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

OMB No. 1545-0047
2017
Open to Public Inspection
Name of the organization
CATHOLIC MANAGED LONG TERM CARE INC
 
Employer identification number

20-8180809
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)BENEFICE ADVANTAGE INC
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
13-4201050
DORMANT/PROVIDE ADMIN., BENEFITS COORDINATING AND OTHER SERVICES TO ARCHCARE NY 501(C)(3) LINE 1 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(2)CALVARY FUND INC
1740 EASTCHESTER ROAD

BRONX,NY10461
13-3259649
SUPPORT CALVARY HOSPITAL NY 501(C)(3) LINE 12A, I CALVARY HOLDING COMPANY INC
 
 
No
(3)CALVARY HOLDING COMPANY
1740 EASTCHESTER ROAD

BRONX,NY10461
06-1531426
TO SUPPORT THE CALVARY HOSPITAL AND ITS AFFILIATED ORGANIZATIONS NY 501(C)(3) LINE 12A, I CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(4)CALVARY HOSPITAL INC
1740 EASTCHESTER ROAD

BRONX,NY10461
13-1740274
OPERATE A TAX EXEMPT HOSPITAL NY 501(C)(3) LINE 3 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(5)CARMEL RICHMOND NURSING HOME COMPANY INC
88 OLD TOWN ROAD

STATEN ISLAND,NY103044299
13-2720248
OPERATE SKILLED NURSING & REHABILITATION FACILITY NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(6)CATHOLIC HEALTH CARE FOUNDATION OF THE ARCHDIOCESE OF NY INC
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
13-4054158
PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIES NY 501(C)(3) LINE 7 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(7)CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
13-3896624
MANAGEMENT SERVICES FOR HEALTH-RELATED FACILITIES IN THE ARCHDIOCESE NY 501(C)(3) LINE 10 PROVIDENCE HEALTH SERVICES
 
 
No
(8)CATHOLIC RESOURCES INC
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
26-1306110
PROVIDE PARISH OUTREACH SERVICES & SOCIAL & HEALTH CARE SERVICE INFORMATION NY 501(C)(3) LINE 1 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(9)FERNCLIFF NURSING HOME COMPANY INC
21 FERNCLIFF DRIVE

RHINEBECK,NY12572
14-1514053
OPERATE SKILLED NURSING FACILITY & ADULT HEALTH CARE PROGRAM NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(10)KATERI RESIDENCE
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
13-3086309
DORMANT/OPERATE SKILLED NURSING & REHABILITATION FACILITY NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(11)MARY MANNING WALSH NURSING HOME COMPANY INC
1339 YORK AVENUE

NEW YORK,NY100214707
13-6220617
OPERATE SKILLED NURSING & REHABILITATION FACILITY NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(12)OUR LADY OF MERCY FUND OF NEW YORK NY
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
13-3452084
DORMANT/PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIES NY 501(C)(3) LINE 7 OUR LADY OF MERCY HEALTH CARE SYSTEM INC
 
 
No
(13)OUR LADY OF MERCY HEALTH CARE SYSTEM INC
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
13-3395946
DORMANT/PROVIDE FUNDS TO SUPPORT THE MISSION OF CHCS FACILITIES NY 501(C)(3) LINE 12A, I CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(14)PROVIDENCE HEALTH SERVICES
1011 1ST AVENUE

NEW YORK,NY10022
13-3354940
SPONSOR OF CATHOLIC HEALTH CARE SYSTEM D/B/A ARCHCARE NY 501(C)(3) LINE 3 N/A
 
No
(15)ST TERESA'S NURSING HOME INC
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
23-7012219
DORMANT/OPERATE SKILLED NURSING & REHABILITATION FACILITY NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(16)ST THERESA'S RESIDENCE
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
13-3110063
DORMANT/INTERMEDIATE CARE FACILITY FOR DEVELOPMENTALLY DISABLED NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(17)ST VINCENT DE PAUL RESIDENCE
900 INTERVALE AVENUE

BRONX,NY10459
13-3598842
OPERATE SKILLED NURSING & REHABILITATION FACILITY NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(18)TERENCE CARDINAL COOKE HEALTH CARE CENTER
1249 FIFTH AVENUE

NEW YORK,NY10029
13-3007801
OPERATE SKILLED NURSING & REHABILITATION FACILITY NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(19)EMPIRE STATE HOME CARE SERVICES INC
15 METROTECH CENTER 11FL

BROOKLYN,NY11201
11-3618585
HOME HEALTH CARE SERVICE NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(20)VISITING NURSE REGIONAL HEALTH CARE SYSTEM INC
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
11-3574017
DORMANT/SUPPORT AND MANAGEMENT SERVICES FOR ITS AFFILIATES NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(21)VISITING NURSE ASSOCIATION OF BROOKLYN INC
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
11-1977434
DORMANT/HOME HEALTH CARE NY 501(C)(3) LINE 10 VISITING NURSE REGIONAL HEALTH CARE SYSTEM INC
 
 
No
(22)BROOKLYN VISITING NURSE FOUNDATION
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
11-3312248
DORMANT/RAISE FUNDS FOR AFFILIATED ORGANIZATION NY 501(C)(3) LINE 12B, II VISITING NURSE REGIONAL HEALTH CARE SYSTEM INC
 
 
No
(23)ARCHCARE COMMUNITY SERVICES INC
205 LEXINGTON AVENUE - 2ND FLOOR

NEW YORK,NY10016
81-3563801
PROVIDE COMMUNITY AND PASTORAL SERVICES AND SUPPORTIVE HOUSING NY 501(C)(3) LINE 12B, II CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(24)DOMINICAN SISTERS FAMILY HEALTH SERVICE INC
299 NORTH HIGHLAND AVENUE

OSSINING,NY10562
13-1740242
HOME HEALTH AGENCY NY 501(C)(3) LINE 10 CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
 
No
(25)FAMILY HOME HEALTH CARE INC
65 SOUTH BROADWAY

TARRYTOWN,NY10591
13-3831377
HOME HEALTH CARE NY 501(C)(3) LINE 10 DOMINICAN SISTERS FAMILY HEALTH SERVICE INC
 
 
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2017
Page 2
Schedule R (Form 990) 2017
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) ST AGNES HOSPITAL

305 NORTH STREET
WHITE PLAINS,NY10605
13-1740121
DORMANT/OPERATE A HOSPITAL NY CATHOLIC HEALTH CARE SYSTEM DBA ARCHCARE
 
C         No












Schedule R (Form 990) 2017
Page 3
Schedule R (Form 990) 2017
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
 
No
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
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
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
Yes
 
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
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
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





Schedule R (Form 990) 2017
Page 4
Schedule R (Form 990) 2017
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) 2017
Page 5
Schedule R (Form 990) 2017
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) 2017

Additional Data


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