Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
SOUTH NASSAU COMMUNITIES HOSPITAL INC |
111352310 | 3 | Yes | 0 | 0 | |
|
Total 1
|
0 | 0 | ||||
Calendar year
(or fiscal year beginning in)
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(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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.).. | ||||||
| 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 | ||||
| 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 2022 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-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2022. 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 2023. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | SOUTH NASSAU COMMUNITIES HOSPITAL INC. IS THE SOLE MEMBER OF 19 ENTITIES: RADIOLOGICAL ASSOCIATES OF LONG ISLAND, P.C., SN SERVICES CORPORATION, SOUTH NASSAU NEONATAL SERVICES, P.C., SOUTH NASSAU FAMILY MEDICINE, P.C., SOUTH NASSAU PRIMARY MEDICAL CARE, P.C., OCEANSIDE COUNSELING CENTER SOUTH NASSAU PHYSICIAN PRACTICE, P.C., SOUTH NASSAU ONCOLOGY, P.C., SN RADIOLOGICAL PRACTICE, P.C., 203 MERRICK ROAD HOLDING CORP, SOUTH NASSAU CARDIOVASCULAR PRACTICE, P.C., SOUTH NASSAU MEDICAL GROUP, P.C., SOUTH NASSAU OBSTRETRICS AND GYNECOLOGY, P.C., SOUTH NASSAU ONCOLOGY PRACTICE, P.C., SNCH COMMUNITY DEVELOPMENT CORPORATION SOUTH NASSAU PHYSICIANS, P.C., SOUTH NASSAU PHYSICIAN GROUP, PC, SOUTH NASSAU UROLOGY, P.C. SOUTH NASSAU COMMUNITIES HOSPITAL SELF-INSURANCE TRUST FUND DTD 10/26 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 | SOUTH NASSAU COMMUNITIES HOSPITAL, INC. IS THE SOLE MEMBER OF THE SUBORDINATE ORGANZIATIONS REPORTED IN THIS GROUP RETURN. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BOARD HAS THE AUTHORITY (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. OTHER AUTHORITY INCLUDES: (A) APPROVAL OF THE TAXPAYER'S MISSION AND PHILOSOPHY; (B) ESTABLISHING THE SIZE OF THE TAXPAYER'S GOVERNING BOARD; (C) SELECTION AND REMOVAL OF THE CHAIRPERSON OF THE TAXPAYER'S GOVERNING BOARD; (D) ESTABLISHING CRITERIA FOR EVALUATING PERFORMANCE OF THE TAXPAYER'S CHIEF EXECUTIVE OFFICER; (E) APPROVAL OF THE TAXPAYER'S OPERATING AND CAPITAL BUDGETS AND BUSINESS PLAN; (F) APPROVAL OF THE ESTABLISHMENT OF ANY MATERIAL NEW LINES OF BUSINESS BY THE TAXPAYER THAT IS NOT OTHERWISE CONTEMPLATED WITHIN A PREVIOUSLY APPROVED BUSINESS PLAN OF THE TAXPAYER; (G) INITIATION BY THE TAXPAYER OF A BANKRUPTCY OR INSOLVENCY ACTION; (H) APPROVAL OF THE ISSUANCE OF LONG-TERM DEBT (I) APPROVAL OF LITIGATION SETTLEMENTS INVOLVING THE TAXPAYER THAT EXCEED APPLICABLE COMMERCIAL OR SELF INSURANCE COVERAGE; (J) APPROVAL OF THE SUBMISSION OF ANY CERTIFICATE OF NEED APPLICATIONS BY OR ON BEHALF OF THE TAXPAYER WITH ANY REGULATORY AUTHORITY; (K) APPROVAL OF THE INITIATION BY THE TAXPAYER OF A NEW CLINICAL SERVICE OR THE DISCONTINUANCE OR SUBSTANTIAL CHANGE IN AN EXISTING CLINICAL SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE AFFILIATES OF SOUTH NASSAU COMMUNITIES HOSPITAL REVIEW AND APPROVE THE IRS FORM 990 ACCORDING TO THE POLICY OF THE PARENT ORGANIZATION, SOUTH NASSAU COMMUNITIES HOSPITAL. AS SUCH, SOUTH NASSAU COMMUNITIES HOSPITAL'S PROCESS IS OUTLINED BELOW: THE AUDIT COMMITTEE, A SUB-COMMITTEE OF THE BOARD OF DIRECTORS, IS ASSIGNED TO REVIEW 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 OF SOUTH NASSAU COMMUNITIES HOSPITAL 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 | THE AFFILIATES OF SOUTH NASSAU COMMUNITIES HOSPITAL'S OFFICERS, DIRECTORS, AND KEY EMPLOYEES OPERATE UNDER THE CONFLICT OF INTEREST POLICY OF ITS PARENT ORGANIZATION, SOUTH NASSAU COMMUNITIES HOSPITAL. THE HOSPITAL ANNUALLY MONITORS COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY PROVIDING ANNUAL QUESTIONNAIRES THAT REQUIRE THE OFFICER, DIRECTOR AND/OR KEY EMPLOYEE TO DISCLOSE POTENTIAL CONFLICTS. FOR FURTHER INFORMATION, PLEASE REFER TO THE SOUTH NASSAU COMMUNITIES HOSPITAL FORM 990 FOR THE YEAR ENDING DECEMBER 31, 2022. |
| FORM 990, PART VI, SECTION B, LINE 15B | COMPENSATION PROCESS FOR TOP OFFICIAL COMPENSATION FOR THE OFFICERS AND OTHER EMPLOYEES IS DETERMINED BY SOUTH NASSAU COMMUNITIES HOSPITAL. PLEASE SEE BELOW FOR PROCEDURES. 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 DISCLOSED ABOVE) AND KEY EMPLOYERS 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 VICE PRESIDENT OF HUMAN RESOURCES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE PUBLIC CAN OBTAIN A COPY OF THE 990 OR THE CONSOLIDATED 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 SOUTH NASSAU COMMUNITIES HOSPITAL AFFILIATES 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: (516) 377-5370. |
| FORM 990, PART IX, LINE 11G | COLLECTION FEES: PROGRAM SERVICE EXPENSES 86,221. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 86,221. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 15,802,049. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,802,049. OTHER OUTSIDE FEES: PROGRAM SERVICE EXPENSES 1,722,540. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,722,540. |
| FORM 990, PART XI, LINE 9: | TRANSFER FROM RELATED PARTIES -3,063,954. ROUNDING -396. |
| PART XII, LINE 2C: | SOUTH NASSAU COMMUNITIES HOSPITAL, THE PARENT OF THESE ORGANIZATIONS, RECEIVED A COMBINED AUDITED FINANCIAL STATEMENT FOR THE YEAR ENDING DECEMBER 31, 2022. THE COMBINED FINANCIAL STATEMENTS ARE PREPARED IN ACCORDANCE WITH ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA ("GAAP"). THE COMBINED FINANCIAL STATEMENTS INCLUDE THE ACCOUNTS OF SOUTH NASSAU COMMUNITIES HOSPITAL AND ALL OF ITS AFFILIATE ORGANIZATIONS WHICH IN SOME CASES FILE SEPARATE RETURNS WITH THE IRS. |
| FORM 990, PAGE 1, BOX H | THE HOSPITAL AND GROUP AFFILIATED ORGANIZATIONS ARE SECTION 501(C)(3) ORGANIZATIONS. THE ORGANIZATIONS ARE EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(A) AND THEIR INCOME IS GENERALLY NOT SUBJECT TO FEDERAL OR NEW YORK STATE INCOME TAXES. SN HEALTHCARE AND SOUTH NASSAU SN, LLC ARE TAXABLE ENTITIES, WHICH ARE NOT INCLUDED IN THE GROUP RETURN. SIBS PLACE, INC. IS ALSO NOT INCLUDED IN THE GROUP RETURN AND FILE SEPARATE FEDERAL FORMS 990. AFFILIATES INCLUDED IN GROUP RETURN SUBORDINATE ORGANIZATIONS OF SOUTH NASSAU COMMUNITIES HOSPITAL (EIN: 27-2843521) GROUP EXEMPTION NUMBER 5611: RADIOLOGICAL ASSOCIATES OF LONG ISLAND, P.C., - EIN: 11-2462030 SN SERVICES CORPORATION, - EIN: 11-2727976 SOUTH NASSAU NEONATAL SERVICES, P.C., - EIN: 11-3319620 SOUTH NASSAU FAMILY MEDICINE, P.C., - EIN: 11-3565450 SOUTH NASSAU PRIMARY MEDICAL CARE, P.C., - EIN: 11-3581988 OCEANSIDE COUNSELING CENTER -EIN: 23-7062966 SOUTH NASSAU PHYSICIAN PRACTICE, P.C., - EIN: 26-2692377 SOUTH NASSAU ONCOLOGY, P.C., - EIN: 27-3857309 203 MERRICK ROAD HOLDING CORP, - EIN: 27-5368294 SOUTH NASSAU CARDIOVASCULAR PRACTICE, P.C., - EIN: 38-3843950 SOUTH NASSAU MEDICAL GROUP, P.C., - EIN: 45-4799159 SOUTH NASSAU OBSTETRICS AND GYNECOLOGY, P.C., - EIN: 45-5272144 SOUTH NASSAU ONCOLOGY PRACTICE, P.C., - EIN: 46-2905667 SNCH COMMUNITY DEVELOPMENT CORPORATION - EIN: 47-1303599 SOUTH NASSAU PHYSICIANS, P.C., - EIN: 47-1545515 SOUTH NASSAU PHYSICIAN GROUP, PC, - EIN: 47-4961193 SOUTH NASSAU UROLOGY, P.C. - EIN: 47-5071498 SOUTH NASSAU COMMUNITIES HOSPITAL SELF-INSURANCE TRUST FUND DTD 10/26 - EIN: 13-6749767 SOUTH NASSAU RADIOLOGY PC - EIN: 45-4799159 |
| FORM 990 PART VI, LINE 13 | THE AFFILIATES OF SOUTH NASSAU COMMUNITIES HOSPITAL OPERATE UNDER THE WRITTEN WHISTLE BLOWER AND DOCUMENT RETENTION POLICIES OF ITS PARENT ORGANIZATION, SOUTH NASSAU COMMUNITIES HOSPITAL. |
| Software ID: | |
| Software Version: |