SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach to Form 990. MediumBullet See separate instructions.
MediumBulletInformation about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047
2013
Open to Public Inspection
Name of the organization
MERCY MEDICAL CENTER
 
Employer identification number

11-1635088
Part I
Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.
(a)
Name, address, and EIN (if applicable) of disregarded entity


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Total income


 		(e)
End-of-year assets


 		(f)
Direct controlling
entity

















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


(b)
Primary activity


 		(c)
Legal domicile (state
or foreign country)

 		(d)
Exempt Code section


 		(e)
Public charity status
(if section 501(c)(3))

 		(f)
Direct controlling
entity

 		(g)
Section 512(b)(13) controlled entity?
Yes No
(1)CATHOLIC HEALTH SYSTEM OF LONG ISLAND

992 NORTH VILLAGE AVENUE

ROCKVILLE CENTRE,NY11570
11-3403968 		SUPPORT ORG NY 501(C)(3) 11A- I NA
 
 
No
(2)CHS SERVICES INC

992 NORTH VILLAGE AVENUE

ROCKVILLE CENTRE,NY11570
11-3555766 		SUPPORT ORG NY 501(C)(3) 11A- II CHSLI
 
 
No
(3)CHS AMBULANCE SERVICES INC

992 NORTH VILLAGE AVENUE

ROCKVILLE CENTRE,NY11570
14-1801961 		DORMANT NY 501(C)(3) 3 CHSLI
 
 
No
(4)GOOD SAMARITAN HOSPITAL MEDICAL CENTER

1000 MONTAUK HIGHWAY

WEST ISLIP,NY11795
11-1888924 		HOSPITAL NY 501(C)(3) 3 CHSLI
 
 
No
(5)GOOD SAMARITAN SELF INSURANCE AGAINST

MALPRACTICE 1000 MONTAUK HIGHWAY

WEST ISLIP,NY11795
11-2537396 		SELF INSURANC NY 501(C)(3) 11A- I GOOD SAMARTN
 
 
No
(6)MARYHAVEN TRANSPORTATION SERVICES

51 TERRYVILLE ROAD

PORT JEFFERSN ST,NY11776
11-3434776 		TRANSPORTATIO NY 501(C)(3) 11A- I MARYHAVENCTR
 
 
No
(7)MARYHAVEN CENTER OF HOPE

51 TERRYVILLE ROAD

PORT JEFFERSN ST,NY11776
11-2861698 		Prgm-disabled NY 501(C)(3) 9 CHSLI
 
 
No
(8)MARYHAVEN SCHOOL CORPORATION

51 TERRYVILLE ROAD

PORT JEFFERSN ST,NY11776
11-2861690 		Schl-disabled NY 501(C)(3) 2 MARYHAVENCTR
 
 
No
(9)THE CENTER OF HOPE FOUNDATION

51 TERRYVILLE ROAD

PORT JEFFERSN ST,NY11776
11-3638367 		SUPPORT ORG NY 501(C)(3) 11A- I MARYHAVENCTR
 
 
No
(10)CATHOLIC HOME CARE

110 Bi-County Blvd Suite 114

FARMINGDALE,NY11735
11-2126736 		HOME CARE NY 501(C)(3) 9 CHSLI
 
 
No
(11)OUR LADY OF CONSOLATION GERIATRIC CARE

111 BEACH DRIVE

WEST ISLIP,NY11795
11-3284066 		LT NURSE CARE NY 501(C)(3) 9 CHSLI
 
 
No
(12)RIVERHEAD HOSTEL HOLDING CORPORATION

51 TERRYVILLE ROAD

PORT JEFFERSN ST,NY11776
11-2499790 		RENTING NY 501(C)(2)   MARYHAVENCTR
 
 
No
(13)SIENA VILLAGE INC

2000 BISHOPS ROAD

SMITHTOWN,NY11787
06-1569129 		SR HOUSING NY 501(C)(3) 9 STCATHERINE
 
 
No
(14)ST CATHERINE OF SIENA MEDICAL CENTER

50 ROUTE 25A

SMITHTOWN,NY11787
06-1562701 		HOSPITAL NY 501(C)(3) 3 CHSLI
 
 
No
(15)ST CHARLES HOSPITAL

200 BELLE TERRE ROAD

PORT JEFFERSN ST,NY11777
11-1871039 		HOSPITAL NY 501(C)(3) 3 CHSLI
 
 
No
(16)CHS HOME SUPPORT SERVICES INC

15 POWER DRIVE

HAUPPAUGE,NY11788
11-3594561 		RESP THERAPY NY 501(C)(3) 9 CATHHOMECARE
 
 
No
(17)ST FRANCIS HOSPITAL

100 PORT WASHINGTON BLVD

ROSLYN,NY11576
11-2050523 		HOSPITAL NY 501(C)(3) 3 CHSLI
 
Yes
 
(18)ST FRANCIS HOSPITAL FOUNDATION

100 PORT WASHINGTON BLVD

ROSLYN,NY11576
11-2916033 		SUPPORT ORG NY 501(C)(3) 11A- I ST FRANCIS
 
Yes
 
(19)ST FRANCIS HOSPITAL RESEARCH & EDUCATIO

100 PORT WASHINGTON BLVD

ROSLYN,NY11576
11-3090867 		RESEARCH ORG NY 501(C)(3) 11A- I ST FRANCIS
 
Yes
 
(20)WSNCHS NORTH INC

4295 HEMPSTEAD TURNPIKE

BETHPAGE,NY11714
11-3438973 		HOSPITAL NY 501(C)(3) 3 CHSLI
 
 
No
(21)THE ST CHARLES CORPORATION

200 BELLE TERRE ROAD

PORT JEFFERSN ST,NY11777
11-2983148 		SUPPORT ORG NY 501(C)(3) 11A- I CHSLI
 
 
No
(22)THE SAMARITAN CORPORATION

992 NORTH VILLAGE AVENUE

ROCKVILLE CENTRE,NY11570
11-2716640 		SUPPORT ORG NY 501(C)(3) 11A- I CHSLI
 
 
No
(23)WISDOM GARDENS HOUSING DEVELOPMENT FUND

51 TERRYVILLE ROAD

PORT JEFFERSN ST,NY11776
11-3559713 		SR HOUSING NY 501(C)(3) 9 MARYHAVENCTR
 
 
No
(24)GOOD SHEPHERD HOSPICE

110 Bi-County Blvd Suite 114

FARMINGDALE,NY11735
11-2958438 		HOSPICE SVC NY 501(C)(3) 9 CHSLI
 
 
No
(25)ST CHARLES HOSPITAL FOUNDATION

200 BELLE TERRE ROAD

PORT JEFFERSON,NY11777
41-2076312 		SUPPORT ORG NY 501(C)(3) 11A- I ST CHARLES
 
 
No
(26)GOOD SAMARITAN HOSPITAL FOUNDATION

1000 MONTAUK HIGHWAY

WEST ISLIP,NY11795
77-0611240 		SUPPORT ORG NY 501(C)(3) 11A- I GOOD SAMARTN
 
 
No
(27)MERCY MEDICAL CENTER FOUNDATION

1000 NORTH VILLAGE AVENUE

ROCKVILLE CENTRE,NY11570
55-0813603 		SUPPORT ORG NY 501(C)(3) 11A- I MERCY MEDCTR
 
Yes
 
(28)ST CATHERINE OF SIENA MEDICAL CTR FDN

50 ROUTE 25A

SMITHTOWN,NY11787
27-1459941 		SUPPORT ORG NY 501(C)(3) 11A- I STCATHERINE
 
 
No
(29)CATHOLIC HOME CARE FOUNDATION

110 Bi-County Blvd Suite 114

FARMINGDALE,NY11735
45-2907761 		SUPPORT ORG NY 501(C)(3) 11A- I CATHHOMECARE
 
 
No
(30)GOOD SHEPHERD HOSPICE FOUNDATION

110 Bi-County Blvd Suite 114

FARMINGDALE,NY11735
26-3169427 		SUPPORT ORG NY 501(C)(3) 11A- I GOODSHEPHERD
 
 
No
(31)OUR LADY OF CONSOLATION FOUNDATION

111 BEACH DRIVE

WEST ISLIP,NY11795
45-0517566 		SUPPORT ORG NY 501(C)(3) 11A- I OURLADYOFC
 
 
No
(32)RVC SUPPORT

992 NORTH VILLAGE AVENUE

ROCKVILLE CENTRE,NY11570
27-1531084 		REAL ESTATE NY 501(C)(3) 11A- I CHSLI
 
 
No
(33)ST FRANCIS CARDIOVASCULAR PHYSICIANS P

100 PORT WASHINGTON BLVD

ROSLYN,NY11576
11-3613997 		HEALTHCARESVC NY 501(C)(3) 11A- I ST FRANCIS
 
 
No
(34)RVC INSURANCE COMPANYINC

992 NORTH VILLAGE AVENUE

ROCKVILLE CENTRE,NY11570
20-8067039 		CAPTIVE INS NY 501(C)(3) 11A- II CHSLI
 
 
No
(35)SAMARITAN EMERGENCY MEDICAL SERVICES PC

1000 MONTAUK HIGHWAY

WEST ISLIP,NY11795
20-8243412 		HEALTHCARESVC NY 501(C)(4)   GOOD SAMARTN
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2013
Page 2
Schedule R (Form 990) 2013
Page 2
Part III
Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.
(a)
Name, address, and EIN of
related organization



 		(b)
Primary activity




 		(c)
Legal
domicile
(state or foreign
country)


 		(d)
Direct controlling
entity



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes No












Part IV
Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.
(a)
Name, address, and EIN of
related organization
 		(b)
Primary activity
 		(c)
Legal
domicile
(state or foreign
country)
 		(d)
Direct controlling
entity
 		(e)
Type of entity
(C corp, S corp,
or trust) 		(f)
Share of total income
 		(g)
Share of end-of-year
assets
 		(h)
Percentage
ownership
 		(i)
Section 512(b)(13) controlled entity?
Yes No
(1) RADIOLOGY CONSULTING OF LONG ISLANDPLLC

1000 MONTAUK HIGHWAY
WEST ISLIP,NY11795
42-1646134 		HEALTHCARE SVC NY GOOD SAMARITAN
  		C-CORP         No
(2) SAMARITAN PEDIATRIC SERVICES PC

1000 MONTAUK HIGHWAY
WEST ISLIP,NY11795
20-8180263 		HEALTHCARE SVC NY GOOD SAMARITAN
  		C-CORP         No
(3) SAMARITAN MEDICAL SERVICES PC

1000 MONTAUK HIGHWAY
WEST ISLIP,NY11795
20-8088453 		HEALTHCARE SVC NY GOOD SAMARITAN
  		C-CORP         No
(4) SOUTHWEST SUFFOLK MEDICAL PC

580 UNION BOULEVARD
WEST ISLIP,NY11795
06-1603195 		HEALTHCARE SVC NY GOOD SAMARITAN
  		C-CORP         No
(5) CARDIAC EKG INTERPRETATION PC

992 N VILLAGE AVENUE
ROCKVILLE CENTRE,NY11570
11-2924518 		HEALTHCARE SVC NY GOOD SAMARITAN
  		C-CORP         No
(6) LI REGIONAL ARTHRITIS & OSTEOPOROSIS CAR

1000 MONTAUK HIGHWAY
WEST ISLIP,NY11795
20-8964140 		HEALTHCARE SVC NY GOOD SAMARITAN
  		C-CORP         No
(7) SAMARITAN MANAGEMENT SERVICES

1000 MONTAUK HIGHWAY
WEST ISLIP,NY11795
11-2838185 		HEALTHCARE SVC NY CHSLI
  		C-CORP         No
(8) FAIRVIEW HILL MANAGEMENT CO INC

200 BELLE TERRE ROAD
PORT JEFFERSON,NY11777
11-2798383 		HOLDING CO NY CHSLI
  		C-CORP         No
(9) ADVANCED REHABILIATION MEDICINE PLLC

200 BELLE TERRE ROAD
PORT JEFFERSON,NY11777
11-3640709 		HEALTHCARE SVC NY STCHARLES HOSP
  		C-CORP         No
(10) ST FRANCIS CARDIAC PREVENTION SERVICES

100 PORT WASHINGTON BLVD
ROSLYN,NY11576
11-3224885 		HEALTHCARE SVC NY STFRANCIS HOSP
  		C-CORP         No
(11) SOUTH SHORE PRACTICE MANAGEMENT

1000 MONTAUK HIGHWAY
WEST ISLIP,NY11795
11-3307977 		HEALTHCARE SVC NY SAMARITAN MGMT
  		C-CORP         No
(12) SAMARITAN HOME CARE AMERICA

1000 MONTAUK HIGHWAY
WEST ISLIP,NY11795
11-3319259 		HEALTHCARE SVC NY SAMARITAN MGMT
  		C-CORP         No
(13) HEALTH CARE TEMP SERVICES INC

200 BELLE TERRE ROAD
PORT JEFFERSON,NY11777
11-2801136 		EMPLOYMENT AGENCY NY FAIRVIEW HILL
  		C-CORP         No
(14) MERCY INTERNAL MEDICINE PC

992 N VILLAGE AVENUE
ROCKVILLE CENTRE,NY11570
51-0639649 		HEALTHCARE SVC NY MERCY MED CTR
  		C-CORP         No
(15) LONG ISLAND EMERGENCY CARE PC

1000 N VILLAGE AVE
ROCKVILLE,NY11571
11-3633515 		PHYSICIAN SVC NY MERCY MED CTR
  		S-CORP         No
Schedule R (Form 990) 2013
Page 3
Schedule R (Form 990) 2013
Page 3
Part V
Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.
Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.
Yes
No
1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?
a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity . . . . . . . . . . . . . . . . . . . . . . .
1a
 
No
b Gift, grant, or capital contribution to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
Yes
 
c Gift, grant, or capital contribution from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1d
 
No
e Loans or loan guarantees by related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1e
Yes
 
f Dividends from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1f
 
No
g Sale of assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1g
 
No
h Purchase of assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1h
 
No
i Exchange of assets with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1j
Yes
 
k Lease of facilities, equipment, or other assets from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . .
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) . . . . . . . . . . . . . . . . . . . .
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) . . . . . . . . . . . . . . . . . . . .
1m
Yes
 
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) . . . . . . . . . . . . . . . . . . . . .
1n
 
No
o Sharing of paid employees with related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1o
Yes
 
p Reimbursement paid to related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1p
Yes
 
q Reimbursement paid by related organization(s) for expenses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1q
Yes
 
r Other transfer of cash or property to related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1r
Yes
 
s Other transfer of cash or property from related organization(s) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1s
Yes
 
2
If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.
(a)
Name of related organization 		(b)
Transaction
type (a-s) 		(c)
Amount involved 		(d)
Method of determining amount involved
(1) ST FRANCIS HOSPITAL

 M, P 62,999 COST





Schedule R (Form 990) 2013
Page 4
Schedule R (Form 990) 2013
Page 4
Part VI
Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.
Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.
(a)
Name, address, and EIN of entity 		(b)
Primary activity 		(c)
Legal domicile
(state or foreign
country) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(e)
Are all partners
section
501(c)(3)
organizations? 		(f)
Share of total income




 		(g)
Share of
end-of-year
assets 		(h)
Disproprtionate allocations? 		(i)
Code V-UBI
amount in box 20
of Schedule K-1
(Form 1065) 		(j)
General or
managing
partner? 		(k)
Percentage
ownership
Yes No Yes No Yes No






























Schedule R (Form 990) 2013
Page 5
Schedule R (Form 990) 2013
Page 5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R (see instructions).
Return Reference Explanation
Schedule R (Form 990) 2013

Additional Data


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