2020-11-12T16:26:15-06:00 2019-12-31 GRANT THORNTON LLP 757 THIRD AVENUE 3RD FLOOR NEW YORK NY 100172013 990 2019-01-01 131740274 CALVARY HOSPITAL INC % ANDREW GRECO CALV 7185182069 1740 EASTCHESTER ROAD BRONX NY 104612392 ANDREW V GRECO CFO 7185182069 2020-10-26 true P00741490 2125990100 24.91.116.203 26377520203175000020 2020-11-12 P 967656ED752500C5D00BF194EB3A6195BBA87A14 3E534C27D70A367EFB614FB161470324716CFE0A 2019 2021-01-29 14:40:06Z FRANK CALAMARI 1740 EASTCHESTER ROAD BRONX NY 104612392 145443100 false 0928 X WWW.CALVARYHOSPITAL.ORG X 1899 NY CALVARY HOSPITAL IS A FULLY ACCREDITED EXTENDED NEOPLASTIC DISEASE CARE HOSPITAL PROVIDING PALLIATIVE CARE FOR TERMINALLY ILL CANCER PATIENTS IN THE UNITED STATES. 16 15 1228 111 0 0 5753800 8858100 113396200 119818700 1940700 1921600 800900 742800 121891600 131341200 5100 5800 0 0 88834701 92955802 0 0 0 33677399 38901098 122517200 131862700 -625600 -521500 100681800 102670200 71929700 71636800 28752100 31033400 X CALVARY HOSPITAL IS A FULLY ACCREDITED ACUTE CARE SPECIALTY HOSPITAL PROVIDING PALLIATIVE CARE FOR TERMINALLY ILL CANCER PATIENTS IN THE UNITED STATES. false false 87336239 5800 88765400 Terminally ill CANCER CARE INPATIENT - CALVARY SERVES ABOUT 23.4% OF ALL INDIVIDUALS WHO DIE OF CANCER IN THE NEW YORK METROPOLITAN AREA EACH YEAR. PATIENTS ARE REFERRED TO CALVARY FROM EVERY MAJOR HOSPITAL AND MEDICAL CENTER IN NEW YORK CITY. IN 2019, CALVARY CARED FOR MORE THAN 5,826 PATIENTS AND FAMILIES AS INPATIENTS IN OUR 200-BED BRONX CAMPUS AND OUR 25-BED SATELLITE AT NYU LANGONE HOSPITAL IN BROOKLYN. THE AVERAGE LENGTH OF INPATIENT STAY IS 26.4 DAYS. 26718864 31011100 CALVARY HOSPITAL HOSPICE IS A MEDICARE-CERTIFIED HOSPICE PROGRAM, WHICH PROVIDES AN INTERDISCIPLINARY CARE TEAM FOR PATIENTS WITH A TERMINAL PROGNOSIS FOR ALL END-STAGE DISEASES. CALVARY HOSPITAL HOSPICE EMBRACES AND IMPLEMENTS THE BASIC ASSUMPTIONS OF THE HOSPICE CONCEPT, INCLUDING THE FOLLOWING: - HOSPICE PROVIDES PALLIATIVE MEDICAL CARE, TREATING THE PHYSICAL, EMOTIONAL AND SPIRITUAL PAIN OF THE PATIENT AND FAMILY. - HOSPICE TREATS THE PATIENT AND LOVED ONES TOGETHER AS A WHOLE UNIT OF CARE AND OFFERS BEREAVEMENT COUNSELING FOR SURVIVING CAREGIVERS AFTER THE PATIENT'S DEATH. - HOSPICE PATIENTS REMAIN IN THE FAMILIAR, COMFORTING SURROUNDINGS OF HOME, WHETHER IT'S A PRIVATE RESIDENCE, NURSING HOME, HOSPITAL OR AN ASSISTED LIVING FACILITY. - HOSPICE CARE PROVIDES THE FOLLOWING FOUR LEVELS OF CARE: ROUTINE CARE, GENERAL INPATIENT CARE (IF NEEDED), CONTINUOUS CARE (DURING A CRISIS), AND RESPITE CARE.HOSPICE SERVICES - NURSING CARE, AS NECESSARY TO MAINTAIN THE PATIENT AT HOME - 24 HOURS A DAY, 7 DAYS A WEEK ON-CALL NURSE PHYSICIAN SERVICES - MEDICAL SOCIAL SERVICES - PASTORAL CARE - COUNSELING SERVICES - NUTRITIONAL COUNSELING - SHORT-TERM INPATIENT AND RESPITE CARE - MEDICAL SUPPLIES RELATED TO TERMINALLY ILL - PERSONAL CARE PROVIDED BY CERTIFIED HOME HEALTH AIDES - THERAPIES (E.G., PHYSICAL, OCCUPATIONAL AND SPEECH) - MEDICATIONS FOR SYMPTOM MANAGEMENT AND PAIN CONTROL RELATED TO THE TERMINALLY ILL - BEREAVEMENT COUNSELING FOR FAMILY MEMBERS - VOLUNTEER SERVICES 972897 42200 CALVARY'S HOME HEALTH AGENCY SERVES PATIENTS IN THE BRONX, QUEENS, NORTHERN MANHATTAN, AND SOUTHERN WESTCHESTER COUNTY. CALVARY OFFERS HOME CARE TO PATIENTS WITH ALL DIAGNOSES. MOST PATIENTS RETURN TO PRE-ILLNESS FUNCTION AND ARE DISCHARGED TO SELF-CARE WITHIN SIX TO EIGHT WEEKS. ALL OF OUR PATIENTS WHO WE CARE FOR AT HOME GET THE SAME LEVEL OF HIGH-QUALITY AND UNIQUE "CALVARY CARE" AS ALL OF OUR INPATIENTS.THE FOLLOWING SERVICES ARE AVAILABLE TO PATIENTS AND THEIR FAMILIES THROUGH CALVARY'S CERTIFIED HOME HEALTH AGENCY: NURSING SERVICES - OUR COMMUNITY HEALTH NURSES PROVIDE NURSING VISITS TO PATIENTS IN THEIR HOMES. - SPECIALIZED NURSING IS AVAILABLE SUCH AS ENTEROSTOMAL THERAPY. - 24-HOUR TELEPHONE ACCESS TO RN (REGISTERED NURSE) ON-CALL.HOME HEALTH AIDE - PROVIDES ASSISTANCE WITH PERSONAL CARE AND OTHER ACTIVITIES RELATED TO HEALTH CARE. NUTRITIONAL SERVICES - CALVARY'S DIETITIANS ARE AVAILABLE BY PHONE TO HELP IN PLANNING THERAPEUTIC NUTRITIONAL MANAGEMENT.THERAPY SERVICES - PHYSICAL THERAPY- OCCUPATIONAL THERAPY - SPEECH THERAPYMEDICAL CARE - CALVARY HOME CARE STAFF WILL WORK CLOSELY WITH THE PATIENT'S OWN PHYSICIAN TO MEET HOME HEALTH NEEDS. - OUR STAFF HAS EXTENSIVE KNOWLEDGE OF PAIN MANAGEMENT.MEDICAL SOCIAL WORK A FULL RANGE OF SOCIAL WORK SERVICES ARE AVAILABLE TO HELP PATIENTS AND FAMILIES COPE WITH THE PROBLEMS OF ILLNESS. - ASSISTANCE IN MEDICAID APPLICATION - ASSISTANCE IN LONG-TERM PLANNINGREFERRING PATIENTS - REFERRALS MAY BE MADE BY PATIENTS FAMILY MEMBERS, FRIENDS, HOSPITALS, CLINICS, PHYSICIANS, OTHER HEALTH CARE PROFESSIONALS AND COMMUNITY AGENCIES. - PART OF THE CALVARY CONTINUUM FACILITATE ADMISSION TO INPATIENT CARE FOR SYMPTOM MANAGEMENT - REFERRAL TO OUTPATIENT AND WOUND CARE CLINICS - PROVIDE INFORMATION ON CALVARY PROGRAMS INCLUDING BEREAVEMENT SUPPORT 115028000 true true false true false false false false true true true true true false true true true true false false false false false false false false true true true false true false false false false false false false false false false false false true true false false false true 130 0 true 1228 true false false false false false false false false false false false false X 16 15 false false false false true true true true true false false true true true true true true true true false X ANDREW GRECO 7185182069 1740 EASTCHESTER ROAD BRONX NY 104612069 Scott P La rue PRESIDENT/CEO of archcare 1.0 37.0 X 0 1246121 338444 Frank A Calamari President/Executive Director 37.0 0.0 X 767223 0 39083 DEVMANI JAITLY MD ATTENDING PHYSICIAN 37.0 0.0 X 649861 0 43358 Michael J Brescia MD Executive Medical Director 37.0 0.0 X 567891 0 35560 Andrew V Greco VICE PRESIDENT & cfo 37.0 0.0 X 490902 0 59043 Christoper Comfort MD COO (AS OF 07/2019) 37.0 0.0 X 455883 0 46058 SREENIVASA PATIBANDLA STAFF PHYSICIAN 37.0 0.0 X 407552 0 28000 ROBERT BRESCIA MD DIR., PALLIATIVE CARE INST. 37.0 0.0 X 396809 0 35560 GAIL CHRZANOWSKI MD ATTENDING PHYSICIAN 37.0 0.0 X 341868 0 38488 RACHELLE PARKER MD DIRECTPR INPATIENT SERVICES 37.0 0.0 X 317912 0 38488 NANCY D'AGOSTINO RN VP OF COMMUNITY PATIENT SVCS 37.0 0.0 X 268598 0 48930 Margaret pelkowski vp for patient care service 37.0 0.0 X 230049 0 33566 ROBERT SIEGEL MD MEDICAL DIRECTOR(AS OF 7/2019) 37.0 0.0 X 138487 0 31042 Thomas J Fahey Jr MD Chairman of Board 2.0 1.0 X X 0 0 0 Anne Cote Taylor secretary 1.0 0.0 X X 0 0 0 Edward D Heben Treasurer 1.0 0.5 X X 0 0 0 JOHN A DECINA Vice-Chairman 0.5 0.5 X X 0 0 0 Rev Eric P Cruz MDIV Director 1.0 0.0 X 0 0 0 Rena M Murtha RN Director 1.0 0.0 X 0 0 0 Amit Sikdar Director 0.5 0.0 X 0 0 0 Joseph L Demarzo Director 1.0 0.0 X 0 0 0 Joseph A Tarantino Director 1.0 0.5 X 0 0 0 CARLOS HERNANDEZ DIRECTOR 0.5 1.0 X 0 0 0 MARYANN JULIA POPIEL DIRECTOR 1.0 0.5 X 0 0 0 Thomas G Ferrara Director 0.5 0.0 X 0 0 0 dr marc prager Director 0.5 0.0 X 0 0 0 james harden director 0.5 0.0 X 0 0 0 john p bertsch Director Emeritus (Non-Voting) 0.5 0.0 X 0 0 0 Steven J Golub Director emeritus (non-voting) 0.5 1.0 X 0 0 0 Manfred Altstadt Director Emeritus (Non-Voting) 0.5 0.5 X 0 0 0 Terence Gallagher Director Emeritus (Non-Voting) 0.5 0.5 X 0 0 0 DANIEL S GURRELL MD DIRECTOR (AS OF 7/2019) 1.0 0.0 X 0 0 0 5033035 1246121 815620 186 false true false NAVIN HAFTY ASSOCIATES LLP 1900 WEST PARK DRIVE SUITE 1800 WESTBROUGH MA 01581 IT CONSULTING 3644179 HVAC INC 681 GRAND BLVD SUITE 7 DEER PARK NY 11729 COGEN INSTALLATION 1707500 MEDICAL INFORMATION TECHNOLOGY MEDITECH CIRCLE WESTWOOD MA 02090 IT SERVICES 1144466 EMPIRE GENERAL CONTRACTING 74 MAIN STREET TUCKAHOE NY 10707 PHARMACY RENOVATION 1117260 CERNER HEALTH SERVICES PO BOX 959167 ST LOUIS MO 63195 IT SERVICES 600824 38 5005000 3853100 8858100 PATIENT SERVICE REVENUE 900099 119818700 119818700 119818700 429200 429200 0 0 47500 47500 0 47500 15587400 6900 14101900 1485500 6900 1492400 1492400 0 0 0 0 0 0 0 0 0 PARKING LOT REVENUE 812930 249400 249400 CAFETERIA 900099 158100 158100 RELATED PARTY REIMBURSEMENTS 900099 144200 144200 143600 143600 695300 131341200 119962900 2472700 5800 5800 0 0 0 3212489 1354296 1858193 0 65812869 62661336 3151533 3251313 3019612 231701 15805430 14679074 1126356 4873701 4526382 347319 1894718 1894718 480362 480362 345688 345688 65709 65709 0 0 10831426 10831426 1339527 668249 671278 2460693 1227564 1233129 294173 146754 147419 0 2447028 1690773 756255 271111 135249 135862 0 70764 35287 35477 242100 242100 0 6407142 6033565 373577 846324 846324 PHARMACEUTICALS 4793825 4793825 MAINTENANCE AND REPAIRS 1496388 746502 749886 FOOD EXPENSE 1048056 522843 525213 LEASES 413839 389710 24129 3152225 1317653 1834572 131862700 115028000 16834700 0 21600 5600 2039300 65000 0 0 27791100 31358100 0 0 0 0 0 0 201100 578238 664000 773262 113260400 90173800 20948300 23086600 22253100 14502100 10679500 7570400 15860400 23873900 0 0 223400 857000 100681800 102670200 17975700 17962500 0 0 0 0 0 0 126200 0 0 0 1833300 1711200 0 1000000 51994500 50963100 71929700 71636800 X -531800 -4833900 29283900 35867300 28752100 31033400 100681800 102670200 X -521500 1726500 1076300 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false true 22000 false true 43709 65709 false Schedule C, PART II-B, LINE 1i, LOBBYING ACTIVITIES Calvary Hospital engages two individuals to directly lobby congress and other governmental agencies on its behalf. The total amount paid to these external consultants in calendar year 2019 is $22,000. Calvary Hospital incurs indirect lobbying expenditures from its membership in various healthcare associations. The $43,709 reported on Schedule C, Part II-B, Line 1(I) includes the portion of its membership dues attributable to lobbying endeavors that the hospital pays to the following membership associations: - The Hospital Association of New York State (HANYS) - The Greater New York Hospital Association (GNYHA) false true 29283900 3309900 5215300 1941800 35867300 30643900 1807200 -1112700 2054500 29283900 26805300 1725600 4295000 2182000 30643900 25378200 1723700 1787400 2084000 26805300 27742000 2037500 -1396800 3004500 25378200 0.05000 0.95000 false false 538000 538000 37763200 29941939 7821261 70557000 56382052 14174948 4402200 3849809 552391 23086600 0 ASSETS OF CALVARY FUND 23873900 F 23873900 0 ACCRUED PENSION LIABILITY 46848900 DUE TO THIRD PARTY PAYORS 3122200 MALPRACTICE LIABILITY 992000 50963100 X 134138200 1726500 1070500 2797000 131341200 131341200 131862700 131862700 131862700 Schedule D, Part X - FIN 48: The hospital follows guidance that clarifies the accounting for uncertainty in tax positions taken or expected to be taken in a tax return, including issues relating to financial statement recognition and measurement. This guidance provides that the tax effects from an uncertain tax position can only be recognized in the financial statements if the position is "more-likely-than-not" to be sustained if the position were to be challenged by a taxing authority. The assessment of the tax position is based solely on the technical merits of the position, without regard to the likelihood that the tax position may be challenged. The hospital is exempt from federal income tax under IRC section 501(c)(3), though it is subject to tax on income unrelated to its exempt purpose, unless that income is otherwise excluded by the IRS. The hospital has processes presently in place to ensure the maintenance of its tax-exempt status; to identify and report unrelated income; to determine its filing and tax obligations in jurisdictions for which it was nexus; and to identify and evaluate other matters that may be considered tax positions. The Hospital has determined that there are no material uncertain tax positions that require recognition or disclosure in the financial statements. Schedule D, Part IV - Escrow and Custodial Arrangements: The Hospital maintains custodial accounts for its patients and various auxiliary groups. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN BENEFICIAL INTEREST IN NET PENSION RELATED ADJUSTMENT .......................($3,828,100) ASSETS OF CALVARY FUND, INC. .....................$4,904,400 RECLASS OF GRANT TO AFFILIATE........................($5,800) TOTAL TO SCHEDULE D, PART XI, LINE 2D ............$1,070,500 true true X true X 0 true X true true false true true 429753 429753 0.00000 9246734 10593810 0 9676487 10593810 0 0.00000 9676487 10593810 0 0.00000 15 1027978 0.00950 1 2000 0.00010 5 18293 0.00020 2 18380 0.00020 23 1066651 0.01000 true 3386578 42028200 51622206 -9594006 X true true 2 1 CALVARY HOSPITAL INC 1740 EASTCHESTER ROAD BRONX NY 10461 CALVARYHOSPITAL.ORG X EXTENDED NEOPLASTIC DISEASE CARE A 2 CALVARY HOSPITAL INC (BROOKLYN CAMP 1740 EASTCHESTER ROAD BRONX NY 11220 CALVARYHOSPITAL.ORG X EXTENDED NEOPLASTIC DISEASE CARE A CALVARY HOSPITAL INC 1 false false true X X X X X X X X X X 19 true false false true X CALVARYHOSPITAL.ORG X true 19 true CALVARYHOSPITAL.ORG false true 0. 300. true true X X X true X CALVARYHOSPITAL.ORG X CALVARYHOSPITAL.ORG X CALVARYHOSPITAL.ORG X X X X X true X false X X X X false X X false false PART I, LINE 3C: CALVARY HOSPITAL INC. USES THE FEDERAL POVERTY GUIDELINES (FPG) TO DETERMINE ELIGIBILITY FOR DISCOUNTED CARE TO LOW-INCOME PATIENTS. Form 990, Schedule H, part I, Line 6a & 6b Calvary Hospital completed its most recent full Community Benefit Report/Community Health Needs Assessment in December of 2019. This Report is posted on Calvary hospital's website. Calvary routinely receives input from all hospitals and health systems in its catchment area; through its Palliative Care Institute, Calvary works directly with the Medical Schools in the New York area, NYC EMS services and the National Cancer Institute. The totality of this input enables Calvary to produce a thorough and targeted community service plan each year. PART I, LINE 7: Calvary Hospital is unique in the healthcare environment in that it provides services to a very specific set of patients: the terminally ill. Patients in-hospital care at Calvary if they have been diagnosed with advanced cancer and other terminal illnesses, which have not responded to curative treatments and require continuous supervision by a medical team. They have severe symptoms related to their illness, such as infections, complex wound care needs, nausea, severe weight loss, pain, or confusion, or due to the severity of their symptoms, care at home is not possible. FROM ITS INCEPTION IN 1899, CALVARY HOSPITAL HAS BEEN FAITHFULLY DEVOTED TO PROVIDING PALLIATIVE CARE TO ADULT PATIENTS IN THE ADVANCED STAGES OF CANCER, AND OTHER LIFE-LIMITING ILLNESSES ADDRESSING THE SYMPTOMS OF THE DISEASE, NOT ITS CURE. A VOLUNTARY, NOT-FOR-PROFIT HOSPITAL, OPERATED IN CONNECTION WITH THE ARCHDIOCESE OF NEW YORK, CALVARY CONTINUES TO EMBODY THIS TRADITION OF CARING THROUGH THE SERVICES AND PROGRAMS OFFERED BY AND THROUGH THE DEDICATION AND CONCERN SHOWN BY ITS STAFF MEMBERS. THE HOSPITAL WILL CONTINUE TO BE FAITHFUL TO THIS TRADITION THROUGH A TWOFOLD COMMITMENT. CALVARY WILL STRIVE PRIMARILY TO EXPAND ITS PROGRAMS AND SERVICES TO MEET THE EMERGING PHYSICAL, PSYCHOSOCIAL, AND SPIRITUAL NEEDS OF BOTH PATIENTS AND FAMILIES THROUGH THE PROVISION OF ACUTE INPATIENT, CALVARY @ HOME (HomeCare, HOSPICE @ HOME), AND A BROOKLYN CAMPUS. IN ADDITION, THROUGH THE PALLIATIVE CARE INSTITUTE, THE HOSPITAL ENDEAVORS TO TRANSMIT TO OTHER HEALTH CARE PROFESSIONALS, THROUGH RESEARCH AND EDUCATION, THE KNOWLEDGE AND COMPETENCE WHICH IT HAS DEVELOPED IN THE CARE OF ADULT PATIENTS WITH ADVANCED CANCER AND OTHER LIFE LIMITING ILLNESSES. THROUGH THIS TWOFOLD COMMITMENT, CALVARY HOSPITAL WILL DEEPEN AND STRENGTHEN THE PHILOSOPHY OF COMPASSIONATE CARE WHICH HAS BEEN THE CORNERSTONE OF ITS PROGRAM OF SERVICE, AND WILL OFFER TO THOSE IN OUR EXPANDED COMMUNITY AND OTHERS, A TRADITION OF SUCCESSFUL EXPERIENCE IN THE CARE OF THE ADVANCED CANCER PATIENT. CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED EXTENDED NEOPLASTIC DISEASE CARE HOSPITAL PROVIDING PALLIATIVE CARE FOR ADVANCED CANCER PATIENTS IN THE UNITED STATES. WITH 225 BEDS IN THE BRONX AND BROOKLYN AND 1,228 EMPLOYEES, CALVARY SERVES MORE THAN 5,399 PATIENTS ANNUALLY AT HOME. CALVARY PROVIDES PALLIATIVE CARE, WHICH IS THE ACTIVE TREATMENT OF THE SYMPTOMS, NOT THE CURE OF THE DISEASE, IN ORDER TO MAKE OUR PATIENTS AS COMFORTABLE AS POSSIBLE. CALVARY'S PROGRAMS INCLUDE INPATIENT CARE CASE MANAGEMENT, CALVARY @ HOME, AND SUPPORT PROGRAMS FOR FAMILIES AND FRIENDS. AS CALVARY APPROACHES THE FUTURE WITH A SENSE OF HOPE AND PROMISE, CALVARY IS EVER MINDFUL OF THE LEGACY OF OUR FOUNDERS, THE WOMEN OF CALVARY, TO PROVIDE COMPREHENSIVE CARE WHILE RECOGNIZING THE INDIVIDUALITY AND DIGNITY OF EVERY PATIENT. AT THE SAME TIME, CALVARY WILL CONTINUE TO DEVELOP NEW PROGRAMS AND SERVICES TO MEET THE NEEDS OF TODAY'S WORLD. Accordingly, Calvary Hospital is not suited to providing the type of community benefits that other traditional hospitals provide. Calvary reports in Part VII the value of any Medicaid services it provides as well as financial assistance costs. TO arrive at the charity care amounts reported in Part VII, CALVARY UTILIZES NET REALIZABLE VALUE OF THE SERVICES RENDERED. This reporting is consistent to what is presented in Calvarys Cost report with the New York State Department of Health. Form 990, Schedule H, PART II, COMMUNITY BUILDING ACTIVITIES: CALVARY HOSPITAL MAKES A NUMBER OF DIFFERENT SUPPORT GROUPS AVAILABLE TO THE COMMUNITY. THESE SUPPORT GROUPS ARE ADVERTISED ON CALVARY HOSPITAL'S WEBSITE, WWW.CALVARYHOSPITAL.ORG, ON ITS CALENDAR OF EVENTS. In addition, the Hospital publishes "CALVARY IN TOUCH", A BI-MONTHLY NEWSLETTER ABOUT BEREAVEMENT ISSUES that is AVAILABLE THROUGH THE HOSPITAL'S WEBSITE AND IS CIRCULATED IN HARD COPY BY MAIL. CALVARY HOSPITAL PROVIDES BEREAVEMENT SUPPORT FOR ADULTS WHO HAVE LOST LOVED ONES AT CALVARY HOSPITAL OR CALVARY@HOME, AND THOSE FROM THE COMMUNITY AT LARGE WHO HAVE LOST SOMEONE BECAUSE OF ILLNESS, ACCIDENTS VIOLENCE, OR ANY OTHER CAUSE. GROUPS ARE OFFERED IN THE BRONX, BROOKLYN and manhattan. THE HOSPITAL Also OFFERS AGE-APPROPRIATE SUPPORT GROUPS FOR CHILDREN, AGES 6 THROUGH 11, AND FOR ADOLESCENTS, AGES 12 TO 18, AND FOR YOUNG ADULTS, AGES 18 TO 25. THESE COMMUNITY SUPPORT GROUPS INCLUDE BUT ARE NOT LIMITED TO: - SUPPORT GROUPS FOR BEREAVED PARENTS - MINDFULNESS AND MOVEMENT THROUGH GRIEF GROUP - PRECIOUS MOMENTS SUPPORT GROUP FOR CHILDREN AGES 6 TO 9 - TWEEN BEREAVEMENT GROUPS FOR TWEENS AGES 10 TO 12 -TEEN BEREAVEMENT GROUPS FOR TEENS AGES 13-17 - Young adults ages 18-25 - DEATH OF A SPOUSE/PARTNER BEREAVEMENT GROUPS - DEATH OF A PARENT BEREAVEMENT GROUPS - MEN ONLY GROUP - PSYCHOTHERAPY GROUP - CAMP COMPASS DAY CAMP FOR BEREAVED CHILDREN OPEN TO ALL CHILDREN WHO HAVE ATTENDED OTHER GROUPS ARE FREE OF CHARGE, AND ARE LED BY CALVARY HOSPITAL STAFF AND STAFF HIRED JUST FOR THIS WEEK LONG EVENT. CALVARY HOSPITAL ALSO MAKES AVAILABLE A NUMBER OF DIFFERENT WELLNESS ACTIVITIES TO THE COMMUNITY. THESE WELLNESS ACTIVITIES INCLUDE BUT ARE NOT LIMITED TO YOGA, zumba, MASSAGE THERAPY, staff drumming CLASSES, RECREATIONAL THERAPY AND PET THERAPY AND A FACILITY DOG ON STAFF. CALVARY HOSPITAL'S THERAPEUTIC RECREATION AND "MUSIC THERAPY PROGRAMS WERE CREATED TO GIVE PATIENTS A SENSE OF ACCOMPLISHMENT AND TO RELIEVE THE SUFFERING OF OUR PATIENTS AND THEIR FAMILIES. THERAPEUTIC RECREATION ACTIVITIES INCLUDES DRAWING, SCULPTURE, AND CERAMICS PROJECTS; HORTICULTURE; A GAMES AND DISCUSSION HOUR; AND HOLIDAY PARTIES. MUSIC THERAPY OFTEN HELPS SOOTHE PATIENTS AND HELPS THEM FOCUS ON LIFE. OUR BOARD CERTIFIED MUSIC THERAPISTS USE MUSIC THERAPY INTERVENTIONS TO SOOTHE PATIENTS, RELIEVE ANXIETY, REMINISCE, AND EASE PAIN AND SUFFERING. MUSIC THERAPY INTERVENTIONS MAY ALSO PROVIDE RELEASE IN THE LAST HOURS OR MOMENTS OF LIFE. PATIENTS RECEIVING MUSIC THERAPY SOMETIMES WRITE SONGS ASSISTED BY THE MUSIC THERAPISTS TO LEAVE FOR LOVED ONES, OR FIND OTHER WAYS TO OPEN THEIR HEARTS THROUGH MUSIC. OUR CLINICIANS REPORT THAT IN SOME CASES, THE ONLY TIME A PATIENT LAUGHS OR SMILES IS DURING A MUSIC THERAPY SESSION. WE ALSO FIND THAT MUSIC THERAPY IS AVAILABLE AT BOTH INPATIENT LOCATIONS AND IS ALSO ONE OF THE SERVICES WE OFFER THROUGH CALVARY@HOME. IN KEEPING WITH OUR MISSION TO SHARE OUR KNOWLEDGE AND EXPERIENCE WITH OTHERS, CALVARY OFFERS INTERNSHIP PROGRAMS IN THE FOLLOWING AREAS: SOCIAL WORK, bereavement, PALLIATIVE CARE AND MUSIC THERAPY, WHICH IS RECOGNIZED AS A NATIONAL CLINICAL TRAINING SITE BY THE AMERICAN MUSIC THERAPY ASSOCIATION. THROUGH ITS EDDIE HIGGINS SCHOLARSHIP PROGRAM, CALVARY HOSPITAL PROVIDES LEADERSHIP DEVELOPMENT AND TRAINING. THE EDDIE HIGGINS SCHOLARSHIP IS NAMED AFTER A CHERISHED MEMBER OF THE CALVARY FAMILY WHO CAME TO THE HOSPITAL AS A YOUNG BOY. EDDIE WAS HOSPITALIZED INTERMITTENTLY FOR 15 YEARS AT CALVARY UNTIL HIS DEATH IN 1982 AT THE AGE OF 29. EDDIE IS REMEMBERED FOR HIS LOVE OF GOD AND HIS REMARKABLE COURAGE DESPITE HIS ILLNESS. CALVARY HAS GIVEN THE ANNUAL SCHOLARSHIP SINCE 1985. CALVARY ALSO HOSTS AN ANNUAL MENTORS THROUGH MOuRNING WORKSHOP, FREE OF CHARGE, FOR SCHOOL PROFESSIONALS TO EDUCATE THEM ON THE GRIEF PROCESS OF CHILDREN. ALSO OFFERED IS A 11 WEEK ANNUAL COURSE THAT WE CHARGE $50/SESSION, which is offered in the Bronx and Brooklyn. Form 990, Part III, Line 4 - Bad Debt Footnote The Hospital's bad debt footnote is reported thusly in its audited financial statements: The Hospital recognizes patient service revenue associated with services provided to patients who have third-party payor coverage on the basis of contractual rates for the services rendered. For uninsured patients that do not qualify for charity care, the Hospital recognizes revenue on the basis of its standard rates for services provided (or on the basis of discounted rates, if negotiated or provided by policy). On the basis of historical experience, a significant portion of the Hospital's uninsured patients will be unable or unwilling to pay for the services provided. Thus, the Hospital records a significant provision for uncollectible accounts receivable related to uninsured patients in the period the services are provided. The Hospital also records a provision for uncollectible accounts to cover the estimated write-offs resulting from insured patients whose benefits are subsequently determined to have been exhausted during their hospitalization or whose coverage is denied by the insurer. insurer. PART III, LINE 2: The methodology that Calvary Hospital employs to estimate its bad debt expense is captured in its audited financial statements. The footnote is reproduced below: Accounts receivable are reduced by an allowance for uncollectible accounts receivable. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate the appropriate allowance for uncollectible accounts receivable and provision for uncollectible accounts receivable. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts receivable. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for uncollectible accounts receivable, if necessary. For receivables associated with self-pay patients, the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts receivable. Part III, Line 5: Calvary Hospital does not traditionally treat the shortfall on its Medicare reimbursement as charity care and does not report it as such in its audited financial statements. PART III, LINE 7: CALVARY HOSPITAL INC. HAS REPORTED A SHORTFALL IN PART III SECTION B LINE 7. THE EXPENSES, REVENUES AND SHORTFALL REPORTED IN PART III LINES 5-7 WERE DEVELOPED FROM THE 2019 CALVARY HOSPITAL, INC. COST REPORTS FILED WITH THE NYS DOH AND NATIONAL GOVERNMENT SERVICES (MEDICARE INTERMEDIARY). PART III, LINE 9B: CALVARY HOSPITAL, INC.'S FINANCIAL ASSISTANCE POLICY CONTAINS PROVISIONS ON THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE. CALVARY HOSPITAL'S COLLECTION POLICY IS THAT ALL REASONABLE EFFORTS WILL BE MADE BY PATIENT ACCOUNTS REPRESENTATIVES TO OBTAIN PAYMENT AND TO SETTLE PATIENT ACCOUNTS RECEIVABLE ON A CONSISTENT BASIS. THE PATIENT ACCOUNTING SYSTEM WILL BEAR ENTRIES OF SUCH ATTEMPTS, INCLUDING THE DATE AND THE REPRESENTATIVE'S INITIALS. ACCOUNTS RESISTING SETTLEMENT MAY BE REFERRED TO A COLLECTION AGENCY. Form 990, Schedule H, Part V, SECTION B, LINE 11: Calvary Hospital assessed the needs of the community through the lenses of the specialized services it is equipped to provide. The Joint Commissions Steering Committee and Quality Committees of the Board of Directors are responsible for evaluating the data and prioritizing the needs. Calvary Hospital used secondary and qualitative data to determine three top health issues based on capacity, resources, competencies, and needs specific to the populations it serves. All needs are a priority with palliative care services being the most significant need. These issues are within the hospitals scope, competency and resources to impact in a meaningful manner. Calvary Hospitals end of life palliative care is the worlds most comprehensive. For more than a century, it has been treating not only the physical pain, but has also been providing enormous emotional relief, to both the patient and the family. Calvary eliminates the stress and anxiety at a time when people are most vulnerable. The hospital identified three primary significant needs within its Community Needs Assessment: 1. Palliative Care Services 2. Bereavement Services 3. Palliative Care Provider Education The Hospitals Community Needs Assessment provides tremendous detail as to how the Hospital addresses these needs. Please refer to the Hospitals website at https://www.calvaryhospital.org/wp-content/uploads/2019/11/CH_CHNA_Brochur e_FINAL-11-12-19-1.pdf Form 990, Schedule H, PART V, SECTION B, LINE 22D: The maximum amount that Calvary Hospital will charge FAP-eligible patients is 15% OF GROSS CHARGES; this reflects an amount that is BELOW OUR LOWEST PAYOR. PART VI, LINE 2: CALVARY HOSPITAL IS THE ONLY FULLY ACCREDITED EXTENDED NEOPLASTIC DISEASE CARE HOSPITAL PROVIDING PALLIATIVE CARE FOR ADULT PATIENTS with advanced cancer and other life-limiting illnesses IN THE UNITED STATES. CalvaryCare may be obtained at our 200-bed Bronx campus or 25-bed Brooklyn campus. Through Calvary@Home, our care is also provided each day in hundreds of private homes, nursing and assisted living facilities in New York City, Westchester, Nassau, and Rockland counties. When home hospice patients are in need of short-term inpatient care, we can seamlessly transfer them to the Dawn Greene Hospice at Mary Manning Walsh Home in Manhattan and the Ozanam Hall of Queens Nursing Home. Calvary treats patients both inpatient and at-home through the Calvary @ home program. CALVARY HOSPITAL USES A VARIETY OF METHODS AND SERVICES TO GATHER COMMUNITY INPUT TO ASSESS THE NEEDS OF THE COMMUNITY, AND TO ASSURE INPUT IN THE COMMUNITY SERVICE PLAN. SOME OF THESE METHODS ARE: A. COMMUNITY OUTREACH SERVICES: COMMUNITY OUTREACH SERVICES FUNCTIONS AS A LIAISON WITH THE COMMUNITY, REFERRERS, PHYSICIANS, PATIENTS, AND FAMILIES AND FACILITATES ADMISSION TO CALVARY. THE DEPARTMENT OUTREACHES THROUGH THE TRI-STATE REGION AND EDUCATES THE HEALTH CARE AND PATIENT COMMUNITIES AS TO THE CONTINUUM OF SERVICES CALVARY PROVIDES (INPATIENT, Calvary @ Home). THROUGH ON-SITE VISITS, PUBLIC PRESENTATIONS AND PARTICIPATION IN COMMUNITY AND PROVIDER ACTIVITIES, THE OUTREACH STAFF CONTINUALLY ASSESSES THE NEEDS OF THE COMMUNITY. the bereavement department also facilitates a community outreach to educate mental health agencies and schools about grief and bereavement as well as provide support to agencies that are experiencing a death in their community B. PROFESSIONAL ADVISORY BOARD: THE PROFESSIONAL ADVISORY BOARD WAS ESTABLISHED IN 1992 TO OBTAIN INPUT FROM THE COMMUNITY. THE ADVISORY BOARD MEETS AT LEAST ANNUALLY AND IS COMPRISED OF PHYSICIANS, NURSES, AND SOCIAL WORKERS, REPRESENTING HOSPITALS, AND HOME CARE AGENCIES, AS WELL AS THE COMMUNITY. THIS GROUP HAS CONTRIBUTED A VARIETY OF IDEAS FOR ENHANCING SERVICES TO THE COMMUNITY. C. COMMUNITY PLANNING BOARD: EACH YEAR THE HOSPITAL INVITES THE HEALTH COMMITTEE OF COMMUNITY PLANNING BOARD *11 TO VISIT THE HOSPITAL. D. OUTREACH REPRESENTATION (OPEN HOUSE) FOR HEALTH CARE PROFESSIONALS: COMMUNITY OUTREACH HOSTS OPEN HOUSES AT BOTH THE BRONX AND BROOKLYN LOCATIONS TO PROVIDE INFORMATION TO AND RECEIVE INFORMATION FROM ITS REFERRERS. CALVARY HOSPITAL, INC. ALSO HAS PUBLIC PARTICIPATION IN THE EXTENDED. COMMUNITY THROUGH PARTICIPATION IN: - GREATER NEW YORK HOSPITAL ASSOCIATION - HOSPITAL ASSOCIATION OF NEW YORK STATE - AMERICAN HOSPITAL ASSOCIATION - NEW YORK CITY DEPARTMENT OF HEALTH - NEW YORK STATE DEPARTMENT OF HEALTH - CATHOLIC HEALTHCARE ASSOCIATION - CMS THROUGH ONGOING PARTICIPATION IN THE GROUPS ABOVE, CALVARY HOSPITAL CONTINUALLY MONITORS THE TRENDS IN THE HEALTHCARE NEEDS OF THE LARGER COMMUNITY. ALTHOUGH THE NATURE OF ITS SERVICES IS LIMITED BY ITS SPECIALIZED MISSION, CALVARY HAS IDENTIFIED A VARIETY OF ACTIVITIES TO PARTICIPATE IN IMPROVING THE HEALTH OF ITS EXTENDED COMMUNITY. PART VI, LINE 3: EACH PERSON REQUESTING CALVARY'S SERVICES MUST BE MADE AWARE OF CALVARY'S UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES PROGRAM AS FOLLOWS: 1. DISTRIBUTE AN INDIVIDUAL NOTICE TO EACH PERSON WHO IS SEEKING SERVICES ON BEHALF OF HIMSELF OR ANOTHER. THIS NOTICE IS PASSED TO THE INDIVIDUAL USUALLY AT THE POINT OF ADMISSION OR REGISTRATION WHEN FINANCIAL ARRANGEMENTS ARE BEING DISCUSSED. THE "NOTICE OF AVAILABILITY OF UNCOMPENSATED (FREE) SERVICES OR DISCOUNTED SERVICES" IS UPDATED ANNUALLY. 2. POST SIGNS PROVIDED BY THE DEPARTMENT OF HEALTH AND HUMAN SERVICES CONSPICUOUSLY IN THE ADMITTING OFFICE, BUSINESS OFFICE, and Calvary @ Home AREAS. THE SIGNS ARE posted IN ENGLISH, SPANISH and russian. ADDITIONALLY, CALVARY HAS ACCESS TO A LANGUAGE TELEPHONE SERVICE and video service THAT ADDS over 240 ADDITIONAL LANGUAGES TO ENGLISH AND SPANISH. PART VI, LINE 4: CALVARY HOSPITAL'S MAIN CAMPUS IS LOCATED IN THE BRONX, NY. THE BRONX IS CONSIDERED THE PRIMARY COMMUNITY FOR THE PURPOSES OF PUBLIC HEALTH PLANNING, AND 45% OF ITS EMPLOYEES RESIDE IN THE PRIMARY SERVICE AREA. IN ADDITION, AS A TERTIARY REFERRAL CENTER FOR ADVANCED DISEASE, CALVARY HOSPITAL SERVES THE ENTIRE TRI-STATE REGION. THE SECONDARY SERVICE IS DETERMINED BASED ON CURRENT REFERRAL PATTERNS. THE PRIMARY REFERRAL SOURCES FOR ADMISSIONS CONTINUE TO BE THE ACUTE CARE HOSPITALS. CURRENTLY 58.7% OF ADMISSIONS ARE REFERRED BY HOSPITALS LOCATED WITHIN THE BOROUGHS OF NEW YORK CITY, ROCKLAND, AND WESTCHESTER COUNTIES, LONG ISLAND, AND THE STATES OF NEW JERSEY AND CONNECTICUT. OTHER REFERRAL SOURCES ARE CALVARY @ Home AND OTHER HOME CARE AND HOSPICE AGENCIES, FAMILIES, PHYSICIANS, NURSING HOMES, AND COMMUNITY AGENCIES. IN 2001, CALVARY EXPANDED ITS SERVICES WITH THE OPENING OF CALVARY'S BROOKLYN CAMPUS, AT NYU LANGONE HOSPITAL - BROOKLYN. in 2014, Calvary @ Home established the Dawn Greene hospice at Mary Manning Walsh Home in Manhattan. In 2016, Calvary @ home began providing Calvary @ Home services to patients residing at the Ozanam Hall of Queens Nursing Home in Queens, New York. PART VI, LINE 7 LIST OF STATES RECEIVING COMMUNITY BENEFIT REPORT: NY true CALVARY HOLDING COMPANY INC 1740 EASTCHESTER ROAD BRONX NY 10461 061531426 501(C)(3) 5800 GENERAL SUPPORT PART II Calvary Hospital does not typically make grants to other organizations; however, in 2019, the Hospital made a grant of $5,800 to its parent organization, Calvary Holding Company, Inc. to reimburse it for expenses incurred on behalf of the hospital. The Hospital does not monitor the use of these grant funds as the issuance of the grant is solely to reimburse expenses already incurred. X X false true X X X X false true false false false false false true false Michael J Brescia MD Executive Medical Director 422987 0 54272 0 90632 0 28000 0 7560 0 603451 0 23445 0 Frank A Calamari President/Executive Director 512689 0 67673 0 186861 0 28000 0 11083 0 806306 0 73198 0 Andrew V Greco VICE PRESIDENT & cfo 303651 0 39367 0 147884 0 28000 0 31043 0 549945 0 15886 0 Scott P La rue PRESIDENT/CEO of archcare 0 868515 0 255814 0 121792 0 312660 0 25784 0 1584565 0 255814 Christoper Comfort MD COO (AS OF 07/2019) 375689 0 43238 0 36956 0 28000 0 18058 0 501941 0 0 0 Margaret pelkowski vp for patient care service 224224 0 0 0 5825 0 23077 0 10489 0 263615 0 0 0 NANCY D'AGOSTINO RN VP OF COMMUNITY PATIENT SVCS 254342 0 0 0 14256 0 27462 0 21468 0 317528 0 0 0 SREENIVASA PATIBANDLA MD STAFF PHYSICIAN 208045 0 0 0 199507 0 28000 0 0 0 435552 0 0 0 ROBERT BRESCIA MD DIR., PALLIATIVE CARE INST. 328362 0 43240 0 25207 0 28000 0 7560 0 432369 0 0 0 DEVMANI JAITLY MD ATTENDING PHYSICIAN 247745 0 0 0 402116 0 28000 0 15358 0 693219 0 0 0 GAIL CHRZANOWSKI MD ATTENDING PHYSICIAN 316997 0 0 0 24871 0 28000 0 10488 0 380356 0 0 0 ROBERT SIEGEL MD MEDICAL DIRECTOR(AS OF 7/2019) 132692 0 0 0 5795 0 0 0 31042 0 169529 0 0 0 RACHELLE PARKER MD DIRECTPR INPATIENT SERVICES 279724 0 0 0 38188 0 28000 0 10488 0 356400 0 0 0 PART I, LINE 1A EFFECTIVE JUNE 1, 1998, THE HOSPITAL ESTABLISHED THE CALVARY HOSPITAL SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP) TO PROVIDE PENSION BENEFITS FOR WAGES EARNED BY CERTAIN PHYSICIANS AND SENIOR EXECUTIVE STAFF WITH COMPENSATION IN EXCESS OF THE IRS LIMITS AND ALSO ESTABLISHED THE CALVARY HOSPITAL KEY EMPLOYEE SHARE OPTION PLAN(KEYSOP) TO PROVIDE ADDITIONAL AND ALTERNATIVE FORMS OF COMPENSATION TO KEY EMPLOYEES. PRIOR TO 2002, THE HOSPITAL UTILIZED THE KEYSOP TO FUND THE SERP. AS A RESULT OF THE IRS 457 REGULATIONS WHICH WERE ISSUED DURING 2002, THE UTILIZATION OF THE KEYSOP TO FUND THE SERP BECAME UNFEASIBLE. AFTER CONSIDERATION OF VARIOUS REPLACEMENT OPTIONS, IN 2003, CALVARY HOSPITAL CHOSE THE TAX GROSS-UP OPTION, WHEREBY, INDIVIDUAL PARTICIPANTS' DEFERRALS WOULD BE GROSSED-UP TO DUPLICATE THE BENEFITS HE WOULD RECEIVE IN A TAX-DEFERRED ARRANGEMENT AND PAID THEM OUT DIRECTLY TO THE PARTICIPANTS. THE FOLLOWING EXECUTIVES RECEIVED TAX GROSS-UP PAYMENTS IN 2019 IN ORDER TO DUPLICATE A TAX DEFERRED VEHICLE: (THE AMOUNTS WERE CALCULATED BY FRANK J. WALTERS ASSOCIATES, INC. UTILIZING EXPECTED TAX RATES TO CALCULATE THE NET AMOUNTS.) Andrew Greco, chief financial officer, received a gross-up for taxes on his SERP distribution and for dependent tuition reimbursement. The tax gross-up is reported in Schedule J, Part II, column (b)(iii). THE ORGANIZATION PROVIDED SOCIAL CLUB DUES IN 2019 FOR FRANK CALAMARI AND THE DUES WERE INCLUDED AS TAXABLE COMPENSATION. PART I, LINE 4B THE FOLLOWING CALVARY HOSPITAL OFFICERS PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN AND RECEIVED THE FOLLOWING DISTRIBUTIONS(WHICH ARE INCLUDED IN COLUMN (B)(III) OTHER REPORTABLE COMPENSATION: FRANK CALAMARI - $73,198.00 MICHAEL BRESCIA - 23,445.00 Andrew Greco- $15,886.00 Scott P. La Rue participated in a supplemental nonqualified retirement plan. Catholic Health Care System D/B/A Archcare distributed $121,792 to Scott in his 2019 W-2. PART I, LINE 7 Calvary Hospital engaged the services of an independent compensation consulting firm that specializes in healthcare executive compensation to design its executive incentive compensation plan. As part of the Plan, the Calvary Executive Team develops a number of strategic goals that executives must meet to participate in the incentive program; these goals are then reviewed and approved annually by the Compensation Committee of the Board. At year end, Calvarys CEO presents the results from the previous year in terms of which goals were achieved by the Executive Team. The Compensation Committee of the Board then convenes with independent compensation consulting firm to determine and approve the bonuses that are distributed to each executive. FORM 990, PART VI, SECTION A, LINE 6: Pursuant to Calvary Hospitals bylaws, Catholic Health Care System ("archcare") is its sole corporate member. FORM 990, PART VI, SECTION A, LINE 7A: Calvary Hospital is a full participating member of Catholic Health Care System ("archcare"), a health care delivery system in New York State. The Calvary Hospital bylaws reserve certain rights to Catholic Health System as the sole member. One of those rights, in Article IV, is the power to appoint and remove board members (as well as the Chairman of the Board). FORM 990, PART VI, SECTION A, LINE 7B: Providence Health Services is the sole member of Catholic Health Care System ("Archcare"), which is, in turn, sole member of Calvary Hospital. Providence is the sponsor of Calvary Hospital (and its related entities) and as such has been reserved certain powers in Calvary Hospitals bylaws, exercised in conjunction with recommendations made by Calvary Health Care System (as sole corporate member). These powers are as follows: 1. Right to amend bylaws; 2. Right to change Calvary Hospitals mission; 3. Right to approve any merger, joint venture, or dissolution of the Fund; 4. Approval with respect to certain real property transactions exceeding $400,000; 5. Approval of any leases expected to exceed a period of 9 years; 6. Approval of the Fund entering into any debt instruments in an amount greater than $400,000; 7. Approval on the disposition of any significant historical artifacts. As noted above, the sole member, Catholic Health Care System has been reserved the right to make recommendations to Providence about any of the above actions. FORM 990, PART VI, SECTION B, LINE 11: THE 2019 FORM 990 OF CALVARY HOSPITAL WAS PREPARED BY Grant Thornton LLP WITH THE ASSISTANCE OF CALVARY ACCOUNTING PERSONNEL. THE DRAFT FORM 990 WAS REVIEWED BY Grant Thornton LLP, THE DIRECTOR OF FINANCE AND the CFO OF CALVARY HOSPITAL BEFORE DISTRIBUTION OF THE FULL VERSION OF THE FINAL DRAFT TO THE board. A COPY OF THE FORM 990 DRAFT WAS PROVIDED TO EACH MEMBER OF THE CALVARY HOSPITAL BOARD OF DIRECTORS ON OCTOBER 27,2020 PRIOR TO ITS FILING WITH THE INTERNAL REVENUE SERVICE IN ELECTRONIC FORMAT. FORM 990, PART VI, SECTION B, LINE 12C: EACH OFFICER, DIRECTOR, TRUSTEE AND KEY EMPLOYEE IS REQUIRED TO ANNUALLY DISCLOSE ANY CONFLICTS OF INTEREST THAT ARISE BY VIRTUE OF THEIR EMPLOYMENT AND POSITION WITH CALVARY HOSPITAL OR CALVARY FUND. CALVARY MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL QUESTIONNAIRE SUBMITTED TO THESE INDIVIDUALS. POTENTIAL CONFLICTS ARE INVESTIGATED IMMEDIATELY AND, IF ANY ARE UNCOVERED, THERE ARE POLICIES IN PLACE TO ENSURE THAT THOSE INDIVIDUALS RECUSE THEMSELVES FROM PARTICIPATING in any decision making related to such conflict. FORM 990, PART VI, SECTION B, LINE 15: CALVARY HOSPITAL, INC. UNDERTAKES A RIGOROUS PROCESS TO ENSURE THAT THE EXECUTIVE COMPENSATION IT PAYS TO ITS TOP MANAGEMENT OFFICIALS AND ALL OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION IS REASONABLE. IN RELEVANT PART, THE BOARD OF DIRECTORS HAS ESTABLISHED A COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT PERSONS THAT HAVE NO PERSONAL INTEREST IN THE PROPOSED COMPENSATION ARRANGEMENT. THE BOARD OF DIRECTORS USES AN INDEPENDENT COMPENSATION CONSULTANT TO HELP ADVISE ON THE APPROPRIATE COMPENSATION LEVELS FOR THE AFOREMENTIONED INDIVIDUALS. THAT COMPENSATION CONSULTANT WILL USE COMPARABILITY OR BENCHMARKLNG DATA (BASED ON INDUSTRY SURVEYS) THAT DOCUMENTS THE COMPENSATION OF PERSONS HOLDING SIMILAR PERSONS IN SIMILAR ORGANIZATIONS. The Hospital commissioned its most recent independent compensation study in February of 2020. ONCE THE COMPENSATION CONSULTANT HAS MADE ITS RECOMMENDATIONS, THE CALVARY COMPENSATION COMMITTEE MUST APPROVE THE COMPENSATION, WITHOUT INPUT OR VOTING PARTICIPATION BY THE PERSON WHOSE COMPENSATION IS BEING APPROVED OR BY ANY OTHER INDIVIDUAL WITH A CONFLICT OF INTEREST. THE FINAL DETERMINATION IS THEN DOCUMENTED IN COMMITTEE MINUTES. THOSE MINUTES WILL CONTAIN THE TERMS OF THE PROPOSED COMPENSATION, THE DECISIONS OF THOSE INDIVIDUALS WHO VOTED ON THE COMPENSATION, AND THE COMPARABILITY DATA THAT WAS RELIED UPON. FORM 990, PART VI, SECTION C, LINE 19: CALVARY HOSPITAL MAKES ITS FORM 990 AVAILABLE TO THE PUBLIC BY RETAINING A COPY AT THE ADDRESS LISTED ON PAGE 1 OF THIS RETURN. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION. FORM 990, PART XI, LINE 9, CHANGES IN NET ASSETS: CHANGE IN BENEFICIAL INTEREST IN NET ASSETS OF CALVARY FUND, INC............$4,904,400 Pension related adjustment....................$(3,828,100) TOTAL TO FORM 990, PART XI, LINE 9............$ 1,076,300 CALVARY PALLIATIVE CARE NETWORK LLC 1740 EASTCHESTER ROAD Bronx NY 10461 HEALTHCARE NY 0 CHC CALVARY NETWORK INDep PRACTICE ASSN 1740 EAsTCHESTER ROAD Bronx NY 10461 HEALTHCARE NY 0 CPCN CALVARY NETWORK MANAGEMENT SERVICES LLC 1740 EASTCHESTER ROAD Bronx NY 10461 HEALTHCARE NY 0 CHC CALVARY FUND INC 1740 EASTCHESTER ROAD Bronx NY 10461 133259649 FUNDRAISING NY 501(C)(3) 12A CHC false CALVARY HOLDING COMPANY 1740 EASTCHESTER ROAD Bronx NY 10461 061531426 MANAGEMENT NY 501(C)(3) 12A archcare false ARCHCARE 155 EAST 56TH STREET FLOOR 2 NEW YORK NY 10022 133896624 management NY 501(C)(3) 1 NA false false true true true true false false false false false false true true true true true true false false Part I, Line 1 & 3, Column (f): CHC - Calvary Holding Company Part I, Line 2, Column (f): CPCN - Calvary Palliative Care Network, Inc. Part II, Line 2, Column (f): CHCS - Catholic Health Care System