2018-11-13T15:09:27-06:00 2017-12-31 BDO USA LLP 100 PARK AVENUE NEW YORK NY 100175001 990 2017-01-01 111631837 Wyckoff Heights Medical Center % VALI GACHE WYCK 7189636702 374 Stockholm Street Brooklyn NY 11237 VALI GACHE CFO 7189636702 2018-11-02 true Angelo Pirozzi P00446022 2128858000 2018-11-02 24.146.152.90 26308920183175000057 2018-11-13 P 1210560841ADC29080D5D665393427DBF2BE5B27 F1BB04593BE31C4F231B246D7D2FCDAC29228980 2017 2019-02-21 02:37:17Z RAMON RODRIGUEZ 374 Stockholm Street Brooklyn NY 11237 354804482 false X WWW.WYCKOFFHOSPITAL.ORG X 1889 NY THE MISSION OF WYCKOFF HEIGHTS MEDICAL CENTER IS TO PROVIDE EXCELLENCE IN CARE THROUGH PREVENTION, EDUCATION, AND TREATMENT IN A SAFE ENVIRONMENT. 10 6 2111 260 0 0 47916321 86814161 231893038 230386618 70786 99959 34038789 37503744 313918934 354804482 0 0 0 0 182149617 186472387 0 0 0 150654090 153708821 332803707 340181208 -18884773 14623274 171778552 176774703 281509734 271882450 -109731182 -95107747 X THE MISSION OF WYCKOFF HEIGHTS MEDICAL CENTER IS TO PROVIDE EXCELLENCE IN CARE THROUGH PREVENTION, EDUCATION, AND TREATMENT IN A SAFE ENVIRONMENT. false false 245895803 262853188 WYCKOFF HEIGHTS MEDICAL CENTER PROVIDES INPATIENT MEDICAL, SURGICAL, OBSTETRIC, PEDIATRIC CARE AND OFFERS EMERGENCY, AMBULATORY SURGERY AND OUTPATIENT CLINICAL SERVICES. WYCKOFF HAS BEEN PROVIDING MEDICAL CARE TO THE COMMUNITY SINCE 1889. WYCKOFF DISCHARGED 14,368 PATIENTS IN 2017. THE HOSPITAL DELIVERS 1,322 BABIES OF WHICH 206 WERE FROM NEONATAL INTENSIVE CARE UNIT. WYCKOFF SEES 276,247 OUTPATIENT VISITS WHICH INCLUDES PEDIATRIC/ADULT EMERGENCY DEPARTMENT AND AMBULATORY SURGERY. THE HOSPITAL OFFERS SERVICES TO THOUSANDS AT ITS NETWORK OF COMMUNITY AMBULATORY CARE CENTERS AND PRESENTS EXTENSIVE COMMUNITY HEALTH EDUCATION AND SCREENING PROGRAMS. FOR FURTHER INFORMATION, PLEASE VISIT THE WEBSITE AT WWW.WYCKOFFHOSPITAL.ORG. 245895803 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false true false true false false false false false true true true false false true 206 0 true 2111 true false false false false false false false false false false X 10 6 false false false false false false false true true false false true true true true true true true true false NY X VALI GACHE 7189636702 374 STOCKHOLM STREET BROOKLYN NY 11237 X GARY GOFFNER Chairman 1.0 3.0 X X 0 0 0 Vincent Arcuri Vice Co-Chairman 1.0 3.0 X X 0 0 0 Herman Hochberg Vice Co-Chairman 1.0 3.0 X X 0 0 0 Fred T Haller Esq Secretary 1.0 3.0 X X 0 0 0 RAMON RODRIGUEZ PRESIDENT/CEO 32.0 3.0 X X 1065861 0 13090 Vito J D'Alessandro thru 8117 Trustee/Dir. Quality Assurance 22.0 3.0 X 76501 0 165 Adam Figueroa Trustee 1.0 3.0 X 0 0 0 Andrew Boisselle Trustee 1.0 3.0 X 0 0 0 Agnieszka Poslednik Esq Trustee 1.0 3.0 X 0 0 0 Mounzer Tchelebi MD Trustee 1.0 3.0 X 0 0 0 Albert Wiltshire Trustee 1.0 3.0 X 0 0 0 FRANK VUTRANO EVP/CFO, thru 9/7/17 32.0 3.0 X 519358 0 4535 TRACY GREEN CFO, as of 10/23/17 32.0 3.0 X 50526 0 0 GUSTAVO DEL TORO EVP/CMO 32.0 3.0 X 570878 0 4178 Andrew Toga EVP of Amb Svcs thru 6/16/17 32.0 3.0 X 338115 0 1538 KEVIN SMYLEY VP/LEGAL SERVICES 32.0 3.0 X 347103 0 5602 MARGARET CORNELIUS VP OF HR 32.0 3.0 X 272571 0 3050 JEBASHINI JERURASA VP/CIO 32.0 3.0 X 228000 0 7222 CATHERINE GALLOGLY-SIMON CNO 32.0 3.0 X 309036 0 11709 PATRICK SULLIVAN VP of Facility & Support 32.0 3.0 X 280115 0 0 Stephen Carryl MD Chairman of Surgery 32.0 3.0 X 889165 0 8662 Thomas Larkin MD Chief Division Ortho 32.0 3.0 X 466541 0 1620 Bernard Chukwuneke MD House Officer 0.0 0.0 X 0 0 0 SANJIVAN PATEL MD Acting Chairman 32.0 3.0 X 482056 0 6817 Elvita G Dominiques DO Director 32.0 3.0 X 414910 0 6817 WILLIAM THELMO MD CHAIRMAN 32.0 3.0 X 396825 0 8247 6707561 0 83252 338 false true false EATON VAN WINKLE LLP 3 PARK AVENUE 16TH FL NEW YORK NY 10016 LEGAL SERVICES 2401607 NORTH AMERICAN PARTNERS INC PO BOX 108 GLEN HEAD NY 115450108 ANESTHESIOLOGISTS 5074711 COHNREZNICK LLP 333 THORNALL STREET EDISON NJ 08837 FINANCIAL CONSULTING 2038565 NORTHWELL HEALTH INC 972 BRUSH HOLLOW RD 5TH FLOOR WESTBURY NY 11590 PHYSICIAN SERVICES 1795978 THE MAX GROUP LLC 7 PONDERFIELD RD BRONXVILLE NY 10708 Reimburse Svc/acctg 3144428 45 86723426 90735 86814161 NET PATIENT SERVICE REVENUE 621300 248798569 248798569 PROVISION FOR BAD DEBTS 621300 -18411951 -18411951 230386618 99959 99959 0 0 194215 194215 0 194215 194215 0 0 0 0 0 0 0 0 0 0 PHYSICIAN BILLINGS 900099 25565424 25565424 PHARMACY - PATIENT 900099 4253221 4253221 STUDENT TRAINING 900099 2036450 2036450 5454434 4868203 586231 37309529 354804482 267109916 880405 0 0 0 0 4109155 4109155 0 0 132197410 92458751 39738659 8701850 6086066 2615784 27984058 19572025 8412033 13479914 9427840 4052074 0 4072993 2848648 1224345 361973 253164 108809 0 0 0 64149519 44866116 19283403 0 69561 48651 20910 10963555 7667901 3295654 0 0 6699129 4685365 2013764 409431 286356 123075 0 122167 85443 36724 1756435 1228449 527986 0 8472783 5925857 2546926 7334080 5129449 2204631 MEDICAL SUPPLIES 36085416 36085416 REPAIRS AND MAINTENANCE 8126518 5683679 2442839 MISCELLANEOUS EXPENSE 4919682 3440821 1478861 EDUCATION 165579 115806 49773 340181208 245895803 94285405 0 -794834 -1910372 5009793 13027599 1328736 1946473 24784173 22707052 0 0 0 0 0 0 4981933 5250211 1908388 1070152 326470111 257440170 63451090 69029941 0 0 0 0 0 0 0 0 71109273 65653647 171778552 176774703 71973567 61773866 0 0 1146567 566633 64182951 60995135 0 0 0 0 24947890 19064321 0 0 119258759 129482495 281509734 271882450 X -109731182 -95107747 0 0 0 0 -109731182 -95107747 171778552 176774703 14623274 257 -96 X false true X true true true X false false false false false false false false true 230363 230363 false false PART II-B, LINE 1I - OTHER ACTIVITIES DESCRIPTION WYCKOFF HEIGHTS MEDICAL CENTER PAYS DUES TO GREATER NEW YORK HOSPITAL ASSOCIATION (GNYHA), LOCAL 1199 - HEALTH EDUCATION PROJECT (LOCAL 1199), AND HEALTHCARE ASSOCIATION OF NEW YORK STATE (HANYS). IN ACCORDANCE WITH CODE SECTION 6033(E) OF THE INTERNAL REVENUE CODE, AND AS REPORTED BY GNYHA/LOCAL 1199 AND HANYS, A PORTION OF THESE DUES ARE ATTRIBUTABLE TO LOBBYING ACTIVITIES. THE LOBBYING ACTIVITIES APPLICABLE TO 2017 GNYHA/LOCAL 1199 and HANYS ANNUAL DUES WERE $12,361, $27,183, RESPECTIVELY. During 2017, Wyckoff Heights Medical Center also paid BROWN & WEINRAUB AND TONIO BURGOS & ASSOCIATES $120,820 and $70,000, respectively, for lobbying activities. 6075373 6075373 109868132 81572576 28295556 1336211 417622 918589 194889545 174098233 20791312 14300850 1351739 12949111 69029941 ASSETS LIMITED AS TO USE 8930799 DEFERRED FINANCING FEES 312872 DUE FROM RELATED PARTIES 9350176 DUE FROM THIRD PARTY PAYORS 6377000 OTHER RECEIVABLES 7148697 INSURANCE CLAIMS RECEIVABLE 33400000 SELF INSURED MALPRACTICE FUND 134103 65653647 0 ACCRUED INTEREST PAYABLE 816980 DUE TO RELATED ORGANIZATIONS 4889291 DUE TO THIRD PARTY PAYORS 46749673 EST. PROFESSIONAL LIABILITY 33400000 CARITAS SETTLEMENT 263656 OTHER LIABILITIES FOR INSURANC 40744505 OTHER LIABILITIES 2618390 129482495 X PART X - FASB ASC 740 FOOTNOTE UNDER GAAP AN ORGANIZATION MUST RECOGNIZE THE TAX BENEFIT ASSOCIATED WITH TAX POSITIONS TAKEN FOR TAX RETURN PURPOSES WHEN IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL NOT BE SUSTAINED UPON EXAMINATION BY A TAXING AUTHORITY. THE MEDICAL CENTER DOES NOT BELIEVE IT HAS TAKEN ANY MATERIAL UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, IT HAS NOT RECORDED ANY LIABILITY FOR UNRECOGNIZED tax benefits. the medical center is subject to routine audits by a taxing authority. AS OF DECEMBER 31, 2017, THE MEDICAL CENTER WAS NOT SUBJECT TO ANY EXAMINATION BY A TAXING AUTHORITY. true true true X 300. true X true true true false true true 3198328 3198328 0.00940 166939408 118578238 48361170 0.14220 170137736 118578238 51559498 0.15160 11000264 11000264 0.03230 49052441 14375411 34677029 0.10190 60052705 14375411 45677293 0.13420 230190441 132953649 97236791 0.28580 7595066 6609102 985964 0.00290 3550 0 3550 0.00000 7598616 6609102 989514 0.00290 true 18411951 44725359 15844967 28880392 X true true 1 1 Wyckoff Heights Medical Center 374 Stockholm Street Brooklyn NY 11237 WWW.WYCKOFFHOSPITAL.ORG X X X X Wyckoff Heights Medical Center 1 false false true X X X X X X X X X 16 true false false true X www.wyckoffhospital.org X true 16 true www.wyckoffhospital.org false true X 300. 300. true true X X X true X www.wyckoffhospital.org X www.wyckoffhospital.org X www.wyckoffhospital.org X X X X X true X false X true X false false Section B, Line 5 The Community Health Needs Assessment included a community member survey and meetings with community stakeholders to obtain input, prioritize needs, and develop strategies for the Community Service Plan. These stakeholders included local community-based organizations, and members of the local community board. Section B, LINE 11 Two priority needs were identified in Wyckoff's Community Health Needs Assessment: 1) Improving health for women and mothers, birth outcomes and child health. 2) Preventing other sexual transmitted diseases. These needs are being addressed via Wyckoff's action plan (implementation strategy). Wyckoff is working to reduce premature births,increase the number of breastfed babies, and reduce obesity in children through its Women, Infants, and Children (WIC) program and it's Maternal and Infant Child Health Collaborative. Wyckoff is working to prevent HIV and STDs through its Positive Health Management Program. There were no needs identified in the Community Health Assessment that are not being addressed by Wyckoff's Implementation strategy. Part I, Line 7 WYCKOFF HEIGHTS MEDICAL CENTER'S COSTING METHODOLOGY WAS BASED UPON THE 2017 NEW YORK STATE INSTITUTIONAL COST REPORT AND THE 2017 MEDICARE (FORM 2552) COST REPORT. THESE COST REPORTS ARE FILED WITH THE NEW YORK STATE DEPARTMENT OF HEALTH AND THE APPLICABLE CMS INTERMEDIARY, RESPECTIVELY. THE COST-TO-CHARGE RATIO DERIVED FROM THE NEW YORK STATE INSTITUTIONAL COST REPORT WAS USED FOR THE VARIOUS SUB-LINE ITEMS OF LINE #7. Part II, Line 3 Behavioral Health Program Activities: Wyckoff's behavioral health programs help address the critical lack of mental health services in the community. Despite nearly one in five individuals experiencing a mental health condition, both Brooklyn and Queens have a deficit of behavioral health providers - particularly those who take public insurance - thus creating a significant unmet need for care. To improve access to integrated, evidence based behavioral health services, in 2016 Wyckoff launched behavioral health services across four primary care clinics: Positive Health, Adult Medicine, Women's Health, and Pediatrics. Most patients engage in the Collaborative Care Program; this initiative provides routine depression and anxiety screening of all patients, as well as access to onsite integrated behavioral health services. Patients with positive screening scores are referred to a Care Manager, a behavioral health clinician who collaborates closely with the patient's primary care provider to improve symptoms of depression and anxiety through a patient-driven mix of evidence based interventions and psychopharmacology. Having behavioral health providers in primary care reduces the stigma of seeking mental health services, and is shown to improve health outcomes in connection with a wide range of chronic diseases. Concurrent with the provision of integrated behavioral health services, Wyckoff offers a robust training program to Internal Medicine, Pediatrics, and Ob-Gyn Residents on a wide variety of behavioral health topics including medication management, suicide assessments, screening for behavioral health, safety planning, and harm reduction strategies for working with patients with substance use issues. This ongoing training ensures Wyckoff is creating a knowledgeable workforce of primary care providers, while also supporting Residents in meeting all of the physical and mental health needs of their patients and thus improving the health of the community. HIV, Hepatitis, and STD prevention and care activities: Wyckoff offers the most robust and comprehensive HIV/Hepatitis/and sexual health services program in the local geographic area. Many of these services are funded by city, state, and federal grants and allow Wyckoff to serve the community in a comprehensive way with both prevention and medical treatment services integrated alongside supportive services like behavioral health, counseling, and case management. Prevention services include social media and social venue outreach, integrated HIV/HCV/STI Testing, STI Treatment/Vaccination, biomedical prevention (Pre- and Post- Exposure Prophylaxis), mental health and substance use counseling, patient navigation including benefits navigation, and evidence-based interventions. Wyckoff has been providing routine HIV and Hepatitis testing services hospital-wide since 2013, and additionally targeted HIV testing and community outreach services with a focus on key populations such as young men who have sex with men (MSM) and women of color. Once clients screen positive for HIV or Hepatitis C, a designated outreach team follows up with each client to provide support and follow up medical care coordination. To support engagement and retention in medical care, Wyckoff houses both Ryan White Part B Medical Case Management and Ryan White Part A Care Coordination services as well as the new innovative program Undetectables funded through a NYC DOHMH grant. The HIV, Hepatitis, and sexual health grants are integral to providing access in the Brooklyn and Queens communities served by Wyckoff to the latest testing and treatment technologies and providing education and health promotion among community members. Through early diagnosis, complete treatment access, and education Wyckoff actively supports the reduction in new infections, early access to treatment management, and improved health outcomes for people living with HIV and/or Hepatitis. Maternal and Infant Health Activities: The Maternal and Infant Health Program at Wyckoff is designed to reach and engage women of childbearing age and provide education and support services that address specific health inequities within the local populations we serve. These include education and support services for teen-age mothers and Hispanic, African American, and Foreign-Born women and their families. The program uses community assessment, consensus building, and the development of education, outreach and marketing strategies to reach women throughout all stages of life course and their children. The program has also implemented approaches that have a strong evidence base in support of their ability to reduce disparities in outcomes, including Baby Basics, a program to integrate evidence-based materials and health literacy strategies into prenatal care. Asthma: Our community has some of the highest asthma rates in New York City and residents experience much higher asthma-related emergency department and hospital discharge rates than elsewhere. To address asthma we have expanded our home-based asthma services through the Breath Easy Asthma Team (BEAT) which provides culturally sensitive, bilingual (English/Spanish) asthma education, trigger identification and referrals. In 2016, Wyckoff achieved Joint Commission Certification for Pediatric Asthma Care. We have continued to improve our clinical asthma outcomes by providing culturally competent, patient-centered care, evidence-based care to patients and their families who suffer from asthma. Through supporting families and clinicians in effective asthma management, we have seen decreased emergency room visits related to asthma and an increase in outpatient asthma management. In September of 2018, we accepted responsibility for a new initiative to provide technical assistance to Day Care Centers in Queens. We will be providing the day care staff and parents education to identify and manage asthma and prepare families to manage childhood asthma when their child enters school. Supplemental Nutrition Program for Women, Infant and Children (WIC): Wyckoffs WIC program has provided a longstanding and critical mechanism to reduce obesity, improve food security, promote positive birth outcomes, increase breastfeeding rates, and reduce health disparities and the risk for chronic disease among local women, infants and children. WIC offers participant-centered and culturally-responsive nutrition assessment and education; breastfeeding promotion and support, including Breastfeeding Peer Counseling and breast pumps; referrals to health and social services; and a variety of nutritious foods. Violence Intervention and Treatment Program: WHMCs Violence Intervention and Treatment Program (VITP) is the only hospital-based rape crisis program (RCP) certified by the New York State Department of Health (NYSDOH) in the borough of Brooklyn. Since 2004, VITP has been an experienced provider of sexual assault, rape, childhood sexual abuse, stalking, dating violence, and domestic/intimate partner violence services, including on-call rape crisis advocates to support all patients who present to the emergency department following a sexual assault, crisis and ongoing counseling, personal advocacy, criminal justice advocacy, accompaniments, compensation assistance, information and referrals, as well as prevention and education services within the hospital and larger community. All services are free, confidential and available in English and Spanish, regardless of immigration or insurance status. Wyckoff is also home to the Enough is Enough program, a state-funded initiative to help institutions of higher learning prevent sexual assault and sexual harassment on campuses through collaboration and training of both faculty and students. Through collaborations with more than 10 colleges and universities and their Title IX Programs, Wyckoffs Enough is Enough offers evidence-based information on prevention interventions, including bystander intervention training, as well as counseling and supportive services to students, faculty, and staff of these organizations who experience sexual harassment, sexual assault or intimate partner violence. Part III, Line 2 THE AMOUNT REPORTED ON LINE 2 IS EQUAL TO THE PROVISION FOR BAD DEBTS PER THE AUDITED FINANCIAL STATEMENTS ("AFS"). THE EXPLANATION OF THE METHODOLOGY USED TO ESTIMATE THIS AMOUNT CAN BE FOUND IN FOOTNOTE (3)(f) on page 11 and footnote (3)(r) ON PAGE 13 OF THE ATTACHED AFS. Part III, Line 4 THE TEXT OF THE FOOTNOTES THAT DESCRIBE BAD DEBT EXPENSE CAN BE FOUND ON PAGES 11 AND 13 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. Part III, Line 8 THE AMOUNT REPORTED ON LINE 6 WAS DERIVED BY USING THE MEDICARE ALLOWABLE COSTS AS REPORTED ON THE HOSPITAL'S NEW YORK STATE INSTITUTIONAL COST REPORT AND THE APPLICABLE ADJUSTMENTS FROM WORKSHEET B. Part III, Line 9B WYCKOFF HEIGHTS MEDICAL CENTER'S ("WHMC") COLLECTION POLICY FOLLOWS THE GUIDELINES ESTABLISHED BY NEW YORK STATE LAW. WHMC'S COLLECTION POLICY, IN CONJUNCTION WITH THE HOSPITAL'S CHARITY CARE AND FINANCIAL ASSISTANCE POLICY, ENSURES THAT EVERY EFFORT IS MADE TO IDENTIFY PATIENTS WHO ARE ELIGIBLE FOR CHARITY CARE. WHMC HAS A WRITTEN DEBT COLLECTION POLICY - ALL SELF-PAY BALANCES ARE OUTSOURCED TO A DESIGNATED SELF-PAY AGENCY FOR COLLECTION. TRUE SELF-PAYS WILL BE FORWARDED ON DAY ONE FROM FINAL BILL. SELF-PAY AFTER INSURANCE PAYMENT OR FINAL INSURANCE DENIAL WILL BE TRANSFERRED TO THE OUTSOURCE COMPANY AS SOON AS THE ACCOUNT IS IDENTIFIED AS HAVING A SELF-PAY BALANCE. ACCOUNTS WILL BE WORKED BY THE OUTSOURCE (EARLY OUT) COMPANY FOR ONE HUNDRED TWENTY (120) DAYS. THE EARLY OUT AGENCY WILL ALSO IDENTIFY ACCOUNTS THAT QUALIFY FOR CHARITY CARE BASED ON NEW YORK GUIDELINES. IF UNPAID AT THE END OF THE CYCLE THE ACCOUNT WILL BE TRANSFERRED TO A DESIGNATED BAD DEBT COLLECTION AGENCY. THE BAD DEBT AGENCIES WILL WORK THE ACCOUNTS FOR SIX (6) MONTHS. IF THE AGENCY FAILS IN THEIR COLLECTION EFFORT, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL AS UNCOLLECTIBLE WITH THE EXCEPTION OF ACCOUNTS WITH ACTIVE PAYMENT ARRANGEMENTS. ITEMIZED BILLS WILL BE AVAILABLE TO PATIENTS UPON REQUEST. PROCEDURE: 1. ALL PATIENTS WITH A SELF-PAY BALANCE (TRUE SELF-PAY OR SELF-PAY BALANCE AFTER INSURANCE) WILL BE TRANSFERRED TO A DESIGNATED SELF-PAY AGENCY FOR PROCESSING. THE AGENCY WILL: A. IDENTIFY AND RETURN ACCOUNTS THAT QUALIFY FOR CHARITY CARE PER NEW YORK GUIDELINES. B. PROCESS A LETTER SERIES (THREE LETTERS) WITHIN ONE HUNDRED TWENTY (120) DAYS. IN ADDITION TO WRITTEN STATEMENTS, PATIENTS WILL RECEIVE A MINIMUM OF THREE (3) PHONE CALLS IN AN ATTEMPT TO COLLECT UPON THEIR OPEN ACCOUNT. C. IDENTIFY ACCOUNTS WITH RETURN MAIL/NO CURRENT PHONE NUMBER THAT CAN NOT BE LOCATED AND RETURN THE ACCOUNT TO BE PLACED IN BAD DEBT. D. AFTER THE ONE HUNDRED TWENTY (120) DAY PERIOD AND THERE HAS BEEN NO PAYMENT RECEIVED, THE ACCOUNT WILL BE RETURNED TO THE HOSPITAL TO BE REVIEWED FOR BAD DEBT PLACEMENT. NOTE: ACCOUNTS WITH PAYMENT ARRANGEMENTS WILL REMAIN AT THE AGENCY UNTIL THEY ARE PAID-IN-FULL. AGENCY WILL CLOSE AND RETURN ACCOUNTS THAT HAVE BROKEN PAYMENT ARRANGEMENTS. 2. A BAD DEBT PRE-LIST WILL BE REVIEWED WEEKLY AND ACCOUNTS PLACED WITH A DESIGNATED BAD DEBT AGENCY FOR A PERIOD OF SIX (6) MONTHS WILL BE CHANGED TO BDCLOSED - BAD DEBT CLOSED ACCOUNT IDENTIFIES THE ACCOUNT AS HAVING ALL COLLECTION EFFORTS EXHAUSTED. THE EXCEPTIONS FOR RETURNING ACCOUNTS AT SIX MONTHS ARE ACCOUNTS WITH ACTIVE PAYMENT ARRANGEMENTS. 3. ACCOUNTS RETURNED FROM THE BAD DEBT AGENCIES WILL BE REVIEWED: A. MEDICARE COPAY/DEDUCTIBLE AMOUNTS WILL BE DOCUMENTED. B. ACCOUNTS CLAIMED AS UNCOLLECTIBLE WILL BE CODED AS 'BAD DEBT RETURNS'(BDCLOSED), WHICH IDENTIFIES THE ACCOUNTS AS HAVING ALL COLLECTION EFFORTS EXHAUSTED. 4. MONTHLY-THE PATIENT ACCOUNTS MANAGER WHO OVERSEES OUTSOURCING WILL: A. RECONCILE THE INVENTORY B. CONDUCT AN AUDIT ON COMPLIANCE TO THIS POLICY AND REPORT THOSE RESULTS TO THE ASSOCIATE VICE-PRESIDENT Part VI, Line 2 PURSUANT TO NEW YORK STATE PUBLIC HEALTH LAW SECTION 2803-L, WYCKOFF HEIGHTS MEDICAL CENTER ("WHMC") IS REQUIRED TO FILE A COMPREHENSIVE COMMUNITY SERVICE PLAN ("CSP") WITH THE NEW YORK STATE DEPARTMENT OF HEALTH ("DOH") EVERY 3 YEARS. THE TEXT OF NEW YORK STATE PUBLIC HEALTH LAW SECTION 2803-L IS AS FOLLOWS: COMMUNITY SERVICE PLANS. (1) THE GOVERNING BODY OF A VOLUNTARY NON-PROFIT GENERAL HOSPITAL MUST ISSUE AN ORGANIZATIONAL MISSION STATEMENT IDENTIFYING AT A MINIMUM THE POPULATIONS AND COMMUNITIES SERVED BY THE HOSPITAL AND THE HOSPITAL'S COMMITMENT TO MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY. (2) THE GOVERNING BODY MUST AT LEAST EVERY THREE YEARS: (I) REVIEW AND AMEND AS NECESSARY THE HOSPITAL MISSION STATEMENT; (II) SOLICIT THE VIEWS OF THE COMMUNITIES SERVED BY THE HOSPITAL ON SUCH ISSUES AS THE HOSPITAL'S PERFORMANCE AND SERVICE PRIORITIES;(III) DEMONSTRATE THE HOSPITAL'S OPERATIONAL AND FINANCIAL COMMITMENT TO MEETING COMMUNITY HEALTH CARE NEEDS, TO PROVIDE CHARITY CARE SERVICES AND TO IMPROVE ACCESS TO HEALTH CARE SERVICES BY THE UNDERSERVED; AND (IV) PREPARE AND MAKE AVAILABLE TO THE PUBLIC A STATEMENT SHOWING ON A COMBINED BASIS A SUMMARY OF THE FINANCIAL RESOURCES OF THE HOSPITAL AND RELATED CORPORATIONS AND THE ALLOCATION OF AVAILABLE RESOURCES TO HOSPITAL PURPOSES INCLUDING THE PROVISION OF FREE OR REDUCED CHARGE SERVICES. (3) THE GOVERNING BODY MUST AT LEAST ANNUALLY PREPARE AND MAKE AVAILABLE TO THE PUBLIC AN IMPLEMENTATION REPORT REGARDING THE HOSPITAL'S PERFORMANCE IN MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY, PROVIDING CHARITY CARE SERVICES, AND IMPROVING ACCESS TO HEALTH CARE SERVICES BY THE UNDERSERVED. (4) THE GOVERNING BODY SHALL FILE WITH THE COMMISSIONER ITS MISSION STATEMENT, ITS ANNUAL IMPLEMENTATION REPORT, AND AT LEAST EVERY THREE YEARS A REPORT DETAILING AMENDMENTS TO THE STATEMENT AND REFLECTING CHANGES IN THE HOSPITAL'S OPERATIONAL AND FINANCIAL COMMITMENT TO MEETING THE HEALTH CARE NEEDS OF THE COMMUNITY, PROVIDING CHARITY CARE SERVICES, AND IMPROVING ACCESS TO HEALTH CARE SERVICES BY THE UNDERSERVED. THE ABOVE-REFERENCED CSP REQUIREMENT WAS ENHANCED BY THE DOH'S PREVENTION AGENDA INITIATIVE. THIS INITIATIVE IS A PROCESS THAT ASKS HOSPITALS SUCH AS WHMC TO WORK WITH LOCAL HEALTH DEPARTMENTS AND COMMUNITY PARTNERS TO ASSESS COMMUNITY HEALTH NEEDS, JOINTLY DEVELOP PLANS TO ADDRESS TWO OR THREE OF THE IDENTIFIED NEEDS AND INCLUDE THIS COLLABORATIVE WORK IN THE WHMC'S CSP UPDATE SUBMITTED TO DOH. INFORMATION ON THE NEW YORK STATE DOH PREVENTION AGENDA CAN BE FOUND AT WWW.HEALTH.STATE.NY.US/PREVENTION/PREVENTION_AGENDA. WHMC LIES IN CULTURALLY DIVERSE QUEENS AND KINGS COUNTY OF NEW YORK CITY. WHMC DETERMINES ITS COMMUNITY HEALTH NEEDS BY PARTICIPATING WITH COMMUNITY GROUPS AND LOCAL HEALTH DEPARTMENT ACTIVITIES. THE HOSPITAL ANALYZES INTERNAL PATIENT SURVEY, UTILIZATION DATA AND BULLETINS AND REPORTS FROM NYS DEPARTMENT OF HEALTH, NYS VITAL STATISTICS, GNYHA AND HANYS TO UNDERSTAND THE DEMOGRAPHICS AND UNMET NEEDS WITHIN THE COMMUNITY. WHMC WORKS CLOSELY WITH THE LOCAL HEALTH DEPARTMENT AND COMMUNITY GROUPS. THE HOSPITAL IS ABLE TO CONSTANTLY MEET THE EMERGING HEALTH CARE NEEDS FROM THE COMMUNITY. THE HOSPITAL IDENTIFIES THE FOLLOWING NEEDS WITHIN THE COMMUNITY: THE NEED TO ACCESS ADVANCED QUALITY HEALTH CARE; THE NEED TO RECEIVE QUALITY CARE FOR THE UNDERSERVED BY OPEN ENROLLMENT OF MEDICAID AND MEDICAID MANAGED CARE PROGRAMS;THE NEED TO OBTAIN HEALTH EDUCATION, DISEASE PREVENTION AND DISEASE MANAGEMENT TO IMPROVE THE HEALTH STATUS OF THE COMMUNITY. IN SUMMARY, THE HOSPITAL FOCUS PRIMARILY ON POSITIVELY IMPACTING THE HEALTH OF OUR COMMUNITY WITH PROGRAMS THAT ARE CULTURALLY AND LINGUISTICALLY TAILORED TO MEET THE UNMET NEEDS OF WOMEN, INFANTS, SENIORS AND MINORITIES IN OUR COMMUNITY. Part VI, Line 3 WYCKOFF HEIGHTS MEDICAL CENTER IS COMMITTED TO PROVIDE ACCESS TO THE HIGHEST LEVEL OF CARE WITH COMPASSION, DIGNITY AND RESPECT. WE ARE ALSO COMMITTED TO CARE ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY. WE NOT ONLY PROVIDE VARIOUS ASSISTANCES TO PATIENTS WHO CAN'T PAY FOR PART OR ALL OF THE CARE THEY RECEIVE BUT ALSO HELP PATIENTS WITH BROADER FISCAL RESPONSIBILITIES TO BALANCE THE NEEDED FINANCIAL ASSISTANCE. WYCKOFF HEIGHTS MEDICAL CENTER CURRENTLY HAS THE FOLLOWING PRINCIPALS WHEN HANDLING THE BILLING, COLLECTION AND FINANCIAL SUPPORT FUNCTIONS FOR OUR PATIENTS: *PROVIDE EFFECTIVE COMMUNICATIONS WITH PATIENTS REGARDING HOSPITAL BILLS *MAKE AFFIRMATIVE EFFORTS TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE FINANCIAL SUPPORT PROGRAMS *OFFER FINANCIAL SUPPORT TO PATIENTS WITH LIMITED RESOURCES *IMPLEMENT POLICIES FOR ASSISTING LOW-INCOME PATIENTS IN A CONSISTENT MANNER *IMPLEMENT FAIR AND CONSISTENT BILLING AND COLLECTION PRACTICES FOR ALL PATIENTS WITH PAYMENT OBLIGATIONS. WYCKOFF HEIGHTS MEDICAL CENTER PROVIDES FINANCIAL COUNSELING TO PATIENTS ABOUT THEIR OBLIGATIONS AND HOSPITAL BILLS. INFORMATION ON HOSPITAL POLICIES ON FINANCIAL SUPPORT AND FEDERAL, STATE AND LOCAL PROGRAMS THAT PROVIDE COVERAGE FOR SERVICES IS AVAILABLE TO PATIENTS THROUGH HOSPITAL'S WEBSITE, HOSPITAL POSTERS AND FLYERS. INFORMATION IS ALSO AVAILABLE IN SPANISH WHICH IS THE MAIN LANGUAGE SPOKEN IN THE COMMUNITY AND POSTED IN THE WAITING AREAS FOR THE EMERGENCY ROOM, THE WOMEN'S HEALTH, THE SECOND FLOOR MAIN CLINIC AREA AND THE OFFSITE CLINICS. FINANCIAL COUNSELORS MAKE EVERY EFFORT TO HELP PATIENTS APPLY FOR PUBLIC AND PRIVATE PROGRAMS FOR WHICH THEY MAY QUALIFY AND THAT MAY HELP THEM OBTAIN AND PAY FOR HEALTHCARE SERVICES. THE HOSPITAL HAS ONSITE MEDICAID ELIGIBILITY REPRESENTATIVES AND THEY MAKE BEDSIDE VISITS TO DETERMINE A PATIENT'S ELIGIBILITY PRIOR TO THE PATIENT'S DISCHARGE. WYCKOFF HEIGHTS MEDICAL CENTER HAS DEVELOPED A WRITTEN POLICY FOR THE BILLING,COLLECTION ON CHARITY CARE AND IS COMMITTED TO IMPLEMENTING AND APPLYING THE POLICY FOR ASSISTING PATIENTS IN NEED IN A PROFESSIONAL, CONSISTENT MANNER. WYCKOFF EDUCATES STAFF MEMBERS WHO WORK CLOSELY WITH PATIENTS (INCLUDING PATIENT REGISTRARS, FINANCIAL INVESTIGATORS, CUSTOMER SERVICE REPRESENTATIVES, AND BILLING AND COLLECTION REPRESENTATIVES) ABOUT THESE POLICIES WITH AN EMPHASIS ON TREATING ALL PATIENTS WITH DIGNITY AND RESPECT REGARDLESS OF THEIR INSURANCE STATUS OR ABILITY TO PAY FOR SERVICES. Part VI, Line 4 WYCKOFF HEIGHTS MEDICAL CENTER IS A 324-BED ACUTE CARE ACADEMIC MEDICAL CENTER COMMITTED TO THE COMPLEX MISSION OF PATIENT CARE, TEACHING AND COMMUNITY SERVICE. THE HOSPITAL HAS ENSURED CONTINUED BROOKLYN AND QUEENS COUNTY COMMUNITY PARTICIPATION AND OUTREACH ACTIVITIES THROUGH LINKAGES WITH COMMUNITY BASED ORGANIZATIONS, LOCAL PHYSICIAN PRACTICES, D&T CENTERS, HOME CARE AGENCIES AND NURSING HOMES. WYCKOFF HEIGHTS MEDICAL CENTER'S PRIMARY AND SECONDARY SERVICE AREAS INCLUDE FIVE PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS); BUSHWICK, WILLIAMSBURG, BEDFORD-STUYVESANT, EAST NEW YORK AND LONG ISLAND CITY. THE HOSPITAL IS LOCATED IN BROOKLYN NEAR THE BROOKLYN/QUEENS BORDER, AND SERVES THE BUSHWICK, BEDFORD-STUYVESANT, EAST NEW YORK AND GREENPOINT COMMUNITIES OF BROOKLYN, AS WELL AS THE RIDGEWOOD, GLENDALE, MASPETH AND MIDDLE VILLAGE COMMUNITIES OF QUEENS. THE HOSPITAL SERVICE AREAS HAVE A TOTAL POPULATION OF 430,000. 177,000 RESIDENTS OR 41% OF THE POPULATION IS LATINO AND 47,400 RESIDENTS OR 11% OF THE POPULATION IS AFRICAN AMERICAN. THE HOSPITAL IS LOCATED IN THE 11237 ZIP CODE WHICH HAS A POPULATION THAT IS 75% LATINO. THE SERVICE AREAS ALSO INCLUDE RECENT IMMIGRANT POPULATIONS FROM LATIN AMERICA, THE CARIBBEAN, EASTERN/SOUTHERN EUROPE AND ASIA. MORE THAN 100,000 RESIDENTS ARE UNDER 18 YEARS OF AGE. IN THE BUSHWICK COMMUNITY 33% ARE 18 OR YOUNGER. MORE THAN 50% OF THE RESIDENTS HAVE INCOMES BELOW THE POVERTY LINE. Part VI, Line 5 THE MISSION OF WYCKOFF HEIGHTS MEDICAL CENTER IS TO PROVIDE EXCELLENCE IN CARE THROUGH PREVENTION, EDUCATION AND TREATMENT IN A SAFE ENVIRONMENT. WYCKOFF PROVIDES COMPREHENSIVE PRIMARY AND SECONDARY LEVEL INPATIENT AND OUTPATIENT MEDICAL, SURGICAL, OBSTETRIC/GYNECOLOGIC AND PEDIATRIC CARE SERVICES. WYCKOFF PROVIDES TERTIARY HEALTHCARE SERVICES, INCLUDING RENAL DIALYSIS, MEDICAL ONCOLOGY SERVICES, NEUROSURGERY, GENETICS, NUCLEAR MEDICINE AND RADIATION ONCOLOGY. AMBULATORY PODIATRIC AND DENTAL SERVICES ARE ALSO AVAILABLE. IN OUR COMMITMENT TO PATIENT-CENTERED CARE, WYCKOFF POLICY EMPHASIZES AMBULATORY ALTERNATIVES TO INPATIENT CARE WHEN FEASIBLE TO PROMOTE RESPONSIBILITY AND PATIENT INDEPENDENCE. EXPANDED COMMUNITY OUTREACH PROGRAMS AND AMBULATORY CENTERS FACILITATE PATIENT ACCESS, WHILE PROMOTING OUR MANY ALLOPATHIC AND OSTEOPATHIC EDUCATIONAL AND TEACHING PROGRAMS. WYCKOFF HEIGHTS MEDICAL CENTER HAS CREATED THE FOLLOWING OBJECTIVES TO HELP US MEET OUR MISSION AND VISION: *PROVIDES THE HIGHEST LEVEL OF CARE FOR ALL PATIENTS, RECOGNIZING THE WORTH AND DIGNITY OF EACH INDIVIDUAL *IMPROVES THE HEALTH STATUS OF THE COMMUNITY BY ACTIVELY PARTICIPATING IN AN ORGANIZED, INNOVATIVE, INTEGRATED HEALTH CARE SYSTEM, USING A FOCUS ON MANAGED CARE *PROMOTES AND SUPPORTS ALL EFFORTS TO PROVIDE A SAFE ENVIRONMENT FOR OUR PATIENT, EMPLOYEES AND VISITORS *WORKS IN PARTNERSHIP WITH PHYSICIANS AND ALL HEALTH CARE PROVIDERS AND EMPLOYEES TO ENCOURAGE PROFESSIONAL GROWTH AND DEVELOPMENT, IN ORDER TO BETTER SERVE THE COMMUNITY AND TO UNDERSTAND AND MEET THE NEEDS OF OUR CULTURALLY DIVERSE POPULATION *IS COMMITTED TO THE ONGOING EMPLOYABILITY OF OUR EMPLOYEES THROUGH THEIR GROWTH AND DEVELOPMENT, DESPITE THE INABILITY TO GUARANTEE INDIVIDUAL JOBS IN A CHANGING HEALTH CARE ENVIRONMENT, BY WORKING TOGETHER RESPONSIBLY AND RESPECTING EACH ROLE HERE. *FOSTERS A SCHOLARLY ATMOSPHERE, SUPPORTING EDUCATIONAL PROGRAMS AND ENDOWMENTS THAT ENHANCE THE COMPETENCY OF ALL INDIVIDUALS WITHIN THE SYSTEM, TO PROMOTE DELIVERY OF HEALTH CARE THAT IS SAFE, EFFECTIVE, PATIENT-CENTERED, TIMELY, EFFICIENT AND EQUITABLE *IS CREATING HEALTH INFORMATION SYSTEMS AND NETWORKS DEDICATED TO MONITORING, STREAMLINING AND IMPROVING THE QUALITY OF CLINICAL AND SERVICE FUNCTIONS, WHILE MAINTAINING PATIENT CONFIDENTIALITY AND YET RESPONDING TO THE HEALTH CARE MARKET GROWTH, OPTIMAL FINANCIAL DEVELOPMENT AND WISE USE OF FINANCIAL ASSETS *PROVIDES MODERN, PROGRESSIVE HEALTH CARE TECHNOLOGIES THAT IMPROVE THE QUALITY OF CARE *PROVIDES OUTREACH TO MEMBERS OF THE COMMUNITY WITH SPECIAL NEEDS, INCLUDING INFANTS, YOUNG CHILDREN AND ADOLESCENTS, PERSONS WITH DISABILITIES, CHRONIC CONDITIONS AND LIFE-THREATENING DISORDERS SUCH AS HIV/AIDS AND SENIOR CITIZENS *PROMOTES AND SUPPORTS PREVENTIVE MEDICINE PROGRAMS THAT REDUCE OCCURRENCE OF DISEASE THROUGH EDUCATION AND PROACTIVE MEASURES *MEASURES SUCCESS BY HOW WELL WE MEET OR EXCEED THE EXPECTATIONS OF OUR COMMUNITY AND PATIENTS *STRIVES TO CREATE A CULTURE OF SERVICE EXCELLENCE IN EVERY ASPECT OF PATIENT CARE. BY PROVIDING OUTSTANDING SERVICE CONSISTENTLY, WE SEEK TO ESTABLISH LIFELONG RELATIONSHIP WITH PATIENTS, EMPHASIZING THAT CARE FOR THE PATIENT ALWAYS COME FIRST. WYCKOFF HEIGHTS MEDICAL CENTER'S MISSION AND COMMITMENT TO QUALITY SERVICE ENABLES THE HOSPITAL TO BECOME THE PREMIER HEALTH CARE PROVIDER FOR THE CULTURALLY DIVERSE COMMUNITY WE SERVE. X X X X true false false false false false false false RAMON RODRIGUEZ PRESIDENT/CEO 864216 0 200000 0 1645 0 0 0 13090 0 1078951 0 0 0 FRANK VUTRANO EVP/CFO, thru 9/7/17 330259 0 50000 0 139099 0 0 0 4535 0 523893 0 0 0 GUSTAVO DEL TORO EVP/CMO 569668 0 0 0 1210 0 0 0 4178 0 575056 0 0 0 Andrew Toga EVP of Amb Svcs thru 6/16/17 234106 0 0 0 104009 0 0 0 1538 0 339653 0 0 0 KEVIN SMYLEY VP/LEGAL SERVICES 344398 0 0 0 2705 0 0 0 5602 0 352705 0 0 0 MARGARET CORNELIUS VP OF HR 271950 0 0 0 621 0 0 0 3050 0 275621 0 0 0 Stephen Carryl MD Chairman of Surgery 744661 0 0 0 144504 0 0 0 8662 0 897827 0 0 0 Thomas Larkin MD Chief Division Ortho 394534 0 0 0 72007 0 0 0 1620 0 468161 0 0 0 SANJIVAN PATEL MD Acting Chairman 287273 0 0 0 194783 0 0 0 6817 0 488873 0 0 0 Elvita G Dominiques DO Director 318183 0 0 0 96727 0 0 0 6817 0 421727 0 0 0 JEBASHINI JERURASA VP/CIO 227778 0 0 0 222 0 0 0 7222 0 235222 0 0 0 CATHERINE GALLOGLY-SIMON CNO 308291 0 0 0 745 0 0 0 11709 0 320745 0 0 0 PATRICK SULLIVAN VP of Facility & Support 275000 0 0 0 5115 0 0 0 0 0 280115 0 0 0 WILLIAM THELMO MD CHAIRMAN 291753 0 0 0 105072 0 0 0 8247 0 405072 0 0 0 Schedule J, Part I, Line 4a: Andrew Toga, EVP of AMB SVCS thru 6/16/17, received a severance payment of $100,000, which is reflected on Part II, Column b(iii). Frank Vutrano, EVP/CFO thru 9/7/17, received a severance payment of $135,205, which is reflected on Part II, Column b(iii). 0 GARY GOFFNER chairman 172130 Rent expense false MOUNZER TCHELEBI trustee 47351 Rent expense false Part IV, Line 1: The organization paid rent to Board Chairman, Gary Goffner, during the year for space for clinical activities that serve the neighborhood. The rent paid is fair market value for the property and the board chairman did not participate in the decision making process. Part IV, Line 2: The organization paid rent to Board Member, Mounzer Tchelebi, during the year for space for clinical activities that serve the neighborhood. The rent paid is fair market value for the property and Mr. Tchelbi did not participate in the decision making process. FORM 990, PART VI, LINE 11B THE FINANCE DIRECTOR AND CFO UNDERTAKE A DETAILED REVIEW OF THE 990. IN ADDITION, BOARD MEMBERS OF THE FINANCE AND AUDIT COMMITTEES UNDERTAKE A REVIEW OF THE ORGANIZATION'S FORM 990 AND THEN REVIEW WITH THE CFO ANY COMMENTARY, OBSERVATIONS, AND RECOMMENDATIONS, AS APPROPRIATE. FORM 990, PART VI, LINE 12C BOARD OF TRUSTEES AUDIT AND COMPLIANCE COMMITTEE REVIEWS ALL ANNUAL CONFLICT OF INTEREST QUESTIONNAIRES AND MAKES RECOMMENDATIONS, IF NECESSARY, TO THE FULL BOARD. POSITIVE RESPONSES ARE REVIEWED AND ADDITIONAL INFORMATION IS GATHERED TO DETERMINE IF A CONFLICT EXISTS. IF A CONFLICT EXISTS, APPROPRIATE ACTION IS TAKEN TO ELIMINATE THE CONFLICT, INCLUDING SUCH STEPS AS REASSIGNMENT OF RESPONSIBILITIES OR ESTABLISHMENT OF PROTECTIVE AGREEMENTS. IF A MATTER INVOLVES A BOARD MEMBER OR OFFICER, APPROPRIATE ACTION, INCLUDING RECUSAL AND ADDITIONAL DISCLOSURES, WILL BE DETERMINED BY THE BOARD. FORM 990, PART VI, LINES 15A & 15B EXECUTIVE COMPENSATION IS REVIEWED BY THE BOARD EXECUTIVE COMPENSATION COMMITTEE WHICH CONSISTS OF ONLY INDEPENDENT BOARD MEMBERS. THE COMMITTEE SOLICITS ASSISTANCE OF OUTSIDE LEGAL COUNSEL AND AN EXECUTIVE COMPENSATION CONSULTING FIRM WHO CONDUCTS STUDIES SHOWING COMPENSATION AT COMPARABLE INSTITUTIONS AND ADVISES THE COMMITTEE ACCORDINGLY. BOARD DECISIONS ARE CONTEMPORANEOUSLY DOCUMENTED IN BOARD MINUTES. FORM 990, PART VI, LINE 19 UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE ONLY THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS. FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:47905294 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTING FEES TOTAL FEES:7342984 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL FEES TOTAL FEES:5367201 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES TOTAL FEES:3448754 FORM 990 PART IX LINE 11G DESCRIPTION:PURCHASE SERVICES TOTAL FEES:85286 BROOKLYN QUEENS HEALTH CARE 374 STOCKHOLM STREET BROOKLYN NY 11237 311650965 SUPPORT WHMC NY 501(c)(3) 12A NA true STOCKHOLM OBSTETRICS & GYNECOLOGICAL SVC 374 STOCKHOLM STREET BROOKLYN NY 11237 113318298 MEDICAL SVCS NY 501(c)(3) 12A WHMC true WYCKOFF HEIGHTS MEDICAL SERVICES PC 374 STOCKHOLM STREET BROOKLYN NY 11237 113519417 SRGRY/ANESTHE NY 501(c)(3) 12A WHMC true WYCKOFF HEIGHTS DENTAL SERVICES PC 374 STOCKHOLM STREET BROOKLYN NY 11237 113440088 DENTISTRY NY 501(c)(3) 12A WHMC true WYCKOFF HEIGHTS MEDICAL CENTER FOUNDATIO 374 STOCKHOLM STREET BROOKLYN NY 11237 113626419 SUPPORT WHMC NY 501(c)(3) 12A WHMC true WYCKOFF IMAGING SERVICE PC 374 STOCKHOLM STREET BROOKLYN NY 11237 861061721 MED IMAGING NY 501(c)(3) 12A WHMC true WYCKOFF MEDICAL SERVICES PC 374 STOCKHOLM STREET BROOKLYN NY 11237 113459881 MEDICAL SVCS NY 501(c)(3) 12A WHMC true WYCKOFF PROFESSIONAL MEDICAL SERVICES PC 374 STOCKHOLM STREET BROOKLYN NY 11237 113437602 MEDICAL SVCS NY 501(c)(3) 12A WHMC true WYCKOFF HEIGHTS HOSPITAL SELF INSURANCE 374 STOCKHOLM STREET BROOKLYN NY 11237 112513146 INACTIVE NY 501(c)(3) 12A WHMC true PREFERRED HEALTH VENTURES INC 374 STOCKHOLM STREET BROOKLYN NY 11237 112974960 INACTIVE NY SEE PART VII C CORP 0 497200 1.00000 true PREFERRED HEALTH VENTURES PHARMACY 374 STOCKHOLM STREET BROOKLYN NY 11237 112974935 INACTIVE NY SEE PART VII C CORP 0 112874 1.00000 true PREFERRED HEALTH VENTURES PLACEMENT INC 374 STOCKHOLM STREET BROOKLYN NY 11237 112973953 INACTIVE NY SEE PART VII C CORP 0 165113 1.00000 true PREFERRED HEALTH PROPERTIES INC 374 STOCKHOLM STREET BROOKLYN NY 11237 112974963 INACTIVE NY SEE PART VII C CORP 0 2900 1.00000 true WYCKOFF EMERGENCY MEDICINE SERVICES PC 374 STOCKHOLM STREET BROOKLYN NY 11237 113495935 MEDICAL SVCS NY SEE PART VII C CORP 11479414 478050 1.00000 true WYCKOFF PRACTICE MANAGEMENT CORP 374 STOCKHOLM STREET BROOKLYN NY 11237 113463990 MANAGEMENT NY SEE PART VII C CORP 540102 39777 1.00000 true STEPHEN CARRYL PC 374 STOCKHOLM STREET BROOKLYN NY 11237 510505134 MEDICAL SVCS NY SEE PART VII C CORP 354773 267378 1.00000 true WYCKOFF MEDICAL ASSOCIATES PC 374 STOCKHOLM STREET BROOKLYN NY 11237 812389221 MEDICAL SERVICE NY SEE PART VI C CORP 7000 5903 1.00000 true false false false false false false false false false false false false false false true true false false STOCKHOLM OBSTETRICS & GYNECOLOGICAL SVC P 3392459 COST WYCKOFF HEIGHTS MEDICAL SERVICES PC P 3617837 COST WYCKOFF HEIGHTS DENTAL SERVICES PC P 1118412 COST WYCKOFF IMAGING SERVICE PC P 1264840 COST WYCKOFF EMERGENCY MEDICINE SERVICES PC P 5513088 COST WYCKOFF PROFESSIONAL MEDICAL SERVICES P 1298125 COST WYCKOFF PRACTICE MANAGEMENT CORP P 539947 COST STEPHEN CARRYL PC P 55000 COST PART IV, column (d) - Direct Controlling Entity NAME OF RELATED ORGANIZATIONS DIRECT CONTROLLING ENTITY PREFERRED HEALTH VENTURES INC: WYCKOFF HEIGHTS MEDICAL CENTER PREFERRED HEALTH VENTURES PHARMACY: PREFERRED HEALTH VENTURES INC PREFERRED HEALTH VENTURES PLACEMENT: PREFERRED HEALTH VENTURES INC PREFERRED HEALTH VENTURES PROPERTIES: PREFERRED HEALTH VENTURES INC WYCKOFF EMERGENCY MEDICINE SERVICES PC: WYCKOFF HEIGHTS MEDICAL CENTER WYCKOFF PRACTICE MANAGEMENT CORP: WYCKOFF HEIGHTS MEDICAL CENTER STEPHEN CARRYL, P.C.: WYCKOFF HEIGHTS MEDICAL CENTER WYCKOFF MEDICAL ASSOCIATES, P.C.: WYCKOFF HEIGHTS MEDICAL CENTER PART VII - SUPPLEMENTAL INFORMATION Respective PC's employ physicians and departmental chairs who provide professional services to the Wyckoff Heights Medical Center.