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ObjectId: 202333129349304218 - Submission: 2023-11-08
TIN: 13-4095845
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to
www.irs.gov/Form990
for instructions and the latest information.
OMB No. 1545-0047
20
22
Open to Public Inspection
Name of the organization
Westchester Medical Center Foundation
Employer identification number
13-4095845
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)
BON SECOURS COMMUNITY HOSPITAL FDN
255 LAFAYETTE AVE
SUFFERN
,
NY
10901
81-0667395
SUPPORT FDN
NY
501(c)(3)
7
BSCHSI
No
(2)
BON SECOURS WARWICK HEALTH FOUNDATION
255 LAFAYETTE AVE
SUFFERN
,
NY
10901
14-1972807
SUPPORT FDN
NY
501(c)(3)
7
BSCHSI
No
(3)
BON SECOURS CHARITY HEALTH SYSTEM INC
255 LAFAYETTE AVE
SUFFERN
,
NY
10901
91-2135195
SUPPORTING
NY
501(c)(3)
Type III-FI
WCHCC
No
(4)
HEALTHALLIANCE FOUNDATION INC
105 MARYS AVENUE
KINGSTON
,
NY
12401
22-2511450
FUNDRAISING
NY
501(c)(3)
7
HA INC
No
(5)
HEALTHALLIANCE HOSPITAL MARY'S AVE CAMPUS
105 MARYS AVENUE
KINGSTON
,
NY
12401
14-1338470
EXEMPT HOSP
NY
501(c)(3)
3
HA INC
No
(6)
MARGARETVILLE MEMORIAL HOSPITAL
42084 STATE ROUTE 28
MARGARETVILLE
,
NY
12455
15-0552726
EXEMPT HOSP
NY
501(c)(3)
3
HA INC
No
(7)
MARGARETVILLE NURSING HOME INC
42158 STATE ROUTE 28
MARGARETVILLE
,
NY
12455
22-3143565
NURSING HOME
NY
501(c)(3)
10
MMH
No
(8)
MARGARETVILLE HEALTH FOUNDATION
42084 STATE ROUTE 28
MARGARETVILLE
,
NY
12455
26-1998454
SUPPORT FDN
NY
501(c)(3)
Type I
MMH
No
(9)
GOOD SAMARITAN FDN FOR BETTER HEALTH
255 LAFAYETTE AVE
SUFFERN
,
NY
10901
13-3400353
SUPPORT FDN
NY
501(c)(3)
7
BSCHSI
No
(10)
WMC HEALTH NETWORK - ROCKLAND INC
100 WOODS RD
TAYLOR PAVILION M222
VALHALLA
,
NY
10595
32-0467873
SUPPORTING
NY
501(c)(3)
Type I
NA
No
(11)
WMC HEALTH NETWORK - ULSTER INC
100 WOODS RD
TAYLOR PAVILION M222
VALHALLA
,
NY
10595
32-0477183
SUPPORTING
NY
501(c)(3)
Type I
WCHCC
No
(12)
WESTCHESTER COUNTY HEALTH CARE CORP
100 WOODS RD
TAYLOR PAVILION M222
VALHALLA
,
NY
10595
13-3964321
HEALTHCARE
NY
NA
No
(13)
WMC-NEW YORK INC
100 WOODS RD
TAYLOR PAVILION M222
VALHALLA
,
NY
10595
13-4107894
FUNDRAISING
NY
501(c)(3)
Type I
WCHCC
No
(14)
NORTH ROAD LHCSA INC
100 WOODS RD
TAYLOR PAVILION M222
VALHALLA
,
NY
10595
46-5293268
HOMECARE SVCS
NY
501(c)(3)
10
WCHCC
No
(15)
MID-HUDSON VALLEY EARLY EDUCATION CENTER
100 WOODS RD
TAYLOR PAVILION M222
VALHALLA
,
NY
10595
46-5534882
PRESCHOOL
NY
501(c)(3)
7
WCHCC
No
(16)
HEALTHALLIANCE INC
105 MARYS AVENUE
KINGSTON
,
NY
12401
26-1850453
SUPPORTING
NY
501(c)(3)
Type I
WCHCC
No
(17)
HEALTHALLIANCE HOSPITAL BROADWAY CAMPUS
396 BROADWAY
KINGSTON
,
NY
12401
14-1349558
EXEMPT HOSP
NY
501(c)(3)
3
HA INC
No
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2022
Page 2
Schedule R (Form 990) 2022
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)
HUDSON RIVER NORTH INSURANCE LIMITED
CAP INSURANCE
CJ
HA INC
C Corporation
No
(2)
NORTHEAST PROVIDER SOLUTIONS INC
100 WOODS RD
TAYLOR PAVILION M222
VALHALLA
,
NY
10595
13-3991673
MSO & HEARING
NY
NA
C Corporation
No
(3)
WCHCC (BERMUDA) LIMITED
CAP INSURANCE
BD
NA
C Corporation
No
(4)
KINGSTON REGIONAL HEALTH CARE ENTERPRISE
396 BROADWAY
KINGSTON
,
NY
12401
16-1514994
INVESTMENT
NY
NA
C Corporation
No
(5)
MID HUDSON PHYSICIANS PC
105 MARYS AVENUE
KINGSTON
,
NY
12401
20-3564769
MEDICAL SVCS
NY
NA
C Corporation
No
(6)
BSCHS MEDICAL GROUP PC
10 FRANKLIN TURNPIKE
MAHWAH
,
NJ
07430
82-1632215
MEDICAL SVCS
NY
BSCHSI
C Corporation
No
(7)
HUDSON RIVER WEST INSURANCE (BARBADOS)
23 LIME TREE BAY AVE
PO BOX 1051
GRAND CAYMAN
,
CJ
KY11102
CJ
CAP INSURANCE
CJ
BSCHSI
C Corporation
No
(8)
WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES PC
100 WOODS RD
TAYLOR PAVILION M222
VALHALLA
,
NY
10595
26-4709927
PHYSICIAN OFFICE
NY
NA
C Corporation
No
Schedule R (Form 990) 2022
Page 3
Schedule R (Form 990) 2022
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
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
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
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) 2022
Page 4
Schedule R (Form 990) 2022
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) 2022
Page 5
Schedule R (Form 990) 2022
Page
5
Part VII
Supplemental Information
Provide additional information for responses to questions on Schedule R. See instructions.
Return Reference
Explanation
Schedule R, Part II
BON SECOURS CHARITY HEALTH SYSTEM, INC. (BSCHS) AND WESTCHESTER MEDICAL CENTER FOUNDATION, INC. HAS A BROTHER-SISTER RELATIONSHIP WITH BSCHS'S SIX SUBORDINATES IN A GROUP EXEMPTION.
Schedule R (Form 990) 2022
Additional Data
Software ID:
22016089
Software Version:
2022v5.0