2019-11-13T06:05:39-06:00 2018-12-31 ERNST & YOUNG US LLP 5 TIMES SQUARE NEW YORK NY 10036 990 2018-01-01 462916938 MONTEFIORE MOUNT VERNON HOSPITAL % EVAN RESNICK MONT 9143498455 12 NORTH SEVENTH AVENUE MOUNT VERNON NY 105502026 COLLEEN M BLYE EXEC V.P. & C.F.O. 7189207602 2019-11-11 true NICOLE M SOKOLOWSKI P01683199 2127733000 173.56.229.42 26308520193175000003 2019-11-13 P 24558E047A149CE0743DDA4F89040DC2FD5B7974 047C777BBD395ADD529156C75D94AFF56594489C 2018 2020-03-31 21:24:44Z STEVEN SAFYER MD 111 EAST 210TH STREET BRONX NY 104672401 87683289 false X See Form 990, Schedule O X 2013 NY TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES WE SERVE. 43 42 718 22 0 7358 15146677 17699475 70894596 69168831 0 0 352768 792754 86394041 87661060 2050 600 0 0 54203435 53013944 0 0 0 44296983 40820577 98502468 93835121 -12108427 -6174061 40976302 41538527 58091540 64878793 -17115238 -23340266 MISSION: TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES WE SERVE. VALUES: HUMANITY, INNOVATION, TEAMWORK, DIVERSITY AND EQUITY - OUR VALUES DEFINE OUR PHILOSOPHY OF CARE. THEY SHAPE OUR ACTIONS AND MOTIVATE AND INSPIRE US TO PURSUE EXCELLENCE AND ACHIEVE OUR GOALS. false false 79881709 600 69168831 Montefiore Mount Vernon Hospital is a 176 bed, community-based teaching hospital that has been serving the medical needs of the community. Montefiore Mount Vernon provides inpatient, critical care and ambulatory services to residents of lower Westchester County. The hospital is part of Montefiore Health System, the University hospital for the Albert Einstein College of Medicine. Montefiore MOUNT VERNON HOSPITAL BEGAN OPERATIONS ON NOVEMBER 6, 2013 as part of the Montefiore Health System. MONTEFIORE MOUNT VERNON'S MISSION IS TO HEAL, TO TEACH, TO DISCOVER AND TO ADVANCE THE HEALTH OF THE COMMUNITIES IT SERVES. To this mission, the health system brings a unique synergy of strengths and resources that has helped define healthcare delivery in the area and have earned Mount Vernon the distinction of being a designated New York stroke and HIV/aids Center. Mount Vernon hospital is also home to the Beale Chronic Wound treatment and hyperbaric center and the Montefiore School of Nursing. The hospital provides a range of diagnostic and therapeutic medical and surgical services in addition to specialty programs and services. It operates a family health and wellness center with more than 20 specialized ambulatory care clinics as well as an inpatient and outpatient behavioral health program offering psychiatric services. The hospital also operates a chronic wound treatment and hyperbaric medicine center that offers advance wound management as well as hyperbaric oxygen therapy helping to reduce the risk of amputation for individuals suffering from traumatic injuries. Montefiore Mount Vernon Hospital also operates a drug and alcohol addiction rehabilitation facility located in close proximity to their main campus committed to helping those addicted in getting the treatment that they need. The center offers personalized treatment program specifically designed for the patient including group counseling, 12-step programs, medically assisted detoxification, and individual counseling, among others, that can help to give our patients the confidence that is needed to successfully overcome their addiction to drugs or alcohol. 79881709 true true false true false false false false false false true false false true true false false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true 9 0 true 718 true true true false false false false false false false false false false false X 43 42 false false true false true true true true true false false true true true true true true false false false NY X EVAN RESNICK 9143498455 555 SO BROADWAY BLDG A FL 1 TARRYTOWN NY 105916301 ODED ABOODI VICE CHAIRMAN & TREASURER 0.3 2.2 X 0 0 0 JAY B ABRAMSON TRUSTEE 0.3 2.2 X 0 0 0 MARGARET HAYES ADAME TRUSTEE 0.2 1.55 X 0 0 0 GEORGE ASCH TRUSTEE (term ended 6/19/18) 0.2 1.05 X 0 0 0 PATRICIA BAUMAN TRUSTEE 0.2 1.05 X 0 0 0 JAMES M BUTLER CHAIRMAN 0.5 4.0 X 0 0 0 BRUCE DONIGER TRUSTEE 0.2 1.05 X 0 0 0 RUTH L GOTTESMAN EDD TRUSTEE 0.2 1.55 X 0 0 0 BARRY W GRAY TRUSTEE 0.2 1.05 X 0 0 0 PATRICIA GREEN TRUSTEE 0.2 1.05 X 0 0 0 THOMAS L HARRISON TRUSTEE 0.2 1.05 X 0 0 0 JOHN HEFFER TRUSTEE 0.3 2.2 X 0 0 0 LEWIS HENKIND SECRETARY 0.3 2.7 X 0 0 0 HELEN A JOHNSON TRUSTEE 0.3 1.7 X 0 0 0 DAVID B KEIDAN TRUSTEE 0.2 1.05 X 0 0 0 ALAN M KLEIN TRUSTEE 0.4 3.1 X 0 0 0 STACEY R LANE TRUSTEE 0.3 2.2 X 0 0 0 JAY B LANGNER TRUSTEE/CHAIRMAN EMERITUS 0.2 1.05 X 0 0 0 MARGARET S NATHAN TRUSTEE 0.2 1.05 X 0 0 0 PETER J NEUFELD TRUSTEE (Term ended 6/19/18) 0.2 1.05 X 0 0 0 GAYLE F ROBINSON TRUSTEE 0.2 1.05 X 0 0 0 JON W ROTENSTREICH TRUSTEE 0.2 1.05 X 0 0 0 HON FELICIA K SHEA TRUSTEE 0.2 1.05 X 0 0 0 EDWIN H STERN III TRUSTEE 0.2 1.05 X 0 0 0 DAVID A TANNER TRUSTEE 0.2 1.8 X 0 0 0 CYNTHIA KING VANCE TRUSTEE 0.3 2.2 X 0 0 0 JENNIE EMIL TRUSTEE 0.2 1.05 X 0 0 0 JONATHAN A LIPTON TRUSTEE 0.3 2.2 X 0 0 0 ZITA G ROSENTHAL TRUSTEE 0.2 1.05 X 0 0 0 NATHAN GANTCHER TRUSTEE 0.2 2.3 X 0 0 0 CATHERINE KLEMA TRUSTEE 0.3 2.2 X 0 0 0 MELISSA CERIALE TRUSTEE 0.3 2.2 X 0 0 0 BARRY S BLATTMAN TRUSTEE 0.3 2.2 X 0 0 0 MARK E BROSSMAN TRUSTEE (Term ended 6/19/18) 0.2 1.05 X 0 0 0 MATTHEW H NORD TRUSTEE 0.2 1.3 X 0 0 0 MICHAEL A STOCKER MD TRUSTEE 0.3 2.7 X 0 0 0 ROGER EINIGER TRUSTEE 0.2 2.3 X 0 0 0 JOEL BRAUN TRUSTEE 0.2 1.05 X 0 0 0 EMANUEL CHIRICO TRUSTEE 0.2 1.05 X 0 0 0 W NORMAN MILNER TRUSTEE 0.2 1.05 X 0 0 0 STEVEN M SAFYER MD chief executive officer 5.0 55.0 X 0 7985351 45244 ALISA R DOCTOROFF TRUSTEE 0.2 1.8 X 0 0 0 JOHN P GUTFREUND TRUSTEE 0.2 1.05 X 0 0 0 RONALD L MOELIS TRUSTEE 0.2 1.05 X 0 0 0 Alan N Suna Trustee (Effective 11/1/18) 0.2 1.05 X 0 0 0 Daniel R Tishman trustee (elected 5/15/18) 0.2 3.05 X 0 0 0 PHILIP O OZUAH MDPHD PRESIDENT 5.0 55.0 X 0 13316550 45068 CHRISTOPHER S PANCZNER Assistant Secretary 5.0 55.0 X 0 1284291 627752 COLLEEN BLYE EXEC VP & CFO 5.0 55.0 X 0 1773397 535728 SUSAN GREEN-LORENZEN RN System SENIOR VP-OPERATIONS 5.0 55.0 X 0 1813543 42968 LYNN RICHMOND Exec VP-Chief Strategy Officer 5.0 55.0 X 0 1700958 335589 Jaccel Kouns VP & Exc Director MMV 60.0 0.0 X 0 369252 45125 Bentley A Ogoke MD Anesthesiologist 60.0 0.0 X 494292 0 32562 BALASA PRASAD MD CHAIRMAN-ANESTHESIA 60.0 0.0 X 457261 0 6800 FRANCIS AGBONKPOLO MD ANESTHESIOLOGIST 60.0 0.0 X 433561 0 27149 Nadeem Hussain MD Psychiatrist 60.0 0.0 X 356225 0 26252 Nkirulka J Iloh MD Attending Physician 60.0 0.0 X 329412 0 24236 JOEL A PERLMAN former officer 0.0 0.0 X 0 252113 45068 2070751 28495455 1839541 104 true true false Excel Emergency Physician Services 484 Temple Hill Road Suite 102 NEW WINDSOR NY 12553 Physician Services 2079009 Fastaff LLC POBox 911452 DENVER CO 802911452 Temporary Nurses 1545585 Allscripts Healthcare LLC 24630 Network Place CHICAGO IL 60673 IT Services 984538 Radiology Advantage New Jersey PA 3805 East Bell Road Suite 5500 PHOENIX AZ 85032 Radiology Services 946870 Century Protective Services Inc 150 Grant Street WHITE PLAINS NY 10601 Security Services 773105 16 17595832 103643 17699475 INPATIENT SERVICES 623000 45905637 45905637 0 0 OUTPATIENT SERVICES 621400 21146690 21146690 0 0 RENTAL INCOME FROM EXEMPT AFFILIATE 531120 1308000 1308000 0 0 OTHER HEALTH CARE SERVICES REVENUE 621999 758504 758504 0 0 MEDICAL EDUCATION 611699 50000 50000 0 0 69168831 0 0 0 45621 22229 23392 0 23392 0 0 23392 0 0 0 0 0 0 0 0 0 0 CAFETERIA/COFFEE SHOP & VENDING INCOME 722514 415156 0 0 415156 PARKING INCOME 812930 288937 0 0 288937 REVERSAL OF BAD DEBT RESERVES 900099 55011 0 0 55011 10258 0 0 10258 769362 87661060 69168831 0 792754 600 600 0 0 0 0 0 40461401 37647161 2814240 0 2577619 2389516 188103 0 7020188 6507887 512301 0 2954736 2739113 215623 0 67782 67782 0 0 77163 634 76529 0 0 0 0 0 8297139 7446815 850324 0 8484 8484 0 0 4926188 4574045 352143 0 2707198 1645082 1062116 0 0 4136679 3547385 589294 0 55446 48961 6485 0 0 19431 19431 0 0 784067 784067 0 0 0 1768061 1475882 292179 0 2859760 2726426 133334 0 MEDICAL SUPPLIES 7361184 7360497 687 0 INTERCOMPANY ADMIN OVERHEAD 6376296 6376296 0 MEMBERSHIP FEES 683604 551543 132061 0 BILLING AND COLLECTION 348121 0 348121 343974 340398 3576 93835121 79881709 13953412 0 700 700 2477712 2957708 157193 216804 4220682 5782995 0 0 0 0 0 0 971310 1430671 358274 456304 19572354 7711009 12780738 11861345 0 0 0 0 0 0 0 0 20009693 18832000 40976302 41538527 20191563 22098306 0 0 299823 320168 0 0 0 0 0 0 0 0 0 0 37600154 42460319 58091540 64878793 X -17115238 -23340266 0 0 0 0 -17115238 -23340266 40976302 41538527 X -6174061 -50967 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 8778 8778 false Schedule C, Part II-B, Line 1i THE other activities includes indirect lobbying cost for the organization's pro-rata share of Healthcare Education Project (HEP) Lobbying expenses. 8350495 1659902 6690593 11211436 6051107 5160329 10423 0 10423 11861345 EST INSURANCE CLAIMS RECEIV 18832000 18832000 0 LOANS PAYABLE - PARENT 20081164 DUE TO THIRD PARTY PAYORS 2356332 MALPRACTICE INSURANCE LIABILITIES 449043 EST INSURANCE CLAIMS LIABILITIES 18832000 DUE TO AFFILIATES 690813 PENSION LIABILITIES 50967 42460319 true true X true X true X 500. true true true false true true 4529845 6103439 0 0.00000 37695884 22804790 14891094 0.15870 42225729 28908229 14891094 0.15870 483062 0 483062 0.00510 7318411 1843167 5475244 0.05830 4612526 4086546 525981 0.00560 12413999 5929713 6484287 0.06900 54639728 34837942 21375381 0.22770 false 356832 26572 13086660 12378016 708644 X true true 1 1 Montefiore Mount Vernon Hospital 12 North Seventh Avenue Mount Vernon NY 10550 www.montefiorehealthsystem.org 5903001H X X X X Montefiore Mount Vernon Hospital 1 false false true X X X X X X X X 16 true true false true X See Part V - Section C X true 16 true See Part V - Section C false true X 100 500. X true true X X X X true X See Part V - Section C X See Part V - Section C X See Part V - Section C X X X X X X true X false X X X X true X false false Schedule H, PART V, SECTION B, LINE 5 The process to identify the needs of the community involved the collection of both secondary and primary data. Multiple conversations and meetings were convened internally and with external partners and a thorough review of the data was conducted. Multiple data sources were used to support the identification and selection of the priority items which were identified, selected and reviewed with the partners. The collection of primary data from a sample of the Westchester County residents was an important element of the development of the Community Health Needs Assessment. Montefiore engaged with the Westchester County Department of Health's online Community Resident and Provider Health Surveys to facilitate the implementation of the primary data collection process for the Community Health Needs Assessment for Westchester County and to assist in the facilitation of these community level connections thereby alleviating additional surveying overload. An online survey was collaboratively developed and made available across Westchester County over the summer of 2016. During this process, Westchester County compiled feedback from over 1,300 responders and identified community concerns by municipality to support CHNA efforts of hospitals for inclusion into their implementation plans. in addition to collaborative input from the local Department of Health, Montefiore worked closely with it communities including the Mount Vernon Community Advisory Board, organized partnerships and collaboratives and other providers in lower Westchester as well as extensive work with representatives of the affected communities to help Montefiore to identify health care needs and determine the appropriate configuration of services. Schedule H, Part V, Section B, Line 6A MONTEFIORE MOUNT VERNON HOSPITAL CHNA WAS CONDUCTED ALONG WITH MONTEFIORE NEW ROCHELLE HOSPITAL. Schedule H, Part V, Section B, Line 7a The CHNA report is available to the public on Montefiore's website: http://www.montefiore.org/documents/communityservices/Community-Health-Nee ds-Assessment-MNR-MMV.pdf Schedule H, Part V, Section B, Line 10a The hospital facility's most recently adopted implementation strategy is posted on the website: http://www.montefiore.org/documents/communityservices/Community-Health-Nee ds-Assessment-MNR-MMV.pdf Schedule H, Part V, Section B, Line 11 Montefiore Mount Vernon Hopital's most recently conducted CHNA illuminated two major categories of health needs that were important across the population surveyed, reflected in the data as critical, and in alignment with the New York State Prevention Agenda. The two priority areas identified were (1)Preventing Chronic Disease and (2)Promoting healthy women, Infants and Children. As part of the submission for the New York State Health Improvement Plan for 2016-2018, required by the New York State Department of Health, montefiore has elected to retain these two priority areas, Prevent Chronic Disease and Promote Healthy Women, Infants and Children and has selected three broad focus areas to implement programs. These broad focus areas are (1)reducing obesity in children and adults, (2)Increase access to high quality chronic disease Preventive care and management in both clinical and community settings and (3) Improving maternal and infant Health. Across these focus areas, various goals, with specific interventions, performance measures and time frames, were delineated; - Create community environments that promote and support healthy food and beverage choices and physical activity; - Increase screening rates for cardiovascular disease, diabetes and breast, cervical and colorectal cancers, especially among disparate populations. - Reduce premature births. Despite the different methods and approached to primary data collection in gathering community input, there was a consistent focus on obesity and related behaviors and outcomes among the main community health concerns. Obesity and its related behaviors have significant impact on chronic disease, therefore, it is intended that the programs that are detailed specifically for the reduction of obesity will also impact the prevalence of diabetes, hypertension, asthma, cancer and cardiovascular disease in Westchester County. Montefiore has a vast portfolio of programs and services that address a majority of the significant community health needs identified in the Community Health Needs Assessment. The breadth and depth of the programs and services vary, but each address a need identified in the community. In particular, there are programs underway in collaboration with Hudson river Healthcare and Westchester Local Government units to work with bodegas on healthy snack displays and creating walking paths in parks and communities. In addition to the multiple resources that have been developed at Montefiore independently and through partnership with other organizations, there is an extensive need for community-based programs and resources that can augment Montefiore's program and services. Knowing how to access these resources is a particular challenge for the health care sector. However, recent developments of multiple free and low cost online search tools have been made, such as www.auntbertha.com, www.hitesite.org, www.nowpow.com, among others. These are a much more comprehensive and practical alternative to the home-grown referral guides that many health care providers have had to use in the past that were hard to keep-up-to date and difficult to search, a problem that is largely addressed by these online version. Many Montefiore sites have been introduced to these new one online resources and work is underway to more seamlessly integrate this kind of solution into the various workflows across the ambulatory, ED and inpatient settings. Schedule H, Part V, Section B, Line 13H Family size is factored into the eligibility criteria for financial assistance. Schedule H, Part V, Section B, Line 15E The organization's FAP provides addresses, locations and phone numbers for offices within Montefiore to assist with completing applications. The financial aid and Medicaid staff at these locations are also certified application counselors that assist with market place and Medicaid applications. Schedule H, Part V, Section B, Lines 16a-16c The direct website where the FAP is publicized: http://www.montefiorehealthsystem.org/body.cfm?id=68 3 MONTEFIORE MT VERNON METHADONE PROGRAM 3 SOUTH SIXTH AVENUE MOUNT VERNON NY 10550 SUBSTANCE ABUSE EXTENSION CLINIC MONTEFIORE MT VERNON ID CLINIC 16 GUION PLACE NEW ROCHELLE NY 10801 SPECIAL CARE EXTENSION CLINIC MONTEFIORE MT VERNON HOSP ACT PROGRAM 3 SOUTH SIXTH AVENUE MOUNT VERNON NY 10550 MENTAL HEALTH CLINIC 1. REQUIRED DESCRIPTIONS: PART I, LINE 7: THE COST-TO-CHARGE RATIO METHODOLOGY WAS UTILIZED TO CALCULATE THE AMOUNT INCLUDED IN THE TABLE. THE CALCULATION OF THIS RATIO WAS DERIVED FROM RATIO OF PATIENT CARE COSTS-TO-CHARGES. PART III, SECTION A, LINE 2: THE COST OF BAD DEBT EXPENSE WAS ESTIMATED BASED ON THE CHARGES, APPLIED TO THE RATIO OF TOTAL PATIENT CARE EXPENSES TO TOTAL CHARGES FOR ALL SERVICES RENDERED. ANY PAYMENTS OR DISCOUNTS ARE EXCLUDED FROM BAD DEBT EXPENSE. PART III, SECTION A, LINE 3: THE ESTIMATED AMOUNT OF BAD DEBT EXPENSE (AT COST) ATTRIBUTED TO PATIENTS UNDER THE ORGANIZATION'S CHARITY CARE POLICY WAS BASED ON RESULTS OF PREDICTIVE ANALYSIS. BAD DEBT SHOULD BE INCLUDED AS A COMMUNITY BENEFIT BECAUSE THE ORGANIZATION PROVIDES MUCH NEEDED HEALTH CARE SERVICES INDISCRIMINATELY TO THE COMMUNITY-AT-LARGE WITHOUT REGARD TO WHETHER OR NOT THE PATIENT HAS INSURANCE AND IF THE BILL WILL EVER BE PAID. PART III, SECTION A, LINE 4: AS REPORTED IN MONTEFIORE HEALTH SYSTEM'S AUDITED CONSOLIDATED FINANCIAL STATEMENTS, BAD DEBT EXPENSE IS DESCRIBED AS FOLLOWS: "Subsequent changes to the estimate of the transaction price (determined on a portfolio basis when applicable) are generally recorded as adjustments to patient service revenue in the period of the change. For the year ended December 31, 2018, changes in the Health Systems estimates of expected payments for performance obligations satisfied in prior years were not significant. Portfolio collection estimates are updated based on collection trends. Subsequent changes that are determined to be the result of an adverse change in the patients ability to pay (determined on a portfolio basis when applicable) are recorded as bad debt expense. Bad debt expense for the year ended December 31, 2018 was not significant". PART III, SECTON B, LINE 8: MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED IN PART III, SECTION B, were derived FROM THE MEDICARE COST REPORT. MEDICARE ALLOWABLE COSTS REPORTED on PART III, LINE 6, PER SCHEDULE H INSTRUCTIONS, WERE DERIVED USING THE Medicare COST REPORT COST-FINDING METHODOLOGY, WHICH APPORTIONS ROUTINE costs TO MEDICARE USING DAYS AND ANCILLARY COSTS TO MEDICARE USING departmental RATIOS OF COSTS TO CHARGES. THE FOLLOWING TABLE represents a reconciliation OF MEDICARE REVENUE AND COSTS INCLUDED ON LINES 5, 6, AND 7 IN PART III TO THE TOTAL ACTUAL MEDICARE REVENUE AND COSTS OF THE Hospital. AS HIGHLIGHTED IN THIS TABLE, INCLUDING THE ADJUSTMENTS described BELOW WOULD HAVE RESULTED IN A MEDICARE Shortfall OF $2,631,856. ALLOWABLE Surplus/ Revenue costs (Shortfall) PART III, LINE 5-7: $13,086,660 $12,378,016 $708,644 ADD: Cost not included: 1,210,570 (1,210,570) ADD: MEDICARE DME: 526,060 1,973,241 (1,447,181) ADD: MED. SUBSID. HLTH. 495,723 1,178,472 (682,749) Adjusted MEDICARE Shortfall: $14,108,443 $16,740,299 ($2,631,856) PART III, SECTION C, LINE 9B: FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE, ALL COLLECTION ACTIVITY IS HALTED AND THE PATIENT IS REFERRED FOR FINANCIAL AID. IF AN ACCOUNT IS IN COLLECTION AND THE PATIENT REQUESTS FINANCIAL AID OR IF THE AGENCY DETERMINES THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE ACCOUNT IS REFERRED BACK TO THE HOSPITAL WHERE THE PATIENT IS PROVIDED ASSISTANCE WITH COMPLETING AN APPLICATION FOR ASSISTANCE. 2. NEEDS ASSESSMENT: MONTEFIORE participates in a variety of organized partnership and collaborative, working with other providers in Westchester County, including the Westchester County Department of Health, community-based organizations and members of the community in planning and developing initiatives aimed at improving the health of the people of Westchester County. The process to identify the needs of the community also involved the collection of both primary and secondary data. Through multiple conversations and meetings with external partners, the data is reviewed and analyzed in the development of implementation strategies tailored to best serve the changing needs of the community. 3. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: ALL INTAKE, REGISTRATION, AND COLLECTION AGENCY STAFF IS TRAINED ON THE HOSPITAL'S FINANCIAL AID POLICY AND HOW TO PROVIDE PATIENTS WITH ASSISTANCE. MONTEFIORE MOUNT VERNON HOSPITAL HAS A POLICY THAT ESTABLISHES GUIDELINES FOR THE BILLING OFFICE TO FOLLOW WHEN WORKING WITH INDIVIDUALS WHO ARE HAVING DIFFICULTY PAYING THEIR MEDICAL BILLS. A REFERRAL IS MADE TO THE HOSPITAL'S FINANCIAL AID OFFICE AND A FINANCIAL COUNSELOR WILL HELP THE PATIENT APPLY FOR FREE OR LOW-COST INSURANCE. IF THE FINANCIAL COUNSELOR DETERMINES THAT THE PATIENT DOES NOT QUALIFY FOR LOW-COST INSURANCE, THE COUNSELOR WILL HELP THE PATIENT APPLY FOR A FINANCIAL AID DISCOUNT BASED ON INCOME LEVEL. THE HOSPITAL MAKES ITS FINANCIAL AID POLICY KNOWN TO THE PUBLIC BY PROVIDING WRITTEN INFORMATION AVAILABLE IN BOTH ENGLISH AND SPANISH, INCLUDING BROCHURES AT ALL PATIENT SERVICE AREAS, INFORMATION POSTED ON THE INTRANET AND INTERNET, AND INFORMATION SENT OUT ON PATIENTS' BILLS. THERE ARE ALSO SIGNS POSTED AT THE MAIN ENTRANCE TO THE HOSPITAL IN ENGLISH AND SPANISH ADVISING PATIENTS OF THE ROOM LOCATION FOR ASSISTANCE WITH FINANCIAL AID. 4. COMMUNITY INFORMATION: The city of Mount Vernon has the highest proportion of Black/African American residents in Westchester County at 66%, with 34% of all residents being foreign born. Additionally, it is the seat of Westchester County's homeless services and senior services programs housing a disporportionate number of economically challenged residents. The City is 4.4 square miles located north of the Bronx and is the 8th largest city and 2nd most populated city in the state of New York. The city has one of the highest percentage of resident living below poverty in Westchester County. The poverty rate is 17.1% compared to 9.7% countywide and the median income is $54,573 compared to $89,968 countywide. 22% of Mount Vernon children are living below poverty; higher than the countywide percentage of 13.3%. As of January 6, 2014, the New York State Education Department, through the Board of Regents at the request of the New York Department of Health reaffirmed the City of Mount Vernon to be an identified Primary Care health Professions Shortage Areas. 5. PROMOTION OF COMMUNITY HEALTH: MONTEFIORE HEALTH SYSTEM, INC. IS A LEADER IN COMMUNITY HEALTH AND HAS A LONG HISTORY OF DEVELOPING INNOVATIVE APPROACHES TO CARE AND CREATING PROGRAMS TO BEST SERVE THE CHANGING NEEDS OF ITS COMMUNITY. MONTEFIORE's Office of Community & Population Health has a dedicated community educator who spearheads initiatives in the city of Mt Vernon. These events are focused on a variety of issues, ranging from chronic disease management and prevention, cancer screenings and promotion of healthy food consumption. Events range from farmers market walks, workshops in the community, walkathons, health fair and community-based health screens. The Mount Vernon Facility has focused its engagement across multiple health indicators; diabetes, breast, cervical and colorectal cancers while addressing cardiovascular disease in the older adult population. To increase screening rates for cardiovascular disease the team coordinates screening services and educational workshops to older adults at frequently occurring points of congregation, including senior centers and naturally occurring retirement communities. These workshops provide a gateway to engage the community in health programming that ensures that our work is targeted towards high needs/high impact activities. 6. AFFILIATED HEALTH CARE SYSTEM: MONTEFIORE MOUNT VERNON HOSPITAL IS AN AFFILIATE OF MONTEFIORE HEALTH SYSTEM, INC. The Health System is a leader in community and population health and has a long history of developing innovative approaches to care and tailoring programs to best serve the changing needs of its community. These include, but are not limited to the following: Community Service Plan, Community Service Strategy, Accountable Care Organization, Patient-centered medical home, disease management programs and community outreach. The integration of these innovative approaches supports Montefiore well in its provision of service to the community. 7. STATE FILING OF COMMUNITY BENEFIT REPORT: MONTEFIORE MOUNT VERNON HOSPITAL FILES A COMMUNITY SERVICE PLAN WITH THE STATE OF NEW YORK. true true false false false false false false false PHILIP O OZUAH MDPHD PRESIDENT 0 2809306 0 1588300 0 8918944 0 17000 0 28068 0 13361618 0 5573098 CHRISTOPHER S PANCZNER Assistant Secretary 0 856837 0 405900 0 21554 0 621174 0 6578 0 1912043 0 0 JOEL A PERLMAN former officer 0 0 0 0 0 252113 0 17000 0 28068 0 297181 0 0 Bentley A Ogoke MD Anesthesiologist 492708 0 0 0 1584 0 6800 0 25762 0 526854 0 0 0 BALASA PRASAD MD CHAIRMAN-ANESTHESIA 457261 0 0 0 0 0 6800 0 0 0 464061 0 0 0 FRANCIS AGBONKPOLO MD ANESTHESIOLOGIST 431977 0 0 0 1584 0 6800 0 20349 0 460710 0 0 0 Nadeem Hussain MD Psychiatrist 355684 0 0 0 541 0 6800 0 19452 0 382477 0 0 0 SUSAN GREEN-LORENZEN RN System SENIOR VP-OPERATIONS 0 1051346 0 470100 0 292097 0 17000 0 25968 0 1856511 0 0 LYNN RICHMOND Exec VP-Chief Strategy Officer 0 1049204 0 630200 0 21554 0 308475 0 27114 0 2036547 0 0 COLLEEN BLYE EXEC VP & CFO 0 1113565 0 658800 0 1032 0 509118 0 26610 0 2309125 0 0 STEVEN M SAFYER MD chief executive officer 0 2077600 0 2455500 0 3452251 0 17000 0 28244 0 8030595 0 0 Jaccel Kouns VP & Exc Director MMV 0 287700 0 75000 0 6552 0 17000 0 28125 0 414377 0 0 Nkirulka J Iloh MD Attending Physician 329264 0 0 0 148 0 4931 0 19305 0 353648 0 0 0 PART I, LINE 4a Joel Perlman, a former officer, was paid severance by a related organization in the amount of $247,169. PART I LINES 3, 4B & PART II - COLUMNS (B)(I), (II) AND (III) As it relates to Compensation from Montefiore Medicine Academic Health System, Inc. and Montefiore Health System, Inc. The Compensation Committee reviews and approves all forms of compensation and benefits provided to each executive with the assistance of a national independent compensation consulting firm. The consulting firm assists the Compensation Committee with its decision-making process to ensure executive compensation levels are reasonable and appropriate relative to those of other similar organizations. Base salaries in Column B(i) are determined based on competitive market practices for comparable positions with similar size organizations and scope of responsibilities. Bonus and incentive compensation in Column B(ii) is based on the achievement of performance goals. The executives' compensation program has a significant pay-at-risk component to ensure the alignment of pay and organizational performance. Goals are set in advance in areas such as quality of care, patient satisfaction, community services and financial performance. Compensation is at risk if the goals established by the Compensation Committee are not met. Other reportable compensation in column B(III) includes distributions from the supplemental executive retirement plan. In a manner designed to qualify for the "rebuttable presumption of reasonableness" the Compensation Committee of the Board of Trustees expressly reviewed and approved these retirement benefit arrangements for senior executives in a manner that qualified under the intermediate sanctions rules of the Federal tax law, and in recognition of (a) the executives' years of service to the organization and (b) the significant contributions to enhancing the ability of the organization to achieve its charitable mission in a manner consistent with financial solvency. Accordingly, this benefit should be viewed as applying to years of service for the organization. Pooled Supplemental Executive Retirement Plan distributions: Steven Safyer, M.D. - $3,444,107 Susan Green Lorenzen, R.N. - $270,063 Philip O. Ozuah, MD, Ph.D - $8,741,113 Supplemental Executive Retirement Plan accrued and unpaid service costs: Christopher Panczner - $604,174 Lynn Richmond - $291,475 Colleen Blye - $492,118. The officers and Key Employees listed in Part II, Column A are not employees of this filing organization, Montefiore Mount Vernon Hospital. These individuals are employed and their compensation is paid by either Montefiore Medicine Academic Health System, Inc., EIN 47-1582973, or Montefiore Health System, Inc., EIN 20-1615393. FORM 990, PART VI, SECTION A, LINE 4: THE ORGANIZATION'S BYLAWS WAS AMENDED March 2018 for a change in the duties of the Chief Executive Officer from a corporate to a board officer position. FORM 990, PART VI, SECTION A, lINE 6: MONTEFIORE HEALTH SYSTEM, INC IS THE SOLE MEMBER OF MONTEFIORE MOUNT VERNON HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A: THE BOARD OF TRUSTEES OF MONTEFIORE HEALTH SYSTEM, INC., THE SOLE MEMBER OF MONTEFIORE MOUNT VERNON HOSPITAL, HAS THE AUTHORITY TO APPOINT THE BOARD OF TRUSTEES OF MONTEFIORE MOUNT VERNON HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7B: THE BOARD OF TRUSTEES OF MONTEFIORE HEALTH SYSTEM, INC., THE SOLE MEMBER OF MONTEFIORE MOUNT VERNON HOSPITAL, HAS THE AUTHORITY TO APPROVE THE OPERATING AND CAPITAL BUDGETS OF MONTEFIORE MOUNT VERNON HOSPITAL. FORM 990, PART VI, SECTION B, LINE 11B: THE FORM 990 WAS PREPARED BY MONTEFIORE HEALTH SYSTEM'S FINANCE DEPARTMENT WITH THE ASSISTANCE OF VARIOUS DEPARTMENTS. THE FORM 990 WAS REVIEWED AND APPROVED BY THE VICE PRESIDENT FINANCE - FINANCIAL REPORTING AND THE HOSPITAL'S SENIOR LEADERSHIP TEAM INCLUDING THE CHIEF FINANCIAL OFFICER. IN ADDITION, AN INDEPENDENT ACCOUNTING FIRM WAS ENGAGED TO REVIEW THE FORM 990. UPON COMPLETION OF THE VARIOUS REVIEWS, THE FORM 990 WAS PRESENTED TO THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES FOR REVIEW AND APPROVAL. ONCE APPROVED BY THE FINANCE COMMITTEE OF THE BOARD OF TRUSTEES, THE FORM 990 WAS PROVIDED TO ALL MEMBERS OF the governing BODY before being filed. FORM 990, PART VI, SECTION B, LINE 12C: ORGANIZATION COMPLIANCE POLICY MONITORING AND ENFORCEMENT: The organization regularly and consistently monitors and enforces compliance with the disclosure policy by means of a survey developed by counsel and approved by the Montefiore Legal and Compliance Committees of the Board of Trustees. The survey is sent to all trustees, officers and key employees for completion. All survey responses are reviewed by the Compliance Officer. Any potential conflicts identified in the responses are discussed with senior management and/or the Legal and Compliance Committees of the Board of Trustees. Potential actions to be taken in response to a conflict is one or more of the following: 1)disclosure of conflict; 2)individual recusal from decisions for transactions where that individual may have a conflict; 3)request the individual to alleviate the conflict; OR 4)removal of the individual from the board of trustees. FORM 990, PART VI, SECTION B, LINE 15A & 15B: All officers and key employees are employed and paid by either Montefiore Medicine Academic Health System, Inc. or Montefiore Health System, Inc., The parent Companies of Montefiore Health Sytem, Inc. and Montefiore Mount Vernon Hospital, respectively. Montefiore Health System, Inc. is committed to ensuring that its executive compensation program adheres to the highest standards of regulatory compliance and best corporate governance. The Board of Trustees has charged the Compensation Committee of the Board (which is comprised of independent Board members with no conflicts of interest in regards to executive compensation) with making all decisions related to compensation for officers and certain key employees. All decisions made by the Compensation Committee are appropriately and timely documented in meeting minutes. The compensation committee's review process follows the Intermediate Sanctions guidelines for qualifying for the rebuttable presumption of reasonableness. The Committee retains an independent compensation consultant to assist it with this process. Compensation levels are established considering data for comparable organizations, an assessment of management performance (including the services provided to the community), and other business judegment factors, consistent with Montefiore's executive compensation philosophy. The Committee's decisions are made in the best interest of Montefiore, and are intended to ensure the recruitment and retention of key executive talent, consistent with the market practices of other not-for-profit healthcare organizations of comparable scope, mission and complexity. On an annual basis, the Committee provides the full Board of Trustees with a description of the committee's review and approval process and its decisions. FORM 990, PART VI, SECTION C, LINE 19: THE CONFLICTS OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 The other decrease in net assets of $50,967 was due to the change in net assets related to defined benefit pension and postretirement plans to be recognized in future periods. FROM 990, PAGE 1, BOX J WEBSITE: HTTP://MONTEFIOREHEALTHSYSTEM.ORG/MOUNTVERNON MMC Corporation 111 East 210th Street Bronx NY 10467 133430322 Real Estate NY 501(C)(3) 12A TYPE I MMC true Montefiore Medical Center 111 East 210th Street Bronx NY 10467 131740114 acad med ctr NY 501(C)(3) 3 MHS true Montefiore Hospital Housing Sect IIInc 3450 Wayne Avenue Bronx NY 10467 237160641 Staff Housing NY 501(C)(2) MMC true Mosholu Preservation Corporation 3400 Reservoir Oval East Bronx NY 10467 133109387 Community Ser NY 501(C)(3) 12A TYPE I MMC true Gun Hill MRI PC 200 EAST GUNHILL ROAD BRONX NY 10467 133734486 DIAG SERVICES NY 501(C)(3) 12A TYPE I MMC true Montefiore Health System Inc 555 SOUTH BROADWAY BLDG A FL 1 TARRYTOWN NY 10591 201615393 PARENT NY 501(C)(3) 12B Type II MMAHS true MMC Residential Corp I Inc 3411 Wayne Avenue Bronx NY 10467 911943271 Staff Housing NY 501(C)(2) MMC true Schaffer Extended Care Center 16 Guion Place New Rochelle NY 10801 462929888 Nursing Home NY 501(C)(3) 3 MHS true Montefiore New Rochelle Hospital 16 Guion Place New Rochelle NY 10801 462931956 Hospital NY 501(C)(3) 3 MHS true Albert College of Medicine Inc 1300 Morris Park Avenue Bronx NY 10461 472209056 MED COLLEGE NY 501(C)(3) 2 MMAHS true Montefiore Medicine ACADEMIC HEALTH SYST 555 South Broadway BLDG A FL 1 Tarrytown NY 10591 471582973 SYS PARENT NY 501(c)(3) 12B Type II NA true Montefiore Nyack Hospital 160 North Midland Avenue Nyack NY 10960 131740119 Hospital NY 501(c)(3) 3 MHS true MONTEFIORE FOUNDATION INC 111 EAST 210TH STREET BRONX NY 10467 471600439 Inactive NY 501(C)(3) 7 MMAHS true White Plains Hospital Medical Center 41 East Post Road White Plains NY 10601 131740130 HOSPITAL NY 501(C)(3) 3 MHS true AECOM Student Housing Co Inc 1300 Morris Park Avenue Bronx NY 10461 237075620 STUDENT HOUS NY 501(C)(2) AECOM true Montefiore CERC Operations Inc 111 East 210th Street Bronx NY 10467 474853506 REHAB CENTER NY 501(c)(3) 3 MMC true White Plains Hospital Ctr FoundationInc 41 East Post Road Davis Ave White Plains NY 10601 133281507 Fundraising NY 501(C)(3) 12A Type I WPHMC true Nyack Hospital Foundation 160 North Midland Avenue Nyack NY 10960 133245804 Fundraising NY 501(C)(3) 7 NYACK HOSP true The Winifred Masterson Burke Rehab Hosp 785 Mamaroneck Avenue White Plains NY 10605 131739937 Rehab Hosp NY 501(c)(3) 3 MHS true St Luke's Cornwall Hospital 70 Dubois Street Newburgh NY 12550 141340054 Hospital NY 501(c)(3) 3 MHS true Hudson Vista Medical PC 70 Dubois Street Newburgh NY 12550 452526738 Healthcare NY 501(c)(3) 12A Type I SLCH true Hudson Vista Physician Services PC 70 Dubois Street Newburgh NY 12550 272020746 Healthcare NY 501(c)(3) 12A Type I SLCH true St Luke's Cornwall Health System Inc 70 Dubois Street Newburgh NY 12550 223026261 Holding Comp NY 501(c)(3) 12A Type I MHS true St Luke's Cornwall Health SYSTEM Fdn 70 Dubois Street Newburgh NY 12550 223026263 Fundraising NY 501(c)(3) 7 SLCHS true Amos and Sarah Holden Home 70 Dubois Street Newburgh NY 12550 141365995 Asst Living NY 501(c)(3) PF SLCHS true Goldsmith D and Mary B Johnes Home 70 Dubois Street Newburgh NY 12550 141364666 Home for Aged NY 501(c)(3) 10 SLCHS true MONTEFIORE MED ACAD HLTH SYS SELF INS TR 555 SOUTH BROADWAY TARRYTOWN NY 105916301 824019223 INS TRUST NY 501(C)(3) 12A TYPE I MMAHS true ALBERT EINSTEIN COLLEGE OF MEDICINE 1300 MORRIS PARK AVENUE BRONX NY 104611975 830621846 MED COLLEGE NY 501(C)(3) 2 MMAHS true UNIVERSITY BEHAVIORAL ASSOCIATES INC 111 EAST 210TH STREET BRONX NY 10467 133877781 MGMT SERVICES NY NA C Corp true THE MONTEFIORE IPA INC 111 EAST 210TH STREET BRONX NY 10467 134114915 Integ Provr ASSOC NY NA C CORP true MMC GI HOLDINGS EAST INC 111 EAST 210TH STREET BRONX NY 10467 721610013 Holding Company NY NA C CORP true MMC GI HOLDINGS WEST INC 111 EAST 210TH STREET BRONX NY 10467 721610015 HOLDING COMPANY NY NA C CORP true MONTEFIORE BEHAVIORAL CARE IPA NO 1INC 111 EAST 210TH STREET BRONX NY 10467 133952750 INTEG PROVR ASSOC NY NA C CORP true BRONX ACCOUNTABLE CARE NETWORK IPA INC 111 EAST 210TH STREET BRONX NY 10467 300689571 Integ Provr Assoc NY NA C CORP true Montefiore Consolidated Ventures Inc 111 East 210th Street Bronx NY 10467 611728539 Holding Company NY NA C Corp true Montefiore Insurance Company Inc 111 East 210th Street Bronx NY 10467 320436594 Inactive NY NA C Corp true Hudson Valley IPA Inc 111 East 210th Street Bronx NY 10467 383978087 Integ Provr Assoc NY NA C CORP true Montefiore Innovations Inc 111 East 210th Street Bronx NY 10467 475106910 Holding Company NY NA C CORP true Highland Medical PC 160 North Midland Avenue Nyack NY 10960 134034481 Healthcare Serv NY NA C CORP true 8 Longview Development Corp Davis Avenue at East Post Road White Plains NY 10601 263321278 HOUSING NY NA C CORP true White Plains Medical Diagnostic Serv 41 East Post Road White Plains NY 10601 453164626 Healthcare Serv NY NA C CORP true Cancer and Blood Medical Services of NY 41 East Post Road White Plains NY 10601 462021804 Healthcare Serv NY NA C CORP true Davis Avenue Corp Davis Avenue at East Post Road White Plains NY 10601 133331643 Inactive NY NA C CORP true White Plains Management Co Inc 41 East Post Road White Plains NY 10601 133331641 Inactive NY NA C CORP true WPHC Building Corp 41 East Post Road White Plains NY 10601 133676932 Inactive NY NA C CORP true White Plains Medical Services PC Davis Avenue at East Post Road White Plains NY 10601 815369152 Healthcare Serv NY NA C Corp true White Plains Physician Services PC Davis Avenue at East Post Road White Plains NY 10601 815309615 Inactive NY NA C Corp true Charitable Remainder Trust (5) Char Remr Trust NY NA Trust true CRHT ACQUISITION INC 555 SOUTH BROADWAY BLDG A FL 1 TARRYTOWN NY 10591 815220651 HOLDING COMPANY NY NA C CORP true QUANTUM BIOTHERAPEUTICS LLC 111 EAST 210TH STREET BRONX NJ 10467 611793667 INACTIVE NY NA C CORP true WHITE PLAINS PHYSICIAN MEDICAL SERV PC DAVIS AVENUE AT EAST POST ROAD WHITE PLAINS NY 10601 830519787 INACTIVE NY NA C CORP true EAST POST ROAD MEDICAL SERVICES PC DAVIS AVENUE AT EAST POST ROAD WHITE PLAINS NY 10601 830535258 INACTIVE NY NA C CORP true EAST POST ROAD PHYSICIAN SERVICES PC DAVIS AVENUE AT EAST POST ROAD WHITE PLAINS NY 10601 830563325 INACTIVE NY NA C CORP true DAVIS AVENUE MEDICAL SERVICES PC DAVIS AVENUE AT EAST POST ROAD WHITE PLAINS NY 10601 830579310 INACTIVE NY NA C CORP true WPH HOLDING COMPANY DAVIS AVENUE AT EAST POST ROAD WHITE PLAINS NY 10601 833893119 HOLDING COMPANY NY NA C CORP true false false false false true false false false false true true true true true true true true false false MONTEFIORE HEALTH SYSTEM INC E 2990004 COST MONTEFIORE HEALTH SYSTEM INC K 857478 COST Montefiore Health System Inc M 1258399 COST Montefiore Medical Center Q 183411 COST Montefiore Medical Center M 7260260 cost Montefiore Medical Center P 119155 Cost Montefiore New Rochelle Hospital J 1308000 Cost Montefiore New Rochelle Hospital P 230107 Cost Montefiore Medicine Academic Health System M 423516 Cost THE MONTEFIORE IPA INC L 2142099 COST Montefiore New Rochelle Hospital O 1959281 cost MONTEFIORE MEDICAL CENTER N 1508928 COST THE WINIFRED MASTERSON BURKE REHAB HOSPITAL M 67616 COST