful accounts bullet        
5 Grants receivable.................      
6 Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions).....      
7 Other notes and loans receivable (attach schedule) bullet  
Less: allowance for doubtful accounts bullet0      
8 Inventories for sale or use..............      
9 Prepaid expenses and deferred charges..........      
10a Investments—U.S. and state government obligations (attach schedule)      
b Investments—corporate stock (attach schedule).......      
c Investments—corporate bonds (attach schedule).......      
11 Investments—land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
12 Investments—mortgage loans.............      
13 Investments—other (attach schedule).......... 2,730,103 Click to see attachment2,838,076 3,524,933
14 Land, buildings, and equipment: basis bullet  
Less: accumulated depreciation (attach schedule) bullet        
15 Other assets (describe bullet)      
16 Total assets (to be completed by all filers—see the
instructions. Also, see page 1, item I) 2,755,206 2,884,813 3,571,670
Liabilities 17 Accounts payable and accrued expenses..........    
18 Grants payable.................    
19 Deferred revenue.................    
20 Loans from officers, directors, trustees, and other disqualified persons    
21 Mortgages and other notes payable (attach schedule)......    
22 Other liabilities (describe bullet)    
23 Total liabilities (add lines 17 through 22).........   0
Net Assets or Fund Balances Foundations that follow FASB ASC 958, check here bullet
and complete lines 24, 25, 29 and 30.
24 Net assets without donor restrictions...........    
25 Net assets with donor restrictions............    
Foundations that do not follow FASB ASC 958, check here bullet
and complete lines 26 through 30.
26 Capital stock, trust principal, or current funds........ 2,755,206 2,884,813
27 Paid-in or capital surplus, or land, bldg., and equipment fund    
28 Retained earnings, accumulated income, endowment, or other funds    
29 Total net assets or fund balances (see instructions)..... 2,755,206 2,884,813
30 Total liabilities and net assets/fund balances (see instructions). 2,755,206 2,884,813
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return) ...............
1
2,755,206
2
Enter amount from Part I, line 27a .....................
2
124,339
3
Other increases not included in line 2 (itemize) bulletClick to see attachment
3
5,545
4
Add lines 1, 2, and 3 ..........................
4
2,885,090
5
Decreases not included in line 2 (itemize) bulletClick to see attachment
5
277
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29 .
6
2,884,813
Form 990-PF (2021)
Form 990-PF (2021)
Page 3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a) List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)		 (b)
How acquired
P—Purchase
D—Donation 		(c)
Date acquired
(mo., day, yr.) 		(d)
Date sold
(mo., day, yr.)
1 a 41. APPLE COMPUTER INC COM   2019-08-01 2021-09-20
b 210. BRISTOL MYERS SQUIBB CO COM     2021-09-20
c 83. PROCTER & GAMBLE CO COM     2021-09-27
d 47. FACEBOOK INC   2018-11-30 2021-09-30
e 29. TEXAS INSTRUMENTS INC     2021-09-30
26. SEMPRA ENERGY   2021-03-16 2021-10-07
81. SEMPRA ENERGY   2020-01-31 2021-10-07
150. COMCAST CORP NEW CL A   2021-03-08 2021-10-11
59. TEXAS INSTRUMENTS INC     2021-10-13
74. DISNEY (WALT) COMPANY HOLDING CO.   2009-03-20 2021-10-18
41. APPLE COMPUTER INC COM     2021-10-25
27. LUMENTUM HOLDINGS INC   2020-02-24 2021-10-25
36. LUMENTUM HOLDINGS INC     2021-10-26
73. FACEBOOK INC     2021-10-27
47. LUMENTUM HOLDINGS INC   2020-02-28 2021-10-27
40. TEXAS INSTRUMENTS INC     2021-10-27
42. ADVANCED MICRO DEVICES INC   2021-09-30 2021-11-05
90. BOSTON SCIENTIFIC CORP COM   2021-06-01 2021-11-05
60. BOSTON SCIENTIFIC CORP COM   2020-07-17 2021-11-05
40. COCA-COLA CO USD   2020-11-11 2021-11-05
60. COCA-COLA CO USD   2019-08-15 2021-11-05
52. MEDTRONIC PLC     2021-11-05
32. MEDTRONIC PLC   2021-03-05 2021-11-15
17. MEDTRONIC PLC   2019-08-16 2021-11-15
1115.539 BNY MELLON MID CAP STK FD CL M   2020-12-16 2021-11-16
836.061 BNY MELLON MID CAP STK FD CL M     2021-11-16
204. VISA INC     2021-11-19
9. BOOKING HOLDINGS INC     2021-11-22
51. MEDTRONIC PLC     2021-11-23
90. AMERICAN INTERNATIONAL GROUP     2021-11-24
47. EATON CORP PLC     2021-11-24
39. TRANE TECHNOLOGIES PLC   2012-02-16 2021-11-24
100. COMCAST CORP NEW CL A     2021-11-26
200. COMCAST CORP NEW CL A   2012-04-13 2021-12-20
43. SALESFORCE COM INC   2010-06-28 2021-12-20
57. MEDTRONIC PLC     2021-12-20
9. ADOBE SYS INC COM   2021-06-14 2022-01-05
12. ADOBE SYS INC COM   2013-02-04 2022-01-05
49. AIR PRODUCTS AND CHEMICALS INC COMMON     2022-01-14
39. AIR PRODUCTS AND CHEMICALS INC COMMON     2022-01-14
20. AIR PRODUCTS AND CHEMICALS INC COMMON     2022-01-18
48. TEXAS INSTRUMENTS INC     2022-01-20
170. PULTE GROUP INC     2022-01-27
102. CHEVRONTEXACO CORP     2022-01-31
36. PAYPAL HOLDINGS INC     2022-02-02
17. PAYPAL HOLDINGS INC   2019-04-10 2022-02-02
86. MEDTRONIC PLC   2018-05-31 2022-02-02
27. FACEBOOK INC     2022-02-03
130. GENERAL MOTORS CO     2022-02-07
200. PULTE GROUP INC   2021-09-27 2022-02-07
43. TRANE TECHNOLOGIES PLC   2012-02-16 2022-02-09
.6667 CONSTELLATION ENERGY CORP   2021-03-16 2022-02-17
12. ADOBE SYS INC COM   2013-02-04 2022-02-18
18. INTUIT INC COM     2022-02-22
18. HOME DEPOT INC USD 0.05   2009-03-23 2022-02-25
74. SKYWORKS SOLUTIONS INC     2022-02-25
6. TESLA MOTORS INC   2021-08-27 2022-02-25
350. GENERAL MOTORS CO     2022-03-17
25. SIMON PPTY GROUP INC NEW   2021-05-27 2022-03-17
1. ACCENTURE PLC IRELAND SHS CL A   2021-12-20 2022-03-17
39. ACCENTURE PLC IRELAND SHS CL A     2022-03-17
24. SIMON PPTY GROUP INC NEW   2021-05-27 2022-03-18
51. SIMON PPTY GROUP INC NEW   2021-03-15 2022-03-18
70. TRADE DESK INC/THE   2021-11-05 2022-03-30
66. SIMON PPTY GROUP INC NEW   2021-03-15 2022-04-07
520. BOSTON SCIENTIFIC CORP COM     2022-04-08
106. CONSTELLATION ENERGY CORP     2022-04-08
46. PIONEER NAT RES CO   2022-01-31 2022-04-08
110. BANK AMER CORP   2015-02-25 2022-04-12
13. MASTERCARD INC   2021-11-19 2022-04-12
10. NETFLIX COM INC   2021-06-24 2022-04-20
43. NETFLIX COM INC     2022-04-20
16. CHARTER COMMUNICATIONS INC-A     2022-04-29
11. CHARTER COMMUNICATIONS INC-A     2022-04-29
2. AMAZON COM INC   2021-08-19 2022-05-03
3. AMAZON COM INC     2022-05-03
74. DATADOG INC   2021-10-13 2022-05-03
16. ADOBE SYS INC COM   2013-02-04 2022-05-06
16. INTUIT INC COM   2019-11-15 2022-05-06
40. SQUARE INC - A     2022-05-06
36. SQUARE INC - A   2022-02-02 2022-05-11
79. SQUARE INC - A   2019-05-02 2022-05-11
36. APPLE COMPUTER INC COM   2022-02-03 2022-05-12
43. APPLE COMPUTER INC COM   2022-03-17 2022-05-12
11. APPLE COMPUTER INC COM   2006-04-06 2022-05-12
5. CROWDSTRIKE HOLDINGS INC - A   2021-09-20 2022-05-12
10. CROWDSTRIKE HOLDINGS INC - A   2021-09-20 2022-05-12
8. ATLASSIAN CORP PLC-CLASS A   2021-06-14 2022-05-12
16. ATLASSIAN CORP PLC-CLASS A     2022-05-12
43. PROCTER & GAMBLE CO COM   2022-02-02 2022-05-17
19. ATLASSIAN CORP PLC-CLASS A   2021-05-26 2022-05-17
14. ATLASSIAN CORP PLC-CLASS A   2018-03-28 2022-05-17
6. COSTCO WHSL CORP NEW   2021-10-18 2022-05-18
15. COSTCO WHSL CORP NEW     2022-05-18
63. PROCTER & GAMBLE CO COM     2022-05-18
5. ALPHABET INC/CA   2021-10-27 2022-05-19
67. APPLE COMPUTER INC COM   2006-04-06 2022-05-19
60. LIVE NATION INC   2021-12-20 2022-06-03
6. MICROSOFT CORP COM   2021-12-20 2022-06-03
34. MICROSOFT CORP COM     2022-06-03
49. PROLOGIS INC   2022-04-07 2022-06-03
230. ROYAL CARIBBEAN CRUISES LTD     2022-06-07
75. AMAZON COM INC   2011-06-01 2022-06-08
42. AMAZON COM INC   2011-06-01 2022-06-10
70. PAYPAL HOLDINGS INC   2022-04-12 2022-06-10
2. ALPHABET INC/CA   2021-10-27 2022-06-13
90. TRADE DESK INC/THE   2021-06-14 2022-06-13
50. TRADE DESK INC/THE   2021-05-26 2022-06-13
36. ATLASSIAN CORP PLC-CLASS A   2018-03-28 2022-06-13
1839.201 BNYM DIV EMG MKTS-Y   2014-01-31 2022-06-16
55. ZOETIS INC   2022-04-08 2022-06-17
32. LIVE NATION INC     2022-06-21
18. LIVE NATION INC   2021-03-01 2022-06-21
48. AMAZON COM INC   2011-06-01 2022-06-22
40. MARRIOTT INTERNATIONAL INC CL A   2021-11-22 2022-06-22
2. ALPHABET INC/CA     2022-06-30
1. ALPHABET INC/CA   2015-08-19 2022-06-30
30. CSX CORP COM   2022-02-09 2022-06-30
280. CSX CORP COM   2017-01-13 2022-06-30
50. LIVE NATION INC     2022-06-30
10843.503 BNY MELLON EMERGING MKTS FD CL M SHS     2022-07-11
2423.462 BNYM SEL MGR S/C VAL-Y     2022-07-11
2012.594 BNYM SELECT MGR S/C GRW-Y   2010-12-20 2022-07-11
963.566 BNYM OPPORT SM CAP-Y   2010-03-12 2022-07-11
1978.747 BNY MELLON INTL EQTY-Y   2010-04-08 2022-07-11
7. PAYPAL HOLDINGS INC   2022-04-12 2022-07-22
118. PAYPAL HOLDINGS INC     2022-07-22
104. ABBOTT LABORATORIES     2022-07-25
58. PROCTER & GAMBLE CO COM     2022-07-29
37. VALERO ENERGY CORP NEW     2022-07-29
200. BAKER HUGHES A GE CO     2022-08-01
25. PIONEER NAT RES CO     2022-08-01
100. DUPONT DE NEMOURS INC     2022-08-03
49. VALERO ENERGY CORP NEW     2022-08-03
150. BAKER HUGHES A GE CO   2022-04-08 2022-08-04
27. CHEVRONTEXACO CORP     2022-08-04
18. PIONEER NAT RES CO   2021-10-11 2022-08-04
90. RAYTHEON TECHNOLOGIES CORP     2022-08-04
60. RAYTHEON TECHNOLOGIES CORP   2021-05-27 2022-08-04
37. VALERO ENERGY CORP NEW   2021-02-04 2022-08-04
4. ILLINOIS TOOL WORKS INC COM   2022-02-09 2022-08-05
11. ILLINOIS TOOL WORKS INC COM   2014-08-15 2022-08-05
30. RAYTHEON TECHNOLOGIES CORP   2021-11-24 2022-08-05
360. AT&T INC   2022-05-19 2022-08-11
13. KLA TENCOR CORP   2022-05-19 2022-08-11
6. KLA TENCOR CORP   2021-02-23 2022-08-11
200. DUPONT DE NEMOURS INC   2022-01-18 2022-08-31
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(e)
Gross sales price 		(f)
Depreciation allowed
(or allowable) 		(g)
Cost or other basis
plus expense of sale 		(h)
Gain or (loss)
(e) plus (f) minus (g)
a 5,846   2,226 3,620
b 12,676   9,718 2,958
c 11,769   7,536 4,233
d 15,991   6,598 9,393
e 5,590   3,777 1,813
3,270   3,411 -141
10,189   12,970 -2,781
7,937   8,274 -337
11,051   7,424 3,627
12,634   1,273 11,361
6,093   1,760 4,333
2,211   2,171 40
2,928   2,766 162
23,017   10,185 12,832
3,809   3,589 220
7,432   4,578 2,854
5,809   4,330 1,479
3,900   3,874 26
2,600   2,256 344
2,271   2,168 103
3,407   3,226 181
6,433   6,491 -58
3,794   3,711 83
2,015   1,746 269
28,580   22,880 5,700
21,420   11,310 10,110
41,059   17,320 23,739
20,775   21,124 -349
5,777   5,068 709
5,222   4,878 344
8,029   4,593 3,436
7,612   964 6,648
5,111   5,454 -343
9,630   2,965 6,665
10,649   985 9,664
5,664   5,066 598
4,706   5,020 -314
6,274   459 5,815
14,263   13,459 804
11,352   8,717 2,635
5,718   4,009 1,709
8,532   4,665 3,867
8,533   8,473 60
13,410   11,449 1,961
4,771   9,702 -4,931
2,253   1,824 429
8,864   7,429 1,435
6,398   1,186 5,212
6,613   7,604 -991
9,748   9,664 84
6,959   1,063 5,896
31   24 7
5,328   459 4,869
8,671   5,418 3,253
5,576   418 5,158
10,252   9,802 450
4,811   4,260 551
15,124   19,515 -4,391
3,291   3,205 86
319   386 -67
12,430   14,296 -1,866
3,127   3,076 51
6,645   6,160 485
5,116   4,862 254
8,256   7,971 285
23,335   18,794 4,541
6,778   3,047 3,731
11,688   10,064 1,624
4,313   1,815 2,498
4,532   4,479 53
2,198   5,161 -2,963
9,450   19,869 -10,419
6,721   10,904 -4,183
4,621   5,597 -976
4,980   6,440 -1,460
7,469   6,677 792
8,458   11,467 -3,009
6,363   612 5,751
6,425   4,241 2,184
3,854   7,318 -3,464
2,673   4,117 -1,444
5,865   5,350 515
5,031   6,290 -1,259
6,081   6,893 -812
1,556   27 1,529
687   1,280 -593
1,394   2,561 -1,167
1,316   2,000 -684
2,656   3,943 -1,287
6,640   6,993 -353
3,305   4,386 -1,081
2,436   733 1,703
2,594   2,755 -161
6,422   6,420 2
9,197   10,163 -966
11,193   14,689 -3,496
9,229   166 9,063
5,716   6,360 -644
1,617   1,911 -294
9,162   3,907 5,255
6,264   8,280 -2,016
12,955   16,419 -3,464
9,110   735 8,375
4,597   412 4,185
5,523   7,797 -2,274
4,277   5,876 -1,599
4,062   5,452 -1,390
2,257   2,895 -638
6,043   1,884 4,159
43,828   35,000 8,828
8,802   11,034 -2,232
2,694   3,355 -661
1,515   1,677 -162
5,286   470 4,816
5,492   6,270 -778
4,388   5,625 -1,237
2,194   691 1,503
870   1,041 -171
8,124   3,610 4,514
4,123   4,638 -515
114,399   82,922 31,477
51,135   45,000 6,135
44,659   33,121 11,538
27,539   24,657 2,882
37,497   33,326 4,171
566   780 -214
9,534   12,641 -3,107
11,239   13,599 -2,360
8,108   8,998 -890
4,100   5,238 -1,138
4,934   7,529 -2,595
5,714   5,188 526
5,754   8,433 -2,679
5,300   5,499 -199
3,609   5,622 -2,013
4,094   2,912 1,182
3,873   3,515 358
8,367   8,328 39
5,578   5,298 280
3,867   2,265 1,602
835   907 -72
2,297   955 1,342
2,781   2,617 164
6,498   7,255 -757
4,866   4,442 424
2,246   1,900 346
11,179   16,724 -5,545
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
      53,681
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69 (l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-) or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69 		(j)
Adjusted basis
as of 12/31/69 		(k)
Excess of col. (i)
over col. (j), if any
a       3,620
b       2,958
c       4,233
d       9,393
e       1,813
      -141
      -2,781
      -337
      3,627
      11,361
      4,333
      40
      162
      12,832
      220
      2,854
      1,479
      26
      344
      103
      181
      -58
      83
      269
      5,700
      10,110
      23,739
      -349
      709
      344
      3,436
      6,648
      -343
      6,665
      9,664
      598
      -314
      5,815
      804
      2,635
      1,709
      3,867
      60
      1,961
      -4,931
      429
      1,435
      5,212
      -991
      84
      5,896
      7
      4,869
      3,253
      5,158
      450
      551
      -4,391
      86
      -67
      -1,866
      51
      485
      254
      285
      4,541
      3,731
      1,624
      2,498
      53
      -2,963
      -10,419
      -4,183
      -976
      -1,460
      792
      -3,009
      5,751
      2,184
      -3,464
      -1,444
      515
      -1,259
      -812
      1,529
      -593
      -1,167
      -684
      -1,287
      -353
      -1,081
      1,703
      -161
      2
      -966
      -3,496
      9,063
      -644
      -294
      5,255
      -2,016
      -3,464
      8,375
      4,185
      -2,274
      -1,599
      -1,390
      -638
      4,159
      8,828
      -2,232
      -661
      -162
      4,816
      -778
      -1,237
      1,503
      -171
      4,514
      -515
      31,477
      6,135
      11,538
      2,882
      4,171
      -214
      -3,107
      -2,360
      -890
      -1,138
      -2,595
      526
      -2,679
      -199
      -2,013
      1,182
      358
      39
      280
      1,602
      -72
      1,342
      164
      -757
      424
      346
      -5,545
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
2 Capital gain net income or (net capital loss) Bracket If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7		 Bracket 2 268,678
3 Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8 ................... 		Bracket 3  
Form 990-PF (2021)
Form 990-PF (2021)
Page 4
Part V
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a Exempt operating foundations described in section 4940(d)(2), check here Bullet and enter “N/A" on line 1. Bracket for line 1a
Date of ruling or determination letter:   (attach copy of letter if necessary–see instructions)
b All other domestic foundations enter 1.39% (0.0139) of line 27b. Exempt foreign organizations enter 4% (0.04) of Part I, line 12, col. (b)
2 Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 2 0
3 Add lines 1 and 2........................... 3 4,694
4 Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-) 4 0
5 Tax based on investment income. Subtract line 4 from line 3. If zero or less, enter -0- ..... 5 4,694
6 Credits/Payments:
a 2021 estimated tax payments and 2020 overpayment credited to 2021 6a 3,672
b Exempt foreign organizations—tax withheld at source...... 6b 0
c Tax paid with application for extension of time to file (Form 8868)... 6c 0
d Backup withholding erroneously withheld ........... 6d  
7 Total credits and payments. Add lines 6a through 6d.............. 7 3,672
8 Enter any penalty for underpayment of estimated tax. Check here if Form 2220 is attached. 8 0
9 Tax due. If the total of lines 5 and 8 is more than line 7, enter amount owed.......Bullet 9 1,022
10 Overpayment. If line 7 is more than the total of lines 5 and 8, enter the amount overpaid...Bullet 10  
11 Enter the amount of line 10 to be: Credited to 2022 estimated taxBullet0 RefundedBullet 11 0
Part VI-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign? ....................
1a
 
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition.................................
1b
 
No
If the answer is "Yes" to 1a or 1b, attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file Form 1120-POL for this year?.....................
1c
 
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1) On the foundation. bullet$   (2) On foundation managers.bullet$  
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.bullet$  
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?.......
2
 
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments? If "Yes," attach a conformed copy of the changes....
3
 
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?.........
4a
 
No
b
If "Yes," has it filed a tax return on Form 990-T for this year?...................
4b
 
 
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?.........
5
 
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
  • By language in the governing instrument, or
  • By state legislation that effectively amends the governing instrument so that no mandatory directions
    • that conflict with the state law remain in the governing instrument?................
    6
    Yes
     
    7
    Did the foundation have at least $5,000 in assets at any time during the year? If "Yes," complete Part II, col. (c),
    and Part XIV..................................
    7
    Yes
     
    8a
    Enter the states to which the foundation reports or with which it is registered (see instructions)
    bulletNY
    b
    If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
    General (or designate) of each state as required by General Instruction G? If "No," attach explanation .
    8b
    Yes
     
    9
    Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
    or 4942(j)(5) for calendar year 2021 or the taxable year beginning in 2021? See the instructions for Part XIII.
    If "Yes," complete Part XIII .............................
    9
     
    No
    10
    Did any persons become substantial contributors during the tax year? If "Yes," attach a schedule listing their names
    and addresses. ...............................
    10
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 5
    Part VI-A
    Statements Regarding Activities (continued)
    11
    At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
    meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions .............
    11
     
    No
    12
    Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
    advisory privileges? If "Yes," attach statement. See instructions.................
    12
     
    No
    13
    Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
    13
    Yes
     
    Website addressbulletN/A
    14
    The books are in care ofbulletBNY MELLON NA Telephone no.bullet (212) 922-8198

    Located atbulletPO BOX 185PITTSBURGHPA ZIP+4bullet152300185
    15
    Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of Form 1041 —check here .........bullet
    and enter the amount of tax-exempt interest received or accrued during the year ........bullet
    15
     
    16 At any time during calendar year 2021, did the foundation have an interest in or a signature or other authority over YesNo
    a bank, securities, or other financial account in a foreign country? .................
    16   No
    See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
    country bullet
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required
    File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
    Yes
    No
    1a
    During the year did the foundation (either directly or indirectly):
    (1) Engage in the sale or exchange, or leasing of property with a disqualified person? ...........
    1a(1)
     
    No
    (2) Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
    a disqualified person? ..............................
    1a(2)
     
    No
    (3) Furnish goods, services, or facilities to (or accept them from) a disqualified person? ...........
    1a(3)
     
    No
    (4) Pay compensation to, or pay or reimburse the expenses of, a disqualified person? ............
    1a(4)
    Yes
     
    (5) Transfer any income or assets to a disqualified person (or make any of either available
    for the benefit or use of a disqualified person)? ......................
    1a(5)
     
    No
    (6) Agree to pay money or property to a government official? (Exception. Check "No"
    if the foundation agreed to make a grant to or to employ the official for a period
    after termination of government service, if terminating within 90 days.) ...............
    1a(6)
     
    No
    b
    If any answer is "Yes" to 1a(1)–(6), did any of the acts fail to qualify under the exceptions described in Regulations
    section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions ..........
    1b
     
    No
    c
    ........bullet
    d
    Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
    that were not corrected before the first day of the tax year beginning in 2021? .............
    1d
     
    No
    2
    Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
    operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
    a
    At the end of tax year 2021, did the foundation have any undistributed income (lines 6d
    and 6e, Part XII) for tax year(s) beginning before 2021?....................
    2a
     
    No
    If "Yes," list the years bullet20, 20, 20, 20
    b
    Are there any years listed in 2a for which the foundation is not applying the provisions of section 4942(a)(2)
    (relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
    to all years listed, answer "No" and attach statement—see instructions.) ..............
    2b
     
     
    c
    If the provisions of section 4942(a)(2) are being applied to any of the years listed in 2a, list the years here.
    bullet20, 20, 20, 20
    3a
    Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
    any time during the year? ..............................
    3a
     
    No
    b
    If "Yes," did it have excess business holdings in 2021 as a result of (1) any purchase by the foundation
    or disqualified persons after May 26, 1969; (2) the lapse of the 5-year period (or longer period approved
    by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or (3)
    the lapse of the 10-, 15-, or 20-year first phase holding period? (Use Schedule C, Form 4720, to determine
    if the foundation had excess business holdings in 2021.) .....................
    3b
     
     
    4a
    Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
    4a
     
    No
    b
    Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
    charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2021? ..
    4b
     
    No
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 6
    Part VI-B
    Statements Regarding Activities for Which Form 4720 May Be Required (continued)
    5a
    During the year did the foundation pay or incur any amount to:
    Yes
    No
    (1) Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))? ..........
    5a(1)
     
    No
    (2) Influence the outcome of any specific public election (see section 4955); or to carry
    on, directly or indirectly, any voter registration drive? ....................
    5a(2)
     
    No
    (3) Provide a grant to an individual for travel, study, or other similar purposes? .............
    5a(3)
     
    No
    (4) Provide a grant to an organization other than a charitable, etc., organization described
    in section 4945(d)(4)(A)? See instructions ........................
    5a(4)
     
    No
    (5) Provide for any purpose other than religious, charitable, scientific, literary, or
    educational purposes, or for the prevention of cruelty to children or animals? .............
    5a(5)
     
    No
    b
    If any answer is "Yes" to 5a(1)–(5), did any of the transactions fail to qualify under the exceptions described in
    Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions ........
    5b
     
     
    c
    .........bullet
    d
    If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
    tax because it maintained expenditure responsibility for the grant? .................
    5d
     
     
    If "Yes," attach the statement required by Regulations section 53.4945–5(d).
    6a
    Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
    a personal benefit contract? .............................
    6a
     
    No
    b
    Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ....
    6b
     
    No
    If "Yes" to 6b, file Form 8870.
    7a
    At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
    7a
     
    No
    b
    If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction? .....
    7b
     
     
    8
    Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
    excess parachute payment during the year? .........................
    8
     
    No
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors
    1 List all officers, directors, trustees, foundation managers and their compensation. See instructions
    (a) Name and address (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation
     (If not paid, enter
    -0-)     		(d) Contributions to employee benefit plans and deferred compensation (e) Expense account,
    other allowances
    BNY MELLON N A TRUSTEE
    1     		22,118    
    PO BOX 185
    PITTSBURGH,PA152300185
    2 Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
    (a) Name and address of each employee paid more than $50,000 (b) Title, and average
    hours per week
    devoted to position     		(c) Compensation (d) Contributions to
    employee benefit
    plans and deferred
    compensation     		(e) Expense account,
    other allowances
    NONE
    Total number of other employees paid over $50,000...................bullet 0
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 7
    Part VII
    Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
    and Contractors (continued)
    3 Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
    (a) Name and address of each person paid more than $50,000 (b) Type of service (c) Compensation
    NONE
    Total number of others receiving over $50,000 for professional services.............bullet0
    Part VIII-A
    Summary of Direct Charitable Activities
    List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc. Expenses
    1  
    2  
    3  
    4  
    Part VIII-B
    Summary of Program-Related Investments (see instructions)
    Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2. Amount
    1  
    2  
    All other program-related investments. See instructions.
    3  
    Total. Add lines 1 through 3.........................bullet  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 8
    Part IX
    Minimum Investment Return (All domestic foundations must complete this part. Foreign foundations, see instructions.)
    1
    Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
    purposes:
    a
    Average monthly fair market value of securities...................
    1a
    4,029,479
    b
    Average of monthly cash balances.......................
    1b
    42,549
    c
    Fair market value of all other assets (see instructions)................
    1c
    0
    d
    Total (add lines 1a, b, and c).........................
    1d
    4,072,028
    e
    Reduction claimed for blockage or other factors reported on lines 1a and
    1c (attach detailed explanation) .............
    1e
    0
    2
    Acquisition indebtedness applicable to line 1 assets..................
    2
    0
    3
    Subtract line 2 from line 1d.........................
    3
    4,072,028
    4
    Cash deemed held for charitable activities. Enter 1.5% (0.015) of line 3 (for greater amount, see
    instructions) .............................
    4
    61,080
    5
    Net value of noncharitable-use assets. Subtract line 4 from line 3. .......
    5
    4,010,948
    6
    Minimum investment return. Enter 5% (0.05) of line 5................
    6
    200,547
    Part X
    Distributable Amount (see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here right arrow and do not complete this part.)
    1
    Minimum investment return from Part IX, line 6..................
    1
    200,547
    2a
    Tax on investment income for 2021 from Part V, line 5.......
    2a
    4,694
    b
    Income tax for 2021. (This does not include the tax from Part V.) ...
    2b
     
    c
    Add lines 2a and 2b............................
    2c
    4,694
    3
    Distributable amount before adjustments. Subtract line 2c from line 1............
    3
    195,853
    4
    Recoveries of amounts treated as qualifying distributions................
    4
    0
    5
    Add lines 3 and 4............................
    5
    195,853
    6
    Deduction from distributable amount (see instructions).................
    6
    0
    7
    Distributable amount as adjusted. Subtract line 6 from line 5. Enter here and on Part XII, line 1 ...
    7
    195,853
    Part XI
    Qualifying Distributions (see instructions)
    1
    Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
    a
    Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26 ..........
    1a
     
    b
    Program-related investments—total from Part VIII-B..................
    1b
     
    2
    Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
    purposes...............................
    2
     
    3
    Amounts set aside for specific charitable projects that satisfy the:
    a
    Suitability test (prior IRS approval required)....................
    3a
     
    b
    Cash distribution test (attach the required schedule) .................
    3b
     
    4
    Qualifying distributions. Add lines 1a through 3b. Enter here and on Part XII, line 4.
    4
     
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 9
    Part XII
    Undistributed Income (see instructions)
    (a)
    Corpus     		(b)
    Years prior to 2020     		(c)
    2020     		(d)
    2021
    1 Distributable amount for 2021 from Part X, line 7 195,853
    2 Undistributed income, if any, as of the end of 2021:
    a Enter amount for 2020 only....... 0
    b Total for prior years:20, 20, 20 0
    3 Excess distributions carryover, if any, to 2021:
    a From 2016...... 0
    b From 2017...... 0
    c From 2018...... 0
    d From 2019...... 467,615
    e From 2020...... 0
    f Total of lines 3a through e ........ 467,615
    4Qualifying distributions for 2021 from Part
    XI, line 4: bullet$ 207,854
    a Applied to 2020, but not more than line 2a 0
    b Applied to undistributed income of prior years
    (Election required—see instructions).....     		0
    c Treated as distributions out of corpus (Election
    required—see instructions)........     		0
    d Applied to 2021 distributable amount..... 195,853
    e Remaining amount distributed out of corpus 12,001
    5 Excess distributions carryover applied to 2021. 0 0
    (If an amount appears in column (d), the
    same amount must be shown in column (a).)
    6Enter the net total of each column as
    indicated below:
    a Corpus. Add lines 3f, 4c, and 4e. Subtract line 5 479,616
    b Prior years’ undistributed income. Subtract
    line 4b from line 2b ..........     		0
    c Enter the amount of prior years’ undistributed
    income for which a notice of deficiency has
    been issued, or on which the section 4942(a)
    tax has been previously assessed......     		0
    d Subtract line 6c from line 6b. Taxable amount
    —see instructions ...........     		0
    e Undistributed income for 2019. Subtract line
    4a from line 2a. Taxable amount—see
    instructions .............     		0
    f Undistributed income for 2021. Subtract
    lines 4d and 5 from line 1. This amount must
    be distributed in 2022 ..........     		0
    7 Amounts treated as distributions out of
    corpus to satisfy requirements imposed by
    section 170(b)(1)(F) or 4942(g)(3) (Election may
    be required - see instructions) .......     		0
    8 Excess distributions carryover from 2016 not
    applied on line 5 or line 7 (see instructions) ...     		0
    9 Excess distributions carryover to 2022.
    Subtract lines 7 and 8 from line 6a ......     		479,616
    10 Analysis of line 9:
    a Excess from 2017.... 0
    b Excess from 2018.... 0
    c Excess from 2019.... 467,615
    d Excess from 2020.... 0
    e Excess from 2021.... 12,001
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 10
    Part XIII
    Private Operating Foundations (see instructions and Part VI-A, question 9)
    1a If the foundation has received a ruling or determination letter that it is a private operating
    foundation, and the ruling is effective for 2021, enter the date of the ruling ....... bullet
     
    b Check box to indicate whether the organization is a private operating foundation described in section or
    2a Enter the lesser of the adjusted net
    income from Part I or the minimum
    investment return from Part X for each
    year listed ..........     		Tax year Prior 3 years (e) Total
    (a) 2021 (b) 2020 (c) 2019 (d) 2018
             
    b 85% (0.85) of line 2a .........          
    c Qualifying distributions from Part XI,
    line 4 for each year listed .....     		         
    d Amounts included in line 2c not used directly
    for active conduct of exempt activities ..........     		         
    e Qualifying distributions made directly
    for active conduct of exempt activities.
    Subtract line 2d from line 2c ....     		         
    3 Complete 3a, b, or c for the
    alternative test relied upon:
    a “Assets" alternative test—enter:
    (1) Value of all assets ......          
    (2) Value of assets qualifying
    under section 4942(j)(3)(B)(i)    		          
    b “Endowment" alternative test— enter 2/3
    of minimum investment return shown in
    Part IX, line 6 for each year listed ..     		         
    c “Support" alternative test—enter:
    (1) Total support other than gross
    investment income (interest,
    dividends, rents, payments
    on securities loans (section
    512(a)(5)), or royalties) ....     		         
    (2) Support from general public
    and 5 or more exempt
    organizations as provided in
    section 4942(j)(3)(B)(iii)....     		         
    (3) Largest amount of support
    from an exempt organization    		          
    (4) Gross investment income          
    Part XIV
    Supplementary Information (Complete this part only if the foundation had $5,000 or more in
    assets at any time during the year—see instructions.)
    1Information Regarding Foundation Managers:
    aList any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
    before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
    NONE
    bList any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
    ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
    NONE
    2Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
    Check here bullet
    aThe name, address, and telephone number or email address of the person to whom applications should be addressed:
    bThe form in which applications should be submitted and information and materials they should include:
    cAny submission deadlines:
    dAny restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
    factors:
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 11
    Part XIV
    Supplementary Information (continued)
    3 Grants and Contributions Paid During the Year or Approved for Future Payment
    Recipient If recipient is an individual,
    show any relationship to
    any foundation manager
    or substantial contributor
    		 Foundation
    status of
    recipient     		Purpose of grant or
    contribution     		Amount
    Name and address (home or business)
    aPaid during the year
    LONG ISLAND COMMUNITY HOSPITAL
    101 HOSPITAL ROAD
    PATCHOGUE,NY11772     		NONE PC GENERAL OPERATING 198,757
    Total .................................bullet 3a 198,757
    bApproved for future payment
    Total .................................bullet 3b  
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 12
    Part XV-A
    Analysis of Income-Producing Activities
    Enter gross amounts unless otherwise indicated. Unrelated business income Excluded by section 512, 513, or 514 (e)
    Related or exempt
    function income
    (See instructions.)
    1Program service revenue: (a)
    Business code     		(b)
    Amount     		(c)
    Exclusion code     		(d)
    Amount
    a
    b
    c
    d
    e
    f
    gFees and contracts from government agencies          
    2 Membership dues and assessments ....          
    3 Interest on savings and temporary cash
    investments ...........     		         
    4 Dividends and interest from securities ....          
    5 Net rental income or (loss) from real estate:
    aDebt-financed property......          
    bNot debt-financed property.....          
    6 Net rental income or (loss) from personal property          
    7 Other investment income .....          
    8 Gain or (loss) from sales of assets other than
    inventory ............     		    18 268,678  
    9 Net income or (loss) from special events:          
    10 Gross profit or (loss) from sales of inventory          
    11 Other revenue: a
    b
    c
    d
    e
    12 Subtotal. Add columns (b), (d), and (e) ..   352,707  
    13Total. Add line 12, columns (b), (d), and (e)..................
    13
    352,707
    (See worksheet in line 13 instructions to verify calculations.)
    Part XV-B
    Relationship of Activities to the Accomplishment of Exempt Purposes
    Line No.
    DownArrow     		Explain below how each activity for which income is reported in column (e) of Part XV-A contributed importantly to
    the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
    instructions.)
    Form 990-PF (2021)
    Form 990-PF (2021)
    Page 13
    Part XVI
    Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
    1
    Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
    Yes
    No
    a
    Transfers from the reporting foundation to a noncharitable exempt organization of:
    (1) Cash...................................
    1a(1)
     
    No
    (2) Other assets.................................
    1a(2)
     
    No
    b
    Other transactions:
    (1) Sales of assets to a noncharitable exempt organization....................
    1b(1)
     
    No
    (2) Purchases of assets from a noncharitable exempt organization..................
    1b(2)
     
    No
    (3) Rental of facilities, equipment, or other assets.......................
    1b(3)
     
    No
    (4) Reimbursement arrangements...........................
    1b(4)
     
    No
    (5) Loans or loan guarantees.............................
    1b(5)
     
    No
    (6) Performance of services or membership or fundraising solicitations................
    1b(6)
     
    No
    c
    Sharing of facilities, equipment, mailing lists, other assets, or paid employees..............
    1c
     
    No
    d
    If the answer to any of the above is "Yes," complete the following schedule. Column (b) should always show the fair market value
    of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
    in any transaction or sharing arrangement, show in column (d) the value of the goods, other assets, or services received.
    (a) Line No. (b) Amount involved (c) Name of noncharitable exempt organization (d) Description of transfers, transactions, and sharing arrangements
    2a
    Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
    described in section 501(c) (other than section 501(c)(3)) or in section 527? ...........
    b
    If "Yes," complete the following schedule.

    (a) Name of organization (b) Type of organization (c) Description of relationship
    Sign Here
    Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
    Bullet Bullet
    May the IRS discuss this return
    with the preparer shown below?
    See instructions.
    Signature of officer or trustee Date Title
    Paid Preparer Use Only Print/Type preparer's name Preparer's Signature Date PTIN
    Firm's name SmallBullet
    		 Firm's EIN SmallBullet
    Firm's address SmallBullet


    		 Phone no.
    Form 990-PF (2021)
    Additional Data


    Software ID:  
    Software Version:  


    Form 990PF - Special Condition Description:
    Special Condition Description

    TY 2021 InvestmentsOtherSchedule2
    Name:
    BROOKHAVEN MEMORIAL HOSPITAL ASSOC
    EIN:
    13-6370889
    Category/ Item Listed at Cost or FMV Book Value End of Year Fair Market Value
    12572Q105 CME GROUP INC AT COST 23,783 25,429
    254687106 DISNEY (WALT) COMPAN      
    46625H100 J P MORGAN CHASE & C AT COST 24,674 28,319
    64110L106 NETFLIX COM INC      
    78409V104 S & P GLOBAL INC AT COST 18,529 26,766
    852234103 SQUARE INC - A      
    87165B103 SYNCHRONY FINANCIAL AT COST 16,636 21,943
    882508104 TEXAS INSTRUMENTS IN      
    883556102 THERMO ELECTRON CORP AT COST 13,028 20,722
    929089100 VOYA FINANCIAL INC AT COST 10,547 21,536
    G5960L103 MEDTRONIC PLC      
    002824100 ABBOTT LABORATORIES AT COST 12,922 18,477
    166764100 CHEVRONTEXACO CORP AT COST 7,978 19,441
    595112103 MICRON TECHNOLOGY AT COST 24,505 32,787
    65339F101 NEXTERA ENERGY INC AT COST 13,433 19,564
    91324P102 UNITED HEALTH GROUP AT COST 26,876 63,358
    92826C839 VISA INC      
    00724F101 ADOBE SYS INC COM      
    05569M384 BNY MELLON INTL EQUI AT COST 75,000 59,656
    05569M871 BNY MELLON INTL FD C AT COST 86,135 80,173
    05587N737 BNYM OPPORT SM CAP-Y      
    101137107 BOSTON SCIENTIFIC CO      
    29444U700 EQUINIX INC AT COST 11,212 13,805
    30161N101 EXELON CORP AT COST 20,180 25,468
    02079K305 ALPHABET INC/CA AT COST 15,023 69,261
    G29183103 EATON CORP PLC AT COST 5,793 21,862
    03027X100 AMERICAN TOWER CORP- AT COST 31,707 37,345
    05588D753 BNY MELLON INTL EQTY      
    05588E850 BNY MELLON HIGH YIEL AT COST 71,427 57,714
    05587K824 BNYM SEL MGR S/C VAL      
    060505104 BANK AMER CORP AT COST 5,933 12,100
    126408103 CSX CORP COM AT COST 7,993 19,623
    22160K105 COSTCO WHSL CORP NEW AT COST 9,026 21,406
    30303M102 FACEBOOK INC AT COST 21,186 26,558
    438516106 HONEYWELL INTL INC AT COST 5,227 27,456
    70450Y103 PAYPAL HOLDINGS INC      
    05589K400 BNYM FLTNG RT INC-Y AT COST 70,627 64,062
    150870103 CELANESE CORP DEL AT COST 9,596 21,063
    191216100 COCA-COLA CO USD AT COST 33,163 35,175
    437076102 HOME DEPOT INC USD 0 AT COST 789 9,806
    452308109 ILLINOIS TOOL WORKS AT COST 10,155 22,795
    594918104 MICROSOFT CORP COM AT COST 43,312 118,707
    654106103 NIKE INC CL B AT COST 12,865 19,055
    742718109 PROCTER & GAMBLE CO AT COST 8,243 7,587
    872590104 T -MOBILE US INC AT COST 39,656 51,106
    026874784 AMERICAN INTERNATION AT COST 19,022 27,945
    05569M368 BNY MELLON CORP BOND AT COST 100,000 92,660
    05569M509 BNY MELLON MID CAP S AT COST 141,216 284,995
    05569M780 BNY MELLON S/T US GV AT COST 8,586 7,644
    05569M814 BNY MELLON INTERMEDI AT COST 200,000 184,867
    05569M830 BNY MELLON BOND FD C AT COST 344,955 296,004
    05587K857 BNYM INTL STCK-Y AT COST 46,434 73,411
    05588D811 BNYM DIV EMG MKTS-Y      
    110122108 BRISTOL MYERS SQUIBB      
    20030N101 COMCAST CORP NEW CL      
    244199105 DEERE & COMPANY AT COST 9,726 27,759
    79466L302 SALESFORCE COM INC      
    037833100 APPLE COMPUTER INC C AT COST 1,099 69,963
    023135106 AMAZON COM INC AT COST 27,986 67,315
    05569M855 BNY MELLON EMERGING      
    05588L839 BNYM ALT DIV STRAT-Y AT COST 230,767 245,958
    126650100 CVS CORP AT COST 18,344 25,519
    723787107 PIONEER NAT RES CO AT COST 23,685 41,528
    91913Y100 VALERO ENERGY CORP N AT COST 2,395 14,640
    G06242104 ATLASSIAN CORP PLC-C      
    007903107 ADVANCED MICRO DEVIC AT COST 10,604 25,716
    05587K865 BNYM SELECT MGR S/C      
    16119P108 CHARTER COMMUNICATIO      
    22788C105 CROWDSTRIKE HOLDINGS AT COST 16,390 21,548
    461202103 INTUIT INC COM      
    55024U109 LUMENTUM HOLDINGS IN      
    83088M102 SKYWORKS SOLUTIONS I      
    89832Q109 TRUIST FINL CORP AT COST 17,446 19,017
    00287Y109 ABBVIE INC AT COST 27,763 43,565
    009158106 AIR PRODUCTS AND CHE      
    482480100 KLA TENCOR CORP AT COST 16,717 26,842
    75513E101 RAYTHEON TECHNOLOGIE AT COST 21,751 25,130
    816851109 SEMPRA ENERGY      
    532457108 ELI LILLY & CO COM AT COST 19,991 29,822
    88339J105 TRADE DESK INC/THE AT COST 4,868 13,167
    G8994E103 TRANE TECHNOLOGIES P AT COST 2,225 13,866
    15135B101 CENTENE CORP DEL AT COST 17,990 25,127
    67066G104 NVIDIA CORP AT COST 23,598 36,527
    03076C106 AMERIPRISE FINL INC AT COST 22,087 25,729
    G46188101 HORIZON THERAPEUTICS AT COST 13,897 10,658
    V7780T103 ROYAL CARIBBEAN CRUI      
    828806109 SIMON PPTY GROUP INC      
    538034109 LIVE NATION INC AT COST 8,504 9,217
    88160R101 TESLA MOTORS INC AT COST 35,854 34,727
    37045V100 GENERAL MOTORS CO      
    235851102 DANAHER CORP COMMON AT COST 24,152 27,261
    518439104 ESTEE LAUDER COMPANI AT COST 30,455 26,964
    09857L108 BOOKING HOLDINGS INC      
    571903202 MARRIOTT INTERNATION AT COST 14,891 14,605
    G1151C101 ACCENTURE PLC IRELAN AT COST 19,368 16,442
    580135101 MC DONALDS CORPORATI AT COST 10,964 11,353
    744573106 PUBLIC SERVICE ENTER AT COST 24,614 22,526
    31428X106 FEDEX CORPORATION AT COST 14,527 13,281
    11135F101 BROADCOM INC AT COST 28,442 24,956
    233203421 DFA EMERG MKTS CORE AT COST 60,000 61,311
    74736K101 QORVO INC AT COST 9,773 8,080
    02209S103 ALTRIA GROUP INC AT COST 26,564 21,658
    05569M806 BNY MELLON SMALL CAP AT COST 70,000 74,406
    517834107 LAS VEGAS SANDS CORP AT COST 14,659 15,428
    57636Q104 MASTERCARD INC AT COST 47,684 45,087
    05722G100 BAKER HUGHES A GE CO AT COST 15,936 11,872
    464287804 ISHARES TR S & P SMA AT COST 51,104 53,460
    717081103 PFIZER INC COM AT COST 23,995 23,520
    00771X419 G Q G PART EMERG MKT AT COST 60,000 61,283
    747525103 QUALCOMM INC AT COST 9,800 8,598
    00206R102 AT&T INC AT COST 10,678 9,296
    G7997R103 SEAGATE TECHNOLOGY H AT COST 32,687 21,427
    26614N102 DUPONT DE NEMOURS IN AT COST 16,724 11,128

    TY 2021 OtherDecreasesSchedule
    Name:
    BROOKHAVEN MEMORIAL HOSPITAL ASSOC
    EIN:
    13-6370889
    Description Amount
    MUTUAL FUND TIMING ADJ 274
    ROUNDING 3


    TY 2021 OtherExpensesSchedule
    Name:
    BROOKHAVEN MEMORIAL HOSPITAL ASSOC
    EIN:
    13-6370889
    Description Revenue and Expenses per Books Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    STATE INCOME TAXES - PRINCIPAL 250 0   250


    TY 2021 OtherIncreasesSchedule
    Name:
    BROOKHAVEN MEMORIAL HOSPITAL ASSOC
    EIN:
    13-6370889
    Description Amount
    CY PENDING SALES ADJ 5,545


    TY 2021 TaxesSchedule
    Name:
    BROOKHAVEN MEMORIAL HOSPITAL ASSOC
    EIN:
    13-6370889
    Category Amount Net Investment Income Adjusted Net Income Disbursements for Charitable Purposes
    FOREIGN TAXES 1,688 1,688   0
    FEDERAL TAX PAYMENT - PRIOR YE 1,800 0   0
    FEDERAL ESTIMATES - PRINCIPAL 3,672 0   0
    FOREIGN TAXES ON NONQUALIFIED 83 83   0