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Northwell 990 2017 PDF
Northwell 990 2017 PDF
0MB No 1545-0047
Return of Organization Exempt From Income Tax
. Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
► Do not enter social security numbers on this form as it may be made public.
- Department of the Treasury
lntemal Revenue Ser;ice ► Goto www.irs.gov/Form990 for instructions and the latest Information.
A For the 2017 calendar year, or tax year beginning , 2017, and ending , 20
C Name of organization D Employer ldentificabon number
B Check If applicable
~
NORTHWELL HEALTHCARE, INC. 11-2965586
- Address
Do1ngbusiness as
--
change
Name change Number and street (or PO box If mail Is not delivered to street address) Room/suite E Telephone number
-
00
0
--
lmtral retll"n
Final return/
terminated
972 BRUSH HOLLOW ROAD
City or town, state or province, country, and ZIP or foreign postal code
(516) 321-6058
CJ CJ
N Amended WESTBURY, NY 11590 G Gross receipts$ 1, 2 21, 3 3 3, 8 5 6 ,
return
c.c MICHAEL J. DOWLING
.-4 - Applicatlon
pending
F Name and address of pnncIpal officer
__R_C:...U:.....::.S_A,-V_E,--N_E..:..._W_H_Y_D_E_P_A:.:.R....:K.....:...,_N_Y"T""_1....1_0_4_2___-4A~---z_--=➔--1
______L__2_0--,-o_o--,-MA
H(a) Is this a group retum for ·
subordinates?
H(b) Are Bil subo•dlnstes Included?
Yes
Yes
No
No
> Tax-exemptstatus /X/so1(c)(3) / /S01(c)( ) ◄ (,nsertno) / /4947(a)(1)or ~ Jls27/ 1t"No,"a1tachal1st(seemslruc1,ons)
D
z J Website: ► WWW. NORTHWELL. EDU ) H(c) Group exemption number ►
~ / Other ►
~ 0
K form of organtzat1on / X / Corporation /
• .::.•"••ii111,•111•r~S--u__m
.
/ Trust/ / AssocIatIon /
~.;..,;;.=~=::..:.==---
L Year of formation 19 9 0/ M State of legal dom1c1le
NY
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c :i.c
...ICC
wee NORTHWELL HEALTHCARE, INC. PROVIDES
Briefly describe the organization's mIssIon or most s1gnif1cant act1v1tIes
5E:E
u,t-
QI
....C ADVISORY AND ADMINISTRATIVE SUPPORT SERVICES TO AFFILIATED HEALTH CARE
"'E ORGANIZATIONS WITHIN NORTHWELL HEALTH.
c~-
0
QI
> 2 Check this box ► D 1f the organization discontinued ,ts operations or disposed of more than 25% of ,ts net assets
C) 3 Number of voting members of the governing body (Part VI, hne 1a) . • • • . . • 3_1_.
1---"3-+-_ _ _ _ _ _ _
oil 26.
Ill 4 Number of independent voting members of the governing body (Part VI, hne 1b). 4
~ 5 Total number of ,nd1v1duals employed ,n calendar year 2017 (Part V, hne 2a) •• 5 6,929.
i.... 6 Total number of volunteers (estimate 1f necessary), . . . . • . . . • • • • • • , , • 6
~
7a Total unrelated business revenue from Part VIII, column ~.f!!i~£·1V·E D· t 7a 8,694,838.
b Net unrelated business taxable income from Forrh 990:J:!lok3Y-. -.-.-~. • • . .,. ... 7b 5,206,736.
gi
;
8
9
Contributions and grants (Part VIII, hne 1h). • •
Program service revenue (Part VIII, line 2g) . . •
~l . ,N,Q.V. 2 .6. 2018 .. ~-
I t!J I . . . . . . . . . . . . . !!:.
Prior Year
857,422,583.
o.
Current Year
910,203,778.
0.
~ 10 Investment income (Part VIII, column (A), hnes 3}, alra·.7,~nt:N_· UT· .. 6,854,580. 13,158,409.
11 Other revenue (Part VIII, column (A), hnes 5, 6d, 8c,.9c\10t~ .• 6,858,327. 9,025,706.
-~~
12 Total revenue - add Imes 8 throuah 11 (must eaual Part VIII, column (Al, hne 12). 871,135,490. 932,387,893.
13 Grants and sImIlar amounts paid (Part IX, column (A), hnes 1-3) . . . • • • . • • 0. o.
14 Benefits paid to or for members (Part IX, column (A), hne 4) . . . . . . . . . . . 0. 0.
Ill 15 Salaries, other compensation, employee benefits (Part IX, column (A), hnes 5-10). 456,109,708. 543,204,576.
QI
Ill
C 16 a Professional fundra1s1ng fees (Part IX, column (A), hne 11 e) . o. 0.
QI
Q.
,c
w
b Total fundra,smg expenses (Part IX, column (D), hne 25) ► ________
O_._ __
17 Other expenses (Part IX, column (A), hnes 11 a-11 d, 11f-24e) 633,402,936. 700,902,343.
18 Total expenses Add Imes 13-17 (must equal Part IX, column (A), hne 25) 1,089,512,644.1,244,106,919.
19 Revenue less expenses Subtract hne 18 from hne 12. -218, 377,154. -311, 719,026.
Beginning of Current Year End of Year
I 1110112010
Sign ► Signature of officer Date
Here SVP & CFO
► MICHELE L. CUSACK
Type or print name and title
2 Did the organization undertake any s1grnf1cant program services during the year which were not listed on the
prior Form 990 or 990-EZ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes D
No 0
If "Yes," describe these new services on Schedule 0
3 Did the organization cease conducting, or make s1grnf1cant changes in how It conducts, any program
services? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes D
No 0
If ''Yes," describe these changes on Schedule 0
4 Describe the organization's program service accomplishments for each of its three largest program services, as measured by
expenses Section 501 (c)(3) and 501 (c)(4) organizations are required to report the amount of grants and allocations to others,
the total expenses, and revenue, 1f any, for each program service reported
1 Is the organization described in section 501 (c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes,"
complete Schedule A. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 X
2 Is the organization required to complete Schedule B, Schedule of Contnbutors (see instructions)?. . . . . . . . . 2 X
3 Did the organization engage in direct or indirect political campaign actIvItIes on behalf of or in opposItIon to
candidates for public office? If "Yes," complete Schedule C, Part I . . . . . . . . . . . . . . . . . . . . . . . . . . 3 X
4 Section 501(c)(3) organizations. Did the organization engage in lobbying actIvItIes, or have a section 501(h)
election in effect during the tax year? If "Yes," complete Schedule C, Part II . . . . . . . . . . . . . . . . . . . . . 4 X
5 Is the organization a section 501 (c)(4), 501 (c)(5}, or 501 (c)(6) organIzatIon that receives membership dues,
assessments, or s1m1lar amounts as defined in Revenue Procedure 98-19? If "Yes," complete Schedule C,
Part Ill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
6 Did the organization maintain any donor advised funds or any s1m1lar funds or accounts for which donors
have the right to provide advice on the d1stribut1on or investment of amounts in such funds or accounts? If
"Yes," complete Schedule D, Part I. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 6 X
7 Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If 'Yes," complete Schedule D, Part II . . . . . . . . . 7 X
8 Did the organization maintain collections of works of art, historical treasures, or other s1m1lar assets? If 'Yes,"
complete Schedule D, Part Ill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 X
9 Did the organization report an amount in Part X, line 21, for escrow or custodial account l1ab11ity, serve as a
custodian for amounts not listed in Part X, or provide credit counseling, debt management, credit repair, or
debt negotIatIon services? If "Yes," complete Schedule D, Part IV . . . . . . . . . . . . . . . . . . . . . . . . . . 9 X
10 Did the organization, directly or through a related organization, hold assets in temporarily restricted
endowments, permanent endowments, or quasi-endowments? If "Yes," complete Schedule D, Part V. . . . . . . 10 X
11 If the organization's answer to any of the following questions Is "Yes," then complete Schedule D, Parts VI,
VII, VIII, IX, or X as applicable - - -
a Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If 'Yes,"
complete Schedule D, Part VI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11a X
b Did the organization report an amount for investments-other securities in Part X, line 12 that Is 5% or more
of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VII . . . . . . . . . . . . . . . . 11b X
c Did the organization report an amount for investments-program related in Part X, line 13 that Is 5% or more
of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIII . . . . . . . . . . . . . . . . 11c X
d Did the organization report an amount for other assets in Part X, line 15 that Is 5% or more of its total assets
reported in Part X, line 16? If "Yes," complete Schedule D, Part IX. . . . . . . . . . . . . . . . . . . . . . . . . . 11d X
e Did the organ1zat1on report an amount for other liab11it1es in Part X, line 25? If "Yes," complete Schedule D, Part X • . • • . . 11e X
f Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses
the organization's l1ab11ity for uncertain tax pos1t1ons under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part X . • . • . 11f X
12a Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XII . . . • • • • • • • . • • . • • • • • • . . • • • • • • . • • . • . • • • . • . . . . . • • • . 12a X
b Was the organization included in consolidated, independent audited financial statements for the tax year? If
"Yes," and tf the organization answered "No" to /me 12a, then completing Schedule D, Parts XI and XII ts optional 12b X
13 Is the organization a school described in section 170(b)(1 )(A)(11)? If "Yes," complete Schedule E . . . . . . . . . . 13 X
14a Did the organization maintain an office, employees, or agents outside of the United States?. . . . . . . . . . . . 14a X
b Did the organization have aggregate revenues or expenses of more than $10,000 from grantmak1ng,
fundra1s1ng, business, investment, and program service actIvItIes outside the United States, or aggregate
foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV . . . . . . . . . . 14b X
15 Did the organization report on Part IX, column (A}, line 3, more than $5,000 of grants or other assistance to or
for any foreign organization? If "Yes," complete Schedule F, Parts II and IV . . . . . . . . . . . . . . . . . . . . . 15 X
16 Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other
assistance to or for foreign 1nd1v1duals? If "Yes," complete Schedule F, Parts Ill and IV . . . . . . . . . . . . . . . 16 X
17 Did the organization report a total of more than $15,000 of expenses for professional fundra1s1ng services on
Part IX, column (A}, lines 6 and 11 e? If 'Yes," complete Schedule G, Part I (see instructions). . . . . . . . . . . . 17 X
18 Did the organization report more than $15,000 total of fundra1s1ng event gross income and contributions on
Part VIII, lines 1 c and Ba? If 'Yes," complete Schedule G, Part II . . . . . . . . . . . . . . . . . . . . . . . . . . . 18 X
19 Did the organization report more than $15,000 of gross income from gaming actIvIt1es on Part VIII, line 9a?
If "Yes "comolete Schedule G Part Ill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 X
Fenn 990 (2017)
JSA
7E1021 1 000
7E10301000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Form 990 (2017) Page 5
UZ!fifj Statements Regarding Other IRS Filings and Tax Compliance
Check 1f Schedule O contains a resoonse or note to anv line 1n this Part V . .n
Yes No
1 a Enter the number reported in Box 3 of Form 1096 Enter -0- 1f not applicable. . . . . . . . · 1l1_a--1I-- ___3_,_6--=-6--1l
b Enter the number of Forms W-2G included in line 1a Enter -0- 1f not applicable. . . . . . . 1......;.1.ccb_.______ 0--1.
c Did the organ1zatIon comply with backup withholding rules for reportable payments to vendors and __
reportable gaming (gambling) winnings to prize winners? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . t--1_c_ _x___
2a Enter the number of employees reported on Form W-3, Transmittal of Wage and Tax
Statements, filed for the calendar year ending with or within the year covered by this return. . 2a
I I 6, 92 9 _________ J
b If at least one Is reported on line 2a, did the organization file all required federal employment tax returns? 2b X
__ J
Note. If the sum of lines 1a and 2a Is greater than 250, you may be required to e-ftle (see Instruct1ons).
3a Did the organization have unrelated business gross income of $1,000 or more during the year? . . . . . . . . . . . 3a
- --
X
b If "Yes," has It filed a Form 990-T for this year? If "No" to /me 3b, provide an explanation m Schedule 0 . . . . . . . . 3b X
4a At any time during the calendar year, did the organization have an interest in, or a signature or other authority
over, a financial account in a foreign country (such as a bank account, securities account, or other financial
account)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4a X
b If "Yes," enter the name of the foreign country ► _B_E_R_M_U_D_A___________________ i
See instructions for filing requirements for F1nCEN Form 114, Report of Foreign Bank and F1nanc1al Accounts '
(FBAR) -Sa- - -- -
X
'
Sa Was the organization a party to a proh1b1ted tax shelter transaction at any time during the tax year? . . . . . . . . .
b Did any taxable party notify the organization that It was or Is a party to a proh1b1ted tax shelter trans~ct1on? Sb X
c If "Yes" to line 5a or 5b, did the organization file Form 8886-T?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Sc
Sa Does the organization have annual gross receipts that are normally greater than $100,000, and did the
organization solicit any contributions that were not tax deductible as charitable contributions?. . . . . . . . . . . 6a X
b If "Yes," did the organization include with every sohc1tat1on an express statement that such contributions or
gifts were not tax deductible?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 6b
7 Organizations that may receive deductible contributions under section 170(c). I
a Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods ·- --- .
7a X '
and services provided to the payor? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
b If "Yes," did the organization notify the donor of the value of the goods or services provided? . . . . . . . . . . . . 7b
c Did the organization sell, exchange, or otherwise dispose of tangible personal property for which It was
X
required to file Form 8282? . . . . . • • • • • • • • · · · · · · · · · · · · · · · · · · · · · · · 1· · · · · · · · · · · 7c
d If "Yes," indicate the number of Forms 8282 filed during the year . . . . . . . . . . . . . . . . .___7=d___.l_ _ _ _---i_
7e
-- -- - X. J
e Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
f Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? . . . . . 7f X
g If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? 7g X
h If the organIzatIon received a contribution of cars, boats, airplanes. or other vehicles, did the organization file a Form 1098-C?•. 7h X
8 Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the - - - -
sponsoring organization have excess business holdings at any time during the year? . . . . . . . . . . . . . . . . . 8 X
l
9 Sponsoring organizations maintaining donor advised funds.
a Did the sponsoring organization make any taxable d1stribut1ons under section 4966?. . . . . . . .
--
9a
-- - -·
X
b Did the sponsoring organization make a d1stribut1on to a donor, donor advisor, or related person?. 9b X
10 Section 501(c)(7) organizations. Enter
a lmt1atIon fees and capital contributions included on Part VIII, line 12 . . . . . . . . . . . .. l,__1_o_a__
l _ _ _ _.....
b Gross receipts, included on Form 990, Part VIII, hne 12, for public use of club fac1ht1es. . .. ~1_0_b_.__ _ _ _---i
11 Section 501 (c)(12) organizations. Enter
a Gross income from members or shareholders . . . . . . . . . . . . . . . . . . . . . . . . . . . ,-1_1_a-+-------t
b Gross income from other sources (Do not net amounts due or paid to other sources
against amounts due or received from them ) . . . . . . . . . . . . . . . . . . . . . . . . . . . -1_1_b_.__ _ _ __
12a Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041? 1-1_2_a-+---+---
b If "Yes," enter the amount of tax-exempt interest received or accrued during the year. . . . . . l~1_2_b_~I_ _ _ __,
13 Section 501(c)(29) qualified nonprofit health insurance issuers.
a Is the organization licensed to issue qualified health plans in more than one state? . . . . . . . . . . . . . . . . . . ,__1_3_a_,__ _,___
Note. See the instructions for add1t1onal information the organization must report on Schedule 0
b Enter the amount of reserves the organization Is required to maintain by the states in which
the organIzatIon Is licensed to issue qualified health plans . . . . . . . . . . . . . . . . . . . l1-1_J_b__
l _ _ _ _--1
c Enter the amount of reserves on hand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13c
14a Did the organization receive any payments for indoor tanning services during the tax year? . . . . . • • • • • • 1-1_4_a-+---+--x_
b If "Yes" has It filed a Form 720 to reoort these oavments? If "No" provide an exolanatton m Schedule 0 14b
JSA
7E1040 1 000 Form 990 (2017)
JU6323 392H V 17-7.2F HEALTH CARE
., Form 990 (2017) NORTHWELL HEALTHCARE, INC. 11-2965586 Page 6
iiflf)j Governance, Management, and Disclosure For each "Yes" response to Imes 2 through lb below, and for a "No"
response to /me Ba, Bb, or 1Ob below, descnbe the circumstances, processes, or changes m Schedule O See mstrucltons
,, Check 1f Schedule O contains a response or note to any line In this Part VI . . . . . . . . . . . . . . . . . . . . . . . . [xJ
Section A. Governma Body and Manaaement
Yes No
1a Enter the number of voting members of the governing body at the end of the tax year . . . . . 1a 31
If there are material differences in voting rights among members of the governing body, or
1f the governing body delegated broad authority to an executive committee or s1m1lar
committee, explain in Schedule 0
'
b Enter the number of voting members included in line 1a, above, who are independent . . . . . 1b 2E
2 Did any officer, director, trustee, or key employee have a family relat1onsh1p or a business relat1onsh1p with -- - - ·- - .!
2 X
any other officer, director, trustee, or key employee?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization delegate control over management duties customarily performed by or under the direct
3 X
supervIsIon of officers, directors, or trustees, or key employees to a management company or other person?
4 Did the organization make any s1gmf1cant changes to ,ts governing documents since the prior Form 990 was filed?. . . 4 X
5 Did the organization become aware during the year of a s1gnif1cant d1versIon of the organization's assets? .. 5 X
6 Did the organization have members or stockholders? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 X
7a Did the organization have members, stockholders, or other persons who had the power to elect or appoint
one or more members of the governing body? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7a X
b Are any governance dec1s1ons of the organization reserved to (or subJect to approval by) members,
stockholders, or persons other than the governing body? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7b X
8 Did the organization contemporaneously document the meetings held or written actions undertaken during
the year by the following
a The governing body? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Ba X
b Each committee with authority to act on behalf of the governing body?. . . . . . . . . . . . . . . . . . . . . . . 8b X
9 Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at
the organization's mailing address? If "Yes," provide the names and addresses ,n Schedule O . . . . . . . . . . . 9 X
Section B. Policies (This Section B requests mformat1on about oollc1es not reawred bv the Internal Revenue Code )
Yes No
1Oa Did the organization have local chapters, branches, or affiliates? . . . . . . . . . . . . . . . . . . . . . . . . . . 10a X
b If ''Yes," did the organization have written policies and procedures governing the actIvItIes of such chapters,
aff1l1ates, and branches to ensure their operations are consistent with the organization's exempt purposes? . . . 10b
11a X
11 a Has the organ1zat1on provided a complete copy of this Form 990 to all members of its governing body before filing the form? .
b Describe in Schedule O the process, 1f any, used by the organization to review this Form 990 - - - - -
12a Did the organization have a written conflict of interest policy? If "No," go to /me 13 . . . . . . . . . . . . . . . . 12a X
b Were officers, directors, or trustees, and key employees required to disclose annually interests that could give
rise to conflicts? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12b X
c Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes,"
descnbe ,n Schedule O how this was done . . . . . . . . . . . . . . . . . . . . . 12c X
13 Did the organization have a written wh1stleblower policy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 X
14 Did the organization have a written document retention and destruction policy? . . . . . . . . . . . . . . . . . . 14 X
15 Did the process for determining compensation of the following persons include a review and approval by
independent persons, comparability data, and contemporaneous substant1at1on of the deliberation and dec1s1on? -- . X - - - -
a The organization's CEO, Executive Director, or top management official . . . . . 15a
b Other officers or key employees of the organization . . . . . . . . . . . . . . . . 15b X
If "Yes" to line 15a or 15b, describe the process in Schedule O (see InstructIons) '
16a Did the organization invest In, contribute assets to, or partIcIpate in a Joint venture or s1m1lar arrangement
with a taxable entity during the year? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
--
16a
-- ~-
X
b If "Yes," did the organization follow a written policy or procedure requmng the organization to evaluate its I
partIcIpatIon in Joint venture arrangements under applicable federal tax law, and take steps to safeguard the
organization's exempt status with respect to such arrangements? . . . . . . . . . . . . . . . . . . . . . . . . .
--
16b
-- -- J
Section C. Disclosure
17 List the states with which a copy of this Form 990 Is required to be filed ► N_Y_,___________________
18 Section 6104 requires an organization to make its Forms 1023 (or 1024 1f applicable), 990, and 990-T (Section 501 (c)(3)s only)
available for public ins~tIon Indicate how you made these available Check all that apply
0 Own website ~ Another's website 0
Upon request O
Other (exp/am ,n Schedule 0)
19 Describe in Schedule O whether (and 1f so, how) the organization made its governing documents, conflict of interest policy, and
financial statements available to the public during the tax year
20 State the name, addressf and teleohone number of the oerson who oossesses the oraanizat1on's books and records ►
NORTHWELL HEALTH, NC. 972 ~RUSH HOLLOW RD WESTB0RY, NY 11590 ~16-321-6058
JSA
7E10421000
Form 990 (2017)
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lo
n,
n,
::,
.,
<I>
lo
Q.
4 For any ind1v1dual listed on line 1a, 1s the sum of reportable compensation and other compensation from the
organization and related organizations greater than $150,000? If ''Yes," complete Schedule J for such -- --
_J
md1v1dual . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • • • • • • • • • • • • • · · · • · · · · · · · · · · · · · 4 X
5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization or ind1v1dual
for services rendered to the orqanizat1on? If ''Yes," comolete Schedule J for such oerson ................
5
-- - - __J
X
Section B. Independent Contractors
1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of
compensation from the organization Report compensation for the calendar year ending with or w1th1n the organization's tax
year
(A) (B) (C)
Name and business address Description of services Compensation
ATTACHMENT 3
2 Total number of independent contractors (including but not l1m1ted to those listed above) who received . ,,
more than $100,000 in compensation from the organization ► 313 ,r:, -I
JSA
7E10551 000 Form 990 (2017)
JU6323 392H V 17-7.2F HEALTH CARE
., NORTHWELL HEALTHCARE, INC • 11-2965586
Form 990 (2017) Page 8
l::E:Ti••~II Section A. Officers, Directors, Trustees, Key Employees, and Hiahest Compensated Employees (continued)
J (A) (B) (C) (D) (E) (F)
Name and title Average PosItIon Reportable Reportable Estimated
hours per (do not check more than one compensation compensation from amount of
week (list any box, unless person Is both an from related other
officer and a director/trustee) compensation
.. :c ,,
hours for the organizations
o - :, 0 from the
related ~::,
~ organization (W-2/1099-MISC)
orgarnzat1ons
below dotted !J. C
C.
iii [
9- ~
E" ~
=i:
. ~~
'<
3
031.0
3
~
(W-2/1099-MISC) organization
and related
"'
0 "O '< -
line)
0 !!!.
~ 2
::,
!!!. .. m.8
i5'
'< 3
organizations
*. ."'
2 "O
::,
CD ., "'
CD
C.
---------------------------------- -------
---------------------------------- -------
---------------------------------- -------
---------------------------------- -------
---------------------------------- -------
------------------------------ ············· ··-··
---------------------------------- -------
1b Sub-total ►
C Total from continuation sheets to Part VII, Section A ►
d Total (add lines 1b and 1c) . ►
2 Total number of ind1v1duals (including but not limited to those listed above) who received more than $100,000 of
-■-■-■
reportable compensation from the organization ► 1302
Yes No
3 Did the organization 11st any former officer, director, or trustee, key employee, or highest compensated
employee on line 1a? If "Yes," complete Schedule J for such tnd1v1dual . . . . . . . . . . . . . . . . . . . . . . . . . . 3 X
4 For any ind1v1dual listed on line 1a, Is the sum of reportable compensation and other compensation from the
---
organization and related organizations greater than $150,000? If ''Yes," complete Schedule J for such
md1v1dual. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 X
5 Did any person listed on line 1a receive or accrue compensation from any unrelated organization or ind1v1dual
for services rendered to the oroanizat1on? If ''Yes," comolete Schedule J for such oerson ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ •••••• 5 X
Section B. Independent Contractors
1 Complete this table for your five highest compensated independent contractors that received more than $100,000 of
compensation from the organization Report compensation for the calendar year ending with or within the organ1zat1on's tax
year
(A) (B) (C)
Name and business address Descriptton of services Compensation
'I:.
'
2 Total number of independent contractors (including but not l1m1ted to those listed above) who received
more than $100,000 in compensation from the organization ►
JSA
7E10551000
JU6323 392H V 17-7.2F HEALTH CARE
-- ~~ -----------------------
,~
"'.. 0:,
c, E
·-"'=
C)
.,;_§
b
C
d
Membership dues .
FundraIsmg events
Related organizations •
1b
1c
1d
I
e Government grants (contnbut1ons) . 1e
.§~
. . GI f All other contributions, gifts, grants,
:e-s
!;O and s1mIlar amounts not included above 1f
C '0
Oc
u"'
g Noncash contributions included in lines 1a-1f $ - - -
GI
h Total. Add Imes 1a-1f . ► 0.
:, Business Code I
C
GI
- - -
> 2a SERVICE TO AFFIL. 561000 855,992,930. 855,992,930.
GI
a: HOMECARE 621610 23,865,595. 23,865,595.
b
...
GI
-~
GI
C CARE MANAGEMENT 561000 6,528,892. 6,528,892.
1/) d MISC PROGRAM SERVICE REVENUE 561000 23,816,361. 23,816,361.
E e
l?
C)
f All other program service revenue .
~
0.. a Total. Add Imes 2a-2f • ► 910,203,778.
3 Investment income (including d1v1dends, interest,
and other similar amounts). A,T'.I'~G!iM.E~'J.' 4. ► 1,570,911. 1,570,911.
4 Income from investment of tax-exempt bond proceeds ► 0.
5 Royalties . ► 0.
(1) Real (11) Personal
Sa Gross rents •
b Less rental expenses
L
I: Rental income or (lm,i.)
d Net rental income or (loss) • ► 0.
7a Gross amount from sales of (1) Secu ntIes (11) Other
...
Form 990 (2017)
Balance Sheet
Check 1f Schedule O contains a response or note to any line 1n this Part X. . . . . . . . . ...... . ..... I I
Page 11
(A) (B)
Beginning of year End of year
1 Cash - non-interest-bearing ........ 99,778,055. 1 44,336,365.
2 Savings and temporary cash investments 0. 2 0.
3 Pledges and grants receivable, net . . . . 0. 3 o.
4 Accounts receivable, net ......... 0. 4 0.
5 Loon~ ond other receivables from current and former officers, directors,
trustees, key employees, and highest com pen sated employees
Complete Part II of Schedule L 0 0
------- --- -- ---
0. 5 0.
l
6 Loans and other receivables from othe r d1sq~ai1fi°eci persons (as' def;ned under section'
4958(f)(1)), persons described in section 4958(c)(3)(B). and contributing employers
and sponsoring organIzatIons of section 501 (c)(9) voluntary employees' benefIc1ary ---·---- --- -- -
_!
organizations (see instructions) Complete Part II of Schedule L. 0. 6 o.
...
(II
QI
(II
7 Notes and loans receivable, net . . . . . !\:T:C:H: :s: 136,132,199. 7 179,896,256.
(II
8 Inventories for sale or use ........ 7,678,660. 8 7,998,190.
<
9 Prepaid expenses and deferred charges 12,054,909. 9 15,811,900.
10a Land, buildings, and equipment cost or l
1111965133. I
other basis Complete Part VI of Schedule D
b Less accumulated deprec1atIon. . . . . . . . ..
10a
10b 312,144,788. 673,913,239. 10c 799,820,345.
-- ---
.,..J
E
(II
QI
:cra
22 Loans and other payables to current and former officers, directors,
trustees, key employees, highest compensated employees, and
---- -
- - -------· I ✓
C:
ra 27 Unrestricted net assets ...... ....... ... .
- 524,335,561. 27
i
- -595,455,979.
ni 28 Temporarily restricted net assets . . . . . . . . . . . . 110,270,211. 28 3,267,495.
co
"O 29
C:
Permanently restricted net assets . . . . . . . . . . . . ....... 36,313,759. 29 -68.
.
:I
u.
0
Organizations that do not follow SFAS 117 (ASC 958), check here
complete lines 30 through 34 .
► Oand
...
(II
QI
30 Capital stock or trust principal, or current funds . . . . . . .. .... 30
(II
(II
31 Paid-in or capital surplus, or land, bu1ld1ng, or equipment fund .... 31
...
<
QI
32 Retained earnings, endowment, accumulated income, or other funds 32
z 33 Total net assets or fund balances ....... .. .... . ..... 670,919,531. 33 -592,188,552.
34 Total hab11it1es and net assets/fund balances . . . . . . . . . . . . . . 2,825,124,312. 34 2,213,070,393.
Form 990 (2017)
JSA
7E 1053 1 ooo
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Form 990 (2017) Page 12
i4ffii3 ■ Reconciliation of Net Assets
Check 1f Schedule O contains a res onse or note to an line 1n this Part XI. ......... X
1 Total revenue (must equal Part VIII, column (A), hne 12) . 1 932,387,893.
2 Total expenses (must equal Part IX, column (A), hne 25) . . . . . . 2 1,244,106,919.
3 Revenue less expenses Subtract hne 2 from hne 1 . . . . . . . . . 3 -311, 719,026.
4 Net assets or fund balances at beginning of year (must equal Part X, hne 33, column (A)) 4 670,919,531.
5 Net unrealized gains (losses) on investments 5 43,303,489.
6 Donated services and use of fac1ht1es 6 o.
7 Investment expenses . . . . . . . . . . . . . 7 0.
. 8 Prior period adJustments . . . . . . . . . . . 8 0.
9 Other changes In net assets or fund balances (explain In Schedule 0) . 9 -994,692,546.
10 Net assets or fund balances at end of year Combine lines 3 through 9 (must equal Part X, line
33, column B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 -592,188,552.
Financial Statements and Reporting
Check 1f Schedule O contains a resoonse or note to anv line in this Part XII .. ... n
Yes No
1 Accounting method used to prepare the Form 990 D
Cash 0
Accrual D
Other _ _ _ _ __
If the organization changed its method of accounting from a prior year or checked "Other," explain in
Schedule 0
2a Were the organization's financial statements compiled or reviewed by an independent accountant?.. _. . . . . 2a X
If "Yes," check a box below to indicate whether the financial statements for the year were compiled or
reviewed on a separate basis, consolidated basis, or both
D Separate basis D Consolidated basis D Both consolidated and separate basis
b Were the organization's f1nanc1al statements audited by an independent accountant? . . . . . . . . . . . . . .
__ J
2b X
If "Yes," check a box below to 1nd1cate whether the financial statements for the year were audited on a
s~rate basis, consolidated basis, or both
LJ Separate basis CK] Consolidated basis □ Both consolidated and separate basis
c. If ''Yes" to line 2a or 2b, does the organization have a committee that assumes respons1b11ity for oversight
of the audit, review, or comp1lat1on of its financial statements and selection of an independent accountant? 2c X
If the organization changed either its over~Ight process or selection process during the tax year, explain in
Schedule 0
__ _j
3a As a result of a federal award, was the organization required to undergo an audit or audits as set forth in
the Single Audit Act and 0MB Circular A-133? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3a X
b If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the
required audit or audits, exolain why in Schedule O and describe any steps taken to underao such audits 3b
Form 990 (2017)
JSA
7E1054 1 000
JU6323 392H V 17-7.2F HEALTH CARE
0MB No 1545-004 7
SCHEDULE A Public Charity Status and Public Support
( Form 99 0 or 99 0-EZ) Complete If the organization Is a secbon 601(c)(3) organization or a section 4947(a)(1) nonexempt charitable trusl
► Attach to Form 990 or Form 990-EZ.
• Department of the Treasury
Internal Revenue Service ► Go to www.irs.gov/Form990 for Instructions and the latest information.
1
2
J
§ Reason for Public Charity Status (All organrzatrons must complete this part) See rnstructrons
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 or 990-EZ))
A hospital or a cooperative hospital service organization described In section 170(b)(1)(A)(iii).
{__../
\-7 /
4 A medical research organization operated in con1unctIon with a hospital described In section 170(b)(1)(A)(iii). Enter the
hospital's name, city, and state
5 DAn 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)
6 D A federal, state, or local government or governmental unit described In section 170(b)(1)(A)(v).
7 D 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)
8 D A community trust described in section 170(b)(1)(A)(vi). (Complete Part II)
9 DAn agricultural research organization described In section 170(b)(1)(A)(ix) operated In con1unctIon 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
1O DAn organization that normally receives (1) more than 33113 % 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 33113 %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 Ill )
11 D An organization organized and operated exclusively to test for public safety See section 509(a)(4).
12 ~ 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 In lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g
a ~ Type I A supporting organization operated, supervised, or controlled by its supported organizat1on(s), typically by giving
the supported organizat1on(s) the power to regularly appoint or elect a maiority of the directors or trustees of the
supporting organization You must complete Part IV, Sections A and B.
b D 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.
c D Type Ill functionally integrated. A supporting organization operated in connection with, and functionally integrated with,
its supported organizat1on(s) (see 1nstructIons) You must complete Part IV, Sections A, D, and E.
d D Type Ill non-functionally integrated. A supporting organization operated in connection with its supported organizat1on(s)
that Is not functionally integrated The organization generally must satisfy a d1stributIon requirement and an attentiveness
requirement (see instructions) You must complete Part IV, Sections A and D, and Part V.
e D Check this box 1f the organization received a written determ1natIon from the IRS that It Is a Type I, Type II, Type Ill
functionally integrated, or Type Ill non-functionally integrated supporting organization
f Enter the number of supported organizations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 I I
g Provide the following 1nformat1on about the supported organizat1on(s)
(I) Name of supported organization (ii) EIN (iii) Type of organization (Iv) Is lhe organ12aI,on (v) Amount of monetary (vi) Amount of
(described on Imes 1-10 11s led ,n your govem,ng support (see other support (see
above (see mstruct,ons)) document? instructions) instructions)
ATTACHMENT 1 Yes No
(A)
(B)
(C)
(D)
(E)
Total
1,081,308,785.
For Paperwork Reducbon Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule A (Form 990 or 990-EZ) 2017
JSA
7E1210 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Schedule A (Form 990 or 990-EZ) 2017 Page 2
1:ifi111 Support Schedule for Organizations Described in Sections 170(b)(1 )(A)(iv) and 170(b)(1 )(A)(vi)
(Complete only 1f you checked the box on line 5, 7, or 8 of Part I or 1f the organization failed to qualify under
____::________:____,:_______...;..:.___ ~ Part Ill )
Part Ill If the organization fails to qualify under the tests listed below, please complete _ __;,.___----+-;-
Section A. Public Support /
Ca le nda r year (or fiscal year beginning in) ► 1---'-'(a"-)..::2.:::..0..:..13=---+-.!.:lb::..cl..::2:..::0..:.14..:......-+--'-(c::..c)...::2:..::0..:.1-=-5-+-__,_ld::.,1:..::2:..:0:....:1.:::..6_+----'(-'e)'-2--'0:....:1..:..7_+-_~(f)~T;,.Io=-''°=-1-
•~;~:~~=~~:~~i.~,;,~. ;.;~. -,~.; :~.-, ~-·,; ;h~ ~;g;~,,~;,o~ ·a;d.~; ~h~~k; bo~ ~~ ,;.~ · 3." 1s;." 1sb." ~' ·, ;;, ~~d ,,;. □
1
15 rs 10% or more, and rf the organrzatron meets the "facts-and-circumstances" test, check this box and stop here.
I
Explain 1n Part VI how the organ1zat1on meets the "facts-and-circumstances" test The organrzatron qualifies as a publicly
□
I
supported organrzatron . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ►
18 ~
:~:r::,~i~n~~ti~~- ~f .th.e _o~g~~r~a'.r~n- d'.d. n_ot. c-h~c.k _a -b~~ ~n _1,~e- 1.3: 6.a .. 1-6~,. 1-7~, _o~ 7.b .. c-h~c-k -t~rs_ ~ b~~ ~n~ ~e-e. . . ►
Schedule A (Fonn 990 or 990-EZ) 2017
□
JSA
7E1220 ?/0
/ U6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586 /
Schedule A (Form 990 or 990-EZ) 2017 Page 3
1:tflijj1 Support Schedule for Organizations Described in Section 509(a)(2) /
(Complete only 1f you checked the box on line 10 of Part I or 1f the organization failed to qualify unde/r
Part II
If the organization fails to qualify under the tests listed below, please complete Part 11.)
Section A Public Suooort /
Calendar year (or flscal year beginning In) ► 1------'-(a-'-)_2_0_13_--+__(_b'--)2_0_1_4____(c_)_2_0_1_5_-+-_(_d_)_2_0_16_-+__(_e)_2_0_1-,f7/'----+---'-(f)--'--T_ot_a_l_
1 Grits, grants, contrrbutrons, and membership fees /
received (Do not include any "unusual grants")
2 Gross receipts from adm1ss1ons, merchandise /
sold or services performed, or fac1llt1es
furnished in any act1v1ty that rs related to the /
organization's tax-exempt purpose • . . , • •
3 Gross receipts from actrvrtres that are not an /
unrelated trade or business under section 513 •
4 Tax revenues levied
organ1zat1on's benefit and either paid to
or expended on its behalf . . . . . . . .
for lhe
/
/
/
5 The value of sel'Vlces or facilities
furnished by a governmental unit to the
organization without charge . . . . . . .
6 Total. Add lines 1 through 5 . . . . . . . /
7 a Amounts included on Imes 1, 2, and 3
received from d1squalif1ed persons . . . . j
I
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 Imes 7a and 7b . . . . . . /
I
8 Public support. (Subtract line 7c from
line 6) . . . . . , . . . . . . . . . . .
Section B Total Suooort I
I
Calendar year (or fiscal year beginning In) ► 1-----'-(a-'-)_2_0_1_3-+-/-+-_('-b'--)2_0_1_4____(c_)_2_0_1_5_-+-_(_d_)_2_0_16_-+__(_e)_2_0_1_7____(f)_T_o_ta_l_
1...
whether or not the business Is regularly
earned on . . . . . . . . . . . . 1-------+------+------+-------+-------+-------
12 Other income Do not include gain or
loss from the sale of cap1taf assets
(Explain in Part VI) . . . · / · . . . . . 1 - - - - - - - + - - - - - - + - - - - - - + - - - - - - - + - - - - - - - + - - - - - - -
13 Total support. (Add lines/ , 10c, 11,
9~~
1
:i:t :i~e, ;e~~- 0 0 0
14 lf ;h;/F~r~ .
organization, check th1,sI.box and stop here. . . . . . . . . . . . . . . . . . . . . . . . , . . . . , ,
Section C. Com utation of Public Su ort Percenta e
........ ►□
1s. for the organization's first, second, third, fourth, or fifth tax year as a section 501 (c)(3)
15 Public support percentage for 2017 (line 8, column (f) d1v1ded by line 13, column (f)). 15 %
16 Public support p/rcentage from 2016 Schedule A, Part Ill, line 15 . . . . . . . . . . 16 %
Section D. Com utation of Investment Income Percenta e
17 Investment income percentage for 2017 (line 10c, column (f) d1v1ded by line 13, column (f)) . . . . . . . . . · 117- - - + - - - - - - - - %
--
18 Investment income percentage from 2016 Schedule A, Part 111, line 17 . , , , , , . . . . . . . . . . . . . ·~1_8~---------~_o_
19a 331/3% support tests - 2017. If the organization did not check the box on line 14, and line 15 Is more than 33113%, and line
17 Is not more than 331/3 %, check this box and stop here. The organization qualifies as a publicly supported organization . ► 0
b 33 1/3 % support tests - 2016. If the organization did not check a box on line 14 or line 19a, and line 16 Is more than 331 /3 %, and
line 18 Is not more than 33113 %, check this box and stop here. The organization qualifies as a publicly supported organization ►
20 Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions ►
JSA Schedule A (Form 990 or 990-EZ) 2017
7E1221 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Schedule A (Form 990 or 990-EZ) 2017 Page 4
UtfHQ Supporting Organizations
(Complete only 1f you checked a box In line 12 on Part I. If you checked 12a of Part I, complete Sections A
and B. If you checked 12b of Part I, complete Sections A and C. If you checked 12c of Part I, complete
Sections A, D, and E If you checked 12d of Part I, complete Sections A and D, and complete Part V)
Section A. All Suooortina Oraanizations
Yes No
1 Are all of the organization's supported organizations listed by name in the organization's governing I
documents? If "No," descnbe in Part VI how the supported organizations are designated If designated by
class or purpose, descnbe the designation If htstonc and continuing relationship, explain
-1 X
2 Did the organization have any supported organization that does not have an IRS determ1nat1on of status
under section 509(a)( 1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported
''
organization was descnbed in section 509(a)(1) or (2)
-2 . -
X
Ja Did the organIzatIon have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer -
(b) and (c) below Ja X
b Did the organIzatIon confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and I
satisfied the public support tests under section 509(a)(2)? If "Yes," descnbe in Part VI when and how the - '
organization made the determination Jb
C 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 Jc
4a Was any supported organization not organized in the United States ("foreign supported organization")? If - - - -··
"Yes," and tf you checked 12a or 12b in Part I, answer (b) and (c) below 4a X
b Did the organization have ultimate control and d1scret1on in deciding whether to make grants to the foreign
supported organization? If "Yes," descnbe in Part VI how the organization had such control and discretion -.. ---- --
despite being controlled or supervised by or in connection with ,ts supported organizations 4b
C 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," exp/am m Part VI what controls the organization used
to ensure that all support to the foreign supported organization was used exclus,vely for section 170(c)(2)(B) - - - -
purposes 4c
Sa Did the organIzatIon add, substitute, or remove any supported organizations during the tax year? If "Yes,"
answer (b) and (c) below (tf appl,cable) Also, provide detail in Part VI, including (1) the names and EIN
numbers of the supported organizations added, substituted, or removed, (11) the reasons for each such action,
(111) tho authonty undor tho organizatton'a organizing document authonzmg auch action, and (tv} how tho action
""
was accompltshed (such as by amendment to the organizing document) Sa X
b 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? Sb
C Substitutions only. Was the subst1tut1on the result of an event beyond the organization's control? Sc
I
6 Did the organization provide support (whether in the form of grants or the provIsIon of services or fac11it1es) to '
anyone other than (1) its supported organizations, (11) 1nd1v1duals that are part of the charitable class benefited
by one or more of its supported organizations, or (111) other supporting organIzatIons that also support or I
-
benefit one or more of the filing organization's supported organizations? If "Yes," provide detail in Part VI. 6 X
7 Did the organization provide a grant, loan, compensation, or other s1m1lar 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 or 990-EZ) 7 X
8 Did the organization make a loan to a d1squal1f1ed person (as defined in section 4958) not described in line 7?
If "Yes," complete Part I of Schedule L (Form 990 or 990-EZ)
.
8
- - X
9a Was the organization controlled directly or indirectly at any time during the tax year by one or more '
t
d1squal1f1ed persons as defined in section 4946 (other than foundation managers and organizations described -X
In section 509(a)(1) or (2))? If "Yes," provide detail in Part VI. 9a
b Did one or more d1squalif1ed persons (as defined in line 9a) hold a controlling interest in any entity in which
the supporting organization had an interest? If "Yes," provide detail in Part VI. 9b X
C Did a d1squalif1ed person (as defined in 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. 9c X
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 Ill non-functionally integrated . .-
supporting organizations)? If "Yes," answer 1Ob below 10a X
b 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
JSA Schedule A (Fonn 990 or 990-EZ) 2017
7E12291000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Schedule A Form 990 or 990-EZ 2017 Page 5
anizations continued
Yes No
11 Has the organ1zat1on accepted a gift or contribution from any of the following persons?
a A person who directly or indirectly controls, either alone or together with persons described 1n (b) and (c)
below, the governing body of a supported organization?
-·--- ._.__.
11a
_ _.!
X
b A family member of a person described In (a) above? 11b X
c A 35% controlled entIt of a erson described 1n a or b above? If "Yes" to a b or c rov,de detail m Part VI. 11c X
Section B. Type I Supporting Organizations
Yes No
1 Did the 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 m Part VI how the supported orgamzat,on(s) effectively operated, supervised, or
controlled the organization's acftv,ttes If the orgamzatton had more than one supported orgamzafton,
describe how the powers to appoint and/or remove dtrectors or trustees were allocated among the supported ____ __,
organizations and what condtftons or restricftons, tf any, applted to such powers durmg the tax year 1 X
2 Did the organization operate tor the benefit of any supported organization other than the supported
organizat1on(s) that operated, supervised, or controlled the supporting organization? If "Yes," exp/am m Part
VI how providing such benefit earned out the purposes of the supported orgamzat1on(s) that operated, --- ___ J
I
supervised, or controlled the supporting orgamzatton 2 X
Section C Type II Suooorting Organizations
Yes No
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 organizat1on(s)? If "No," describe m Part VI how control
or management of the supporting orgamzafton was vested m the same persons that controlled or managed
the supported orgamzat,on(s)
Section D All Type Ill Supporting Organizations
Yes No
1 Did the organization provide to each of ,ts supported organizations, by the last day of the fifth month of the
organization's tax year, (1) a written notice describing the type and amount of support provided during the prior !
tax year, (11) a copy of the Form 990 that was most recently filed as of the date of notification, and (111) copies of
_ _:_J
I
the organ1zat1on's governing documents in effect on the date of not1f1cat1on, to the extent not previously
provided? • 1
2 Were any of the organization's officers, directors, or trustees either (1) appointed or elected by the supported I
organizat1on(s) or (11) serving on the governing body of a supported organization? If "No," exp/am m Part VI how
the organization mamtamed a close and continuous working relattonshtp with the supported orgamzat,on(s)
_J
2
3 By reason of the relat1onsh1p described in (2), did the organization's supported organizations have a ''
s1gn1f1cant 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 m Part VI the role the orgamzatton's _____JI
supported orgamzaftons played m this regard 3
Section E. Type Ill Functionally Integrated Supporting Organizations
1 Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions)
a
b
H
D The organization sat1sf1ed the Act1v1t1es Test Complete line 2 below
The organization Is the parent of each of its supported organizations Complete line 3 below
C The organization supported a governmental entity Descnbe m Part VI how you supported a government entity (see mstruct,onsJ
Yes No
2 Act1v1t1es Test Answer (a) and (b) below.
a Did substantially all of the organization's actIvIt1es during the tax year directly further the exempt purposes of
l
I
the supported organizat1on(s) to which the organization was responsive? If "Yes," then ,n Part VI identify
those supported organizations and explain how these acttv,t,es dtrectly furthered thetr exempt purposes,
how the organization was responsive to those supported orgamzattons, and how the organization determined
that these act1v11tes constttuted substanttally all of ,ts act,v,ttes
-- - --- -----'
2a
l
b Did the act1v1t1es described ,n (a) constitute act1v1t1es that, but for the organ1zat1on's involvement, one or more
of the organization's supported organizat1on(s) would have been engaged 1n? If "Yes," exp/am ,n Part VI the
reasons for the orgamzatton's pos,t,on that ,ts supported orgamzat1on(s) would have engaged ,n these
act1v,t1es but for the organization's involvement
--
2b
-- J
3 Parent of Supported Organizations Answer(a) and (b) below. 1
a Did the organ1zat1on have the power to regularly appoint or elect a maJority of the officers, directors, or
trustees of each of the supported organizations? Provide detatls ,n Part VI.
--
3a
-- _ __J
b Did the organ,zat,on exercise a substantial degree of d1rect1on over the pohc1es, programs, and act1v1t1es of each
of its suooorted organizations? If "Yes "descnbe ,n Part VI the role played by the oraamzafton ,n this reaard
--
3b
-- _J
JSA Schedule A (Form 990 or 990-EZ) 2017
7E12301000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Schedule A Form 990 or 990-EZ) 2017 Page 6
e Ill Non-Functional!
Check here-if the organization sat1sf1ed the Integral Part Test as a qualifying trust on Nov 20, 1970 (explain In Part VI) See
instructions_ All other Type Ill non- f unct1onallv inteorated suooorting organizations must complete sectIons A through E .
(B) Current Year
Section A - Adjusted Net Income (A) Prior Year
(optional)
1 Net short-term capital gain 1
2 Recoveries of prior-year d1stribut1ons 2
3 Other gross income (see 1nstruct1ons) 3
4 Add lines 1 through 3 4
5 Deprec1at1on 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 hne 4) 8
(B) Current Year
Section B - Minimum Asset Amount (A) Prior 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)
a Average monthly value of securities 1a
I
b Averaoe 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 Vil !
2 Acqu1sItIon indebtedness applicable to non-exempt-use assets 2
3 Subtract line 2 from hne 1d 3
4 Cash deemed held for exempt use Enter 1-1/2% of line 3 (for greater amount,
see instructions) 4
5 Net value of non-exempt-use assets {subtract line 4 from hne 3) 5
6 Multiply line 5 by 035 6
7 Recoveries of prior-year d1stribut1ons 7
8 Minimum Asset Amount (add line 7 to line 6) 8
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, hne 8, Column A) 3
4 Enter greater of line 2 or hne 3 4
5 Income tax imposed in prior year 5
6 Distributable Amount. Subtract hne 5 from hne 4, unless subJect to
emergency temporary reduction (see instructions) 6
7 LJ Check here 1f the current year Is the organization's first as a non-functionally integrated Type Ill supporting organization (see
InstructIons
Schedule A (Fonn 990 or 990-EZ) 2017
JSA
7E12312000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Schedule A (Form 990 or 990-EZ) 2017 Page 7
•::,,n•'• Type Ill Non-Functionally Integrated 509(a)(3) Supporting Organizations (contmued)
Section D • Distributions Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform actIvIty that directly furthers exempt purposes of supported
organizations, in excess of income from actIvIty
3 Adm1rnstratIve expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qual1f1ed set-aside amounts (prior IRS approval required)
6 Other d1stnbut1ons (describe In Part VI) See instructions
7 Total annual distributions. Add lines 1 through 6
8 D1stribut1ons to attentive supported organizations to which the organization Is responsive
(provide details In Part VI) See instructions
9 Distributable amount for 2017 from Section C, line 6
10 Line 8 amount d1v1ded by Line 9 amount
(ii) (iii)
(i)
Section E - Distribution Allocations (see instructions) Underdistributions Distributable
Excess Distributions
Pre-2017 Amount for 2017
1 Distributable amount for 2017 from Section C, line 6
2 Underd1stribut1ons, 1f any, for years prior to 2017
(reasonable cause required-explain In Part VI) See '
instructions
3 Excess d1stribut1ons carryover, 1f any, to 2017 r
a I
b From 2013
C From 2014
d From 2015 '
e From 2016
f Total of lines 3a through e
g Applied to underdIstributIons of prior years
'
h Applied to 2017 distributable amount
i Carryover from 2012 not applied (see instructions) I
j Remainder Subtract lines 3g, 3h, and 31 from 3f
4 D1stribut1ons for 2017 from
Section D, line 7 $
a Applied to underd1stributIons of prior years !
b Applied to 2017 distributable amount
C Remainder Subtract lines 4a and 4b from 4 1
5 Remaining underd1stributIons for years prior to 2017, 1f
any Subtract lines 3g and 4a from line 2 For result ''
greater than zero, explain In Part VI See InstructIons
'
I
6 Remaining underd1stribut1ons for 2017 Subtract lines 3h
and 4b from line 1 For result greater than zero, explain In
Part VI See instructions
7 Excess distributions carryover to 2018 Add lines 3J !
>
and 4c
,
8 Breakdown of line 7
a Excess from 2013. '
l
b Excess from 2014.
C Excess from 2015. ''
d Excess from 2016. I
e Excess from 2017.
Schedule A (Fonn 990 or 990-EZ) 2017
JSA
7E1232 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Schedule A (Form 990 or 990-EZ) 2017 Page 8
Uitifa Supplemental Information. Provide the explanations required by Part II, line 10, Part II, line 17a or 17b, Part
Ill, 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, Imes 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, Imes 5, 6, and 8, and Part V, Section E,
Imes 2, 5, and 6 Also complete this part for any add1t1onal information (See instructions)
ATTACHMENT 1
SCHEDULE A, PART I - INFORMATION ABOUT SUPPORTED ORGANIZATIONS
(III) TYPE OF (IV) (V) AMOUNT OF (VI) OTHER
(I) NAME OF SUPPORTED ORGANIZATION (II) EIN ORGANIZATION YES NO SUPPORT SUPPORT AMOUNT
► Complete If the organization Is described below. ► Attach to Form 990 or Form 990-EZ. Open to Public
Department of the Treasury
► Go to www.i,s.gov/Form990 for Instructions and the latest Information.
Internal Revenue SeMce 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
• Section 501 (c)(3) organizations Complete Parts 1-A and B Do not complete Part 1-C
• Section 501 (c) (other than section 501 (c)(3)) organizations Complete Parts I-A and C below Do not complete Part 1-B
• 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
• Section 501 (c)(3) organizations that have filed Form 5768 (election under section 501 (h)) Complete Part II-A Do not complete Part 11-B
• Section 501 (c)(3) organ1zat1ons that have NOT filed Form 5768 (election under section 501 (h)) Complete Part 11-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
• Section 501 (c)(4), (5), or (6) organizations Complete Part Ill
Name of organization Employer Identification number
NORTHWELL HEALTHCARE, INC. 11-2965586
Complete if the organization is exempt under section 501(c) or is a section 527 organization.
1 Provide a description of the organization's direct and indirect political campaign actIvItIes in Part IV (see Instruct1ons for
defin1t1on of "political campaign act1v1t1es")
Political campaign actIvIty expenditures (see 1nstruct1ons) . . . . . . . . . . . . . . . ► $ _ _ _ _ _ _ _ _ _ _ __
Volunteer hours for olit1cal cam aI n actIvItIes see instructions . . . . . . . . . .
Complete if the organization is exempt under section 501(c)(3).
1@1A Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1 Enter the amount directly expended by the f1hng organization for section 527 exempt function
actIvItIes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► $ _ _ _ _ _ _ _ _ _ _ __
2 Enter the amount of the f1l1ng organization's funds contributed to other organizations for section
527 exempt function actIvItIes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► $ _ _ _ _ _ _ _ _ _ _ __
3 Total exempt function expenditures Add lines 1 and 2 Enter here and on Form 1120-POL,
hne 1 7b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► $ -----.----.---.----.---
4 Did the filing organization file Form 1120-POL for this year?. . . . . . . . . . . . . . . . . . . . . . . Yes LJ No LJ
5 Enter the names, addresses and employer 1dent1f1cat1on 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 f1hng organization's funds Also enter
the amount of political contributions received that were promptly and directly delivered to a separate pol1t1cal organization, such
as a separate segregated fund or a political action committee (PAC) If add1t1onal space Is needed, provide information in Part IV
(a) Name (b) Address (c) EIN (d) Amount paid from (e) Amount of political
filing organization's contributions received and
funds If none, enter -0- promptly and directly
delivered to a separate
political organ1zat1on If
none, enter -0-
(1)
(2)
(3)
(4)
(5)
(6)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule C (Form 990 or 990-EZ) 2017
JSA
7E1264 1 000
Calendar year (or fiscal year (a) 2014 (b) 2015 (c)2016 (d)2017 (e) Total
beginning 1n)
JSA
7E12651000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Schedule C (Form 990 or 990-EZ) 2017 Page 3
Uifiiii:1 Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768
• (election under section 501(h)).
(a) (b)
For each "Yes," response on Imes 1a through 11 below, provide m Part IV a detailed
descnpt1on of the lobbying activity Yes No Amount
During the year, did the f1l1ng organization attempt to influence foreign, national, state or local
leg1slat1on, including any attempt to influence public opinion on a leg1slat1ve matter or
referendum, through the use of
X
a Volunteers? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,_____,,__--<
b Paid staff or management (include compensation in expenses reported on Imes 1c through ~1)?. _ _ _x--1 __________,'
c Media advertisements? . . . . . . . . . . . . . . . . X
d Mailings to members, legislators, or the public? . . . . X
X
e Publ1catIons, or published or broadcast statements? .
f Grants to other organizations for lobbying purposes? . X
g Direct contact with legislators, their staffs, government offlc1als, or a leg1slat1ve body? . X
h Rallies, demonstrations, seminars, conventions, speeches, lectures, or any s1m1lar means?. X 840,214
i Other act1v1t1es? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . X
j Total Add Imes 1c through 11 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ____ ,___ _ _ _8_4_0_,_2_1_4
2a Did the act1v1t1es in line 1 cause the organization to be not described in section 501(c)(3)? 1----tf---X---f _ _ _ _ _ _ _ _ _ _ _ J
b If "Yes," enter the amount of any tax incurred under section 4912 . . . . . . . . . . . . . .
c If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ____ 1 - - - - - - - - - -
d If the f11inQ orqanizatIon incurred a section 4912 tax, did It file Form 4 720 for this year?. . . X
• · Complete if the organization is exempt under section 501 (c)(4), section 501 (c)(5), or section
501 (c)(6).
Yes No
..
5 Taxable amount of lobbying and political expenditures (see instructions) . . . .
·- Supplemental Information
.............. 5
Provide the descriptions required for Part I-A, line 1, Part 1-8, line 4, Part I-C, line 5, Part II-A (affiliated group list), Part II-A, Imes 1 and
2 (see instructions), and Part 11-8, line 1 Also, complete this part for any add1t1onal information
LOBBYING ACTIVITY
OF THEIR MEMBERS.
7E1500 1 000
JU6323 392H V 17-7.2F HEALTH CARE
SCHEDULED 0MB No 1545-0047
(Form 990)
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.
Department of the Treasury ► Attach to Form 990. Open to Public
Internal Revenue Service ► Go to www.irs.gov/Form990 for instructions and the latest Information. Inspection
Name of the organization Employer Identification number
a
b
§
collection items (check all that apply)
Public exh1b1t1on
Scholarly research
d
e Other
B
loan or exchange programs
--------------------
c Preservation for future generations
4 Provide a description of the organization's collections and explain how they further the organization's exempt purpose in Part
XIII
5 During the year, did the organization sol1c1t or receive donations of art, historical treasures, or other s1mIlar
assets to be sold to raise funds rather than to be maintained as part of the organization's collection? . . . . Yes No
Escrow and Custodial Arrangements.
Complete 1f the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form
990, Part X, line 21.
1a Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes No D D
b If "Yes," explain the arrangement in Part XIII and complete the following table
Amount
C Beginning balance ...... 1c
d Add1t1ons during the year .. 1d
e D1stribut1ons during the year . 1e
f Ending balance . . . . . . . . 1f
2a Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account hab1hty? LJYes
-~,~-·
b If "Yes," explain the arrangement in Part XIII Check here 1f the explanation has been provided on Part XIII . . . ......
Endowment Funds.
Complete 1f the organization answered "Yes" on Form 990, Part IV, line 10.
(a) Current year (b) Prior year (c) Two years back
.HNo
JSA
7E1269 1 000
( 1) Financial derivatives ■ ■ • ■ •
(1)
(2) .
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col (B) line 13) ► I
■ :r.u111•·• Other Assets.
Complete 1f the organization answered "Yes" on Form 990, Part IV, line 11 d. See Form 990, Part X, line 15
(a) Descnpt1on (b) Book value
(1) SECURITY DEPOSITS 482,122.
(2) DUE FROM AFFILIATES 21,092,602.
(3) OTHER ASSETS 7,870,381.
(4)INSURANCE CLAIMS RECEIVABLE 3,677,219.
(5) INTEREST IN FOUNDATION 3,272,826.
(6)INVESTMENT IN SUBSIDIARIES 273,316,253.
(7) BOND FINANCING . 16,895,381.
(8)RESERVE - OTHER LT DEBT -134,907,150.
(9)
Total. (Column (b) must equal Form 990, Part X, col (B) /me 15). ••••••••••••••••••••• ■ •••
► 191,699,634.
■ :r.Til•:• Other Liabilities.
Complete 1f the organIzatIon answered "Yes" on Form 990, Part IV, line 11 e or 11 f. See Form 990, Part X,
line 25
1. (a) Description of hab11ity (b) Book value lI
(1) Federal income taxes ATTAC.ttMt;NT l
(2) OTHER LT LIABILITIES 2,266,072. '
I
1 Total revenue, gains, and other support per audited financial statements ... . . . . . ........ 1 1293462121.
2 Amounts included on hne 1 but not on Form 990, Part VIII, hne 12
2a 41,096,971
a Net unrealized gains (losses) on investments
b Donated services and use of fac1ht1es . . . ... 2b
C Recoveries of prior year grants. 2c
2d 970,000.
d Other (Describe 1n Part XIII )
2e 42,066,971.
e Add Imes 2a through 2d ....
Subtract line 2e from line 1.. 3 1251395150.
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 1n Part XIII ) 4b -319,007,257
-
C Add Imes 4a and 4b .......................... . . . . .......... 4c -319,007,257.
5 Total revenue Add lines 3 and 4c. {This must eaual Form 990 Part I /me 12 l . . . 5 ........... 932,387,893.
1::r.,.-.-11 ■ Reconciliation of Expenses per Audited Financial Statements With Expenses per Return.
Complete 1f the organization answered "Yes" on Form 990, Part IV, line 12a
1 Total expenses and losses per audited financial statements 1 1236078231.
2 Amounts included on hne 1 but not on Form 990, Part IX, line 25
a Donated services and use of fac11it1es 2a
b Prior year adJustments 2b
C Other losses. 2c
d Other (Describe 1n Part XIII ) 2d
e Add Imes 2a through 2d 2e
3 Subtract line 2e from line 1 3 1236078231.
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 1n Part XIII ) 4b 8,028,688.
Add Imes 4a and 4b 4c 8,028,688.
C
5 Total exoenses Add lines 3 and 4c. fThts must eaual Form 990 Part I /me 18 > 5 1244106919.
ll!IEm( Supplemental Information.
Provide the descriptions required for Part II, Imes 3, 5, and 9, Part Ill, lines 1a and 4, Part IV, lines 1b and 2b, Part V, line 4, Part X, hne
2, Part XI, Imes 2d and 4b, and Part XII, Imes 2d and 4b Also complete this part to provide any add1t1onal 1nformat1on
SEE PAGE 5
7E1271 1 000
JU6323 392H V 17-7.2F HEALTH CARE
- Schedule D (Form 990) 2017 NORTHWELL HEALTHCARE, INC. 11-2965586 Page 5
Uifflf3il1 Supplemental Information (continued)
ENTITIES. UNDER THE ASSET AND LIABILITY METHOD, DEFERRED INCOME TAXES ARE
BETWEEN THE FINANCIAL STATEMENT CARRYING AMOUNTS AND THE TAX BASIS OF
MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSET
RELATE TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND NET OPERATING LOSS
TOTAL (319,007,257)
TOTAL 8,028,688
ATTACHMENT 1
SCHEDULE DI PART X - OTHER LIABILITIES
TOTALS 2121915881740.
(Form 990) For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
► Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
Department of the Treasury ► Attach to Form 990. Open to Public
Internal Revenue Ser111ce ► Go to www.irs.gov/Form990 for Instructions and the latest information. Inspection
Name of the organ,zallon Employer Identification number
NORTHWELL HEALTHCARE, INC. 11-2965586
Questions Regarding Compensation
Yes No
1a Check the appropriate box(es) 1f the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a Complete Part Ill 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 indemnif1cat1on and gross-up payments Health or social club dues or InitIat1on fees
D1scret1onary spending account Personal services (such as, maid, chauffeur, chef)
b 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 Ill to
explain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1---1_b-+---+---
2 Did the organization require substant1at1on prior to reImburs1ng or allowing expenses incurred by all
directors, trustees, and officers, including the CEO/Executive Director, regarding the items checked on line
3
1a? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Indicate which, 1f 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
2
----->---
related organization to establish compensation of the CEO/Executive Director, but explain In Part Ill
~
Compensation committee ~ Written employment contract
Independent compensation consultant X Compensation survey or study
Form 990 of other organizations X Approval by the board or compensation committee
4 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
a Receive a severance payment or change-of-control payment?. . . . . . . . . . . . . . 4a X
b Part1c1pate in, or receive payment from, a supplemental nonqual1fied retirement plan?. 4b X
c Part1c1pate in, or receive payment from, an equity-based compensation arrangement?. 4c X
If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part Ill
a
b
Only section 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? . . . . . . . . . . .
__J
Sa
Sb
X
X
If "Yes" on line 5a or 5b, describe In Part Ill
6 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
a The organization? . . . . . . . . . . . . . . 1---6_a--+----+--X-
b Any related organization? . . . . . . . . . . . . . 1---6...;;.b-+---+--x_
If "Yes" on line 6a or 6b, describe In Part Ill
7 For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonf1xed
payments not described on lines 5 and 6? If "Yes," describe In Part Ill. . . . . . . . . . . . . . . . . . . . . . . . 1---7-1--_x_ __
8 Were any amounts reported on Form 990, Part VII, paid or accrued pursuant to a contract that was subject
to the in1t1al contract exception described in Regulations section 53 4958-4(a)(3)? If "Yes," describe
in Part Ill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f--8---t--+-X~
9 If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in
Regulations section 53 4958-6(c)? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule J (Fonn 990) 2017
JSA
7E1290 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2 9655'8 6
JSA
7E1291 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965S86
DENNIS CONNORS (i) 925,897. 2,228,261. 32,468. 475,767. 9,874. 3,672,267. 1,822,244.
1
svp, REGIONAL EXECUTIVE DIR (ii) o. o. 0. 0. 0. o. 0.
MICHELE CUSACK (i) 775,211. 284,418. 12,050. 121,106. 28,381. 1,221,166. 0.
2
svp & CFO (ii) 0. 0. 0. 0. o. 0. 0.
RICHARD MILLER (i) 777,892. 299,893. 31,475. 198,971. 19,265. 1,327,496. 0.
JEVP, CHF BUSINESS STRATEGY OF (ii) o. o. 0. 0. 0. o. 0.
LAURENCE KRAEMER (i) 632,884. 204,756. 41,764. 29,700. 28,423. 937,527. 0.
svP, INTERIM CHF LGL OF (ii) 0. 0. 0. 0. 0. 0. 0.
4
MARK GLOADE (1) 469,518. 67,744. 39,464. 29,700. 28,423. 634,849. 0.
ffVP DEPUTY GENERAL COUNSEL (ii) o. 0. 0. 0. 0. o. 0.
JASON NAIDICH (i) 967,044. 306,156. 29,465. 139,581. 28,423. 1,470,669. 0.
6
sVP/REGIONAL EXECUTIVE DIR (ii) 0. 0. 0. 0. 0. o. 0.
JOSEPH MOSCOLA (i) 845,913. 341,342. 29,726. 88,541. 14,396. 1,319,918. 0.
-fVP, CHIEF PEOPLE OFFICER (11) 0. 0. 0. 0. o. 0. 0.
(1)
8 (ii)
(ii
9 (ii)
(i)
10 (ii)
(i)
11 (ii)
(i)
12 (ii)
(i)
13 (ii)
(i)
14 (ii)
(i)
15 (ii)
(i)
16 (ii)
Schedule J (Form 9901 2017
JSA
7E1291 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965986
UNVESTED BENEFIT AMOUNT AND THE AMOUNTS OUTLINED HEREIN WERE PROPERLY NOT
REPORTED IN EACH INDIVIDUAL'S FORM W-2, BOX 5. THESE AMOUNTS ARE INCLUDED
MOSCOLA($58,841).
ON FORM 990, PART VII, SECTION A, LINE lA, THE ORGANIZATION MAY PROVIDE
JSA
7E1505 1 000
JU6323 392H V 17-7 .2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-29655'86
THE AMOUNT REPORTED IN SCHEDULE J, PART II, COLUMN (F) INCLUDES SERP
AMOUNTS WHICH WERE PREVIOUSLY REPORTED ON FORM 990, SCHEDULE J, PART II,
THE SERP PLAN AND ARE NOW BEING REPORTED FOR A SECOND TIME UPON RECEIPT
JSA
7E1505 1 000
JU6323 392H V 17-7.2F HEALTH CARE
SCHEDULEL Transactions With Interested Persons 0MB No 1545-0047
(Form 990 or 990-EZ) ► Complete if the organization answered "Yes" on Form 990, Part IV, line 25a, 25b, 26, 27, 28a,
28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
► Attach to Form 990 or Form 990-EZ. Open To Public
Department of the Treasury
Internal Revenue Service ► Go to www.irs.gov/Form990 for instructions and the latest Information. Inspection
Name of the organization Employer 1dent1ficaUon number
Yes No
(1)
(2)
(3)
(4)
(5)
(6)
2 Enter the amount of tax incurred by the organization managers or d1squalif1ed persons dunng the year
under section 4958 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ► $ -------
3 Enter the amount of tax, 1f any, on line 2, above, reimbursed by the organ1zatIon. ► $ _ _ _ __
(a) Name of interested person (bl Relationsh,p (cl Purpose of (di Loan 10 or (e) Original (f) Balance due (g) In default? (h) Approved (i)Wntten
w,rh organ,zat,on loan from lhe principal amount by board or agreement?
orgamzat1on? committee?
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule L (Form 990 or 990-EZ) 2017
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NORTHWELL HEALTHCARE, INC. 11-2965586
Yes No
11) ELIZABETH OSTUNI FAM REL: LAWRENCE SMITH 79,532. EMPLOYEE X
(2) KRISTOFER SMITH FAM REL: LAWRENCE SMITH 757,555. EMPLOYEE X
JSA
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JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Yes No
(1) GURNEY'S INN RESORT BUS REL: LLOYD GOLDMAN 382,486. COMPANY X
(2) .
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
■::... Supplemental Information
Provide add1t1onal 1nformat1on for responses to questions on Schedule L (see 1nstruct1ons)
JSA
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Schedule L (Form 990 or 990-EZ) 2017
JU6323 392H V 17-7.2F HEALTH CARE
SCHEDULEO Supplemental Information to Form 990 or 990-EZ 0MB No 1545-0047
(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.
► Attach to Form 990 or 990-EZ. Open to Public
Department of the Treasury
Internal Revenue Service ► Information about Schedule O (Form 990 or 990-EZ) and Its Instructions Is at www.lrs.govRorm990. Inspection
Name of the organization Employer Identification number
NORTHWELL HEALTHCARE, INC. 11-2965586
NEGOTIATED AT ARM'S LENGTH; (2) ALL PURCHASES ARE AT FAIR MARKET VALUE;
.
MARK CLASTER HAS A BUSINESS RELATIONSHIP WITH ROBERT ROSENTHAL.
WILLIAM MACK.
SAUL KATZ HAS A BUSINESS RELATIONSHIP WITH SETH LIPSAY, F.J. MCCARTHY AND
ROBERT ROSENTHAL.
SETH LIPSAY HAS A BUSINESS RELATIONSHIP WITH SAUL KATZ AND ROBERT
ROSENTHAL.
For Privacy Act and Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ. Schedule O (Form 990 or 990-EZ) (2017)
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Schedule O (Form 990 or 990-EZ) 2017 Page 2
Name of the organizatIon Employer Identification number
• NORTHWELL HEALTHCARE, INC. 11-2965586
F.J. MCCARTHY HAS A BUSINESS RELATIONSHIP WITH SAUL KATZ AND ROBERT
ROSENTHAL.
WILLIAM MACK.
THE ANNUAL RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX (FORM 990) FOR
NORTHWELL HEALTH, INC. AND AFFILIATED ENTITIES ARE PREPARED WITH INPUT
RESOURCES, AND LEGAL. BEFORE FILING THE RETURNS, THE DOCUMENTS ARE
PORTAL. MEMBERS OF THE EXECUTIVE COMMITTEE ARE THEN INFORMED THE RETURNS
ARE READY FOR REVIEW. THE EXECUTIVE COMMITTEE, WHICH IS A COMMITTEE MADE
APPLICABLE LAW AND EXCEPT TO THE EXTENT, IF ANY, THAT SUCH AUTHORITY
JSA
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7E1228 1 000
THE BOARD WITH FULL POWERS OF THE BOARD TO REVIEW AND APPROVE THE
COMPENSATION FOR THE FOLLOWING YEAR. FOR PURPOSES OF THEIR REVIEW THE
COMMITTEE CONSIDERS THE RECOMMENDATIONS OF THE CEO FOR ALL PERSONS OTHER
THAN THE CEO. FOR PURPOSES OF THE REVIEW EACH YEAR THE COMMITTEE RECEIVES
MAKES ITS DECISIONS ON THIS BASIS, WITH THE OVERALL OBJECTIVE OF PAYING
FOR OFFICERS OR KEY EMPLOYEES ARE SEPARATELY CONSIDERED AND NORMALLY ONLY
RICHARD D. GOLDSTEIN
JSA
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7E12281000
HOLD SIMILAR POSITIONS WITH BOTH THIS ORGANIZATION AND OTHER AFFILIATES
ORGANIZATION AND SUCH OTHER AFFILIATES. THE HOURS SHOWN FOR ALL SUCH
THIS ORGANIZATION. FOR DIRECTORS AND TRUSTEES, THE HOURS SHOWN REFLECT
THE ESTIMATED AVERAGE WEEKLY TIME. FOR OFFICERS, KEY EMPLOYEES AND
HIGHEST COMPENSATED EMPLOYEES, THE HOURS SHOWN REFLECT THE WEEKLY HOURS
ARE, GENERALLY, LESS THAN THE ACTUAL WEEKLY HOURS DEVOTED TO NORTHWELL
TOTAL (994,692,546)
ATTACHMENT 1
FORM 990, PART III, LINE 1 - ORGANIZATION'S MISSION
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7E1228 1 000
ATTACHMENT 2
FORM 990, PART III, LINE 4D - OTHER PROGRAM SERVICES
ATTACHMENT 3
990, PART VII- COMPENSATION OF THE FIVE HIGHEST PAID IND. CONTRACTORS
'
ALLSCRIPTS INFORMATION SERVICES 123,276,276.
5501 DILLARD AVE
CARY, NC 27518
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ATTACHMENT 5
FORM 990, PART X - NOTES AND LOANS RECEIVABLE
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.,
• ; NORTHWELL HEALTHCARE, INC. 11-2965586
ATTACHMENT 5 (CONT'D)
BORROWER: DR. JONATHAN KLONSKY
ORIGINAL AMOUNT: 121,566.
%
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9-chedule O (Form 990 or 990-EZ) 2017 Page 2
Name of the organ,zat,on Employer identification number
NORTHWELL HEALTHCARE, INC. 11-2965586
• ATTACHMENT 5 (CONT'D)
BORROWER: DR. INES MUIA-CHISENA
ORIGINAL AMOl!JNT: 40,495.
%
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ATTACHMENT 6
ENDING COST
DESCRIPTION BOOK VALUE OR FMV
TOTALS 973,507,703.
ATTACHMENT 7
FORM 990, PART X - SECURED MORTGAGES AND NOTES PAYABLE
Ufflii Identification of Disregarded Entities. Complete 1f the organ12ation answered "Yes" on Form 990, Part IV, line 33
(a) (b) (c) (d) (e) (f)
Name, address, and EIN (If applicable) of disregarded entrty Primary activity Legal domicile (state Total income End-of-year assets Direct controlling
or foreIg n country) entity
(1) POPULATION HEALTH MANAGEMENT LLC 45-2409051
972 BRUSH HOLLOW RD WESTBURY, NY 11590 ACO NY 0. 60,958. HCI
(2) NORTH SHORE-LIJ CENTRAL STERILE VENTURES 46-3962651
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 CENTRAL STERI NY o. 0. HCI
(3) TRUE NORTH HEALTH SOLUTIONS, LLC 4 6-5006979
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. 0. HCI
(41 HEALTHFORCE, LLC 47-1725565
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. o. HCI
(51 TRUE NORTH HEALTH SERVICES COMPANY, LLC 47-5051630
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. o. HCI
(61 NSLIJ PHYSICAL ASSETS DEVELOPMENT, LLC 47-4788549
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. 0. HCI
Identification of Related Tax-Exempt Organizations. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 34, because it had
•WHIM one or more related tax-exempt organizations during the tax year
(a) (bl (c) (d) (e) (f) (g)
Name, address, and EIN of related organization Primary acbv,ty Legal domicile (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
controlled
or foreign country) (11 sect10n 501(c)(3)) entity
entity?
Yes No
(1) NORTHWELL HEALTH 11-3418133
972 BRUSH HOLLOW RD WESTBURY, NY 11590 SUPPORT NY 50l(C)(3) 12, TYPE I N/A X
(2) NORTH SHORE UNIVERSITY HOSPITAL 11-1562701
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HEALTH CARE NY 501 (C) (3) HCI
3 X
(3) LONG ISLAND JEWISH MEDICAL CENTER 11-2241326
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HEALTH CARE NY 501 (C) (3) HCI
3 X
(41 GLEN COVE HOSPITAL 11-1633487
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HEALTH CARE NY 50l(C)(3) HCI
3 X
PLAINVIEW HOSPITAL 11-3241243
151
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HEALTH CARE NY 50l(C)(3) 3 HCI X
(61 SOUTHSIDE HOSPITAL 11-1667761
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HEALTH CARE NY 501 (C) (3) 3 HCI X
(71 NORTHWELL HEALTH LABORATORIES 11-3412370
972 BRUSH HOLLOW RD WESTBURY, NY 11590 SUPPORT NY 501(C)(3) 12, TYPE I NORTHWELL X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2017
JSA
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JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
0MB No 1545-0047
SCHEDULER Related Organizations and Unrelated Partnerships
(Form 990)
► Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
► Attach to Form 990.
~@17
Open to Public
Department of the Treasury
Internal Revenue Serv,ce ► Goto www.irs.gov/Form990 for instructions and the latest information. Inspection
Name of the organ12atIon Employer identification number
1@11 Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33
(a) {b) (c) (d) (e) (I)
Name. address. and EIN (If applicable) of disregarded entity Primary act1V1ty Legal domicile (state Total income End-Of-year assets Direct controlling
or foreign country) entity
( 1) BLUE SKY DEVELOPMENT GROUP, LLC 47-4788493
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. 0. HCI
(2) NS-LIJ CARE SOLUTIONS, LLC 47-4872859
972 BRUSH HOLLOW RD WESTBURY, NY 11590 CARE MGMT NY 4,313,460. 1,125,704. HCI
(3) NORTH SHORE-LIJ MSSP ACO, LLC 47-4101065
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. 0. HCI
(4) NSLIJ 600 COMMUNITY DRIVE 47-2869912
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. 0. HCI
(5) TRUE HEALTH DEVELOPMENT, LLC 47-3126338
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. 0. HCI
(6) TRUE NORTH HUMAN CAPITAL, LLC 47-4797475
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. 0. HCI
Identification of Related Tax-Exempt Organizations. Complete 1f the organ12at1on answered "Yes" on Form 990, Part IV, hne 34, because 1t had
•ih•ii one or more related tax-exempt organ12at1ons during the tax year
{a) (b) (c) (d) (e) (I) (g)
Name, address, and EIN of related organ12at1on Primary actIvrty Legal domIc1le (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
controlled
or foreign country) (1f section 501(c)(3)) entity
entity?
Yes No
111 FEINSTEIN INSTITUTE FOR MEDICAL RESEARCH 11-2673595
972 BRUSH HOLLOW RD WESTBURY, NY 11590 RESEARCH NY 501 (C) ( 3) 4 NORTHWELL X
121 NORTHWELL HEALTH FOUNDATION 11-2965575
972 BRUSH HOLLOW RD WESTBURY, NY 11590 FUNDRAISING NY 501 (C) (3) 7 NORTHWELL X
131 NORTHWELL HEALTH STERN FAMILY CECR 23-7007485
972 BRUSH HOLLOW RD WESTBURY, NY 11590 NURSING HOME NY 501 (C) (3) 9 HCI X
{41 LIJ MEDICAL CENTER AT HOME PHARMACY 11-3251128
972 BRUSH HOLLOW RD WESTBURY, NY 11590 SUPPORT NY 501 (C) ( 3) 12, TYPE I NORTHWELL X
{ 5 1 LIJ FOUNDATION 11-2661239
972 BRUSH HOLLOW RD WESTBURY, NY 11590 SUPPORT NY 501 (C) (3) 12, TYPE I NORTHWELL X
{61 NORTH SHORE-LIJ MEDICAL CARE CENTERS 11-3473923
972 BRUSH HOLLOW RD WESTBURY, NY 11590 SUPPORT NY 501 (C) (3) 12, TYPE I NORTHWELL X
{71 SSH INC 11-2774102
972 BRUSH HOLLOW RD WESTBURY, NY 11590 SUPPORT NY 501 (C) (3) 12, TYPE I SOUTHSIDE X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2017
JSA
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NORTHWELL HEALTHCARE, INC. 11-2965586
0MB No 1545-0047
SCHEDULER Related Organizations and Unrelated Partnerships
(Form 990)
► Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
► Attach to Form 990.
~@17
Open to Public
Department of the Treasury
Internal Revenue SeMce ► Go to www.irs.gov/Form990 for instructions and the latest information. Inspection
Name of the organization Employer identification number
1:ffl11 Identification of Disregarded Entities. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 33.
(al (bl (Cl (d) (e) (f)
Name, address. and EIN (If applicable) of disregarded entity Primary activity Legal dom1c1le (state Total income End-of-year assets Direct controlling
or foreign country) entity
(1) CARE PHYSICIANS RISK PURCHASING GROUP 81-0764534
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. 0. HCI
(2) TRUE NORTH MANAGEMENT SERVICES ORG, LLC 00-0000000
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. o. HCI
(3) MEDICAL RISK PURCHASING GROUP, LLC 81-3566623
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. o. HCI
(4) NORTHWELL ANESTHESIA MSO VENTURES, LLC 82-1323719
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. o. HCI
(5) NORTHWELL EVENTS, LLC 82-0866279
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. 0. HCI
(6) TRUE NORTH INTERNATIONAL VENTURES, LLC 82-0821990
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY 0. o. HCI
Identification of Related Tax-Exempt Organizations. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 34, because 1t had
•:tiHii one or more related tax-exempt organ12at1ons during the tax year.
(al (b) (c) (di (el (f) 191
Name. address, and EIN of related organization Primary acbvity Legal dom1c1le (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
controlled
or fore1g n country) (1f section 501(c)(3)) entity entrty?
Yes No
( 11 NORTH SHORE COMMUNITY SERVICES INC 23-7273200
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HOUSING NY 501 (C) (2) N/A NORTHWELL X
(21 NORTH SHORE UNIVERSITY HOSPITAL HOUSING 11-2171903
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HOUSING NY 501 (C) (2) N/A NORTHWELL X
, 31 NSUH AT GLEN COVE HOUSING 23-7010468
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HOUSING NY 501 (C) (2) N/A NORTHWELL X
(4} HILLSIDE HOSPITAL HOUSES 11-2113949
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HOUSING NY 501 (C) (2) N/A NORTHWELL X
( 51 SIUH SYSTEMS INC 06-1074604
475 SEAVIEW AVE STATEN ISLAND, NY 10305 FUNDRAISING NY 501 (C) ( 3) 7 HCI X
(Sl STATEN ISLAND UNVERSITY HOSPITAL 11-2868878
475 SEAVIEW AVE STATEN ISLAND, NY 10305 HEALTH CARE NY 501 (C) (3) 3 HCI X
, 11 STATEN ISLAND UNIVERSITY HOSPITAL FDN 87-0765787
360 SEAVIEW AVE STATEN ISLAND, NY 10305 FUNDRAISING 501 (C) (3) 7
NY SIUH X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2017
JSA
7E1307 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
•idii Identification of Disregarded Entities. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 33
(a) (b) (c) (d) (e) (f)
Name. address, and EIN (rf applicable) of disregarded entity Primary activity Legal dom,c,le (state Total income End-Of-year assets Direct controlling
or foreign country) entity
(1)
(2)
(3)
(4)
(5)
(6)
Identification of Related Tax-Exempt Organizations. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 34, because 1t had
Utdiii one or more related tax-exempt organ12at1ons during the tax year
(a} {b) (c) (d) (e) (f) (g)
Name, address, and EIN of related organtZat,on Primary act1V1ty Legal dom,c,le (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
controlled
or foreign country) (11 section 501 (c)(3)) entity
entity?
Yes No
(1) THE HEART INSTITUTE 31-1757254
475 SEAVIEW AVE STATEN ISLAND, NY 10305 INACTIVE NY 50l(C)(3) N/A
12, TYPE I X
(2) HOSPICE CARE NETWORK 11-2925757
99 SUNNYSIDE BLVD WOODBURY, NY 11797 HOSPICE NY 50l(C)(3) NORTHWELL
9 X
(3) HUNTINGTON HOSPITAL 11-1630914
270 PARK AVENUE HUNTINGTON, NY 11743 HEALTH CARE NY 501 (C) (3) 3 HCI X
(4) HUNTINGTON HOSPITAL DOLAN FAMILY HEALTH 11-3368505
264 PULASKI RD GREENLAWN, NY 11740 HEALTH CARE NY 501 (C) (3) 3 HUNTINGTON X
(5) PHYSICIANS OF UNIVERSITY HOSPITAL PC 20-0096809
1 EDGEWATER PLAZA, 6TH FL STATEN ISLAND, NY 10305 HEALTH CARE NY 501 (C) ( 3) 12, TYPE I SIUH X
(6) LENOX HILL HOSPITAL 13-1624070
100 EAST 77TH ST NEW YORK, NY 10021 HEALTH CARE NY 501 (C) (3) 3 HCI X
( 7) LHH CORPORATION 13-3272016
100 EAST 77TH ST NEW YORK, NY 10021 SUPPORT NY 50l(C)(3) 12, TYPE I NORTHWELL X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2017
JSA
7E1307 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
SCHEDULER
. .
0MB No 1545-0047
Related Organizations and Unrelated Partnerships
(Form 990)
► Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
► Attach to Form 990.
~@17
Open to Public
Department of the Treasury
Internal Revenue Serv,ce ► Goto www.irs.gov/Fonn990 for instructions and the latest information. Inspection
Name of the organ12atIon Employer 1denbficabon number
1tn 11 Identification of Disregarded Entities. Complete 1f the organization answered "Yes" on Form 990, Part IV, hne 33
(a) (b) (c) (d) (e) (f)
Name, address. and EIN (If applicable) of disregarded entrty Primary act1V1ty Legal dom1c1le (state Total income End-of-year assets Direct controlling
or foreign country) entity
(1)
(2)
(3)
(4)
(5)
(6)
Identification of Related Tax-Exempt Organizations. Complete 1f the organization answered "Yes" on Form 990, Part IV, hne 34, because 1t had
•itdil■ one or more related tax-exempt organizations during the tax year
(a) (b) (c) (d) (e) (f) (g)
Name, address, and EIN of related organIzatIon Primary acllvrty legal dom1cIle (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
controlled
or fore1g n country) (1f section 501 (c)(3)) entity
entity?
Yes No
(1) THE ELMEZZI GRADUATE SCHOOL or MOLECULAR 11-3284934
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 GRADUATE SCHO NY 501 (C) (3) 2 RESEARCH X
(2) SPORTS PHYSICAL THERAPY & REHAB SVCS 06-1655704
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HEALTH CARE NY 501 (C) ( 3) 9 LIJ X
(3) NORTH SHORE-LIJ ALLIANCE 26-3727582
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HEALTH CARE NY 501 (C) (3) 3 N/A X
(4) THE LONG ISLAND HOME 11-2837244
400 SUNRISE HIGHWAY AMITYVILLE, NY 11701 HEALTH CARE NY 501 (C) (3) 3 LHH CORP X
( 5) CLNY ALLIANCE, INC 46-3146870
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 LABORATORY NY 501 (C) (3) 3 LABS X
(6) NORTH SHORE-LIJ CARDIOVASCULAR MEDICINE, 27-5078717
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SERVI NY 501 (C) (3) 12, TYPE I NSUH X
(7) NORTH SHORE-LIJ CARDIOLOGY AT DEER PARK, 27-5078531
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SERVI NY 501 (C) (3) 12, TYPE I NSUH X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2017
JSA
7E1307 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
Uffiii Identification of Disregarded Entities. Complete 1f the organization answered "Yes" on Form 990, Part IV, hne 33
(a) (b) (c) (d) (e) (f)
Name. address, and EIN (If applicable) of disregarded entity Primary act1v,ty legal domicile (state Total income End-of-year assets Direct controlling
or foreign country) entity
(1)
(2)
(3)
(41
(51
(6)
Identification of Related Tax-Exempt Organizations. Complete 1f the organization answered "Yes" on Form 990, Part IV, hne 34, because ,t had
•iiHii one or more related tax-exempt organizations during the tax year
(a) (bl (c) (d) (e) (f) (g)
Name, address. and EIN of related organization Primary actlVlty Legal dom1c1le (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
controlled
or foreign country) (11 section 501 (c)(3)) entity entrty?
Yes No
111 NORTH SHORE-LIJ HEART SURGERY, PC 27-5078838
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SERVI NY 50l(C)(3) 12, TYPE I NSUH X
121 NORTH SHORE-LIJ INTERNAL MEDICINE, PC 27-5078631
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SERVI NY 501 (C) (3) 12, TYPE I NSUH X
(3) NORTH SHORE-LIJ MEDICAL GROUP URGENT MED 27-5078426
972 BROSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SERVI NY 501(C)(3) 12, TYPE I NSUH X
(4) NORTH SHORE-LIJ MEDICAL , PC 45-3023019
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SERVI NY 501 (C) (3) 12, TYPE I NSUH X
( 5 ) NORTH SHORE-LIJ HEALTH PLAN, INC 46-1617516
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 INSURANCE NY 501 (C) (3) 9 HPLAN HOLD X
161 ADVOCATE COMMUNITY PROVIDERS 47-2528627
972 BRUSH HOLLOW RD WESTBURY, NY 11590 DSRIP NY 501 (C) (3) 7 N/A X
171 NS-LIJ HEALTH PLAN HOLDING COMPANY, INC. 46-2478147
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HOLDING COMP NY 50l(C)(3) 12, TYPE I HCI X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2017
JSA
7E1307 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
0MB No 1545-0047
SCHEDULER Related Organizations and Unrelated Partnerships
(Form 990)
► Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
► Attach to Form 990.
~©17
Open to Public
Department of the Treasury
► Goto www.irs.gov/Form990 for instructions and the latest information. Inspection
Internal Rel.'enue Ser111ce
Name of the organization Employer 1denbficabon number
1@11 Identification of Disregarded Entities. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 33.
(a) (b) (c) (d) (e) (f)
Name, address, and EIN (If applicable) of disregarded entity P nm a ry activity Legal dom1c1le (state Total income End-of-year assets Direct controlling
or foreign country) entity
(1)
(2)
(3)
(4)
(5)
(6)
Identification of Related Tax-Exempt Organizations. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 34, because 1t had
■@iii one or more related tax-exempt organizations during the tax year
(a) (b) (c) (d) (e) (f) (g)
Name, address, and EIN of related organization Primary actIv,ty Legal domIcIle (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
controlled
or foreign country) (1f section 501 (c)(3)) entity
entity?
Yes No
(1) PHELPS MEMORIAL HOSPITAL ASSOCIATION 13-1725076
701 NORTH BROADWAY SLEEPY HOLLOW, NY 10591 HOSITAL NY 501 (C) (3) 3 HCI X
(21 PHELPS MEDICAL SERVICES, PC 27-4416017
701 NORTH BROADWAY SLEEPY HOLLOW, NY 10591 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I PHELPS X
(3) NORTHERN WESTCHESTER HOSPITAL ASSOC 13-1740118
400 EAST MAIN ST MOUNT KISCO, NY 10549 HOSPITAL NY 50l(C)(3) 3 HCI X
(4) NORTHERN WESTCHESTER HOSPITAL FOUNDATION 13-4067064
400 EAST MAIN ST MOUNT KISCO, NY 10549 FOUNDATION NY 501 (C) (3) 9 NWHA X
( 5) NORCORP, INC. 13-3366748
400 EAST MAIN ST MOUNT KISCO, NY 10549 SUPPORT ORG NY 501 (C) (3) 12, TYPE I NWHA X
(61 NORTHER WESTCHESTER REALTY HOLDING COMP 91-2134215
4 00 EAST MAIN ST MOUNT KISCO, NY 10549 HOLDING COMP NY 501 (C) (2) N/A NWHA X
(7) CENTRAL SUFFOLK HOSPITAL ASSOCIATION 11-1661359
1300 ROANOKE AVE RIVERHEAD, NY 11901 HEALTH CARE NY 501 (C) (3) 3 HCI X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2017
JSA
7E1307 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
[ffll Identification of Disregarded Entities. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 33
(a) (b) (c) (d) (e) (f)
Name, address, and EIN (If applicable) of disregarded entity Primary act,vrty Legal dom,clle (state Total income End-Of-year assets Direct controlling
or foreign country) entity
(1)
(2)
(3)
(4)
(5)
(6)
Identification of Related Tax-Exempt Organizations. Complete 1f the organ12at1on answered "Yes" on Form 990, Part IV, line 34, because 1t had
hffl•ii one or more related tax-exempt organizations during the tax year
(a) (b) (c) (d) (e) (f) (g)
Name, address, and EIN of related organization Primary activity Legal dom1cIle (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
controlled
or foreign country) (1f section 501 (c)(3)) entity entity?
Yes No
11) STATEN ISLAND PERFORMING PROVIDER SYSTEM 47-2544659
972 BRUSH HOLLOW RD WESTBURY, NY 11590 DSRIP NY !APPLIED FOi N/A N/A X
12) VISITING NURSE OF HUDSON VALLEY, INC. 13-1739952
540 WHITE PLAINS RD TARRYTOWN, NY 10591 HOME HEALTH C NY 501 (Cl (3) 10 HCI X
13) HOSPICE CARE IN WESTCHESTER AND PUTNAM, 13-3882602
540 WHITE PLAINS RD TARRYTOWN, NY 10591 HOSPICE CARE NY 501 (C) (3) VNA HUDSON
10 X
14) VNA HOME HEALTH SERVICES, INC. 13-3690105
540 WHITE PLAINS RD TARRYTOWN, NY 10591 HOME HEALTH C NY 501 (C) (3) 10 VNA HUDSON X
15) MARCUS EMERGENCY MEDICINE, PC 47-4377679
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I NSUH X
16) NORTH SHORE-LIJ RADIOLOGY SERVICES, PC 22-3970667
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I NSUH X
17) NORTH SHORE-LIJ ANESTHESIOLOGY, PC 46-1617561
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 50l(C)(3) 12, TYPE I SSIDE X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2017
JSA
7E1307 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
•
0MB No 1545-0047
SCHEDULER Related Organizations and Unrelated Partnerships
(Form 990)
► Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
► Attach to Form 990.
~@17
Open to Public
Department of the Treasury
► Goto www.irs.gov/Form990 for instructions and the latest information. Inspection
Internal Revenue Serv,ce
Name of the organization Employer identification number
•iiH• Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33
(al (bl (cl (di (el (I)
Name. address, and EIN (d applicable) of disregarded entity Primary acllvrty Legal domicile (state Total income End-Of-year assets Direct controlling
or foreIg n country) entity
(1)
(2)
(3)
(4)
(5)
(6)
Identification of Related Tax-Exempt Organizations. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 34, because it had
•ifi•ii one or more related tax-exempt organizations during the tax year
(a) (b) (cl (di (el (I) (gl
Name, address, and EIN of related organization Primary activity Legal domIc1le (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
controlled
or foreign country) (1f section 501 (c)(3)) entity entity?
Yes No
(1) NORTH SHORE-LIJ OB-GYN, PC 4 6-1382916
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I LIJMC X
(2) CARNEGIE CARDIOVASCULAR, PC 47-4377825
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I LENOX HILL X
(3) WESTCHESTER HEALTH MEDICAL, PC 47-4539584
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I NSUH X
(4) PECONIC CARDIOLOGY, PC 81-3149464
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I NSUH X
(51 NORTH SHORE-LIJ OB-GYN AT GARDEN CITY, P 46-2886776
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I NSUH X
(61 NORTH SHORE-LIJ MEDICAL GROUP AT HUNTING 27-4384049
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I NSUH X
(71 NORTH SHORE-LIJ PEDIATRICS OF SUFFOLK CO 46-5746956
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I NSUH X
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2017
JSA
7E1307 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
·-
OMB No 1545-0047
SCHEDULER Related Organizations and Unrelated Partnerships
(Form 990)
► Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
► Attach to Form 990.
~©17
Open to Public
Department of the Treasury
Internal Revenue Serv,ce ► Go to www.irs.gov/Form990 for instructions and the latest information. Inspection
Name of the organization Employer 1denbficat1on number
1@11 Identification of Disregarded Entities. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 33
(a) (b) (c) (d) (e) (f)
Name, address, and EIN (If applicable) of disregarded entity Primary acttv1ty Legal dom1cIle (state Total income End-of-year assets Direct controlling
or fore1g n country) entity
(1)
(2)
(3)
(4)
(5)
(6)
Identification of Related Tax-Exempt Organizations. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 34, because rt had
•WHIM one or more related tax-exempt organ12at1ons during the tax year
(a) (b) (c) (d) (e) (f) (g)
Name, address, and EIN of related organ12atIon Primary acttv1ty Legal dom1ctle (state Exempt Code section Public chanty status Direct controlling Section 512(b)(13)
controlled
or foreign country) (11 section 501(c)(3)) entity entity?
Yes No
(1) BROOKLYN AMBULATORY CARE, PC 47-4447289
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I NSUH X
(2) LAKEVILLE SURGERY, PC 47-4377760
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY 501 (C) (3) 12, TYPE I LENOX HILL X
(3)
(4)
(5) . .
'
(6)
(7)
For Paperwork Reduction Act Notice, see the Instructions for Form 990. Schedule R (Form 990) 2017
JSA
7E1307 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586
•
Schedule R (Form 990) 2017 Page 2
■ iflijjj Identification of Related Organizations Taxable as a Partnership. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 34,
because 1t had one or more related organizations treated as a partnership during the tax year
(al (bl (cl (di (el (f) (g) (h) (1) (i) (kl
Name, address, and EIN of Primary act1vrty Legal Direct controlling Predominant Share of total Share of end-of- Ol1propol1:lon;llli, CodeV- UBI General or Percentage
related organization entity income (related, income year assets amount 1n box 20 managing ownership
dom1c1le unrelated,
1111:x.111:loN?
r<es No
(1) NORTH SHORE HEALTH SYSTEM ENTERPRISES 11-3316922
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HOLDING COMPA NY NORTHWELL C X
(2)
(3)
(4)
(5)
(6)
(7)
Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV,
iidUi line 34, because 1t had one or more related organizations treated as a corporation or trust during the tax year
(a) (b) (c) (d) (e) (f) (g) (h) (i)
Name, address, and EIN of related organization Primary act1V1ty Legal dom1clle Direct controlling Type of entrty Share of total Share of Percentage Section
(state or foreign entity (C corp, S corp, or trust) income end-of-year assets ownership 512(b)(13]
controlled
country) entrtv?
r<es No
(1) CARECONNECT GRODP HOLDING COMPANY, INC. 47-2478692
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HOLDING COMPA NY HPLAN HOLDING C X
(2) NORTH SHORE-LIJ URGENT CARE, PC 47-1758444
972 BRUSH HOLLOW RD WESTBURY, NY 11590 MEDICAL SERVI NY NSUH C X
(3) WELLBRIDGE PSYCHIATRY, PC 4 6-54 95054
972 BRUSH HOLLOW RD WESTBURY, NY 11590 MEDICAL SERVI NY NSUH C X
(2)
(3)
(4)
(5)
(6)
(7)
Identification of Related Organizations Taxable as a Corporation or Trust. Complete 1f the organization answered "Yes" on Form 990, Part IV,
•:fdU1 line 34, because 1t had one or more related organizations treated as a corpora!1on or trust during the tax year
(a) (b) (c) (d) (e) (f) (g) (h) (i)
Name, address, and EIN of related organ12at1on Primary activity Legal dom,c,le Direct controlling Type of entity Share of total Share of Percentage Section
(state or foreign entity (C corp, S corp, or trust) income end-of-year assets ownership 512(b)(13]
controlled
country) ent,tv?
Yes No
(1) NS-LIJ OB-GYN AT NEW HYDE PARK, PC 47-3722278
972 BRUSH HOLLOW RD WESTBURY, NY 11590 MEDICAL SVCS NY NSUH C X
(2) COMMUNITY DRIVE SURGERY, PC 82-1672429
972 BRUSH HOLLOW RD WESTBURY, NY 11590 MEDICAL SVCS NY NSUH C X
(3) MARCUS AVENUE MEDICAL, PC 30-0930577
972 BRUSH HOLLOW RD WESTBURY, NY 11590 MEDICAL SVCS NY NSUH C X
(4) CARECONNECT ADMINISTRATIVE SERVICES, INC n-5182974
972 BRUSH HOLLOW RD WESTBURY, NY 11590 ADMIN NY GROUP HOLDING C X
(5) NORTHWELL FLEXSTAFF, INC. 81-0836815
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY NSH ENTERPRISE C X
(6) FEINSTEIN CENTER FOR BIOELECTRONIC MED 81-2885700
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY FEINSTEIN C X
(7) TRUE NORTH HEALTH MANAGEMENT, INC. 81-3428274
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY HCI C o. 0. 100.0000 X
JSA Schedule R (Form 990) 2017
7E13081 000
•ifl•il• Identification of Related Organizations Taxable as a Partnership. Complete 1f the organization answered "Yes" on Form 990, Part IV, line 34,
because 1t had one or more related organ12abons treated as a partnership during the tax year
(a) (b) (c) (d) (e)
Pre dominant
(f) (g) (h) (1) (J) (k)
Name, address, and EIN of Primary acbvrty Legal Direct controlling Share of total Share of end-of- D11proportion;ilta CodeV- UBI General or Percentage
related organization dom1c1le entity income (related, income year assets anx.tiont? amount in box 20 managing ownership
unrelated,
(state or excluded from of Schedule K-1 pMner?
foreign tax under (Form 1065)
country) sections 512 - 514)
Yes No Yes No
(1)
(2)
(3)
(4)
(5)
(6)
(7)
Identification of Related Organizations Taxable as a Corporation or Trust. Complete 1f the organization answered "Yes" on Form 990, Part IV,
•ifl•Ni line 34, because 1t had one or more related organizations treated as a corporation or trust during the tax year
(a) (b) (c) (d) (e) (f) (g) (h) (i)
Name, address, and EIN of related organization Primary activity Legal dom,c,le Direct controlling Type of entity Share of total Share of Percentage Section
(state or foreign entity (C corp, S corp, or trust) income end-of-year assets ownership 512(b)(13
controlled
country) entrtv?
Yes No
(1) NARROWS IPA, INC. 13-3978565
972 BRUSH HOLLOW RD WESTBURY, NY 11590 BUSINESS SVC NY NSUH C X
(2) VIVOHEALTH PLANS, INC. 46-1164689
972 BRUSH HOLLOW RD WESTBURY, NY 11590 INACTIVE NY HCI C o. 0. 100.0000 X
(3) FORMATIV HEALTH MANAGEMENT, INC. 81-3454243
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HOLDING CO DE FM HEAL TH INTER C X
(4) FORMATIV HEALTH NEWCO, INC. 81-3928889
972 BROSH HOLLOW RD WESTBURY, NY 11590 HOLDING CO NY FM HEALTH HOLD C X
(5) FORMATIV HEALTH HOLDCO, INC. 81-3928672
972 BRUSH HOLLOW RD WESTBURY, NY 11590 HOLDING CO DE FM HEALTH C X
(6) NORTHWELL QUALITY AND MEDICAL AFFAIRS, I 82-4113233
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 INACTIVE NY NW HEALTHCARE C 0. o. 100.0000 X
(7) MONTAUK RISK RETENTION GROUP, INC. 82-2587942
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 INSURANCE NY N/A C X
JSA Schedule R (Form 990) 2017
7E13081 000
(2)
(3)
(4)
(5)
(6)
(7)
Identification of Related Organizations Taxable as a Corporation or Trust. Complete 1f the organization answered "Yes" on Form 990, Part IV,
•id•Ni line 34, because 1t had one or more related organizations treated as a corporation or trust during the tax year
(al (b) (Cl (di (el (f) (gl (hi Iii
Name, address, and EIN of related organization Primary act1V1ty Legal domicile Direct controlling Type of entity Share of total Share of Percentage Section
(state or foreign entity (C corp, S corp, or trust) income end-Of-year assets ownership 512(b)(13:
controlled
country) entrtv?
[Yes No
(1) TRUE NORTH FLEXSTAFF, INC. 82-1446568
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 INACTIVE NY NW HEALTHCARE C 0. 0. 100.0000 X
(2) NORTHWELL PROTON THERAPY, PC 81-2766298
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 INACTIVE NY NSUH C X
(J) SUITE 130 PLASTIC SURGERY, PC 82-1772747
972 BRUSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY LIJ C X
(4) NORTHEASTERN ANESTHESIA OF NEW JERSEY, P 20-8709500
972 BROSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NJ NSUH C X
(5) BRIGHTWATERS GYNECOLOGY, PC 82-1883445
972 BROSH HOLLOW ROAD WESTBURY, NY 11590 MEDICAL SVCS NY NSUH C X
(6)
(7)
Note: Complete line 1 1f any entity 1s listed in Parts II, Ill, or IV of this schedule Yes No
1 During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed 1n Parts II-IV?
a Receipt of (i) interest, (ii) annu1t1es, (iii) royalties, or (iv) rent from a controlled entity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a X
b Gift, grant, or capital contribution to related orgamzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b X
c Gift, grant, or capital contribution from related orgamzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1c X
d Loans or loan guarantees to or for related orgamzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1d X
e Loans or loan guarantees by related orgamzation(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1e X
-
f D1v1dends from related orgamzat1on(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1f
g Sale of assets to related orgamzat1on(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1g X
h Purchase of assets from related orgamzat1on(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1h X
i Exchange of assets with related orgamzat1on(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1i X
j Lease of fac1lit1es, equipment, or other assets to related orgamzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1i X
(6) NORTHWELL HEALTH STERN FAMILY CTR FOR REHAB p 6,024,000. AT COST
JSA Schedule R (Form 990) 2017
7E1309 2 000
1 During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed 1n Parts II-IV?
a Receipt of (i) interest, (ii) annu1t1es, (iii) royalties, or (iv) rent from a controlled entity. . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a
b Gift, grant, or capital contribution to related orgamzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . 1b
C Gift, grant, or capital contribution from related orgamzat1on(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1c
d Loans or loan guarantees to or for related orgamzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1d
e Loans or loan guarantees by related orgamzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1e
Note: Complete line 1 1f any entity 1s listed in Parts II, Ill, or IV of this schedule Yes No
1 During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed 1n Parts II-IV?
a Receipt of (i) interest, (ii) annu1t1es, (iii) royalties, or (iv) rent from a controlled entity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a
b Gift, grant, or capital contribution to related orgamzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b
C Gift, grant, or capital contribution from related orgamzat1on(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . 1c
d Loans or loan guarantees to or for related orgamzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . 1d
e Loans or loan guarantees by related orgamzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1e
I
•---
(3) NORTHWELL HEALTH STERN FAMILY CTR FOR REHAB Q 6,024,000. AT COST
Note: Complete line 1 1f any entity 1s listed in Parts II, Ill, or IV of this schedule Yes No
1 During the tax year, did the organization engage in any of the following transactions with one or more related organizations listed 1n Parts II-IV?
a Receipt of (i) interest, (ii) annu1t1es, (iii) royalties, or (iv) rent from a controlled entity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a
b Gift, grant, or capital contribution to related orgarnzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b
C Gift, grant, or capital contribution from related orgarnzat1on(s). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1c
d Loans or loan guarantees to or for related orgarnzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • . . . . . . . . . . . . . . . . . . . . . . . 1d
e Loans or loan guarantees by related orgarnzat1on(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1e
-
(1) NORTH SHORE-LIJ RADIOLOGY PC Q 375,000. AT COST
■ ififa Unrelated Organizations Taxable as a Partnership. Complete 1f 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 act1v1t1es (measured by total assets
or gross revenue) that was not a related organization See instructions regarding exclusion for certain investment partnerships
(a) (b) (c) (d) (e) (f) (g) (h) (1) U) (k)
Name. address. and EIN of entrty Primary activ,ty Legal domicile Predominant Are all partners Share of Share of 01sproport1onate CodeV- UBI General or Percentage
(state or foreign income (related, section total income end-Of-year allocabons? amount In box 20 managing ownership
country) unrelated, excluded 501(c)(3) assets of Schedule K-1 partner?
from tax under organizations? (Form 1065)
sections 512-514) No
Yes No Yes Yes No
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
( 11)
(12)
(13)
(14)
(15)
(16)
7E1310 1 000
JU6323 392H V 17-7.2F HEALTH CARE
NORTHWELL HEALTHCARE, INC. 11-2965586